Method and apparatus for suture placement

• US 20060241658A1
• Filed: 04/20/2005
• Published: 10/26/2006
• Est. Priority Date: 04/20/2005
• Status: Abandoned Application

• Current Assignee: Arthroscopic Innovations LLC
• Original Assignee: Arthroscopic Innovations LLC
• Inventors: Cerundolo, Daniel
• Application Number:
  US11/110,432
• Publication Number:
  US 20060241658A1
• Time in Patent Office: Days
• US Class Current: 606/148
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment

Abstract

An apparatus and method for placing a suture by manipulating a cannula and attached needle. The cannula may be usable in a minimally-invasive surgical procedure, and the needle may be selectively attached to and/or separated from the cannula. The cannula and needle may include complementary locking members that engage with each other and allow the needle to be used to place a suture by manipulation of the cannula.

Claims

1. An apparatus comprising:

a cannula having at least one lumen, the cannula being constructed and arranged to be placed in an arthroscopic portal in a minimally-invasive surgical procedure and allow an instrument to be passed through the at least one lumen of the cannula; and

a needle attached to the cannula and having a tissue penetrating portion adapted to carry a suture;

wherein the needle, when carrying a suture, is manipulable by movement of the cannula to penetrate a material to place the suture in the material.

2. The apparatus of claim 1, wherein the cannula has a groove with a shape, and the needle has a portion with a shape that engages with the groove.

3. The apparatus of claim 1, wherein rotation of the cannula causes rotation of the tissue penetrating portion of the needle.

4. The apparatus of claim 1, wherein the needle has a hollow portion that accommodates a suture.

5. The apparatus of claim 1, wherein the needle has a cannula engaging portion that engages with the cannula and the tissue penetrating portion is positioned distally of the cannula engaging portion.

6. The apparatus of claim 1, wherein the cannula has a longitudinal axis and the tissue penetrating portion includes a curved end portion positioned in a plane that is transverse to the longitudinal axis.

7. The apparatus of claim 6, wherein rotation of the cannula about the longitudinal axis causes the curved end portion to travel along an arc-shaped path.

8. The apparatus of claim 1, wherein the cannula has a longitudinal axis, and rotation of the cannula about the longitudinal axis causes the tissue penetrating portion to move in an arc-shaped path.

9. The apparatus of claim 1, wherein the cannula has a longitudinal axis, and the tissue penetrating portion is positioned in a plane that is transverse to the longitudinal axis.

10. The apparatus of claim 1, wherein the cannula has a longitudinal axis, and the tissue penetrating portion includes a semicircular end portion that lies in a plane perpendicular to the longitudinal axis.

11. The apparatus of claim 10, wherein the cannula has a longitudinal axis that passes through a center of a lumen of the cannula and passes through a center of the semicircular end portion.

12. The apparatus of claim 1, wherein the tissue penetrating portion includes a hollow section adapted to carry a suture.

13. The apparatus of claim 1, wherein the needle is hollow along its length to carry a suture.

14. The apparatus of claim 1, wherein the cannula includes a valve that inhibits the flow of fluid through a lumen of the cannula.

15. The apparatus of claim 1, wherein the cannula and needle are constructed and arranged to place a suture in a rotator cuff.

16. The apparatus of claim 1, wherein the cannula and needle are constructed and arranged to form a mattress stitch in a rotator cuff.

17. The apparatus of claim 1, wherein the needle is movable axially relative to the cannula.

18. The apparatus of claim 1, wherein the cannula has a longitudinal axis, and the needle is movable in a direction generally along the longitudinal axis relative to the cannula.

19. The apparatus of claim 1, wherein the cannula and the needle have complementary locking members that are engagable so that the needle is operable to place the suture based on movement of the cannula.

20. The apparatus of claim 19, wherein the cannula has an oval-shaped groove and the needle has at least one oval-shaped portion that engages with the oval-shaped groove.

21. The apparatus of claim 1, wherein the needle is selectively separable from the cannula.

22. A method of performing a surgical procedure, comprising:

attaching a needle to a cannula, the needle being constructed and arranged to carry a suture;

providing the cannula and needle in an arthroscopic portal, the cannula being constructed and arranged to allow an instrument to be passed through a lumen of the cannula and used at a surgical site; and

manipulating the cannula so as to use the needle to penetrate a material to place a suture in the material.

23. The method of claim 22, wherein the material is a rotator cuff tendon.

24. The method of claim 23, further comprising:

securing the suture and rotator cuff tendon to a portion of a humerus.

25. The method of claim 22, wherein the step of manipulating comprises rotating the cannula about a longitudinal axis of the cannula.

26. The method of claim 22, wherein the step of manipulating comprises placing a mattress stitch in the material.

27. The method of claim 22, wherein the needle is removably attached to the cannula.

28. The method of claim 22, further comprising moving the needle axially relative to the cannula.

29. The method of claim 22, wherein the needle includes a material engaging portion that is hollow and accommodates the suture.

30. The method of claim 22, further comprising inserting a surgical instrument in a lumen of the cannula while the needle is attached to the cannula.

31. An apparatus comprising:

a cannula having at least one lumen and constructed and arranged to be used in a minimally-invasive surgical procedure and allow an instrument to be passed through the at least one lumen of the cannula, the cannula having at least one feature adapted to engage with a needle such that the needle, when carrying a suture, is manipulable by movement of the cannula to place the suture in a material.

32. The apparatus of claim 31, wherein the cannula is arranged to allow the needle to be movable axially relative to the cannula while remaining engaged with the cannula.

33. The apparatus of claim 32, wherein the cannula has a longitudinal axis, and the cannula is arranged to allow movement of the needle in a direction generally along the longitudinal axis relative to the cannula.

34. The apparatus of claim 31, wherein the cannula has at least one locking member that is complementary and engagable with at least one locking member associated with the needle.

35. The apparatus of claim 31, wherein the lumen of the cannula has a longitudinal axis, and the cannula is arranged to engage with the needle so that rotation of the cannula about the longitudinal axis causes rotation of a tissue penetrating portion of the needle.

36. The apparatus of claim 31, wherein the needle is removably engagable with the cannula.

37. The apparatus of claim 31, wherein the cannula includes at least one groove adapted to engage with at least a portion associated with the needle.

38. An apparatus comprising:

a needle constructed and arranged to carry a suture and to engage with a cannula having at least one lumen, the cannula being constructed and arranged to be placed in an arthroscopic portal in a minimally-invasive surgical procedure and allow an instrument to be passed through the at least one lumen of the cannula and used at a surgical site, engagement of the needle and the cannula being arranged so that the needle is manipulable by movement of the cannula in a minimally-invasive surgical procedure to place a suture in a material.

39. The apparatus of claim 38, wherein the needle has at least one locking member that is complementary and engagable with at least one locking member associated with the cannula.

40. The apparatus of claim 38, wherein the needle is arranged to engage with at least one groove associated with the cannula.

41. The apparatus of claim 38, wherein the needle is removably engagable with the cannula.

42. The apparatus of claim 38, wherein the needle includes a curved tissue penetrating portion that is arranged to move in a circular path when the needle is engaged with the cannula and the cannula is rotated about a longitudinal axis.

43. The apparatus of claim 38, wherein the needle includes a hollow portion adapted to carry a suture.