Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Reexamination Certificate
1999-04-05
2001-11-27
Reip, David O. (Department: 3731)
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
C606S148000, C606S144000, C606S207000
Reexamination Certificate
active
06322571
ABSTRACT:
TECHNICAL FIELD OF THE INVENTION
The invention relates generally to medical devices and more particularly to apparatus and methods for repairing a divided or ruptured tendon, ligament and other fibrous body tissues using a suture.
BACKGROUND OF THE INVENTION
A wide variety of equipment and procedures have previously been used to perform tenorrhaphy, the union of a divided or ruptured tendon by a suture and tenodesis, the suturing of the end of a tendon to a bone. Over the past decade, several multiple grasping, multiple strand suture techniques have been developed to repair tendon lacerations. These techniques are based on the concept that repair strength is roughly proportional to the number of suture strands that cross the repair site. In addition, suturing techniques that appropriately grasp a tendon at multiple sites generally create a stronger repair than a simple weave.
Although these repair techniques provide greater strength, their use has not been widespread because they are technically quite demanding. In fact, even traditional methods of tendon repair are difficult to satisfactorily perform due to the small size and other characteristics of tendons and the correspondingly small surgical field. The technique of tendon repair has become an even greater concern due to demands placed on such repairs by aggressive rehabilitation. Thus, surgeons face the dilemma of using stronger suture techniques to improve outcome but which are also much more difficult and time-consuming to perform and may possibly cause additional damage to the tendon.
During tendon repair, it is important to minimize any further damage to a lacerated tendon. The lacerated ends of a tendon tend to fray when handled, especially when an attempt is made to place multiple sutures in the lacerated end of the tendon. In addition, surgical trauma increases postoperative adhesions possibly resulting in decreased digital motion which is undesirable.
SUMMARY OF THE INVENTION
Accordingly, a need has arisen for improved equipment and methods to place multiple sutures in the lacerated end of a tendon, ligament or other types of fibrous body tissues. One aspect of the present invention includes a tendon suture-repair device having a clamp assembly for securely holding the lacerated end of a tendon and guiding suture placement in the lacerated end. Another aspect of the present invention includes providing a clamp assembly having a cutting guide to allow easy and neat trimming of the lacerated end of a tendon or ligament prior to placement of one or more sutures therein. A manipulator is preferably provided for opening and closing the clamp assembly and positioning the clamp assembly with the lacerated end disposed therein during surgical repair.
According to one embodiment of the invention, a repair technique and device are provided to efficiently produce a high quality multiple grasping, multiple strand suture repair of a lacerated tendon. The device achieves the advantages of such repair while eliminating most of the frustration associated with traditional tendon suturing techniques. In addition, the device greatly reduces unwanted and deleterious handling of a tendon to substantially mitigate surgical trauma which often occurs with the use of standard surgical instruments.
Technical benefits of the present invention include tendon repair procedures and equipment satisfactory for use with contemporary surgical practices and rehabilitation programs. The relatively small size and configuration of equipment incorporating teachings of the present invention is compatible with relatively small surgical fields commonly associated with tendon and ligament repair. Additional technical benefits include providing generally a stronger tendon repair as compared to traditional tenorrhaphy equipment and procedures. The resulting tendon repair will generally meet or exceed the standards of contemporary surgery and rehabilitation for tendon injuries. More aggressive rehabilitation programs have demonstrated improved clinical results for patients having a lacerated tendon. Repairing a tendon using apparatus and methods incorporating teachings of the present invention will often allow patients to better participate in such rehabilitation programs.
Another aspect of the present invention includes providing apparatus and methods which may be used to repair lacerated tendons or ligaments in a patient's upper and lower extremities and for suturing the end of a tendon to a bone. One embodiment of the present invention includes a clamp assembly having a channel formed therein to securely but gently hold the lacerated end of a tendon and substantially reduce or eliminate deleterious effects of handling the tendon during placement of sutures. The size and shape of a clamp assembly and associated components may be selected in accordance with the teachings of the present invention to accommodate restrictions imposed by relatively small operating fields available during tendon repair surgery. A tendon repair system incorporating teachings of the present invention is generally more accurate and efficient as compared to previous techniques and provides more uniform, reproducible results from one surgical procedure to the next.
Equipment and procedures incorporating teachings of the present invention may be used by all surgeons as well as any physician who performs tendon and ligament repairs, including emergency room (ER) physicians. In addition, such equipment and procedures may be used for tendon or ligament transfer and operations that use body tissue grafts such as a ligament reconstruction in the hand or foot.
REFERENCES:
patent: 963899 (1910-07-01), Kistler
patent: 3176316 (1965-04-01), Bodell
patent: 3545008 (1970-12-01), Bader, Jr.
patent: 3633582 (1972-01-01), Steinman
patent: 3745590 (1973-07-01), Stubstad
patent: 4469101 (1984-09-01), Coleman et al.
patent: 4553543 (1985-11-01), Amarasinghe
patent: 4585458 (1986-04-01), Kurland
patent: 4602634 (1986-07-01), Barkley
patent: 4635636 (1987-01-01), Goldstein
patent: 4723548 (1988-02-01), Lalonde
patent: 4960420 (1990-10-01), Goble et al.
patent: 5007920 (1991-04-01), Torre
patent: 5251642 (1993-10-01), Handlos
patent: 5298012 (1994-03-01), Handlos
patent: 5366457 (1994-11-01), McGuire et al.
patent: 5415651 (1995-05-01), Schmieding
patent: 5464415 (1995-11-01), Chen
patent: 5534008 (1996-07-01), Acksel
patent: 5593024 (1997-01-01), Seiler
patent: 5624453 (1997-04-01), Ahmed
patent: 5649937 (1997-07-01), Bito et al.
patent: 5656605 (1997-08-01), Hansson et al.
patent: 5697933 (1997-12-01), Gundlapalli et al.
patent: 5746757 (1998-05-01), McGuire
patent: 5800544 (1998-09-01), Demopoulos et al.
patent: 5843098 (1998-12-01), Allen et al.
patent: 0 820 725 A2 (1998-01-01), None
patent: WO 96/16612 (1996-06-01), None
patent: 97/37002 (1997-10-01), None
International Preliminary Examination Report for pending application PCT/US99/23491, Apr. 6, 2001.
“The Pactan Repair Device,”Small Joint Orthopaedics, by Wright Medical Technology, Inc.
“Plastic & Reconstructive/Hand Surgery” by Accurate Surgical & Scientific Instruments Corp.
International Search Report for PCT/US99/11821 mailed Sep. 6, 1999, 7 pages.
“Goldstein Microspike, Approximator Clamps fr Vasovasostomy & Vasoepididymostomy,” Accurate Surgical & Scientific Instruments Corporation.
“Surgery of Peripheral Nerves and Tendons” by V.E. Meyer, S&T Marketing Ltd.
“Flexor Tendon Injuries: I. Foundations of Treatment” by James W. Strickland, M.D.,Journal of the American Academy of Orthopaedic Surgeons, vol. 3, #1, Jan./Feb. 1995.
“Flexor Tendon Injuries: II. Operative Technique” by James W. Strickland, M.D.,Journal of the American Academy of Orthopaedic Surgeons, vol. 3, #1, Jan./Feb. 1995.
International Search Report for PCT/US 99/23491, Feb. 1, 2000.
Baker & Botts L.L.P.
Reip David O.
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