Surgery – Instruments – Suture retaining means
Reexamination Certificate
1998-07-13
2001-01-16
Jackson, Gary (Department: 3731)
Surgery
Instruments
Suture retaining means
C606S228000, C156S073100
Reexamination Certificate
active
06174324
ABSTRACT:
FIELD OF THE INVENTION
The invention relates to surgical suture fastening devices.
BACKGROUND OF THE INVENTION
In the surgical repair of soft tissue, such as, for example, the surgical reattachment of ligaments to bone or the attachment of tendon to muscle, it is known to use multi-part devices to surgically fasten the soft tissues to be repaired to the bone so as to avoid the use of knots. Suture knots are disadvantageous because they can be difficult to effect in tight spaces, they may not be uniformly tensioned and thus may slip or bind, and they can cause pressure on, or trauma to, surrounding tissue.
U.S. Pat. No. 5,593,425 to Bonutti et al. discloses surgical suture fastening devices which are assembled using a heat bondable material. The '425 patent teaches that a portion of a suture thread is inserted into an opening in a retainer formed of a plastic material having a melting point which is lower than the melting point of the suture material. At least one portion of the retainer is heated to its melting point. The plastic material of the retainer flows around the suture thread and creates a bond with the suture thread as the molten plastic material of the retainer cools below its melting point.
One disadvantage of the device disclosed in the '425 patent is that the surgeon must maintain tension on the retainer while simultaneously heat bonding the retainer to the suture, a sometimes difficult procedure. Another disadvantage of the Bonutti et al. device is that because the material of the retainer melts over the suture strands to encase them, instead of the suture material itself melting and bonding to itself, it may be difficult to control the geometry of the bond and/or the melting of the retainer and sutures, resulting in non-uniform coverage of the sutures by the melted material which flows around it.
It would therefore be an advantage to provide a suture fastening device that not only holds the strands of a suture thread together in preparation for bonding, but also effects melting of the suture strands within the device so that the sutures themselves are joined together and are not merely encased in a retainer which has been melted and cooled around them.
SUMMARY OF THE INVENTION
According to one aspect of the invention, there is provided a suture guide and fastener, comprising a suture retaining device adapted to receive one or more suture strands. This device includes:
i) means for orienting the suture strands within the device so that the suture strands are contiguous for at least a portion of their respective lengths within the device; and
ii) means for receiving applied energy to the contiguous portion of the suture strands to effect bonding of the suture strands within the suture retaining device.
In a preferred embodiment, the means for orienting the suture strands includes guides for providing slidable insertion of the suture strands into and through the suture retaining device.
The fastener can further include means for retaining the suture strands in the device, preferably including one or more recesses in the suture retaining device. In a preferred embodiment, such a recess has a depth of at least two diameters of the suture strand, and a width of less than two diameters of the suture strand, whereby the suture strands in the recess are overlapped over at least a portion of their respective lengths. The device further preferably includes means for securing non-overlapping portions of the suture strands within the suture retaining device. The means for receiving applied energy preferably includes an opening in the suture retaining device which provides direct access to the suture strands therein, so that an energy source, such as an ultrasonic weld horn or laser or heat source, can be applied directly to the suture strands to bond them.
In an alternative embodiment, the means for retaining the suture strands in a contiguous orientation includes at least two recesses in the suture retaining device, each recess being adapted to receive a single suture strand. The suture strand contacing surfaces of the recess are preferably contoured to provide maximum contact area between the suture retaining device and the suture strands. In this embodiment, the suture retaining device encloses the suture strands, and energy is applied to an external surface of the suture retaining device.
The applied energy is preferably ultrasonic or thermal energy applied with, for example, an ultrasonic welding horn or a laser. If ultrasonic energy is applied, the suture retaining device preferably functions as a stationary ultrasonic weld anvil and holds one of the suture strands stationary relative to the other to create relative motion between them and cause localized melting of the suture strands as a result of frictional heating.
In one embodiment, the suture retaining device and the suture strands are preferably made of a material which melts upon application of ultrasonic energy thereto, whereby bonding is effected between the suture strands and the suture retaining device upon application of ultrasonic energy thereto.
In an alternative embodiment, the sutures only are made of a material which melts upon application of ultrasonic energy thereto, whereby bonding is effected between the suture strands within the suture retaining device upon application of ultrasonic energy thereto.
In another embodiment, the fastener can further include a suture thread fixedly attached at one end thereof to a portion of the suture retaining device.
REFERENCES:
patent: 3513848 (1970-05-01), Winston et al.
patent: 4662068 (1987-05-01), Polonsky
patent: 5593425 (1997-01-01), Bonutti et al.
Egan Thomas D.
Taylor Daniel C.
Axya Medical Inc.
Jackson Gary
McDermott & Will & Emery
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