Surgical suture and associated anchoring mechanism for tissue retraction

• US 6,547,725 B1
• Filed: 04/10/2001
• Issued: 04/15/2003
• Est. Priority Date: 08/10/1998
• Status: Expired due to Fees

• Current Assignee: Coroneo, Inc.
• Original Assignee: Coroneo, Inc.
• Inventors: Paolitto, Anthony, Valentini, Valerio, Cartier, Raymond
• Primary Examiner(s): Calvert, John J.
• Assistant Examiner(s): Hoey, Alissa L.
• Application Number:
  US09/762,437
• Time in Patent Office: 735 Days
• Field of Search: 606/139, 600/201, 600/210, 600/215, 600/217, 600/231, 600/233
• US Class Current: 600/201
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• 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

Abstract

The present invention provides a tissue retractor (2) for displacing body tissue during surgery consisting of a tissue piercing member such as a surgical needle (20), a wire-like filament such as a suture line (23) affixed to the surgical needle (20), a fixed element such as an anchoring port (90) being associated with a stable surgical platform such as a sternum retractor (1), and a movable element such as an anchoring plug (25) cooperating with anchoring port (90) to engage a portion of suture line (23) after the suture line (23) is threaded through the body tissue with the surgical needle (20) and after the suture wire (20) is tension to effect a predetermined displacement of the body tissue. The predetermined displacement of body tissue is maintained by retention of the engaged portion of suture line (23) by the fixed anchoring portion (90) and the movable anchoring plug (25).

Claims

1. A tissue retractor for displacing body tissue during surgery, said tissue retractor comprising:

a tissue piercing member;

a suture line coupled to said tissue piercing member;

a surgical platform;

a fixed element, said fixed element being fixably attached to said surgical platform;

a movable element, said movable element being movable relative to said fixed element between an anchoring configuration wherein said movable and fixed elements are in a substantially proximal relationship relative to each other and a releasing configuration wherein said movable and fixed elements are in a substantially spaced relationship relative to each other;

said fixed and movable elements being configured and sized to be able to mechanically interact with each other for frictionally locking a portion of said suture line therebetween when said movable element is in said anchoring configuration.

2. The tissue retractor according to claim 1, wherein the fixed element is an anchoring port located in the surgical platform, the movable element is an anchoring plug attached to the suture line, the anchoring plug being received in the anchoring port in slip-fit interconnection therewith, the portion of the suture line being engaged between the anchoring plug and a surface defining the anchoring port when the anchoring plug is received therein.

3. The tissue retractor according to claim 2, wherein the anchoring plug is slidably attached to the suture line.

4. The tissue retractor according to claim 3, wherein the anchoring plug provides contiguous and substantially planar faces, at least one of which contacts with the portion of the suture line, and wherein the anchoring port is generally wedge shaped and is defined by substantially planar surfaces thereof whose angular configuration coincides with that associated with the substantially planar faces of the anchoring plug, the portion of the suture line being lodged against at least one such substantially planar surface by the anchoring plug.

5. The tissue retractor according to claim 4, wherein the anchoring plug is generally diamond-shaped and provides four such planar faces.

6. The tissue retractor according to claim 2, wherein the anchoring plug is fixedly attached to the suture line.

7. The tissue retractor according to claim 6, wherein the anchoring plug provides a tapered outer surface and further provides a free terminal end portion thereof having a slot therein for guiding the suture line into the anchoring port.

8. The tissue retractor according to claim 7, wherein the anchoring port provides a handle member for manipulation of the anchoring plug.

9. The tissue retractor according to claim 1, wherein the fixed element is au anchoring port located in the surgical platform, the movable element is an anchoring plug, the anchoring plug having a slot therein for receiving the portion of the suture line, the anchoring plug being received in the anchoring port in slip-fit interconnection therewith, the portion of the suture line being engaged by compression thereof when the anchoring plug is received in the anchoring port.

10. The tissue retractor according to claim 9, wherein the anchoring plug is fixedly attached to the suture line.

11. The tissue retractor according to claim 1, wherein the fixed element is a pinch roller located in the surgical platform, the movable element is a traction roller capable of translation towards and away from the pinch roller, the portion of the suture line being engaged between the pinch roller and the traction roller at circumferential surfaces thereof, and wherein the traction roller is entrained towards the pinch roller to engage the portion of the suture line thereagainst by tensile action of the suture wire when the suture line is introduced therebetween.

12. The tissue retractor according to claim 1, wherein the fixed element is a contact surface against which the portion of the suture line is held, the movable element is a lever member which is rotatably disposed adjacent the contact surface, the suture line being engaged at a point of engagement thereof between the contact surface and the lever member, the lever member being located such that tensile action of the suture line induces a clamping force at the point of engagement.

13. The tissue retractor according to claim 12, wherein the lever member is biased to bear against the contact surface and wherein biased rotation of the lever member in generally the direction of loading of the suture wire.

14. The tissue retractor according to claim 1, wherein the fixed element is a first contact surface against which the portion of the suture line is held, the movable element is a screw member which is threadedly mounted in the contact surface, the screw member providing a second contact surface, and wherein rotation of the screw member results in the portion of the suture line being clamped between the first and second contact surfaces.

15. The tissue retractor according to claim 14, wherein the second contact surface is provided on a washer through which the screw member is disposed, and wherein the tissue retractor further provides a biasing element to urge the first and second contact surfaces together.

16. The tissue retractor according to claim 1, wherein the fixed element is a first contact surface against which the portion of the suture line is held, the movable element is a pivotally disposed lever member providing second and third contact surfaces for the suture line, the portion of the suture line being engaged at a point of engagement thereof between the first and second contact surfaces by rotation of the lever member, and wherein tensile action of the suture line at the third contact surface induces a clamping force at the point of engagement.

17. A suture line anchoring device for anchoring a portion of a suture line to a surgical platform, said anchoring device comprising:

a fixed element, said fixed element being fixably attached to said surgical platform;

a movable element, said movable element being movable relative to said fixed element between an anchoring configuration wherein said movable and fixed elements are in a substantially proximal relationship relative to each other and a releasing configuration wherein said movable and fixed elements are in a substantially spaced relationship relative to each other;

said fixed and movable elements being configured and sized to be able to mechanically interact with each other for frictionally locking said portion of said suture line therebetween when said movable element is in said anchoring configuration.

18. An anchoring device as recited in claim 17 wherein when said fixed and movable elements are in said releasing configuration, said fixed and movable elements define an insertion spacing therebetween for receiving said portion of said surgical suture line;

said surgical platform including a slot formed therein for receiving a segment of said suture line;

said insertion spacing and said slot being substantially in register with each other;

said movable element being pivotable relative to said fixed element between said anchoring and releasing configurations.

19. An anchoring device as recited in claim 18 further comprising a biasing element for biasing said movable element towards said anchoring configuration.

20. An anchoring device as recited in claim 17 wherein said movable element is pivotable relative to said fixed element between said anchoring and releasing configurations.

21. An anchoring device as recited in claim 20 further comprising a biasing element for exerting a biasing force that biases said movable element towards said anchoring configuration.

22. An anchoring device as recited in claim 21 wherein said biasing element allows adjustment of the magnitude of said biasing force.

23. An anchoring device as recited in claim 20 wherein said movable element includes a handle extending therefrom for facilitating manipulation thereof.

24. An anchoring device as recited in claim 20 wherein said fixed and movable elements are configured, sized and positioned so that when said portion of said suture line is clamped therebetween, tension applied to said portion of said suture line in at least one direction will increase the clamping force exerted by said fixed and movable elements on said portion of said suture line.

25. An anchoring device as recited in claim 17 wherein said fixed and movable elements respectively define a fixed and a movable contacting surface for contacting said portion of said suture line when said movable element is in said anchoring configuration, at least one of said fixed or movable contacting surfaces defining a friction enhancing configuration for enhancing the clamping force exerted by said fixed and movable elements on said portion of said suture line, when said movable element is in said anchoring configuration.

26. A suture line anchoring device for anchoring a portion of a suture line to a surgical platform, said anchoring device comprising:

a first element, said first element defining a first contact location for contacting said portion of said surgical suture line;

a second element, said second element defining a second contact location for contacting said portion of said surgical suture line;

said first and second elements being configured, sized and coupled to said surgical platform for allowing the distance between said first and second contact locations to vary between an anchoring configuration wherein said first and second contact locations are in a substantially proximal relationship relative to each other and a releasing configuration wherein said first and second contact locations are in a substantially spaced relationship relative to each other;

said first and second contact locations being also configured and sized to be able to mechanically interact with each other for frictionally locking said portion of said suture line therebetween when in said anchoring configuration.

27. An anchoring device as recited in claim 26 wherein a chosen one of said first or second elements is fixably coupled to said surgical platform and the other one of said first or second elements is movably coupled to said surgical platform for allowing movement relative thereto between said anchoring and releasing configurations.

28. An anchoring device as recited in claim 27 wherein said other one of said first or second elements is pivotably coupled to said surgical platform for allowing pivotal movement relative to said chosen one of said first or second elements between said anchoring and releasing configurations.

29. An anchoring device as recited in claim 27 wherein said other one of said first or second elements is selectively pivotable relative to said chosen one of said at least one of said first or second elements.

30. An anchoring device as recited in claim 26, wherein said surgical platform is a surgical retractor, said surgical retractor including a first and a second spreader arm, said first and second spreader arms being coupled to a guide bar for allowing generally opposite relative movement therebetween through the use of an actuator;

each of said first and second spreader arms being respectively provided with corresponding first and second spreader blades, at least one of said spreader arms having a mounting rail extending at least partially therealong, said fixed and movable elements defining an insertion spacing therebetween for allowing insertion therein of said portion of said suture line when said fixed and movable elements are in said releasing configuration, said surgical retractor being provided with a slot formed therein for receiving a segment of said suture line, said slot being substantially in communication with said insertion spacing.

31. An anchoring device as recited in claim 30, wherein at least one of said first or second spreader arms has an arcuate configuration, said arcuate configuration defining a concavity oriented generally towards the other one of said first or second spreader arms.

32. An anchoring device as recited in claim 31, wherein said at least one of said first or second spreader arms is provided with said mounting rail, said mounting rail extending in a generally aligned relationship therewith.

33. An anchoring device as recited in claim 30, wherein said slot is configured and sized for allowing insertion of said segment of said suture line thereinto, without interfering with the operation of said mounting rail.

34. An anchoring device as recited in claim 30, wherein said anchoring device is at least partially embedded in said surgical retractor, said anchoring device being configured, sized, and positioned so as to prevent interference with the operation of said mounting rail.

35. An anchoring device as recited in claim 26, wherein said first and second elements are configured, sized and positioned so that when said portion of said suture line is clamped tberebetween, tension applied to said portion of said suture line in at least one direction will increase the clamping force exerted by said first and second elements on said portion of said suture line.

36. An anchoring device as recited in claim 26, wherein either one of said first or second contact locations is configured for increasing fiction exerted on said portion of said suture line, when said first and second elements are in said anchoring configuration and said portion of said suture line is inserted therebetween.