Suture anchor device

• US 6,110,183 A
• Filed: 12/22/1998
• Issued: 08/29/2000
• Est. Priority Date: 12/22/1998
• Status: Expired due to Term

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Cope, Constantin
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): TRINH, HOA B
• Application Number:
  US09/219,330
• Time in Patent Office: 616 Days
• Field of Search: 606/139, 606/144-148, 606/232, 112/169, 112/80.03, 604/104, 604/168
• US Class Current: 606/139
• 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• 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 2017/061 hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185

Abstract

A suture anchor device, a visceral anchor for anchoring a viscus to a body wall, a kit for anchoring a viscus to a body wall and a method for anchoring a viscus to a body wall are described. The method and device reduce the probability of injuring the interior of a viscus as a large gauge needle is not required to deliver the visceral anchor. In one embodiment, the distal end of the visceral anchor may function as a dilator.

Claims

1. A suture anchor device, comprising:

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and

a visceral anchor comprising;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and

an attachment member disposed within said lumen of said second sheath and configured to secure said suture.

2. The device of claim 1, wherein said suture has a proximal end and a distal end, said proximal end attached to a suture needle and said distal end being said first secured region.

3. The device of claim 1, wherein said device further comprises a suture securing means.

4. The device of claim 3, wherein said suture securing means comprises a cap disposed at said proximal end of said first sheath, said cap having a locking slot.

5. The device of claim 4, wherein said first secured region of said suture is positioned in said locking slot.

6. The device of claim 1 wherein said attachment member comprises an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough.

7. The device of claim 6, wherein said attachment member comprises a first sleeve disposed about said elongated member.

8. The device of claim 7, wherein said first sleeve is disposed circumferentially about said elongated member.

9. The device of claim 7, wherein said attachment member comprises a second sleeve disposed about said elongated member in spaced relation to said first sleeve.

10. The device of claim 9, wherein said second sleeve is disposed circumferentially around said elongated member.

11. The device of claim 1, wherein said reinforcing member and said attachment member of said anchor are telescopingly engaged.

12. The device of claim 1, wherein said distal end of said second sheath is tapered.

13. The device of claim 12, wherein said distal end of said second sheath is conical.

14. A suture anchor device, comprising:

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;

a cap mounted at said proximal end of said first sheath, said cap having a locking slot; and

a visceral anchor comprising;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath; and

a suture having a first secured region and a second secured region, the first secured region being a distal end of said suture attached to said anchor.

15. A suture anchor device, comprising:

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a cannula having a proximal end, a distal end and a lumen extending longitudinally therethrough, said cannula disposed in said lumen of said first sheath; and

a visceral anchor comprising;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

a suture having a first secured region and a second secured region, said first secured region being attached to said anchor; and

an attachment member disposed within said lumen of said second sheath and configured to secure said suture.

16. The device of claim 15, said device further comprising a suture securing means.

17. the device of claim 16, wherein said suture securing means comprises a cap mounted at said proximal end of said first sheath, said cap having a locking slot.

18. The device of claim 17, wherein said second secured region of said suture is positioned in said locking slot.

19. The device of claim 15, wherein translational movement of said cannula relative to said first sheath results in deployment of said anchor.

20. The device of claim 15, wherein said distal end of said second sheath is tapered.

21. The device of claim 20, wherein said distal end of said second sheath is conical.

22. A suture anchor device, comprising:

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

an elongated member disposed in said lumen of said second sheath, said elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough; and

a suture having a first secured region and a second secured region, said first secured region being attached to said elongated member.

23. A visceral anchor for anchoring a viscus to a body wall, comprising:

a sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said sheath; and

a suture having opposing ends, one of said opposing ends attached to said anchor.

24. The anchor of claim 23, said anchor further comprising at least one sleeve disposed about said elongated member.

25. The anchor of claim 23, wherein said attachment member comprises two sleeves disposed about said elongated member.

26. The anchor of claim 23, wherein the other of said opposite ends of said suture is attached to a suture needle.

27. The anchor of claim 23, wherein said distal end of said sheath is configured for entering a passageway in a body made by puncturing a region of said body.

28. The anchor of claim 23, wherein said distal end of said sheath is tapered.

29. The anchor of claim 23, wherein said one of said opposing ends is attached to said attachment member.

30. A visceral anchor, comprising:

a sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said sheath, said attachment member including at least one sleeve circumferentially disposed about said elongated member; and

a suture having opposing ends, one of said opposing ends attached to said anchor.

31. The anchor of claim 30, wherein said anchor further comprises a second sleeve, said second sleeve disposed about said elongated member in spaced relation to said at least one sleeve.

32. The anchor of claim 30, wherein said one of said opposing ends is attached to said attachment member.

33. A kit for anchoring a viscus to a body wall, comprising:

a needle;

a suture anchor device, said device comprising;

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;

a visceral anchor comprising;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

a suture having a first secured region and a second secured region, said first secured region being attached to said anchor; and

an attachment member disposed within said lumen of said second sheath and configured to secure said suture.

34. The kit of claim 33, further including a wire guide.

35. A kit for anchoring a viscus to a body wall, comprising:

a needle;

a suture anchor device, said device comprising;

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

an elongated member disposed in said lumen of said second sheath, said elongated member having a proximal end, a distal end, a lumen extending longitudinally therethrough; and

a suture having a first secured region and a second secured region, said first secured region being attached to said elongated member.

36. The kit of claim 35, further including a wire guide.

37. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:

providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus lumen;

positioning a suture anchor device through said tract and in said viscus lumen, said device comprising;

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and

a visceral anchor including;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and

an attachment member disposed within said lumen of said second sheath and configured to secure said suture;

deploying said anchor into said viscus lumen; and

moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.

38. The method of claim 37, wherein said proximal end of said suture is attached to a suture needle.

39. The method of claim 37, said method further comprising anchoring said suture outside of the body to retain said viscus against the body wall.

40. The method of claim 37, wherein said anchoring comprises inserting said suture needle into the skin of said body.

41. The method of claim 37, wherein said device further comprises a suture securing means.

42. The method of claim 41, wherein said suture securing means comprises a cap mounted at said proximal end of said first sheath, said cap having a locking slot.

43. The method of claim 42, wherein said deploying said anchor comprises removing said suture from said locking slot of said cap.

44. The method of claim 37, wherein said deploying said anchor comprises moving said reinforcing member relative to said first sheath so that said anchor is deployed in said viscus lumen.

45. The method of claim 37, wherein said providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen comprises making a puncture by inserting a needle through the skin and into said viscus lumen.

46. The method of claim 45, wherein said needle has a lumen.

47. The method of claim 46, further comprising inserting a wire guide through said lumen of said needle and into said viscus lumen and removing said needle.

51. The method of claim 47, wherein said wire guide is a micro wire guide.

48. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:

puncturing the skin with a needle having a lumen to provide a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus lumen;

inserting a wire guide through the lumen of said needle and into said viscus lumen;

removing said needle;

positioning a suture anchor device through said tract and in said viscus lumen, said device comprising;

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath; and

a visceral anchor comprising;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

a suture having a first secured region and a second secured region, the first secured region being attached to said anchor; and

an attachment member disposed within said lumen of said second sheath and configured to secure said suture;

deploying said anchor into said viscus lumen; and

moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.

49. A method for anchoring a viscus to a body wall of a patient, said viscus having an interior viscus wall and a viscus lumen, said method comprising:

providing a tract from outside of the body through the skin and said interior viscus wall to said viscus lumen, the tract having a longitudinal axis extending from outside the body to said viscus lumen;

positioning a suture anchor device through said tract and in said viscus lumen, said device comprising;

a first sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough;

a reinforcing member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said reinforcing member disposed in said lumen of said first sheath;

a second sheath having a proximal end, a distal end and a lumen extending longitudinally therethrough, said proximal end of said second sheath abutting said distal end of said first sheath;

an attachment member including an elongated member having a proximal end, a distal end and a lumen extending longitudinally therethrough, said attachment member disposed in said lumen of said second sheath, said attachment member including at least one sleeve circumferentially disposed about said elongated member; and

a suture having a first secured region and a second secured region, said first secured region being attached to said device;

deploying said anchor into said viscus lumen; and

moving said proximal end of said suture to draw said anchor against the interior wall of said viscus so that said viscus is pulled against the body wall.

50. The method of claim 49, wherein said first secured region is attached to said attachment member.

52. A surgical apparatus adapted to be inserted through a body wall to form an anchor relative to the body wall comprising:

a two piece dilator having a first piece and a releasable second piece, said first piece being an outer cannula having a near end and a far end, the outer cannula having an outer surface and an inner surface extending between the near end and the far end, the inner surface defining a first passageway extending generally along a first axis between the near end and far end, said releasable second piece having a first end and a second end, said second piece having an outward facing surface and an inward facing surface extending between the first end and the second end, the inward facing surface defining a second passageway extending generally along a second axis between the first end and second end;

a pull string having a first end and a second end, the second end of said pull string being attached to said second piece;

an elongated member having a proximal end and a distal end, said member having an outer surface and an inner surface extending between the proximal end and the distal end, the inner surface of said member defining a third passageway extending between the proximal end and distal end, said member adapted to fit within the first passageway of said first piece; and

,

said apparatus having a first mode wherein said member is generally disposed within the first passageway and the distal end of said member acts as a telescoping joint such that said first piece and said second piece are associated with one another and the first axis is substantially parallel to the second axis, the distal end of said member extending beyond the far end of said first piece and into the first end of the second passageway in the first mode, and said apparatus having a second mode wherein said second piece is released when the distal end of said member is substantially withdrawn from the second passageway.

53. The apparatus of claim 52, wherein the second end of said second piece is tapered.

54. The apparatus of claim 52, wherein the first axis is substantially coaxial with the second axis in the first mode.