SUTURE METHODS AND DEVICES
First Claim
1. A barbed suture comprising:
- an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having an anchor including at least one arcuate limb extending outside the periphery of the body to a greater degree than the barbs, the anchor preventing movement of the suture in the direction of movement of the pointed end.
11 Assignments
0 Petitions
Accused Products
Abstract
A barbed suture including a body with barbs on the periphery, a pointed end, and an anchor at one end to resist movement of the suture in the direction of the pointed end is provided. One or more limbs on the anchor may be provided, which may be arcuate, of varying lengths, and of varying distribution about the periphery of the suture body. Other anchor designs are provided. Methods of placing single-directional and bi-directional barbed sutures to approximate the tissue on each side of a wound and to position and support tissue in the absence of a wound, as in cosmetic surgery, are provided, and may include terminal J-stitches or S-stitches. Methods of placement may be made with sharp, pointed ends, which may be needles, or insertion devices. Sinusoidal patterns of sutures that have amplitudes generally perpendicular to the resultant holding force of the suture are provided.
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Citations
111 Claims
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1. A barbed suture comprising:
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an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having an anchor including at least one arcuate limb extending outside the periphery of the body to a greater degree than the barbs, the anchor preventing movement of the suture in the direction of movement of the pointed end. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A barbed suture comprising:
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an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having an anchor including a bar perpendicular to body of the suture to form a T-configuration extending outside the periphery of the body to a greater degree than the barbs, and further including segments mounted to the bar, the anchor preventing movement of the suture in the direction of movement of the pointed end. - View Dependent Claims (13)
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14. A barbed suture comprising:
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an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having an anchor configured to resemble a harpoon end and extending outside the periphery of the body to a greater degree than the barbs, the anchor preventing movement of the suture in the direction of movement of the pointed end. - View Dependent Claims (15)
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16. A barbed suture comprising:
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an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having a loop through which the elongated body may pass to secure tissue as an anchor, the anchor preventing movement of the suture in the direction of movement of the pointed end. - View Dependent Claims (17, 19)
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18. A barbed suture comprising:
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an elongated body;
one pointed end;
a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end; and
one end having an anchor configured to resemble an object selected from the group including an umbrella, a coneflower, and an “
M”
, the anchor preventing movement of the suture in the direction of movement of the pointed end.
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20. A method of placing a barbed suture in bodily tissue, the suture including at least one pointed end and a central portion having barbs that allow movement of the suture in the direction of movement of the pointed end and resist movement of the suture away from the direction of movement of the pointed end, the method comprising:
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inserting the pointed end of the suture in the tissue;
advancing the suture through the tissue such that the central portion is disposed along a first path; and
deviating from the first path proximate to the at least one pointed end of the suture along a second path, wherein the second path forms an angle with the projected first path, had the suture remained on the first path, of at least approximately 30 degrees. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method of placing a barbed suture in bodily tissue to approximate tissue on each side of a wound, the suture including at least one pointed end and a central portion having barbs that allow movement of the suture in the direction of movement of the pointed end and resist movement of the suture away from the direction of movement of the pointed end, the method comprising:
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inserting the pointed end of the suture in the tissue;
advancing the suture through the tissue along a first path;
deviating from the first path to follow a second path generally disposed laterally away from the wound; and
deviating from the second path proximate to the at least one pointed end of the suture along a third path, wherein the third path forms an angle with the projected second path, had the suture remained on the second path, of at least approximately 30 degrees. - View Dependent Claims (33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44)
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45. A method of placing a single-directional barbed suture in bodily tissue to approximate a wound, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the method comprising:
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inserting the pointed end of the suture into one face of the wound; and
advancing the suture through the tissue until the anchor achieves adequate holding strength in the tissue to resist further movement in the tissue, wherein the anchor is embedded in the tissue. - View Dependent Claims (46)
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47. A method of placing a single-directional suture in tissue using an insertion device, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor when extended extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the insertion device including a tubular element in which the suture body is at least in part initially disposed and having leading and trailing ends, the method comprising:
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(a) inserting the pointed end of the suture and the leading end of the insertion device into the tissue at an insertion point;
(b) pushing the pointed end of the suture and the leading end of the insertion device through the tissue until reaching an endpoint;
(c) gripping and pulling the insertion device at the trailing end to remove the insertion device; and
(d) manually grouping and advancing the tissue along the body of the suture as desired. - View Dependent Claims (48, 49, 50, 51, 52)
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53. A method of placing a single-directional suture in tissue using an insertion device, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor when extended extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the insertion device including a tubular element having leading and trailing ends, the method comprising:
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(a) inserting the leading end of the insertion device at an insertion point and through the tissue until reaching an endpoint;
(b) inserting a leading end of the suture into the insertion device at least until the trailing end of the suture is within the insertion device;
(c) inserting a plunger into the trailing end of the insertion device to abut the trailing end of the suture;
(d) depressing the plunger to push the leading end of the suture out of the insertion device;
(e) gripping and pulling the insertion device at the trailing end to remove the insertion device, leaving the suture in place; and
(f) manually grouping and advancing the tissue along the body of the suture as desired. - View Dependent Claims (54, 55, 56, 57, 58)
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59. A method of performing a surgical procedure using a barbed suture including an elongated body, first and second sharp pointed distal ends for penetrating tissue, and a plurality of barbs extending from the periphery of the body, the barbs on a first portion of the body between the first end of the suture and a first axial location on the body for permitting movement of the suture through the tissue in a direction of movement of the first end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the body between the second end of the suture and a second axial location on the body which is less than the distance from the second end to the first axial location permitting movement of the suture through the tissue in a direction of movement of the second end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the second end, and using an insertion device including a tubular element, the insertion device having leading and trailing ends, the method comprising:
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(a) inserting the leading end of the insertion device at an insertion point in the tissue;
(b) advancing the leading end of the insertion device through tissue until reaching a selected point;
(c) inserting the first pointed end of the suture into the insertion device at least until one barb extends out of the insertion device;
(d) gripping and pulling the insertion device at the trailing end to remove the insertion device, leaving the full length of the suture in place in the tissue; and
(e) manually grouping and advancing the tissue along the body of the suture as desired. - View Dependent Claims (60, 61, 62)
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63. A method of performing a surgical procedure using a barbed suture including an elongated body, first and second sharp pointed distal ends for penetrating tissue, and a plurality of barbs extending from the periphery of the body, the barbs on a first portion of the body between the first end of the suture and a first axial location on the body for permitting movement of the suture through the tissue in a direction of movement of the first end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the body between the second end of the suture and a second axial location on the body which is less than the distance from the second end to the first axial location permitting movement of the suture through the tissue in a direction of movement of the second end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the second end, the method comprising:
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(a) inserting the first end of the suture into tissue at an insertion point;
(b) advancing the suture in a generally curvilinear path until the second axial location is at the point of insertion of the first end of the suture and the first end of the suture exits the tissue at an exit point, leaving a length of the first portion of the suture in the tissue;
(c) inserting the second end of the suture at the insertion point of the first end of the suture into tissue;
(d) advancing the suture in a generally curvilinear path distally from the first portion of the suture, until the second end of the suture exits the tissue at an exit point, leaving a length of the second portion of the suture in the tissue; and
(e) manually grouping and advancing the tissue along the body of the suture as desired, wherein the amplitude of each curvilinear path is generally perpendicular to the resultant holding force exerted by the suture on the tissue. - View Dependent Claims (64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87)
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88. A method of placing a first single-directional barbed suture and a second single-directional barbed suture in bodily tissue, the sutures each including an elongated body, one pointed end, and one trailing end, and a plurality of barbs extending from the periphery of the body, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the method comprising:
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(a) inserting the first end of the first suture into tissue at an insertion point;
(b) advancing the suture in a generally curvilinear path until the pointed end of the first suture exits the tissue at an exit point, leaving a length of the body of the first suture in the tissue;
(c) inserting the pointed end of the second suture into tissue at the insertion point of the first suture;
(d) advancing the second suture in a generally curvilinear path until the pointed end of the second suture exits the tissue at an exit point, leaving a length of the body of the second suture in the tissue;
(e) tying the first and second suture together at the insertion point; and
(f) manually grouping and advancing the tissue along the body of each suture as desired, wherein the amplitude of each curvilinear path is generally perpendicular to the resultant holding force exerted by each suture on the tissue. - View Dependent Claims (89, 90)
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91. A method of placing a single-directional barbed suture in bodily tissue, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the method comprising:
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(a) making an incision in the tissue to define a face of the tissue;
(b) inserting the pointed end of the suture in the face of the tissue;
(c) advancing the pointed end of the suture through the tissue to an exit point;
(d) placing the anchor in the incision; and
(e) advancing the pointed end of the suture through the tissue until the anchor achieves adequate holding strength in the tissue to resist further movement in the tissue, wherein the anchor is embedded in the tissue. - View Dependent Claims (92, 93, 94, 95, 96)
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97. A method for joining two ends of severed internal tissue to allow tissue healing and regrowth together of the two ends of the internal tissue in vivo using a single-directional barbed suture, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the method comprising:
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(a) inserting the pointed end of the suture into a first end of the internal tissue;
pushing the pointed end through the internal tissue along a curvilinear path, proceeding away from the first end and farther into the tissue;
(b) gripping the pointed end of the suture and pulling the pointed end out of the internal tissue for drawing the anchor proximate to the first end of the tissue;
(c) pushing the pointed end along the curvilinear path then returning along the path to the first end, and exiting from the first end of the tissue;
(d) inserting the pointed end into an opposing, second end of tissue;
(e) pushing the pointed end along a curvilinear path, proceeding away from the second end and farther into the tissue, then returning to the second end, and exiting from the second end of the tissue; and
(f) inserting the pointed end into the first end of tissue, pushing the pointed end along a curvilinear path, proceeding away from the second end and farther into the tissue, then returning toward the first end and exiting the tissue. - View Dependent Claims (98)
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99. A method of placing a single-directional barbed suture in a bodily tube to approximate first and second ends of the tube, the suture including an elongated body, one pointed end, one end terminating in an anchor, and a plurality of barbs extending from the periphery of the body, the anchor extending outside the periphery of the body to a greater degree than the barbs, the barbs permitting movement of the suture through the tissue in the direction of movement of the pointed end and preventing movement of the suture in a direction opposite the direction of movement of the pointed end, the anchor preventing movement of the suture in the direction of movement of the pointed end, the method comprising:
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(a) inserting the pointed end of the suture through the wall and into the interior of the first end of the tube;
(b) inserting the pointed end of the suture from the interior of the tube through the wall of the second end of the tube;
(c) advancing the suture through the walls of the tube until the anchor contacts the outer surface of the wall of the first end of the tube for drawing together the two ends of the tube;
(d) inserting the pointed end of the suture through the wall of the first end of the tube at a point circumferentially spaced from the previous insertion point; and
(e) repeating steps (b) through (d) for advancing the suture around the tube. - View Dependent Claims (100, 101, 102)
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103. A method of placing a bi-directional barbed suture in a bodily tube to approximate first and second ends of the tube, the barbed suture including an elongated body, first and second sharp pointed distal ends for penetrating tissue, and a plurality of barbs extending from the periphery of the body, the barbs on a first portion of the body between the first end of the suture and a first axial location on the body for permitting movement of the suture through the tissue in a direction of movement of the first end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the body between the second end of the suture and a second axial location on the body which is less than the distance from the second end to the first axial location permitting movement of the suture through the tissue in a direction of movement of the second end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the second end, the method comprising:
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(a) inserting an end of the first portion of the suture through the wall and into the interior of the first end of the tube;
(b) inserting the end of the first portion of the suture from the interior of the tube through the wall of the second end of the tube;
(c) advancing the first portion of the suture through the walls of the tube until the opposed barbs on the second portion of the suture contact the outer surface of the wall of the first end of the tube for drawing the two ends of the tube together;
(d) inserting the end of the first portion of the suture through the wall and into the interior of the first end of the tube at a point circumferentially spaced in a first direction from the previous insertion point of the first end of the suture;
(e) inserting the end of the second portion of the suture through the wall and into the interior of the second end of the tube at a point circumferentially spaced from the exit point of the end of the first portion of the suture;
(f) inserting the end of the second portion of the suture from the interior of the tube through the wall of the first end of the tube at a point circumferentially spaced in a second direction from the initial insertion point of the second end of the suture; and
(g) repeating steps (a) through (f) for advancing each end of the barbed suture around the tube. - View Dependent Claims (104, 105, 106)
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107. A method of placing a bi-directional barbed suture in a bodily tube to approximate first and second ends of the tube, the barbed suture including an elongated body, first and second sharp pointed distal ends for penetrating tissue, and a plurality of barbs extending from the periphery of the body, the barbs on a first portion of the body between the first end of the suture and a first axial location on the body for permitting movement of the suture through the tissue in a direction of movement of the first end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the body between the second end of the suture and a second axial location on the body which is less than the distance from the second end to the first axial location permitting movement of the suture through the tissue in a direction of movement of the second end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the second end, the method comprising:
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(a) inserting an end of the first portion of the suture through the wall of the first end of the tube;
(b) inserting the end of the first portion of the suture from the interior of the tube through the wall of the second end of the tube;
(c) advancing the first portion of the suture through the walls of the tube until the opposed barbs on the second portion of the suture contact the outer surface of the wall of the first end of the tube for drawing the two ends of the tube together;
(d) inserting the end of the first portion of the suture through the wall and into the interior of the first end of the tube at a point circumferentially spaced in a first direction from the previous insertion point of the first portion of the suture;
(e) inserting the second portion of the suture through the wall of the first end of the tube at a point adjacent the initial insertion point of the first portion of the suture;
(f) inserting the end of the second portion of the suture from the interior of the tube through the wall of the second end of the tube at a point circumferentially spaced from the adjacent exit point of the end of the first portion of the suture;
(g) inserting the end of the second portion of the suture through the wall of the first end of the tube at a point circumferentially spaced in a second direction from the previous insertion point of the second portion of the suture; and
(h) repeating steps (b) through (g) for advancing each end of the barbed suture around the tube. - View Dependent Claims (108, 109, 110, 111)
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Specification