Suture anchor and approximating device

• US 20060030884A1
• Filed: 08/05/2004
• Published: 02/09/2006
• Est. Priority Date: 03/14/2002
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences Limited (Teleflex Incorporated)
• Original Assignee: NeoTract, Inc. (Teleflex Incorporated)
• Inventors: Yeung, Teresa T., Yeung, Jeffrey Eric
• Granted Patent: US 7,766,939 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/062 penetration depth

Abstract

An elastically curved suture anchor is resiliently straightened and delivered into tissue by a needle. When the needle is withdrawn, resumption of the curvature provides leverage for anchor rotation as the attached suture is pulled to fasten the anchor within the tissue. A fin at the proximal end of the anchor further increases the rotational leverage and expedites anchor fastening. When two or more anchors with connecting suture are delivered in series on a needle, the tension of the suture helps to draw the anchors together and approximates the pierced tissue.

Claims

1. A suture anchor deployable with a suture anchor delivery device having a needle, the suture anchor comprising:

a suture anchor body having a longitudinal axis and formed of an elastic material, said suture anchor body having a straightened position and a curved position,

a passage extending through said suture anchor along said longitudinal axis, said passage sized and configured for the needle of the suture anchor delivery device to pass therethrough,

a suture opening sized and configured to received a suture, said suture opening passing through a portion of said suture anchor,

a guiding platform attached to one side of said suture anchor body,

wherein said suture body is resiliently straightened into said straightened position when the needle of said suture anchor delivery device is located within said passage,

and wherein when the needle is removed, said suture anchor body resumes said curved position.

2. The suture anchor of claim 1, wherein said guiding platform is generally flat.

3. The suture anchor of claim 1, wherein said suture opening passes through said platform.

4. The suture anchor of claim 3, wherein said platform has a protrusion and said suture opening passes through said protrusion

5. The suture anchor of claim 3, further comprising a second suture opening passing through said platform.

6. The suture anchor of claim 5, wherein one of said suture openings is located on a left side of said platform and the other suture opening is located on a right side of said platform.

7. The suture anchor of claim 1, wherein said platform is located on a concave side when said suture anchor is in said curved position.

8. The suture anchor of claim 1, wherein said platform is located on a convex side when said suture anchor is in said curved position.

9. The suture anchor of claim 1, further comprising a groove located on a bottom surface of said platform, and wherein said groove is closed when said suture anchor is in said curved position.

10. The suture anchor of claim 9, wherein said groove is V-shaped.

11. The suture anchor of claim 1, wherein said platform is near a middle portion of said suture anchor.

12. The suture anchor of claim 1, wherein said platform extends along at least a majority of a length of said suture anchor body.

13. The suture anchor of claim 1, wherein said platform extends along approximately three quarters of a length of said suture anchor body.

14. The suture anchor of claim 1, wherein a longitudinal axis of said platform runs generally parallel to said longitudinal axis of said suture anchor body.

15. The suture anchor of claim 1, wherein a distal end of said platform is tapered.

16. The suture anchor of claim 1, wherein a proximal end of said platform is tapered.

17. The suture anchor of claim 1, wherein said platform is tapered at both proximal and distal ends.

18. The suture anchor of claim 1, wherein said platform is mounted generally tangentially to said suture anchor body.

19. The suture anchor of claim 1, wherein said platform is oblong.

20. The suture anchor of claim 1, wherein a proximal end of said platform curves around a proximal end of said suture anchor body, thereby covering the proximal end of said suture anchor body.

37. The suture anchor of claim 1, 21 or 32, wherein said suture anchor is formed of a material chosen from the group of materials consisting of polypropylene, polyethylene, poly-ether-ether-ketone, acetal resin, polysulfone and polycarbonate.

38. The suture anchor of claim 1, 21 or 32, wherein said suture anchor is biodegradable.

39. The suture anchor of claim 1, 21 or 32, wherein said suture anchor is formed of a material chosen from the group of materials consisting of polylactate, polyglycolic, poly-lactide-co-glycolide, polycaprolactone, and trimethylene carbonate.

40. The suture anchor of claim 1, 21 or 32, further comprising a coating on said suture anchor.

41. The suture anchor of claim 1, 21 or 32, further comprising a coating on said suture anchor, said coating chosen from the group of coatings consisting of lubricants, growth factors, nutrients, buffering agents, collagen, hydroxyapatite, analgesics, sealants, blood clotting agents, antibiotics, radiopaque agents and echogenic agents.

42. The suture anchor of claim 1, 21 or 32, further comprising a coating of a biocompatible polymer.

43. The suture anchor of claim 1, 21 or 32, further comprising a coating of chosen from the group of coatings consisting of polyurethane, polytetrafluoroethylene, silicon, and ultra high molecular weight polyethylene.

44. The suture anchor of claim 1, 21 or 32, wherein said suture anchor is formed of a material chosen from the group of material consisting of polypropylene, polyethylene, poly-ether-ether-ketone, acetal resin, polysulfone, polycarbonate, polylactate, polyglycolic, poly-lactide-co-glycolide, polycaprolactone, trimethylene carbonate, polydioxanone, polyanhydride, trimethylene carbonate, poly-beta-hydroxybutyrate, polyhydroxyvalerate, poly-gama-ethyl-glutamate, poly-DTH-iminocarbonate, poly-bisphenol-A-iminocarbonate, poly-ortho-ester, polycyanoacrylate, polyphosphazene, nickel-titanium alloy, spring tempered stainless steel, titanium, stainless steel and metallic material.

45. The suture anchor of claim 1, 21 or 32, further comprising a second suture anchor and a suture threaded through said suture opening and through a second suture opening extending through a body of said second suture anchor.

46. A suture anchor delivery system, comprising:

the suture anchor of claim 1, 21 or 36,

a needle having a step dividing said needle into a proximal portion and a distal portion, said distal portion being sized and configured to fit within said passage, said proximal portion having a larger diameter,

wherein, when said needle is located within said passage, said needle holds said suture anchor in said straightened position.

47. The suture anchor delivery system of claim 46, wherein a proximal end of said suture anchor body rests against said step when said needle is located within said passage.

48. The suture anchor delivery system of claim 46, wherein a sharp distal end of said needle protrudes from a distal end of said passage.

49. The suture anchor delivery system of claim 46, further comprising a second step in said needle and a second suture anchor.

50. The suture anchor delivery system of claim 49, wherein said suture passing through both of said suture anchors.

21. A suture anchor deployable with a suture anchor delivery device having a needle, the suture anchor comprising:

a suture anchor body having a longitudinal axis and formed of an elastic material, said suture anchor body having a straightened position and a curved position,

a passage extending through said suture anchor along said longitudinal axis, said passage sized and configured for the needle of the suture anchor delivery device to pass therethrough,

a suture opening sized and configured to received a suture, said suture opening passing through a portion of said suture anchor,

a guiding fin attached to one side of said suture anchor body,

wherein said suture anchor body is resiliently straightened into said straightened position when the needle of said suture anchor delivery device is located within said passage,

and wherein when the needle is removed, said suture anchor body resumes said curved position.

22. The suture anchor of claim 21, wherein said fin extends generally perpendicular from said suture anchor body.

23. The suture anchor of claim 21, wherein said fin is located proximate said proximal end of said suture anchor body.

24. The suture anchor of claim 21, wherein said fin is tapered such that a proximal end of the said fin is larger than a distal end of said fin.

25. The suture anchor of claim 21, wherein said fin is located on a concave side when said suture anchor is in said curved position.

26. The suture anchor of claim 21, wherein said fin is located on a convex side when said suture anchor is in said curved position.

27. The suture anchor of claim 21, wherein a proximal end of said fin is angled.

28. The suture anchor of claim 21, wherein a proximal end of said fin is angled to match a tapered distal step of the needle.

29. The suture anchor of claim 21, wherein said fin is extending outward from a middle portion of said suture anchor body and wherein said suture opening extends therethrough.

30. The suture anchor of claim 21, wherein said suture opening is located opposite said fin.

31. The suture anchor of claim 21, wherein said fin has a pointed proximal tip that extends beyond an end of said suture anchor body.

32. A suture anchor deployable with a suture anchor delivery device having a needle, the suture anchor comprising:

a suture anchor body having a longitudinal axis,

a passage extending through said suture anchor along said longitudinal axis, said passage sized and configured for the needle of the suture anchor delivery device to pass therethrough,

a suture opening sized and configured to received a suture, said suture opening passing through a portion of said suture anchor,

a guiding fin attached to a first side of said suture anchor body,

a guiding platform attached a second side of said suture anchor body.

33. The suture anchor of claim 32, wherein said guiding fin extends generally perpendicular to said guiding platform.

34. The suture anchor of claim 32, wherein a proximal end of said platform curves around a proximal end of said suture anchor body, thereby covering the proximal end of said suture anchor body and wherein said fin has a pointed proximal tip that extends beyond an end of said suture anchor body and said platform.

35. The suture anchor of claim 32, wherein said suture anchor is formed of an elastic material.

36. The suture anchor of claim 35, wherein said suture anchor has a straightened position and a curved position, and wherein said suture anchor may be held in said straightened position by the needle, when the needle is located within said passage, and when said needle is removed, said suture anchor resumes said curved position.

51. A method for delivering a suture anchor within tissue of a patient, the method comprising the steps of:

(a) puncturing the tissue with a needle, carrying a suture anchor;

(b) removing the needle from the suture anchor;

(c) and pulling a suture connected to the suture anchor causing a fin on the suture anchor to snag the surrounding tissue, thereby causing said suture anchor to rotate within tissue.

53. The method of claim 51 or 52 further comprising the step of:

(d) holding the suture anchor in the tissue with a sleeve located around the needle during step (b).

54. The method of claim 51 or 52 used to treat urinary incontinence, the method further comprising the steps of:

(d) identifying the location of the urethra;

(e) inserting the needle into the anterior wall of a vagina of the patient lateral to the urethra during step (a);

(f) repeating steps (a) thru (e) until a wall of the vagina is repositioned;

(g) and tying the sutures, thereby supporting the urethra with the repositioned wall of the vagina.

55. The method of claim 51 or 52 used to treat uterine prolapse, the method further comprising the steps of:

(d) repositioning the uterus;

(e) fastening the repositioned uterus with steps (a) thru (c);

(f) and repeating steps (a) thru (c) until the uterus is secure.

56. The method of claim 51 or 52 used to reattach ligament onto bone, the method further comprising the steps of:

(d) repositioning a torn ligament over bone;

(e) repeating steps (a) thru (c) until the ligament is secure;

(f) tying the suture;

(g) and allowing the ligament to heal over the bone.

57. The method of claim 56, wherein the bone is cancellous.

58. The method of claim 51 or 52 used to treat a bulging intervertebral disc, the method further comprising the steps of:

(d) inserting the needle into the bulging disc in step (a);

(e) pushing the suture anchor out an opposite side of the bulging disc;

(f) threading a disc compressing device onto the suture;

(g) pulling and tying the suture, thereby compressing the bulging disc between the suture anchor and the disc compressing device.

59. The method of claim 58, wherein step (e) is performed by using a sleeve located around the needle to push the suture anchor.

60. The method of claim 51 or 52, wherein step (b) is performed by the fin on the suture anchor snagging on the tissue, thereby holding the suture anchor in the tissue while the needle is withdrawn from the suture anchor.

61. The method of claim 60, wherein a second suture anchor is located on the needle and the suture passes through the second suture anchor and further comprising the steps of:

(d) removing the needle from the second suture anchor;

(e) allowing the second suture anchor to resume a curved configuration;

(f) pulling on the suture to cause the second suture anchor to rotate within the surrounding tissue;

(g) and pulling the suture further to draw together the tissue proximate the first suture anchor and the tissue proximate the second suture anchor.

62. The method of claim 61, wherein the first suture anchor is located distal to said second suture anchor.

63. The method of claim 61 used to repair a loose anal sphincter, wherein in step (a), the tissue is both sides of the loose anal sphincter and step (g) narrows the sphincter.

64. The method of claim 61 used to shorten a ligament, wherein in step (a), the tissue is the ligament and step (g) shortens the ligament.

65. The method of claim 64, further comprising the step of repeating steps (a) thru (g) until the ligament is sufficiently shortened.

66. The method of claim 61 used for treating urinary incontinence, wherein in step (a), the needle passes through the vagina and into the abdominal fascia or ligament and step (g) moves a wall of the vagina to support a urethral wall.

67. The method of claim 66, further comprising the step of repeating steps (a) thru (g) until the urethral wall is supported sufficiently to alleviate the urinary incontinence.

68. The method of claim 61, wherein a second pair of suture anchors with a second suture is located on the needle and is deployed.

69. The method of claim 51 or 52, wherein step (b) is performed by a sleeve located around the needle holding the suture anchor in the tissue while the needle is withdrawn from the suture anchor.

70. The method of claim 69, wherein a second suture anchor is located on the needle and the suture passes through the second suture anchor and further comprising the steps of:

(d) removing the needle from the second suture anchor;

(e) allowing the second suture anchor to resume a curved configuration;

(f) pulling on the suture to cause the second suture anchor to rotate within the surrounding tissue;

(g) and pulling the suture further to draw together the tissue proximate the first suture anchor and the tissue proximate the second suture anchor.

71. The method of claim 70, wherein step (d) is performed by the fin on the second suture anchor snagging on the tissue, thereby holding the second suture anchor in the tissue while the needle is withdrawn from the second suture anchor.

72. The method of claim 70, wherein step (d) is performed by the sleeve located around the needle holding the second suture anchor in the tissue while the needle is withdrawn from the second suture anchor.

73. The method of claim 70, wherein the first suture anchor is located distal to said second suture anchor.

74. The method of claim 70 used to repair a loose anal sphincter, wherein in step (a), the tissue is both sides of the loose anal sphincter and step (g) narrows the sphincter.

75. The method of claim 70 used to shorten a ligament, wherein in step (a), the tissue is the ligament and step (g) shortens the ligament.

76. The method of claim 75, further comprising the step of repeating steps (a) thru (g) until the ligament is sufficiently shortened.

77. The method of claim 70 used for treating urinary incontinence, wherein in step (a), the needle passes through the vagina and into the abdominal fascia or ligament and step (g) moves a wall of the vagina to support a urethral wall.

78. The method of claim 77, further comprising the step of repeating steps (a) thru (g) until the urethral wall is supported sufficiently to alleviate the urinary incontinence.

79. The method of claim 70, wherein a second pair of suture anchors with a second suture is located on the needle and is deployed.

52. A method for delivering a suture anchor within tissue of a patient, the method comprising the steps of:

(a) puncturing the tissue with a needle carrying a suture anchor;

(b) removing the needle from the suture anchor, thereby allowing the suture anchor to resume its curved configuration;

(c) and pulling a suture connected to the suture anchor causing a fin on the suture anchor to snag the surrounding tissue, thereby causing said suture anchor to rotate within tissue.

80. A suture anchor delivery device, comprising:

a needle,

a first sleeve located around said needle

and a second sleeve located around said needle and said first sleeve.

81. The suture anchor delivery device of claim 80, further comprising a first suture anchor having a first passage extending therethrough, said first passage sized to receive said needle and sized too small to receive said first sleeve, and further comprising a second suture anchor having a second passage extending therethrough, said second passage sized to receive said first sleeve and sized too small to receive said second sleeve.