Method and apparatus for providing suture in a passageway

• US 20070208356A1
• Filed: 05/03/2007
• Published: 09/06/2007
• Est. Priority Date: 04/20/2005
• Status: Active Grant

• Current Assignee: Arthroscopic Innovations LLC
• Original Assignee: Arthroscopic Innovations LLC
• Inventors: Cerundolo, Daniel
• Granted Patent: US 7,955,341 B2
• 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

A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Claims

1. A surgical apparatus comprising:

a guide apparatus constructed and arranged to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes, the first and second holes leading into the body portion from different positions, the guide apparatus including;

first and second guide members each having distal and proximal ends and a longitudinal passage extending to the distal end of the guide member, respectively, the first and second guide members being constructed and arranged to pass through an arthroscopic passage and be selectively positioned at a site so that the first and second passages communicate with the first and second holes, respectively;

wherein the first and second guide members are positionable at a known position relative to each other when extending through respective arthroscopic passages.

2. The apparatus of claim 1, wherein:

the first and second guide members include first and second guide tubes, respectively, each guide tube having a bore leading to the distal end that forms the longitudinal passage;

the apparatus further comprising;

a reference structure constructed and arranged to engage with the first and second guide tubes so that when the first and second guide tubes are positioned in respective first and second positions relative to the reference structure, the distal ends of the first and second guide tubes are adjacent each other.

3. The apparatus of claim 2, wherein the distal ends of the first and second guide tubes include a threaded portion adapted to allow the first and second guide tubes to be screwed into the body portion.

4. The apparatus of claim 2, wherein the reference structure includes first and second sleeves that respectively receive the first and second guide tubes, and the first and second guide tubes each include a stop that engages with the sleeves to position the distal ends of the first and second guide tubes adjacent each other.

5. The apparatus of claim 2, wherein the reference structure includes first and second sleeves that respectively receive the first and second guide tubes, and the first and second guide tubes each include at least one indicator mark to position the distal ends of the first and second guide tubes adjacent each other.

6. The apparatus of claim 2, wherein the first and second guide tubes each include a knob at a proximal end constructed and arranged to be handled by an operator to position the distal end into a corresponding hole.

7. The apparatus of claim 2, wherein the bore in the first and second guide tubes extends from the proximal end to the distal end.

8. The apparatus of claim 1, further comprising:

at least one bone perforator constructed and arranged to form a hole in bone while being guided in orientation by the guide apparatus.

9. The apparatus of claim 1, further comprising:

a suture fixation device constructed and arranged to be positioned relative to the passageway and aid in securing a suture at least partially positioned in the passageway.

10. The apparatus of claim 9, further comprising:

a suture fixation device applicator constructed and arranged to hold the suture fixation device and facilitate positioning of the suture fixation device at least partially in the passageway.

11. The apparatus of claim 9, further comprising:

a suture feed device constructed and arranged to facilitate positioning a suture through an opening in the suture fixation device.

12. The apparatus of claim 1, wherein the body portion is a portion of a bone.

13. The apparatus of claim 1, wherein the guide apparatus is constructed and arranged to be positioned relative to the first hole formed in the body portion and define a location for the second hole in the body portion.

14. The apparatus of claim 13, wherein the guide apparatus is constructed and arranged to guide movement of a bone perforator when forming the second hole.

15. The apparatus of claim 14, wherein the guide apparatus is positioned relative to the first hole by fixing the first guide member in the first hole, and the bone perforator is movable within the longitudinal passage of the second guide member to form the second hole.

16. The apparatus of claim 1, further comprising a suture retriever arranged to retrieve, from the longitudinal passage of the second guide member, a suture fed into the longitudinal passage of the first guide member.

17. The apparatus of claim 1, wherein the arthroscopic passage is formed by an arthroscopic cannula.

18. The apparatus of claim 1, wherein the guide apparatus is arranged so that with the first and second guide members fixed relative to the first and second holes and at the known position relative to each other, a suture is positionable in the longitudinal passage of the first guide member and is retrievable via the longitudinal passage of the second guide member.

19. The apparatus of claim 1, wherein when in the known position relative to each other, the distal ends of the first and second guide members are immediately adjacent each other.

20. The apparatus of claim 1, further comprising a reference structure to which the first and second guide members may be attached, wherein the first and second guide members and the reference structure are arranged so that with the first and second guide members respectively positioned in an arthroscopic cannula and in communication with the first and second holes, respectively, the reference structure is positioned outside of a body cavity.