Closure device and method for tissue repair

• US 7,153,312 B1
• Filed: 11/02/2000
• Issued: 12/26/2006
• Est. Priority Date: 12/02/1999
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Sikora, George, Bojarski, Raymond A., Torrie, Paul A.
• Primary Examiner(s): Calvert, John J.
• Assistant Examiner(s): Hurley, Shaun R
• Application Number:
  US09/704,926
• Time in Patent Office: 2,245 Days
• Field of Search: 606/139, 606/144, 606/145, 606/148
• US Class Current: 606/144
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• 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: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: Y10T 24/3916 One-piece

Abstract

A surgical method includes positioning a fixation member relative to tissue, moving a flexible member coupled to the fixation member relative to the fixation member to bring two tissue surfaces together, and moving a retaining element coupled to the flexible member relative to the fixation member. The retaining element acts to limit loosening of the flexible member relative to the fixation member. An apparatus for repairing a tear in soft tissue includes first and second fixation members, a flexible member substantially immovably secured to the first fixation member and movably coupled to the second fixation member, and a retaining element coupled to the flexible member. In another embodiment, an apparatus for repairing a tear in soft tissue includes a fixation member, and a flexible member movably coupled to the fixation member. A first end of the flexible member is looped back and secured to the flexible member.

Claims

1. A flexible member holder, comprising:

a tube,

a shaft extending from the tube,

a first tine at an end region of the shaft defining a first region for receiving a first portion of a loop of a flexible member,

a second tine at the end region of the shaft defining a second region for receiving a second portion of the loop of the flexible member; and

a tissue penetration device slidably received within the tube and configured to extend between the first and second regions.

2. The holder of claim 1 wherein the shaft extends distally from the tube.

3. The holder of claim 1 wherein each of the first and second regions comprises a groove.

4. The holder of claim 1 further comprising a fixation member to which the flexible member is attached.

5. The holder of claim 4 wherein the tissue penetration device is configured to receive the fixation member.

6. The holder of claim 4 wherein the fixation member includes a cylindrical region received within the tissue penetration device.

7. The holder of claim 4 wherein the fixation member includes a fin that extends through a slot of the tissue penetrating device.

8. The holder of claim 4 wherein the fixation member includes holes for receiving the flexible member.

9. The holder of claim 1 wherein the tissue penetrating device includes a slot.

10. The holder of claim 1 wherein the tube defines a lumen through which the tissue penetration device is slidable received.

11. The holder of claim 1 wherein the tissue penetrating device includes a needle.

12. The holder of claim 1 wherein the tissue penetrating device includes a beveled tip.

13. The holder of claim 1 further comprising a handle for advancing the tissue penetration device relative to the shaft.

14. The holder of claim 1 wherein one or more of the tines is oriented along an axis that is different from a longitudinal axis of the tissue penetration device.

15. The holder of claim 1 wherein one or more of the first and second portions of the flexible member loop is oriented along an axis that is different from a longitudinal axis of the tissue penetration device.

16. A flexible member holder, comprising:

a tube,

a shaft extending from the tube and having;

a first region for receiving a first portion of a loop of a flexible member,

a second region for receiving a second portion of the loop of the flexible member; and

a tissue penetration device slidably received within the tube and configured to extend between the first and second regions.

17. The holder of claim 16 wherein the shaft extends distally from the tube.

18. The holder of claim 16 wherein the tissue penetration device includes a needle.

19. The holder of claim 16 wherein the tissue penetration device includes a beveled tip.

20. The holder of claim 16 further comprising a handle for advancing the tissue penetration device relative to the shaft.

21. The holder of claim 16 wherein one or more of the first and second portions of the flexible member loop is oriented along an axis that is different from a longitudinal axis of the tissue penetration device.

34. The holder of claim 16 wherein the shaft extends distally from the tube along a shaft axis and the first and second regions extend along a distal plane that is acute with the shaft axis.

35. The holder of claim 16 wherein the tube extends along a tube axis and the first and second regions extend along a distal plane that is 90 degrees or less from the tube axis.

22. A method of delivering an implant to body tissue, the method comprising:

positioning a first portion of a loop of a flexible member at a first region of a shaft that extends from a tube,

positioning a second portion of the loop of the flexible member at a second region of the shaft,

sliding a tissue penetration device though the tube such that the tissue penetrating device extends between the first and second regions of the shaft.

23. The method of claim 22 wherein positioning the first portion includes positioning the first portion of the loop at a first tine at a first end region of the shaft, the first tine defining the first region.

24. The method of claim 22 wherein positioning the second portion includes positioning the second portion of the loop at a second tine at a second end region of the shaft, the second tine defining the second region.

25. The method of claim 22 further comprising advancing the tissue penetration device through the body tissue.

26. The method of claim 22 further comprising retracting the tissue penetration device from the body tissue.

27. The method of claim 25 further comprising advancing the tissue penetration device such that the tissue penetrating device exits the body tissue at a surface of the tissue after the tissue penetration device has been advanced through the body tissue.

28. The method of claim 22 further comprising advancing the tissue penetration device through a tear in the body tissue.

29. The method of claim 22 further comprising positioning a fixation member in the tissue penetration device.

30. The method of claim 29 further comprising attaching the flexible member to the fixation member.

31. The method of claim 30 wherein extending the tissue penetration device includes extending the fixation member.

32. The method of claim 31 further comprising advancing the tissue penetration device through the body tissue such that the fixation member is advanced through and exits the body tissue at a tissue surface.

33. The method of claim 32 further comprising retracting the tissue penetration device from the body tissue such that the fixation member remains at the tissue surface.

36. A flexible member holder, comprising:

a tube,

a shaft extending from the tube and having;

a first region for receiving a first portion of a loop of a flexible member, and

a second region for receiving a second portion of the loop of the flexible member; and

a tissue penetrating elongate rigid member within the tube, the elongate rigid member being the sole elongate rigid member advanceable within the tube.

37. The holder of claim 36 wherein the tissue penetrating elongate rigid member is configured to extend between the first and second regions.

38. The holder of claim 36 further comprising a fixation member to which the flexible member is attached.

39. The holder of claim 38 wherein the tissue penetrating elongate rigid member is configured to receive the fixation member.

40. The holder of claim 38 wherein the fixation member includes a cylindrical region received within the tissue penetrating elongate rigid member.

41. The holder of claim 38 wherein the fixation member includes a fin that extends through a slot of the tissue penetrating elongate rigid member.

42. The holder of claim 38 wherein the fixation member includes holes for receiving the flexible member.

43. The holder of claim 36 wherein the tube defines a lumen through which the tissue penetration device is advanceable.

44. The holder of claim 36 wherein the tissue penetrating elongate rigid member includes a needle.

45. The holder of claim 36 wherein the tissue penetrating elongate rigid member includes a beveled tip.

46. The holder of claim 36 further comprising a handle for advancing the tissue penetrating elongate rigid member within the tube.

47. A flexible member holder, comprising:

a tube,

a shaft extending from the tube, and

a tissue penetrating elongate rigid member within the tube, the tissue penetrating elongate rigid member being the sole elongate rigid member advanceable within the tube,

wherein the shaft includes a distal portion with formations for receiving a flexible member and defining an opening for receiving the tissue penetrating elongate rigid member.

48. The holder of claim 47 wherein the tissue penetrating elongate rigid member is configured to extend through the opening.

49. The holder of claim 47 further comprising a fixation member to which the flexible member is attached.

50. The holder of claim 49 wherein the tissue penetrating elongate rigid member is configured to receive the fixation member.

51. The holder of claim 49 wherein the fixation member includes a cylindrical region received within the tissue penetrating elongate rigid member.

52. The holder of claim 49 wherein the fixation member includes a fin that extends through a slot of the tissue penetrating elongate rigid member.

53. The holder of claim 49 wherein the fixation member includes holes for receiving the flexible member.

54. The holder of claim 47 wherein the tube defines a lumen through which the tissue penetration device is advanceable.

55. The holder of claim 47 wherein the tissue penetrating elongate rigid member includes a needle.

56. The holder of claim 47 wherein the tissue penetrating elongate rigid member includes a beveled tip.

57. The holder of claim 47 further comprising a handle for advancing the tissue penetrating elongate rigid member within the tube.

58. A method of delivering an implant to body tissue, the method comprising:

positioning a first portion of a loop of a flexible member at a first region of a shaft that extends from a tube,

positioning a second portion of the loop of the flexible member at a second region of the shaft,

advancing an elongate rigid member through the tube, the elongate rigid member being the only elongate rigid member advanceable within the tube, and

piercing tissue with the elongate rigid member.

59. The method of claim 58 further comprising extending the elongate rigid member between the first and second regions of the shaft.

60. A method of delivering an implant to body tissue, the method comprising:

positioning a flexible member at formations of a distal portion of a shaft extending from a tube to define an opening,

advancing an elongate rigid member through the tube, the elongate rigid member being the only elongate rigid member advanceable within the tube, and

piercing tissue with the elongate rigid member.

61. The method of claim 60 further comprising extending the elongate rigid member through the opening.