|Número de publicación||US3802438 A|
|Tipo de publicación||Concesión|
|Fecha de publicación||9 Abr 1974|
|Fecha de presentación||31 Mar 1972|
|Fecha de prioridad||31 Mar 1972|
|También publicado como||DE2313871A1|
|Número de publicación||US 3802438 A, US 3802438A, US-A-3802438, US3802438 A, US3802438A|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (13), Citada por (200), Clasificaciones (13)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
United States Patent 1191 Wolvek 1451 Apr. 9, 1974 SURGICAL INSTRUMENT  Inventor: Sidney Wolvek, Brooklyn, NY.
 Assignee: Technibiotics, Inc., Brooklyn, NY.
 Filed: Mar. 31, 1972  Appl. No.: 240,185
 US. Cl. 128/335  Int. Cl A611 17/00  Field of Search 128/334, 335, 335.5, 339. 128/303 R, 20, 345, 121, 124, 334 C, 346.
92 R, 92 B, 92 D; 254/66; 140/934, 93.2;
Primary ExaminerRichard A. Gaudet Assistant Examiner1-lenry J. Recla Attorney, Agent, or FirmDarby & Darby 5 7 ABSTRACT Method and apparatus for closing an incision in the body of a patient including forming a suture by passing a loop of wire through opposite sides of the incision and inserting the end portions of the wire into and through bores formed in a splice plate comprising a substantially rectangular member having a pair of parallel bores formed longitudinally therethrough. The end portions of the wire are then inserted into an in-  R f s Cit d strument for applying a controlled tension to said wire UNITED STATES PATENTS comprising a pair of parallely spaced legs having 3 015 685 l 1962 G l h l 174 90 mechanisms for fixedly holding each respective wire 3477436 1969 g et a 5 end portion therein. A rack and pinion arrangement is 2359O83 9/1944 81/41"? activated to increase the distance between the legs 11/1946 jjji 81/418 thereby tensioning the wire at a controlled rate. When 3,541,591 11/1970 Hoegermanm 128/335 sufficient closure of the incision is attained, the splice 538,451 4/1895 Bauve 254/66 plate is crimped thereby splicing the wires therein. 1,481,414 l/1924 Cary 24/23 W The end ortions of the wire extendin be ond the P g y 1,6 5, 5 1928 Llebo ltz 339/276 R splice plate are cut flush with an edge surface of the 3,581,551 6/1971 wllkmso" 128/325 splice plate thereby forming a safe suture. An alter- 2,327,683 8/1943 Warner et a1. 24/123 W "ate embodiment i d having the length of Suture FOREIGN PATENTS OR APPLlCATlONS wire prethreaded on the splice plate prior to the oper- 204,25s 11/1956 Australia 140/1235 anon- 2,0l3,707 4/1970 France 128/335 494,960 9 1919 France 128/335 10 Clam, 9 Draw'ng F'gures SURGICAL INSTRUMENT BACKGROUND OF THE INVENTION This invention relates to a method and apparatus for use during surgical operations, and more particularly to a method and apparatus for closing incisions made in certain bones during surgery in the chest and other regions.
In the course of surgery in and around the chest cavity area, and more particularly during heart surgery, an incision is commonly made in the sternum, or breast bone, in order to gain access to that portion of the body which is being operated upon. Of course, subsequent to the completion of the operation the incision must be closed.
In one method used in the past to accomplish this closure, the sternum is punctured to form an opening 'on one side of the incision with a chisel-ended circular needle, a thin wire brought down and through this opening and then brought up through a similarly formed opening in the sternum on the other side of the incision. The portions of the wire extending outwardly from the sternum are then manually pulled together to achieve a tight closure of the incision. In this method the wires are pulled together using a hemostat or needle holder and when the incision is deemed by the physician to have beenclosed sufficiently the wire ends are spliced by twisting them together. The twisted end is cut leaving five to seven twists at the closure.
Many difficulties have arisen in the use of the prior art method described hereinabove. The uncontrolled physical pulling on the wire by the physician to obtain sufficient closure of the incision, has often resulted in one or more of the wires snapping. Too much tension applied to the wires may also cause the sternum to be cut involving serious injury to the patient. Further, the hemostat may slip from the wire with a consequent risk of damage to both the equipment and the patient. In addition, at the inception of the wire splicing operation, the twisting of the wire changes the loading on the suture from a linear (tension) loading to a shear loading. This reduces the holding power of the wire. Also, the resulting six or seven twists which remain in the body may either irritate the .periosteum of the sternum or pierce the skin, only a small layer of which is present over the sternum in this area, in many cases. The twisted portions of the wire may also provide an infection path should the loose end pass through the skin.
SUMMARY OF THE INVENTION Accordingly, an object of this invention is to provide a new and improved apparatus for assisting in the closure of incisions made in bones during surgery.
Another object is the provision of a new and improved incision closing instrument which controls the amount of tension placed on the wires during the closing of the incision.
Still another object is to provide a new and improved incision closing instrument which will safely grasp the wire used for closing the incision.
A further object is to provide a new and improved wound closing instrument which maintains the suture in tension at all times.
A still further object of this invention'is the provision of a wound closing instrument which assures the absence of any surplus wire which might irritate the anatomical region about the chest cavity or pierce the surrounding skin and to provide a closure which is more acceptable from a cosmetic point of view.
In accordance with a preferred embodiment of this invention, these and other objects are achieved by providing an instrument removably connectable to wire end portions which have been passed through openings formed in the sides of the bone adjacent the incision and drawing these ends in a controlled manner to apply tension to the wire. Prior to fastening the wire end portions to the instrument, the wire end portions are passed in opposite directions through a splice plate which, although confining those portions of the wire contained therein, permits movement of the wire ends through the plate. After the wire has been tensioned to a sufficient amount to close the incision, a tool having appropriately formed jaws crimps the splice plate to hold and fasten the wires contained therein. The wire end portions extending beyond the splice plate are then cut off flush with the splice plate edges. In an alternative embodiment the wire is passed through the splice plate prior to the operation.
DESCRIPTION OF THE DRAWINGS A more complete description of the invention and many of the attendant advantages thereof will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings in which:
FIG. 1 is a plan view of an instrument according to the present invention;
FIG. 2 is a side view of the instrument shown in FIG.
FIG. 3 is an end view of the splice plate greatly exaggerated in size according to the present invention;
FIG. 4 is a view of the splice plate of FIG; 3 in section taken along line 44;
FIGS. 5a and 5b are a perspective view and a side view respectively showing the relative position of the incision and wire suture according to the present invention;
FIGS. 6a and 6b are a front elevational view and a plan view respectively of a crimping tool according to the present invention; and
FIG. 7 is a plan view of an alternate arrangement of the splice plate and suture according to the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to the drawings wherein like reference characters designate identical or corresponding parts throughout the several views, and more particularly to FIGS. 1 and 2 thereof, a wound or incision closing instrument 10 is shown as including a substantially L- shaped member 12 coupled in a manner described below to an angularly shaped member 14 so that the two can move relative to each other. L-shaped member 12 is formed with a first leg 16 integral with and at right angles to a second longer leg 18. Leg 16 has a recessed surface 20 formed in its free end which extends a limited distance and terminates in a knurled vertical wall 22. A knurled wheel 24 is mounted off center about a pivot 26 so that the wheel 24 acts as a cam upon rotation by grasping and turning a spoke 24a and defines a passage 25 in cooperation with wheel 24 which is closable upon rotation of the wheel.
The second, longer leg 18 of member 12 has a straight gear or rack 28 fastened by conventional fasteners 29 within an insert 31 formed therein which extends along a substantial portion of the leg. It should be understood that the rack 28 may also be formed integrally with member 12.
The angular shaped member 14 includes a body portion 30 and a leg 32 formed in a generally L-shaped relationship. The body portion 30 is formed with a channel 34 having a rectangular cross section through which the rack 28 can pass. A pinion gear 36 (shown in phantom in FIG. 1) is pivotally mounted to body portion 30 sufficiently close to channel 34 such that a portion thereof extends therewithin and the teeth of pinion 36 mesh with the teeth of the rack 28. A spoked wheel 44 is connected to gear 36 to provide a means for turning the gear. The spokes are used to permit rotation of gear 36 by one or two fingers of the hand. This makes it easier to use the instrument during surgery. As should be apparent, rotation of the pinion gear 36 by turning the spoke wheel 44 will move member 14 relative to member 12.
A rotatable detent wheel 46 is threadedly mounted in body portion 30 of member 14 adjacent channel 34. The detent wheel 46 includes a lock washer (not shown) positioned directly beneath the wheel and extending over a portion of leg 18 of L-shaped member 12. Rotation of wheel 46 downwardly into body portion 30 will cause the lock washer to bear against the upper surface of leg 18 thereby fixing the position of L-shaped member 12 with respect to angular shaped member 14.
Leg 32 of member 14 has a recessed surface 38 formed in the free end portion thereof and, in a manner like recessed surface in leg 16, is terminated by a vertical knurled wall 40. A knurled wheel 42 is mounted off center about a pivot 41, in a manner similar to wheel 24, so that the wheel can act as a cam, upon rotation by grasping and rotating attached spoke 42a. A second closable passage 43 is defined between the wheel 42 and the wall 40.
Referring more particularly to FIG. 1 and FIG. 2, upon assembly of the instrument 10, it is seen that the passages and 43 are substantially colinear. Further, the lower faces 48 and 50 of the L-shaped member 12 and the angular shaped member 14 respectively do not have any protrusions extending therefrom and are substantially flat. This enables the physician to lay the instrument on the chest cavity of the patient during an operation withoutdanger of causing injury by puncturing or lacerating the body tissue in contact with the instrument. It is to be understood that the two passages may be formed in a manner other than as specifically shown. For example, threaded bores may be formed in the ends of legs 16 and 32 or the closable passages may be formed on a surface laterally extending from each leg.
FIGS. 3 and 4 show one embodiment of a splice plate 52 for use with the present invention, greatly exaggerated in size. Splice plate 52 is a three dimensional body having a rectangular shape and is formed of a suitable biologically acceptable material, such for example, as stainless steel. A pair of bores 56 and 58 are parallely formed adjacent to each other through the long dimension of plate 52. Typical dimensions of splice plate 52 include about 5 millimeters in the long dimension, about 4 millimeters in width and about 2.5 millimeters in thickness (FIG. 3). The diameter of bores 56 and 58 are such that the suture wires used to close the incision or wound can slide through the bores and is typically about 0.94 millimeters. It is to be understood that although the splice plate is shown as substantially rectangular, other shapes may be utilized having dimensions of the same order as those described above.
The operation of the instrument can be ascertained by referring to FIG. 5. The sternum 60 of a patient is shown having an incision 62 formed therein with the periosteum 61 overlying the sternum. As shown in FIG. 5b, a stainless steel wire suture 64 is passed through holes formed on either side of the incision in the sternum, the holes having been previously opened by any suitable instrument. The end portions 64a, 64b of the sture 64 are then directed through bores 56 and 58 in splice plate 52 in opposite directions by the doctor closing the incision.
The doctor next takes the instrument and places the end portions 64a, 64b of suture 64 within passage 25 and the other within passage 43 in the respective legs 16 and 32 of the instrument 10. The instrument can be laid flat on the patients chest at this time. The wheels 24 and 42 are then rotated by spokes 24a and 42a. The camming action of the wheels 24 and 42 grab the respective wire end portions 64a, 64!) between walls 22 and 40 and the respective knurled wheels 24 and 42. The use of the camming action and the spokes on wheels 24 and 42 in combination with the open passages 25 and 43 is advantageous since it is relatively easy to lay the end of the suture in the passages between the wheel and its corresponding knurled wall rather than to thread the suture through a hole, an operation which would become even more difficult when working with a bloody suture wire. Further, the cam arrangement universalizes the instrument for all diameters of suture wire. Also the use of the spokes on the wheels 24, 42 permits easy turning of the latter to provide an arrangement for quickly fastening the ends of the suture to the instrument.
With the detent wheel 46 in a loose position, spoked wheel 44 is rotated by the doctor in the appropriate direction to cause angular shaped member 14 to move away from leg 16. This action causes the loop of wire 64 to tighten. This tightening action is continued thereby drawing together the sides of the sternum adjacent the incision. During or just prior to the inception of the incision closing procedure, the splice plate 52 may be grasped between the jaws 68 of a crimping tool 66 and held therebetween as the sides of the sternum are drawn together. The crimping tool 66 may be a conventional compound pliars tool having identical opposed jaws 68. Each jaw 68 may be formed having a substantially horizontally disposed inwardly projecting surface 69 integrally formed with a bevelled, substantially vertical projection 70 recessed from the inner edge thereof. The surfaces 69 form a platform for the splice plate 52 as it is grasped during the wound closing procedure. The maximum separation of the jaws 68 is preferably fixed so that the space 71 between the projecting surfaces is smaller than the width dimension of the splice plate thereby assuring that the splice plate will not pass therebetween into the non-functional portion of the jaws but rather will be positioned between the bevelled projections 70. As the sternum is drawn together, the handles 72 of crimping tool 66 are squeezed gently so. that the projections 70, although bearing against the sides of the splice plate, will not deform it. After the sternum is closed, the handles 72 are squeezed together tightly thereby causing the bevelled projections to move into and deform the splice plate. The inwardly projecting surfaces 71 serve as a movement limiting device by mutually abutting upon sufficient inward movement. Thus, the amount of deformation is limited by the distance that surfaces 69 extend inwardly. The maximum pinching 74 (FIG. 5a) on each side of the splice plate is preferably about 0.5 mil limeters. Finally, the excess of the wire suture ends 64a, 64b extending through splice plate 52 is sheared off flush with the edge surface of the plate. Thus, no rough edges are left which might injure the patient. This process is repeated between four to six times along the incision until the wound is completely closed.
A particularly efficient arrangement of the instrument and associated apparatus includes the splice plate 52 having the length of suture wire 64 previously passed through one of the bores as shown in FIG. 7. A surgical needle 80 is provided on one end of the wire and the other end of the wire is folded back on itself for about one-eighth inch, thereby maintaining the splice plate along the length of wire. The surgery proceeds much the same as described above. However, several advantages are attained using the alternate configuration of pre-wired splice plate. Openings on either side of the incision need not be previously formed since the surgical needle may be used to do so as the suture is formed. Since the plate has become an intergral part of the easily manipulated suture wire, the difficulty in handling the small splice plate is greatly reduced. One of the in-surgery splice plate hole-finding operations is eliminated for the surgeon since the splice plate is strung onto the suture wire prior to the operation. Further, there is no longer any need to spend time identifying the plate hole size (and therefore wire size) since the plate is now predisposed on the matching suture wire size,
An alternative arrangement of the apparatus includes providing individual splice plates apart from the suture wires and performing the threading procedure during the operation. To provide a measure of caution against inadvertently dropping splice plate 52 into the chest cavity, a thin thread or wire 76 (FIG. 4), for example of silk or other inert material, is attached to the splice plate at a bore 60, formed at one end of plate 52 transverse to bores 56,58. Thus, if the splice plate were dropped during the operation, location of the plate and its retrieval are quick and easy. The attached thread may also be used to preliminarily tag" the splice plate indicating the size wire which may be used in the suture.
In cases where splice plate 52 was made extremely small, the crimping operation was found to be difficult due to the fact that the splice plate tended to fall into a notch 78 (FIG. 5A) left in the periosteum after the incision. For this reason, a minimum length of about 4 millimeters was found to be optimum for the long dimension of the splice plate. Of course, it is preferable for the splice plate to be as small as possible and a long dimension of not more than about 8 millimeters is desirable.
Thus, the surgical instrument described above provides for a controlled tensioning of the suture by a precise rotation by the physician of spoked wheel 44. The flat faces 48 and 50 permit resting the instrument on the body of the patient during the operation. The use of only one hand of the doctor is necessary to operate any of the cams or gears contained in theinstrument thereby allowing the physician free use of the other hand. Further, the danger of exposed rough twisted wire splices irritating or infecting the surrounding body tissue is obviated by the use of the splice plate 52 with a subsequent removal of exposed wire end portions flush therewith.
What is claimed is:
l. A surgical splice plate for locking two end portions of surgical suture wire together comprising:
a member formed of a deformable material which is biologically acceptable to the human body having at least one passage formed therethrough receivable of said suture wire end portions, said member having a long dimension greater than 3 millimeters but does not exceed 9 millimeters,
said splice plate adapted to be implanted within the human body during the closing of an incision subsequent to a surgical operation.
2. A splice plate according to claim 1 wherein said biologically acceptable material is stainless steel.
3. A splice plate according to claim 1 wherein two passages are formed in the splice plate, each passage receivable of an end portion of the suture wire.
4. A splice plate according to claim 3 wherein said passages are generally parallel to each other.
5. A splice plate according to claim 1 wherein an elongate flexible member is attached to said splice plate at one end having means for identifying the splice plate attached to the other end.
6. A suture splicing assembly comprising:
a splice plate for locking two end portions of surgical suture wire together including a member formed of a deformable material which is biologically acceptable to the human body having a pair of substantially parallel passages formed therethrough receivable of said suture wire end portions, said member having a long dimension which does not exceed 9 millimeters, and I a length of suture wire passing through one of said passages, said wire having a surgical needle fastened thereto at one end and the other end folded upon itself, thereby maintaining said wire within said one of said bores.
7. An assembly as recited in claim 6 wherein said splice plate and said suture wire are formed of the same material.
8. An assembly as recited in claim 7 wherein said material is stainless steel.
9. A method for closing an incision in the body of a patient comprising the steps of:
forming a suture by passing a loop of a wire through openings formed in tissue of the patient on opposite sides of the incision;
inserting at least one end portion of said wire through at least one bore formed in a splice plate of deformable material;
tensioning the end portions of said wire in opposite directions in a controlled manner;
crimping said splice plate to fix the ends of the wire therein; and
cutting those portions of wire not within the formed loop flush with said splice plate.
10. A method as recited in claim 9, wherein both end portions of said wire are inserted through said at least one bore in opposite directions.
a m m
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US538451 *||18 Sep 1894||30 Abr 1895||Wire stretching and splicing tool|
|US1481414 *||9 Dic 1919||22 Ene 1924||of brooklyn|
|US1675857 *||11 Nov 1924||3 Jul 1928||Benjamin Liebowitz||Wire connecter|
|US2327683 *||4 Jun 1942||24 Ago 1943||Nat Telephone Supply Co||Wire holding device|
|US2359083 *||17 Ago 1942||26 Sep 1944||Aircraft Marine Prod Inc||Tool for making electrical connectors|
|US2411838 *||5 Feb 1944||26 Nov 1946||Aircraft Marine Prod Inc||Tool|
|US3015685 *||9 Feb 1959||2 Ene 1962||Bayerische Schrauben Und Feder||Connection of two side by side electric cables|
|US3477436 *||11 Mar 1966||11 Nov 1969||Research Corp||Method of accelerating wound healing by use of interacting metallic sutures|
|US3541591 *||26 Abr 1968||17 Nov 1970||Henry J Hoegerman||Method and apparatus for closing wounds|
|US3581551 *||22 Jul 1968||1 Jun 1971||Wilkinson Jack E||Surgical clamp apparatus|
|AU204258A *||Título no disponible|
|FR494960A *||Título no disponible|
|FR2013707A1 *||Título no disponible|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US4128100 *||8 Oct 1976||5 Dic 1978||Wendorff Erwin R||Suture|
|US4201215 *||6 Sep 1977||6 May 1980||Crossett E S||Apparatus and method for closing a severed sternum|
|US4467805 *||25 Ago 1982||28 Ago 1984||Mamoru Fukuda||Skin closure stapling device for surgical procedures|
|US4532926 *||20 Jun 1983||6 Ago 1985||Ethicon, Inc.||Two-piece tissue fastener with ratchet leg staple and sealable latching receiver|
|US4532927 *||20 Jun 1983||6 Ago 1985||Ethicon, Inc.||Two-piece tissue fastener with non-reentry bent leg staple and retaining receiver|
|US4534350 *||20 Jun 1983||13 Ago 1985||Ethicon, Inc.||Two-piece tissue fastener with compressible leg staple and retaining receiver|
|US4548202 *||20 Jun 1983||22 Oct 1985||Ethicon, Inc.||Mesh tissue fasteners|
|US4573469 *||20 Jun 1983||4 Mar 1986||Ethicon, Inc.||Two-piece tissue fastener with coinable leg staple and retaining receiver and method and instrument for applying same|
|US4627437 *||5 Jun 1985||9 Dic 1986||Ethicon, Inc.||Method of applying a fastener to tissue with a pair of hollow needles|
|US4693248 *||29 Jul 1985||15 Sep 1987||Ethicon, Inc.||Two-piece tissue fastener with deformable retaining receiver|
|US4730615 *||3 Mar 1986||15 Mar 1988||Pfizer Hospital Products Group, Inc.||Sternum closure device|
|US4750492 *||27 Feb 1985||14 Jun 1988||Richards Medical Company||Absorbable suture apparatus, method and installer|
|US4813416 *||18 Mar 1987||21 Mar 1989||The Research Foundation Of State University Of New York||Bonding assembly and method for sternum closing|
|US5078721 *||16 Jun 1989||7 Ene 1992||Mckeating John A||Device for surgical ligation|
|US5318575 *||3 Feb 1992||7 Jun 1994||United States Surgical Corporation||Method of using a surgical repair suture product|
|US5330489 *||9 Oct 1992||19 Jul 1994||United States Surgical Corporation||Sternum closure buckle|
|US5339870 *||9 Oct 1992||23 Ago 1994||United States Surgical Corporation||Sternum buckle and applier|
|US5355913 *||9 Oct 1992||18 Oct 1994||United States Surgical Corporation||Surgical repair device|
|US5356412 *||9 Oct 1992||18 Oct 1994||United States Surgical Corporation||Sternum buckle with rotational engagement and method of closure|
|US5356417 *||9 Oct 1992||18 Oct 1994||United States Surgical Corporation||Absorbable sternum closure buckle|
|US5364407 *||21 Mar 1994||15 Nov 1994||Poll Wayne L||Laparoscopic suturing system|
|US5366480 *||15 Dic 1992||22 Nov 1994||American Cyanamid Company||Synthetic elastomeric buttressing pledget|
|US5417698 *||9 Oct 1992||23 May 1995||United States Surgical Corporation||Apparatus for tightening elongated wound closure elements|
|US5423820 *||20 Jul 1993||13 Jun 1995||Danek Medical, Inc.||Surgical cable and crimp|
|US5449361 *||21 Abr 1993||12 Sep 1995||Amei Technologies Inc.||Orthopedic cable tensioner|
|US5462542 *||24 Ene 1994||31 Oct 1995||United States Surgical Corporation||Sternum buckle with serrated strap|
|US5476465 *||1 Jun 1994||19 Dic 1995||Amei Technologies Inc.||Surgical cable crimp|
|US5531763 *||7 Oct 1994||2 Jul 1996||United States Surgical Corporation||Suture cinching apparatus|
|US5540698 *||16 Sep 1993||30 Jul 1996||Amei Technologies Inc.||System and method for securing a medical cable|
|US5643295 *||25 Ene 1995||1 Jul 1997||Yoon; Inbae||Methods and apparatus for suturing tissue|
|US5665109 *||29 Dic 1994||9 Sep 1997||Yoon; Inbae||Methods and apparatus for suturing tissue|
|US5693060 *||7 Jun 1995||2 Dic 1997||Smith & Nephew, Inc.||Suture securing device and method|
|US5741281 *||7 May 1996||21 Abr 1998||Smith & Nephew, Inc.||Suture securing apparatus|
|US5879371 *||9 Ene 1997||9 Mar 1999||Elective Vascular Interventions, Inc.||Ferruled loop surgical fasteners, instruments, and methods for minimally invasive vascular and endoscopic surgery|
|US5984933 *||29 Jul 1997||16 Nov 1999||Yoon; Inbae||Apparatus for suturing tissue|
|US6030410 *||18 May 1998||29 Feb 2000||Zurbruegg; Heinz Robert||Sternal closure technique and kit for performing same|
|US6332889||3 Ago 1999||25 Dic 2001||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US6368334 *||12 Mar 1998||9 Abr 2002||Lasersurge, Inc.||Vascular hole closure|
|US6409743 *||8 Jul 1999||25 Jun 2002||Axya Medical, Inc.||Devices and methods for securing sutures and ligatures without knots|
|US6423088||30 Jun 2000||23 Jul 2002||Axya Medical, Inc.||Sharp edged device for closing wounds without knots|
|US6511489 *||19 Oct 2001||28 Ene 2003||Frederic P. Field||Surgical suturing instrument and method of use|
|US6527785||27 Mar 2001||4 Mar 2003||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US6605091||30 Jun 2000||12 Ago 2003||Pioneer Laboratories, Inc.||Surgical cable assembly and method|
|US6629975 *||20 Dic 1999||7 Oct 2003||Pioneer Laboratories, Icn.||Multiple lumen crimp|
|US6663643||19 Oct 2001||16 Dic 2003||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US6767352||19 Oct 2001||27 Jul 2004||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US6786913||1 Feb 2000||7 Sep 2004||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US6832532||8 Feb 2002||21 Dic 2004||Pioneer Laboratories||Multiple lumen crimp|
|US6926730||10 Oct 2000||9 Ago 2005||Medtronic, Inc.||Minimally invasive valve repair procedure and apparatus|
|US7011668||23 Jul 2002||14 Mar 2006||Dvl Acquistion Sub, Inc.||Surgical suturing instrument and method of use|
|US7037315||13 Sep 2002||2 May 2006||Dvl Aquisition Sub, Inc.||Surgical suturing instrument and method of use|
|US7131978||19 May 2003||7 Nov 2006||Dvl Acquisition Sub, Inc.||Surgical suturing instrument and method of use|
|US7131979||19 May 2003||7 Nov 2006||Dvl Acquisition Sub, Inc.||Surgical suturing instrument and method of use|
|US7131980||18 Ene 2002||7 Nov 2006||Dvl Acquisitions Sub, Inc.||Surgical suturing instrument and method of use|
|US7361179||22 Abr 2004||22 Abr 2008||Ethicon, Inc.||Sternal closure device and method|
|US7445626||16 Dic 2003||4 Nov 2008||Abbott Laboratories||Device and method for suturing tissue|
|US7547313||16 May 2003||16 Jun 2009||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7666194||28 Ene 2003||23 Feb 2010||Onux Medical, Inc.||Surgical suturing instrument and method of use|
|US7722643||29 Jul 2002||25 May 2010||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7744611||19 Nov 2003||29 Jun 2010||Medtronic, Inc.||Minimally invasive valve repair procedure and apparatus|
|US7758614||5 Abr 2002||20 Jul 2010||Tornier, Inc.||Coupling member for knotless sutures and ligatures|
|US7763040||10 Feb 2003||27 Jul 2010||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7806842||6 Abr 2007||5 Oct 2010||Sp Design, Llc||Cable-based orthopedic bracing system|
|US7837696||5 Dic 2003||23 Nov 2010||Abbott Laboratories||Articulating suturing device and method|
|US7842047||27 Feb 2006||30 Nov 2010||Abbott Laboratories||Articulating suturing device and method|
|US7842048||30 Nov 2010||Abbott Laboratories||Articulating suture device and method|
|US7842049||25 Oct 2006||30 Nov 2010||Abbott Laboratories||Systems for anchoring a medical device in a body lumen|
|US7846170||20 Mar 2007||7 Dic 2010||Abbott Laboratories||Articulating suturing device and method|
|US7850701||2 Ago 2004||14 Dic 2010||Abbott Laboratories||Articulating suturing device and method|
|US7879047||10 Dic 2003||1 Feb 2011||Medtronic, Inc.||Surgical connection apparatus and methods|
|US7883517||8 Ago 2005||8 Feb 2011||Abbott Laboratories||Vascular suturing device|
|US7892255||28 Ago 2003||22 Feb 2011||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7896892||3 Abr 2003||1 Mar 2011||Medtronic, Inc.||Multiple bias surgical fastener|
|US7914544||7 Dic 2004||29 Mar 2011||Medtronic, Inc.||Minimally invasive valve repair procedure and apparatus|
|US7938840||18 Nov 2003||10 May 2011||Medtronic, Inc.||Apparatus and methods for anastomosis|
|US7963973||2 Sep 2005||21 Jun 2011||Medtronic, Inc.||Multiple loop tissue connector apparatus and methods|
|US7976556||21 Dic 2006||12 Jul 2011||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8016845 *||4 Feb 2004||13 Sep 2011||Lsi Solutions, Inc.||Instrument for guiding the surgical cutting of tissue and method of use|
|US8029519||14 Sep 2006||4 Oct 2011||Medtronic, Inc.||Eversion apparatus and methods|
|US8038688||14 Nov 2005||18 Oct 2011||Abbott Laboratories||Articulating suturing device and method|
|US8048092||6 Dic 2010||1 Nov 2011||Abbott Laboratories||Articulating suturing device and method|
|US8048108||4 Feb 2009||1 Nov 2011||Abbott Vascular Inc.||Vascular closure methods and apparatuses|
|US8057491||13 Dic 2010||15 Nov 2011||Abbott Laboratories||Articulating suturing device and method|
|US8066724||10 Ene 2003||29 Nov 2011||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8083754||8 Ago 2005||27 Dic 2011||Abbott Laboratories||Vascular suturing device with needle capture|
|US8105345||10 Ene 2003||31 Ene 2012||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8118822||5 Abr 2001||21 Feb 2012||Medtronic, Inc.||Bridge clip tissue connector apparatus and methods|
|US8128587||1 Oct 2010||6 Mar 2012||Sp Design, Llc||Cable-based orthopedic bracing system|
|US8137364||11 Sep 2003||20 Mar 2012||Abbott Laboratories||Articulating suturing device and method|
|US8172860||12 Dic 2008||8 May 2012||Abbott Laboratories||Articulating suturing device and method|
|US8177836||10 Mar 2009||15 May 2012||Medtronic, Inc.||Apparatus and methods for minimally invasive valve repair|
|US8202281||29 Nov 2010||19 Jun 2012||Abbott Laboratories||Systems for anchoring a medical device in a body lumen|
|US8211122||9 Ago 2007||3 Jul 2012||Abbott Laboratories||Device for suturing intracardiac defects|
|US8211124||5 Feb 2007||3 Jul 2012||Medtronic, Inc.||Sealing clip, delivery systems, and methods|
|US8211131||5 Abr 2011||3 Jul 2012||Medtronic, Inc.||Apparatus and methods for anastomosis|
|US8252008||28 Ago 2012||Abbott Laboratories||Articulating suturing device and method|
|US8257368||9 Ago 2007||4 Sep 2012||Abbott Laboratories||Device for suturing intracardiac defects|
|US8267947||21 Jul 2006||18 Sep 2012||Abbott Laboratories||Vascular suturing device|
|US8298251||27 Feb 2008||30 Oct 2012||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8313498||7 Feb 2011||20 Nov 2012||Abbott Laboratories||Vascular suturing device|
|US8323298||19 Nov 2010||4 Dic 2012||Abbott Laboratories||Articulating suturing device and method|
|US8337497||7 Oct 2009||25 Dic 2012||Doctors Research Group, Inc.||Methods for sternal closure|
|US8353092||7 Feb 2011||15 Ene 2013||Medtronic, Inc.||Multiple bias surgical fastener|
|US8353921||4 Ago 2010||15 Ene 2013||Medtronic, Inc||Tissue connector apparatus and methods|
|US8361088||23 Oct 2008||29 Ene 2013||Abbott Laboratories||Device and method for suturing intracardiac defects|
|US8394114||26 Sep 2003||12 Mar 2013||Medtronic, Inc.||Surgical connection apparatus and methods|
|US8398680 *||19 Mar 2013||Lsi Solutions, Inc.||Bioabsorbable magnesium knots for securing surgical suture|
|US8419753||7 Oct 2008||16 Abr 2013||Abbott Laboratories||Suturing device with split arm and method of suturing tissue|
|US8430893||23 Ago 2012||30 Abr 2013||Abbott Laboratories||Articulating suturing device and method|
|US8496657||29 Ago 2008||30 Jul 2013||P Tech, Llc.||Methods for utilizing vibratory energy to weld, stake and/or remove implants|
|US8518060||9 Abr 2009||27 Ago 2013||Medtronic, Inc.||Medical clip with radial tines, system and method of using same|
|US8529583||31 Mar 2000||10 Sep 2013||Medtronic, Inc.||Surgical clip removal apparatus|
|US8574244||19 Dic 2007||5 Nov 2013||Abbott Laboratories||System for closing a puncture in a vessel wall|
|US8597309||13 Sep 2012||3 Dic 2013||Abbott Laboratories||Suturing device with split arm and method of suturing tissue|
|US8617185||13 Feb 2008||31 Dic 2013||P Tech, Llc.||Fixation device|
|US8623033 *||8 Mar 2012||7 Ene 2014||Coloplast A/S||Suture system with capsule eyelet providing multiple suture tissue fixation|
|US8652149||23 Ene 2002||18 Feb 2014||Lsi Solutions, Inc.||Vascular hole closure|
|US8663248||12 Dic 2008||4 Mar 2014||Abbott Laboratories||Articulating suturing device and method|
|US8663252||1 Sep 2010||4 Mar 2014||Abbott Cardiovascular Systems, Inc.||Suturing devices and methods|
|US8668697||24 Ago 2010||11 Mar 2014||Abyrx, Inc.||Methods and devices for sternal closure|
|US8668704||24 Abr 2009||11 Mar 2014||Medtronic, Inc.||Medical clip with tines, system and method of using same|
|US8747439||10 Jul 2006||10 Jun 2014||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US8758370||1 Dic 2003||24 Jun 2014||Interventional Therapies, Llc||Suture loading assembly|
|US8808329||3 Abr 2012||19 Ago 2014||Bonutti Skeletal Innovations Llc||Apparatus and method for securing a portion of a body|
|US8814902||31 Jul 2006||26 Ago 2014||Bonutti Skeletal Innovations Llc||Method of securing body tissue|
|US8845687||17 Sep 2013||30 Sep 2014||Bonutti Skeletal Innovations Llc||Anchor for securing a suture|
|US8845699||6 Mar 2012||30 Sep 2014||Bonutti Skeletal Innovations Llc||Method of securing tissue|
|US8858573||24 Abr 2012||14 Oct 2014||Abbott Cardiovascular Systems, Inc.||Apparatus and method for suturing body lumens|
|US8864778||10 Abr 2012||21 Oct 2014||Abbott Cardiovascular Systems, Inc.||Apparatus and method for suturing body lumens|
|US8920440||5 Ago 2010||30 Dic 2014||Coloplast A/S||Suture assembly and system|
|US8920442||23 Ago 2006||30 Dic 2014||Abbott Vascular Inc.||Vascular opening edge eversion methods and apparatuses|
|US8992547||21 Mar 2012||31 Mar 2015||Ethicon Endo-Surgery, Inc.||Methods and devices for creating tissue plications|
|US8992550||21 Jul 2011||31 Mar 2015||Coloplast A/S||Suture system with capsule eyelet providing multiple suture tissue fixation|
|US8998932||18 Jun 2012||7 Abr 2015||Abbott Laboratories||Systems for anchoring a medical device in a body lumen|
|US9060767||2 Mar 2009||23 Jun 2015||P Tech, Llc||Tissue fastener and methods for using same|
|US9067362 *||31 Oct 2007||30 Jun 2015||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US9089323||21 Feb 2006||28 Jul 2015||P Tech, Llc||Device and method for securing body tissue|
|US9113866||15 Dic 2011||25 Ago 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9113867||15 Dic 2011||25 Ago 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9113868||15 Dic 2011||25 Ago 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9113879||15 Dic 2011||25 Ago 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9119615||15 Dic 2011||1 Sep 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9138222||17 Feb 2004||22 Sep 2015||P Tech, Llc||Method and device for securing body tissue|
|US9149281||7 Jun 2013||6 Oct 2015||P Tech, Llc||Robotic system for engaging a fastener with body tissue|
|US9155535||28 Ene 2013||13 Oct 2015||Abbott Laboratories||Device and method for suturing intracardiac defects|
|US9155544||20 Mar 2002||13 Oct 2015||P Tech, Llc||Robotic systems and methods|
|US9173647||21 Feb 2006||3 Nov 2015||P Tech, Llc||Tissue fixation system|
|US9173650||31 May 2011||3 Nov 2015||P Tech, Llc||Methods and devices for trauma welding|
|US9173657||15 Dic 2011||3 Nov 2015||Ethicon Endo-Surgery, Inc.||Devices and methods for endoluminal plication|
|US9192395||7 May 2013||24 Nov 2015||P Tech, Llc||Robotic fastening system|
|US9226828||20 Sep 2013||5 Ene 2016||P Tech, Llc||Devices and methods for stabilizing tissue and implants|
|US9241707||31 May 2012||26 Ene 2016||Abbott Cardiovascular Systems, Inc.||Systems, methods, and devices for closing holes in body lumens|
|US20020123756 *||23 Ene 2002||5 Sep 2002||Sauer Jude S.||Vascular hole closure|
|US20020128666 *||11 Dic 2001||12 Sep 2002||Sancoff Gregory E.||Surgical suturing instrument and method of use|
|US20030105475 *||23 Jul 2002||5 Jun 2003||Sancoff Gregory E.||Surgical suturing instrument and method of use|
|US20030105476 *||13 Sep 2002||5 Jun 2003||Sancoff Gregory E.||Surgical suturing instrument and method of use|
|US20030114863 *||28 Ene 2003||19 Jun 2003||Field Frederic P.||Surgical suturing instrument and method of use|
|US20030171761 *||4 Mar 2003||11 Sep 2003||Sancoff Gregory E.||Surgical suturing instrument and method of use|
|US20030181800 *||20 Mar 2002||25 Sep 2003||Bonutti Peter M.||Methods of securing body tissue|
|US20030216755 *||22 Oct 2002||20 Nov 2003||Oleg Shikhman||Wound suturing device|
|US20040054303 *||29 Jul 2002||18 Mar 2004||Taylor Geoffrey L.||Blanching response pressure sore detector apparatus and method|
|US20040092967 *||19 May 2003||13 May 2004||Sancoff Gregory E.||Surgical suturing instrument and method of use|
|US20040097908 *||1 Dic 2003||20 May 2004||Oleg Shikhman||Handle assembly for a surgical instrument|
|US20040097968 *||1 Dic 2003||20 May 2004||Oleg Shikhman||Suture loading assembly|
|US20040122449 *||5 Dic 2003||24 Jun 2004||Modesitt D. Bruce||Articulating suturing device and method|
|US20040186487 *||30 Mar 2004||23 Sep 2004||Klein Enrique J.||Device and method for suturing tissue|
|US20040254592 *||19 May 2003||16 Dic 2004||Dicarlo Joseph A.||Surgical suturing instrument and method of use|
|US20050038449 *||20 Ene 2004||17 Feb 2005||Sancoff Gregory E.||Apparatus and method for placing suture wires into tissue for the approximation and tensioning of tissue|
|US20050070922 *||16 Dic 2003||31 Mar 2005||Field Frederic P.||Surgical suturing instrument and method of use|
|US20050143761 *||2 Ago 2004||30 Jun 2005||Modesitt D. B.||Articulating suturing device and method|
|US20050171561 *||16 Dic 2003||4 Ago 2005||Songer Ronald W.||Device and method for suturing tissue|
|US20050240189 *||22 Abr 2004||27 Oct 2005||Rousseau Robert A||Sternal closure device and method|
|US20060079914 *||14 Nov 2005||13 Abr 2006||Modesitt D B||Articulating suturing device and method|
|US20060173469 *||29 Mar 2006||3 Ago 2006||Klein Enrique J||Device and method for suturing of internal puncture sites|
|US20060241695||10 Jul 2006||26 Oct 2006||Bonutti Peter M||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US20060282101 *||18 May 2006||14 Dic 2006||Dvl Acquisition Sub, Inc.||Surgical suturing instrument and method for use|
|US20070032798 *||8 Ago 2005||8 Feb 2007||Pantages Anthony J||Vascular suturing device with needle capture|
|US20070032801 *||8 Ago 2005||8 Feb 2007||Pantages Anthony J||Vascular suturing device|
|US20070167959 *||20 Mar 2007||19 Jul 2007||Abbott Laboratories||Articulating suturing device and method|
|US20080039845 *||6 Feb 2007||14 Feb 2008||Bonutti Peter M||Methods and devices for intracorporeal bonding of implants with thermal energy|
|US20080108916 *||31 Oct 2007||8 May 2008||Bonutti Peter M||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US20080249448 *||6 Abr 2007||9 Oct 2008||Stevenson Craig G||Cable-based orthopedic bracing system|
|US20080249545 *||7 Abr 2008||9 Oct 2008||Interventional Therapies||Suturing, crimping and cutting device|
|US20100262167 *||9 Abr 2009||14 Oct 2010||Medtronic, Inc.||Medical Clip with Radial Tines, System and Method of Using Same|
|US20100274267 *||24 Abr 2009||28 Oct 2010||Medtronics, Inc.||Medical Clip with Tines, System and Method of Using Same|
|US20100324597 *||21 Jun 2010||23 Dic 2010||Oleg Shikhman||Crimping and cutting device|
|US20110046528 *||1 Oct 2010||24 Feb 2011||Sp Design, Llc||Cable-based orthopedic bracing system|
|US20110046642 *||24 Feb 2011||Coloplast A/S||Suture assembly and system|
|US20110046645 *||24 Feb 2011||Colophast A/S||Suture assembly and system|
|US20110051160 *||24 Ago 2010||3 Mar 2011||Canon Kabushiki Kaisha||Information updating apparatus, image history inspection apparatus, information updating method, and storage medium|
|US20110071472 *||29 Nov 2010||24 Mar 2011||Abbott Laboratories||Systems for anchoring a medical device in a body lumen|
|US20110082459 *||7 May 2008||7 Abr 2011||Dan Aravot||Structured sternal incision|
|US20110082498 *||7 Abr 2011||Doctors Research Group, Inc.||Methods for sternal closure|
|US20110251641 *||13 Oct 2011||Lsi Solutions, Inc.||Bioabsorbable magnesium knots for securing surgical suture|
|US20130012990 *||21 Mar 2011||10 Ene 2013||Mcclellan William T||Knotless locking tissue fastening system and method|
|US20130023906 *||24 Ene 2013||Coloplast A/S||Suture system with capsule eyelet providing multiple suture tissue fixation|
|EP0958786A2 *||21 Abr 1999||24 Nov 1999||Heinz Robert Dr. med. Zurbrügg||Sternal closure technique and kit for performing same|
|WO1995003002A1 *||15 Jul 1994||2 Feb 1995||Danek Medical Inc||Surgical cable crimp and method|
|WO1998030151A1 *||7 Ene 1998||16 Jul 1998||Elective Vascular Intervention||Ferruled loop surgical fasteners, instruments, and methods for minimally invasive vascular and endoscopic surgery|
|WO2008136001A2||7 May 2008||13 Nov 2008||Aravot Cardio Ltd||Structured sternal incision|
|Clasificación de EE.UU.||606/232|
|Clasificación internacional||A61B17/04, A61B17/82, A61B17/06, A61B17/88|
|Clasificación cooperativa||A61B17/04, A61B17/82, A61B17/8869, A61B2017/0496, A61B17/823|
|Clasificación europea||A61B17/04, A61B17/82K, A61B17/82|