Adhesives for use with suture system minimize tissue erosion

• US 7,740,646 B2
• Filed: 09/20/2006
• Issued: 06/22/2010
• Est. Priority Date: 03/31/2006
• Status: Expired due to Fees

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Widenhouse, Christopher W., Shelton, Frederick E., Ortiz, Mark S., Voegele, James W., Hunt, John V., Kolata, Ronald J., Turner, Douglas J.
• Primary Examiner(s): Woo; Julian W
• Assistant Examiner(s): RYCKMAN, MELISSA K
• Application Number:
  US11/533,571
• Publication Number:
  US 20070233188A1
• Time in Patent Office: 1,371 Days
• Field of Search: 606228-231, 606/222, 604/144
• US Class Current: 606/228
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• 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 17/0487 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 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0619 thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it
• CPC Class Codes: A61B 2017/306 holding by means of suction

Abstract

A design for a suture for use in suture appositioning techniques, and a method for use are disclosed. In one embodiment the suture may comprise a hollow length having a wall forming a lumen, which may serve as a conduit through which fluid may be pumped and discharged through a plurality of perforations in the wall. In another embodiment the suture may comprise a plurality of suture members connected by a connecting member. In one embodiment of a method disclosed, a suture having a hollow length having a wall forming a lumen, with a plurality of perforations in the wall, may be placed in a stitching procedure to apposition tissues, and a fluid such as an adhesive, adhesive activating agent or drug may be pumped through the lumen and discharged out the perforations for various beneficial effects.

Claims

1. A device for use in appositioning of tissues, comprising in combination:

a first suture having a hollow length, said first suture comprising a distal end and a proximal end, wherein said first suture comprises a single non-rigid tubular structure of unitary construction, the hollow length having a wall forming a lumen, wherein the wall provides an outer surface having at least one perforation therethrough, wherein the outer surface extends continuously along the hollow length of the first suture, wherein said outer surface is configured for direct contact with said tissues, wherein said perforations are configured to provide direct fluid communication between said tissues and said lumen;

said first suture further comprising a suturing needle attached to the distal end of said first suture, wherein the needle is configured to penetrate tissue and create a passage therethrough;

a curable fluid tissue adhesive deliverable directly to the tissues through said lumen via said perforation and in contact with said first suture, wherein, upon delivery to said tissues, said adhesive adheres to said tissues and said first suture such that the adhesive is configured to distribute a holding force to tissue adjacent to the first suture by adhering the tissue;

an adhesive delivery apparatus in fluid communication with the first suture, wherein the adhesive delivery apparatus contains a first portion of the adhesive, wherein the first suture contains a second portion of the adhesive, wherein the adhesive delivery apparatus is operable to urge the second portion of the adhesive through the first suture and out of the at least one perforation of the first suture to dispense the second portion of the adhesive to adjacent tissue;

wherein said first suture has sufficient flexibility to be drawn behind said needle through said passage in said tissue; and

a second suture connected to the first suture by a flexible connecting member, wherein the connecting member comprises a first end and a second end, wherein the connecting member terminates at the first end at the first suture, wherein the connecting member terminates at the second end at the second suture, wherein the connecting member is configured to flex in response to application of an inward force urging the first suture and the second suture together, wherein the connecting member is configured to urge the first suture and the second suture toward a spaced-apart relationship upon cessation of the inward force.

2. The device of claim 1 wherein said adhesive comprises a cyanoacrylate.

3. The device of claim 1 wherein said adhesive comprises an isocyanate.

4. The device of claim 1 further comprising a drug delivered through said lumen.

5. The device of claim 4 wherein the drug comprises an antibiotic.

6. The device of claim 4 wherein the drug comprises a tissue sclerosing agent.

7. The device of claim 1 further comprising a fluid adhesive activating agent delivered through said lumen and in contact with said fluid tissue adhesive.

8. The device of claim 1 further comprising a pump fluidly connected to the lumen.

9. The device of claim 8 wherein the pump comprises a syringe.

10. The device of claim 1 wherein the second suture has a hollow length, the hollow length having a wall forming a lumen, the wall having at least one perforation therethrough.

11. The device of claim 1 further comprising a lubricant coating on said first suture.

12. The device of claim 1 further comprising an inner surface on said wall, and an adhesive activating agent coating on at least one of said inner and outer surfaces.