Tissue repair system

• US 7,608,108 B2
• Filed: 04/24/2006
• Issued: 10/27/2009
• Est. Priority Date: 04/29/2005
• Status: Active Grant

• Current Assignee: Jmea Corporation
• Original Assignee: Jmea Corporation
• Inventors: Yeh, Jack Y., Sack, James A., Woods, Richard W., Bhatnagar, Mohit K.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): CARTER, TARA ROSE E
• Application Number:
  US11/379,940
• Publication Number:
  US 20070038222A1
• Time in Patent Office: 1,282 Days
• Field of Search: 623 1711- 1716, 623/16.11, 606/108, 606/139, 606/142, 606/143, 606/149, 606215-200, 606/75, 606/99, 606/213, 227/19, 227/175.1, 227/177.1, 227/180.1, 227/181.1, 227/901
• US Class Current: 623/17.16
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• 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 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/2913 cams or guiding means
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30172 T-shaped
• CPC Class Codes: A61F 2002/30197 Omega-shaped
• CPC Class Codes: A61F 2002/30205 : conical
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument

Abstract

A repair system including a closure prosthesis and deployment device, and associated methods for repairing any imperfection including a flaw, hole, tear, bulge, or, in some cases, a deliberate cut or incision in any tissue including an intervertebral disc is disclosed. The prosthesis has first and second side portions with a connecting central portion, and is designed to span an imperfection with opposite ends positioned on opposite sides of the imperfection or the same side of the imperfection. The prosthesis may include anchoring features including barbs and/or members that extend transversely or at different angles. The deployment device can include a cannula for positioning the prosthesis near the imperfection, and, in some cases, a mechanism that may cause the two sides of the prosthesis to be deployed in a specific order.

Claims

1. A method for attaching a first tissue with a second tissue using a prosthesis having a central portion connected to a first end portion and a second end portion, the first end portion having a first anchoring device and the second end portion having a second anchoring device, comprising the steps of:

inserting a first end portion of prosthesis into a first portion of the first tissue by moving an actuator a first distance;

wherein the first end portion is disposed within a first channel formed in a first penetrating member

ejecting the first end portion of the prosthesis from the first channel of the first penetrating member and into the first tissue prior to implanting the second end portion, wherein the second end portion is disposed within a second channel formed in a second penetrating member; and

controlling the insertion of the second end portion of the prosthesis into the second tissue by moving the actuator a second distance beyond the first distance.

2. the method according to claim 1, wherein the first anchoring device includes at least one projection extending away from the first portion.

3. The method according to claim 2, wherein the second anchoring device includes at least one projection extending away from the second end portion.

4. The method according to claim 1, wherein the prosthesis includes a metallic material.

5. The method according to claim 1, wherein the prosthesis is made of a material including a biocompatible material selected from the group consisting of plastic, nylon, prolene, dacron, ultra high molecular weight polyethylene (UHMPWE), poly L-lactic acid (PLLA), polyglycolic acid (PGA), polytetrafluorethylene (PTFE), polyaryletherketone (PAEK), polyetheretherketone (PEEK), polyoxymethylene (acetal), polycarbonate, polysulfone, silicone elastomers, titanium, titanium alloys, CoCr alloys, nickel titanium (nitinol) alloys, implant grade stainless steels, and any combination thereof.

6. The method according to claim 1, wherein the first tissue is a soft tissue and the second tissue is bone.

7. The method according to claim 1, wherein the first tissue is bone and the second tissue is bone.

8. The method according to claim 1, wherein the first tissue is the same as the second tissue.

9. The method according to claim 1, wherein the first tissue is a bone and the second tissue is soft tissue.

10. A method for repairing an imperfection associated with a tissue comprising the steps of:

inserting a prosthesis deployment device into a patient, wherein a prosthesis is positioned proximate a distal end of the prosthesis deployment device wherein the prosthesis has a central portion connected to the first end portion, wherein the first end portion is disposed within a first penetrating member of the prosthesis deployment device and a second end portion connected to the central portion, wherein the second end portion is disposed within a second penetrating member of the prosthesis deployment device;

the first end portion having a first anchoring device, and the second end portion having a second anchoring device;

positioning the distal end of the prosthesis deployment device proximate the tissue;

inserting a first penetrating member of the prosthesis deployment device into a first portion of the tissue by moving a first actuator associated with the prosthesis deployment device, wherein the first portion of the tissue is on a first side of the imperfection, and wherein the first penetrating member of the prosthesis deployment device creates its own path through the first portion of the tissue;

ejecting a first end portion of a prosthesis from the first penetrating member and into the first portion of the tissue by moving a second actuator associated with the prosthesis deployment device while a second end portion of the prosthesis remains generally stationary within the second penetrating member of the prosthesis deployment device;

inserting the second end portion of the prosthesis into a second portion of the tissue that is spaced from the first portion of the tissue by moving the second actuator, wherein the second portion of the tissue is on a second side of the imperfection, and wherein the movement of the second end portion of the prosthesis is independent from the movement of the first end portion of the prosthesis; and

spanning the imperfection with the central portion of the prosthesis.

11. The method according to claim 10, wherein the second end portion of the prosthesis is further inserted into the tissue thereby drawing the first side of the imperfection and the second side of the imperfection closer together.

12. The method according to claim 10, wherein the first anchoring device includes at least one barb.

13. The method according to claim 12, wherein the second anchoring device includes at least one barb.

14. The method according to claim 10, wherein the tissue is selected from the group consisting of skin, muscle, fascia, cartilage, a ligament, meniscus, bone, and combinations of these tissues.

15. A method for attaching a first tissue with a second tissue comprising the steps of:

positioning a device configured to deliver a prosthesis proximate the first tissue and the second tissue, wherein a prosthesis is associated with a distal end of the device configured to deliver a prosthesis, wherein the prosthesis has a central portion connected to a first end portion and a second end portion, wherein the first end portion has a first anchoring device, and the second end portion has a second anchoring device;

positioning the device configured to deliver a prosthesis so that the first end portion of the prosthesis is positioned proximate the first tissue and the second end portion of the prosthesis is positioned proximate the second tissue;

penetrating the first tissue with a first member of the device configured to deliver a prosthesis, wherein the first end portion of the prosthesis is positioned within a first hollow portion of the first member of the device configured to deliver a prosthesis;

inserting the first end portion of the prosthesis into the first tissue while retaining the second end portion of the prosthesis within the device, wherein the first end portion of the prosthesis is inserted by moving an actuator associated with the device configured to deliver a prosthesis a first distance to eject the first end portion of the prosthesis from the first hollow portion of the first member of the device configured to deliver a prosthesis;

penetrating the second tissue with a second member of the device configured to deliver a prosthesis after the first end portion of the prosthesis has stopped moving, wherein the second end portion of the prosthesis is positioned within a second hollow portion of the second member of the device configured to deliver a prosthesis; and

inserting the second end portion of the prosthesis into the second tissue by moving the actuator associated with the device configured to deliver a prosthesis a second distance to eject the second end portion of the prosthesis from the second hollow portion of the second member of the device configured to deliver a prosthesis so that the central portion of the prosthesis spans between the first tissue and the second tissue.

16. The method according to claim 15, wherein the second end portion of the prosthesis is further inserted into the second tissue by further moving the actuator thereby drawing the first tissue and the second tissue closer together.

17. The method according to claim 15, wherein the first tissue is different from the second tissue.

18. The method according to claim 15, wherein the prosthesis includes a material selected from the group consisting of a metallic material and a material that includes plastic.

19. The method according to claim 15, wherein the first tissue is selected from the group consisting of a tendon, a ligament, and bone, and the second tissue is bone.

20. The method according to claim 15, wherein the first tissue is the same as the second tissue.