Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3664345 A
Publication typeGrant
Publication dateMay 23, 1972
Filing dateJul 6, 1970
Priority dateJul 6, 1970
Publication numberUS 3664345 A, US 3664345A, US-A-3664345, US3664345 A, US3664345A
InventorsClyde Harwell Dabbs, Hugh G Neil
Original AssigneeClyde Harwell Dabbs, Hugh G Neil
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Surgical buttons
US 3664345 A
Abstract
A surgical button for retaining a suture after passing through the skin on one side of an abdominal or other wound. The button comprises a non-metallic disc made of nylon or other suitable plastic material which has an axial orifice therethrough for passage of the suture and which axial passage or orifice is intersected by a radial orifice extending diametrically therethrough to receive a locking pin which engages the suture in a wedging action to hold it tightly in the disc. The button also comprises a pad of soft, spongy material, such as sponge rubber, secured to one face of the disc with a covering of cloth or fabric which lies against the skin and prevents irritation or maceration. No tying of the suture is involved. It is held in place by the wedging action of the disc.
Images(1)
Previous page
Next page
Claims  available in
Description  (OCR text may contain errors)

United States Patent Dabbs et al. 5] May 23, 1972 54] SURGICAL BUTTONS FOREIGN PATENTS OR APPLICATIONS [72] Inventors: Clyde Harwell Dabbs, 606 Main Ave 494,960 6/ 1919 France ..128/ 335 S.W.; Hugh G. Neil, PO. Box 1950, both f Knoxville, Term Primary Examiner--Dalton L. Truluck Attorney-Burns, Doane, Benedict, Swecker & Mathis [22] Filed: July 6, 1970 21 Appl. No.: 52,449 [57] ABSTRACT A surgical button for retaining a suture after passing through the skin on one side of an abdominal or other wound. The but- [52] U.S. Cl ..128/335 ton comprises a nommetamc disc made of nylon or other [51] lllt. Cl. Suitable plastic material has an axial orifice [58] Fleld of Search ..128/334 R, 334 C, 335, 335.5, therethrough for passage Ofthe Suture and which axial passage 128/339 or orifice is intersected by a radial orifice extending diametrically therethrough to receive a locking pin which engages the [56] References Cited suture in a wedging action to hold it tightly in the disc. The button also comprises a pad of soft, spongy material, such as UNITED STATES PATENTS sponge rubber, secured to one face of the disc with a covering of cloth or fabric which lies against the skin and prevents irl' 72 332 g ritation or maceration. No tying of the suture is involved. It is 1/ 1 held in place by the wedging action of the disc. 2,075,508 3/1937 Davidson 128/335 3,541,591 11/1970 Hoegerman ..l28/335 10 Claims,4l)rawingFigures VIIIA' v/Il/l/AWl/l/Il/Z SURGICAL BUTTONS SUMMARY OF THE INVENTION This invention relates to improvements in surgical buttons used for holding sutures for abdominal and other wounds without damage to the skin even when left in place over several weeks.

Since the dawn of medicine, surgeons have sought to improve the methodology and technics of wound closure. The ancient enemy of the healing tissue is tension. Tension on the tissues at the line of closure poses an ever present threat of mechanical disruption of the wound itself. Moreover, tension interferes with the healing process per se, by increasing edema, and interference with the blood supply to the parts caught between the sutures.

Historically, various technics have been used to place retention sutures in wounds, designed to relieve the tension on the primary line of closure. Abdominal wounds (laparotomy incisions) have constituted the chief use of retention sutures because wound dehiscence (wound rupture) here results in evisceration, a physiologic catastrophe.

I-Ieretofore, there has been no satisfactory, and easily applicable method of accomplishing the desired objective, that is, to take the tension off the primary closure. The conventional method of using retention sutures consists of placing large strong sutures of silk, wire, monofilament nylon, etc. through all layers of the abdominal wall except the peritoneium (inner lining) and then pulling tightly and tying, usually over some sort of cloth or rubber padding.

Often a section of small rubber tubing (catheter) is used to protect the skin. Since wounds require three weeks to attain their maximal tensile strength of healing, it is necessary to leave all retention sutures in for approximately this long, if they are to serve any useful function. The forces exerted by tying a loop, as is conventionally done, inevitably produce necrosis (death) of living tissues subjected to the constant strong linear pressure along a very narrow area (the width of the contacting (inner) side of the wire or material). This is a well recognized phenomenon, and discourages the widespread use of retention sutures. The cutting in of the sutures is oftentimes extremely painful to the patient and the resulting scars are unsightly. Even more important, from a functional standpoint, the more necrosis that occurs, the looser the loop becomes so that, by the end of three weeks (the critical period) the retention sutures are so loose that they offer no protection from dehiscence whatsoever.

Buttons and frames have been used down through the years in order to change the direction of forces ad still relieve the tension on the primary wound. A commercially available button, known as the Davy button, has been available for several years and is easier to apply that clothing buttons. While it is true that the use of external fixation via buttons improves the situation by eliminating the cutting action resulting from a tightly tied loop, buttons have not gained widespread acceptance. One reason that buttons are not more widely used is that the edge of the button digs in to the skin and, over a period of three weeks, produces pressure necrosis around one or more of the buttons.

The defects of the commercially available buttons are as follows:

l. The thin metal edge predisposes to pressure necrosis of the skin.

2. The absence of padding on the surface next to the skin results in pressure necrosis.

3. Gripping of the retention suture by crushing the metal nipple requires a special tool as part of the sterile operating room equipment.

4. The hardness of the metal precludes performing this maneuver with any of the surgical clamps ordinarily available.

5. Gripping of the suture so that it is held securely requires practice by the surgeon before it can be done properly, and consistently. If not crushed just right the suture pulls out.

6. The protruding nipple from the outer side of the button interferes with wearing of abdominal supports and clothing post-operatively by reason of the fact that it protrudes approximately three-eighths inch above the surface.

7. The crushed metal nipple presents an irregular, jagged projection which snags on clothing, dressing, etc.

One object of this invention is to obviate the objections to the buttons used heretofore and to improve the construction thereof and the method of holding in place sutures after passage from abdominal or other wounds.

Another object of the invention is to eliminate the tying of sutures to buttons and to provide for secure connection therebetween by a wedging action.

Still another object of the invention is to eliminate skin necrosis by contact of the button or a pad thereon with the surface of the skin.

In carrying out these objects, we have provided a surgical button comprising a disc of suitable non-metallic material, such as nylon. This disc has an opening extending axially therethrough for passage of the suture and a diametrically extending or radial opening which intersects the axial opening and receives a pin that extends into wedging relation, clamping the suture against a side of the axial opening, thereby retaining it securely in the disc. The face of the disc toward the skin is provided with a suitable cushion material or pad thereon, preferably larger in diameter than the diameter of the disc and which is covered with a layer of fabric or cloth which lies in contact with the skin between the latter and the pad.

Padded buttons and discs have been used in approximately two hundred cases, with an average of six buttons per case. This constitutes an experience in observing approximately twelve hundred padded discs or buttons in patients. Since the adoption of the bottom-faced rubber pads, there have been no instances of skin necrosis.

BRIEF DESCRIPTION OF DRAWINGS One embodiment of the invention is illustrated in the accompanying drawings, in which:

FIG. 1 is a perspective view, diagrammatically illustrating an incised abdominal wall and showing the application of the buttons for holding sutures in place;

FIG. 2 is a vertical section through the abdominal section, substantially on the line 2-2 in FIG. 1;

FIG. 3 is a cross section through the surgical button, illustrating the clamping of a suture therein; and

FIG. 4 is a disassembled perspective view, showing the parts of the surgical button.

The surgical button is designated generally at l and comprises a disc 2 of suitable, preferably non-metallic material. This disc may be made by cutting a section from a nylon rod of a suitable diameter, such, for example, as three-eighths inch or three-fourths inch, according to the size of surgical button desired. The thickness of the button should be sufficient to hold firmly as, for example, one-eighth inch or three-sixteenths inch.

A small hole, indicated at 3, is drilled through the center of the disc to allow passage of a surgical needle therethrough and to receive the suture. A radial or diametrical opening or passage 4 extends transversely through the disc 2 intersecting the axial opening 3. A pin 5 of a diameter substantially to fit the radial passage 4 is inserted therethrough and preferably has a pointed or wedge-shaped end 6 thereon to squeeze the suture laterally in the axial opening 3. The pin 5 is shorter than the diameter of the disc and serves to wedge the suture in place in the axial opening 3. The pin 5 may be formed of nylon or stainless steel or other suitable material.

The surgical button 1 also includes a pad 7 formed preferably from latex foam rubber of a thickness suitable for effective cushioning action. A thickness of one-eighth inch or one-fourth inch has been found suitable for the purpose. This pad is secured to one face of the disc 2 by a waterproof adhesive so that it is effectively secured. The pad 7 may be of a diameter or area larger than the disc 2 to distribute the force over a large area and to allow use of a smaller size disc. The face of the pad 7 opposite from the disc 2 is covered with a sheet of cotton webbing or fabric, illustrated at 8 in FIG. 4. This sheet 8 is secured to the pad 7 by a suitable adhesive.

The regular or large size disc is designed for use in laparotomy wounds and wounds involving large heavy tissues or flaps and the like. The small size disc is for smaller skin flaps such as radical neck flaps, thyroidectomy flaps, face flaps in plastic surgery, and incisions where no great stress is applied to the primary wound post-operatively. The regular size is designed to be used with large, strong retention sutures of the magnitude of No. 2 material. The small size, on the other hand, is designed for use with sutures of smaller size, e.g. No. monofilament nylon. The discs are identical except for the differences in the dimensions.

The invention is illustrated in FIGS. 1 and 2 as applied to an abdominal section, generally indicated at 9, made up of a series of layers of muscular tissue and skin within which an incision 10 has been made. The sides of the incision 10 are closed by sutures 11 at suitable or desired points. The main suture material secured by the buttons is indicated at 12.

THE PROCEDURE FOR LAPAROTOMY WOUND CLOSURE IS AS FOLLOWS:

The retention sutures 12 may be placed before any of the layers are closed, after the peritoneum is closed, or after the musculofacial layer is closed, depending on the personal preference of the surgeon. In any event, it is considered important that the retention sutures not pass through into the peritoneal cavity. A free loop of suture inside the peritoneal cavity may occasionally be the source of intestinal obstruction. Whichever method is preferred, the technic of anchoring the retention sutures is similar. First, pass the needle containing the desired suture material 12 from the external surface of the disc 2 (the unpadded side) down through the central hole 3 through the foam rubber pad 7. Pull the suture 12 through, leaving a short section of the suture protruding from the external (nylon) surface, as shown in FIG. 1. Grasp the free end with a hemostat to keep under slight tension while the suture 12 is impacted by pushing the pin through the horizontal hold 4 with a Kocher clamp until the pin 5 is flush with the edge of the disc 2. Test the grip on the suture manually, to make sure that it is held firmly. Then pass the needle through all layersof the abdominal wall, except the peritoneum. In otherwords, passing the suture from the (patients) left hand side of a vertical abdominal wound, the needle (and suture) would pass through, successively, skin, subcutaneous tissue, musculofacial layer including transversalis fascia, then through the right hand side, musculofacial layers, subcutaneous tissue and skin.

The opposite (right hand) disc is then transfixed by passing the needle up through the foam rubber pad 7, through the center hole 3. A hemostat is placed on the suture 12, one or two inches above the disc and the suture cut. The same procedure is repeated at desired intervals until two, three, four or more pairs of retention sutures have been placed, depending on the length of the wound, the degree of protection desired and the personal preference of the surgeon. After all the sutures have been placed, the primary wound closure is completed according to the preference of the surgeon.

The tension sutures 12 are then completed one at a time as follows: The first is tightened by picking up the free end of the suture 12 and pulling it through the central hole 3 of the right hand disc 2 until the desired tension is achieved, keeping in mind that the tension will become greater when the anesthetic agent has worn off.

While the resiliency of the pads will protect the skin postoperatively from necrosis, even with considerable abdominal distention, the degree of distension which may occur is unpredictable. For this reason, it is the practice to adjust the degree of tension so that the skin is depressed only slightly. The

remaining (right hand) disc is now depressed into the skin to a similar degree and the suture fastened by squeezing the pin 5 into place. The excess suture is cut off, leaving a few millimeters protruding (FIG. 1). Care should be taken to place the sutures far enough from the skin edge 10 so as not to interfere with skin closure; 1 to 1 inches will usually suffice.

A similar technic can be used quite'effectively on any surgical wound in which the incision is made through the skin. It is particularly useful in dissections involving flaps such as mastectomy wounds, radical neck dissections, thyroidectomies, rotated flaps to plastic surgery, and the like.

No special after-care is required. The stay sutures are left in place a minimum of 3 weeks (the time required of attaining maximal tensile strength in a cleanly healing wound). Skin sutures may be removed anytime after the first day. No dressing is required over or under the discs. The patient may bathe or shower as desired. An occasional patient may react to the suture material and develop irritation around the suture tract. In the majority, however, there is no reaction at all even after three weeks by reason of the protection of the cotton layer 8. The sutures are easily remove when desired. One side is lifted up enough to insert the point of a scissors between the skin and the disc and the suture clipped. The other disc with the remainder of the suture attached is then withdrawn.

We are convinced that the widespread use of this device will solve the ancient problem of retention sutures in closing abdominal wounds. Its use in a wide variety of other types of surgical wounds adds a new dimension to wound healing. Relieving of the distracting forces at the primary line of closure results in greatly improved patient comfort and cosmesis.

While a preferred embodiment of the invention is illustrated and described, it is recognized that variations and changes may be made therein without departing from the invention.

We claim:

1. A surgical button comprising a disc having an axial opening therethrough for passage of a suture, said disc having a radial opening extending from the periphery inward and intersecting said axial opening, and a pin inserted into the radial opening in position for wedging relation with the suture.

2. A surgical button according to claim 1, wherein the pin has a tapered end at the axial opening for wedging the suture.

3. A surgical button according to claim 1, wherein the disc is relatively thick and flat and is formed of non-metallic material.

4. A surgical button comprising a disc having an axial opening therethrough for passage of a suture, said disc having a radial opening extending from the periphery inward and intersecting said axial opening, a pin inserted into the radial opening in position for wedging relation with the suture, said button including a thick pad of cushioning material on one side of the disc, and a strip of fabric covering the side of the pad opposite from the disc to be disposed between the cushion pad and the skin.

5. A surgical button comprising a relatively flat non-metallic disc having an axial opening therethrough for passage of a suture through the disc, said disc having a second opening extending diametrically therethrough intersecting the axial opening, a pin inserted in the second opening for wedging the suture in the axial opening, a pad of cushion material secured to one face of the disc, and a fabric material covering the outer face of the pad opposite from the disc to be disposed against the skin.

6. A surgical button according to claim 5, wherein the pin has a tapered end for wedging the suture in place.

7. A surgical button according to claim 5, wherein the pad and fabric covering are of greater area than the disc.

8. A method of securing a suture in place after passage from the skin of a patient, comprising passing the suture through a perforated disc, and inserting a pin radially through the disc in wedging relation with the suture.

9. A surgical button comprising a relatively flat disc, a pad of cushion material secured to one face of the disc, a sheet of fabric extending over the opposite face of the pad from the disc and substantially throughout said opposite face to lie in contact with the skin and to protect the skin from the cushion material, said pad and sheet of fabric being in position for passage of a suture therethrough from the skin to the disc, and means for securing the suture to the disc. 5

10. A surgical button according to claim 9, wherein the disc is non-metallic and the fabric sheet covers the entire area of the face of the pad to which said sheet is secured.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US877476 *Apr 16, 1904Jan 28, 1908Robert B BachNeedle.
US2075508 *Jul 18, 1934Mar 30, 1937Davidson Edward WSuture retainer
US2199025 *Jun 8, 1936Apr 30, 1940Conn Carl EMeans and method of closing surgical incisions
US3541591 *Apr 26, 1968Nov 17, 1970Henry J HoegermanMethod and apparatus for closing wounds
FR494960A * Title not available
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3976079 *May 6, 1975Aug 24, 1976Samuels Peter BSecuring devices for sutures
US4006747 *Apr 23, 1975Feb 8, 1977Ethicon, Inc.Surgical method
US4688561 *Sep 17, 1985Aug 25, 1987Reese H WilliamBone handling apparatus and method
US4732151 *Oct 8, 1986Mar 22, 1988Patent Research & Development Corp.Low trauma suturing
US4938760 *Mar 29, 1989Jul 3, 1990American Medical Systems, Inc.Female suspension procedure
US5258015 *May 3, 1991Nov 2, 1993American Cyanamid CompanyLocking filament caps
US5269809 *Apr 5, 1991Dec 14, 1993American Cyanamid CompanyLocking mechanism for use with a slotted suture anchor
US5366480 *Dec 15, 1992Nov 22, 1994American Cyanamid CompanySynthetic elastomeric buttressing pledget
US5462558 *Aug 29, 1994Oct 31, 1995United States Surgical CorporationSuture clip applier
US5520702 *Feb 24, 1994May 28, 1996United States Surgical CorporationMethod and apparatus for applying a cinch member to the ends of a suture
US5630824 *Jun 1, 1994May 20, 1997Innovasive Devices, Inc.For locking a suture to a tissue
US5643295 *Jan 25, 1995Jul 1, 1997Yoon; InbaeMethods and apparatus for suturing tissue
US5645553 *May 15, 1995Jul 8, 1997United States Surgical CorporationSuture clip applier
US5665109 *Dec 29, 1994Sep 9, 1997Yoon; InbaeMethods and apparatus for suturing tissue
US5669917 *May 12, 1995Sep 23, 1997Lasersurge, Inc.Surgical crimping device and method of use
US5693060 *Jun 7, 1995Dec 2, 1997Smith & Nephew, Inc.Suture securing device and method
US5741281 *May 7, 1996Apr 21, 1998Smith & Nephew, Inc.Suture securing apparatus
US5908428 *Sep 19, 1997Jun 1, 1999United States Surgical CorporationStitching devices for heart valve replacement surgery
US5931844 *Mar 31, 1998Aug 3, 1999Smith & Nephew, Inc.Surgical drive tool
US5935149 *Aug 21, 1997Aug 10, 1999Smith & Nephew Inc.Suturing tissue
US5954057 *Apr 22, 1998Sep 21, 1999Li Medical Technologies, Inc.Soft tissue suspension clip, clip assembly, emplacement tool and method
US5984933 *Jul 29, 1997Nov 16, 1999Yoon; InbaeApparatus for suturing tissue
US6063106 *Sep 18, 1998May 16, 2000Gibson; William Frits StewartSurgical spacer
US6083244 *Sep 12, 1997Jul 4, 2000Tendon Technology, Ltd.Apparatus and method for tendon or ligament repair
US6086608 *Jan 14, 1997Jul 11, 2000Smith & Nephew, Inc.Suture collet
US6146406 *Feb 12, 1998Nov 14, 2000Smith & Nephew, Inc.Bone anchor
US6200329Aug 31, 1998Mar 13, 2001Smith & Nephew, Inc.Suture collet
US6257890 *Mar 18, 1999Jul 10, 2001Friadent GmbhGingiva former
US6409743 *Jul 8, 1999Jun 25, 2002Axya Medical, Inc.Devices and methods for securing sutures and ligatures without knots
US6423088Jun 30, 2000Jul 23, 2002Axya Medical, Inc.Sharp edged device for closing wounds without knots
US6432123 *Jun 18, 2001Aug 13, 2002Ethicon, Inc.Suture locking device
US6482210Nov 12, 1999Nov 19, 2002Orthopaedic Biosystems, Ltd., Inc.Soft tissue/ligament to bone fixation device with inserter
US6623492Jan 25, 2000Sep 23, 2003Smith & Nephew, Inc.Tissue fastener
US6984241Oct 3, 2001Jan 10, 2006Tendon Technology, Ltd.Apparatus and methods for tendon or ligament repair
US7033380Jul 1, 2002Apr 25, 2006Ethicon, Inc.Suture locking device
US7108710Nov 26, 2002Sep 19, 2006Abbott LaboratoriesMulti-element biased suture clip
US7153312Nov 2, 2000Dec 26, 2006Smith & Nephew Inc.Closure device and method for tissue repair
US7255675Oct 27, 2004Aug 14, 2007Michael GertnerDevices and methods to treat a patient
US7255700Jun 18, 2003Aug 14, 2007Biomet Sports Medicine, Inc.Device and method of fastening a graft to a bone
US7347863Sep 29, 2004Mar 25, 2008Usgi Medical, Inc.Apparatus and methods for manipulating and securing tissue
US7361180Sep 29, 2004Apr 22, 2008Usgi Medical, Inc.Apparatus for manipulating and securing tissue
US7390329Jan 14, 2005Jun 24, 2008Usgi Medical, Inc.Methods for grasping and cinching tissue anchors
US7416554Sep 25, 2003Aug 26, 2008Usgi Medical IncApparatus and methods for forming and securing gastrointestinal tissue folds
US7416556Jun 6, 2002Aug 26, 2008Abbott LaboratoriesStop-cock suture clamping system
US7500983Jun 9, 2004Mar 10, 2009Biomet Sports Medicine, LlcApparatus for soft tissue attachment
US7571729Feb 28, 2005Aug 11, 2009Usgi Medical, Inc.Apparatus and methods for performing mucosectomy
US7601159Sep 30, 2004Oct 13, 2009Usgi Medical, Inc.Interlocking tissue anchor apparatus and methods
US7601165Sep 29, 2006Oct 13, 2009Biomet Sports Medicine, LlcMethod and apparatus for forming a self-locking adjustable suture loop
US7608092Feb 20, 2004Oct 27, 2009Biomet Sports Medicince, LLCMethod and apparatus for performing meniscus repair
US7608098Nov 9, 2004Oct 27, 2009Biomet Sports Medicine, LlcBone fixation device
US7611521Apr 2, 2004Nov 3, 2009Tendon Technology, Ltd.Apparatus and methods for tendon or ligament repair
US7618426Aug 11, 2003Nov 17, 2009Usgi Medical, Inc.Apparatus and methods for forming gastrointestinal tissue approximations
US7621925Sep 30, 2004Nov 24, 2009Usgi Medical, Inc.Needle assembly for tissue manipulation
US7651509Aug 16, 2004Jan 26, 2010Smith & Nephew, Inc.Methods and devices for tissue repair
US7658751Sep 29, 2006Feb 9, 2010Biomet Sports Medicine, LlcMethod for implanting soft tissue
US7678135Apr 14, 2006Mar 16, 2010Usgi Medical, Inc.Compressible tissue anchor assemblies
US7695493Jun 9, 2004Apr 13, 2010Usgi Medical, Inc.System for optimizing anchoring force
US7695503Jun 9, 2004Apr 13, 2010Biomet Sports Medicine, LlcMethod and apparatus for soft tissue attachment
US7703459Sep 29, 2004Apr 27, 2010Usgi Medical, Inc.Apparatus and methods for mapping out endoluminal gastrointestinal surgery
US7704264Nov 17, 2004Apr 27, 2010Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US7708759Jul 16, 2003May 4, 2010Tendon Technology, Ltd.Apparatus and methods for securing tendons or ligaments to bone
US7736374Mar 1, 2005Jun 15, 2010Usgi Medical, Inc.Tissue manipulation and securement system
US7736378May 7, 2004Jun 15, 2010Usgi Medical, Inc.Apparatus and methods for positioning and securing anchors
US7736379Jul 11, 2005Jun 15, 2010Usgi Medical, Inc.Compressible tissue anchor assemblies
US7744613Dec 12, 2003Jun 29, 2010Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US7749250Feb 3, 2006Jul 6, 2010Biomet Sports Medicine, LlcSoft tissue repair assembly and associated method
US7758614Apr 5, 2002Jul 20, 2010Tornier, Inc.Coupling member for knotless sutures and ligatures
US7776077Mar 12, 2008Aug 17, 2010Biomet Sports Medicince, LLCMethod for soft tissue attachment
US7806904Feb 24, 2004Oct 5, 2010Integrated Vascular Systems, Inc.Closure device
US7815655 *Aug 3, 2007Oct 19, 2010Neotract, Inc.Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US7819895Apr 18, 2006Oct 26, 2010Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US7819898Aug 12, 2005Oct 26, 2010Biomet Sports Medicine, LlcMethod and apparatus for soft tissue fixation
US7828817Aug 4, 2005Nov 9, 2010Integrated Vascular Systems, Inc.Apparatus and methods for delivering a closure device
US7828820Mar 21, 2006Nov 9, 2010Biomet Sports Medicine, LlcMethod and apparatuses for securing suture
US7841502Dec 18, 2007Nov 30, 2010Abbott LaboratoriesModular clip applier
US7842068Nov 30, 2001Nov 30, 2010Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US7846181Feb 15, 2006Dec 7, 2010Depuy Mitek, Inc.Suture locking device
US7850709Jun 4, 2003Dec 14, 2010Abbott Vascular Inc.Blood vessel closure clip and delivery device
US7850797Mar 12, 2009Dec 14, 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US7854810Dec 17, 2003Dec 21, 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US7857828Feb 1, 2005Dec 28, 2010Integrated Vascular Systems, Inc.Clip applier and methods of use
US7857830Oct 9, 2007Dec 28, 2010Biomet Sports Medicine, LlcSoft tissue repair and conduit device
US7867249Aug 8, 2003Jan 11, 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US7867253Aug 31, 2007Jan 11, 2011Kimberly-Clark Worldwide, Inc.Suture retention hub
US7879071May 9, 2003Feb 1, 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US7887551Oct 23, 2002Feb 15, 2011Smith & Nephew, Inc.Soft tissue attachment and repair
US7887555Jul 9, 2003Feb 15, 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US7887563Jun 14, 2005Feb 15, 2011Abbott Vascular Inc.Surgical staple
US7901428Oct 3, 2002Mar 8, 2011Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US7905900Jan 30, 2003Mar 15, 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US7905903Nov 6, 2007Mar 15, 2011Biomet Sports Medicine, LlcMethod for tissue fixation
US7905904Jan 15, 2008Mar 15, 2011Biomet Sports Medicine, LlcSoft tissue repair device and associated methods
US7909851Jan 15, 2008Mar 22, 2011Biomet Sports Medicine, LlcSoft tissue repair device and associated methods
US7914539Dec 5, 2005Mar 29, 2011Biomet Sports Medicine, LlcTissue fixation device
US7918845Nov 16, 2004Apr 5, 2011Usgi Medical, Inc.Endoluminal tool deployment system
US7918869May 7, 2004Apr 5, 2011Usgi Medical, Inc.Methods and apparatus for performing endoluminal gastroplasty
US7931580Mar 29, 2007Apr 26, 2011Michael GertnerMethods and devices for percutaneously modifying organs to treat patients
US7931669May 17, 2002Apr 26, 2011Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US7935136 *Jun 16, 2005May 3, 2011Alamin Todd FFacet joint fusion devices and methods
US7942884Jul 1, 2003May 17, 2011Usgi Medical, Inc.Methods for reduction of a gastric lumen
US7942898Jul 1, 2003May 17, 2011Usgi Medical, Inc.Delivery systems and methods for gastric reduction
US7946976Jun 15, 2005May 24, 2011Michael GertnerMethods and devices for the surgical creation of satiety and biofeedback pathways
US7955340Dec 12, 2003Jun 7, 2011Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US7959650Aug 22, 2008Jun 14, 2011Biomet Sports Medicine, LlcAdjustable knotless loops
US7967843Mar 10, 2009Jun 28, 2011Biomet Sports Medicine, LlcMethod for soft tissue attachment
US8007512Oct 8, 2003Aug 30, 2011Integrated Vascular Systems, Inc.Plunger apparatus and methods for delivering a closure device
US8034090Mar 21, 2006Oct 11, 2011Biomet Sports Medicine, LlcTissue fixation device
US8057511May 7, 2004Nov 15, 2011Usgi Medical, Inc.Apparatus and methods for positioning and securing anchors
US8066719Nov 18, 2004Nov 29, 2011Ewers Richard CApparatus and methods for forming gastrointestinal tissue approximations
US8070673Sep 29, 2006Dec 6, 2011Michael GertnerDevices and methods to treat a patient
US8088130May 29, 2009Jan 3, 2012Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to a bone
US8109965Sep 29, 2006Feb 7, 2012Biomet Sports Medicine, LLPMethod and apparatus for soft tissue fixation
US8118836Aug 22, 2008Feb 21, 2012Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to a bone
US8128644Sep 19, 2003Mar 6, 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8128658Aug 22, 2008Mar 6, 2012Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to bone
US8137382Aug 22, 2008Mar 20, 2012Biomet Sports Medicine, LlcMethod and apparatus for coupling anatomical features
US8157815Feb 6, 2007Apr 17, 2012Neotract, Inc.Integrated handle assembly for anchor delivery system
US8157816Aug 31, 2007Apr 17, 2012Kimberly-Clark Worldwide, Inc.Gastropexy kit
US8197497Jun 19, 2006Jun 12, 2012Medtronic Vascular, Inc.Method and apparatus for applying a knot to a suture
US8206417Jun 9, 2004Jun 26, 2012Usgi Medical Inc.Apparatus and methods for optimizing anchoring force
US8211118Jan 7, 2011Jul 3, 2012Neotract, Inc.Apparatus and method for manipulating or retracting tissue and anatomical structure
US8216252Mar 1, 2005Jul 10, 2012Usgi Medical, Inc.Tissue manipulation and securement system
US8216253Apr 22, 2008Jul 10, 2012Usgi Medical, Inc.Apparatus for manipulating and securing tissue
US8216254Jul 30, 2009Jul 10, 2012Neotract, Inc.Anchor delivery system with replaceable cartridge
US8216260Aug 25, 2008Jul 10, 2012Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US8221454Oct 27, 2009Jul 17, 2012Biomet Sports Medicine, LlcApparatus for performing meniscus repair
US8231654May 6, 2011Jul 31, 2012Biomet Sports Medicine, LlcAdjustable knotless loops
US8236009Oct 14, 2009Aug 7, 2012Usgi Medical, Inc.Needle assembly for tissue manipulation
US8236026Mar 27, 2006Aug 7, 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8251998Feb 12, 2008Aug 28, 2012Biomet Sports Medicine, LlcChondral defect repair
US8257394Jan 14, 2005Sep 4, 2012Usgi Medical, Inc.Apparatus and methods for positioning and securing anchors
US8262676Sep 18, 2009Sep 11, 2012Usgi Medical, Inc.Apparatus and methods for forming gastrointestinal tissue approximations
US8273106Dec 22, 2010Sep 25, 2012Biomet Sports Medicine, LlcSoft tissue repair and conduit device
US8292921Mar 11, 2011Oct 23, 2012Biomet Sports Medicine, LlcSoft tissue repair device and associated methods
US8298262Jun 22, 2009Oct 30, 2012Biomet Sports Medicine, LlcMethod for tissue fixation
US8298291Apr 26, 2006Oct 30, 2012Usgi Medical, Inc.Methods and apparatus for securing and deploying tissue anchors
US8303604Sep 30, 2009Nov 6, 2012Biomet Sports Medicine, LlcSoft tissue repair device and method
US8308765May 7, 2004Nov 13, 2012Usgi Medical, Inc.Apparatus and methods for positioning and securing anchors
US8308780Aug 17, 2010Nov 13, 2012Biomet Sports Medicine, LlcMethod for soft tissue attachment
US8313497Jun 28, 2006Nov 20, 2012Abbott LaboratoriesClip applier and methods of use
US8317825Apr 7, 2009Nov 27, 2012Biomet Sports Medicine, LlcSoft tissue conduit device and method
US8323315Dec 14, 2007Dec 4, 2012Depuy Mitek, Inc.Suture locking device
US8323316Mar 23, 2010Dec 4, 2012Covidien LpKnotted suture end effector
US8333788Oct 1, 2009Dec 18, 2012Covidien LpKnotted suture end effector
US8337525Mar 11, 2011Dec 25, 2012Biomet Sports Medicine, LlcSoft tissue repair device and associated methods
US8343175Apr 26, 2010Jan 1, 2013Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US8343227May 27, 2010Jan 1, 2013Biomet Manufacturing Corp.Knee prosthesis assembly with ligament link
US8361113Jun 22, 2009Jan 29, 2013Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to a bone
US8366744Sep 23, 2011Feb 5, 2013Smith & Nephew, Inc.Apparatus for tissue repair
US8382772Apr 16, 2012Feb 26, 2013Kimberly-Clark Worldwide, Inc.Gastropexy kit
US8382776Apr 2, 2010Feb 26, 2013Cook Medical Technologies LlcMedical devices, systems and methods for rapid deployment and fixation of tissue anchors
US8382800Mar 15, 2010Feb 26, 2013Usgi Medical, Inc.Compressible tissue anchor assemblies
US8394110Feb 28, 2011Mar 12, 2013Neotract, Inc.Apparatus and method for manipulating or retracting tissue and anatomical structure
US8409253Jul 1, 2010Apr 2, 2013Biomet Sports Medicine, LlcSoft tissue repair assembly and associated method
US8439936Nov 18, 2008May 14, 2013Zone 2 Surgical, Inc.Device and method for tendon, ligament or soft tissue repair
US8444657Apr 28, 2005May 21, 2013Usgi Medical, Inc.Apparatus and methods for rapid deployment of tissue anchors
US8460339Aug 26, 2010Jun 11, 2013Abbott LaboratoriesMulti element biased suture clip
US8469975Jun 6, 2012Jun 25, 2013Nobles Medical Technologies, Inc.Method and apparatus for applying a knot to a suture
US8480692Sep 7, 2012Jul 9, 2013Zone 2 Surgical, Inc.Device and method for tendon, ligament or soft tissue repair
US8486092Mar 11, 2009Jul 16, 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8486108Feb 1, 2006Jul 16, 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8491606Dec 27, 2010Jul 23, 2013Neotract, Inc.Median lobe retraction apparatus and method
US8491632Aug 15, 2011Jul 23, 2013Biomet Sports Medicine, LlcMethod and apparatus for soft tissue fixation
US8500818May 27, 2010Aug 6, 2013Biomet Manufacturing, LlcKnee prosthesis assembly with ligament link
US8506596Nov 8, 2010Aug 13, 2013Biomet Sports Medicine, LlcMethods and apparatuses for securing suture
US8506597Oct 25, 2011Aug 13, 2013Biomet Sports Medicine, LlcMethod and apparatus for interosseous membrane reconstruction
US8512374Jan 15, 2004Aug 20, 2013Depuy Mitek, LlcSoft tissue locking device
US8512375Dec 30, 2004Aug 20, 2013Smith & Nephew, Inc.Closure device and method for tissue repair
US8529584Dec 27, 2010Sep 10, 2013Neotract, Inc.Median lobe band implant apparatus and method
US8551139Nov 28, 2007Oct 8, 2013Cook Medical Technologies LlcVisceral anchors for purse-string closure of perforations
US8551140Jul 13, 2011Oct 8, 2013Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to bone
US8562645May 2, 2011Oct 22, 2013Biomet Sports Medicine, LlcMethod and apparatus for forming a self-locking adjustable loop
US8562647Oct 29, 2010Oct 22, 2013Biomet Sports Medicine, LlcMethod and apparatus for securing soft tissue to bone
US8574235May 19, 2011Nov 5, 2013Biomet Sports Medicine, LlcMethod for trochanteric reattachment
US8574243Dec 12, 2003Nov 5, 2013Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue folds
US8579932Feb 24, 2004Nov 12, 2013Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure device
US8590760May 24, 2005Nov 26, 2013Abbott Vascular Inc.Surgical stapler
US8597327Nov 3, 2010Dec 3, 2013Biomet Manufacturing, LlcMethod and apparatus for sternal closure
US8603136May 3, 2007Dec 10, 2013Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US8608777Oct 21, 2011Dec 17, 2013Biomet Sports MedicineMethod and apparatus for coupling soft tissue to a bone
US8623051Aug 2, 2011Jan 7, 2014Smith & Nephew, Inc.Tissue repair device
US8628542Dec 27, 2010Jan 14, 2014Neotract, Inc.Median lobe destruction apparatus and method
US8632569Dec 20, 2012Jan 21, 2014Biomet Sports Medicine, LlcSoft tissue repair device and associated methods
US8647368Apr 2, 2010Feb 11, 2014Cook Medical Technologies LlcTissue anchors and medical devices for rapid deployment of tissue anchors
US8652171May 2, 2011Feb 18, 2014Biomet Sports Medicine, LlcMethod and apparatus for soft tissue fixation
US8652172Jul 6, 2011Feb 18, 2014Biomet Sports Medicine, LlcFlexible anchors for tissue fixation
US8672968Feb 8, 2010Mar 18, 2014Biomet Sports Medicine, LlcMethod for implanting soft tissue
US8672969Oct 7, 2011Mar 18, 2014Biomet Sports Medicine, LlcFracture fixation device
US8690910Mar 31, 2006Apr 8, 2014Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8715298Feb 8, 2013May 6, 2014Neotract, Inc.Apparatus and method for manipulating or retracting tissue and anatomical structure
US8721684Mar 5, 2012May 13, 2014Biomet Sports Medicine, LlcMethod and apparatus for coupling anatomical features
US8726909Jan 27, 2006May 20, 2014Usgi Medical, Inc.Methods and apparatus for revision of obesity procedures
US8734468Mar 28, 2011May 27, 2014Neotract, Inc.Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US8740937May 22, 2008Jun 3, 2014Cook Medical Technologies LlcSuture lock
US8740940Jan 23, 2013Jun 3, 2014Usgi Medical, Inc.Compressible tissue anchor assemblies
US8758396Apr 27, 2006Jun 24, 2014Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US8771316Mar 5, 2012Jul 8, 2014Biomet Sports Medicine, LlcMethod and apparatus for coupling anatomical features
US8771352May 17, 2011Jul 8, 2014Biomet Sports Medicine, LlcMethod and apparatus for tibial fixation of an ACL graft
US8777956Aug 16, 2012Jul 15, 2014Biomet Sports Medicine, LlcChondral defect repair
US8784447Apr 25, 2005Jul 22, 2014Abbott Vascular Inc.Surgical stapler
US8801783May 27, 2010Aug 12, 2014Biomet Sports Medicine, LlcProsthetic ligament system for knee joint
US8828027Jun 14, 2010Sep 9, 2014U.S.G.I. Medical, Inc.Tissue manipulation and securement system
US8834492Dec 27, 2010Sep 16, 2014Neotract, Inc.Continuous indentation lateral lobe apparatus and method
US8840645Feb 17, 2012Sep 23, 2014Biomet Sports Medicine, LlcMethod and apparatus for coupling soft tissue to a bone
US20090234386 *Mar 11, 2008Sep 17, 2009Dean John CSuture Cleat for Soft Tissue Injury Repair
US20110022087 *Oct 7, 2010Jan 27, 2011Arthroscopic Innnovations LLCSuture fixation device and method for surgical repair
USRE43143Dec 2, 2005Jan 24, 2012Hayhurst John OTissue manipulation
EP0534152A1 *Aug 26, 1992Mar 31, 1993United States Surgical CorporationNerve repair device
EP1791474A1 *Sep 9, 2005Jun 6, 2007Canica Design Inc.Button anchor system for moving tissue
WO1989007912A1 *Mar 4, 1988Sep 8, 1989P R D CorpLow trauma suturing
WO1996022735A1Jan 25, 1996Aug 1, 1996Inbae YoonMethods and apparatus for suturing tissue
WO2000059329A1 *Mar 24, 2000Oct 12, 2000Stoever BerndMethod of fastening a jewellery item and jewellery item
WO2009027860A1 *Jun 19, 2008Mar 5, 2009Kimberly Clark CoSuture retention hub
Classifications
U.S. Classification606/232
International ClassificationA61B17/04
Cooperative ClassificationA61B17/0401, A61B2017/0414, A61B2017/045, A61B2017/0404
European ClassificationA61B17/04A