A surgical suture and a delivery system for positioning and
inserting the suture is disclosed. The suture includes a base
member having two substantially parallel, rigid, barbed shafts
upstanding therefrom. The delivery system includes a hollow sleeve
member having an elongate cross section with the long dimension
of the cross section sufficient to accommodate the width of the
base member. In use, the end of the hollow sleeve is positioned
adjacent a body tissue wound which is to be repaired and the suture
is inserted into the tissue by pushing the suture through the
sleeve by means of a pusher member. If necessary, a starter member
is first pushed through the sleeve to provide started openings
in the tissue into which the barbed shafts are then inserted.
Claims:
I claim:
1. A surgical suturing system comprising:
a surgical suture having a base member, two substantially parallel
shafts upstanding from said base member and having pointed barbs
at the ends thereof;
means for positioning and inserting said suture into body tissue;
said means for positioning and inserting comprises:
a hollow sleeve member through which said suture can be delivered;
a pusher member sized to fit through the hollow interior of said
sleeve member and capable of pushing said suture into said body
tissue; and
a starter member sized to fit through said sleeve member and
comprising a substantially rigid rod having two pointed projections
at the end thereof, said projections capable of creating two starter
holes in said body tissue into which can be inserted said substantially
parallel shafts.
2. The suturing system of claim 1 wherein said hollow interior
of said hollow sleeve member has an elongate cross section having
a long dimension to accomodate the width of said base member of
said suture.
3. The suturing system of claim 2 wherein said pusher member
has an elongate cross section.
4. The suturing system of claim 1 wherein said pusher member
further comprises releaseable means for securing said suture to
the end thereof.
Description:
BACKGROUND OF THE INVENTION
This invention relates generally to surgical sutures and to suturing
systems, and more specifically to a surgical suture and system
for repairing meniscus tissue. This invention is an improvement
on the sutures disclosed and claimed in my copending application,
entitled, "Surgical Fasteners and Method," filed Feb.
28, 1984, the disclosure of which is incorporated herein by reference.
There are a number of techniques used for closing and repairing
incisions, tears, or wounds in body tissue. These include, for
example, the use of stitches, staples, tape, clamps, the sutures
disclosed in my above-identified copending aplication, and the
like. The technique used in a particular application depends on
the size, nature, location of the opening or tear, and the like.
Despite the wide range of available techniques, however, a need
still existed for a surgical suture which would provide the ease
and precision of insertion in arthroscopic surgery of my previously
disclosed suture, but which would provide an even more secure
joining of the body tissue, especially meniscus tissue.
It is therefore an object of this invention to provide an improved
surgical suture.
It is further object of this invention to provide an improved
surgical suture and system for placement and insertion of the
suture.
It is another object of this invention to provide an improved
suture for arthroscopic surgery.
BRIEF SUMMARY OF THE INVENTION
The foregoing and other objects and advantages of the invention
are achieved with the multiple shafted suture and system as herein
described. In one embodiment of the invention, the suture includes
a base member from which two substantially parallel shafts are
upstanding. Each of the shafts has a pointed end for insertion
into the tissue to be repaired and one or more barbs along the
length thereof to lock the shaft into the tissue being repaired.
The suture is positioned and inserted by pushing the suture through
a hollow sleeve with a rigid pusher.
BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. 1 and 2 illustrate, in front view, embodiments of surgical
sutures;
FIGS. 3 and 4 illustrate an insertion sleeve and pusher in vertical
and horizontal section, respectively;
FIG. 5 illustrates a starter; and
FIG. 6 illustrates a suture in position across a tear in a meniscus.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
FIGS. 1 and 2 illustrate two embodiments of sutures in accordance
with the invention. FIG. 1 illustrates a suture 10 having a base
member 12 with two shafts 13, 14 upstanding therefrom. Each of
the shafts terminate in a pointed end 15, 16. The pointed ends
facilitate the insertion of the suture into the body tissue to
be repaired. Barbs 19 and 20 lock the shafts into position in
the tissue after insertion. In use, the shafts are inserted into
the tissue and across the tear to pull the sides of the tear together,
with the barbs maintaining the suture shafts in place.
FIG. 2 illustrates a further embodiment of the invention. Suture
22 includes a base member 24 with substantially parallel shafts
26, 27 upstanding from the opposite ends of the base member. Suture
22 includes two barbs 29, 30 and 31, 32 projecting outwardly from
the shafts 26, 27, respectively. Barbs 29 and 31 additionally
provide pointed ends to shafts 26, 27 to facilitate insertion
of the shafts into body tissue.
The sutures illustrated in FIGS. 1 and 2 are but two illustrations
of sutures in accordance with the invention. In general, the sutures
include a base member from which a plurality of substantially
parallel shafts are upstanding. In a preferred embodiment, the
sutures includes two shafts. The plurality of shafts, as contrasted
with only a single suture shaft, provide a substantially increased
joining strength for holding the opposing edges of a wound together.
The insertion of a single multishafted suture replaces the insertion
of a plurality of single shaft sutures. In some instances it is
difficult, time consuming and even traumatic to individually insert
a plurality of sutures.
Sutures in accordance with the invention preferably have a base
width of about 3-6 mm in 1 mm increments. Further, the sutures
are preferably available having a base thickness of about 1-4
mm, in 1 mm increments. Additionally, sutures in accordance with
the invention preferably have a shaft length of about 8-16 mm
in 1 mm increments.
The sutures can formed of metal, plastic, biologically absorbable
material such as surgical gut, or the like. The base member and
upstanding shafts can be of either circular or flat rectangular
cross section. The barbs, having a width somewhat greater than
the width of the shaft, can be conical, flat triangular projections,
or the like. Although only sutures having 1 or 2 barbs on each
shaft have been shown, the sutures can, in general, have a plurality
of projections.
FIGS. 3 and 4 illustrate a delivery system 40 for positioning
and inserting sutures in accordance with the invention. Sutures
in accordance with the invention are especially designed for the
repair of a torn meniscus, for example a knee joint, although
such sutures are adaptable for other tissue repair. Use of the
suture in such an application, for example in arthroscopic surgery,
requires the remote positioning and insertion of the suture. The
correct positioning and insertion are facilitated by delivery
system 40 in a method as described below. Sutures are provided
in a variety of sizes; a delivery system is provided for each
size of suture to constitute a surgical suture system.
FIG. 3 illustrates the delivery system in a vertical section.
The delivery system includes a hollow tubular sleeve 42 which
can be inserted through an incision to the interior of the knee.
The sleeve is substantially rigid, and can be either straight
or have a variety of angular bends as needed for a particular
patient. A pusher rod 44, sized to pass through the hollow interior
of the sleeve pushes the surgical suture 46 into the body tissue.
The pusher rod preferably is provided with means for releaseably
holding the suture until it is properly inserted. The holding
means can comprise, for example, a pair of spring clips 48, vacuum
means (not shown), or the like. The pusher rod is substantially
rigid, having sufficient flexibility to traverse any angular bends
in sleeve 42.
FIG. 4 illustrates sleeve 42 and pusher rod 44 in cross section.
The sleeve has an elongted cross sectional shape, with the length
50 adapted to receive a suture of particular base width. The pusher
rod also has an elongated shape matching the shape of the sleeve.
The elongated shape prevents the rotation within the sleeve of
the multiple shafted suture and thereby enhances the accuracy
of positioning the suture.
FIG. 5 illustrates, in side view, a starter 52 which may be used
with the sleeve 42 to initiate openings in the body tissue into
which the suture is inserted. The starter includes a substantially
rigid rod 54 having a plurality of sharp points 56 at the end.
The sharp points match the number and position of shafts on the
suture being used. The starter is pushed through the sleeve to
initiate openings in the tissue into which the suture is inserted.
The use of a starter is particularly advantageous when using sutures
of a semi-rigid material which would otherwise be difficult to
insert into some, especially resistant, body tissue.
FIG. 6 illustrates the use and positioning of a suture, in accordance
with the invention, in the repair of a torn meniscus 60. Meniscus
60 is shown having a tear 62. Dual shafted suture 64 is inserted
into the meniscus tissue so that base member 66 is seated against
the surface of the meniscus and shafts 68, 69 pass through the
tissue and across tear 62. When fully inserted, the suture pulls
the edges of tear 62 together and maintains them in that position
while healing occurs. Barbs 70 lock the suture in place. In an
alternate embodiment, the shafts may pass completely through the
meniscus, as indicated by the dotted lines, with one or more barbs
resting on the exterior surface of the meniscus.
Thus it is apparent that there has been provided, in accordance
with the invention, a surgical suture and system which fully meet
the objects and advantages set forth above. Although the invention
has been described with reference to specific embodiments thereof,
it is not intended that the invention be limited to those illustrative
embodiments. Rather, it is intended that all variations and modifications
as fall within the spirit of the invention be included within
the appended claims. |
