Suture method

• US 8,764,796 B2
• Filed: 02/10/2006
• Issued: 07/01/2014
• Est. Priority Date: 06/29/2001
• Status: Active Grant

• Current Assignee: Ethicon Incorporated (Johnson & Johnson), Ethicon, LLC (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Kaplan, Andrew, Leung, Jeffrey C., Megaro, Matthew A., Ruff, Gregory L
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US11/307,520
• Publication Number:
  US 20060111734A1
• Time in Patent Office: 3,063 Days
• Field of Search: 606/228, 606/232, 606/139, 606/151
• 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 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/1146 of tendons
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/0061 Implements located only on one side of the opening
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• 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 hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/06171 helically or spirally coiled for needles A61B2017/06076
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065

Abstract

A method for joining and holding closed a wound in bodily tissue, fastening junctions of wounds, tying off wounds, joining a foreign element to tissue, and altering the position of tissue using a barbed suture including sharp pointed ends. Each end of the suture includes barbs on that permit movement in an opposing direction to the barbs on the other end of the suture. This two-way barbed suture is used by the method of the present invention in applications including abdominal surgeries such as a Nissen fundoplication, laparoscopic uses such as stabilizing a bowel structure and performing a closure of a cystostomy, liver to bowel anastomosis, closure of an orifice of a Zenker'"'"'s Diverticulum, endoscopic uses such as closure of ulcerative lesions or and post-procedural tissue defects, bladder wound closure, valve replacement surgery, device attachment, cosmetic surgery, and blood vessel wound closure.

Claims

1. A method of mounting a device to an internal organ of a subject, the device including at least one eyelet for securing the device and through which a suture may pass, using a barbed suture including an elongated body, first and second sharp pointed distal ends for penetrating tissue, and a plurality of barbs extending from the periphery of the body, the barbs on a first portion of the body between the first end of the suture and a first axial location on the body for permitting movement of the suture through the tissue in a direction of movement of the first end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the first end, and the barbs on a second portion of the body between the second end of the suture and a second axial location on the body which is less than the distance from the second end to the first axial location permitting movement of the suture through the tissue in a direction of movement of the second end and preventing movement of the suture relative to the tissue in a direction opposite the direction of movement of the second end, the method comprising the steps of:

(a) placing the device in a desired position on an internal organ of the subject'"'"'s body, where the internal organ is selected from liver, gall bladder, bowel and stomach;

(b) threading-the first pointed end of the suture through one eyelet;

(c) inserting the first pointed end of the suture into tissue of the internal organ;

(d) pushing the first end of the suture through the tissue until the first end of the suture extends out of the tissue at an exit point;

(e) gripping the first end of the suture and pulling the first end out of the tissue while drawing the first portion of the suture through the tissue, leaving a portion of the suture between the first and second axial locations out of the tissue and leaving a length of the first portion of the suture in the tissue between the point of insertion and exit point of the first end;

(f) after steps (a)-(e), inserting the second pointed end of the suture into tissue of the internal organ;

(g) pushing the second end of the suture through the tissue until the second end of the suture extends out of the tissue at an exit point, leaving a portion of the suture between the first and second axial locations out of the tissue; and

(h) gripping the second end of the suture and pulling the second end out of the tissue while drawing the second portion of the suture through the tissue until the device is mounted on the internal organ of the subject'"'"'s body, and leaving a length of the second portion of the suture in the tissue of the internal organ between the point of insertion and exit point of the second end;

wherein the first and second portions of the suture extend in the tissue in generally opposing directions and cause the suture to resist displacement of the device away from the internal organ.

2. The method of claim 1 wherein at least one of the first and second sutures is inserted in a curvilinear path.