Method of securing body tissue

• US 8,814,902 B2
• Filed: 07/31/2006
• Issued: 08/26/2014
• Est. Priority Date: 05/03/2000
• Status: Expired due to Fees

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): DOWE, KATHERINE MARIE
• Application Number:
  US11/461,110
• Publication Number:
  US 20060265011A1
• Time in Patent Office: 2,948 Days
• Field of Search: 606/232, 606/74, 606/75, 606/103, 606/59, 606/98, 606/280, 606/286, 606/287, 623/13.14, 128/898
• US Class Current: 606/232
• 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 17/0487 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 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• 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 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0619 thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it suture cutters A61B17/0467; ultrasonic cutters A61B17/320068; electrically heated instruments A61B18/08

Abstract

To secure a first body tissue with a second body tissue, a first anchor is moved along a first path through the first body tissue into the second body tissue. A second anchor is moved along a second path through the first body tissue into the second body tissue. A suture extending between the anchors may be tightened by moving the second anchor along a path which extends transverse to the path of the first anchor. The suture which extends between the anchors may have free ends which are connected with a suture retainer. The free ends of the suture may be interconnected either before or after the anchors are moved along the first and second paths. Alternatively, the suture may be a continuous loop which extends between the two anchors. A guide assembly may be provided to guide movement of the anchors along the two paths. The paths along which the anchors move may intersect so that the anchors may be interconnected at the intersection between the two paths.

Claims

1. A method of securing a first body tissue portion to a second body tissue portion, the method comprising:

utilizing a first anchor having a body and a protrusion connected to the body;

utilizing a first suture portion and adjustably coupling the first suture portion to the first anchor such that the first suture portion extends from the first anchor and is freely movable until secured;

utilizing a second anchor having a body and a protrusion connected to the body;

utilizing a second suture portion and adjustably coupling the second suture portion to the second anchor such that the second suture portion extends from the second anchor and is freely movable until secured;

moving the first anchor along a first path through the first body tissue portion and into the second body tissue portion such that the first anchor protrusion is enclosed by the first and second body tissue portions and the first anchor body extends from the first body tissue portion;

moving the second anchor along a second path through the first body tissue portion and into the second body tissue portion such that the second anchor protrusion is enclosed by the first and second body tissue portions and the second anchor body extends from the first body tissue portion, and wherein the second path is oriented to intersect with the first path in the second body tissue portion;

tensioning the first suture portion extending from the first anchor and transmitting force through the first suture portion to the first body tissue portion;

tensioning the second suture portion extending from the second anchor and transmitting force through the second suture portion to the first body tissue portion;

applying ultrasonic vibratory energy to at least one of the first suture portion and the second suture portion to heat material forming the at least one of the first suture portion and the second suture portion such that the material becomes moldable and flows when subjected to pressure;

applying ultrasonic vibratory energy to the other of the first and second suture portions to heat material forming the other of the first and second suture portions such that the material becomes moldable and flows when subjected to pressure; and

connecting the first and second anchors together at the point at which the first path intersects the second path, whereby the first body tissue is secured to the second body tissue.

2. The method of claim 1 wherein the first suture portion and the second suture portion are part of the same suture.

3. A method of securing a first body tissue portion to a second body tissue portion, the method comprising:

utilizing a first anchor having a body and a protrusion connected to the body;

utilizing a first suture portion and adjustably coupling the first suture portion to the first anchor such that the first suture portion extends from the first anchor and is freely movable until secured;

utilizing a second anchor having a body and a protrusion connected to the body;

utilizing a second suture portion and adjustably coupling the second suture portion to the second anchor such that the second suture portion extends from the second anchor and is freely movable until secured;

moving the first anchor along a first path through the first body tissue portion and into the second body tissue portion such that the first anchor protrusion is enclosed by the first and second body tissue portions and the first anchor body extends from the first body tissue portion;

moving the second anchor along a second path through the first body tissue portion and body tissue portion such that the second anchor protrusion is enclosed by the first and second body tissue portions and the second anchor body extends from the first body tissue portion, and wherein the second path is oriented to intersect with the first path in the second body tissue portion;

tensioning the first suture portion extending from the first anchor and transmitting force through the first suture portion to the first body tissue portion;

tensioning the second suture portion extending from the second anchor and transmitting force through the second suture portion to the first body tissue portion;

applying ultrasonic vibratory energy to at least one of the first suture portion and the second suture portion to heat material forming the at least one of the first suture portion and the second suture portion such that the material becomes moldable and flows when subjected to pressure;

applying ultrasonic vibratory energy to the other of the first and second suture portions to heat material forming the other of the first and second suture portions such that the material becomes moldable and flows when subjected to pressure; and

connecting the first and second anchors together, whereby the first body tissue is secured to the second body tissue;

wherein connecting the first and second anchors together includes engaging a surface on the first anchor with a surface on the second anchor.

4. The method of claim 3 wherein connecting the first and second anchors together includes moving one of the anchors into an opening in the other anchor.

5. A method of securing a first body tissue portion to a second body tissue portion, the method comprising:

utilizing a first anchor having a body and a protrusion connected to the body;

utilizing a second anchor having a body and a protrusion connected to the body;

utilizing a suture connecting the first and second anchors;

moving the first anchor along a first path through the first body tissue portion and into the second body tissue portion, the first anchor being moved such that the first anchor protrusion is at least partially enclosed by and contacted by the first or second body tissue portion and the first anchor body is positioned in or against the first body tissue portion;

moving the second anchor along a second path through the first body tissue portion and into the second body tissue portion, the second anchor being moved such that the second anchor protrusion is at least partially enclosed by and contacted by the first or second body tissue portion and the second anchor body is positioned in or against the first body tissue portion;

moving the first anchor along the first path and moving the second anchor along the second path, wherein the first and second paths are oriented to intersect in the second body tissue portion;

tensioning the suture; and

transmitting force through the suture to the first body tissue;

wherein the first anchor and the second anchor are interconnected at the point at which the first path intersects the second path, whereby the first body tissue is secured to the second body tissue.

6. The method of claim 5 further comprising providing a suture retainer, connecting the suture to the suture retainer, and applying ultrasonic vibratory energy to the suture retainer to heat material forming the suture retainer such that the material becomes moldable and flows when subjected to pressure.

7. A method of securing a first body tissue to a second body tissue, the method comprising:

utilizing a first anchor having a body, the body including a leading end defining a first wedge tapering to a first apex, having a first plurality of annular projections on an annular surface of the first wedge;

utilizing a second anchor having a body, the body including a leading end defining a second wedge tapering to a second apex, having a second plurality of annular projections operable to engage the first plurality of annular projections on an annular surface of the second wedge;

moving the first anchor along a first path through the first body tissue and into the second body tissue;

moving the second anchor along a second path through the first body tissue and into the second body tissue, the second path intersecting the first path at a location in the second body tissue;

pivoting the first anchor from a first position aligned with a longitudinal central axis of the path of movement into the tissue to a second position skewed relative to the path of movement into the tissue;

pivoting the second anchor from a first position aligned with a longitudinal central axis of the path of movement into the tissue to a second position skewed relative to the path of movement into the tissue;

interconnecting the first anchor with the second anchor at the location in the second tissue where the first path intersects the second path by engaging the second plurality of annular projections on the second wedge of the second anchor with the first plurality of annular projections on the first wedge of the first anchor such that the anchors connect to secure the first body tissue to the second body tissue; and

utilizing a suture between the first anchor and the second anchor and applying ultrasonic vibratory energy to the suture to heat material forming the suture such that the material becomes moldable and flows when subjected to pressure.

8. A method of securing a first body tissue to a second body tissue, the method comprising:

utilizing a first anchor having a body, the body including a leading end and a trailing end, the leading and trailing ends defining a first axis, first and second sides, and an aperture midway between the leading end and the trailing end, extending generally perpendicular to the first axis;

utilizing a second anchor having a body, the body including a leading end and a trailing end, the leading end and the trailing ends defining a second axis, and at least one projection projecting from the leading end, extending generally perpendicular to the second axis;

moving the first anchor along a first path of movement through the first body tissue and into the second body tissue;

moving the second anchor along a second path of movement through the first body tissue and into the second body tissue, the second path intersecting the first path at a location in the second body tissue;

pivoting the first anchor from a position aligned with the first path of movement to a second position skewed relative to the first path of movement;

pivoting the second anchor from a position aligned with the second path of movement to a position skewed relative to the second path of movement;

moving the second anchor, transverse to the first axis, through the opening in the first anchor from the first side to the second side; and

engaging the second side of the first anchor with the at least one projection projecting from the leading end of the second anchor;

wherein the first and second anchors interconnect to secure the first body tissue to the second body tissue.