SYSTEM FOR PROVIDING SURGICAL ACCESS

• US 20150119934A1
• Filed: 10/29/2014
• Published: 04/30/2015
• Est. Priority Date: 10/29/2013
• Status: Active Grant

• Current Assignee: Entourage Medical Technologies, Inc.
• Original Assignee: Entourage Medical Technologies, Inc.
• Inventors: Diaz, Stephen H., Shluzas, Alan E.
• Granted Patent: US 9,883,857 B2
• Time in Patent Office: Days
• US Class Current: 606/228
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• 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 2017/00862 elastic or resilient
• CPC Class Codes: A61B 2017/00871 polymeric
• CPC Class Codes: A61B 2017/00884 enhancing wound closure
• CPC Class Codes: A61B 2017/0403 Dowels
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0408 Rivets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0495 : Reinforcements for suture lines
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06076 : helically or spirally coiled
• CPC Class Codes: A61B 2017/06171 : helically or spirally coiled
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure

Abstract

One embodiment is directed to a system for closing a wound created across a portion of a tissue structure, comprising a suture member having proximal and distal ends; an anchor member coupled to the distal end of the suture member; a tension retainer assembly releasably coupleable to the suture member; and a suture buttress movably intercoupled to the suture member between the anchor member and the tension retainer and configured to minimize direct sliding contact between the suture member and the tissue structure portion around the location of the suture buttress.

Claims

1. A system for closing a wound created across a portion of a tissue structure, comprising:

a. a suture member having proximal and distal ends;

b. an anchor member coupled to the distal end of the suture member;

c. a tension retainer assembly releasably coupleable to the suture member; and

d. a suture buttress movably intercoupled to the suture member between the anchor member and the tension retainer and configured to minimize direct sliding contact between the suture member and the tissue structure portion around the location of the suture buttress.

2. The system of claim 1, wherein the suture member comprises a monofilament structure.

3. The system of claim 1, wherein the suture member comprises a braided structure.

4. The system of claim 1, wherein the suture member has an overall outer cross sectional diameter of between about 0.005 inches and about 0.015 inches.

5. The system of claim 1, wherein the anchor member has at least one shape feature that is configured to slide past nearby tissue structures during inward insertion loading associated with rotation of the first helical member in the first direction, and to resist movement relative to the nearby tissue structures upon application of outward extraction loading associated with rotation of the first helical member in the second direction.

6. The system of claim 1, wherein at least a portion of the anchor member is configured to rotate relative to wall of the tissue structure upon application of a tensioning load to the suture member.

7. The system of claim 5, wherein the anchor member comprises a main body portion comprising a solid or tubular construct.

8. The system of claim 7, wherein the shape feature configured to slide past nearby tissue structures during inward insertion loading comprises a tapered distal tip.

9. The system of claim 7, wherein the shape feature configured to resist movement relative to the nearby tissue structures upon application of outward extraction loading comprises a projecting portion configured to extend to a projecting position beyond an outer diameter of the rest of the anchor member when tension is applied to the intercoupled suture member.

10. The system of claim 9, wherein the projecting portion comprises a portion of the anchor member that has been deformed out into the projecting position.

11. The system of claim 9, wherein the projecting portion comprises a piece of material that has been coupled to the anchor member to assume the projecting position.

12. The system of claim 9, further comprising two or more projecting portions.

13. The system of claim 9, wherein the projecting portion comprises a superelastic alloy that is shape set to the projecting position and configured to be deliverable in an elastically compressed form within a superelastic thermal range for the alloy.

14. The system of claim 1, wherein the suture buttress defines a lumen therethrough which is configured to accommodate passage of at least a portion of the suture member.

15. The system of claim 14, wherein the suture buttress is substantially tubular.

16. The system of claim 1, wherein the suture buttress comprises a braided construct formed from individual yarn structures.

17. The system of claim 16, wherein the braided construct is configured to be axially compressible to have an axially compressed length to axially uncompressed length ratio that is between about 10:

1 and about 2;

1.

18. The system of claim 17, wherein the braided construct is configured to be axially compressible to have an axially compressed length to axially uncompressed length ratio that is about 6:

1.

19. The system of claim 16, wherein the braided construct is configured to increase in overall outer cross sectional diameter with axial compression.

20. The system of claim 1, wherein the suture buttress comprises a polymeric material selected from the group consisting of:

polyester, polypropylene, polyglycolic acid, and poly lactic acid.

21. The system of claim 1, wherein the suture buttress comprises a flexible metal selected from the group consisting of:

titanium, stainless steel, and Nitinol superalloy.

22. The system of claim 16, wherein the braided construct is tubular and has an outer diameter of about 0.050 inch and an inner diameter of about 0.030 inch.

23. The system of claim 1, wherein the suture buttress is configured for be formed into a helical shape.

24. The system of claim 23, wherein the helical shape has an outer helical diameter of about 21 mm with a helical pitch of about 3.5 mm.

25. The system of claim 24, wherein the suture buttress is configured to be formed into between about 1 and about 2 full helical turns.

26. The system of claim 25, wherein the suture buttress is configured such that tensioning the suture member causes the helical shaped suture buttress to reduce in helical diameter, closing the wound across the tissue structure.

27. The system of claim 26, wherein the suture buttress is configured such that once maximum axial compression of the suture buttress is reached, further tensioning of the suture member does not reduce the helical diameter, shielding the tissue structure from cut-through by the suture buttress.