Surgical suture abstract
A surgical suture and a delivery system for positioning and inserting
the suture is disclosed. The suture includes a base member having
two substantially parallel, rigid, barbed shafts upstanding therefrom.
The delivery system includes a hollow sleeve member having an elongate
cross section with the long dimension of the cross section sufficient
to accommodate the width of the base member. In use, the end of
the hollow sleeve is positioned adjacent a body tissue wound which
is to be repaired and the suture is inserted into the tissue by
pushing the suture through the sleeve by means of a pusher member.
If necessary, a starter member is first pushed through the sleeve
to provide started openings in the tissue into which the barbed
shafts are then inserted.
Surgical suture claims
1. A surgical suturing system comprising:
a surgical suture having a base member, two substantially parallel
shafts upstanding from said base member and having pointed barbs
at the ends thereof;
means for positioning and inserting said suture into body tissue;
said means for positioning and inserting comprises:
a hollow sleeve member through which said suture can be delivered;
a pusher member sized to fit through the hollow interior of said
sleeve member and capable of pushing said suture into said body
a starter member sized to fit through said sleeve member and comprising
a substantially rigid rod having two pointed projections at the
end thereof, said projections capable of creating two starter holes
in said body tissue into which can be inserted said substantially
2. The suturing system of claim 1 wherein said hollow interior
of said hollow sleeve member has an elongate cross section having
a long dimension to accomodate the width of said base member of
3. The suturing system of claim 2 wherein said pusher member has
an elongate cross section.
4. The suturing system of claim 1 wherein said pusher member further
comprises releaseable means for securing said suture to the end
Surgical suture description
BACKGROUND OF THE INVENTION
This invention relates generally to surgical sutures and to suturing
systems, and more specifically to a surgical suture and system for
repairing meniscus tissue. This invention is an improvement on the
sutures disclosed and claimed in my copending application, entitled,
"Surgical Fasteners and Method," filed Feb. 28 1984
the disclosure of which is incorporated herein by reference.
There are a number of techniques used for closing and repairing
incisions, tears, or wounds in body tissue. These include, for example,
the use of stitches, staples, tape, clamps, the sutures disclosed
in my above-identified copending aplication, and the like. The technique
used in a particular application depends on the size, nature, location
of the opening or tear, and the like. Despite the wide range of
available techniques, however, a need still existed for a surgical
suture which would provide the ease and precision of insertion in
arthroscopic surgery of my previously disclosed suture, but which
would provide an even more secure joining of the body tissue, especially
It is therefore an object of this invention to provide an improved
It is further object of this invention to provide an improved surgical
suture and system for placement and insertion of the suture.
It is another object of this invention to provide an improved suture
for arthroscopic surgery.
BRIEF SUMMARY OF THE INVENTION
The foregoing and other objects and advantages of the invention
are achieved with the multiple shafted suture and system as herein
described. In one embodiment of the invention, the suture includes
a base member from which two substantially parallel shafts are upstanding.
Each of the shafts has a pointed end for insertion into the tissue
to be repaired and one or more barbs along the length thereof to
lock the shaft into the tissue being repaired. The suture is positioned
and inserted by pushing the suture through a hollow sleeve with
a rigid pusher.
BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. 1 and 2 illustrate, in front view, embodiments of surgical
FIGS. 3 and 4 illustrate an insertion sleeve and pusher in vertical
and horizontal section, respectively;
FIG. 5 illustrates a starter; and
FIG. 6 illustrates a suture in position across a tear in a meniscus.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
FIGS. 1 and 2 illustrate two embodiments of sutures in accordance
with the invention. FIG. 1 illustrates a suture 10 having a base
member 12 with two shafts 13 14 upstanding therefrom. Each of the
shafts terminate in a pointed end 15 16. The pointed ends facilitate
the insertion of the suture into the body tissue to be repaired.
Barbs 19 and 20 lock the shafts into position in the tissue after
insertion. In use, the shafts are inserted into the tissue and across
the tear to pull the sides of the tear together, with the barbs
maintaining the suture shafts in place.
FIG. 2 illustrates a further embodiment of the invention. Suture
22 includes a base member 24 with substantially parallel shafts
26 27 upstanding from the opposite ends of the base member. Suture
22 includes two barbs 29 30 and 31 32 projecting outwardly from
the shafts 26 27 respectively. Barbs 29 and 31 additionally provide
pointed ends to shafts 26 27 to facilitate insertion of the shafts
into body tissue.
The sutures illustrated in FIGS. 1 and 2 are but two illustrations
of sutures in accordance with the invention. In general, the sutures
include a base member from which a plurality of substantially parallel
shafts are upstanding. In a preferred embodiment, the sutures includes
two shafts. The plurality of shafts, as contrasted with only a single
suture shaft, provide a substantially increased joining strength
for holding the opposing edges of a wound together. The insertion
of a single multishafted suture replaces the insertion of a plurality
of single shaft sutures. In some instances it is difficult, time
consuming and even traumatic to individually insert a plurality
Sutures in accordance with the invention preferably have a base
width of about 3-6 mm in 1 mm increments. Further, the sutures are
preferably available having a base thickness of about 1-4 mm, in
1 mm increments. Additionally, sutures in accordance with the invention
preferably have a shaft length of about 8-16 mm in 1 mm increments.
The sutures can formed of metal, plastic, biologically absorbable
material such as surgical gut, or the like. The base member and
upstanding shafts can be of either circular or flat rectangular
cross section. The barbs, having a width somewhat greater than the
width of the shaft, can be conical, flat triangular projections,
or the like. Although only sutures having 1 or 2 barbs on each shaft
have been shown, the sutures can, in general, have a plurality of
FIGS. 3 and 4 illustrate a delivery system 40 for positioning and
inserting sutures in accordance with the invention. Sutures in accordance
with the invention are especially designed for the repair of a torn
meniscus, for example a knee joint, although such sutures are adaptable
for other tissue repair. Use of the suture in such an application,
for example in arthroscopic surgery, requires the remote positioning
and insertion of the suture. The correct positioning and insertion
are facilitated by delivery system 40 in a method as described below.
Sutures are provided in a variety of sizes; a delivery system is
provided for each size of suture to constitute a surgical suture
FIG. 3 illustrates the delivery system in a vertical section. The
delivery system includes a hollow tubular sleeve 42 which can be
inserted through an incision to the interior of the knee. The sleeve
is substantially rigid, and can be either straight or have a variety
of angular bends as needed for a particular patient. A pusher rod
44 sized to pass through the hollow interior of the sleeve pushes
the surgical suture 46 into the body tissue. The pusher rod preferably
is provided with means for releaseably holding the suture until
it is properly inserted. The holding means can comprise, for example,
a pair of spring clips 48 vacuum means (not shown), or the like.
The pusher rod is substantially rigid, having sufficient flexibility
to traverse any angular bends in sleeve 42.
FIG. 4 illustrates sleeve 42 and pusher rod 44 in cross section.
The sleeve has an elongted cross sectional shape, with the length
50 adapted to receive a suture of particular base width. The pusher
rod also has an elongated shape matching the shape of the sleeve.
The elongated shape prevents the rotation within the sleeve of the
multiple shafted suture and thereby enhances the accuracy of positioning
FIG. 5 illustrates, in side view, a starter 52 which may be used
with the sleeve 42 to initiate openings in the body tissue into
which the suture is inserted. The starter includes a substantially
rigid rod 54 having a plurality of sharp points 56 at the end. The
sharp points match the number and position of shafts on the suture
being used. The starter is pushed through the sleeve to initiate
openings in the tissue into which the suture is inserted. The use
of a starter is particularly advantageous when using sutures of
a semi-rigid material which would otherwise be difficult to insert
into some, especially resistant, body tissue.
FIG. 6 illustrates the use and positioning of a suture, in accordance
with the invention, in the repair of a torn meniscus 60. Meniscus
60 is shown having a tear 62. Dual shafted suture 64 is inserted
into the meniscus tissue so that base member 66 is seated against
the surface of the meniscus and shafts 68 69 pass through the tissue
and across tear 62. When fully inserted, the suture pulls the edges
of tear 62 together and maintains them in that position while healing
occurs. Barbs 70 lock the suture in place. In an alternate embodiment,
the shafts may pass completely through the meniscus, as indicated
by the dotted lines, with one or more barbs resting on the exterior
surface of the meniscus.
Thus it is apparent that there has been provided, in accordance
with the invention, a surgical suture and system which fully meet
the objects and advantages set forth above. Although the invention
has been described with reference to specific embodiments thereof,
it is not intended that the invention be limited to those illustrative
embodiments. Rather, it is intended that all variations and modifications
as fall within the spirit of the invention be included within the