Apparatus and method for repairing or reattaching soft tissue
First Claim
1. Apparatus for use in installing an implant in soft tissue, comprisinga guide structure insertable through a body portal and into proximity with the soft tissue, the guide structure being configured to guide a length of the implant through the soft tissue and to bring legs of the length of implant into proximity with each other, the guide structure being further configured to be withdrawn toward the body portal in a manner which (a) causes the guide structure to become disengaged from the length of implant, and (b) leaves the length of implant extending through the soft tissue and the legs of the length of implant in proximity with each other, wherein the guide structure includes (a) a pair of guide portions supported in spaced apart relation to each other and defining a gap which enables soft tissue to be disposed between the guide portions, (b) a tissue piercing device moveable in the gap between the guide portions and configured to pierce soft tissue disposed in the gap between the guide portions, and (c) an introducer tube configured to receive and guide the length of implant, the introducer tube being moveable in opposite directions in the gap between the guide portions, the introducer tube being moveable in one direction to form a passageway in the gap for guiding the length of implant through soft tissue in the gap and in an opposite direction for reestablishing the gap between the guide portions, the guide portions being configured to guide the legs of the length of implant into proximity with each other, and the re-established gap between the guide portions enabling legs of the length of implant to pass therethrough as the guide structure is being withdrawn toward the body portal;
- and a force applying device including a drive wheel extending at least partially into the introducer tube, the drive wheel being rotatable about an axis and having an external surface configured for applying force to the length of implant disposed in the introducer tube to move the length of implant in the introducer tube.
1 Assignment
0 Petitions
Accused Products
Abstract
An apparatus and method for delivering or installing a surgical suture or suture-like implant into soft tissue, such as the meniscus of the knee, for example, for reattachment or repair of that tissue. The apparatus and method facilitate ease of placement of the suture or implant by the surgeon, protect surrounding tissue and nerves from damage during use, and permit suturing to occur through a single body portal. An injury to soft tissue, such as a tear in the meniscus of the knee joint or detachment of soft tissue from bone, is repaired through a single body portal by installing a surgical suture across the injury, tear, or detachment and passing that suture back through the body portal so that the suture can be joined and the injury, tear, or detachment can be reapproximated by the surgeon while working through the single body portal.
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Citations
38 Claims
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1. Apparatus for use in installing an implant in soft tissue, comprising
a guide structure insertable through a body portal and into proximity with the soft tissue, the guide structure being configured to guide a length of the implant through the soft tissue and to bring legs of the length of implant into proximity with each other, the guide structure being further configured to be withdrawn toward the body portal in a manner which (a) causes the guide structure to become disengaged from the length of implant, and (b) leaves the length of implant extending through the soft tissue and the legs of the length of implant in proximity with each other, wherein the guide structure includes (a) a pair of guide portions supported in spaced apart relation to each other and defining a gap which enables soft tissue to be disposed between the guide portions, (b) a tissue piercing device moveable in the gap between the guide portions and configured to pierce soft tissue disposed in the gap between the guide portions, and (c) an introducer tube configured to receive and guide the length of implant, the introducer tube being moveable in opposite directions in the gap between the guide portions, the introducer tube being moveable in one direction to form a passageway in the gap for guiding the length of implant through soft tissue in the gap and in an opposite direction for reestablishing the gap between the guide portions, the guide portions being configured to guide the legs of the length of implant into proximity with each other, and the re-established gap between the guide portions enabling legs of the length of implant to pass therethrough as the guide structure is being withdrawn toward the body portal; - and
a force applying device including a drive wheel extending at least partially into the introducer tube, the drive wheel being rotatable about an axis and having an external surface configured for applying force to the length of implant disposed in the introducer tube to move the length of implant in the introducer tube. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
providing a guide structure as set forth in claim 1, locating the guide structure in a selected orientation with respect to the soft tissue, operating the guide structure to guide a length of implant through the soft tissue, and withdrawing the guide structure from the soft tissue in a manner which maintains the implant in the soft tissue and disengages the guide structure from the length of implant with legs of the length of implant in proximity to each other. -
27. The method as defined in claim 26, further comprising
manipulating the guide structure into a selected orientation after the length of implant has been guided through the soft tissue, the selected orientation enabling friction between the length of implant and the soft tissue to cause the guide structure to disengage from the length of implant as the guide structure is withdrawn from the soft tissue. -
28. A method for installing an implant in soft tissue within an articular space, comprising
providing a guide structure as defined in claim 1, locating the guide structure in a first selected orientation relative to soft tissue in the articular space, operating the guide structure to guide a length of implant through the soft tissue in the articular space, and manipulating the guide structure into a second selected orientation after the length of implant has been guided through the soft tissue, the second selected orientation enabling friction between the length of implant and the soft tissue to cause the guide structure to disengage from the length of implant as the guide structure is withdrawn from the soft tissue. -
29. A method as defined in claim 28, wherein the articular space comprises a knee joint repair space and the soft tissue comprises a meniscus.
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30. Apparatus for use in installing an implant in soft tissue, comprising
a guide structure insertable through a body portal and into proximity with the soft tissue, the guide structure being configured to guide a length of the implant through the soft tissue and to bring legs of the length of implant into proximity with each other, the guide structure being further configured to be withdrawn toward the body portal in a manner which (a) causes the guide structure to become disengaged from the length of implant, and (b) leaves the length of implant extending through the soft tissue and the legs of the length of implant in proximity with each other, wherein the guide structure includes (a) a pair of guide portions supported in spaced apart relation to each other and defining a gap which enables soft tissue to be disposed between the guide portions, (b) a tissue piercing device moveable in the gap between the guide portions and configured to pierce soft tissue disposed in the gap between the guide portions, and (c) an introducer moveable in opposite directions in the gap between the guide portions, the introducer being moveable in one direction to form a passageway in the gap for guiding the length of implant through soft tissue in the gap and in an opposite direction for reestablishing the gap between the guide portions; - the guide portions being configured to guide the legs of the length of implant into proximity with each other, the pair of guide portions including a pair of guide tube sets, each of which includes a pair of adjacent guide tubes, the pair of guide tube sets configured to enable portions of the length of implant to be guided through soft tissue, and at least one pair of adjacent guide tubes being further configured to maintain legs of the portions of implant in adjacent spaced relation to each other as the portions of implant are guided through soft tissue; and
the re-established gap between the guide portions enabling legs of the length of implant to pass therethrough as the guide structure is being withdrawn toward the body portal. - View Dependent Claims (31)
- the guide portions being configured to guide the legs of the length of implant into proximity with each other, the pair of guide portions including a pair of guide tube sets, each of which includes a pair of adjacent guide tubes, the pair of guide tube sets configured to enable portions of the length of implant to be guided through soft tissue, and at least one pair of adjacent guide tubes being further configured to maintain legs of the portions of implant in adjacent spaced relation to each other as the portions of implant are guided through soft tissue; and
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32. Apparatus for use in installing an implant in soft tissue, comprising
a guide structure insertable through a body portal and into proximity with the soft tissue, the guide structure being configured to guide a length of the implant through the soft tissue and to bring legs of the length of implant into proximity with each other, the guide structure being further configured to be withdrawn toward the body portal in a manner which (a) causes the guide structure to become disengaged from the length of implant, and (b) leaves the length of implant extending through the soft tissue and the legs of the length of implant in proximity with each other, wherein the guide structure includes (a) a pair of guide portions supported in spaced apart relation to each other and defining a gap which enables soft tissue to be disposed between the guide portions, (b) a tissue piercing device moveable in the gap between the guide portions and configured to pierce soft tissue disposed in the gap between the guide portions, and (c) an introducer moveable in opposite directions in the gap between the guide portions, the introducer tube moveable in one direction to form a passageway in the gap for guiding the length of implant through soft tissue in the gap and in an opposite direction for reestablishing the gap between the guide portions; - the guide portions being configured to guide the legs of the length of implant into proximity with each other, at least one of a pair of guide portions including a single lumen tube structure defining a pair of tube portions and a reduced central portion joining the pair of tube portions, each of the pair of tube portions configured to guide a portion of the length of implant in a lengthwise direction, and the central portion configured to maintain the pair of tube portions in spaced relation to each other and allowing a connecting portion of the length of implant to slide sideways in the central portion with an interference fit; and
the re-established gap between the guide portions enabling legs of the length of implant to pass therethrough as the guide structure is being withdrawn toward the body portal.
- the guide portions being configured to guide the legs of the length of implant into proximity with each other, at least one of a pair of guide portions including a single lumen tube structure defining a pair of tube portions and a reduced central portion joining the pair of tube portions, each of the pair of tube portions configured to guide a portion of the length of implant in a lengthwise direction, and the central portion configured to maintain the pair of tube portions in spaced relation to each other and allowing a connecting portion of the length of implant to slide sideways in the central portion with an interference fit; and
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33. Apparatus for use in installing an implant in soft tissue, comprising
a guide structure insertable through a body portal and into proximity with the soft tissue, the guide structure being configured to guide a length of the implant through the soft tissue and to bring legs of the length of implant into proximity with each other, the guide structure being further configured to be withdrawn toward the body portal in a manner which (a) causes the guide structure to become disengaged from the length of implant, and (b) leaves the length of implant extending through the soft tissue and the legs of the length of implant in proximity with each other, wherein the guide structure includes a guide tube and a receiver connected with the guide tube, the receiver including a plurality of elements configured to form an opening for receiving and retaining the length of implant guided through torn tissue.
Specification