STITCH LOCK FOR ATTACHING TWO OR MORE STRUCTURES

• US 20120150223A1
• Filed: 10/27/2011
• Published: 06/14/2012
• Est. Priority Date: 04/27/2010
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Manos, Jamie, Henrichsen, Kevin, Miller, William, Vennard, Daniel
• Granted Patent: US 9,743,919 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• 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 17/0483 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 17/0487 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 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning 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
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/0619 : thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it
• CPC Class Codes: A61B 2017/2917 : with flexible part
• CPC Class Codes: A61B 2017/292 : connection of actuating rod to handle, e.g. ball end in recess

Abstract

An anchor assembly can include at least one anchor member, such as a pair of anchor members that are configured to be implanted in a target anatomical location in a first configuration, and can subsequently be actuated to an expanded configuration that secures the anchor members in the target anatomy. The anchor assembly can further include a connector member configured as a stitch lock that attaches the pair of anchor members together across a gap so as to approximate the anatomical defect.

Claims

1. A stitch lock assembly:

a first segment of a strand of suture; and

a second segment of a strand of suture that is elongate along a central axis so as to define a length, the first segment woven at least into the second segment along a portion of the length of the second segment so as to define a stitch lock having at least two woven segments of the first segment that are woven at least into the second segment, each of the woven segments defined at least by an entry location whereby the first segment enters the second segment,

wherein the woven segments are configured to translate through the second segment strand when the second segment is in tension at a first level of tension that is less than a threshold level of tension, and the second segment applies a compressive force to the first strand when the second segment is in tension at a second level of tension that is at least substantially equal the threshold level of tension so as to prevent the first segment from translating through the second segment.

2. The stitch lock assembly as recited in claim 1, wherein at least one of the woven segments enters the second segment at a respective one of the entry locations and extends through the second segment so as to exit from the second segment at an exit location.

3. The stitch lock assembly as recited in claim 1, wherein the first segment is elongate along a central axis, and the central axis defines an angle with respect to the second axis at least at one of the entry locations, the angle between and including approximately 0 degrees and approximately 180 degrees.

4. The stitch lock assembly as recited in claim 1, wherein adjacent woven segments extend at least into the second segment at locations spaced apart a distance including approximately 0 mm and approximately 3 mm.

5. The stitch lock assembly as recited in claim 2, wherein the first and second segments are separate from each other.

6. The stitch lock assembly as recited in claim 5, wherein each of the first and second segments defines a respective first end and a respective second end, such that the woven segments are disposed between the first and second ends of the first segment, and the woven segments are disposed between the first and second ends of the second segment.

7. The stitch lock assembly as recited in claim 6, wherein the second ends of the first and second segments are attached to respective first and second structures, such that when the second segment is in tension at the first level of tension, the first segment is translatable through the second strand so as to bias the first and second structures toward each other.

8. The stitch lock assembly as recited in claim 7, wherein at least one of the structures comprises an anchor configured to be implanted at a target anatomical location.

9. The stitch lock assembly as recited in claim 8, wherein the anchor includes an anchor body and an actuation member that is configured to receive an actuation force that causes the anchor body to expand.

10. The stitch lock assembly as recited in claim 9, wherein the actuation member is integral with the anchor body and defines one of the first and second strands.

11. The stitch lock assembly as recited in claim 9, wherein the actuation member is separate from the anchor body and defines one of the first and second strands.

12. The stitch lock assembly as recited in claim 11, wherein the anchor body includes an eyelet, and the actuation member is inserted through the eyelet.

13. The stitch lock assembly as recited in claim 9, wherein the anchor is a first anchor, the anchor body is a first anchor body, and the actuation member is a first actuation member, the stitch lock assembly further comprising:

a second anchor including a second anchor body and a second actuation member configured to receive an actuation force that causes the second anchor body to expand.

14. The stitch lock assembly as recited in claim 13, wherein the first actuation member defines the first and second segments.

15. The stitch lock assembly as recited in claim 13, wherein the stitch lock is a first stitch lock, the stitch lock assembly further comprising a second stitch lock that includes a respective first segment and a respective second segment, wherein the respective first segment is woven at least into the respective second segment, the first segment of the second stitch lock is defined by the second actuation strand, and the second segment of the second stitch lock is defined by the second actuation strand.

16. The stitch lock assembly as recited in claim 15, further comprising a loop that is disposed between the first and second stitch locks, wherein the loop is configured to decrease in size as the first segment of at least one of the first and second stitch locks is translated through the associated second segment.

17. The stitch lock assembly as recited in claim 13, wherein the first and second segments of at least one of the first and second stitch locks are separate from and attached to the first and second actuation strands, and are attached to the first and second actuation strands.

18. The stitch lock assembly as recited in claim 13, wherein one of the first and second anchors includes an eyelet, and the separate first and second segments are attached to the eyelet.

19. The stitch lock assembly as recited in claim 15, wherein the first and second stitch locks define a first pair of stitch locks, the stitch lock assembly further comprising a second pair of the first and second stitch locks.

20. The stitch lock assembly as recited in claim 19, comprising a first loop disposed between the first and second pairs of stitch locks, a second loop disposed between the first and second stitch locks of the first pair of stitch locks, ad a third loop disposed between the first and second stitch locks of the second pair of stitch locks.

21. The stitch lock assembly as recited in claim 19, wherein the first, second, and third loops are configured to decrease in size when the first segments of each of the stitch locks of the first and second pairs of stitch locks are translated through the associated second segment.

22. The stitch lock assembly as recited in claim 2, wherein the first and second segments are integral with each other so as to define a common strand.

23. The stitch lock assembly as recited in claim 22, wherein the common strand defines a loop that is closed by the stitch lock, and the loop is configured to decrease in size as the first segment translates through the second segment.

24. The stitch lock assembly as recited in claim 23, wherein the loop is slidably attached to at least one structure.

25. The stitch lock assembly as recited in claim 23, wherein the at least one structure comprises an anchor body having an eyelet, and the loop is inserted through the eyelet.

26. The stitch lock assembly as recited in claim 25, wherein the at least one structure is a first structure, the stitch lock assembly further comprising a second structure, wherein as the loop decreases in size, the first structure is biased toward the second structure.

27. The stitch lock assembly as recited in claim 23, wherein the stitch lock is a first stitch lock, the stitch lock assembly further comprising a second stitch lock that includes a respective first segment and a respective second segment, wherein the respective first segment is woven at least into the respective second segment.

28. The stitch lock assembly as recited in claim 27, wherein the loop is a first loop, the common strand defines a second loop that is closed by the second stitch lock, and the second loop is configured to decrease in size as the first segment translates through the second segment.

29. The stitch lock assembly as recited in claim 28, wherein the common strand comprises a first end that defines the first loop, a second end that defines the second loop, and a bridge segment that is connected between the first and second loops.

30. The stitch lock assembly as recited in claim 28, wherein each of the first and second loops is attached to a corresponding first and second structure, and the first and second structures are biased toward each other as the first and second loops decrease in size.

31. The stitch lock assembly as recited in claim 22, wherein the common strand is configured to attach to first and second structures that are configured to be biased toward each other as the first segment translates through the second segment.

32. The stitch lock assembly as recited in claim 31, wherein the first structure comprises a first anchor including a first anchor body and a first actuation member that is configured to receive a first actuation force that causes the first anchor body to expand, and the second structure comprises a second anchor including a second anchor body and a second actuation member that is configured to receive a second actuation force that causes the second anchor body to expand.

33. The stitch lock assembly as recited in claim 32, wherein the common strand defines a loop that is closed by the stitch lock, and the loop is attached to at least one of the first and second anchor bodies, such that the first and second anchor bodies are biased toward each other as the loop decreases in size in response to translation of the first segment through the second segment.

34. The stitch lock assembly as recited in claim 33, wherein the loop is attached to an eyelet of the at least one anchor body.

35. The stitch lock assembly as recited in claim 33, wherein the loop is woven through the at least one anchor body.

36. The stitch lock assembly as recited in claim 35, wherein the stitch lock is a first stitch lock, and the common strand further defines a second stitch lock that includes a first segment and a second segment, wherein the first segment of the second stitch lock is woven at least into the second segment of the second stitch lock.

37. The stitch lock assembly as recited in claim 36, wherein the common strand defines a first loop that is closed by the first stitch lock and a second loop that is closed by the second stitch lock, and the second loop is attached to the second anchor body.

38. The stitch lock assembly as recited in claim 32, wherein the common strand is integral with one of the first and second anchor bodies, and separate from and attached to the other of the first and second anchor bodies.

39. The stitch lock assembly as recited in claim 1, further comprising a tension relief instrument configured to compress the second segment so as to reduce the tension in the second segment to a level less than the threshold tension level.

40. A method for biasing first and second structures to each other, the method comprising the steps of:

weaving a first segment of a strand of suture at least into a second segment of a strand of suture a portion so as to define at least two woven segments of the first segment that are woven at least into the second segment, each of the woven segments defined at least by an entry location whereby the first segment enters the second segment,

attaching the first strand to a first structure;

attaching the second strand to a second structure;

translating the first strand through the second strand so as to bias at least one of the first and second structures toward the other of the first and second structures until a tension in the second strand reaches a level that is substantially equal to a threshold tension level;

applying a compressive force from the second segment to the first segment so as to prevent the first segment from translating through the second segment once the tension in the second strand has reached the level that is substantially equal to the threshold tension level.