SUTURE BASED TISSUE REPAIR

• US 20110077667A1
• Filed: 06/08/2009
• Published: 03/31/2011
• Est. Priority Date: 06/06/2008
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Synthes USA LLC (Johnson & Johnson)
• Inventors: Schmidt, Brian, Singhatat, Wamis, Reichen, Mark, Talbot, James, Keane, Michael
• Granted Patent: US 10,022,122 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/0466 Suture bridges
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/081 Tissue approximator A61B2017/1103, A61B17/8866 take precedence

Abstract

The present invention provides an apparatus for suture-based tissue repair, preferably for the annulus of a spinal disc, that includes a suture loop preferably pre-tied with a sliding knot, a clasp-type component that captures the ends of the suture loop, and an optional plug member that fills the tissue defect. Also disclosed is a method that places the suture loop in a full-thickness stitch encircling the tissue defect, secures the ends of the suture loop to the clasp, and cinches the suture loop to approximate the tissue without the need to tie knots. Also disclosed is a suture passer that enables a suture strand or loop to be passed through the tissue wall, captured, and retrieved. The suture passer may optionally incorporate a clasp in such an arrangement that enables a suture loop passed through the tissue wall to be captured directly by the clasp.

Claims

1. A system for bodily tissue repair comprising:

a strand of suture having at least one loop and at least one knot;

a clasp device for securing the at least one loop of suture and having at least one at least partially closed eyelet.

2. The system of claim 1 wherein the eyelet comprises a closed ring.

3. The system of claim 1 wherein the eyelet is C-shaped, U-shaped, S-shaped, O-shaped, coil shaped, or other shape having an opening to permit a suture to pass into the eyelet.

4. The system of claim 1 further comprising a suture passer and retriever instrument further including a needle having a receptacle for receiving the suture.

17. The system of claim 1, wherein the clasp device and suture strand are configured and sized for repairing a defect in the annulus of a spinal disc.

5. A system for repairing a defect in the soft tissue comprising:

a strand of suture having at least one loop having two ends and a sliding, locking, or ratcheting knot;

a clasp device having an at least partially closed eyelet for securing the two ends of the loop, wherein the suture and clasp device are configured in combination to surround the tissue defect and at least partially approximate the defect with the two ends of the loop extending in opposite directions of the clasp device.

6. The system of claim 5 wherein the suture and clasp device are in series in forming a loop surrounding the tissue defect.

7. The system of claim 5 further comprising a needle for releasably attaching to the suture and for passing the suture through the soft tissue.

8. The system of claim 7 further comprising a suture passer and retriever instrument, the suture passer and retriever instrument configured to cooperate with the needle.

9. The system of claim 8 wherein the suture passer and retriever instrument further comprises a boom arm for capturing the suture.

10. The system of claim 9 wherein the suture passer and retriever instrument is releasably coupleable to the clasp device.

11. The system of claim 5 further comprising a plug member for filling and sealing the tissue defect.

12. The system of claim 5 further comprising a plurality of barbs, one barb connected to each of the ends of the suture loop, and wherein the clasp device has a plurality of eyelets, each eyelet connectable to the barbs, wherein the eyelet is expandable and at least a portion of the barb is configured to pass through the eyelet.

13. The system of claim 8 wherein the suture passer and retriever instrument comprises a wire loop for capturing the suture.

14. The system of claim 5 wherein the clasp device includes a two piece clip, the first piece connectable to a first end of the suture loop, a second piece of the clip connectable to a second end of the suture loop and the first piece coupleable to the second piece.

15. The system of claim 8 wherein the clasp device has two hooks having open slots to receive the suture, the hooks being resiliently flexible to collapse to a smaller size and expand to a larger size.

16. The system of claim 8 wherein the suture passer and retriever instrument further comprises two needles, each needle connectable to an end of the suture and being independently moveable, the clasp device releasably connectable to the suture passer and retriever instrument, the clasp device having an opening for receiving the suture.

18. A method of repairing a defect in an annulus of a spinal disc comprising:

providing a suture having at least one loop and a sliding, locking, or ratcheting knot;

providing a clasp device for capturing the ends of the suture loop;

providing a passing device for attaching to the at least one suture loop, the passing device for passing the suture through a wall of the annulus;

attaching a first end of the suture loop to the passing device;

inserting the passing device with the first suture end through the disc annulus wall;

inserting second end of the suture loop through the disc annulus wall;

connecting the first end and second end of the suture loop to the clasp device while the suture loop ends and clasp device are outside the spinal disc;

inserting the clasp device through the annulus defect so that the suture loop and clasp device form a continuous loop around the annulus defect; and

tightening the suture to tension the suture loop to at least partially close the defect, wherein the clasp device and suture loop are in series with each other and both the suture and clasp device approximate and draw the defect closed.

19. The method of claim 18 wherein the passing device comprises a needle and further comprising releasably attaching the needle to the suture loop.

20. The method of claim 18 wherein the passing device is coupled to the clasp device, and further comprising releasing the clasp device from the passing device.

21. The method of claim 18 further comprising:

inserting the first end of the suture loop through the annulus wall from the outside to the inside of the disc;

retrieving the first end of the suture loop through the defect in the annulus so that the first end of the suture loop is outside the disc space;

inserting the second end of the suture loop from the outside to the inside of the disc;

retrieving the second end of the suture loop through the defect in the annulus so that the second end of the suture loop is outside the disc space.

22. The method of claim 21 wherein the clasp device comprises a multi-piece connectable clip, further comprising

connecting a first piece of the multi-piece clip to a second piece of the multi-piece clip.

23. The method of claim 22 further comprising:

connecting a first end of the suture loop to the first piece of the multi-piece clip; and

connecting a second end of the suture loop to the second piece of the multi-piece clip.

24. The method of claim 23 wherein the suture loop is connected to at least one of the first and second pieces of the multi-piece clip before the first or second end of the suture loop is inserted through the disc annulus wall.