Suture anchor applicator

• US 20070112384A1
• Filed: 11/15/2005
• Published: 05/17/2007
• Est. Priority Date: 11/15/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Griffith, David, Conlon, Sean
• Granted Patent: US 7,815,659 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 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0435 the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• 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 2017/06052 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 2090/036 abutting on tissue or skin

Abstract

A medical instrument is provided including a shaft having a proximal end and a distal end that define an axis, wherein the distal end is penetratable into tissue. The instrument also includes a tissue stop disposed on the shaft near the distal end and changeable between a collapsed configuration and an expanded configuration, wherein the distal end is penetratable into the tissue approximately to a predetermined depth when the tissue stop is in the expanded configuration.

Claims

1. A medical instrument comprising:

a shaft having a proximal end and a distal end, wherein the distal end is adapted to penetrate tissue; and

a tissue stop disposed on the shaft and changeable between a collapsed configuration and an expanded configuration, wherein the distal end is penetratable into tissue approximately to a predetermined depth when the tissue stop is in the expanded configuration.

2. The medical instrument of claim 1, wherein the shaft is flexible and sized for insertion into the working channel of a conventional, flexible endoscope when the tissue stop is in the collapsed configuration.

3. The medical instrument of claim 1, further comprising a handle attached to the proximal end of the shaft, wherein the shaft has a channel extending therethrough and an actuating element extending through the channel, and the handle has a first actuator and the proximal end of the actuating element is operatively connected to the first actuator, and wherein the distal end of the channel is adapted to retain an implantable medical object in a loaded position such that the first actuator may be actuated by a user to move the actuating element in the distal direction and eject the medical object out of the distal end of the channel.

4. The medical instrument of claim 3, wherein the implantable medical object is a suture anchor having a suture attached thereto.

5. The medical instrument of claim 1, wherein the tissue stop comprises at least one arm radially extendable between a first position when the tissue stop is in the collapsed configuration and a second position when the tissue stop is in the expanded configuration.

6. The medical instrument of claim 5, wherein the arm is formed from a polymer.

7. The medical instrument of claim 5, wherein the arm is formed to be in the second position when unconstrained.

8. The medical instrument of claim 5, wherein the arm is formed to be in the first position when unconstrained, and wherein the arm is deformable such that tissue stop changes from the collapsed to the expanded configuration when the distal end of the shaft is penetrated into the tissue and the distal end of the tissue stop is pressed against the tissue with sufficient force to deform the arm.

9. The medical instrument of claim 1, wherein the tissue stop comprises a plurality of arms arranged around the periphery of the shaft and having proximal ends connected to a proximal stop ring and distal ends connected to a distal stop ring, and wherein the proximal and distal stop rings are spaced apart and coaxially retained on the shaft such that the distal stop ring is movable in the longitudinal direction and the proximal stop ring is fixed on the shaft, and wherein the arms are straight and parallel when the tissue stop is in the collapsed configuration and the arms are deformable such that the portions of the arms between the proximal and distal stop rings extend radially outward from the axis when the distal end of the shaft is penetrated into tissue and the distal stop ring is pushed against the tissue and is urged towards the proximal stop ring.

10. The medical instrument of claim 1, wherein the tissue stop comprises a plurality of arms arranged around the periphery of the shaft and having proximal ends connected to a proximal stop ring and distal ends connected to a distal stop ring, and wherein the proximal and distal stop rings are spaced apart and coaxially retained on the shaft such that one of the proximal and distal stop rings is movable in the longitudinal direction and the other one of the proximal and distal stop rings is fixed on the shaft, and wherein the arms are straight and parallel when the tissue stop is in the collapsed configuration and the arms are deformable such that the portions of the arms between the proximal and distal stop rings extend radially outward from the shaft when the movable one of the proximal and distal stop rings is urged towards the other of the proximal and distal stop rings, and wherein the shaft includes a force element having proximal and distal ends and the distal end of the force element is operatively connected to the movable one of the proximal and distal rings and the proximal end of the force element is operatively connected to an actuator on the handle such that a user may actuate the actuator to apply a force to the proximal end of the force element to change the tissue stop between the collapsed and expanded configurations.

11. A medical instrument for applying a suture anchor to the tissue of a patient, the instrument comprising:

a handle including a first, a second and a third actuator; and

a shaft having proximal and distal ends defining an axis, wherein the proximal end is attached to the handle and the shaft includes;

an inner tube having a channel therethrough, wherein at least one suture anchor may be retained in a loaded position inside of the distal portion of the channel;

an actuating element extending through the channel, wherein the proximal end of the actuating element is operatively connected to the third actuator and the distal end of the actuating element is proximal to the suture anchor;

an intermediate tube coaxially retained on the inner tube, wherein the proximal end of the intermediate tube is operatively connected to the first actuator and the distal end of the intermediate tube is movable between an extended position distal to the distal end of the inner tube and a retracted position proximal to the distal end of the inner tube;

an outer tube coaxially and slidably retained over the intermediate tube, wherein the proximal end of the outer tube is operatively connected to the second actuator; and

a tissue stop coaxially retained on the distal portion of the intermediate tube and operatively connected to the distal end of the outer tube, wherein the tissue stop comprises at least one arm that is radially extendable between a position near the axis when the tissue stop is in the collapsed configuration and a position spaced apart from the axis when the tissue stop is in the expanded configuration,

whereby the second actuator may be actuated to position and hold the distal end of the intermediate tube between the extended and retracted positions at a desired longitudinal distance from the distal end of the inner tube, and the first actuator may be actuated to change the tissue stop between the collapsed and expanded configurations such that the distal end of the inner tube is penetratable into tissue approximately to a predetermined depth, and the third actuator may be actuated to eject the suture anchor from the distal end of the channel of the inner tube.

12. The medical instrument of claim 11, wherein the shaft is flexible and sized for insertion into the working channel of a conventional, flexible endoscope.

13. The medical instrument of claim 11, wherein the distal end of the inner tube has a ground tip to facilitate the penetration of the inner tube into tissue.

14. The medical instrument of claim 11, wherein the handle includes calibrations or a visual indicator to indicate the penetration depth of the distal end of the inner tube.

15. The medical instrument of claim 11, wherein the tissue stop is formed from a polymer.

16. The medical instrument of claim 11, wherein the tissue stop comprises a distal stop ring, a proximal stop ring, and a plurality of arms arranged around the periphery of the intermediate tube and having proximal ends connected to the proximal stop ring and distal ends connected to the distal stop ring, and wherein the proximal and distal stop rings are spaced apart and coaxially retained on the intermediate tube such that the proximal stop ring is operatively connected to the outer tube and movable in the longitudinal direction and the distal stop ring is fixed on the intermediate tube, and wherein the arms are straight and parallel when the tissue stop is in the collapsed configuration and the arms are deformable such that the portions of the arms between the proximal and distal stop rings extend radially outward from the axis when the proximal stop ring is urged towards the distal stop ring.

17. A suture anchor applicator comprising:

a shaft having proximal and distal ends defining an axis therebetween, wherein the shaft is flexible and sized for insertion into the working channel of a conventional, flexible endoscope when the tissue stop is in the collapsed configuration, and wherein the shaft includes;

an inner tube having a channel extending therethrough, wherein the distal end of the inner tube is formed into a tissue penetrating tip, and wherein a distal portion of the channel is adapted to retain at least one suture anchor;

an actuating element slidably retained in the channel, wherein the actuating element is movable in the distal direction such that the distal end of the actuating element ejects a suture anchor positioned in the distal portion of the channel;

an outer tube retained on the inner tube;

a tissue stop retained on the inner tube and connected to the distal end of the outer tube, wherein the tissue stop comprises at least one arm radially extendable between a position near the axis in a collapsed configuration and a position spaced apart from the axis in an expanded configuration, whereby the penetrating tip is penetratable into the tissue approximately to a predetermined depth when the arm of the tissue stop is in the expanded configuration.

18. The suture anchor applicator of claim 17, wherein the outer tube and the tissue stop are slidably retained on the inner tube such that the tissue stop is longitudinally positionable on the inner tube by moving the proximal end of the outer tube, whereby the penetrating tip is penetratable into the tissue approximately to a predetermined depth according to the longitudinal position of the tissue stop relative to the inner tube when the arm of the tissue stop is in the expanded configuration.

19. The suture anchor applicator of claim 17, wherein the tissue stop comprises a pair of arms, wherein the arms are approximately parallel to the axis and positioned about 180 degrees apart when in the collapsed configuration, and wherein the arms extend radially outward in approximately opposite directions when in the expanded configuration.

20. The suture anchor applicator of claim 19, wherein the tissue stop is formed from a polymer and formed such that the arms are normally in the expanded configuration when unconstrained.

21. The suture anchor applicator of claim 17, further comprising a handle attached to the proximal end of the shaft, wherein the handle includes an actuator operatively connected to the proximal end of the actuating element such that actuation of the actuator moves the actuating element in the longitudinal direction.