WO2003077771A1 - Suturing apparatus and method - Google Patents

Suturing apparatus and method Download PDF

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Publication number
WO2003077771A1
WO2003077771A1 PCT/GB2003/001079 GB0301079W WO03077771A1 WO 2003077771 A1 WO2003077771 A1 WO 2003077771A1 GB 0301079 W GB0301079 W GB 0301079W WO 03077771 A1 WO03077771 A1 WO 03077771A1
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WO
WIPO (PCT)
Prior art keywords
suturing
tubular means
needle
suturing apparatus
body part
Prior art date
Application number
PCT/GB2003/001079
Other languages
French (fr)
Inventor
Angus Everett Strover
Original Assignee
Angus Everett Strover
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Angus Everett Strover filed Critical Angus Everett Strover
Priority to AU2003214408A priority Critical patent/AU2003214408A1/en
Publication of WO2003077771A1 publication Critical patent/WO2003077771A1/en

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Classifications

    • 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
    • A61B17/0482—Needle or suture guides
    • 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
    • A61B17/0483—Hand-held instruments for holding sutures
    • 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
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • 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
    • A61B2017/0474—Knot pushers
    • 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
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/061—Needles, e.g. needle tip configurations hollow or tubular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0646—Surgical staples, i.e. penetrating the tissue for insertion into cartillege, e.g. meniscus

Definitions

  • the flexible elongate wire or strip 24 is advanced into the portion 8 of the meniscal tissue at a point beyond the tear 4, its sharpened end 26 cutting through the tissue until the aperture 28 is brought into alignment with the spinal or hypodermic needle 20 in the first tubular means 10.
  • the spinal or hypodermic needle 20, provided with the suturing thread 22, is then advanced along the first tubular means 10, so that it protrudes from the distal end 10A of the first tubular means 10 and such that it cuts through the portion 6 of the damaged meniscal tissue, across the tear 4 and into the portion 8 of the meniscal tissue.
  • the needle 20 is then withdrawn, leaving a portion 22B of looped end 22A of the suturing thread 22 extending across the tear 4 in the meniscal tissue. Greater friction exists between the thread 22 and the meniscal tissue 6, 8 than between the thread 22 and the needle 20 and this facilitates removal of the needle 20 while leaving the thread 22 in the tissue.
  • the flexible elongate wire or strip 24 is then withdrawn along the second tubular means 12 with the looped portion 22A of the thread 22 held in the aperture 28, as shown in Figure 10, and then captured between the aperture 28 and the flexible plastics sheath 30.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Suturing apparatus for use in the repair of an internal body part includes a substantially tubular member (10) and a probe (24). The substantially tubular member (10) is adapted to receive a tubular needle (20) arranged to receive suturing thread (22) such that an end (22A) of the suturing thread protrudes from a sharp distal end (20A) of the needle which is adapted for insertion into and removal from the body part through the tubular member. The probe (24) extends substantially adjacent to the tubular member (10) and is provided with a sharp end (26) adapted for insertion into the body part. The probe is formed with an aperture (28) in an end region thereof, the aperture being alignable with an axis of the tubular member at a point beyond an end of the tubular member so as to permit passage of the needle (20) therethrough on insertion thereof into the body part.

Description

SUTURING APPARATUS AND METHOD
This invention relates to suturing apparatus for use in the repair of an internal body part. The invention also relates to a method of surgery utilising such suturing apparatus .
The invention is particularly, but not exclusively, applicable for use in endoscopic surgical procedures for the repair of a damaged internal body part, such as a torn meniscus or cartilage of a knee, or for the repair of a damaged ankle joint or a shoulder component, or for closing surgical wounds within the abdomen.
In prior art techniques for repairing torn meniscal tissue of a knee, it has been common practice to carry out a suturing operation, starting either from within the knee joint cavity and/or from outside of the knee joint and working inwardly therefrom.
The present invention is advantageous in that it provides apparatus and a method of surgery in which damage, such as a tear, in an internal body part is able to be repaired, starting from the inside and remaining within the body part.
According to one aspect of the present invention there is provided suturing apparatus for use in the repair of an internal body part, the apparatus comprising:
substantially tubular means adapted to receive tubular needle means arranged to receive suturing thread such that an end of the suturing thread protrudes from a sharp distal end of the needle means which is adapted for insertion into and removal from the body part through the tubular means; and
probe means extending substantially adjacent to the tubular means and provided with a sharp end adapted for insertion into the body part, the probe means being formed with an aperture in an end region thereof, the aperture being alignable with an axis of the tubular means at a point beyond an end of the tubular means so as to permit passage of the needle means therethrough on insertion thereof into the body part.
According to another aspect of the present invention there is provided a method of surgery utilising suturing apparatus for use in the repair of an internal body part, the apparatus comprising:
substantially tubular means adapted to receive tubular needle means arranged to receive suturing thread such that an end of the suturing thread protrudes from a sharp distal end of the needle means which is adapted for insertion into and removal from the body part through the tubular means; and
probe means extending substantially adjacent to the tubular means and provided with a sharp end adapted for insertion into the body part, the probe means being formed with an aperture in an end region thereof, the aperture being alignable with an axis of the tubular means at a point beyond an end of the tubular means so as to permit passage of the needle means therethrough on insertion thereof into the body part.
The end of the suturing thread which protrudes from the distal end of the needle means is suitably arranged to be folded back along an external surface of the needle means when the needle means is inserted into the body part.
The apparatus is suitably arranged whereby friction between the suturing thread and material of the body part is greater than corresponding friction between the suturing thread and the needle means .
The tubular means is suitably arranged to be shorter than the needle means, such as by about 10 to 15 mm.
The probe means may be provided in a further substantially tubular means provided alongside the first- mentioned tubular means. A flexible plastics sheath, such as of polyvinyl acetate or polyurethane, may be provided between the probe means and the further tubular means and cooperating with the probe means for capturing the suturing thread.
The probe means may be in the form of a flexible elongate member which is adapted to be inserted into and subsequently withdrawn from the body part. The flexible elongate member may be adapted to co-operate with the further tubular means to curve towards the axis of the first-mentioned tubular means when the flexible elongate member is inserted into the body part. The flexible elongate member may be in wire or strip form. The further tubular means may have a distal end region diverging from a corresponding distal end region of the first-mentioned tubular means and terminating in an angled portion adapted to deflect the flexible elongate member towards the axis of the first-mentioned tubular means. The angled portion may be arranged to deflect the flexible elongate member through an angle of about 90 degrees. The flexible elongate member may comprise a flexible strip, such as of metal, which may be spring steel or titanium-nickel alloy. The strip may be about 2 to 3 mm wide and may be sharpened only at its distal end to form a cutting edge. Alternatively, the flexible elongate member may comprise a flexible wire, such as in the form of a flexible needle, which may be of metal, such as spring steel or titanium-nickel alloy. The flexible wire or needle may have a diameter of about 0.5 to 1 mm and may be sharpened only at its distal end to form a cutting edge. The flexible wire or needle may have a flattened and widened portion near the distal end thereof which is provided with the aperture therein.
Upon withdrawal of the flexible elongate member along the further tubular means, together with the captured suturing thread, the captured suturing thread may be tied, such as in a knot, with a further portion of the suturing thread extending at the first-mentioned tubular means upon withdrawal of the needle means, whereby repair of the internal body part is completed. Such tying may be effected separately, or by a knot tying means forming an integral part of the apparatus.
The apparatus may be orientated such that, in operation, the first-mentioned tubular means forms a lower tubular means and the further tubular means forms an upper tubular means.
Alternatively, the probe means may be in the form of a solid member mounted alongside the tubular means. The probe means may be provided with a region diverging from the axis of the tubular means and with a region extending towards and crossing the axis of the tubular means with the aperture substantially aligned with the axis of the tubular means.
The aperture in the end region of the probe means may be adapted for capturing the suturing thread protruding from the distal end of the needle means upon withdrawal of the needle means from the body part.
The first-mentioned tubular means and/or, where provided, the further tubular means may be provided with a longitudinal slit to permit exit therethrough of the suturing thread.
The first-mentioned tubular means and, where provided, the further tubular means may comprise metal and may be secured together, or integrated or united, or assembled into a support, at least at end regions remote from the distal ends thereof.
The body part may comprise a torn meniscus or cartilage of a knee, or may comprise damaged tissue in another body part, such as an ankle joint, or a shoulder capsule, or a glenoid labrum or a rotator cuff in a shoulder.
The apparatus of the present invention may be utilised in an endoscopic surgical procedure.
For a better understanding of the invention and to show more clearly how it may be carried into effect, reference will now be made, by way of example, to the accompanying drawings in which:
Figures 1A to 1G are diagrammatic side views of an embodiment of suturing apparatus according to the present invention for use in the repair of a damaged internal body part and illustrating sequential operating stages of the apparatus;
Figure 2 is a cross-sectional view along line A-A of the apparatus of Figure 1A;
Figure 3 is a diagrammatic side view of a further embodiment of suturing apparatus according to the present invention; and
Figure 4 is a cross-sectional view along line B-B of the apparatus of Figure 3.
As shown in Figures 1A and 2, suturing apparatus 2 is provided for use, as part of an endoscopic surgical procedure, in the repair of a damaged internal body part. As shown in Figures IB to ID, the damaged body part comprises a tear 4 in portions 6 and 8 of meniscal tissue of a knee joint. However, the apparatus 2 is not restricted to this particular application and may be applied in the repair of some other damaged internal body part, such as an ankle joint, or a shoulder capsule, or a glenoid labrum or a rotator cuff in a shoulder.
The apparatus 2 comprises a lower first tubular means 10 and an upper second tubular means 12. The tubular means 10 and 12 are secured together, or integrated or united, or connected to a support, at a region 14. The tubular means 10 and 12 suitably comprise metal. The first tubular means 10 has a slit 16 extending longitudinally along the full length thereof and the second tubular means 12 also has a slit 18 extending longitudinally along the full length thereof. While the slits 16, 18 are shown positioned at a side of the respective tubular means, the slits may be positioned elsewhere. For example, slit 16 may be provided in a lower region of the tubular means 10 and the slit 18 may be positioned in an upper region of the tubular means 12.
A tubular, spinal or hypodermic, needle 20 is threaded with appropriate suturing thread 22, such that an end portion 22A of the thread protrudes from a sharp distal end 20A of the needle 20. The needle 20 is passed through the first tubular means 10 and the end portion 22A of the thread 22 is folded back along an external surface of the needle 20. The first tubular means 10 is arranged to be shorter than the needle 20 by about 10 to 15 mm.
The second tubular means 12 is provided alongside, but extending beyond, the first tubular means 10. The second tubular means 12 has a distal end region 12A diverging from a corresponding distal end region 10A of the first tubular means 10 (i.e., diverging from an axis of the first tubular means 10) and terminating in an angled portion 12B which extends towards the axis of the first tubular means 10. The region 12A of the second tubular means 12 may be about 25 mm in length and may diverge upwards by about 6 mm relative to an associated non- divergent region. The angled terminating portion 12B may be about 4 to 5 mm in length.
A probe member in the form of a flexible elongate member 24, such as a wire or strip, is arranged to be advanced along the second tubular means 12 and subsequently withdrawn along the second tubular means 12. Such wire or strip 24 suitably comprises spring steel or titanium- nickel alloy and has a sharpened distal end 26 forming a cutting edge. An aperture 28 is provided at the distal end of the wire or strip 24. The aperture 28 is dimensioned such that it is capable of receiving the distal end 20A of the needle 20, together with the trailing end 22A of the suturing thread 22.
When the flexible elongate wire or strip 24 is of strip form, it takes the form of a blade and is suitably about 2 to 3 mm in width. When of wire form, such wire form may comprise a flexible needle of about 0.5 to 1 mm in diameter having a flattened and widened portion, near the sharpened distal end thereof, which is provided with the aperture 28.
A flexible plastics sheath 30, such as of polyvinyl acetate or polyurethane, is provided between the flexible elongate wire or strip 24 and the second tubular means 12.
The flexible elongate wire or strip 24 cooperates with the second tubular means 12 such that, when the wire or strip 24 is advanced along the second tubular means 12, it is diverted downwardly through an angle of about 90 degrees by the angled portion 12B of the second tubular means 12 and crosses the axis of the first tubular means 10. The aperture 28 in the distal end of the wire or strip 24 is thus able to be brought into alignment with the spinal or hypodermic needle 20 advancing axially through the first tubular means 10.
Operation of the apparatus 2 is as follows. As shown in Figures 1A and IB, the flexible elongate wire or strip 24 is advanced into the portion 8 of the meniscal tissue at a point beyond the tear 4, its sharpened end 26 cutting through the tissue until the aperture 28 is brought into alignment with the spinal or hypodermic needle 20 in the first tubular means 10. The spinal or hypodermic needle 20, provided with the suturing thread 22, is then advanced along the first tubular means 10, so that it protrudes from the distal end 10A of the first tubular means 10 and such that it cuts through the portion 6 of the damaged meniscal tissue, across the tear 4 and into the portion 8 of the meniscal tissue. In the portion 8 of the meniscal tissue, the sharp distal end 20A of the needle 20, together with the folded-back trailing end portion 22A of the suturing thread 22, passes through the aperture 28 in the flexible elongate wire or strip 24 and extends beyond the aperture 28 by about 15 mm.
The needle 20 is then withdrawn, leaving a portion 22B of looped end 22A of the suturing thread 22 extending across the tear 4 in the meniscal tissue. Greater friction exists between the thread 22 and the meniscal tissue 6, 8 than between the thread 22 and the needle 20 and this facilitates removal of the needle 20 while leaving the thread 22 in the tissue.
The flexible elongate wire or strip 24 is then withdrawn along the second tubular means 12 with the looped portion 22A of the thread 22 held in the aperture 28, as shown in Figure 10, and then captured between the aperture 28 and the flexible plastics sheath 30.
The needle 20 and the flexible wire or strip 24 are both finally withdrawn completely, as shown in Figure ID, pulling the suturing thread through the second tubular means 12. The suturing apparatus is then withdrawn, optionally after removing the suturing thread from the first and second tubular means 10, 12 through the slits 16 and 18, leaving a double suture through the tear 4 as shown in Figure IE. One strand of the suturing thread 22 is then pulled through, leaving a single strand in place through the meniscal tear 4. A knot is then made outside the portal through which the surgical procedure is effected and advanced towards the meniscal tear using a conventional arthroscopic knot pusher 32 as illustrated diagrammatically in Figure IF. The knot is completed, pulled tight and cut using a conventional arthroscopic punch or scissors (not shown) to repair the tear as shown in Figure 1G.
As an alternative to separate knots, as will be clear to an arthroscopic surgeon, the apparatus may be used to perform continuous stitching along the meniscal tear.
By means of the apparatus of the present invention, damage to an internal body part, such as torn meniscal tissue, is repaired by working from the inside of the body part and remaining inside the body part, rather than by starting either from the outside and working towards the inside, or starting from the inside and working towards the outside.
The suturing apparatus shown in Figures 3 and 4 is similar to that shown in Figures 1 and 2 and the same references are used to denote the same or similar components. The apparatus shown in Figures 3 and 4 comprises a lower tubular means 10 and an upper solid probe member 34 secured to or integral with the tubular means 10. If desired, the tubular means 10 may have a slit (not shown) extending longitudinally along the full length thereof.
A tubular needle 20 is threaded with an appropriate suturing thread 22 with an end of the suturing thread protruding from the end of the needle 20. The probe member 34 has a region 34A diverging from an axis of the tubular means 10 and an end region 34B extending towards and crossing the axis of the tubular means 10. The end of the probe member 34 is sharpened as shown at 36. The end region 34B of the probe member is provided with an aperture 38 which is coaxial with the tubular means 10 such that the tubular needle 20 can, when extended, pass through the aperture 38.
Operation of the suturing apparatus of Figures 3 and 4 is similar to that of Figures 1 and 2 in that the end 36 of the probe member is inserted into the meniscal tissue at a point beyond the tear and the needle 20 is advanced through the aperture 38. The needle 20 is subsequently withdrawn to leave a loop of the suturing thread 22 extending across the tear in the miniscal tissue and through the aperture 38 in the probe member 34. There is greater friction between the thread 22 and the meniscal tissue than between the thread and the needle 20 which facilitates removal of the needle while leaving the thread in place in the tissue. The end 36 of the probe member 34 is then withdrawn from the meniscal tissue and pulls a loop of the thread 22 out of the meniscal tissue at a point beyond the tear.
The loop of suturing thread 22 can either be pulled out of the arthroscopic portal (not shown) , knotted to the thread passing through the needle 20 as described in relation to the embodiment of Figures 1 and 2 and pushed up to the tear, or can be picked up by the end of the probe member 34 and moved along the tear to create a continuous suture along the meniscal tear.

Claims

1. Suturing apparatus for use in the repair of an internal body part, the apparatus characterised by:
substantially tubular means (10) adapted to receive tubular needle means (20) arranged to receive suturing thread (22) such that an end (22A) of the suturing thread protrudes from a sharp distal end (20A) of the needle means which is adapted for insertion into and removal from the body part through the tubular means; and
probe means (24) extending substantially adjacent to the tubular means (10) and provided with a sharp end (26) adapted for insertion into the body part, the probe means being formed with an aperture (28) in an end region thereof, the aperture being alignable with an axis of the tubular means at a point beyond an end of the tubular means so as to permit passage of the needle means (20) therethrough on insertion thereof into the body part.
2. Suturing apparatus as claimed in claim 1, characterised in that the end (22A) of the suturing thread (22) which protrudes from the distal end (20A) of the needle means (20) is arranged to be folded back along an external surface of the needle means when the needle means is inserted into the body part.
3. Suturing apparatus as claimed in claim 1 or 2, characterised in that the apparatus is arranged whereby friction between the suturing thread (22) and material of the body part is greater than corresponding friction between the suturing thread and the needle means (20) .
4. Suturing apparatus as claimed in any preceding claim, characterised in that the tubular means (10) is arranged to be shorter than the needle means (20), such as by about 10 to 15 mm.
5. Suturing apparatus as claimed in any preceding claim, characterised in that the probe means (24) is provided in a further substantially tubular means (12) provided alongside the first-mentioned tubular means (10).
6. Suturing apparatus as claimed in claim 5, characterised in that a flexible plastics sheath (30), such as of polyvinyl acetate or polyurethane, is provided between the probe means (24) and the further tubular means (12) and cooperating with the probe means for capturing the suturing thread (22) .
7. Suturing apparatus as claimed in claim 5 or 6, characterised in that the probe means (24) is in the form of a flexible elongate member which is adapted to be inserted into and subsequently withdrawn from the body part.
8. Suturing apparatus as claimed in claim 7, characterised in that the flexible elongate member (24) is adapted to co-operate with the further tubular means
(12) to curve towards the axis of the first-mentioned tubular means (10) when the flexible elongate member is inserted into the body part.
9. Suturing apparatus as claimed in claim 7 or 8, characterised in that the flexible elongate member (24) is in wire or strip form.
10. Suturing apparatus as claimed in claim 7, 8 or 9, characterised in that the further tubular means (12) has a distal end region (12A) diverging from a corresponding distal end region (10A) of the first-mentioned tubular means (10) and terminating in an angled portion (12B) adapted to deflect the flexible elongate member towards the axis of the first-mentioned tubular means.
11. Suturing apparatus as claimed in claim 10, characterised in that the angled portion (12B) is arranged to deflect the flexible elongate member (24) through an angle of about 90 degrees.
12. Suturing apparatus as claimed in any one of claims 7 to 11, characterised in that the flexible elongate member
(24) comprises a flexible strip, such as of metal, which may be spring steel or titanium-nickel alloy.
13. Suturing apparatus as claimed in claim 12, characterised in that the strip is about 2 to 3 mm wide and may be sharpened only at its distal end (26) to form a cutting edge.
14. Suturing apparatus as claimed in any one of claims 7 to 11, characterised in that the flexible elongate member
(24) comprises a flexible wire, such as in the form of a flexible needle, which may be of metal, such as spring steel or titanium-nickel alloy.
15. Suturing apparatus as claimed in claim 14, characterised in that the flexible wire has a diameter of about 0.5 to 1 mm and may be sharpened only at its distal end (26) to form a cutting edge.
16. Suturing apparatus as claimed in claim 14 or 15, characterised in that the flexible wire has a flattened and widened portion near the distal end (26) thereof which is provided with the aperture (28) therein.
17. Suturing apparatus as claimed in any one of claims 7 to 16, characterised in that knot-tying means is provided such that, upon withdrawal of the flexible elongate member (24) along the further tubular means, together with the captured suturing thread (22), the captured suturing thread is tied, such as in a knot, with a further portion of the suturing thread extending at the first-mentioned tubular means (10) upon withdrawal of the needle means (20), whereby repair of the internal body part is completed.
18. Suturing apparatus as claimed in any preceding claim, characterised in that the apparatus is adapted to be orientated such that, in operation, the first- mentioned tubular means (10) forms a lower tubular means and the further tubular means (12) forms an upper tubular means .
19. Suturing apparatus as claimed in any one of claims 1 to 17, characterised in that the probe means (24) is in the form of a solid member mounted alongside the tubular means (10) .
20. Suturing apparatus as claimed in claim 19, characterised in that the probe means (24) is provided with a region (12A) diverging from the axis of the tubular means (10) and with a region (12B) extending towards and crossing the axis of the tubular means with the aperture (28) substantially aligned with the axis of the tubular means.
21. Suturing apparatus as claimed in any preceding claim, characterised in that the aperture (28) in the end region of the probe means (24) is adapted for capturing the suturing thread (22) protruding from the distal end (20A) of the needle means (20) upon withdrawal of the needle means from the body part.
22. Suturing apparatus as claimed in any preceding claim, characterised in that the tubular means (10, 12) is provided with a longitudinal slit (16, 18) to permit exit therethrough of the suturing thread (22) .
23. Suturing apparatus as claimed in any preceding claim, characterised in that the tubular means (10, 12) comprises metal and may be secured together, or integrated or united, or assembled into a support (14), at least at end regions remote from the distal ends thereof.
PCT/GB2003/001079 2002-03-15 2003-03-13 Suturing apparatus and method WO2003077771A1 (en)

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Application Number Priority Date Filing Date Title
AU2003214408A AU2003214408A1 (en) 2002-03-15 2003-03-13 Suturing apparatus and method

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GB0206071.3 2002-03-15
GB0206071A GB0206071D0 (en) 2002-03-15 2002-03-15 Suturing apparatus and method

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GB (1) GB0206071D0 (en)
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US8162961B2 (en) 2007-07-23 2012-04-24 Zimmer Orthobiologies, Inc. Medical devices and methods for cutting and suturing biological tissue
US8177795B2 (en) 2008-10-21 2012-05-15 Cayenne Medical, Inc. Meniscal repair systems and methods
US8449533B2 (en) 2009-11-09 2013-05-28 Ceterix Orthopaedics, Inc. Devices, systems and methods for meniscus repair
US8465505B2 (en) 2011-05-06 2013-06-18 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US8500809B2 (en) 2011-01-10 2013-08-06 Ceterix Orthopaedics, Inc. Implant and method for repair of the anterior cruciate ligament
US8663253B2 (en) 2007-07-03 2014-03-04 Ceterix Orthopaedics, Inc. Methods of meniscus repair
US8702731B2 (en) 2007-07-03 2014-04-22 Ceterix Orthopaedics, Inc. Suturing and repairing tissue using in vivo suture loading
US8814885B2 (en) 2008-03-04 2014-08-26 Cayenne Medical, Inc. Arthroscopic meniscal repair systems and methods
US8821518B2 (en) 2007-11-05 2014-09-02 Ceterix Orthopaedics, Inc. Suture passing instrument and method
US8911456B2 (en) 2007-07-03 2014-12-16 Ceterix Orthopaedics, Inc. Methods and devices for preventing tissue bridging while suturing
US9011454B2 (en) 2009-11-09 2015-04-21 Ceterix Orthopaedics, Inc. Suture passer with radiused upper jaw
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US11744575B2 (en) 2009-11-09 2023-09-05 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US8562631B2 (en) 2009-11-09 2013-10-22 Ceterix Orthopaedics, Inc. Devices, systems and methods for meniscus repair
US10004492B2 (en) 2009-11-09 2018-06-26 Ceterix Orthopaedics, Inc. Suture passer with radiused upper jaw
US9848868B2 (en) 2011-01-10 2017-12-26 Ceterix Orthopaedics, Inc. Suture methods for forming locking loops stitches
US10987095B2 (en) 2011-01-10 2021-04-27 Ceterix Orthopaedics, Inc. Suture methods for forming locking loops stitches
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US10561410B2 (en) 2011-01-10 2020-02-18 Ceterix Orthopaedics, Inc. Transosteal anchoring methods for tissue repair
US9913638B2 (en) 2011-01-10 2018-03-13 Ceterix Orthopaedics, Inc. Transosteal anchoring methods for tissue repair
US8500809B2 (en) 2011-01-10 2013-08-06 Ceterix Orthopaedics, Inc. Implant and method for repair of the anterior cruciate ligament
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US8465505B2 (en) 2011-05-06 2013-06-18 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US10188382B2 (en) 2011-05-06 2019-01-29 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US9247934B2 (en) 2011-05-06 2016-02-02 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US10524778B2 (en) 2011-09-28 2020-01-07 Ceterix Orthopaedics Suture passers adapted for use in constrained regions
US9636110B2 (en) 2013-03-13 2017-05-02 Alpha Scientific Corporation Structural support incorporating multiple strands
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US10299786B2 (en) 2013-03-15 2019-05-28 Alpha Scientific Corporation Surgical suturing device with transverse engagement
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