Apparatus for the treatment of tissue

• US 9,675,347 B2
• Filed: 12/30/2013
• Issued: 06/13/2017
• Est. Priority Date: 10/20/1999
• Status: Expired due to Fees

• Current Assignee: KRT Investors, Inc.
• Original Assignee: KRT Investors, Inc.
• Inventors: Burns, Matthew M., Wales, Lawrence W., Dukart, Brian L., Wessman, Bradley J., Houfburg, Rodney L., Bentley, Ishmael, Cauthen, III, Joseph C.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US14/144,017
• Publication Number:
  US 20140316439A1
• Time in Patent Office: 1,261 Days
• Field of Search: 623 1711- 1716, 606 79, 606 80, 606 83, 606 84, 606 86 R, 606138-149, 606151, 606279
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• 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 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/30907 Nets or sleeves applied to surface of prostheses or in cement
• CPC Class Codes: A61F 2/3872 Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/0072 Delivery tools therefor
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/3008 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30158 : trapezoidal
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30451 : soldered or brazed or welded
• CPC Class Codes: A61F 2002/30461 : sutured, ligatured or stitched
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30784 : Plurality of holes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/3097 : using laser
• 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
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2210/0019 : operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00011 : Metals or alloys

Abstract

A system for treatment of tissue includes a fixation apparatus and a delivery tool releasably carrying the fixation apparatus. The fixation apparatus includes first and second anchors and an adjustable band connecting the anchors. The band includes a cinch line and a tether connected to one of the anchors. The delivery apparatus includes a body, a tubular shaft, a displacement rod within the tubular shaft, and an actuator.

Claims

1. A medical apparatus comprising:

a delivery apparatus releasably carrying a fixation apparatus,

the delivery apparatus including a body, a tubular shaft extending from the body and having a distal end, a displacement rod longitudinally displaceable within the body and the tubular shaft and including a proximal end and a distal end, and an actuator coupled to the body and attached to the proximal end of the displacement rod,

the fixation apparatus including first and second anchors, a flexible band connecting the first and second anchors and including a cinch line releasably coupled to the delivery apparatus, and a tether having a proximal end and a distal end;

wherein the actuator is operable by a user to sequentially eject the first anchor and the second anchor from the distal end of the tubular shaft, and

wherein the proximal end of the tether is secured to the delivery apparatus and the distal end of the tether is attached to the second anchor such that the tether is operable to prevent ejection of the second anchor from the tubular shaft during ejection of the first anchor from the tubular shaft.

2. The medical apparatus of claim 1, wherein the fixation apparatus includes a first suture connected to the first anchor, a separate, second suture connected to the second anchor, and wherein the band includes a separate, third suture coupled to the first and second sutures, the third suture forming a suture loop having an adjustable length, and the cinch line is configured such that applying tension to the cinch line foreshortens the adjustable length of the suture loop.

3. The medical apparatus of claim 2, wherein the first and second sutures are each in the form of a suture loop, and wherein the third suture extends through the loops formed by the first and second sutures such that the first and second anchors are slidably coupled to the third suture.

4. The medical apparatus of claim 1, wherein the delivery apparatus further includes a system for regulating movement of the actuator and the displacement rod.

5. The medical apparatus of claim 4, wherein the system for regulating movement of the actuator is configured to allow the actuator and the displacement rod to be advanced a first distance so as to eject the first anchor from the distal end of the tubular shaft, and wherein the tether is operable to resist expulsion of the second anchor from the tubular shaft during deployment of the first anchor.

6. The medical apparatus of claim 5, wherein the system for regulating movement of the actuator is configured to allow the actuator and the displacement rod to be advanced a second distance so as to eject the second anchor from the distal end of the tubular shaft.

7. The medical apparatus of claim 6, wherein the delivery apparatus is further configured to sever the tether during ejection of the second anchor from the distal end of the tubular shaft so that the tether does not resist ejection of the second anchor from the distal end of the tubular shaft.

8. The medical apparatus of claim 1, wherein the tether extends through the tubular shaft, and wherein the proximal end of the tether is attached to the delivery apparatus within the body of the delivery apparatus.

9. The medical apparatus of claim 8, wherein the delivery apparatus includes a tether severing element in the body including a cutting edge for severing the tether.

10. The medical apparatus of claim 1, wherein the delivery apparatus includes a guide extending into the body, a guide spring biasing the guide toward the actuator, and displacement spring in the body biasing the displacement rod in a proximal direction and away from the distal end of the tubular shaft, and wherein the actuator includes a groove, and wherein the guide extends into and is slidably received by the groove so as to regulate movement of the actuator and the displacement rod.

11. The medical apparatus of claim 1, wherein the groove includes a first longitudinally extending portion having a first length, and a second longitudinally extending portion having a second length, and wherein the actuator is configured to be advanceable a first distance corresponding to the first length so as to eject the first anchor from the distal end of the tubular shaft, and is further configured to be advanceable a second distance corresponding to the second length so as to eject the second anchor from the distal end of the tubular shaft.

12. The medical apparatus of claim 11, wherein the groove further includes a radially extending portion between the first and second longitudinally extending portions, and wherein the actuator is rotatable relative to the body after it has been advanced the first distance.

13. The medical apparatus of claim 12, wherein the actuator is configured to be advanceable the second distance after is has been rotated relative to the body.

14. The medical apparatus of claim 13, wherein the delivery apparatus is configured such that advancing the actuator the second distance causes the tether line to be severed within the body.

15. The medical apparatus of claim 1, wherein the fixation apparatus is configured to secure an implant to soft tissue of a patient.

16. The medical apparatus of claim 15, wherein the implant is a therapeutic device.

17. The medical apparatus of claim 16 wherein the implant is an orthopedic device.

18. The medical apparatus of claim 17 wherein the orthopedic device is a mesh configured to repair a defect in an annulus of an intervertebral disc.

19. The medical apparatus of claim 1, wherein the fixation apparatus is configured to re-approximate a defect in soft tissue of a patient.

20. The medical apparatus of claim 19, wherein the soft tissue is an intervertebral disc annulus.