CA2280575A1 - Cannulated tissue anchor system - Google Patents
Cannulated tissue anchor system Download PDFInfo
- Publication number
- CA2280575A1 CA2280575A1 CA002280575A CA2280575A CA2280575A1 CA 2280575 A1 CA2280575 A1 CA 2280575A1 CA 002280575 A CA002280575 A CA 002280575A CA 2280575 A CA2280575 A CA 2280575A CA 2280575 A1 CA2280575 A1 CA 2280575A1
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- Prior art keywords
- needle
- tissue anchor
- tissue
- anchor
- bore
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0416—Packages or dispensers for suture anchors or for anchor applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0646—Surgical staples, i.e. penetrating the tissue for insertion into cartillege, e.g. meniscus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/916—Tool for installing or removing orthopedic fastener
Abstract
A system for inserting a cannulated tissue anchor during endoscopic surgical procedures. The system incorporates an elongated generally cylindrical tissue anchor having a plurality of barbs outwardly extending from its body and a transverse head situated at its proximal end. The head is elongated along a major axis which is misaligned relative to the rows of barbs on the body of the tissue anchor in order to enhance retention of the anchor within selected tissue. The anchor may be inserted during an endoscopic surgical procedure by a single-handed operation utilizing an instrument having a longitudinally slidable needle for guiding the anchor into place and a longitudinally slidable push rod for pushing the anchor along the needle. The system incorporates a package/loading device to facilitate the assembly of a cannulated tissue anchor with the inserter, the package/loading device being provided with a means for guiding the inserter needle through the axial bore of the tissue anchor.
Description
CANNULATED TISSUE ANCHOR SYSTEM
BACKGROUND OF THE INVENTION
FIELD OF THE INVENTION
The invention relates to implant devices and instruments used to repair body tissue. In particular, the invention relates to an implant device, instruments and methods for repairing body tissue during endoscopic surgical procedures.
Still more particularly, the invention relates to implant devices, instruments and methods for repairing meniscal tissue during arthroscopic surgery of the knee.
DESCRIPTION OF THE PRIOR ART
Implant devices for repairing body tissue are known in the prior art. While such devices may be classified into several categories, the present invention is related to elongated devices having transversely extending barbs or projections which assist in retaining the implant in place within a tissue defect (e.g. a tear) to hold body tissue in close approximation during the healing process.
One such known device is described in U.S. Patent 4,873,976 (Schrieber). This device comprises a solid elongated shaft having a plurality of transversely extending projections, a pointed tip and a transverse circular head at its proximal end.
Other similar devices are disclosed in U.S. Patents 4, 884, 572; 4, 895, 148; 4, 924, 865; and 4, 976, 715 all issued to Bays et al. The devices disclosed in these Bays et al. patents primarily differ from the Schrieber device in that they are cannulated. The Bays et al. patents are assigned to the assignee hereof and, along with Schrieber, are incorporated by reference herein.
All of the above described elongated devices are arrow-like and are designed to be inserted or pushed into tissue to be repaired. The devices are sometimes referred to as "tissue anchors" because they hold tissue together during healing. While these devices are intended to be used during arthroscopic or more generally endoscopic procedures, that very fact makes the insertion sometimes difficult. It is known to use elongated cannulas to guide the implants into position and smaller push rods to push them in. In the Schrieber type device, the implant is pushed through a cannula with an elongated pusher sized to be slidingly received within the cannula. With devices such as those disclosed in the Bays et al. patents the implant device is secured to the distal tip of a holding device and pushed into place, with or without the use of a guiding cannula.
BACKGROUND OF THE INVENTION
FIELD OF THE INVENTION
The invention relates to implant devices and instruments used to repair body tissue. In particular, the invention relates to an implant device, instruments and methods for repairing body tissue during endoscopic surgical procedures.
Still more particularly, the invention relates to implant devices, instruments and methods for repairing meniscal tissue during arthroscopic surgery of the knee.
DESCRIPTION OF THE PRIOR ART
Implant devices for repairing body tissue are known in the prior art. While such devices may be classified into several categories, the present invention is related to elongated devices having transversely extending barbs or projections which assist in retaining the implant in place within a tissue defect (e.g. a tear) to hold body tissue in close approximation during the healing process.
One such known device is described in U.S. Patent 4,873,976 (Schrieber). This device comprises a solid elongated shaft having a plurality of transversely extending projections, a pointed tip and a transverse circular head at its proximal end.
Other similar devices are disclosed in U.S. Patents 4, 884, 572; 4, 895, 148; 4, 924, 865; and 4, 976, 715 all issued to Bays et al. The devices disclosed in these Bays et al. patents primarily differ from the Schrieber device in that they are cannulated. The Bays et al. patents are assigned to the assignee hereof and, along with Schrieber, are incorporated by reference herein.
All of the above described elongated devices are arrow-like and are designed to be inserted or pushed into tissue to be repaired. The devices are sometimes referred to as "tissue anchors" because they hold tissue together during healing. While these devices are intended to be used during arthroscopic or more generally endoscopic procedures, that very fact makes the insertion sometimes difficult. It is known to use elongated cannulas to guide the implants into position and smaller push rods to push them in. In the Schrieber type device, the implant is pushed through a cannula with an elongated pusher sized to be slidingly received within the cannula. With devices such as those disclosed in the Bays et al. patents the implant device is secured to the distal tip of a holding device and pushed into place, with or without the use of a guiding cannula.
All such arrow-like implant devices must not only enter tissue easily, but must resist migration once situated in place.
Consequently, it is an object of this invention to provide a tissue anchor which has barbs to facilitate insertion and has a head design to minimize distal migration.
It is desirable to simplify the insertion process for these types of push-in arrow-like implant devices. It is also desirable to make such modifications to prior art arrow-like implant devices and systems as may improve their use and performance during and after (i.e. during healing when retention within tissue is important).
Accordingly, it is a further object of this invention to develop a tissue repair system incorporating a cannulated push-in implant or tissue anchor device, preferably bioabsorbable, and a simplified insertion apparatus, preferably operable by one hand.
It is also generally an object of this invention to provide a tissue anchor inserting device and method for guiding and inserting a cannulated tissue anchor into position at a surgical site.
It is another object of this invention to provide an elongated inserting device for receiving therein a cannulated tissue anchor, preferably at its distal end.
Consequently, it is an object of this invention to provide a tissue anchor which has barbs to facilitate insertion and has a head design to minimize distal migration.
It is desirable to simplify the insertion process for these types of push-in arrow-like implant devices. It is also desirable to make such modifications to prior art arrow-like implant devices and systems as may improve their use and performance during and after (i.e. during healing when retention within tissue is important).
Accordingly, it is a further object of this invention to develop a tissue repair system incorporating a cannulated push-in implant or tissue anchor device, preferably bioabsorbable, and a simplified insertion apparatus, preferably operable by one hand.
It is also generally an object of this invention to provide a tissue anchor inserting device and method for guiding and inserting a cannulated tissue anchor into position at a surgical site.
It is another object of this invention to provide an elongated inserting device for receiving therein a cannulated tissue anchor, preferably at its distal end.
It is still another object of this invention to provide an elongated inserting device suitable for endoscopic procedures and capable of being operated from its proximal end.
It is also an object of this invention to provide a tissue anchor inserting system which facilitates the assembly of an inserting device with a cannulated tissue anchor.
It is yet another object of this invention to provide such a system with a holder for retaining a tissue anchor to facilitate such assembly.
SUI~R~tARY OF THE INVENTION
These and other objects are accomplished by the preferred embodiment of the system disclosed herein which comprises a tissue anchor component, an inserter component and a package component. The tissue anchor component is a device comprising an elongated shaft having a proximal end, a distal end and a longitudinally extending bore therethrough. A plurality of barbs is longitudinally spaced along the shaft and the barbs are tapered in a distal direction to facilitate distal movement of the shaft through tissue material. The barbs are aligned in at least one row (preferably four rows) on the external surface of the shaft and a transversely extending head is situated at the proximal end of the shaft. The head has an aperture aligned with the bore and is generally elongated along a major axis which is misaligned relative to at least one of the rows of barbs.
The invention also resides in a tissue anchor inserter component and method for using the inserter with a cannulated tissue anchor. The inserter comprises a housing, a first elongated tubular shaft extending distally from the housing, the shaft having an axially aligned bore therethrough and an elongated needle adapted to be slidably received within the bore.
The shaft is adapted to receive a cannulated tissue anchor while the needle is adapted to be received in the bore of the anchor.
A trigger means is provided for moving the distal end of the needle between a first, retracted position, in which the needle is maintained within the bore, and a second, extended position, in which the needle is extended distally, beyond the bore. A
pusher rod for pushing the anchor out of the device is adapted to be slidably received within the bore and moved between a first, retracted position, in which the distal end of the pusher rod is maintained within the bore of the shaft, and a second, extended position, in which the distal end of the pusher rod is adj acent the distal end of the shaft.
The inserter component is used to perform the method of inserting a cannulated tissue anchor into tissue to be treated at a surgical site. The method comprises the steps of providing a cannulated tissue anchor and providing a tissue anchor inserter as described above. The method further comprises providing the tubular shaft with a receiving chamber, for slidably receiving the needle and the tissue anchor, and a pusher means for engaging the tissue anchor to push it out of the receiving chamber. The needle is then extended distally from the receiving chamber, inserted into the bore of the tissue anchor and then retracted with the tissue anchor into the receiving chamber. The surgical site at which the tissue anchor is to be placed is located and the needle is extended from the receiving chamber into tissue at the surgical site. The pusher means is advanced distally to push the tissue anchor distally along the extended needle and into the surgical tissue. The procedure is completed by removing the needle from the tissue.
The invention also resides in a combination package and loading component which is a device for retaining a cannulated tissue anchor and facilitating its assembly with the above described inserter. The package comprises a base and a funnel means, the base having a first surface for receiving a cannulated tissue anchor thereon in predetermined orientation and the funnel means for being aligned with the bore of the tissue anchor to facilitate insertion of the inserter needle into the anchor.
The package further comprises a releasable holding means having a second surface for holding the tissue anchor in alignment with the funnel until the assembly of the anchor with the inserter has been completed.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a side elevational view of a cannulated implant device constructed in accordance with the principles of this invention.
Figure 2 is a left end view thereof showing the head in phantom.
Figure 3 is a plan view of an inserting instrument for use with the implant device shown in Figure 1.
Figure 4 is a side elevational view of Figure 3.
Figure 5 is a side elevation view of a portion of the needle means used in the instrument of Figure 3.
Figure 6 is a right side view of Figure 5.
Figure 7 is a partial bottom plan view of Figure 5.
Figure 8 is a side elevation view of the remaining portion of the needle means, this portion intended to be assembled with the portion shown in Figure 5.
Figure 9 is a left side view of Figure 8.
Figure 10 is a partial top plan view of Figure 8.
Figure 11 is a plan view of the pusher means used in the instrument of Figure 3.
Figure 12 is a side elevation view of a partially assembled inserting instrument showing the needle means and the pusher means.
Figure 13 is a plan view of the handle of the inserting instrument in cross-section.
Figure 14 is a plan view of the handle assembled with the proximal end of the pusher means.
Figure 15 is a plan view of the handle of the inserting instrument showing external features thereon.
Figure 16 is a right side view of Figure 15.
Figures 17-19 are plan views of the proximal end of the inserting instrument in various stages of use.
Figure 20 is an alternate embodiment of the instrument shown in Figure 3 showing the instrument during one stage of the process for using the instrument with an implant device such as that shown in Figure 1.
Figure 21 shows the inserting instrument of Figure 20 showing an implant device in place at the distal tip of the instrument.
Figure 22 shows the instrument of Figure 21, partially in cross-section, showing the implant device retracted into the body of the inserting instrument.
Figure 23 shows a close-up of the distal tip of the instrument of Figure 22.
Figure 24 shows the instrument in a different stage of the method of use.
Figure 25 is a close up of the distal end of Figure 24.
Figure 26 shows another stage in the method of use.
Figure 27 is a close-up of the distal end of Figure 26.
Figure 28 is a front perspective view of a molded device used in assembling a cannulated tissue anchor onto an inserting instrument such as that shown in Figure 3, the package/loading device being shown in an open configuration.
Figure 29 is a front perspective view of the loading device of Figure 28 shown in a closed configuration.
Figure 30 is a view of the loading device of Figure 28 showing a cannulated tissue anchor positioned within the device prior to it being closed.
Figure 31 is a front perspective view of the loading device of Figure 20 shown in a closed configuration.
Figures 32 through 36 are various views of the package/loading device shown in Figures 28 through 31 showing various steps in the process of loading a cannulated tissue anchor onto an associated insertion device.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to Figures 1 and 2 there is shown a cannulated tissue anchor 10 constructed in accordance with the principles of this invention, While anchor 10 is generally constructed in accordance with the teachings of the aforementioned Bays et al. patents, it will be noted that anchor comprises some improvements over all known prior art tissue i anchors. Thus, anchor 10 comprises an elongated shaft 12 having an axial bore 13 and a plurality of barbs 14 situated on its external surface and extending between a distal end 16 and a proximal end 18. The barbs are arranged in four linear rows 20, 22, 24 and 26 with rows 20 and 24 having an equal number of barbs in each row and rows 22 and 26 having a lesser number of barbs in each row. The barbs in adjacent rows are longitudinally staggered to enable the tissue anchor to resist rotation about its axis 28. The anchor may be made in various lengths and diameters with various numbers of barbs and with various lengths of smooth, barb-free shafts between the proximal most barbs 29 and proximal end 18. In the preferred embodiment, all rows have three barbs each if the anchor length L is 10 mm. If the anchor length L is 13 mm or 16 mm, rows 20 and 24 each have five barbs and rows 22 and 26 each have four barbs (as shown in Figure 1) .
The distal-most barbs in all cases are situated at the same distance from distal end 16.
In the preferred embodiment, the barbs on opposing rows 20 and 24 are undercut on their proximally facing side 27 at an angle of approximately 21° facing proximally. The barbs on opposing rows 22 and 26 are not undercut and their proximally facing surfaces 28 are perpendicular to axis 28. As will be understood by those skilled in the art, this arrangement permits the anchor to be molded in a two-part mold with a parting line through rows 20 and 24. The undercut enhances the holding strength of the anchor by enabling tissue to "flow" back behind the undercut barbs as the anchor is pushed into place.
Anchor 10 further comprises a head 30 at its proximal end 18. In the preferred embodiment, head 30 is a generally flat oval structure having a major axis 32 which is angled relative to the plane of rows 20 and 24 as best seen in Figure 2. This intentional misalignment of the axis of head 32 enables it to abut tissue in the areas adjacent to the distally facing sides of portions 34 and 36 of the head. It will be understood that as the barb rows 20, 22, 24 and 26 are pushed into tissue to be treated at the surgical site, the tissue is necessarily pushed aside or slightly deformed in the areas adjacent the barbs and along the lines of the barbs. If the head axis 32 were to be aligned in the plane of two diametrically opposed rows of barbs, for example, the head may have a tendency to migrate distally along the tissue defects created by the barb rows. The intentional misalignment of the axis of the head prevents the distal advancement of the barb because the head lies adjacent "virgin" tissue which is not subj ect to deformation by the barb rows. Thus, it will be understood that the particular shape and orientation of head 30 enables the profile of the head to be minimized while also minimizing the possible migration of the tissue anchor at or from the surgical site. This beneficial orientation of the major axis of the head would also apply to ii f tissue anchors in which the barbs might be arranged in helical rows.
Referring now to Figures 3 through 12, there is described a tissue anchor inserter system for inserting a cannulated tissue anchor (such as anchor 10) and the method for using same. While the inserter shown in Figures 3 and 4 is shown with a straight distal end, it will be understood that various simple or compound curves could be formed in the distal end to enable the implant to be endoscopically or otherwise delivered to a variety of sites. An example of possible curves is shown in Figure 20.
As shown in Figures 3 and 4, tissue anchor inserter 100 comprises a hollow handle 102, an elongated tubular shaft 104 extending from one end of the handle and having a distal end 106.
End 106 is provided with a window 107 to enable a user to see the position of the anchor as will be understood below. The proximal end 108 of shaft 104 is secured to the distal end of handle 102 and communicates with the interior thereof. Handle 102 carries a pair of diametrically opposed trigger projections 110 and 112 which, as will be understood below, comprise the proximal end of a needle means 114. Handle 102 also carries a pusher handle 120 which, as will be understood below, is situated at the proximal end of a pusher means 122. The handle is also provided with a pair of finger recesses 124 and 126 to facilitate single handed operation.
.,.
As shown in Figures 5 through 10, needle means 114 comprises an elongated trocar or needle 130 extending distally from a slide body 131 to which trigger projection 110 is secured.
In the preferred embodiment, needle 130 may be made of a stainless steel or a memory alloy such as nitinol and has a diameter of .025 inches (.635 mm) to fit in anchor bore 13 which has a diameter of .026 inches (.660 mm). Slide body 131 is formed of a suitable polymeric material which may be insert molded with needle 130. Slide body 131 is joined to the bottom of trigger 110 at a reduced-width neck portion 132, the purpose of which will be understood below. Trigger assembly 133 (Figure 12) is formed by inserting slide body 131 into slide body 134 best seen in Figures 8-10. Slide body 134 is molded with trigger projection 112 and has a member 135 having a chamber 136 and a slot 137. Member 135 is joined to the bottom of trigger 112 at a reduced-width neck portion 138. Trigger assembly 133 is assembled with pusher means 122 shown in Figure 11 by sliding the needle of body 131 into the lumen of pusher rod 142 and inserting body 131 into the chamber 136 of body 134, directing the needle through slot 137. This results in the trigger assembly being situated in the pusher body, as shown in Figure 12.
As shown in Figure 11, pusher means 122 comprises a body 140 having a pusher handle 120 at its proximal-most end and having an elongated cannulated pusher rod 142 extending from its distal end. Body 140 has an elongated slot 144 extending therethrough for receiving trigger assembly 133 and enabling the slide body to move proximally and distally within slot 144, independently of the motion of pusher body 140, between a proximal-most position as shown in Figures 3 and 4 and a distal-most position as shown in Figure 26. If desired, only one trigger projection (110 or 112) may be utilized although the use of two symmetrical projections enables inserter 100 to be operated from either side of handle 102. (If only one trigger projection is utilized, slot 144 need not be a through-slot, but simply a recess in body 140. ) Pusher body 140 is adapted to be slidably received within a receiving chamber 150 at the proximal end of handle 102 (best seen in Figure 13) and may also be provided with a plurality of circumferentially arranged, outwardly extending projections 146. The projections rest against the rim 152 of chamber 150 and provide some resistance to the distal movement of pusher body 140 relative to handle 102 in order to prevent inadvertent delivery of the tissue anchor at the work site. The various lengths of shaft 104, needle 130 and pusher 142 rod are selected to facilitate the operation of the inserter using the method steps described below.
The body of handle 102 adjacent chamber 150 is provided with a pair of diametrically opposed slots 160 and 162 which receive neck portions 132 and 138, respectively. As shown in Figures 15 and 16, a pair of raised ribs 164 and 166 is parallel to slot 160 and a pair of raised ribs 168 and 170 is parallel to f slot 162. Each rib has an inwardly extending projection 172 to provide a detent to a plurality of paired projections 174 molded into the bottom of trigger projections 110 and 112 (best seen in Figures 7 and 10). These projections comprise selective depth penetration means to enable a user to select the desired distance by which needle 130 extends beyond distal end 106. As shown in Figure 17, when projections 172 are distal of any projections 174 on trigger 110 (or 112 since the projections are symmetrically situated), the needle will be understood to be totally within shaft 104. When projections 172 abut the distal-most projections 180, 181 as shown in Figure 18, the needle will, in the preferred embodiment, be understood to extend 2 mm beyond end 106. As shown in Figure 19, when projections 172 abut projections 183, 184 the needle will, in the preferred embodiment, be understood to extend the distance indicated by the indicia, here shown as 10 mm. Additional detents are provided at 13 mm and 16 mm as shown, the various marked distances corresponding to lengths of the tissue anchor to be implanted. The projections further serve to provide tactile and audible feedback to the surgeon to facilitate use and operation of the inserter.
Referring now to Figures 20 through 27, the single-handed method of using the insertion instrument to insert a cannulated tissue anchor will be described. As shown in Figure 20, the first step in the process is to move needle means 114 distally in order to extend needle 130 from the distal end 106.
The movement of needle means 114 is limited by virtue of the dimensions of the various components of the device so that the needle 130 will extend beyond the distal end 106 a selected distance equal to the length of the tissue anchor for which the system is being used (e.g. 10 mm, 13 mm or 16 mm). In Figure 20 the trigger assembly 133 is at the 16 mm mark. The next step in the process is to load a tissue anchor 10 onto the protruding needle by inserting the needle through the central bore of the anchor (Figure 21). In Figure 21 the trigger assembly 133 is at the 13 mm mark and the anchor shown is 13 mm long. The process described in these drawings is applicable to all anchor sizes.
As shown in Figure 22, needle means 114 is then retracted to its proximal-most position in order to retract the needle and the anchor into tube 106. The distal end of the tissue anchor/inserter assembly in this loaded condition is shown in greater detail in Figure 23 which, for clarity, is not to scale (in the preferred embodiment the dimensions of the anchor and the various tubes and rods may clearly be made to create a tighter fit). It will be noted that in this loaded configuration the anchor resides in an annular chamber 190 at the distal end of inserter 100 and the proximal side of head 30 of the tissue anchor abuts the distal tip of pusher rod 142. The assembled anchor/inserter is now ready for insertion into the patient and advancement of the distal end 106 to the work site.
When the anchor is ready to be inserted, the distal end 106 is placed as desired and needle means 114 is pushed distally the desired distance (e.g. 13 mm as shown in Figures 24 and 25) in order to advance needle 130 into the tissue to be repaired (not shown). The needle would normally extend across a tear in tissue (such as meniscus) and the tissue anchor would be placed to close the tear and hold the tissue together. The needle is sized to slide easily within the bore of the anchor so it can be advanced and properly positioned before the anchor is pushed in.
Once the needle 130 is sufficiently extended, pusher 120 may be pushed distally as shown in Figures 26 and 27 thereby causing pusher rod 142 to push anchor 10 along needle 130 into the tissue. The progress and position of the anchor may be seen through window 107 (best seen in Figure 3). The pusher rod may be made to extend slightly beyond the distal tip of end 106 in order to "countersink" the head of the tissue anchor into the tissue.
In the preferred embodiment of the inserter described above, the pusher rod extends 1 mm beyond the distal tip of shaft 104, as shown at 143, at all of the trigger positions. That is, for example, in the 16 mm position the needle extends 15 mm beyond the pusher rod which extends 1 mm beyond the tip. The instrument may be removed after retracting the needle from the site.
The method of operation of inserter 100 may be accomplished in other embodiments. For example, a pistol grip handle (not shown) may be provided with a trigger activated two-part slide with predetermined stops such that one squeeze of the trigger would engage it with the (proximal end of the) needle and cause the needle to be pushed distally, release of the trigger would disengage it from the needle and a second squeeze would engage it with the (proximal end of the) pusher rod and cause it to be pushed distally, thus pushing the anchor out of a sheath attached to the handle and encasing the anchor, needle and pusher. Alternatively, separate triggers could be provided for the needle and the pusher.
While the method described above can be initiated by the manual loading of a cannulated tissue anchor onto the needle of the insertion device, the tissue anchor may alternatively be held in a combination package and loading device which facilitates the assembly of the anchor with the insertion device.
Such a package/loading device is shown in Figures 28 through 36.
As shown in Figure 28, package/loading device 200 comprises a receptacle portion 202 and a holding portion 204, and serves as a biocompatible package for holding and shipping the tissue anchor after its manufacture and a loading fixture for use with an inserter. The package can also hold the anchor during its sterilization by conventional means. All parts of the device may be integrally molded, sterilizable and, if desired, translucent or transparent. Receptacle 202 comprises a tissue anchor receiving means 210, a funnel means 212 and a hinged cover 214. Receptacle portion 202 is situated adjacent a protection/
gauge means 216, the purpose of which will be understood more fully below.
Holding portion 204 comprises a flat finger grip area 205. The lateral sides 217 and 218 of receptacle portion 202 comprise additional finger grip areas. All such areas may be provided with anti-slip ridges 219 or other structures to enhance a user's manipulation of the package.
As shown in Figure 29, cover 214 may be moved about its hinge 220 into a closed position and retained there by a latch means 222. Cover 214 and receptacle 202 have surfaces 230 and 232, respectively which are intended to produce a receiving space between them within which tissue anchor 10 is to be retained.
Surfaces 230 and 232 are provided with complementary recesses which form anchor retaining means 210 and funnel means 212 when the cover is closed. In the closed position, funnel means 212 presents a circular opening at the proximal end of the loading device in order to facilitate assembly of the anchor with the inserter 100 as will be understood below. Funnel means 212 provides a conical docking feature to help a user aim the needle into the bore of the device which is held in alignment with the axis of the funnel.
As shown in Figure 30, a cannulated tissue anchor 10 may be placed in tissue anchor receiving means 210 with the body of the anchor in trough 240 and the head of the anchor in transverse recess 242, both trough 240 and recess 242 being axially aligned with funnel means 212. Trough 240 and recess 242 have symmetrical counterparts 244 and 246, respectively, formed in surface 230 of cover 214. When the cover is closed, the tissue anchor is retained firmly within tissue anchor retaining means 210 with its axially aligned bore aligned with the axis 250 of funnel means 212. Figure 31 shows a view of a closed, transparent loading device retaining a tissue anchor therein. It will be understood that the angular orientation of the major axis of the head of anchor 10 may or may not be fixed relative to other components of the package and inserter.
The steps of using the loading device 200 to assemble the cannulated tissue anchor with the insertion device 100 are shown in Figures 32 through 36. For simplicity, only the distal end 106 of the insertion device and the distal end of needle 130 are shown. As shown in Figure 32, needle 130 is extended beyond the distal end 106 and the insertion device is moved in the direction of arrow 250 in order to enable the funnel means 212 to guide the tip of needle 130 into the axial bore of the cannulated tissue anchor. The inserter is advanced distally until the position shown in Figure 33 where distal end 106 either abuts or is close to abutting the proximal side of the closed loading device at which point the needle will be situated within the axial bore of the tissue anchor. Depending upon the length of the needle and anchor, the distal tip of the needle may be visible in the space 252 between cover 214 and end wall 264. As (.
shown in Figure 34, cover 214 may be opened in the direction shown by arrow 253 by releasing latch 222 thereby releasing the anchor. As shown in Figure 35, the distal end 106 of the inserter may then be moved further in direction 250 in order to enable the distal tip of needle 130 to pass through slot 260 into protection/gauge means 216 which includes a receiving chamber 262 formed between end wall 264 and blocking or protective wall 265.
Slot 260 is an aperture sized to receive the needle while preventing advancement of the anchor beyond end wall 264, thereby enabling the anchor to be fully seated onto needle 130. In the preferred embodiment, the width of slot 260 is .026 inches (.660 mm). End wall 264 simply serves to define slot 260 while protective wall 265 serves as protection against inadvertent user contact with the tip of the needle. Further advancement of distal end 106 as shown in Figure 36 will enable the anchor to be pushed into the interior of the distal end. This alone will tend to move the trigger means 114 distally although the trigger means may be simultaneously moved distally by a user to facilitate the placement of the anchor within the interior of the distal end of the insertion device. The insertion device may now be used in the manner described above with respect to Figures 24 through 27.
While the inserter 100 has a trigger position which defines when the needle extends 2 mm beyond the distal end of the instrument, other methods may be used to so position the needle.
For example, the thickness of wall 264 may serve as a gauge to indicate the desired distance by which the tip of the needle extends beyond the tip of the anchor. As the needle extends through slot 260 and the end 106 abuts wall 264, the user may see the needle in chamber 262. If desired, by retracting the needle so it extends from end 106 only by the thickness of wall 264 (e. g. 2 mm), the user can elect to have the needle extend a given amount (to aid in tissue manipulation, for example, prior to piercing the tissue in preparation for anchor placement).
It will be understood by those skilled in the art that numerous improvements and modifications may be made to the preferred embodiment of the invention disclosed herein without departing from the spirit and scope thereof.
It is also an object of this invention to provide a tissue anchor inserting system which facilitates the assembly of an inserting device with a cannulated tissue anchor.
It is yet another object of this invention to provide such a system with a holder for retaining a tissue anchor to facilitate such assembly.
SUI~R~tARY OF THE INVENTION
These and other objects are accomplished by the preferred embodiment of the system disclosed herein which comprises a tissue anchor component, an inserter component and a package component. The tissue anchor component is a device comprising an elongated shaft having a proximal end, a distal end and a longitudinally extending bore therethrough. A plurality of barbs is longitudinally spaced along the shaft and the barbs are tapered in a distal direction to facilitate distal movement of the shaft through tissue material. The barbs are aligned in at least one row (preferably four rows) on the external surface of the shaft and a transversely extending head is situated at the proximal end of the shaft. The head has an aperture aligned with the bore and is generally elongated along a major axis which is misaligned relative to at least one of the rows of barbs.
The invention also resides in a tissue anchor inserter component and method for using the inserter with a cannulated tissue anchor. The inserter comprises a housing, a first elongated tubular shaft extending distally from the housing, the shaft having an axially aligned bore therethrough and an elongated needle adapted to be slidably received within the bore.
The shaft is adapted to receive a cannulated tissue anchor while the needle is adapted to be received in the bore of the anchor.
A trigger means is provided for moving the distal end of the needle between a first, retracted position, in which the needle is maintained within the bore, and a second, extended position, in which the needle is extended distally, beyond the bore. A
pusher rod for pushing the anchor out of the device is adapted to be slidably received within the bore and moved between a first, retracted position, in which the distal end of the pusher rod is maintained within the bore of the shaft, and a second, extended position, in which the distal end of the pusher rod is adj acent the distal end of the shaft.
The inserter component is used to perform the method of inserting a cannulated tissue anchor into tissue to be treated at a surgical site. The method comprises the steps of providing a cannulated tissue anchor and providing a tissue anchor inserter as described above. The method further comprises providing the tubular shaft with a receiving chamber, for slidably receiving the needle and the tissue anchor, and a pusher means for engaging the tissue anchor to push it out of the receiving chamber. The needle is then extended distally from the receiving chamber, inserted into the bore of the tissue anchor and then retracted with the tissue anchor into the receiving chamber. The surgical site at which the tissue anchor is to be placed is located and the needle is extended from the receiving chamber into tissue at the surgical site. The pusher means is advanced distally to push the tissue anchor distally along the extended needle and into the surgical tissue. The procedure is completed by removing the needle from the tissue.
The invention also resides in a combination package and loading component which is a device for retaining a cannulated tissue anchor and facilitating its assembly with the above described inserter. The package comprises a base and a funnel means, the base having a first surface for receiving a cannulated tissue anchor thereon in predetermined orientation and the funnel means for being aligned with the bore of the tissue anchor to facilitate insertion of the inserter needle into the anchor.
The package further comprises a releasable holding means having a second surface for holding the tissue anchor in alignment with the funnel until the assembly of the anchor with the inserter has been completed.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a side elevational view of a cannulated implant device constructed in accordance with the principles of this invention.
Figure 2 is a left end view thereof showing the head in phantom.
Figure 3 is a plan view of an inserting instrument for use with the implant device shown in Figure 1.
Figure 4 is a side elevational view of Figure 3.
Figure 5 is a side elevation view of a portion of the needle means used in the instrument of Figure 3.
Figure 6 is a right side view of Figure 5.
Figure 7 is a partial bottom plan view of Figure 5.
Figure 8 is a side elevation view of the remaining portion of the needle means, this portion intended to be assembled with the portion shown in Figure 5.
Figure 9 is a left side view of Figure 8.
Figure 10 is a partial top plan view of Figure 8.
Figure 11 is a plan view of the pusher means used in the instrument of Figure 3.
Figure 12 is a side elevation view of a partially assembled inserting instrument showing the needle means and the pusher means.
Figure 13 is a plan view of the handle of the inserting instrument in cross-section.
Figure 14 is a plan view of the handle assembled with the proximal end of the pusher means.
Figure 15 is a plan view of the handle of the inserting instrument showing external features thereon.
Figure 16 is a right side view of Figure 15.
Figures 17-19 are plan views of the proximal end of the inserting instrument in various stages of use.
Figure 20 is an alternate embodiment of the instrument shown in Figure 3 showing the instrument during one stage of the process for using the instrument with an implant device such as that shown in Figure 1.
Figure 21 shows the inserting instrument of Figure 20 showing an implant device in place at the distal tip of the instrument.
Figure 22 shows the instrument of Figure 21, partially in cross-section, showing the implant device retracted into the body of the inserting instrument.
Figure 23 shows a close-up of the distal tip of the instrument of Figure 22.
Figure 24 shows the instrument in a different stage of the method of use.
Figure 25 is a close up of the distal end of Figure 24.
Figure 26 shows another stage in the method of use.
Figure 27 is a close-up of the distal end of Figure 26.
Figure 28 is a front perspective view of a molded device used in assembling a cannulated tissue anchor onto an inserting instrument such as that shown in Figure 3, the package/loading device being shown in an open configuration.
Figure 29 is a front perspective view of the loading device of Figure 28 shown in a closed configuration.
Figure 30 is a view of the loading device of Figure 28 showing a cannulated tissue anchor positioned within the device prior to it being closed.
Figure 31 is a front perspective view of the loading device of Figure 20 shown in a closed configuration.
Figures 32 through 36 are various views of the package/loading device shown in Figures 28 through 31 showing various steps in the process of loading a cannulated tissue anchor onto an associated insertion device.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to Figures 1 and 2 there is shown a cannulated tissue anchor 10 constructed in accordance with the principles of this invention, While anchor 10 is generally constructed in accordance with the teachings of the aforementioned Bays et al. patents, it will be noted that anchor comprises some improvements over all known prior art tissue i anchors. Thus, anchor 10 comprises an elongated shaft 12 having an axial bore 13 and a plurality of barbs 14 situated on its external surface and extending between a distal end 16 and a proximal end 18. The barbs are arranged in four linear rows 20, 22, 24 and 26 with rows 20 and 24 having an equal number of barbs in each row and rows 22 and 26 having a lesser number of barbs in each row. The barbs in adjacent rows are longitudinally staggered to enable the tissue anchor to resist rotation about its axis 28. The anchor may be made in various lengths and diameters with various numbers of barbs and with various lengths of smooth, barb-free shafts between the proximal most barbs 29 and proximal end 18. In the preferred embodiment, all rows have three barbs each if the anchor length L is 10 mm. If the anchor length L is 13 mm or 16 mm, rows 20 and 24 each have five barbs and rows 22 and 26 each have four barbs (as shown in Figure 1) .
The distal-most barbs in all cases are situated at the same distance from distal end 16.
In the preferred embodiment, the barbs on opposing rows 20 and 24 are undercut on their proximally facing side 27 at an angle of approximately 21° facing proximally. The barbs on opposing rows 22 and 26 are not undercut and their proximally facing surfaces 28 are perpendicular to axis 28. As will be understood by those skilled in the art, this arrangement permits the anchor to be molded in a two-part mold with a parting line through rows 20 and 24. The undercut enhances the holding strength of the anchor by enabling tissue to "flow" back behind the undercut barbs as the anchor is pushed into place.
Anchor 10 further comprises a head 30 at its proximal end 18. In the preferred embodiment, head 30 is a generally flat oval structure having a major axis 32 which is angled relative to the plane of rows 20 and 24 as best seen in Figure 2. This intentional misalignment of the axis of head 32 enables it to abut tissue in the areas adjacent to the distally facing sides of portions 34 and 36 of the head. It will be understood that as the barb rows 20, 22, 24 and 26 are pushed into tissue to be treated at the surgical site, the tissue is necessarily pushed aside or slightly deformed in the areas adjacent the barbs and along the lines of the barbs. If the head axis 32 were to be aligned in the plane of two diametrically opposed rows of barbs, for example, the head may have a tendency to migrate distally along the tissue defects created by the barb rows. The intentional misalignment of the axis of the head prevents the distal advancement of the barb because the head lies adjacent "virgin" tissue which is not subj ect to deformation by the barb rows. Thus, it will be understood that the particular shape and orientation of head 30 enables the profile of the head to be minimized while also minimizing the possible migration of the tissue anchor at or from the surgical site. This beneficial orientation of the major axis of the head would also apply to ii f tissue anchors in which the barbs might be arranged in helical rows.
Referring now to Figures 3 through 12, there is described a tissue anchor inserter system for inserting a cannulated tissue anchor (such as anchor 10) and the method for using same. While the inserter shown in Figures 3 and 4 is shown with a straight distal end, it will be understood that various simple or compound curves could be formed in the distal end to enable the implant to be endoscopically or otherwise delivered to a variety of sites. An example of possible curves is shown in Figure 20.
As shown in Figures 3 and 4, tissue anchor inserter 100 comprises a hollow handle 102, an elongated tubular shaft 104 extending from one end of the handle and having a distal end 106.
End 106 is provided with a window 107 to enable a user to see the position of the anchor as will be understood below. The proximal end 108 of shaft 104 is secured to the distal end of handle 102 and communicates with the interior thereof. Handle 102 carries a pair of diametrically opposed trigger projections 110 and 112 which, as will be understood below, comprise the proximal end of a needle means 114. Handle 102 also carries a pusher handle 120 which, as will be understood below, is situated at the proximal end of a pusher means 122. The handle is also provided with a pair of finger recesses 124 and 126 to facilitate single handed operation.
.,.
As shown in Figures 5 through 10, needle means 114 comprises an elongated trocar or needle 130 extending distally from a slide body 131 to which trigger projection 110 is secured.
In the preferred embodiment, needle 130 may be made of a stainless steel or a memory alloy such as nitinol and has a diameter of .025 inches (.635 mm) to fit in anchor bore 13 which has a diameter of .026 inches (.660 mm). Slide body 131 is formed of a suitable polymeric material which may be insert molded with needle 130. Slide body 131 is joined to the bottom of trigger 110 at a reduced-width neck portion 132, the purpose of which will be understood below. Trigger assembly 133 (Figure 12) is formed by inserting slide body 131 into slide body 134 best seen in Figures 8-10. Slide body 134 is molded with trigger projection 112 and has a member 135 having a chamber 136 and a slot 137. Member 135 is joined to the bottom of trigger 112 at a reduced-width neck portion 138. Trigger assembly 133 is assembled with pusher means 122 shown in Figure 11 by sliding the needle of body 131 into the lumen of pusher rod 142 and inserting body 131 into the chamber 136 of body 134, directing the needle through slot 137. This results in the trigger assembly being situated in the pusher body, as shown in Figure 12.
As shown in Figure 11, pusher means 122 comprises a body 140 having a pusher handle 120 at its proximal-most end and having an elongated cannulated pusher rod 142 extending from its distal end. Body 140 has an elongated slot 144 extending therethrough for receiving trigger assembly 133 and enabling the slide body to move proximally and distally within slot 144, independently of the motion of pusher body 140, between a proximal-most position as shown in Figures 3 and 4 and a distal-most position as shown in Figure 26. If desired, only one trigger projection (110 or 112) may be utilized although the use of two symmetrical projections enables inserter 100 to be operated from either side of handle 102. (If only one trigger projection is utilized, slot 144 need not be a through-slot, but simply a recess in body 140. ) Pusher body 140 is adapted to be slidably received within a receiving chamber 150 at the proximal end of handle 102 (best seen in Figure 13) and may also be provided with a plurality of circumferentially arranged, outwardly extending projections 146. The projections rest against the rim 152 of chamber 150 and provide some resistance to the distal movement of pusher body 140 relative to handle 102 in order to prevent inadvertent delivery of the tissue anchor at the work site. The various lengths of shaft 104, needle 130 and pusher 142 rod are selected to facilitate the operation of the inserter using the method steps described below.
The body of handle 102 adjacent chamber 150 is provided with a pair of diametrically opposed slots 160 and 162 which receive neck portions 132 and 138, respectively. As shown in Figures 15 and 16, a pair of raised ribs 164 and 166 is parallel to slot 160 and a pair of raised ribs 168 and 170 is parallel to f slot 162. Each rib has an inwardly extending projection 172 to provide a detent to a plurality of paired projections 174 molded into the bottom of trigger projections 110 and 112 (best seen in Figures 7 and 10). These projections comprise selective depth penetration means to enable a user to select the desired distance by which needle 130 extends beyond distal end 106. As shown in Figure 17, when projections 172 are distal of any projections 174 on trigger 110 (or 112 since the projections are symmetrically situated), the needle will be understood to be totally within shaft 104. When projections 172 abut the distal-most projections 180, 181 as shown in Figure 18, the needle will, in the preferred embodiment, be understood to extend 2 mm beyond end 106. As shown in Figure 19, when projections 172 abut projections 183, 184 the needle will, in the preferred embodiment, be understood to extend the distance indicated by the indicia, here shown as 10 mm. Additional detents are provided at 13 mm and 16 mm as shown, the various marked distances corresponding to lengths of the tissue anchor to be implanted. The projections further serve to provide tactile and audible feedback to the surgeon to facilitate use and operation of the inserter.
Referring now to Figures 20 through 27, the single-handed method of using the insertion instrument to insert a cannulated tissue anchor will be described. As shown in Figure 20, the first step in the process is to move needle means 114 distally in order to extend needle 130 from the distal end 106.
The movement of needle means 114 is limited by virtue of the dimensions of the various components of the device so that the needle 130 will extend beyond the distal end 106 a selected distance equal to the length of the tissue anchor for which the system is being used (e.g. 10 mm, 13 mm or 16 mm). In Figure 20 the trigger assembly 133 is at the 16 mm mark. The next step in the process is to load a tissue anchor 10 onto the protruding needle by inserting the needle through the central bore of the anchor (Figure 21). In Figure 21 the trigger assembly 133 is at the 13 mm mark and the anchor shown is 13 mm long. The process described in these drawings is applicable to all anchor sizes.
As shown in Figure 22, needle means 114 is then retracted to its proximal-most position in order to retract the needle and the anchor into tube 106. The distal end of the tissue anchor/inserter assembly in this loaded condition is shown in greater detail in Figure 23 which, for clarity, is not to scale (in the preferred embodiment the dimensions of the anchor and the various tubes and rods may clearly be made to create a tighter fit). It will be noted that in this loaded configuration the anchor resides in an annular chamber 190 at the distal end of inserter 100 and the proximal side of head 30 of the tissue anchor abuts the distal tip of pusher rod 142. The assembled anchor/inserter is now ready for insertion into the patient and advancement of the distal end 106 to the work site.
When the anchor is ready to be inserted, the distal end 106 is placed as desired and needle means 114 is pushed distally the desired distance (e.g. 13 mm as shown in Figures 24 and 25) in order to advance needle 130 into the tissue to be repaired (not shown). The needle would normally extend across a tear in tissue (such as meniscus) and the tissue anchor would be placed to close the tear and hold the tissue together. The needle is sized to slide easily within the bore of the anchor so it can be advanced and properly positioned before the anchor is pushed in.
Once the needle 130 is sufficiently extended, pusher 120 may be pushed distally as shown in Figures 26 and 27 thereby causing pusher rod 142 to push anchor 10 along needle 130 into the tissue. The progress and position of the anchor may be seen through window 107 (best seen in Figure 3). The pusher rod may be made to extend slightly beyond the distal tip of end 106 in order to "countersink" the head of the tissue anchor into the tissue.
In the preferred embodiment of the inserter described above, the pusher rod extends 1 mm beyond the distal tip of shaft 104, as shown at 143, at all of the trigger positions. That is, for example, in the 16 mm position the needle extends 15 mm beyond the pusher rod which extends 1 mm beyond the tip. The instrument may be removed after retracting the needle from the site.
The method of operation of inserter 100 may be accomplished in other embodiments. For example, a pistol grip handle (not shown) may be provided with a trigger activated two-part slide with predetermined stops such that one squeeze of the trigger would engage it with the (proximal end of the) needle and cause the needle to be pushed distally, release of the trigger would disengage it from the needle and a second squeeze would engage it with the (proximal end of the) pusher rod and cause it to be pushed distally, thus pushing the anchor out of a sheath attached to the handle and encasing the anchor, needle and pusher. Alternatively, separate triggers could be provided for the needle and the pusher.
While the method described above can be initiated by the manual loading of a cannulated tissue anchor onto the needle of the insertion device, the tissue anchor may alternatively be held in a combination package and loading device which facilitates the assembly of the anchor with the insertion device.
Such a package/loading device is shown in Figures 28 through 36.
As shown in Figure 28, package/loading device 200 comprises a receptacle portion 202 and a holding portion 204, and serves as a biocompatible package for holding and shipping the tissue anchor after its manufacture and a loading fixture for use with an inserter. The package can also hold the anchor during its sterilization by conventional means. All parts of the device may be integrally molded, sterilizable and, if desired, translucent or transparent. Receptacle 202 comprises a tissue anchor receiving means 210, a funnel means 212 and a hinged cover 214. Receptacle portion 202 is situated adjacent a protection/
gauge means 216, the purpose of which will be understood more fully below.
Holding portion 204 comprises a flat finger grip area 205. The lateral sides 217 and 218 of receptacle portion 202 comprise additional finger grip areas. All such areas may be provided with anti-slip ridges 219 or other structures to enhance a user's manipulation of the package.
As shown in Figure 29, cover 214 may be moved about its hinge 220 into a closed position and retained there by a latch means 222. Cover 214 and receptacle 202 have surfaces 230 and 232, respectively which are intended to produce a receiving space between them within which tissue anchor 10 is to be retained.
Surfaces 230 and 232 are provided with complementary recesses which form anchor retaining means 210 and funnel means 212 when the cover is closed. In the closed position, funnel means 212 presents a circular opening at the proximal end of the loading device in order to facilitate assembly of the anchor with the inserter 100 as will be understood below. Funnel means 212 provides a conical docking feature to help a user aim the needle into the bore of the device which is held in alignment with the axis of the funnel.
As shown in Figure 30, a cannulated tissue anchor 10 may be placed in tissue anchor receiving means 210 with the body of the anchor in trough 240 and the head of the anchor in transverse recess 242, both trough 240 and recess 242 being axially aligned with funnel means 212. Trough 240 and recess 242 have symmetrical counterparts 244 and 246, respectively, formed in surface 230 of cover 214. When the cover is closed, the tissue anchor is retained firmly within tissue anchor retaining means 210 with its axially aligned bore aligned with the axis 250 of funnel means 212. Figure 31 shows a view of a closed, transparent loading device retaining a tissue anchor therein. It will be understood that the angular orientation of the major axis of the head of anchor 10 may or may not be fixed relative to other components of the package and inserter.
The steps of using the loading device 200 to assemble the cannulated tissue anchor with the insertion device 100 are shown in Figures 32 through 36. For simplicity, only the distal end 106 of the insertion device and the distal end of needle 130 are shown. As shown in Figure 32, needle 130 is extended beyond the distal end 106 and the insertion device is moved in the direction of arrow 250 in order to enable the funnel means 212 to guide the tip of needle 130 into the axial bore of the cannulated tissue anchor. The inserter is advanced distally until the position shown in Figure 33 where distal end 106 either abuts or is close to abutting the proximal side of the closed loading device at which point the needle will be situated within the axial bore of the tissue anchor. Depending upon the length of the needle and anchor, the distal tip of the needle may be visible in the space 252 between cover 214 and end wall 264. As (.
shown in Figure 34, cover 214 may be opened in the direction shown by arrow 253 by releasing latch 222 thereby releasing the anchor. As shown in Figure 35, the distal end 106 of the inserter may then be moved further in direction 250 in order to enable the distal tip of needle 130 to pass through slot 260 into protection/gauge means 216 which includes a receiving chamber 262 formed between end wall 264 and blocking or protective wall 265.
Slot 260 is an aperture sized to receive the needle while preventing advancement of the anchor beyond end wall 264, thereby enabling the anchor to be fully seated onto needle 130. In the preferred embodiment, the width of slot 260 is .026 inches (.660 mm). End wall 264 simply serves to define slot 260 while protective wall 265 serves as protection against inadvertent user contact with the tip of the needle. Further advancement of distal end 106 as shown in Figure 36 will enable the anchor to be pushed into the interior of the distal end. This alone will tend to move the trigger means 114 distally although the trigger means may be simultaneously moved distally by a user to facilitate the placement of the anchor within the interior of the distal end of the insertion device. The insertion device may now be used in the manner described above with respect to Figures 24 through 27.
While the inserter 100 has a trigger position which defines when the needle extends 2 mm beyond the distal end of the instrument, other methods may be used to so position the needle.
For example, the thickness of wall 264 may serve as a gauge to indicate the desired distance by which the tip of the needle extends beyond the tip of the anchor. As the needle extends through slot 260 and the end 106 abuts wall 264, the user may see the needle in chamber 262. If desired, by retracting the needle so it extends from end 106 only by the thickness of wall 264 (e. g. 2 mm), the user can elect to have the needle extend a given amount (to aid in tissue manipulation, for example, prior to piercing the tissue in preparation for anchor placement).
It will be understood by those skilled in the art that numerous improvements and modifications may be made to the preferred embodiment of the invention disclosed herein without departing from the spirit and scope thereof.
Claims (26)
1. A tissue anchor device comprising:
an elongated shaft having a proximal end, a distal end and a longitudinally extending bore therethrough;
a plurality of barbs longitudinally spaced along said shaft, said barbs being tapered in a distal direction to facilitate distal movement of said shaft through material, said barbs aligned in at least one row on the external surface of said shaft; and a transversely extending head situated at the proximal end of said shaft, said head having an aperture aligned with said bore and being generally elongated along a major axis which is misaligned relative to at least one of said barbs.
an elongated shaft having a proximal end, a distal end and a longitudinally extending bore therethrough;
a plurality of barbs longitudinally spaced along said shaft, said barbs being tapered in a distal direction to facilitate distal movement of said shaft through material, said barbs aligned in at least one row on the external surface of said shaft; and a transversely extending head situated at the proximal end of said shaft, said head having an aperture aligned with said bore and being generally elongated along a major axis which is misaligned relative to at least one of said barbs.
2. A tissue anchor device according to claim 1 further comprising:
at least one straight, longitudinally aligned row of said barbs situated on the external surface of said shaft and further comprising said major axis of said head being aligned such that, when viewed endwise along the axis of said shaft, said major axis lies at a predetermined angle greater than zero relative to said row of barbs.
at least one straight, longitudinally aligned row of said barbs situated on the external surface of said shaft and further comprising said major axis of said head being aligned such that, when viewed endwise along the axis of said shaft, said major axis lies at a predetermined angle greater than zero relative to said row of barbs.
3. A tissue anchor device according to claim 1 further comprising:
four rows of said barbs, each spaced 90° about said shaft, the barbs of two diametrically opposed rows having proximally facing surfaces which are aligned perpendicular to said bore and the barbs of the remaining two diametrically opposed rows having proximally facing surfaces which are undercut.
four rows of said barbs, each spaced 90° about said shaft, the barbs of two diametrically opposed rows having proximally facing surfaces which are aligned perpendicular to said bore and the barbs of the remaining two diametrically opposed rows having proximally facing surfaces which are undercut.
4. A tissue anchor device according to claim 2 further comprising:
at least four rows of said barbs wherein said major axis of said head lies at a predetermined angle greater than zero relative to each of said rows of barbs.
at least four rows of said barbs wherein said major axis of said head lies at a predetermined angle greater than zero relative to each of said rows of barbs.
5. A tissue anchor device according to claim 2 wherein said predetermined angle is 45°.
6. A tissue anchor device according to claim 4 wherein said predetermined angle is 45°.
7. A tissue anchor device according to claim 1 wherein said barbs are arranged in at least two longitudinally aligned rows which are spaced a predetermined arcuate distance from each other at each point along the length of said shaft and wherein the barbs of one of said rows are longitudinally spaced from the associated barbs of an adjacent row of said barbs.
8. A tissue anchor inserter for use with a cannulated tissue anchor, comprising:
a housing;
a first elongated tubular shaft extending distally from said housing, said shaft having a proximal end, a distal end and an axially aligned bore therethrough;
an elongated needle slidably received within said bore, said needle having a proximal end and a distal ends trigger means for moving said distal end of said needle between a first, retracted position, in which said distal end of said needle is maintained within said bore, and a second, extended position, in which said distal end of said needle is extended distally, beyond said bore;
a pusher rod slidably received within said bore, said pusher rod having a proximal end and a distal end; and pusher means for moving the distal end of said pusher rod between a first, retracted position, in which said distal end of said pusher rod is maintained within said bore, and a second, extended position, in which said distal end of said pusher rod is adjacent the distal end of said first elongated shaft.
a housing;
a first elongated tubular shaft extending distally from said housing, said shaft having a proximal end, a distal end and an axially aligned bore therethrough;
an elongated needle slidably received within said bore, said needle having a proximal end and a distal ends trigger means for moving said distal end of said needle between a first, retracted position, in which said distal end of said needle is maintained within said bore, and a second, extended position, in which said distal end of said needle is extended distally, beyond said bore;
a pusher rod slidably received within said bore, said pusher rod having a proximal end and a distal end; and pusher means for moving the distal end of said pusher rod between a first, retracted position, in which said distal end of said pusher rod is maintained within said bore, and a second, extended position, in which said distal end of said pusher rod is adjacent the distal end of said first elongated shaft.
9. A tissue anchor inserter according to claim 8 further comprising:
an annular receiving channel situated at the distal end of said first elongated shaft for receiving said tissue anchor and said distal end of said needle.
an annular receiving channel situated at the distal end of said first elongated shaft for receiving said tissue anchor and said distal end of said needle.
10. A tissue anchor inserter according to claim 8 wherein said elongated needle is longitudinally movable independently of said pusher rod and wherein each is independently movable relative to said housing.
11. A tissue anchor inserter according to claim 8 wherein said trigger means and said pusher means are situated adjacent said housing and at the distal ends of said elongated needle and said pusher rod, respectively.
12. A tissue anchor inserter according to claim 10 wherein said pusher rod comprises an axially aligned bore for slidably receiving said needle therein.
13. A tissue anchor inserter according to claim 8 further comprising:
variable depth penetration means for enabling said needle to be oriented relative to said handle in any one of a plurality of positions by which the needle may be caused to extend from said first elongated shaft by one of a selected plurality of predetermined distances.
variable depth penetration means for enabling said needle to be oriented relative to said handle in any one of a plurality of positions by which the needle may be caused to extend from said first elongated shaft by one of a selected plurality of predetermined distances.
14. In combination, a cannulated tissue anchor and a tissue anchor inserter comprising:
a longitudinally slidable needle means for receiving said tissue anchor thereon and a pusher means for longitudinally slidable movement, independently of said needle means, to push said tissue anchor distally relative to said needle means.
a longitudinally slidable needle means for receiving said tissue anchor thereon and a pusher means for longitudinally slidable movement, independently of said needle means, to push said tissue anchor distally relative to said needle means.
15. A cannulated tissue anchor insertion system for inserting a tissue anchor into a tissue defect comprising:
a cannulated tissue anchor having an axial bore therethrough;
a housing;
an elongated needle having a proximal end and a distal end, said needle for being slidably received within said axial bore;
a tubular sheath extending distally from said housing for slidably receiving therein said tissue anchor and said needle therein;
an elongated pusher rod interposed between said needle and said sheath;
means for moving said needle independently of said pusher rod to move said needle distally into said tissue; and means for moving said pusher rod independently of said needle to move said tissue anchor distally along said needle and into said tissue.
a cannulated tissue anchor having an axial bore therethrough;
a housing;
an elongated needle having a proximal end and a distal end, said needle for being slidably received within said axial bore;
a tubular sheath extending distally from said housing for slidably receiving therein said tissue anchor and said needle therein;
an elongated pusher rod interposed between said needle and said sheath;
means for moving said needle independently of said pusher rod to move said needle distally into said tissue; and means for moving said pusher rod independently of said needle to move said tissue anchor distally along said needle and into said tissue.
16. A method of inserting a cannulated tissue anchor into tissue to be treated at a surgical site comprising the steps of:
providing a cannulated tissue anchor;
providing a tissue anchor inserter comprising an elongated needle for being received within the bore of said tissue anchor, a cannulated shaft having a receiving chamber for slidably receiving said needle and said tissue anchor and a pusher means for engaging said tissue anchor and pushing it out of said receiving chamber;
extending said needle distally from said receiving chamber;
inserting said needle into the bore of said tissue anchor;
retracting said needle and said tissue anchor into said receiving chamber;
locating the surgical site at which said tissue anchor is to be placed;
extending said needle from said receiving chamber and into said surgical site advancing said pusher means distally to push said tissue anchor distally along said extended needle and into said surgical sites and removing said needle from said tissue.
providing a cannulated tissue anchor;
providing a tissue anchor inserter comprising an elongated needle for being received within the bore of said tissue anchor, a cannulated shaft having a receiving chamber for slidably receiving said needle and said tissue anchor and a pusher means for engaging said tissue anchor and pushing it out of said receiving chamber;
extending said needle distally from said receiving chamber;
inserting said needle into the bore of said tissue anchor;
retracting said needle and said tissue anchor into said receiving chamber;
locating the surgical site at which said tissue anchor is to be placed;
extending said needle from said receiving chamber and into said surgical site advancing said pusher means distally to push said tissue anchor distally along said extended needle and into said surgical sites and removing said needle from said tissue.
17. A method of inserting a cannulated tissue anchor into tissue to be treated at a surgical site comprising the steps of:
providing a cannulated tissue anchor, said tissue anchor having a bore therethrough;
providing an elongated needle having a distal end and a proximal end, said needle adapted to be slidably received within the bore of said tissue anchor;
placing said needle through the bore of said tissue anchor;
providing a pusher means for moving said tissue anchor relative to said needle;
positioning said distal end of said needle adjacent the tissue at the surgical site:
moving said needle into the tissue: and moving said pusher means to move said tissue anchor from said needle into the tissue.
providing a cannulated tissue anchor, said tissue anchor having a bore therethrough;
providing an elongated needle having a distal end and a proximal end, said needle adapted to be slidably received within the bore of said tissue anchor;
placing said needle through the bore of said tissue anchor;
providing a pusher means for moving said tissue anchor relative to said needle;
positioning said distal end of said needle adjacent the tissue at the surgical site:
moving said needle into the tissue: and moving said pusher means to move said tissue anchor from said needle into the tissue.
18. A method according to claim 17 further comprising the step of axially aligning said needle and said tissue anchor within a tubular sheath to facilitate positioning of said needle and said tissue anchor adjacent the tissue at the surgical site.
19. A method according to claim 17 wherein the movement of all components relative to each other may be accomplished with one hand.
20. A method according to claim 17 further comprising the steps of:
providing a cannulated shaft for slidably receiving therein said tissue anchor, said needle and said pusher means, said shaft having an open distal end for abutting said tissue: and moving said pusher means distally relative to said distal end of said shaft in order to countersink said tissue anchor at the surgical site.
providing a cannulated shaft for slidably receiving therein said tissue anchor, said needle and said pusher means, said shaft having an open distal end for abutting said tissue: and moving said pusher means distally relative to said distal end of said shaft in order to countersink said tissue anchor at the surgical site.
21. A package for retaining a cannulated tissue anchor having a bore comprising:
a base having a first surface for receiving a cannulated tissue anchor thereon in predetermined orientation releasable holding means having a second surface for holding the cannulated tissue anchor adjacent said base; and funnel means for being aligned with a cannulated tissue anchor held between said first and second surfaces, said funnel means for facilitating insertion of an elongated member into the bore of the cannulated tissue anchor.
a base having a first surface for receiving a cannulated tissue anchor thereon in predetermined orientation releasable holding means having a second surface for holding the cannulated tissue anchor adjacent said base; and funnel means for being aligned with a cannulated tissue anchor held between said first and second surfaces, said funnel means for facilitating insertion of an elongated member into the bore of the cannulated tissue anchor.
22. A package according to claim 21 further comprising:
cooperating trough means on each of said first and second surfaces for retaining the cannulated tissue anchor.
cooperating trough means on each of said first and second surfaces for retaining the cannulated tissue anchor.
23. A package according to claim 21 further comprising:
receiving means situated distally of said funnel means and axially aligned therewith for receiving therein said elongated member after it has passed through said bore.
receiving means situated distally of said funnel means and axially aligned therewith for receiving therein said elongated member after it has passed through said bore.
24. A package according to claim 21 wherein said base, said releasable holding means and said funnel means are integrally formed together.
25. A package according to claim 23 wherein said receiving means is an aperture through which said elongated member may pass.
26. A package according to claim 25 further comprising a protective wall means, situated distally of said receiving means, for preventing said elongated member from extending beyond a predetermined point.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US09/141,175 US6146387A (en) | 1998-08-26 | 1998-08-26 | Cannulated tissue anchor system |
| US09/141,175 | 1998-08-26 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2280575A1 true CA2280575A1 (en) | 2000-02-26 |
Family
ID=22494512
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002280575A Abandoned CA2280575A1 (en) | 1998-08-26 | 1999-08-20 | Cannulated tissue anchor system |
Country Status (5)
| Country | Link |
|---|---|
| US (4) | US6146387A (en) |
| EP (1) | EP0982003A3 (en) |
| JP (1) | JP2000070274A (en) |
| AU (1) | AU3919699A (en) |
| CA (1) | CA2280575A1 (en) |
Families Citing this family (174)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7211088B2 (en) * | 1999-02-02 | 2007-05-01 | Arthrex, Inc. | Bioabsorbable tissue tack with oval-shaped head and method of tissue fixation using the same |
| US6074395A (en) * | 1999-02-02 | 2000-06-13 | Linvatec Corporation | Cannulated tissue anchor insertion system |
| US6689153B1 (en) | 1999-04-16 | 2004-02-10 | Orthopaedic Biosystems Ltd, Inc. | Methods and apparatus for a coated anchoring device and/or suture |
| US6723107B1 (en) | 1999-04-19 | 2004-04-20 | Orthopaedic Biosystems Ltd. | Method and apparatus for suturing |
| DE60037406T2 (en) | 1999-04-26 | 2008-05-21 | GMP Vision Solutions, Inc., Ft. Lauderdale | INFLATABLE DEVICE FOR TREATING GLAUCOMA |
| US6626899B2 (en) * | 1999-06-25 | 2003-09-30 | Nidus Medical, Llc | Apparatus and methods for treating tissue |
| US6991643B2 (en) | 2000-12-20 | 2006-01-31 | Usgi Medical Inc. | Multi-barbed device for retaining tissue in apposition and methods of use |
| US6554852B1 (en) * | 1999-08-25 | 2003-04-29 | Michael A. Oberlander | Multi-anchor suture |
| EP1210014A1 (en) | 1999-09-07 | 2002-06-05 | Microvena Corporation | Retrievable septal defect closure device |
| US7887551B2 (en) | 1999-12-02 | 2011-02-15 | Smith & Nephew, Inc. | Soft tissue attachment and repair |
| US7153312B1 (en) | 1999-12-02 | 2006-12-26 | Smith & Nephew Inc. | Closure device and method for tissue repair |
| US6623492B1 (en) * | 2000-01-25 | 2003-09-23 | Smith & Nephew, Inc. | Tissue fastener |
| US6638239B1 (en) | 2000-04-14 | 2003-10-28 | Glaukos Corporation | Apparatus and method for treating glaucoma |
| US7867186B2 (en) | 2002-04-08 | 2011-01-11 | Glaukos Corporation | Devices and methods for treatment of ocular disorders |
| DE10021122C1 (en) | 2000-04-29 | 2001-11-08 | Aesculap Ag & Co Kg | Thread anchor system for connecting tissue parts and instrument for inserting an anchor implant |
| US7556638B2 (en) * | 2000-05-26 | 2009-07-07 | Arthrex, Inc. | Retrograde fixation technique with insert-molded interference screw |
| US6743233B1 (en) | 2000-08-02 | 2004-06-01 | Orthopaedic Biosystems, Ltd., Inc. | Medical screw and method of installation |
| DE50015692D1 (en) * | 2000-09-07 | 2009-08-27 | Synthes Gmbh | DEVICE FOR FIXING SURGICAL IMPLANTS |
| US7485124B2 (en) * | 2000-10-19 | 2009-02-03 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a fastener delivery mechanism |
| US6447524B1 (en) * | 2000-10-19 | 2002-09-10 | Ethicon Endo-Surgery, Inc. | Fastener for hernia mesh fixation |
| US6425900B1 (en) * | 2000-10-19 | 2002-07-30 | Ethicon Endo-Surgery | Method for attaching hernia mesh |
| US6915901B2 (en) | 2000-12-11 | 2005-07-12 | Marc Feinberg | Packaging assembly for surgical use |
| US7431710B2 (en) | 2002-04-08 | 2008-10-07 | Glaukos Corporation | Ocular implants with anchors and methods thereof |
| ES2304438T3 (en) | 2001-04-07 | 2008-10-16 | Glaukos Corporation | GLAUCOMA STENT FOR THE TREATMENT OF GLAUCOMA. |
| US7288105B2 (en) | 2001-08-01 | 2007-10-30 | Ev3 Endovascular, Inc. | Tissue opening occluder |
| US7331984B2 (en) | 2001-08-28 | 2008-02-19 | Glaukos Corporation | Glaucoma stent for treating glaucoma and methods of use |
| US20030060842A1 (en) * | 2001-09-27 | 2003-03-27 | Yem Chin | Method and apparatus for measuring and controlling blade depth of a tissue cutting apparatus in an endoscopic catheter |
| EP1324312B1 (en) * | 2001-11-08 | 2008-02-13 | Yamaha Corporation | Keyboard musical instrument having keys regulated with stable key balance pieces |
| US7129404B2 (en) * | 2001-11-08 | 2006-10-31 | Yamaha Corporation | Keyboard musical instrument having keys regulated with stable key balance pieces and process for fabricating keys |
| US6814236B2 (en) * | 2001-12-31 | 2004-11-09 | Ethicon, Inc. | Blister tray with a package for a small device |
| US6685728B2 (en) | 2002-01-25 | 2004-02-03 | Stryker Endoscopy | Threaded suture anchor and method of use |
| US6984237B2 (en) | 2002-05-22 | 2006-01-10 | Orthopaedic Biosystems Ltd., Inc. | Suture passing surgical instrument |
| US6793678B2 (en) | 2002-06-27 | 2004-09-21 | Depuy Acromed, Inc. | Prosthetic intervertebral motion disc having dampening |
| US7588595B2 (en) * | 2002-10-29 | 2009-09-15 | Stryker Endoscopy | Graft fixation device and method |
| IL190642A (en) | 2002-11-13 | 2011-06-30 | Biomet 3I Llc | Dental implant system |
| US7449025B1 (en) * | 2002-12-17 | 2008-11-11 | O'donnell Pat D | Surgical instrument to secure body tissues |
| WO2004069055A2 (en) | 2003-02-04 | 2004-08-19 | Ev3 Sunnyvale Inc. | Patent foramen ovale closure system |
| US9314235B2 (en) | 2003-02-05 | 2016-04-19 | Smith & Nephew, Inc. | Tissue anchor and insertion tool |
| AU2004212942A1 (en) | 2003-02-14 | 2004-09-02 | Depuy Spine, Inc. | In-situ formed intervertebral fusion device |
| EP1635723B1 (en) | 2003-06-13 | 2011-08-10 | Tyco Healthcare Group LP | Multiple member interconnect for surgical instrument and absorbable screw fastener |
| US8926637B2 (en) | 2003-06-13 | 2015-01-06 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
| US8029477B2 (en) | 2003-12-19 | 2011-10-04 | Ethicon Endo-Surgery, Inc. | Applier with safety for implantable medical device |
| US7862546B2 (en) * | 2003-06-16 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Subcutaneous self attaching injection port with integral moveable retention members |
| US8715243B2 (en) | 2003-06-16 | 2014-05-06 | Ethicon Endo-Surgery, Inc. | Injection port applier with downward force actuation |
| US20050131352A1 (en) * | 2003-06-16 | 2005-06-16 | Conlon Sean P. | Subcutaneous injection port for applied fasteners |
| US20040267367A1 (en) | 2003-06-30 | 2004-12-30 | Depuy Acromed, Inc | Intervertebral implant with conformable endplate |
| JP4755983B2 (en) * | 2003-07-16 | 2011-08-24 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical stapling device with tissue tensioner |
| US7361182B2 (en) * | 2003-12-19 | 2008-04-22 | Lightnix, Inc. | Medical lancet |
| US8162897B2 (en) | 2003-12-19 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Audible and tactile feedback |
| US7976539B2 (en) | 2004-03-05 | 2011-07-12 | Hansen Medical, Inc. | System and method for denaturing and fixing collagenous tissue |
| US8636802B2 (en) | 2004-03-06 | 2014-01-28 | DePuy Synthes Products, LLC | Dynamized interspinal implant |
| EP1740123A4 (en) * | 2004-04-26 | 2008-09-03 | Howmedica Osteonics Corp | Stent for avascular meniscal repair and regeneration |
| US10478179B2 (en) | 2004-04-27 | 2019-11-19 | Covidien Lp | Absorbable fastener for hernia mesh fixation |
| US8257394B2 (en) | 2004-05-07 | 2012-09-04 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
| FR2871366A1 (en) | 2004-06-09 | 2005-12-16 | Ceravic Soc Par Actions Simpli | PROSTHETIC EXPANSIBLE BONE IMPLANT |
| US8062305B2 (en) * | 2005-03-16 | 2011-11-22 | Tyco Healthcare Group Lp | Surgical portal with enhanced retention capabilities |
| FR2884406B1 (en) | 2005-04-14 | 2008-10-17 | Memometal Technologies Soc Par | INTRAMEDULAR OSTEOSYNTHESIS DEVICE OF TWO BONE PARTS, IN PARTICULAR HAND AND / OR FOOT |
| US8702718B2 (en) | 2005-04-29 | 2014-04-22 | Jmea Corporation | Implantation system for tissue repair |
| US7632313B2 (en) | 2005-04-29 | 2009-12-15 | Jmea Corporation | Disc repair system |
| US7608108B2 (en) | 2005-04-29 | 2009-10-27 | Jmea Corporation | Tissue repair system |
| US7651483B2 (en) | 2005-06-24 | 2010-01-26 | Ethicon Endo-Surgery, Inc. | Injection port |
| US7918844B2 (en) | 2005-06-24 | 2011-04-05 | Ethicon Endo-Surgery, Inc. | Applier for implantable medical device |
| EP1743587B1 (en) * | 2005-07-08 | 2008-03-26 | BIEDERMANN MOTECH GmbH | Bone anchoring element |
| EP1948073B1 (en) | 2005-11-14 | 2014-03-19 | C.R.Bard, Inc. | Sling anchor system |
| US7632308B2 (en) | 2005-11-23 | 2009-12-15 | Didier Loulmet | Methods, devices, and kits for treating mitral valve prolapse |
| US20070244494A1 (en) * | 2006-04-18 | 2007-10-18 | Downing Stephen W | Methods and devices for treating atrial septal defects |
| US20070250118A1 (en) * | 2006-04-20 | 2007-10-25 | Masini Michael A | Compression tissue repair apparatus and methods |
| US8870916B2 (en) | 2006-07-07 | 2014-10-28 | USGI Medical, Inc | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
| US20080033487A1 (en) * | 2006-08-07 | 2008-02-07 | Bioduct, Llc | Medical device for repair of tissue and method for implantation and fixation |
| CA2660117C (en) * | 2006-08-07 | 2012-07-03 | Howmedica Osteonics Corp. | Insertion system for implanting a medical device and surgical methods |
| US8758367B2 (en) * | 2006-09-05 | 2014-06-24 | Smith & Nephew, Inc. | Anchor delivery system |
| WO2008033950A2 (en) | 2006-09-13 | 2008-03-20 | C. R. Bard, Inc. | Urethral support system |
| CA2668954C (en) | 2006-11-10 | 2020-09-08 | Glaukos Corporation | Uveoscleral shunt and methods for implanting same |
| US8105382B2 (en) | 2006-12-07 | 2012-01-31 | Interventional Spine, Inc. | Intervertebral implant |
| FR2913876B1 (en) | 2007-03-20 | 2009-06-05 | Memometal Technologies Soc Par | OSTEOSYNTHESIS DEVICE |
| US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
| JP5341901B2 (en) * | 2007-10-25 | 2013-11-13 | スミス アンド ネフュー インコーポレーテッド | Anchor assembly |
| US8206280B2 (en) | 2007-11-13 | 2012-06-26 | C. R. Bard, Inc. | Adjustable tissue support member |
| CN101909548B (en) | 2008-01-17 | 2014-07-30 | 斯恩蒂斯有限公司 | An expandable intervertebral implant and associated method of manufacturing the same |
| US20090229214A1 (en) * | 2008-03-12 | 2009-09-17 | Nelson Steven J | Foam-concrete rebar tie |
| WO2009124269A1 (en) | 2008-04-05 | 2009-10-08 | Synthes Usa, Llc | Expandable intervertebral implant |
| AU2009270960B2 (en) | 2008-07-17 | 2015-09-03 | Smith & Nephew, Inc. | Surgical devices |
| FR2935601B1 (en) * | 2008-09-09 | 2010-10-01 | Memometal Technologies | INTRAMEDULLARY IMPLANT RESORBABLE BETWEEN TWO BONE OR TWO BONE FRAGMENTS |
| US20110011917A1 (en) * | 2008-12-31 | 2011-01-20 | Hansen Medical, Inc. | Methods, devices, and kits for treating valve prolapse |
| US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
| WO2011005788A1 (en) | 2009-07-06 | 2011-01-13 | Synthes Usa, Llc | Expandable fixation assemblies |
| US8211126B2 (en) | 2009-09-22 | 2012-07-03 | Jmea Corporation | Tissue repair system |
| US9936939B2 (en) * | 2009-11-10 | 2018-04-10 | Smith & Nephew, Inc. | Tissue repair devices |
| US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
| US9498273B2 (en) | 2010-06-02 | 2016-11-22 | Wright Medical Technology, Inc. | Orthopedic implant kit |
| US9724140B2 (en) | 2010-06-02 | 2017-08-08 | Wright Medical Technology, Inc. | Tapered, cylindrical cruciform hammer toe implant and method |
| US8608785B2 (en) | 2010-06-02 | 2013-12-17 | Wright Medical Technology, Inc. | Hammer toe implant with expansion portion for retrograde approach |
| US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
| US9907560B2 (en) | 2010-06-24 | 2018-03-06 | DePuy Synthes Products, Inc. | Flexible vertebral body shavers |
| TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
| US20120029538A1 (en) | 2010-07-27 | 2012-02-02 | Reeser Steven M | Surgical Tack and Tack Drive Apparatus |
| US20120078372A1 (en) | 2010-09-23 | 2012-03-29 | Thomas Gamache | Novel implant inserter having a laterally-extending dovetail engagement feature |
| US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
| DE102011001401A1 (en) * | 2010-12-20 | 2012-06-21 | Frank-Peter Spahn | Crestal implant and method for its processing |
| US8556916B2 (en) | 2011-02-14 | 2013-10-15 | Smith & Nephew, Inc. | Method and device for suture manipulation |
| CN102240224A (en) * | 2011-05-19 | 2011-11-16 | 黄长明 | Bone nail and tool using same |
| US9237887B2 (en) * | 2011-05-19 | 2016-01-19 | Biomet Sports Medicine, Llc | Tissue engaging member |
| US10201405B2 (en) | 2011-06-28 | 2019-02-12 | Biomet 3I, Llc | System and method of dental implant and interface to abutment for restoration |
| US9248028B2 (en) | 2011-09-16 | 2016-02-02 | DePuy Synthes Products, Inc. | Removable, bone-securing cover plate for intervertebral fusion cage |
| US8556074B2 (en) * | 2011-10-25 | 2013-10-15 | Warsaw Orthopedic, Inc | Encapsulated data carrier tag for track and trace purposes |
| JP6465490B2 (en) | 2012-03-26 | 2019-02-06 | グローコス コーポレーション | Implant delivery device |
| US10806444B2 (en) | 2012-06-06 | 2020-10-20 | Laprotx Llc | Multiple leg surgical fastener |
| US9433456B2 (en) | 2012-07-18 | 2016-09-06 | Jmea Corporation | Method and system for implanting multiple prostheses |
| WO2014018098A1 (en) | 2012-07-26 | 2014-01-30 | DePuy Synthes Products, LLC | Expandable implant |
| US9198657B2 (en) | 2012-09-13 | 2015-12-01 | Basil Anthony Kocur | Anchor unit implant |
| US9486201B2 (en) | 2012-09-27 | 2016-11-08 | Depuy Mitek, Llc | Directionally specific bone anchors and method |
| US9750595B2 (en) | 2012-09-28 | 2017-09-05 | Covidien Lp | Implantable medical devices which include grip-members and methods of use thereof |
| US8945232B2 (en) | 2012-12-31 | 2015-02-03 | Wright Medical Technology, Inc. | Ball and socket implants for correction of hammer toes and claw toes |
| US9351733B2 (en) | 2013-01-18 | 2016-05-31 | Covidien Lp | Surgical fastener applier |
| US9717601B2 (en) | 2013-02-28 | 2017-08-01 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
| US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
| US9173652B2 (en) * | 2013-03-11 | 2015-11-03 | Linvatec Corporation | All-suture anchor inserter |
| US9358010B2 (en) | 2013-03-12 | 2016-06-07 | Covidien Lp | Flex cable and spring-loaded tube for tacking device |
| US9867620B2 (en) | 2013-03-14 | 2018-01-16 | Covidien Lp | Articulation joint for apparatus for endoscopic procedures |
| US9592151B2 (en) | 2013-03-15 | 2017-03-14 | Glaukos Corporation | Systems and methods for delivering an ocular implant to the suprachoroidal space within an eye |
| US10517759B2 (en) | 2013-03-15 | 2019-12-31 | Glaukos Corporation | Glaucoma stent and methods thereof for glaucoma treatment |
| US9655621B2 (en) | 2013-03-15 | 2017-05-23 | Covidien Lp | Surgical instrument for dispensing tacks and solution |
| US9351728B2 (en) | 2013-06-28 | 2016-05-31 | Covidien Lp | Articulating apparatus for endoscopic procedures |
| US9358004B2 (en) | 2013-06-28 | 2016-06-07 | Covidien Lp | Articulating apparatus for endoscopic procedures |
| US9668730B2 (en) | 2013-06-28 | 2017-06-06 | Covidien Lp | Articulating apparatus for endoscopic procedures with timing system |
| US10085746B2 (en) | 2013-06-28 | 2018-10-02 | Covidien Lp | Surgical instrument including rotating end effector and rotation-limiting structure |
| US20150032130A1 (en) | 2013-07-24 | 2015-01-29 | Covidien Lp | Expanding absorbable tack |
| US9526498B2 (en) | 2013-09-17 | 2016-12-27 | Covidien Lp | Surgical device with a trigger lockout mechanism device |
| US9724139B2 (en) | 2013-10-01 | 2017-08-08 | Wright Medical Technology, Inc. | Hammer toe implant and method |
| US9474561B2 (en) | 2013-11-19 | 2016-10-25 | Wright Medical Technology, Inc. | Two-wire technique for installing hammertoe implant |
| FR3015221B1 (en) | 2013-12-23 | 2017-09-01 | Vexim | EXPANSIBLE INTRAVERTEBRAL IMPLANT SYSTEM WITH POSTERIOR PEDICULAR FIXATION |
| US9545274B2 (en) | 2014-02-12 | 2017-01-17 | Wright Medical Technology, Inc. | Intramedullary implant, system, and method for inserting an implant into a bone |
| US9498266B2 (en) | 2014-02-12 | 2016-11-22 | Wright Medical Technology, Inc. | Intramedullary implant, system, and method for inserting an implant into a bone |
| WO2015149292A1 (en) | 2014-04-02 | 2015-10-08 | Covidien Lp | Surgical fastener applying apparatus, kits and methods for endoscopic procedures |
| WO2015164819A1 (en) | 2014-04-24 | 2015-10-29 | Smith & Nephew, Inc. | Suture passer |
| US20150342875A1 (en) | 2014-05-29 | 2015-12-03 | Dose Medical Corporation | Implants with controlled drug delivery features and methods of using same |
| US9936943B1 (en) | 2014-08-07 | 2018-04-10 | Nicholas MANCINI | Suture passing surgical device with atraumatic grasper preventing accidental perforations |
| WO2016043751A1 (en) | 2014-09-18 | 2016-03-24 | Wright Medical Technology, Inc. | Hammertoe implant and instrument |
| CN105960211B (en) | 2014-12-19 | 2019-01-11 | 瑞特医疗技术公司 | For anchor log in the marrow of interphalangeal arthrodesis of toe |
| US9757168B2 (en) | 2015-03-03 | 2017-09-12 | Howmedica Osteonics Corp. | Orthopedic implant and methods of implanting and removing same |
| US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
| US11090097B2 (en) | 2015-03-17 | 2021-08-17 | Covidien Lp | Connecting end effectors to surgical devices |
| US9451982B1 (en) | 2015-06-06 | 2016-09-27 | Coloplast A/S | System for implanting a penile prosthetic into a penis includes a delivery cap coupled to a tow suture |
| US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
| CN105078522B (en) * | 2015-08-28 | 2017-07-25 | 南京英麦德医疗科技有限公司 | A kind of suturing soft tissue device |
| WO2017040853A1 (en) | 2015-09-02 | 2017-03-09 | Glaukos Corporation | Drug delivery implants with bi-directional delivery capacity |
| US9924935B2 (en) | 2015-10-23 | 2018-03-27 | Smith & Nephew, Inc. | Suture anchor assembly with slip fit tip |
| EP3251621B1 (en) | 2016-06-03 | 2021-01-20 | Stryker European Holdings I, LLC | Intramedullary implant |
| JP7019616B2 (en) | 2016-06-28 | 2022-02-15 | イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー | Expandable and angle adjustable intervertebral cage with range of motion joints |
| JP6995789B2 (en) | 2016-06-28 | 2022-01-17 | イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー | Expandable and angle adjustable intervertebral cage |
| US10743859B2 (en) | 2016-10-21 | 2020-08-18 | Covidien Lp | Surgical end effectors |
| US11298123B2 (en) | 2016-10-21 | 2022-04-12 | Covidien Lp | Surgical end effectors |
| US10617409B2 (en) | 2016-10-21 | 2020-04-14 | Covidien Lp | Surgical end effectors |
| CN109843187B (en) | 2016-10-31 | 2022-12-06 | 史密夫和内修有限公司 | Suture passer and grasper instruments and methods |
| US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
| US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
| US10888309B2 (en) | 2017-01-31 | 2021-01-12 | Covidien Lp | Surgical fastener devices with geometric tubes |
| US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
| US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
| US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
| US11116625B2 (en) | 2017-09-28 | 2021-09-14 | Glaukos Corporation | Apparatus and method for controlling placement of intraocular implants |
| EP3691586A2 (en) | 2017-10-06 | 2020-08-12 | Glaukos Corporation | Systems and methods for delivering multiple ocular implants |
| USD846738S1 (en) | 2017-10-27 | 2019-04-23 | Glaukos Corporation | Implant delivery apparatus |
| US11298126B2 (en) | 2018-05-02 | 2022-04-12 | Covidien Lp | Shipping wedge for end effector installation onto surgical devices |
| US11116500B2 (en) | 2018-06-28 | 2021-09-14 | Covidien Lp | Surgical fastener applying device, kits and methods for endoscopic procedures |
| CN108852488A (en) * | 2018-07-10 | 2018-11-23 | 西安卓恰医疗器械有限公司 | A kind of medical internal fixing peg for fracture and medical fracture setting tool |
| US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
| US11523817B2 (en) | 2019-06-27 | 2022-12-13 | Covidien Lp | Endoluminal pursestring device |
| US11197675B2 (en) | 2019-12-19 | 2021-12-14 | Covidien Lp | Positioning guide for surgical instruments and surgical instrument systems |
| USD944985S1 (en) | 2019-12-19 | 2022-03-01 | Covidien Lp | Positioning guide cuff |
| USD944984S1 (en) | 2019-12-19 | 2022-03-01 | Covidien Lp | Tubular positioning guide |
| US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
| US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
| US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
Family Cites Families (70)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US170190A (en) * | 1875-11-23 | Improvement in buffer-stems | ||
| US368687A (en) * | 1887-08-23 | Chaeles d | ||
| US362843A (en) * | 1887-05-10 | Ciiaeles keebison | ||
| US3123077A (en) * | 1964-03-03 | Surgical suture | ||
| US204913A (en) * | 1878-06-18 | Improvement in furniture-pads | ||
| US1321011A (en) * | 1919-11-04 | Surgical | ||
| US816026A (en) * | 1905-03-09 | 1906-03-27 | Albert J Meier | Surgical clip. |
| US1153450A (en) * | 1914-09-03 | 1915-09-14 | Schuyler Renwick Schaff | Guy-anchor. |
| US1848318A (en) * | 1931-02-27 | 1932-03-08 | Ciampi Giotto | Elastic shoe lace and catch therefor |
| US2020062A (en) * | 1931-09-30 | 1935-11-05 | Alfred L Jackson | Structural building device |
| US2065659A (en) * | 1934-08-04 | 1936-12-29 | Arthur V Cullen | Fastening method and means |
| US2243717A (en) * | 1938-09-20 | 1941-05-27 | Moreira Franciseo Elias Godoy | Surgical device |
| US2248054A (en) * | 1939-06-07 | 1941-07-08 | Becker Joseph | Screw driver |
| US2267925A (en) * | 1941-02-11 | 1941-12-30 | Herbert A Johnston | Fracture securing apparatus |
| US2413142A (en) * | 1945-06-11 | 1946-12-24 | Edwin M Jones | Suturing assembly and method |
| US2631584A (en) * | 1948-07-22 | 1953-03-17 | Alfred T Purificato | Fracture securing instrument |
| US2725053A (en) * | 1953-10-26 | 1955-11-29 | Bambara John | Surgical nail guide |
| US2779083A (en) * | 1955-02-09 | 1957-01-29 | Edward N Eaton | Lip and mouth adjuster |
| US3003155A (en) * | 1956-07-06 | 1961-10-10 | Felix C Mielzynski | Hair darts for implanting in live or artificial media |
| US3166072A (en) * | 1962-10-22 | 1965-01-19 | Jr John T Sullivan | Barbed clips |
| US3399432A (en) * | 1965-12-08 | 1968-09-03 | Dennison Mfg Co | Button attachment |
| US3470834A (en) * | 1968-03-08 | 1969-10-07 | Dennison Mfg Co | Fastener attaching device |
| US3716058A (en) * | 1970-07-17 | 1973-02-13 | Atlanta Res Inst | Barbed suture |
| US3862684A (en) * | 1971-04-26 | 1975-01-28 | Karlsruhe Augsburg Iweka | Aseptic packing container and method of making and filling it |
| US3699969A (en) * | 1971-06-01 | 1972-10-24 | William Glenn Allen | Method for implanting natural or synthetic fibers into living tissue |
| US3848080A (en) * | 1973-09-06 | 1974-11-12 | Illinois Tool Works | Ground wire clip |
| US3892232A (en) * | 1973-09-24 | 1975-07-01 | Alonzo J Neufeld | Method and apparatus for performing percutaneous bone surgery |
| US3946740A (en) * | 1974-10-15 | 1976-03-30 | Bassett John W | Suturing device |
| US4006747A (en) * | 1975-04-23 | 1977-02-08 | Ethicon, Inc. | Surgical method |
| US4007732A (en) * | 1975-09-02 | 1977-02-15 | Robert Carl Kvavle | Method for location and removal of soft tissue in human biopsy operations |
| US4060089A (en) * | 1975-09-03 | 1977-11-29 | United States Surgical Corporation | Surgical fastening method and device therefor |
| CA1101289A (en) * | 1976-09-07 | 1981-05-19 | Vsesojuzny Nauchno-Issledovatelsky I Ispytatelny Institut Meditsinskoi T Ekhniki | Surgical apparatus for suturing soft tissues with lengths of suturing material with spicules |
| JPS5411158A (en) | 1977-06-28 | 1979-01-27 | Asahi Glass Co Ltd | Flame-retardant and fiberglass reinforced thermoplastic polyester resin |
| US4235238A (en) * | 1978-05-11 | 1980-11-25 | Olympus Optical Co., Ltd. | Apparatus for suturing coeliac tissues |
| US4244370A (en) * | 1978-11-20 | 1981-01-13 | American Medical Systems, Inc. | Tool for positioning implantable medical prosthetic device _and method of using same |
| US4259959A (en) * | 1978-12-20 | 1981-04-07 | Walker Wesley W | Suturing element |
| US4263903A (en) * | 1979-01-08 | 1981-04-28 | Richards Manufacturing Co., Inc. | Medical staple means |
| AT363172B (en) * | 1979-09-07 | 1981-07-10 | Novex Foreign Trade Co Ltd | MARKHOEHLENNAGEL |
| US4383527A (en) * | 1981-02-20 | 1983-05-17 | Howmedica, Inc. | Device for guiding the insertion of surgical wires into bone tissue |
| US4409974A (en) * | 1981-06-29 | 1983-10-18 | Freedland Jeffrey A | Bone-fixating surgical implant device |
| US4493323A (en) * | 1982-12-13 | 1985-01-15 | University Of Iowa Research Foundation | Suturing device and method for using same |
| US4462395A (en) * | 1983-03-02 | 1984-07-31 | Johnson Lanny L | Arthroscopic ligamentous and capsular fixation system |
| JPS6025213A (en) | 1983-07-21 | 1985-02-08 | 松下電器産業株式会社 | Method of producing film capacitor |
| US4873976A (en) * | 1984-02-28 | 1989-10-17 | Schreiber Saul N | Surgical fasteners and method |
| JPS6140418A (en) | 1984-07-31 | 1986-02-26 | Mitsubishi Motors Corp | Manufacture of turbine housing for turbo supercharger |
| US4635637A (en) * | 1984-03-29 | 1987-01-13 | Schreiber Saul N | Surgical suture |
| US4895148A (en) * | 1986-05-20 | 1990-01-23 | Concept, Inc. | Method of joining torn parts of bodily tissue in vivo with a biodegradable tack member |
| US4924865A (en) * | 1986-05-20 | 1990-05-15 | Concept, Inc. | Repair tack for bodily tissue |
| FI81498C (en) * | 1987-01-13 | 1990-11-12 | Biocon Oy | SURGICAL MATERIAL OCH INSTRUMENT. |
| US5059206A (en) * | 1989-04-12 | 1991-10-22 | Winters Thomas F | Method and apparatus for repairing a tear in a knee meniscus |
| US5129906A (en) * | 1989-09-08 | 1992-07-14 | Linvatec Corporation | Bioabsorbable tack for joining bodily tissue and in vivo method and apparatus for deploying same |
| US5031768A (en) * | 1990-04-09 | 1991-07-16 | Ultradent Products, Inc. | Instrument tray and disposable receptacle having alternative locking means |
| US5144942A (en) * | 1991-03-21 | 1992-09-08 | United States Surgical Corporation | Endoscopic instrumentation kit and package therefor |
| US5236431A (en) * | 1991-07-22 | 1993-08-17 | Synthes | Resorbable fixation device with controlled stiffness for treating bodily material in vivo and introducer therefor |
| FI95537C (en) * | 1992-01-24 | 1996-02-26 | Biocon Oy | Surgical implant |
| IT1258315B (en) * | 1992-04-10 | 1996-02-22 | Recordati Chem Pharm | FLAVONE DERIVATIVES |
| JPH06140418A (en) * | 1992-10-22 | 1994-05-20 | Hitachi Denshi Ltd | Manufacture of semiconductor device |
| US5380334A (en) * | 1993-02-17 | 1995-01-10 | Smith & Nephew Dyonics, Inc. | Soft tissue anchors and systems for implantation |
| US5354292A (en) * | 1993-03-02 | 1994-10-11 | Braeuer Harry L | Surgical mesh introduce with bone screw applicator for the repair of an inguinal hernia |
| US5466243A (en) * | 1994-02-17 | 1995-11-14 | Arthrex, Inc. | Method and apparatus for installing a suture anchor through a hollow cannulated grasper |
| US5522843A (en) * | 1994-02-23 | 1996-06-04 | Orthopaedic Biosystems Limited, Inc. | Apparatus for attaching soft tissue to bone |
| US5730744A (en) * | 1994-09-27 | 1998-03-24 | Justin; Daniel F. | Soft tissue screw, delivery device, and method |
| US5569252A (en) * | 1994-09-27 | 1996-10-29 | Justin; Daniel F. | Device for repairing a meniscal tear in a knee and method |
| US5667513A (en) * | 1995-06-07 | 1997-09-16 | Smith & Nephew Dyonics Inc. | Soft tissue anchor delivery apparatus |
| US5997552A (en) * | 1995-10-20 | 1999-12-07 | United States Surgical Corporation | Meniscal fastener applying device |
| US5782862A (en) * | 1996-07-01 | 1998-07-21 | Bonutti; Peter M. | Suture anchor inserter assembly and method |
| US5868250A (en) * | 1996-09-26 | 1999-02-09 | Brackett; Fred | Tray for holding medical instruments |
| US5715942A (en) * | 1996-11-15 | 1998-02-10 | Li Medical Technologies, Inc. | Package and holder for suture anchor with sutures and surgical needles attacked |
| US5928252A (en) * | 1997-01-21 | 1999-07-27 | Regen Biologics, Inc. | Device and method for driving a needle and meniscal repair |
| US5902306A (en) * | 1997-05-01 | 1999-05-11 | Linvatec Corporation | Surgical wire driver with one-handed gripping attachment |
-
1998
- 1998-08-26 US US09/141,175 patent/US6146387A/en not_active Expired - Fee Related
-
1999
- 1999-07-14 AU AU39196/99A patent/AU3919699A/en not_active Abandoned
- 1999-08-06 EP EP99306246A patent/EP0982003A3/en not_active Withdrawn
- 1999-08-20 CA CA002280575A patent/CA2280575A1/en not_active Abandoned
- 1999-08-26 JP JP11239690A patent/JP2000070274A/en active Pending
-
2000
- 2000-06-09 US US09/591,375 patent/US6280448B1/en not_active Expired - Lifetime
- 2000-06-09 US US09/591,374 patent/US6290702B1/en not_active Expired - Lifetime
- 2000-06-09 US US09/591,376 patent/US6346109B1/en not_active Expired - Lifetime
Also Published As
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|---|---|
| US6346109B1 (en) | 2002-02-12 |
| EP0982003A3 (en) | 2001-05-30 |
| AU3919699A (en) | 2000-03-09 |
| US6146387A (en) | 2000-11-14 |
| US6290702B1 (en) | 2001-09-18 |
| US6280448B1 (en) | 2001-08-28 |
| JP2000070274A (en) | 2000-03-07 |
| EP0982003A2 (en) | 2000-03-01 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Discontinued | ||
| FZDE | Discontinued |
Effective date: 20050822 |