AU2011250869B2 - Method of forming barbs on a suture and apparatus for performing same - Google Patents

Abstract

A method of providing a barbed suture by cutting at least one barb on a suture by means of a blade and altering the trajectory of the blade during cutting to create the barb. Apparatus for providing a barbed suture is also disclosed.

Description

AUSTRALIA Patents Act 1990 ORIGINAL COMPLETE SPECIFICATION STANDARD PATENT Invention METHOD OF FORMING BARBS ON A SUTURE AND APPARATUS FOR PERFORMING Title: SAME......... ...... ....... .......... ... .. ................... The following statement is a full description of this invention, including the best method of performing it known to me:- METHOD OF FORMING BARBS ON A SUTURE AND APPARATUS FOR PERFORMING SAM BACKGROUND OF THE INVENTION Fieldof the nveftif The invention relates to a method of baring suture filament by varying the blade geometry and/or the movement of a blade when cutting a suture filament where the method can also be utilized to cut a plurality of axially spaced barbs on the exterior of sutures and an apparatus for performing this. to D altanotraumtic wonds ar In the prior art, it is well known that surgical and traumatic wounds are typically closed with a filament introduced into the tissue by a needle attached to one end. Closure of the wound and holding tissues together supports healing and re-growth. What is typically used for this procedure is known as a suture. 15 A barbed suture is a one-way suture which allows passage of a needle-draWn suture in one direction through tissue, but not in the opposite direction. A barbed suture is generally an elongated body having a pointed leading end and a plurality of axially and circumferentially spaced barbs on the exterior surface of the elongated body. 20 In closing a wound with a barbed suture, the suture is passed through tissue at each of the opposed sides of a wound. Suture pairs are formed in which trailing ends of sutures are positioned generally in alignment at opposite sides of the wound. On insertion of each suture, the needle is pushed to extend out of the tissue at a point laterally remote from the wound, then the needle is pulled out to draw the 25 suture to the desired position, and the suture is then severed from the needle. (Note that methods of using barbed sutures are disclosed in copending U.S. Patent Application Serial No. 09/896,455, filed June 29, 2001, entitled "Suture Method" and assigned to Quill Medical, Inc., the disclosure of which is incorporated herein by reference.) The advantage of using barbed sutures is that there is an ability to put 30 tension in the tissue with the result of less slippage of the suture in the wound. The number of suture pairs is selected in accordance with the size of the wound and the strength required to hold the wound closed. Although tissue anchoring is easier done with a very pointed barb and a relatively skinny tip, better tissue holding results are obtained with a fuller tip barb. In some circumstances of tissue repair, a random configuration of barbs on the exterior of the suture might be preferred. With as many barb angles as possible, 5 superior wound holding would be achieved. However, in other circumstances where the wound or tissue repair needed is small, a small suture would be preferable. A small suture would require a reduced number of barbs on the exterior of the suture. Various methods of cutting the barbs have been proposed (see e.g. U.S. Patent No. 5,931,855). However, such methods have not been commercially 10 exploited for reasons which are unclear. It is seen from the foregoing that there is a need for a method of cutting barbs on the exterior of sutures with a minimum of difficulty and in a reliable and relatively economic fashion so as to allow for the wide spread commercialization of such sutures- Such a method should also be able to vary the size of the barbs, their 15 location and depth to allow for variation thereof and virtuality of their application. The method should be able to cut a plurality of barbs with the positioning depending on the number of barbs needed. The need also exists for a device able to use the method described above which can provide a plurality of axially spaced barbs either in a random or similar configuration, with the configuration depending upon, among 20 other things, the type of tissue being repaired. SUMMARY OF THE INVENTION It is therefore a principal object of the present invention to provide for a practical method of cutting barbs in a suture. It is therefore a further object of the present invention to provide a method 25 for cutting fuller tipped barbs of various sizes on the exterior of a suture. It is therefore a still further object of the present invention to provide a method for cutting a plurality of axially spaced barbs on the exterior of a suture. It is therefore a still further object of the present invention to provide a method for cutting a plurality of axially spaced barbs circumferentially about the 30 exterior of a suture. 2 -3 It is therefore a still further object of the present invention to provide a method f or cutting a plurality of axially spaced barbs in similar or random configurations on the exterior of a suture. It is therefore a yet further object of the invention to provide for an illustrative 5 apparatus to perform this method. To attain the objects described, there is provided a method of providing a barbed suture said method including the steps of providing at least one barb on a suture by cutting the suture by means of a blade, altering a trajectory of the blade during the cutting to create the barb, wherein during cutting, the blade moves in a first direction and 10 along a second direction, and during cutting the blade is articulated about an axis so as to impart additional barb depth in a third direction. By altering the blade geometry and/or degree or trajectory of blade movement, the barbs can be made of varying sizes designed for various surgical applications. For example: for joining fat and relatively soft tissues, larger barbs are desired, whereas smaller barbs are more suited for collagen intensive 15 tissues. Also, the use of a combination of large and small barbs on the same suture will ensure maximum anchoring properties wherein barb sizes are customized for each tissue layer. The cutting method may be achieved with a cutting device disclosed herein. The device disclosed can produce six sets of barbs in staggered positions along the 20 length of a suture, such that three sets of barbs are faced opposite to another three sets of barbs. Viewing the suture on a cross-sectional plane, the barb sets would be positioned either 120 or 180 degrees to each other, depending on the cutting method. Longitudinally, each barb cut would begin where the nearest one ends. Compared with the method of cutting barbs in an untwisted state, using the 25 twisted configuration can: simplify production equipment; produce a stronger suture; reduce production cycle time by at least a factor of three; and be easily scalable to smaller diameters and produce barbs in a spiral fashion rather than at 120 or 180 degrees. By way of variations, slight modifications, and/or combinations of the methods of cutting with and without twisting the suture, barbs can be obtained with random 30 configurations. There are instances in tissue repair that the random configuration may be ideal to anchor tissues in as many barb angles as possible to 30 provide superior wound holding properties. These and other objects and characteristics of the present invention will become apparent from the further disclosure to be made in the detailed description given below. 28/06/13,dh-20014 - specipg3 -cdm.docx,3 BRIEF DESCRIPTION OF THE DRAWINGS Thus by the present invention its objects and advantages will be realized the description of which should be taken in conjunction with the drawings wherein Figures IA-F depict the cutting motion of a blade with one degree of 5 freedom from movement and two degrees of freedom from blade geometry. Figures 2A-C depict the cutting motion of a blade with two degrees of freedom from blade movement and one degree of freedom from blade geometry. Figures 3A-C depict they cutting motion of a blade with three degrees of freedom from blade movement and a solid plane geometry. 10 Figures 4A-C depict a zigzag (oscillating back and forth and downward) cutting motion of a blade with three degrees of freedom from blade movement and solid plane blade geometry, Figures 5A-C depict the cutting motion of an articulating blade with three degrees of freedom from blade movement. 15 Figure 6 is a top view of the assembled cutting device. Figure 7 is a perspective view of the cutting bed. Figure 8 depicts an end, a side, and a cross-sectional view of the retention knob of the cutting device. Figure 9 depicts a top and side view of the blade assembly of the cutting 20 device and a top view of an example blade for the blade assembly. Figure 10 depicts a top and side view of the template block of the blade assembly. Figure 11 depicts a top and side view of the cutting template used with the cutting device. 25 Figure 12 depicts a top and side view of the tamp used with the cutting device. Figure 13 depicts the securing of the suture to the retention knob and placement on the spacing bar, Figure 14 depicts the placement of the various fixtures used with the cutting 30 bed vise. 4 e is depicts the blade assembly placement and downward movement in Figure 15 g template with the rest of the cutting device removed from the relation to the cuttingtm figure for clarity purposes. t and upward movement in Figure 16 depicts the blade assembly placement 5 relation to the cutting template. f barbs in the cutting bedvise Fgr17 is a front view depicting the setting of ab ntectigbdvs Figure 17iafrnviwertio method of cutting. before and after cutting using the 120 degree ttin f the suture in the cutting bed Figure 18 is a front view depicting the setting o vise before cut using the twisting method of cutting. 10 Figure 19 depicts the various conditions of a suture before and after the twisting method of cutting. f barbed suture using the 120 Figure 20 is a side, top and detail view o a degree rotation method of cutting. near indexing mechanism with Figures 21 A-C depict perspective views of a li 15 a rotary reciprocating blade a rotational indexing mechanism with a Figure 22 is a perspective view o rotary reciprocating blade assembly. ANPEERE MOIET DETAILED DESCRIPTION OF CERTANEe eMerDINTS We refer now to the drawings in detail wherein like numerals refer to like 20 elements throughout the several views. The purpose of the present invention is to provide for an effective way of producing a barbed suture. In this regard, several different types of methods are disclosed which are directed to the cutting action of a blade on the suture to Create the barbs. As will be described, the cutting action envisioned takes into account the 25 movement of the blade and the blade geometry. Essentially, the cutting of the suture with a blade takes into account three dimensions x-y-z of the suture 6. Each dimension is important and may be addressed by the cutting motion of the blade and/or the blade geometry. Depending on the blade geometry, the blade movement can have an effect in the other 30 dimensions. In this regard, Figure lA illustrates a consistent cutting motion of a blade with one degree of freedom of movement and two degrees of freedom from blade 5 6 One degree of freedom from movement is movement in geometry across a suture 6. on -ere 0" layout. For Figure JA, direction (2) one direction in a three-dimensional "x-y- ly f dire (2) follows the lateral "x" axis in the cut of suture 6, with the movement of blade 8 in direction (2) before accomplishing a cut. An edge 10 of blade 8 has an angle, 5 depicted as (12), in its blade geometry between the tips of sides 14,16 of blade 8, as well as an angle (not shown) in its blade geometry between the top and bottom planes of blade 8. Such a geometry will cause an effect in the y and z dimensions (i. e. in the length and depth of the barb) just by the movement of blade S in the X direction. 10 As shown in Figure IB, these angles allow a cut into suture 6 in the y and z directions during movement in direction (2). This cutting-into movement is depicted as resultant direction (18). Figure IC depicts the completed cut of suture 6 with a continued movement in direction (2) away from the suture 6. Similar to Figure IA, Figure ID illustrates a cutting motion of a blade 8 with 15 one degree of freedom of movement and two degrees of freedom from blade geometry across a suture 6. In Figure 1D, blade 8 is a hollow ground blade, in which edge 10 has an angle in its blade geometry between the tips of its sides 14, 16, as well as a concave or curved-in face in its blade geometry between the top and bottom planes of blade 8. Such a geometry will cause an effect in the y and z 20 dimensions (i.e. in the length and depth of the barb) just by the movement of blade 8 in the x direction. As shown in Figures 1E and IF, this blade geometry allow a cut into suture 6 in the y and z directions during movement of blade 8 in direction (2). Comparison of Figure IE with Figure IF illustrates how movement of blade 8 in direction (2) 25 increases the length and depth of the barb. Turning now to Figures 2A-C, a consistent cutting motion of a blade with two degrees of freedom of movement and one degree of freedom from blade geometry is illustrated. Two degrees of freedom of movement is movement in two directions x and y. For Figure 2A, direction (2) follows the lateral "x" axis and 30 direction (22) follows the forward "y" axis in the cut of suture 6. In this regard the movement of blade 8 in two directions (2) and (22) simultaneously may be used to 6 t. Edge 10 of blade 8 is at an angle of 90 or less, depicted as (24), accomplish a cut Edg ofsdeh4e1 f ld 8. e its blade geometry between the tips of sides 14, 16 of blade of show in F forward movement in direction (22) and along a As shown in Figure 2B, forwardumoveentha produced in Figure 1, since lateral direction (2) allows a longer cut into suture 6 thnthe x-axis determines the in Figure 1 the blade geometry and blade movement length of the barb, whereas in Figure 2 the blade geometry and blade movemen along both the bYb and " axes determines the length of the barb. This longer along oth te y a 2C shows the completed cut of thle cutting action is in the "y" direction. Figure suture 6 with a continued movement in direction (2) away from the suture. to Figure 3A illustrates a further consistent cutting motion of a blade with three degrees of freedom of blade movement and edge 10 of 900 or less. Three degrees of freedom from movement is movementin the three directions of a three-dimensional dx-y-z" layout. For Figure 3m, direction (2) follows the lateral "x" axis, direction (22) follows the forward "y" axis and direction (32) follows the downward "z" axis. 2The movement of blade 8 in all three directions (2), (22) and (32) may be used to accomplish the cutting of a barb on the suture 6. The combination of movement in lateral direction (2), forward direction (22) and downward direction (32) would allow one to vary the length and depth of the cut to create a barb. It may be a deeper barb by cutting further in direction (32) and/or a 20 longer barb by cutting further in direction (22). By moving blade 8 in lateral direction (2), forward direction (22) and downward direction (32) simultaneously forms a trajectory, which may be altered to create barbs with different qualities such as aspect ratios. Figure 3C shows the completed cut of suture 6 with a continued movement in directions (2), (22) and (32) away from the suture 6. 25 A yet further method of cutting a barb is shown in Figures 4A-C where a back and forth or zigzag (oscillating on the "x" axis combined with the movement in Z and/or y axis) motion of the blade with three degrees of freedom of blade movement and a solid plane geometry cuts the barb with a saw-like cutting motion. Three degrees of freedom of movement is movement in three directions in the 30 three-dimensional "x-y-z" layout. In Figure 4A, direction (2) follows the lateral 'x axis, direction (22) follows the forward "y" axis, direction (32) follows the downward "z" axis, and direction 42 follows the lateral "x" axis except in a direction 7 .Figure 4A shows the movement which may be used to opposite to direction (2). F directions (22) and (M with alternation in movement accomplish a cut of blade 8 in dietin (2)ld ol estriht between the between directions (2) and (42). Edge 10 of blade 8 would be strai tips of sides 14, 16 of blade S. lateral directions (2) and (42), The combination of alternating movement in l dir intdownward steady movement in forward direction (22) and steady movement igzard direction (32) allows the depth of the cut to be varied. The resultant zigzag cutting motion is shown as alternating direction (44) in Figure 4B. Figure 4C shows the completed cut of suture 6. in Figures 5A-5C where 10 A still further method of cutting a barb is shown in gure Cutting articulation of blade 8 about an axis 9,in combination with any Of the cutting motions described in Figs. 1-4 above, may be used to vary the depth of the barb. In Figure 5A, direction (2) follows the lateral "y" axis (into the plane of the drawing), direction (22) follows the forward "Y" axis and direction (32) follows the downward Sa i igure 5B shows the blade movement which may be used to 15 z" axis. F o directions (2) and (22), similar to that depicted in accomplishing a cut ov et in direction (22) and along a lateral direction (2) Fig. 2B. Forward movement fn freedom 22a of blade movement. in Fig. SC, produces a barb based on two degrees of freedom de movemtin dg. o blade 8 is also allowed to articulate about axis 9, providing an additional degree of 20 freedom, which may be used to impart additional barb depth in direction (32) in the z-axis, This articulating motion of blade 8 may be employed in combination with any of the blade geometries and/or blade movements previously described. Articulation of blade 9 may also be used to lift a cut barb up and away from the surface of suture 6, thereby leading to a fuller or more Pronounced barb. 25 The blade motion shown in Figures 1-5 can cut a suture filament made of polyglycolide, polydioxinone, polypropylene, other resorbables, other nonresorbables, Gore-Tex, bi-component material or sutures made of other material suitable for the purpose. While in the aforesaid examples, only a single blade is shown, it is 30 envisioned that a plurality of blades may be utilized. They may be in tandem or on a rotary mechanism or on any other type of mechanical device which effects the 8 implementation of the movement so described. Also, while the suture is shown in an untwisted state, it may be cut in a twisted state as hereinafter described. By way of examples of mechanical devices for implementing the foregoing, refe i ade o F es 6-19 and 21-22. It should be understood, however, reference is made to Figures id decuiead other types of devices for that these devices should not be considered exclusive an such implementation are contemplated, there is shown a cutting device Turning now more particularly to Figure 6, Turnng nw moe pf suture 6 using the 50 that allows an operator to cut multiple barbs on the exterior o methods previously described. The cutting device 50 includes retention knobs 52, 0 54 for retaining the suture 6 on a vise 63 during cutting. Retention knobs 52, 54 include knob holders 61, 62. Cutting bed vise screws 58, 60 are used to open and to close cutting bed vise 63, where suture 6 is placed during cutting. A cutting template 64 directs the cutting motion of a blade assembly 66 containing a plurality of blades across suture 6. Two additional cutting templates 15 are provided for operation of the cutting device but are offset to provide a different axial position of the blades with respect to suture 6. The cutting templates have the same configuration as cutting template 64 and are installed in a similar manner throughout the several views. Also, while the templates shown are particularly suited for practicing one way of cutting the barbs, such templates can be readily 20 modified to allow the performance of other ways, including those previously described as will be appreciated by a skilled artisan. Cutting bed vise 63 assists in the alignment of the cutting templates. On the top of block 68 of cutting bed vise 63 are two protrusions. These protrusions are alignment pins 70, 72 which are used for setting the cutting templates and a tamp 25 101. As will be apparent to one skilled in the art, the configuration of cutting bed vise 63 may vary. If the suture is rotated (e.g. 120 degrees or 180 degrees) to effect cutting barbs about its circumference, the cutting bed vise may be configured as shown in Figure 6. If the suture is twisted prior to cutting, as will be discussed, the 30 cutting bed vise 63 preferably has a configuration with trapezoidal sides such as those shown in Figure 7. Because suture material is somewhat compliant, this design provides superior clamping to a vise with parallel sides. Note that the vise 9 shown In Figure 7 can also be used with a rotated suture, since there is a space to accommodate a cut barb. In this regard, in Figure 7, blocks 68, 74 taper outward from the tops on their interior sides to a surface 76, with the blocks depicting a trapezoidal shape when viewed from an end profile- Protruding from the taper of block 68 is a trapezoidal or anvil suture clamp 78 which is used to secure suture 6 during the closing of cutting bed vise 63. Suture clamp 78 is a wedge shape which sets on surface 76 and ends slightly below top 80. In addition to securing suture 6, retention knobs 52, 54 are rotated between thevarious cutting methods and are numerically indexed for precise movement. As 10 depicted in Figure 8, retention knob 52 is a solid elongated body. Retention knob 52 comprises a cylinder 82 having a gripping area 84 integral with a triangular protrusion 86. Triangular protrusion 86 can rest on cutting bed 56 or a spacing bar 100, shown in Figure 13. An anchor screw 90 secures suture 6 to the retention knob. The triangular protrusion includes numerical marks for guiding the operator in 15 positioning the retention knob during various stages of the cutting method; however, the triangular protrusion may be indexed in other variations. One side of the triangular protrusion has the number "1" imprinted, another side has the number "2" imprinted and a third side has the number "3" imprinted. Retention knob 54has the same characteristics as retention knob 52. 20 For cutting a plurality of barbed sutures at one time, a multi-blade assembly is used. As depicted in Figure 9, blade assembly 66 consists of a plurality of blades 8 secured in retaining block 92. In Figure 8, thirteen blades are depicted, although obviously the number of blades used may vary. Edge 10 of each of the blades used in the blade assembly 66 would extend through a template block 94, shown in 25 Figure 10 by the amount of the desired barb depth. Retaining block 92 of Figure 9 consists of two rectangular blocks which retain blade assembly 66 by a vise action. Blade assembly 66 donfoemingly fits to a cutaway section of the retaining block and blades 8 are inserted at a desired angle, which in this case is 148 degrees. The blades are secured in the retaining block 92 30 with the template block 94 attached thereto. Template block 94 acts as a guide for the blade assembly within the confines of the cutting templates. 10 As shown in Figure 11, the cutting template 64 provides a cutting path 97 for blade assembly 66. Cutting path 97 is shown as a parallelogram perimeter. Note, however, for example, the cutting path 97 may be shaped with a rectangular perimeter to suit the movements described in the cutting method of Figure 1, or 5 other shapes to permit additional degrees of blade movement as described in Figures 2-5. Additional cutting templates are provided and are similarly made with the purpose of offsetting the blade cut in an axial direction. The cutting template 64 is identified so as to indicate to the user which one is to be used at which stage of cutting. On opposite sides of the cutting template 64 is a channel 99 sized to 10 accommodate the other sections of suture 6 not being cut by blade assembly 66. As shown in Figure 12A, a tamp 101 is provided to insure that suture 6 is uniformly seated on the anvil 78. Apertures 102, 104 on tamp 101 are provided to engage the alignment pins 70, 72. A channel 105 is provided to hold suture 6 in place during the calibration. The depth of the channel 105 equals the thickness of 15 the suture 6 above vise top 80. To operate cutting device 50, first one secures the suture 6 to anchor screws 90 on one of retention knobs 52, 54 as shown in Figure 13. Retention knob 52 is placed on the ledge of spacing bar 100 with the suture 6 drawn thereacross with the second retention knob 54 positioned on the opposing ledge. The suture should not 20 be overly taut once it is secured to the second retention knob by anchor screw 90. After sizing, suture 6 is placed on cutting bed 56 and held in place by cutting bed vise 63. The retention knobs 52 and 54 are indexed in a first position. As will be apparent in a second and third cutting for a barbed suture having barbs spaced 120 degrees apart, retention knobs 52 and 54 are rotated to second and third positions 25 respectively. As shown in Figure 14, the tamp 101 is placed on the cutting bed 56 positioning the suture 6 in vice 63 which is tightened, and the tamp is then removed Cutting template 64 is then placed onto cutting bed 56. In the cutting method of suture 6, blade assembly 66 is placed onto cutting 30 bed 56. The blade assembly is pressed down while slid from the top of the cutting template to the bottom along path 97 as shown in Figure 15. The blade depth is set 11 to produce the desired depth of the barb. After blade assembly 66 stops at the bottom of cutting template 64, the blade assembly is removed. To create barbs in a direction opposite those first cut, blade assembly 66 may then be turned 180 degrees and placed onto cutting bed 56 as shown in Figure 16. The 5 left and top of the blade assembly are in contact with the right and bottom of the cutting template along path 97. The blade assembly is pressed down while the blade assembly is slid from the bottom to the top. After the blade assembly 66 stops at the top of cutting template 64, the blade assembly and the template are removed. As the process proceeds, suture 6 may be rotated, e.g. 120 degrees, 180 10 degrees, etc., and the cutting process repeated as shown in Figures 15-16. The suture should be set securely in the opening of cutting bed vise 63 and previously cut barbs should not project above top surface 80, and the process is repeated. For three sets of barbs about the circumference, the suture is rotated three times, for two sets, two times, etc.. 15 Figure 17A-F shows the setting of the barbs in vise 63 before and after cutting for a suture having barbs spaced 120 degrees apart. Figure 17A shows the vise open, suture 6 uncut, with vise notches 120, 122 unused, Figure 17B shows the vise closed with blade assembly 66 about to cut suture 6. Figure 17C shows the vise opened after the first set of barbs are cut and placed in notch 122. Figure 17D shows 20 the vise closed before blade assembly 66 engages suture 6 to cut the second set of barbs. Figure 17E shows the vise open with two sets of barbs shown and placed in notches 120, 122. Figure 17F shows the vise closed before blade assembly 66 engages suture element 6 for the cut. After cutting, the suture 6 is removed and examined. As will be apparent to a skilled artisan, additional or fewer notches may 25 be provided for protecting barbs during subsequent cutting steps. In the twisting method of cutting barbs, suture 6 is set up as previously described and twisted along its axis. The number of twists required are dependant upon the number of barbs, the material of the suture and the diameter of the suture, For example, it has been found that size 0, PDS-2 material requiring 2-1/2" of barbs 30 would require twisting it thirty-nine times for an acceptable result. Of course, too much twisting may cause the suture material to overrun itself, leading to undesirable results including damaged suture material. 12 The securing of a twisted suture 6 on cutting bed 56 is, however, slightly different. In this regard, Figures 18A and B show the setting of suture 6 in clamp 76 before and during cut. Figure 18A shows suture 6 being placed in the vise prior to clamping, with Figure 18B showing the suture post clamping. The lightly clamped 5 suture 6 forms an elliptical shape and is ready to be cut. The cutting method of suture 6 would be the same as that aforediscussed without, however, the need for the suture to be rotated. Figures 19A-D show the various conditions of suture 6 using the twisting method of cutting. In Figure 19A the suture 6 is shown unmodified, with an to imaginary line 150 shown to depict its longitudinal axis. Figure 19B shows the suture 6 as it is twisted in direction (152) in preparation for cutting. Figure 19C shows barbs cut in the twisted condition, with barbs cut along one side thereof. After the suture 6 has been cut and allowed to return to its untwisted condition, the barbs are such as those shown in Figure 19D where the barbs spiral around the 15 circumference of the suture. The difference in the placement of the barbs in the twisted versus the untwisted method can best be seen by comparing Figure 19D with Figure 20. In Figure 20, the suture 6 cut in the untwisted state is shown with spaced barbs at 1200 about the circumference of the suture 6. In Figure 19D, the suture 6 was cut in the 20 twisted state, and, upon de-twisting, the pattern of the barbs takes on a spiral configuration along the length of the suture 6. Note that by omitting cutting motions when suture 6 is cut in either a twisted or untwisted state, the barbs can be formed in a random configuration on the exterior of the suture. Also, the suture may be cut in both a twisted and untwisted state to 25 produce other types of random configurations of barbs. Alternate embodiments for cutting barbs according to the present invention are shown in Figures 21-22. Figures 21A-C show a linear indexing mechanism for advancing suture 6 along cutting bed vise 63 in direction (22), while reciprocating blade assembly 250 cuts barbs along the axis of suture 6. Suture 6 may be advanced 30 along cutting bed vise 63 in a twisted state to form spiral cut barbs as shown in Figures 21A and B, in an untwisted state, or rotated about its axis in increments (e.g. 120 degrees, 180 degrees, etc.) as it advances as shown in Figure 21C. 13 Reciprocating blade assembly 250 includes blade 8 connected via arm 225 to a linear reciprocating solenoid 220, which reciprocates in direction (2) and (42) corresponding to the x-axis, and to rotary solenoid 230, which can turn about its axis as shown in Figures 21A and B. Cutting bed vise 63 is synchronized with 5 reciprocating blade assembly 250 and the indexing mechanism such that the vise closes to hold suture 6 in place during cutting and opens to allow suture 6 to be advanced by the indexer to the next cutting position. Linear solenoid 220 and rotary solenoid 230 may be adjusted to control the linear stroke and blade angle of arm 225 of reciprocating blade assembly 250 to 10 allow for varying the depth of the barbs cut in the y and z axes. In addition, rotation of rotary solenoid 230 allows barbs to be cut in the opposite direction along the axis of suture 6 as shown in Figure 21B. The blade angle and stroke may also be adjusted to sever suture 6 at any desired length. Figure 22 shows a rotational indexing mechanism for advancing suture 6. In 15 Figure 22, suture 6 is shown advancing around a rotating drum 210, while reciprocating blade assembly 250 cuts barbs along the axis of suture 6. Suture 6 is fed onto drum 210 and into cutting channel 215 via suture supply spool 300. Barbed suture is wound off drum 210 onto take-up spool 310. Spools 300 and 310 may supply and take up suture 6 in an untwisted state, or alternatively, either or both 20 spools may be rotated in such a way as to twist and untwist suture 6 to allow spiral cut barbs as described above. While the invention has been described in connection with what is considered to be the most practical and preferred embodiment, it should be understood that this invention is not to be limited to the disclosed embodiment, but on the contrary, is 25 intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims. 14

Claims (12)

1. A method of providing a barbed suture said method including the steps of: providing at least one barb on a suture by cutting the suture by means of a 5 blade, altering a trajectory of the blade during the cutting to create the barb, wherein during cutting, the blade moves in a first direction and along a second direction, and during cutting the blade is articulated about an axis so as to impart additional barb depth in a third direction. 10

2. The method of claim 1, further including the step of articulating said blade about an axis so as to lift the cut barb.

3. The method of any one of the preceding claims, further including the step of cutting the suture in three dimensions along x-y-z axes by blade geometry in 15 conjunction with blade motion, wherein the first direction is the y-axis which is the longitudinal axis of the suture, the second direction is the x-axis which is perpendicular to the longitudinal axis and the third direction is the z-axis which is perpendicular to the x-axis. 20

4. The method of any one of the preceding claims, further including the steps of providing barb sets which are positioned at 120 or 180 degrees to each other, when viewing the suture on a cross-sectional plane.

5. The method of any one of the preceding claims, further including the step of 25 cutting the barbs with the suture in a twisted configuration.

6. The method of any one of the preceding claims, further including the step of providing barbs of different sizes on the suture. 30

7. The method of any one of the preceding claims, further including the step of producing barbs in a spiral fashion. 28/06/13,dh-20014 - claims - cdm.docx,15 -16

8. An apparatus for cutting barbs on a suture including: a suture; and at least one blade for cutting barbs on the suture, an axis for articulating said blade, 5 wherein the apparatus is adapted to carry out cutting motions of the blade to cut into the suture for a first distance on a downward axis and a second distance on a forward axis, then to undergo an articulation around the axis for articulating said blade, and then to cut into the suture for a third distance on a downward axis and a fourth distance on a forward axis. 10

9. The apparatus of claim 8, further including means for twisting the suture.

10. A suture including at least one barb caused by cutting into the suture. wherein the remaining surface in the suture located opposite to the 15 underside of the barb viewed in cross-section, said cross-section being along the longitudinal axis of the suture, includes two different trajectory paths, at least one being angled with respect to the longitudinal axis of the suture, the first trajectory path starting from the outer surface of the suture and having an end, the second trajectory path starting from said end of the first trajectory path and having an end at 20 a base of the barb, wherein the angle between the first trajectory path and the longitudinal axis of the suture being greater than the angle between the second trajectory path and the longitudinal axis of the suture. 25

11. The suture of claim 10, having at least one barb on the suture cut into the suture by means of a blade; and altering a trajectory of the blade to create the barb.

12. The suture of claim 10 or 11, further including barb sets positioned 120 30 degrees to each other. 28/06/13.dh-200 14 - claims - cdm.docx, 16