RU2016129258A - Восстановление ткани шовным материалом полностью без узлов - Google Patents

Восстановление ткани шовным материалом полностью без узлов Download PDF

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RU2016129258A
RU2016129258A RU2016129258A RU2016129258A RU2016129258A RU 2016129258 A RU2016129258 A RU 2016129258A RU 2016129258 A RU2016129258 A RU 2016129258A RU 2016129258 A RU2016129258 A RU 2016129258A RU 2016129258 A RU2016129258 A RU 2016129258A
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fixing
suture
implant
suture material
channel
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RU2016129258A
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Кристофер РОДРИГЕС
Три НГУЙЕН
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Артрокер Корпорейшн
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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
    • A61B17/04—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
    • 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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
    • 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
    • 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
    • A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
    • 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
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448—Additional elements on or within the anchor
    • A61B2017/045—Additional elements on or within the anchor snug fit within the anchor
    • 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
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0459—Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
    • 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
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0461—Means for attaching and blocking the suture in the suture anchor with features cooperating with special features on the suture, e.g. protrusions on the suture
    • A61B2017/0462—One way system, i.e. also tensioning the suture
    • 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
    • A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A61B2017/0618—Sutures elastic, e.g. stretchable
    • 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A61B2017/06185—Sutures hollow or tubular

Claims (33)

1. Фиксатор для фиксации ткани к кости или ткани к ткани у человека или животного без завязывания узла, содержащий:
фиксирующий имплантат для введения в кость или ткань, включающий первую конфигурацию, имеющую удлиненный корпус, продольную ось, дистальный и проксимальный концы и боковые стенки; и
шовный материал, проходящий сквозь фиксирующий имплантат и включающий первый удлиненный мягкий канал для удержания шовного материала;
при этом шовный материал имеет первый участок длины, выходящий из фиксирующего имплантата для создания первой петли, проходящей сквозь ткань, возвращающийся к фиксирующему имплантату и протягиваемый сквозь первый канал для удержания шовного материала;
при этом при приложении в проксимальном направлении первой силы к первой петле происходит радиальное уменьшение первого канала для удержания шовного материала, блокировка шовного материала и предотвращение распускания первой петли; и
при этом натяжение первого и второго концов шовного материала при размещении фиксирующего имплантата в отверстии, приводит к изменению конфигурации фиксирующего имплантата из первой удлиненной, радиально суженной конфигурации во вторую, укороченную продольно, радиально расширенную конфигурацию, так чтобы развернуть фиксирующий имплантат в отверстии.
2. Фиксатор по п. 1, отличающийся тем, что шовный материал дополнительно включает второй мягкий удлиненный канал для удержания шовного материала, при этом натяжение первой петли приводит к уменьшению радиального размера как первого, так и второго канала для удержания шовного материала, таким образом закрепляя шовный материал и предотвращая распускание первой петли.
3. Фиксатор по п. 1 или 2, отличающийся тем, что шовный материал является плетеным шовным материалом.
4. Фиксатор по п. 3, отличающийся тем, что фиксирующий имплантат имеет плетеную структуру.
5. Фиксатор по любому из пп. 1 или 2, отличающийся тем, что фиксирующий имплантат имеет трубчатую структуру в первой конфигурации.
6. Фиксатор по п. 5, отличающийся тем, что шовный материал, по меньшей мере частично, вплетен в боковые стенки фиксирующего имплантата.
7. Фиксатор по любому из пп. 1, 2, 4, 6, отличающийся тем, что фиксирующий имплантат и первый шовный материал состоят из биоразлагаемых материалов.
8. Фиксирующий узел для прикрепления ткани к кости или ткани к ткани животного или человека, содержащий:
фиксирующий имплантат для введения в кость или ткань, включающий первую конфигурацию имеющую удлиненную форму, продольную ось, дистальный и проксимальный концы, а также боковые стенки;
первый шовный материал, проходящую сквозь фиксирующий имплантат и включающую первый канал для удержания шовного материала; и
первую ловушку, проходящую сквозь первый канал для удержания шовного материала и предназначенную для протягивания первого конца первого шовного материала через первый канал для удержания шовного материала для формирования проходящей через ткань первой петли шовного материала, при этом натяжение первой петли шовного материала задействует канал для удержания шовного материала для затягивания первого шовного материала в нем, таким образом предотвращая распускание первой петли шовного материала.
9. Фиксирующий узел по п. 8, отличающийся тем, что дополнительно включает вторую ловушку, проходящую через расположенный вдоль шовного материала второй канал для удержания шовного материала, для протягивания через него первого конца первого шовного материала.
10. Фиксирующий узел по п. 8 или 9, отличающийся тем, что при протягивании через первый канал для удержания шовного материала первого конца первого шовного материала с формированием проходящей через ткань первой петли шовного материала, первый шовный материал исходит из ткани, вдоль наружной поверхности боковых стенок, в фиксирующий имплантат на дистальном конце.
11. Фиксирующий узел по любому из пп. 8 или 9, отличающийся тем, что дополнительно включает удлиненную трубку для введения, при этом фиксирующий имплантат расположен внутри дистального просвета трубки для введения.
12. Фиксирующий узел по п. 11, отличающийся тем, что дополнительно включает внутренний толкающий элемент, расположенный внутри трубки для введения и включающий упорную поверхность напротив проксимального конца фиксирующего имплантата, при этом трубка для введения подвижна относительно толкающего элемента в осевом направлении.
13. Фиксирующий узел по п. 12, отличающийся тем, что дополнительно включает стержень между трубкой для введения и дистальным концом фиксирующего имплантата, который предотвращает значительное искривление фиксирующего имплантата при протягивании первой ловушкой первого конца первого шовного материала.
14. Фиксирующий узел в соответствии с пунктом 13, отличающийся тем, что дополнительно включает узел между фиксирующим имплантатом и первым шовным материалом.
15. Фиксирующий узел по любому из пп. 8, 9, 12-14, отличающийся тем, что фиксирующий имплантат выполнен из жесткого материала.
16. Фиксирующий узел по любому из пп. 8, 9, 12-14, отличающийся тем, что фиксирующий имплантат дополнительно включает вторую конфигурацию, имеющую укороченную продольно и увеличенную радиально форму.
17. Фиксирующий узел по любому из пп. 8, 9, 12-14, отличающийся тем, что канал для удержания шовного материала выполнен в виде зигзагообразного прохода.
18. Способ фиксации ткани к кости человека или животного без завязывания узла, включающий:
создание отверстия в кости;
проведение первого конца шовного материала через ткань;
протягивание первого конца шовного материала через первый канал для удержания шовного материала, по меньшей мере частично расположенный в фиксирующем имплантате, таким образом формируя первую петлю шовного материала, проходящую из фиксирующего
имплантата через ткань и обратно к фиксирующему имплантату, при этом канал для удержания шовного материала включает мягкий удлиненный канал;
введение фиксирующего имплантата в отверстие;
развертывание мягкого фиксирующего имплантата в отверстии; и
сведение ткани с мягким фиксирующим имплантатом.
RU2016129258A 2013-12-20 2014-12-18 Восстановление ткани шовным материалом полностью без узлов RU2016129258A (ru)

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US201361918796P 2013-12-20 2013-12-20
US61/918,796 2013-12-20
PCT/US2014/071164 WO2015095524A2 (en) 2013-12-20 2014-12-18 Knotless all suture tissue repair

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US (4) US9962150B2 (ru)
EP (1) EP3082618B1 (ru)
JP (1) JP2017500125A (ru)
KR (1) KR20160098251A (ru)
CN (1) CN106028959B (ru)
AU (1) AU2014364517B2 (ru)
MX (1) MX2016008146A (ru)
RU (1) RU2016129258A (ru)
WO (1) WO2015095524A2 (ru)
ZA (1) ZA201603244B (ru)

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US20150173739A1 (en) 2015-06-25
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AU2014364517A1 (en) 2016-06-02
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