DOUBLE ROW FIXATION SYSTEM, MEDIAL ROW ANCHOR PLACEMENT SYSTEM

• US 20090138002A1
• Filed: 06/25/2008
• Published: 05/28/2009
• Est. Priority Date: 06/25/2007
• Status: Active Grant

• Current Assignee: Tornier Incorporated
• Original Assignee: Axya Medical, Inc. (Tornier Incorporated)
• Inventors: Fenton, Paul
• Granted Patent: US 8,292,902 B2
• Time in Patent Office: Days
• US Class Current: 606/28
• 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 17/0483 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 17/282 Jaws
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0619 thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it

Abstract

An instrument is disclosed including: a top jaw member extending between a proximal end and a distal end and including a first top anchor target slot and a second top anchor target slot; a bottom jaw member extending between a proximal end and a distal end and including a first bottom anchor target slot and a second bottom anchor target slot; and a joint member connected to the proximal ends of the top jaw member and the bottom jaw member.

Claims

1. An instrument comprising:

a top jaw member extending between a proximal end and a distal end and comprising a first top anchor target slot and a second top anchor target slot;

a bottom jaw member extending between a proximal end and a distal end and comprising a first bottom anchor target slot and a second bottom anchor target slot; and

a joint member connected to the proximal ends of the top jaw member and the bottom jaw member;

wherein the top and bottom jaw members, in an open position, define an area for receiving a portion of tissue, and the joint member articulates the jaw members from the open position to a tissue engaging position wherein the top and bottom jaw members grasp the portion of tissue;

wherein, when the jaw members are in the tissue engaging position, the first top anchor slot and first bottom anchor slot are adapted to receive a first anchor extending into the first top anchor slot, through the portion of tissue, and out of the first bottom anchor slot; and

wherein, when the jaw members are in the tissue engaging position, the second top anchor slot and second bottom anchor slot are adapted to receive a second anchor extending into the second top anchor slot, through the portion of tissue, and out of the second bottom anchor slot.

2. The instrument of claim 1, wherein the top jaw member and bottom jaw member each comprise a paddle extending along a longitudinal axis between the proximal end of the jaw member and the distal end of the jaw member, said paddle further extending along a transverse axis, transverse to said longitudinal axis, extending between a first side and a second side of the paddle.

3. The instrument of claim 2, wherein the first top anchor slot comprises an aperture formed in the first side of the top jaw member paddle;

the second top anchor slot comprises an aperture formed in the second side of the top jaw member paddle;

the first bottom anchor slot comprises an aperture formed in the first side of the bottom jaw member paddle; and

the second bottom anchor slot comprises an aperture formed in the second side of the bottom jaw member paddle.

4. The instrument of claim 3, wherein the first top anchor slot and second top anchor slot are positioned at points substantially equidistant from the proximal end of the top jaw member;

and

the first bottom anchor slot and second bottom anchor slot are positioned at points substantially equidistant from the proximal end of the bottom jaw member.

5. The instrument of claim 4, wherein, when the jaw members are in the tissue engaging position;

the first top anchor slot is substantially aligned with the first bottom anchor slot along an axis substantially orthogonal to the transverse and longitudinal axes of the top and bottom jaw member paddles; and

the second top anchor slot is substantially aligned with the second bottom anchor slot along an axis substantially orthogonal to the transverse and longitudinal axes of the top and bottom jaw member paddles.

6. The instrument of claim 1, wherein the tissue engaging position consists of the open position.

7. An endoscopic assembly including the instrument of claim 1, and further comprising:

a handle;

a controller mounted on the handle;

a stem operatively connecting the controller to the instrument to selectively articulate the jaw members.

8. The endoscopic assembly of claim 7, further comprising a surgical cannula surrounding at leas a portion of the stem or the instrument.

9. A surgical kit comprising:

a first and a second suture anchor each comprising

a rigid punch tip portion having a first end adapted to penetrate through tissue and into bone and second end;

a suture portion extending from the second end of the punch tip portion; and

a grasper comprising;

a top jaw member extending between a proximal end and a distal end and comprising a first top anchor target slot and a second top anchor target slot;

a bottom jaw member extending between a proximal end and a distal end and comprising a first bottom anchor target slot and a second bottom anchor target slot;

a joint member connected to the proximal ends of the top jaw member and the bottom jaw member;

wherein the top and bottom jaw members, in an open position, define an area for receiving a portion of tissue, and the joint member articulates the jaw members from the open position to a tissue engaging position wherein the top and bottom jaw members grasp the portion of tissue;

wherein, when the jaw members are in the tissue engaging position, the first top anchor slot and first bottom anchor slot are adapted to receive a first anchor extending into the first top anchor slot, through the portion of tissue, and out of the first bottom anchor slot; and

wherein, when the jaw members are in the tissue engaging position, the second top anchor slot and second bottom anchor slot are adapted to receive a second anchor extending into the second top anchor slot, through the portion of tissue, and out of the second bottom anchor slot.

10. The kit of claim 9, wherein

the first top anchor slot comprises an aperture formed in the first side of the top jaw member paddle;

the second top anchor slot comprises an aperture formed in the second side of the top jaw member paddle;

the first bottom anchor slot comprises an aperture formed in the first side of the bottom jaw member paddle; and

the second bottom anchor slot comprises an aperture formed in the second side of the bottom jaw member paddle.

11. The kit of claim 10, wherein

the first top anchor slot and second top anchor slot are positioned at points substantially equidistant from the proximal end of the top jaw member;

and

the first bottom anchor slot and second bottom anchor slot are positioned points substantially equidistant from the proximal end of the bottom jaw member.

12. The kit of claim 11, wherein, when the jaw members are in the tissue engaging position:

the first top anchor slot is substantially aligned with the first bottom anchor slot along an axis substantially orthogonal to the transverse and longitudinal axes of the top and bottom jaw member paddles; and

the second top anchor slot is substantially aligned with the second bottom anchor slot along an axis substantially orthogonal to the transverse and longitudinal axes of the top and bottom jaw member paddles.

13. The surgical kit of claim 9, further comprising:

an anchor driver configured to engage the second end of the punch tip portion of at least one of the first and second anchors and drive said punch tip through tissue grasped by the grasper and into a portion bone located adjacent the bottom jaw member.

14. The surgical kit of claim 13, wherein the punch tip portion of each of the suture anchors comprises a threaded tip, and the anchor driver is adapted to rotate and drive the at least one of the first and second anchors to bore into the portion of bone.

15. The surgical kit of claim 13 further comprising a suture welder comprising:

a suture holding element adapted to receive the suture portions of the first and second suture anchors and place said suture portions in proximity to each other; and

a welding element adapted to apply energy to areas of the suture portions to at least partially fuse the suture portions to each other.

16. The surgical kit of claim 15, wherein the welding element comprises a heater adapted to heat the suture portions.

17. The surgical kit of claim 15, wherein the welding element comprises an ultrasound unit adapted to apply ultrasound energy to the areas of the suture portions to at least partially fuse the suture portions to each other.

18. The surgical kit of claim 12, wherein the suture welder further comprises a tensioner adapted to apply tension to the suture portions.

19. A surgical method for securing a portion of tissue to an adjacent portion of bone comprising:

providing a first and a second suture anchor each comprising;

a rigid punch tip portion having a first end adapted to penetrate through tissue and into bone and second end;

a suture portion extending from the second end of the punch tip portion; and

providing a grasper comprising;

a top jaw member extending between a proximal end and a distal end and comprising a first top anchor target slot and a second top anchor target slot;

a bottom jaw member extending between a proximal end and a distal end and comprising a first bottom anchor target slot and a second top anchor target slot;

a joint member connected to the proximal ends of the top jaw member and the bottom jaw member;

wherein the top and bottom jaw members, in an open position, define an area for receiving a portion of tissue, and the joint member articulates the jaw members from the open position to a tissue engaging position wherein the top and bottom jaw members grasp the portion of tissue;

wherein, when the jaw members are in the tissue engaging position, the first top anchor slot and first bottom anchor slot are adapted to receive a first anchor extending into the first top anchor slot, through the portion of tissue, and out of the first bottom anchor slot; and

wherein, when the jaw members are in the tissue engaging position, the second top anchor slot and second bottom anchor slot are adapted to receive a second anchor extending into the second top anchor slot, through the portion of tissue, and out of the second bottom anchor slot;

grasping the portion of tissue between the top and bottom jaw elements such that the bottom jaw element is adjacent the bone;

positioning first and second anchors proximal the first and second top anchor slots, respectively driving the punch tip portions of first and second anchors, respectively, through the first and second top anchor slot, through the tissue, through the first and second bottom anchor slots, and into the bone;

removing the grasper; and

attaching the suture portions of the first and second anchors to each other to secure the tissue to the bone.

20. The method of claim 19, wherein attaching the suture portions of the first and second anchors to each other comprises:

placing the suture portions in proximity to each other; and

applying energy to the suture portions to at least partially fuse the suture portions to each other.

21. The method of claim 20, wherein attaching the suture portions of the first and second anchors to each other comprises tensioning the suture portions to secure the tissue to the bone.

22. The method of claim 20, wherein the energy comprises thermal energy.

23. The method of claim 20, wherein the energy comprises heat energy.

24. The method of claim 19, wherein the tissue comprises a portion of a rotator cuff.

25. The method of claim 24, wherein the bone comprises a portion of a humerous skeletal bone head.