SURGICAL SUTURE ARRANGEMENT

• US 20090326561A1
• Filed: 06/27/2008
• Published: 12/31/2009
• Est. Priority Date: 06/27/2008
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Spivey, James T., Carroll, Kempton K. II, Linenkugel, Duane A.
• Granted Patent: US 8,361,112 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• 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 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• 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

Abstract

A surgical instrument may comprise a shaft having proximal and distal ends defining an axis therebetween. The shaft may be flexible and sized for insertion into the working channel of a flexible endoscope. The shaft may be configured to be used in conjunction with various suture anchor applicators. One suture anchor applicator may have a first tube with a first channel and a tissue penetrating tip. The first channel may be adapted to retain a second tube. The second tube may have a second channel and a blunt tip. The second channel may be adapted to retain at least one suture anchor and may include an exit port adapted for ejecting suture anchors. An alternative suture anchor applicator may comprise a first tube and a second tube with a tissue penetrating tip. The second channel is adapted to retain at least one suture anchor.

Claims

1. A surgical instrument, comprising:

a shaft having proximal and distal ends defining an axis therebetween, wherein the shaft is flexible and sized for insertion into the working channel of a flexible endoscope, and wherein the shaft comprises;

a first tube having a first channel extending from the proximal end of the first tube to the distal end of the first tube, wherein the distal end of the first tube is formed into a tissue penetrating tip, wherein at least a portion of the first channel is adapted to retain a second tube;

the second tube having a second channel extending from the proximal end of the second tube to the distal end of the second tube, wherein the distal end of the second tube is a blunt tip, wherein the second channel is adapted to retain at least one suture anchor, and wherein the second tube includes an exit port adapted for ejecting suture anchors;

a tag pusher;

a stylet pusher; and

a compression member disposed between the stylet pusher and the proximal end of the second tube.

2. The surgical instrument of claim 1, wherein the tag pusher is at least partially contained within the stylet pusher.

3. The surgical instrument of claim 2, wherein the tag pusher extends from the stylet pusher, through the compression member, and into the second channel to eject the suture anchor.

4. The surgical instrument of claim 1, wherein the compression member is in an expanded position.

5. The surgical instrument of claim 4, wherein the compression member enters into a compressed position when the blunt tip is pressed against tissue to be penetrated.

6. The surgical instrument of claim 5, wherein the compression member allows the first tube to extend past the second tube to penetrate tissue when a specified amount of force is applied to the blunt tip.

7. The surgical instrument of claim 1, wherein the first tube contains a slot in the first channel which corresponds with the exit port of the second tube.

8. The surgical instrument of claim 7, wherein the slot and the exit port are configured to allow a suture to run from the suture anchor proximally towards the proximal end of the surgical instrument.

9. The surgical instrument of claim 1, wherein the second tube is slidably retained in the first tube.

10. A surgical instrument, comprising:

a shaft having proximal and distal ends defining an axis therebetween, wherein the shaft is flexible and sized for insertion into the working channel of a flexible endoscope, and wherein the shaft comprises;

a first tube having a first channel extending from the proximal end of the first tube to the distal end of the first tube, wherein at least a portion of the first tube is adapted to retain a second tube;

the second tube having a second channel extending from the proximal end of the second tube to the distal end of the second tube, wherein the distal end of the second tube is formed into a tissue penetrating tip, and wherein the second channel is adapted to retain at least one suture anchor; and

a tag pusher, wherein the tag pusher comprises a first member and a second member connected with a compression member.

11. The surgical instrument of claim 10, wherein the tag pusher extends at least partially into the second channel.

12. The surgical instrument of claim 10, wherein a suture anchor is retained at a distal end of the tag pusher.

13. The surgical instrument of claim 10, wherein the suture anchor extends distally past the tissue penetrating tip in a shielding position.

14. The surgical instrument of claim 10, wherein the compression member compresses when a force is applied to the suture anchor.

15. The surgical instrument of claim 14, wherein the compression member enters into a compressed position when the suture is pressed against tissue to be penetrated.

16. The surgical instrument of claim 15, wherein the compression member allows the second tube to extend past the suture anchor to penetrate tissue when a specified amount of force is applied to the suture anchor.

17. The surgical instrument of claim 16, wherein the suture anchor is ejected from the second channel once the tissue penetrating tip has punctured the tissue.

18. A method comprising:

pressing a first member of a surgical instrument against a patient'"'"'s tissue;

retracting the first member into a second member of the surgical instrument by applying a sufficient amount of force to overcome the force exerted on the first member by a compression member;

penetrating the patient'"'"'s tissue;

deploying a suture anchor applicator on a distal side of the patient'"'"'s tissue; and

removing the first member and the second member from the patient'"'"'s tissue.

19. The method of claim 18, wherein the suture anchor may be deployed by firing a tag pusher.

20. The method of claim 18, wherein the suture anchor may be deployed by the springing action of the compression member.

21. The method of claim 18, further comprising:

sterilizing the surgical instrument; and

storing the surgical instrument in a sterile container.