US20150080917A1 - Knot pusher and suture cutter instrument - Google Patents
Knot pusher and suture cutter instrument Download PDFInfo
- Publication number
- US20150080917A1 US20150080917A1 US14/550,425 US201414550425A US2015080917A1 US 20150080917 A1 US20150080917 A1 US 20150080917A1 US 201414550425 A US201414550425 A US 201414550425A US 2015080917 A1 US2015080917 A1 US 2015080917A1
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- Prior art keywords
- suture
- knot
- inner member
- opening
- outer tube
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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
- A61B17/0469—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
- A61B17/0467—Instruments for cutting 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
- A61B2017/0474—Knot pushers
Definitions
- the present invention relates to methods of arthroscopic surgery and, more specifically, to an improved knot pusher/suture cutter instrument used for manipulating suture during methods of tissue repair.
- Tissue repair typically requires the surgeon to pass suture material through selected tissue, form a plurality of surgical knots extracorporeally and then move the knots into position adjacent the desired tissue to be sutured. In such procedures, the surgeon must tie the knots on the suture strands after the suture is threaded through the selected tissues to be sutured, and then cut the remaining suture strands from the surgical site.
- High strength suture materials such as FiberWire®, for example, are difficult to cut mainly because of their increased strength.
- An improved surgical instrument that acts both as a knot pusher instrument (forcing the knots down into the proper position) and as a suture cutter (cutting the ends of suture) is needed.
- the present invention provides a combination knot pusher/suture cutter device for manipulating a knotted suture to properly locate the knot relative to the tissue being sutured, and then for removing excess suture from the knot.
- the combination knot pusher/suture cutter device of the present invention comprises a body member including a handle and an inner member (or inner rod) having a knot-engageable section at the opposite end (distal end) for engaging and moving the knotted suture by manipulation of the handle.
- the knot-engageable section of the inner member comprises a slot at its distal end which allows suture to be threaded through it.
- the inner member is provided within an outer sleeve that is designed to be actuated by a spring and a thumb pusher (trigger) located on a surface of the handle. By actuating the thumb trigger (for example, by sliding forward the thumb trigger), the outer sleeve is advanced and the suture post is cut.
- FIG. 1 illustrates a perspective view of a combined knot pusher/suture cutter assembly according to an embodiment of the present invention
- FIG. 2 illustrates another perspective view of the combined knot pusher/suture cutter assembly of FIG. 1 ;
- FIG. 3 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly of FIG. 1 ;
- FIG. 4 illustrates a side view of the combined knot pusher/suture cutter assembly of FIG. 1 ;
- FIG. 5 illustrates another side view (rotated 90 degrees) of the combined knot pusher/suture cutter assembly of FIG. 1 (with suture threader attached);
- FIG. 6 illustrates a top view of the combined knot pusher/suture cutter assembly of FIG. 5 ;
- FIG. 7 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly of FIG. 1 ;
- FIG. 8 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly of FIG. 7 (in the advanced or post-cut position).
- the present invention provides a combination knot pusher/suture cutter device for manipulating a knotted suture to properly locate the knot relative to the tissue being sutured, and then for removing excess suture from the knot.
- the combined knot pusher/suture cutter assembly of the present invention comprises a body member including a handle and an inner member (or inner rod) having a knot-engageable section at the opposite end (distal end) for engaging and moving the knotted suture by manipulation of the handle.
- the knot-engageable section of the inner member comprises a slot at its distal end which allows suture to be threaded through it.
- the inner member is provided within an outer sleeve that is designed to be actuated by a spring and a thumb pusher (trigger) located on a surface of the handle. By actuating the thumb trigger (for example, by sliding forward the thumb trigger), the outer sleeve is advanced and the suture post is cut.
- FIGS. 1-8 illustrate a combined knot pusher/suture cutter assembly 100 of the present invention.
- the combined knot pusher/suture cutter assembly 100 comprises a handle 1 , an inner rod or inner tube 2 disposed within an outer tube 5 , a thumb pusher (trigger) 3 in communication with a spring 4 , and a suture threader 6 that is configured to securely engage the outer tube 5 .
- a knot-engageable/suture cutter section 10 is provided at most distal end of the knot pusher/suture cutter assembly 100 as shown, for example, in FIG. 7 .
- inner rod 2 is provided at its most distal end with knot-engageable/suture cutter section 10 that includes a slot 20 which is designed to allow suture to be threaded through it.
- Slot 20 is in communication with opening 22 ( FIG. 7 ) located at a most distal end 21 of inner rod 2 .
- Knot-engageable/suture cutter section 10 also a cutting edge 59 ( FIG. 7 ) for cutting suture passing through the slot 20 .
- a method of assembling the combined knot pusher/suture cutter assembly 100 begins by orienting the slot of suture threader 6 ( FIG. 3 ) with the slot of the handle (both slots facing up and forming an angle of about 90 degrees), as shown in FIG. 6 .
- the inner rod 2 is sled into the handle 1 with thumb pusher 3 and spring 4 aligned in handle slot. Once alignment is achieved, the inner rod 2 is pressed into handle 1 until bottomed out. Although suture threader 6 may be positioned at about 90 degrees, this position is not necessary.
- Outer tube 5 is then slid onto inner rod 2 and pressed into the thumb pusher. When the outer tube 5 is advanced over inner rod 2 , the thumb pusher should move easily.
- a flexible strand such as a suture strand (for example, a high strength suture such as FiberWire®) is threaded from the suture threader 6 into the slot 20 of the inner rod 2 so that the suture exits the hole with about 0.5 in stickout.
- the suture threader 6 may then be securely attached to the shaft of the outer tube 5 , by snapping the threader to the tube, for example.
- the surgeon first threads the suture post through the opening 22 at the distal tip using the suture threader attached to the outer tube, so that it exits out through the slot 20 before the outer sleeve 5 .
- the surgeon then will hold tension on the post, with one hand, and advance the device 100 forward (with the other hand) to slide the knot down until the suture construct is tightly secured.
- the surgeon will slide the thumb trigger 3 forward to advance the outer sleeve 5 and cut the suture.
- Spring 4 within the handle 1 is designed to return the thumb trigger 3 back to the original position, which (in turn) allows the outer sleeve 5 to move back as well.
- the combined knot pusher/suture cutter assembly 100 of the present invention is designed to act both as a knot pusher instrument (forcing the knots down into the proper position) and as a suture cutter (cutting the ends of suture).
- the instrument 100 of the present invention is also designed to cut suture clean and without difficulty, regardless of the strength of the suture material.
- a special application of the instrument 100 of the present invention is for cutting FiberWire® cleanly and without difficulty. Because of its strength, FiberWire® cannot be cleanly cut by scissoring or clipping (pinching). By sliding the Fiberwire® along a sharp edge, in a relatively short distance, it can be cut cleanly.
- the FiberWire® is forced to slide along a sharp edge, thus being cut cleanly.
- the combined knot pusher/suture cutter assembly 100 of the present invention has also particular application to advancing knots and cutting suture during methods of tissue repair employing cinch stitching.
- the instrument 100 of the present invention may be employed to push knots and/or cut suture posts once the suture implant constructs have been deployed within the meniscal tissue to be repaired (by using a plurality of first and second trocars carrying the implants on their external surfaces, for example).
- the present invention also provides methods for meniscal repair by cinch stitching.
- the method comprises the steps of (i) providing a meniscal cinch assembly comprising first and second trocars, a depth stop adapted to securely engage one of the trocars, and a suture implant construct having first and second implants loaded on the external surface of the first and second trocars; (ii) passing at least one of the first and second implants through tissue to be repaired (for example, the meniscal tissue); and (iii) pushing knots and/or cutting suture material attached to the first and second implants with the combined knot pusher/suture cutter assembly 100 of the present invention.
- the combined knot pusher/suture cutter assembly 100 described above may be also employed in additional surgical applications that require knot formation and suture cutting, for example, in shoulder applications where the device may be employed as both a knot pusher and a suture cutter.
- the term “high strength suture” is defined as any elongated flexible member, the choice of material and size being dependent upon the particular application.
- the term “suture” as used herein may be a cable, filament, thread, wire, or any other flexible member suitable for tissue fixation in the body.
- the suture comprises a high strength suture sold by Arthrex, Inc. under the tradename FiberWire®.
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- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
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Abstract
A combined knot pusher/suture cutter device for manipulating a knotted suture to properly locate the knot relative to the tissue being sutured, and then for removing excess suture from the knot. The knot pusher/suture cutter includes a body member with a handle and an inner member (or inner rod) having a knot-engageable section at the opposite end (distal end) for engaging and moving the knotted suture by manipulation of the handle. The knot-engageable section of the inner member is provided with a slot at its distal end which allows suture to be threaded through it. The inner member is provided within an outer sleeve that is designed to be actuated by a spring and a thumb pusher (trigger) located on a surface of the handle. By actuating the thumb trigger (for example, by sliding forward the thumb trigger), the outer sleeve is advanced and the suture post is cut.
Description
- This is a divisional of U.S. application Ser. No. 12/397,213, filed Mar. 3, 2009, which claims the benefit of U.S. Provisional Application No. 61/033,653, filed Mar. 4, 2008, the entire disclosures of which are incorporated by reference herein.
- The present invention relates to methods of arthroscopic surgery and, more specifically, to an improved knot pusher/suture cutter instrument used for manipulating suture during methods of tissue repair.
- Tissue repair typically requires the surgeon to pass suture material through selected tissue, form a plurality of surgical knots extracorporeally and then move the knots into position adjacent the desired tissue to be sutured. In such procedures, the surgeon must tie the knots on the suture strands after the suture is threaded through the selected tissues to be sutured, and then cut the remaining suture strands from the surgical site. High strength suture materials, such as FiberWire®, for example, are difficult to cut mainly because of their increased strength.
- An improved surgical instrument that acts both as a knot pusher instrument (forcing the knots down into the proper position) and as a suture cutter (cutting the ends of suture) is needed. An instrument that cuts suture clean and without difficulty, regardless of the strength of the suture material, is also needed.
- The present invention provides a combination knot pusher/suture cutter device for manipulating a knotted suture to properly locate the knot relative to the tissue being sutured, and then for removing excess suture from the knot.
- The combination knot pusher/suture cutter device of the present invention comprises a body member including a handle and an inner member (or inner rod) having a knot-engageable section at the opposite end (distal end) for engaging and moving the knotted suture by manipulation of the handle. The knot-engageable section of the inner member comprises a slot at its distal end which allows suture to be threaded through it. The inner member is provided within an outer sleeve that is designed to be actuated by a spring and a thumb pusher (trigger) located on a surface of the handle. By actuating the thumb trigger (for example, by sliding forward the thumb trigger), the outer sleeve is advanced and the suture post is cut.
- Other features and advantages of the present invention will become apparent from the following description of the invention, which refers to the accompanying drawings.
-
FIG. 1 illustrates a perspective view of a combined knot pusher/suture cutter assembly according to an embodiment of the present invention; -
FIG. 2 illustrates another perspective view of the combined knot pusher/suture cutter assembly ofFIG. 1 ; -
FIG. 3 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly ofFIG. 1 ; -
FIG. 4 illustrates a side view of the combined knot pusher/suture cutter assembly ofFIG. 1 ; -
FIG. 5 illustrates another side view (rotated 90 degrees) of the combined knot pusher/suture cutter assembly ofFIG. 1 (with suture threader attached); -
FIG. 6 illustrates a top view of the combined knot pusher/suture cutter assembly ofFIG. 5 ; -
FIG. 7 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly ofFIG. 1 ; and -
FIG. 8 illustrates an expanded view of the distal end of the combined knot pusher/suture cutter assembly ofFIG. 7 (in the advanced or post-cut position). - In the following detailed description, reference is made to various specific embodiments in which the invention may be practiced. These embodiments are described with sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that other embodiments may be employed, and that structural and logical changes may be made without departing from the spirit or scope of the present invention.
- The present invention provides a combination knot pusher/suture cutter device for manipulating a knotted suture to properly locate the knot relative to the tissue being sutured, and then for removing excess suture from the knot. The combined knot pusher/suture cutter assembly of the present invention comprises a body member including a handle and an inner member (or inner rod) having a knot-engageable section at the opposite end (distal end) for engaging and moving the knotted suture by manipulation of the handle. The knot-engageable section of the inner member comprises a slot at its distal end which allows suture to be threaded through it. The inner member is provided within an outer sleeve that is designed to be actuated by a spring and a thumb pusher (trigger) located on a surface of the handle. By actuating the thumb trigger (for example, by sliding forward the thumb trigger), the outer sleeve is advanced and the suture post is cut.
- Referring now to the drawings, where like elements are designated by like reference numerals,
FIGS. 1-8 illustrate a combined knot pusher/suture cutter assembly 100 of the present invention. As shown in the drawings, the combined knot pusher/suture cutter assembly 100 comprises ahandle 1, an inner rod orinner tube 2 disposed within anouter tube 5, a thumb pusher (trigger) 3 in communication with aspring 4, and asuture threader 6 that is configured to securely engage theouter tube 5. A knot-engageable/suture cutter section 10 is provided at most distal end of the knot pusher/suture cutter assembly 100 as shown, for example, inFIG. 7 . - As more clearly illustrated in
FIG. 7 ,inner rod 2 is provided at its most distal end with knot-engageable/suture cutter section 10 that includes aslot 20 which is designed to allow suture to be threaded through it.Slot 20 is in communication with opening 22 (FIG. 7 ) located at a mostdistal end 21 ofinner rod 2. Knot-engageable/suture cutter section 10 also a cutting edge 59 (FIG. 7 ) for cutting suture passing through theslot 20. - Referring now to
FIGS. 3-6 , a method of assembling the combined knot pusher/suture cutter assembly 100 begins by orienting the slot of suture threader 6 (FIG. 3 ) with the slot of the handle (both slots facing up and forming an angle of about 90 degrees), as shown inFIG. 6 . Theinner rod 2 is sled into thehandle 1 withthumb pusher 3 andspring 4 aligned in handle slot. Once alignment is achieved, theinner rod 2 is pressed intohandle 1 until bottomed out. Althoughsuture threader 6 may be positioned at about 90 degrees, this position is not necessary.Outer tube 5 is then slid ontoinner rod 2 and pressed into the thumb pusher. When theouter tube 5 is advanced overinner rod 2, the thumb pusher should move easily. - A flexible strand such as a suture strand (for example, a high strength suture such as FiberWire®) is threaded from the
suture threader 6 into theslot 20 of theinner rod 2 so that the suture exits the hole with about 0.5 in stickout. Thesuture threader 6 may then be securely attached to the shaft of theouter tube 5, by snapping the threader to the tube, for example. - In use, the surgeon first threads the suture post through the opening 22 at the distal tip using the suture threader attached to the outer tube, so that it exits out through the
slot 20 before theouter sleeve 5. The surgeon then will hold tension on the post, with one hand, and advance thedevice 100 forward (with the other hand) to slide the knot down until the suture construct is tightly secured. Then the surgeon will slide the thumb trigger 3 forward to advance theouter sleeve 5 and cut the suture.Spring 4 within thehandle 1 is designed to return the thumb trigger 3 back to the original position, which (in turn) allows theouter sleeve 5 to move back as well. - The combined knot pusher/
suture cutter assembly 100 of the present invention is designed to act both as a knot pusher instrument (forcing the knots down into the proper position) and as a suture cutter (cutting the ends of suture). Theinstrument 100 of the present invention is also designed to cut suture clean and without difficulty, regardless of the strength of the suture material. A special application of theinstrument 100 of the present invention is for cutting FiberWire® cleanly and without difficulty. Because of its strength, FiberWire® cannot be cleanly cut by scissoring or clipping (pinching). By sliding the Fiberwire® along a sharp edge, in a relatively short distance, it can be cut cleanly. With the knot pusher/suture cutter assembly 100 of the present invention, because theslot 20 on theinner shaft 2 is at an angle to theouter sleeve 5 and the longitudinal axis of the shaft, the FiberWire® is forced to slide along a sharp edge, thus being cut cleanly. - The combined knot pusher/
suture cutter assembly 100 of the present invention has also particular application to advancing knots and cutting suture during methods of tissue repair employing cinch stitching. In this particular application, theinstrument 100 of the present invention may be employed to push knots and/or cut suture posts once the suture implant constructs have been deployed within the meniscal tissue to be repaired (by using a plurality of first and second trocars carrying the implants on their external surfaces, for example). - The present invention also provides methods for meniscal repair by cinch stitching. According to an exemplary embodiment, the method comprises the steps of (i) providing a meniscal cinch assembly comprising first and second trocars, a depth stop adapted to securely engage one of the trocars, and a suture implant construct having first and second implants loaded on the external surface of the first and second trocars; (ii) passing at least one of the first and second implants through tissue to be repaired (for example, the meniscal tissue); and (iii) pushing knots and/or cutting suture material attached to the first and second implants with the combined knot pusher/
suture cutter assembly 100 of the present invention. - The combined knot pusher/
suture cutter assembly 100 described above may be also employed in additional surgical applications that require knot formation and suture cutting, for example, in shoulder applications where the device may be employed as both a knot pusher and a suture cutter. - For the purposes of the present invention, the term “high strength suture” is defined as any elongated flexible member, the choice of material and size being dependent upon the particular application. For the purposes of illustration and without limitation, the term “suture” as used herein may be a cable, filament, thread, wire, or any other flexible member suitable for tissue fixation in the body. In a preferred embodiment of the invention, and as described above, the suture comprises a high strength suture sold by Arthrex, Inc. under the tradename FiberWire®.
- Although the present invention has been described in connection with preferred embodiments, many modifications and variations will become apparent to those skilled in the art. While preferred embodiments of the invention have been described and illustrated above, it should be understood that these are exemplary of the invention and are not to be considered as limiting. Accordingly, it is not intended that the present invention be limited to the illustrated embodiments, but only by the appended claims.
Claims (7)
1. A hand instrument, comprising:
a shaft comprising an inner member disposed coaxially within an outer tube;
a cutting section located at a distal end of the inner member, the cutting section being provided with an opening for passing suture therethrough and with a sharp cutting edge for cutting the suture, the opening being in communication with an axial opening located at a most distal end of the inner member, the opening on the inner member forming an angle relative to the outer tube and to a longitudinal axis of the knot pusher/suture cutter instrument to allow cutting of the suture, by forcing the suture to slide along the sharp cutting edge of the opening; and
an actuator assembly, located at the proximal end of the shaft and coupled with the outer tube, for advancing the outer tube relative to the inner member, forcing the suture to slide along the sharp cutting edge of the opening of the inner member, to cut the suture with the sharp cutting edge of the opening.
2. The hand instrument of claim 1 , wherein the outer tube has a distal end for pushing a knot of the flexible strand.
3. The hand instrument of claim 1 , wherein the actuator assembly is a handle assembly.
4. The hand instrument of claim 3 , wherein the handle assembly comprises a thumb pusher.
5. The hand instrument of claim 1 , wherein the actuator assembly moves the outer tube relative to the inner member a predetermined amount.
6. The hand instrument of claim 5 , wherein the movement of the outer member of further causes the flexible strand to be cut by the cutting section.
7. The hand instrument of claim 1 , wherein the suture is a high strength suture comprising ultrahigh molecular weight polyethylene.
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US14/550,425 US20150080917A1 (en) | 2008-03-04 | 2014-11-21 | Knot pusher and suture cutter instrument |
Applications Claiming Priority (3)
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US3365308P | 2008-03-04 | 2008-03-04 | |
US12/397,213 US8911457B2 (en) | 2008-03-04 | 2009-03-03 | Method of using knot pusher and suture cutter instrument |
US14/550,425 US20150080917A1 (en) | 2008-03-04 | 2014-11-21 | Knot pusher and suture cutter instrument |
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US12/397,213 Division US8911457B2 (en) | 2008-03-04 | 2009-03-03 | Method of using knot pusher and suture cutter instrument |
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US20150080917A1 true US20150080917A1 (en) | 2015-03-19 |
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US12/397,213 Active 2032-02-07 US8911457B2 (en) | 2008-03-04 | 2009-03-03 | Method of using knot pusher and suture cutter instrument |
US14/550,425 Abandoned US20150080917A1 (en) | 2008-03-04 | 2014-11-21 | Knot pusher and suture cutter instrument |
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US12/397,213 Active 2032-02-07 US8911457B2 (en) | 2008-03-04 | 2009-03-03 | Method of using knot pusher and suture cutter instrument |
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- 2009-03-03 EP EP09154208A patent/EP2098171A1/en not_active Withdrawn
- 2009-03-03 US US12/397,213 patent/US8911457B2/en active Active
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2014
- 2014-11-21 US US14/550,425 patent/US20150080917A1/en not_active Abandoned
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US20030109891A1 (en) * | 2001-12-07 | 2003-06-12 | Mike Dana | Snared suture trimmer |
US20040162569A1 (en) * | 2003-02-19 | 2004-08-19 | George Sikora | Transmitting an actuating force along a curved instrument |
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WO2017070312A1 (en) * | 2015-10-23 | 2017-04-27 | Medeon Biodesign, Inc. | System and method for suture knot forming |
JP2018534106A (en) * | 2015-10-23 | 2018-11-22 | メデオン・バイオデザイン・インコーポレイテッドMedeon Biodesign, Inc. | System and method for suture knot formation |
CN109069143A (en) * | 2015-10-23 | 2018-12-21 | 特鲁莫医疗公司 | The system and method formed for suture knot |
EP3405119A4 (en) * | 2015-10-23 | 2019-07-03 | Terumo Medical Corporation | System and method for suture knot forming |
RU2745134C2 (en) * | 2015-10-23 | 2021-03-22 | Терумо Медикал Корпорейшн | System and method for forming suture thread units |
US10959720B2 (en) | 2015-10-23 | 2021-03-30 | Terumo Medical Corporation | System and method for suture knot forming |
IL258820B (en) * | 2015-10-23 | 2022-10-01 | Medeon Biodesign Inc | System and method for suture knot forming |
IL258820B2 (en) * | 2015-10-23 | 2023-02-01 | Medeon Biodesign Inc | System and method for suture knot forming |
Also Published As
Publication number | Publication date |
---|---|
EP2098171A1 (en) | 2009-09-09 |
US20090228026A1 (en) | 2009-09-10 |
US8911457B2 (en) | 2014-12-16 |
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Legal Events
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STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |