MENISCAL REPAIR SYSTEMS AND METHODS

• US 20100106169A1
• Filed: 10/21/2009
• Published: 04/29/2010
• Est. Priority Date: 10/21/2008
• Status: Active Grant

• Current Assignee: Cayenne Medical Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Cayenne Medical Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Domingo, Nicanor A., Niese, Brad A., Nguyen, Hoang P., Baird, Kevin N.
• Granted Patent: US 8,177,795 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/0493 Protective devices for suturing, i.e. for protecting the patient's organs or the operator
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• 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 2017/06095 pliable
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Abstract

A device for repairing a tear in a portion of tissue comprises a proximal actuator portion, a transfer needle extending distally from the proximal actuator portion and a catch needle extending distally from the proximal actuator portion. A suture needle is disposed in the transfer needle, and is extendable from the transfer needle toward the catch needle and retractable from the catch needle toward the transfer needle. An extendable catch plunger is disposed in the catch needle for capturing suture therein when it is transferred from the transfer needle. A retractable insertion sheath is provided for covering the transfer needle and the catch needle when the device is inserted into a procedural site. A depth limiting apparatus limits the depth of insertion of the needle into the procedural site.

Claims

1. A device for repairing a tear in a portion of tissue, comprising:

a proximal actuator portion;

a transfer needle extending distally from the proximal actuator portion and having a distal tip for piercing tissue;

a catch needle extending distally from the proximal actuator portion and having a distal tip for piercing tissue;

a suture needle disposed in said transfer needle, said suture needle being extendable from said transfer needle toward said catch needle and retractable from said catch needle toward said transfer needle;

an extendable catch plunger disposed in said catch needle for capturing suture therein when it is transferred from said transfer needle; and

a retractable insertion sheath for covering the transfer needle and the catch needle when the device is inserted into a procedural site;

wherein said proximal actuator portion comprises an insertion sheath actuator for retracting said insertion sheath, a suture needle advancement actuator for advancing said suture needle, and a catch plunger release mechanism for releasing said catch plunger for travel distally, said suture needle advancement actuator having a position which also actuates said catch plunger release mechanism.

2. The device as recited in claim 1, wherein said transfer needle comprises a window disposed laterally thereon, through which said suture needle is extended or retracted.

3. The device as recited in claim 1, wherein said catch needle comprises a window disposed laterally thereon, through which said suture needle is extended or retracted.

4. The device as recited in claim 3, and further comprising a second window disposed on said catch needle on a side opposed to the side on which the first window is disposed, through which a distal end of the suture needle extends when the suture needle is fully extended into the catch needle.

5. The device as recited in claim 1, wherein the suture needle is sufficiently flexible that it attains a straightened configuration when housed within the transfer needle, and acquires a bend which assists in directing it toward the catch needle when the distal end of the suture needle extends out of the transfer needle.

6. The device as recited in claim 1, and further comprising a depth limiting apparatus for limiting the depth of insertion of said needles into the procedural site.

7. The device as recited in claim 6, wherein said depth limiting apparatus comprises a depth gauge disposed on said proximal actuator portion.

8. The device as recited in claim 7, wherein said insertion sheath actuator comprises a button which slides axially along a slot in said proximal actuator portion, said depth gauge comprising graduated markings disposed along said slot, so that a practitioner can retract said sheath by sliding the insertion sheath actuator button a predetermined distance along said slot to control the depth of insertion of said device.

9. The device as recited in claim 1, wherein said depth limiting apparatus comprises a force feedback unit disposed on a distal end of said device.

10. The device as recited in claim 9, wherein said force feedback unit comprises a compression force element disposed on a distal end of one of said needles.

11. The device as recited in claim 10, wherein said one of said needles is a shorter one of said needles.

12. The device as recited in claim 11, wherein said one of said needles is said transfer needle.

13. The device as recited in claim 10, wherein said compression force element comprises a plunger.

14. The device as recited in claim 9, wherein said depth limiting apparatus further comprises a depth limiter which is movable distally along said device, responsive to a reduction of force on said force feedback unit.

15. The device as recited in claim 1, wherein said transfer needle and said catch needle are each curved along their respective lengths.

16. A device for repairing a tear in a portion of tissue, comprising:

a proximal actuator portion;

a needle for dispensing suture into the tissue to be repaired;

a retractable insertion sheath for covering the needle when the device is inserted into a procedural site; and

a depth limiting apparatus for limiting the depth of insertion of said needle into the procedural site;

wherein said proximal actuator portion comprises an insertion sheath actuator for retracting said insertion sheath.

17. The device as recited in claim 16, wherein said depth limiting apparatus comprises a depth gauge disposed on said proximal actuator portion.

18. The device as recited in claim 17, wherein said insertion sheath actuator comprises a button which slides axially along a slot in said proximal actuator portion, said depth gauge comprising graduated markings disposed along said slot, so that a practitioner can retract said sheath by sliding the insertion sheath actuator button a predetermined distance along said slot to control the depth of insertion of said device.

19. The device as recited in claim 16, wherein said depth limiting apparatus comprises a force feedback unit disposed on a distal end of said device.

20. The device as recited in claim 19, wherein said force feedback unit comprises a compression force element disposed on a distal end of said needle.

21. The device as recited in claim 20, wherein said compression force element comprises a plunger.

22. The device as recited in claim 19, wherein said depth limiting apparatus further comprises a depth limiter which is movable distally along said device, responsive to a reduction of force on said force feedback unit.

23. A method for repairing a tear in a portion of tissue, said method comprising:

inserting a device comprising a proximal actuator portion and a distal needle portion into a procedural site;

retracting a sheath covering said needle proximally to expose the distal end of the needle;

advancing the needle into the tissue to be repaired, so that a distal end of the needle is disposed beyond the tear, until a depth limiting structure prevents further advancement of the needle;

creating a suture loop in said tissue to repair the tear;

withdrawing the needle proximally from the procedural site; and

using a pre-tied knot to cinch the suture loop and thereby repair the tear.

24. The method as recited in claim 23, wherein the advancing step comprises advancing a pair of needles into the tissue to be repaired, and the suture loop creating step is performed by dispensing suture from one of the needles into a second of the needles, and then releasing a catch plunger to move distally and clamp the suture to retain it in the second needle.

25. The method as recited in claim 23, wherein the depth limiting structure comprises a distal end of the sheath, and the sheath retracting step includes a step of determining a distance through which the sheath is retracted by consulting a depth gauge disposed on the proximal actuator portion.

26. The method as recited in claim 23, wherein the depth limiting structure comprises a depth limiter which is movable distally along the device toward the tissue to be repaired responsive to a release of force on a force feedback unit disposed on a distal end of the needle.