Method of using ultrasonic vibration to secure body tissue with fastening element

• US 9,067,362 B2
• Filed: 10/31/2007
• Issued: 06/30/2015
• Est. Priority Date: 03/13/2000
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M., Cremens, Matthew J., Ruholl, Kevin
• Primary Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/932,051
• Publication Number:
  US 20080108916A1
• Time in Patent Office: 2,799 Days
• Field of Search: 606/151, 606/232, 606/139
• US Class Current: 1/1
• 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 2017/0445 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 2017/0464 for soft tissue
• 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 2017/0619 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
• CPC Class Codes: B29C 65/08 using ultrasonic vibrations non-plastics element to plastics elements B29C65/645
• CPC Class Codes: B29C 65/4815 Hot melt adhesives, e.g. thermoplastic adhesives
• CPC Class Codes: B29C 65/5071 and being composed by one single element
• CPC Class Codes: B29C 65/5085 and comprising grooves, e.g. being E-shaped, H-shaped
• CPC Class Codes: B29C 66/1122 Single lap to lap joints, i.e. overlap joints B29C66/45, B29C66/472, B29C66/52272 take precedence
• CPC Class Codes: B29C 66/526 Joining bars
• CPC Class Codes: B29C 66/5261 for forming coaxial connections, i.e. the bars to be joined forming a zero angle relative to each other
• CPC Class Codes: B29C 66/69 General aspects of joining filaments bundling articles B65B13/00; interconnecting successive lengths of material B65H69/00
• CPC Class Codes: B29C 66/71 characterised by the composition of the plastics material of the parts to be joined welding bar compositions B29C65/125
• CPC Class Codes: B29C 66/7379 degradable
• CPC Class Codes: B29C 66/73791 biodegradable
• CPC Class Codes: B29C 66/81423 being concave
• CPC Class Codes: B29C 66/8322 Joining or pressing tools reciprocating along one axis
• CPC Class Codes: B29C 66/83221 : cooperating reciprocating tools, each tool reciprocating along one axis
• CPC Class Codes: B29C 66/83241 : cooperating pivoting tools
• CPC Class Codes: B29C 66/861 : Hand-held tools
• CPC Class Codes: B29C 66/8614 : Tongs, pincers or scissors
• CPC Class Codes: B29C 66/951 : by measuring or controlling the vibration frequency and/or the vibration amplitude of vibrating joining tools, e.g. of ultrasonic welding tools
• CPC Class Codes: B29C 66/9513 : characterised by specific vibration frequency values or ranges
• CPC Class Codes: B29C 66/9517 : characterised by specific vibration amplitude values or ranges
• CPC Class Codes: B29K 2059/00 : Use of polyacetals , e.g. POM, i.e. polyoxymethylene or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2067/003 : PET, i.e. poylethylene terephthalate
• CPC Class Codes: B29K 2067/006 : PBT, i.e. polybutylene terephthalate
• CPC Class Codes: B29K 2067/043 : PGA, i.e. polyglycolic acid or polyglycolide
• CPC Class Codes: B29K 2077/00 : Use of PA, i.e. polyamides, e.g. polyesteramides or derivatives thereof, as moulding material

Abstract

A suture and a suture retainer are positioned relative to body tissue. Ultrasonic vibratory energy is utilized to heat the suture retainer and effect a bonding of portions of the suture retainer to each other and/or to the suture. Portions of the body tissue may be pressed into linear apposition with each other and held in place by cooperation between the suture and the suture retainer. The suture retainer may include one or more portions between which the suture extends. The suture retainer may include sections which have surface areas which are bonded together. If desired, the suture may be wrapped around one of the sections of the suture retainer. The suture retainer may be formed with a recess in which the suture is received. If desired, the suture retainer may be omitted and the sections of the suture bonded to each other.

Claims

1. A method of securing an object with respect to body tissue using ultrasonic vibratory energy, the method comprising:

positioning the object with respect to the tissue, wherein the object is a thermoplastic;

contacting a thermoplastic fastener to the object;

applying ultrasonic vibratory energy to the fastener to heat the fastener to a fastener transition temperature, such that the object is not heated to an object transition temperature; and

deforming at least a portion of the fastener to secure the object to the fastener.

2. The method of claim 1, wherein the frequency of the ultrasonic vibratory energy is in the range of 20 kilohertz to about 70 kilohertz.

3. The method of claim 1, wherein the ultrasonic vibratory energy is transmitted for 0.25 to about 1.0 seconds.

4. The method of claim 3, further comprising squeezing the fastener for about 1 second after transmission of ultrasonic vibratory energy is stopped.

5. The method of claim 4, wherein squeezing the fastener further comprises compressing the fastener from about 0.010 to 0.050 inches.

6. The method of claim 1, further comprising tensioning the object to be fastened.

7. The method of claim 1, wherein the object is at least one of a suture, pin, bolt, wire, and fastener.

8. The method of claim 1, wherein applying ultrasonic vibratory energy further includes transmitting ultrasonic vibratory energy through the fastener to the object.

9. The method of claim 1, wherein the fastener is deformed with an ultrasonic vibratory energy transmitter and the ultrasonic vibratory energy transmitter applies the ultrasonic vibratory energy to the deformed fastener.

10. The method of claim of claim 9, wherein the ultrasonic energy transmitter does not contact the object.

11. The method of claim 1, wherein the fastener is secured to the object with a first portion of an inner surface of the fastener bonding to a second portion of the inner surface of the fastener.

12. A method of securing a fastener in a patient using ultrasonic vibratory energy, the method comprising:

positioning an elongated object in the patient, wherein the elongated object includes at least a portion of a thermoplastic;

positioning the fastener including a material that deforms with the application of heat in contact with the object, wherein the fastener includes at least a portion of a thermoplastic;

contacting at least a portion of a horn communicating vibratory ultrasonic energy to at least a portion of the fastener;

applying ultrasonic vibratory energy to the fastener to heat the fastener to a fastener transition temperature, such that the object is not heated to an object transition temperature; and

deforming the fastener to secure the object to the fastener.

13. The method of claim 12, wherein the object is at least one of a tendon, ligament, suture, pin, bolt, wire, and fastener.

14. The method of claim 12, wherein applying ultrasonic vibratory energy further includes transmitting ultrasonic vibratory energy through the fastener to the object.

15. The method of claim 12, wherein the object includes a polymeric material.

16. A method of securing a fastener in a body using ultrasonic vibratory energy, the method comprising:

positioning an elongated object in the body, wherein the elongated object includes at least a portion of a thermoplastic;

positioning a fastener including a thermoplastic material deformable upon the application of heat in contact with the object;

contacting at least a portion of a horn communicating vibratory ultrasonic energy to at least a portion of the fastener;

applying pressure to urge the fastener against the object; and

applying ultrasonic vibratory energy to the fastener to heat the fastener to a fastener transition temperature, such that the object is not heated to an object transition temperature, to thereby secure the object to the fastener.

17. The method of claim 16, wherein the fastener is secured to the object and the fastener is deformed with a first portion of an inner surface of the fastener bonding to a second portion of the inner surface of the fastener.