WO2011091189A1 - Tissue repair implant and delivery device and method - Google Patents

Tissue repair implant and delivery device and method Download PDF

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Publication number
WO2011091189A1
WO2011091189A1 PCT/US2011/021952 US2011021952W WO2011091189A1 WO 2011091189 A1 WO2011091189 A1 WO 2011091189A1 US 2011021952 W US2011021952 W US 2011021952W WO 2011091189 A1 WO2011091189 A1 WO 2011091189A1
Authority
WO
WIPO (PCT)
Prior art keywords
tissue
implant
anchor
suture
needle
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/US2011/021952
Other languages
English (en)
French (fr)
Inventor
Michael P. Whitman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
NEW HOPE VENTURES LP
Original Assignee
NEW HOPE VENTURES LP
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 NEW HOPE VENTURES LP filed Critical NEW HOPE VENTURES LP
Priority to CA2825186A priority Critical patent/CA2825186A1/en
Priority to JP2012550131A priority patent/JP5981349B2/ja
Priority to EP11735207.0A priority patent/EP2525722A4/en
Publication of WO2011091189A1 publication Critical patent/WO2011091189A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/10—Surgical instruments, devices or methods for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00579—Barbed implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00632—Occluding a cavity, i.e. closing a blind opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0408—Rivets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0412—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from suture anchor body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
    • A61B2017/0435—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
    • A61B2017/0437—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being resilient or spring-like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A61B2017/0488—Instruments for applying suture clamps, clips or locks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • A61B2017/0648—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks threaded, e.g. tacks with a screw thread
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B2017/081—Tissue approximator

Definitions

  • a method comprises positioning a first implant in a first predetermined position adjacent a first tissue, positioning a second implant in a second predetermined position adjacent a second tissue, bringing the first and second tissues into apposition by pulling the first and second implants into apposition with each other, and creating multiple puncture wounds in the first and second tissues with the first and second implants to allow the first and second tissues to heal together in the region of the puncture wounds.
  • Figures 3 A to 3 C sequentially illustrate the opening of the needle and deployment of a plate or implant from the needle.
  • Figure 7A illustrates the catheter after being maneuvered to the proximal position.
  • Figures 7B and 7C sequentially illustrate the pulling together of the two plates or implants.
  • Figure 15A illustrates the driving of an anchoring fastener through a first tissue and into a second tissue using the device of Figure 14.
  • the cords 3300 and the twisting arms 3405 are retracted proximally with respect to the housing 3001, while the tubular sleeve 3400 rotates about its longitudinal axis.
  • the rotation of the tubular sleeve 3400 about its longitudinal axis causes the twisting arms 3405 to engage the respective cords 3300 and revolve around the longitudinal axis of the tubular sleeve 3400.
  • the micro implants 250 may have a diameter of one millimeter, or approximately one millimeter, and a length that is in a range from 5 millimeters to 10 millimeters. According to example embodiments, the diameter is less than one millimeter. According to example embodiments, the diameter is in a range from 0.8 millimeters to 1.2 millimeters. It should be understood, however, that other dimensions may be provided.
  • the splits 359 may be formed by making a cut radially into the body 351 and extending in an axial direction.
  • the two split portions 357 and 358 are attached to the remainder of the body 351 at a distal position and extend proximally to free ends.
  • the free ends include a plurality of sharp protrusions along a curved surface. These points are formed due to the corrugations.
  • the ridges 355 form the sharp protrusions.
  • the ridges 355 form the sharp protrusions, as illustrated in the inset partial side view in Figure 13, which are advantageous for gripping tissue and preventing distal sliding of the fastener 250.
  • the shaft 5115 includes many features, e.g., the maneuverability, the winding mechanism and the clipping mechanism, of the catheter 3000 described above.
  • the system 5000 operates in a manner analogous to the device 3000 described above.
  • one or more of the implants 3200 are replaced by the implants 250.
  • the implants 250 may be hydraulically delivered, or delivered by a piercing needle, or any other appropriate driving mechanism.
  • hydraulic delivery it is noted that a very precise force may be delivered at the distal end portion of the shaft 5115 to drive the fastener 250. This force may be controlled by the processor 5110 in connection with hydraulics, e.g., in the handpiece.
  • the fasteners are preferably driven at a speed greater than 50 meters per second, more preferably in a range of 50 to 350 meters per second, and most preferably at 350 meters per second. However, it should be understood that the fasteenrs may be driven at any suitable speed sufficient for the fasteners to puncture tissue.
  • a rapid penetration of the layer(s) of tissue may be required in order to effect a desired penetration. If an implant 250 is applied slowly, the tissue may be pushed distally away by the implant and/or needle without adequate penetration.
  • some example delivery mechanisms eject the implant a relatively high velocity.
  • saline is used to pressurize the channel within the catheter or needle at such a rate that the plunger will eject the implant 250 at the precise velocity.
  • Other example embodiments utilize a spring-loaded mechanical mechanism to eject the implant. Further example embodiments push the implant using long push rods which run the length of the catheter. The ejection modality is computer-controlled.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Rheumatology (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
PCT/US2011/021952 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method Ceased WO2011091189A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CA2825186A CA2825186A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method
JP2012550131A JP5981349B2 (ja) 2010-01-20 2011-01-20 組織修復用インプラント及び投入デバイス及び方法
EP11735207.0A EP2525722A4 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US29686810P 2010-01-20 2010-01-20
US61/296,868 2010-01-20

Publications (1)

Publication Number Publication Date
WO2011091189A1 true WO2011091189A1 (en) 2011-07-28

Family

ID=44278090

Family Applications (4)

Application Number Title Priority Date Filing Date
PCT/US2011/021947 Ceased WO2011091185A1 (en) 2010-01-20 2011-01-20 Tissue closure device and method
PCT/US2011/021949 Ceased WO2011091186A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method
PCT/US2011/021946 Ceased WO2011091184A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method
PCT/US2011/021952 Ceased WO2011091189A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method

Family Applications Before (3)

Application Number Title Priority Date Filing Date
PCT/US2011/021947 Ceased WO2011091185A1 (en) 2010-01-20 2011-01-20 Tissue closure device and method
PCT/US2011/021949 Ceased WO2011091186A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method
PCT/US2011/021946 Ceased WO2011091184A1 (en) 2010-01-20 2011-01-20 Tissue repair implant and delivery device and method

Country Status (5)

Country Link
US (6) US9050065B2 (enExample)
EP (5) EP2525722A4 (enExample)
JP (7) JP5981348B2 (enExample)
CA (4) CA2825184A1 (enExample)
WO (4) WO2011091185A1 (enExample)

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EP2525721A1 (en) 2012-11-28
US20130211450A1 (en) 2013-08-15
EP2525722A4 (en) 2017-12-27
EP2525722A1 (en) 2012-11-28
JP2013517107A (ja) 2013-05-16
US20110178535A1 (en) 2011-07-21
WO2011091185A1 (en) 2011-07-28
JP5981348B2 (ja) 2016-08-31
US20130211426A1 (en) 2013-08-15
JP2019093216A (ja) 2019-06-20
CA2825186A1 (en) 2011-07-28
US20110178534A1 (en) 2011-07-21
US9050065B2 (en) 2015-06-09
EP2525721A4 (en) 2017-09-13
EP2525723A4 (en) 2013-07-17
US9427220B2 (en) 2016-08-30
JP2016182514A (ja) 2016-10-20
US9138211B2 (en) 2015-09-22

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