United States Patent uoi
Kletschka et al.
[ii] 3,910,281 [45] Oct. 7, 1975
[54] SUTURE ANCHOR
[75] Inventors: Harold D. Kletschka, Minneapolis;
Edson H. Rafferty, Excelsior, both of Minn.
[73] Assignee: Bio-Medicus, Inc., Minnetonka, Minn.
[22] Filed: Oct. 9, 1973 [21] Appl. No.: 404,297
[52] U.S. CI 128/335; 24/18
[51] Int. CI A61b 17/04
[58] Field of Search 128/335, 335.5, 334 R;
24/18
[56] References Cited
UNITED STATES PATENTS
1,830,014 11/1931 Brady ,24/18
2,458,252 1/1949 Chatterton 24/18
3,753,438 8/1973 Wood et al 128/335
A suture having a surgical needle connectable to one end has an enlarged anchoring member secured to the other end thereof. A lateral projection is provided on the anchoring member. The lateral projection is grasped by a physical instrument to position the anchor member during the suture tying procedure and a slit formed in the anchor member releasably secures the suture to the anchor member for subsequent tensioning adjustments.
4 Claims, 7 Drawing Figures
1
SUTURE ANCHOR
The present invention is directed to an anchoring device for releasably securing a suture for subsequent tensin adjustments. 5
The need for a more simple procedure to tie off sutures has long been recognized. In this respect, a number of button-type, as well as various other shaped anchoring devices, have been developed in attempts to provide some means for quickly and easily tying off su- 10 tures. However, these devices have not gained great popularity due to various disadvantges which are present in their manufacture and Use.
For example, some of these devices are of such construction as to make it extremely difficult to complete 15 the suture tie off procedure or of a configuration which is difficult or expensive to produce. A further problem in the use of sutures has been in the occurrence of or reduction in swelling of the flesh in the area of suture application. That is, when swelling of the flesh occurs 20 subsequent to application of the suture, undue tension is applied to the suture with the result that tearing of the skin often occurs. Conversely, when the swelling reduces after the application of the suture, improper closure support for the wound becomes the case. Either 25 of the above events serves as a major irritant to the patient, since the surgical stitches must often be removed and replaced or the skin tear becomes infected. Devices which have attempted to solve this problem have, on one hand, been overly complicated and expensive to 30 manufacture. On the other hand, certain of these devices are not constructed to provide for tension adjustments to the suture either before or after the occurrence of or reduction in swelling of flesh in the area of the stitch formed by the suture. 35
Our novel suture anchor presents a deterrent to the problems present in conventional suture stitches as well as those employing special anchors and tying devices. In this respect, a suture, having one end which is connectable to a needle, has an enlarged anchoring mem- 40 ber secured to the other end. Subsequent to sewing application of the suture to an incision, a lateral projection on the anchor member may be grasped by a surgical instrument to support the anchor member during a suture tying procedure. In this procedure, the suture is 45 drawn taut and wrapped about itself beneath the anchor member or about a reduced waist portion on the anchor member. A slit formed in the anchor member releasably receives and anchors the suture in a final tieoff step in the procedure. This concept of a suture anchor provides a structure which is easily applied to close an incision within a minimum amount of time. It also provides a structure which can be easily retensioned subsequently to compensate for either increased ^ or reduced swelling of the area adjacent the surgical stitch formed by the suture.
Our invention further contemplates the provision of an individual preciit suture, needle and suture anchor which are integrally formed together to ensure maxi- ^ mum convenience and simplicity to the physician in carrying out his surgical duties.
In one form of our suture anchor, the reduced waist portion of the anchor elevates the suture at the point at which the suture enters the skin. This provides a rriin- 65 imum source of irritation at this point by allowing the access of a maximum amount of air to such a point of entry. The structural features and advantages of our in
2
vention will- become apparent: from the description below in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a view in perspective of a suture anchor showing a conventional surgical needle in conjunction therewith;
FIG. 2 is a view in perspective of a modified suture anchor and an integrally formed surgical needle;
FIGs. 3, 4 and 5 are perspective views of still further modified suture anchors, portions thereof broken away;
FIG. 6 is a view in perspective of the partial application of the suture anchor of FIG. 5 to an open incision; and
FIG. 7 is an enlarged view in vertical section as seen generally from the line 7—7 of FIG. 6 showing the incision closed and the suture anchor tied off to form a completed stitch.
DESCRIPTION OF THE PREFERRED
EMBODIMENTS
Referring initially to FIG. 1 of the drawings, a suture anchor assembly is indicated generally by the numeral 10a. Suture anchor assembly 10a is comprised of a suture 11 having one end which is connectable to a typical curved surgical needle 12 by passing the end of the suture 11 through the eye 13 of the needle 12 in the conventional manner. An enlarged anchoring member 14 on the other end of the suture 11 is formed in the shape of a flat disc having opposite side surfaces 15,16. The other end of the suture 11 is threadedly engaged through an opening formed in the anchor member 14 adjacent the periphery thereof, suture 11 is tied off, as at 17, to secure the suture 11 to the anchor member 14 in a manner to extend from the side surface 15.
A lateral projection, illustrated as a cylindrical post 18^ extends longitudinally from the other opposite side 16 at a point diametrically spaced from the connection of the suture 11. Post 18 has a slit 19 formed in the circumference thereof to extend angularly inwardly toward the longitudinal axis thereof. The purpose of the slit 19 will become apparent from a description of the method of use of the suture anchor assembly 10a or other modified anchor assemblies 10i> through lOe, hereinafter to be described.
With respect to the anchor assemblies 10f> through lOe, each thereof is generally similar in nature to the anchor assembly 10a described and shown in FIG. 1. As such, parts of the several assemblies 10b through lOe corresponding to similar parts of the anchor assembly 10a, will carry similar numerals with a respective exponent letter "b" through "e" added thereto.
Thus, referring to the first modified suture anchor assembly 10i> of FIG. 2, it can be seen that the enlarged anchoring member 14b is formed in the shape of a sphere and as an integral part of the suture lib. The surgical needle 12b differs from the needle 12 in that the needle 12b forms an integral longitudinal extension of the suture lib. This is accomplished by forming the base of the needle 12b as a hollow tube and inserting one end of the suture lib therein, as at 22. The base of the needle 12£> is crimped to fixedly secure the end of the suture 1 lb therein. Surgical needle 12b provides an improvement over the surgical needle 12 in that the opening formed in the flesh during a stitching procedure is somewhat smaller than that made by the surgi3,9
3
cal needle 12 and a double thickness of the suture 11 of FIG. 1. Although the surgical needle 12b may be formed from suitable surgical steel, we wish it to be understood that such a needle may be formed from a suitable plastic material as an integral extension of the suture lib.
Slit 19b is formed in a hemispherical plane of the sphere 14b and is disposed so that the juncture of the suture lib with the sphere 14b is offset from the slit 19b. In the drawings, the juncture of the suture lib with the sphere 14b is shown as being generally opposite the slit 19b for convenience sake.
The lateral projection of the anchor member 10b is shown in the form of a relatively thin flag-like projection 18b which extends outwardly from the sphere 14b. For convenience in grasping and steadying the body member 14b by an appropriate surgical instrument, not shown, flag-like projection 18b lies in a plane extending generally perpendicular to the hemispherical plane of the slit 19b. However, it will be realized that flag-like extension may be positioned other than perpendicular to the plane of slit 19b, as long as it does not interfere with the tying off procedure of the suture lib. This assures that the spherical anchor member 14b is not drawn too tightly against the skin in the stitch forming procedure and correctly positions the spherical member 14b in the final tie off step of the stitching procedure.
FIG. 3 illustrates another embodiment of a suture anchor assembly 10c wherein the suture 11c is formed as an integral part of an elongated anchor member 14c. The elongated anchor member 14c is formed with a reduced waist portion 23 between opposite enlarged ends thereof. As shown, the suture 11c extends from one of the opposite enlarged ends 24 in general alignment with the longitudinal dimension of the anchor member 14c, the enlarged end 24 in this embodiment being a sphere. The other end of the body member 14c is shown in the form of a cylinder and provides a cylindrical lateral projection 18c which may be grasped by a surgical instrument during the suture tying procedure. The cylindrical projection 18c is connected to the spherical end 24 by a reduced waist portion 23 such that the longitudinal axis of the portion 18c extends through the center of the sphere 24. A slit 19c is formed in the outermost end of the cylindrical portion 18c so as to lie in a plane which longitudinally generally bisects the cylindrical portion 18c.
Referring now to FIG. 4, a still further embodiment of a suture anchor assembly lOd is shown which includes an elongated body 14d having a reduced waist portion 23d between opposite enlarged ends thereof. A suture 1 Id is formed as an integral part of the elongated anchor member 14d and extends from one of the opposite enlarged ends 24d in general alignment with the longitudinal dimension of the anchor member I4d. The other end of the anchor member 14d serves to form a lateral projection 18a" on the anchor member 14d which may be grasped by a surgical instrument during a suture tying procedure (i.e., in the manner of projections 18, 18b and 18c). In this embodiment, the anchor member 14*/ is formed with planar opposite side surfaces 15d, 16d which facilitate gripping of the body member 14a" by the surgical instrument, not shown.
A slit 19d is formed in the other end or projection 18d so as to lie in a plane extending generally perpendicular to the plane of the planar side surfaces lSd,
[0,281
4
16d, the slit 19d serving the same function as the slits 19 through 19c.
FIG. 5 of the drawings illustrates a final embodiment of the present invention wherein an elongated anchor 5 member 14e is formed with a reduced waist portion 23e between opposite enlarged ends, which ends are indicated at 24e and 18e. A suture 1 le is formed as an integral part of the anchor member 14c and forms a juncture with the reduced waist 23e so as to extend trans
10 versely from the longitudinal dimension of the anchor member 14e centrally between the enlarged opposite ends 24e, 18c. The symmetrical configuration of the anchor member 14e permits either of the enlarged ends 24e, 18c to serve as the lateral projection of the body
15 member 14e suitable to be grasped by a surgical tool to steady the body member 14c during the stichforming procedure. Due to the symmetrical nature of the body member 14c, a slit 19e is formed in each of the enlarged ends 18e, 24e generally oppositely of the juncture of
20 the suture lie and reduced waist 23e. This permits greater versatility in releasably anchoring the suture 11c during the final tie off procedure of the stitch as will be hereinafter described. In the drawings, FIGS. 6 and 7 illustrate a stitch
25 forming procedure relative to an incision 30. As used herein, "incision" is intended to encompass wounds, lacerations and the like which disrupt normal tissue integrity, as well as openings made for surgical purposes. As shown, the final modified version suture anchoring
30 assembly lOe is illustrated in FIGS 6 and 7 and described in the stitch-forming procedure. However, it will be appreciated that similar stitch-forming procedures apply regardless of which one of the assemblies 10a through lOe is selected for use. In any case, proce
35 dures described in connection with the suture anchor assembly lOe will apply to the assemblies 10a through lOd except for slight variations which will be hereinafter noted.
With the aid of a surgical needle, such as 12 or 12*,
40 the suture 1 le is passed through the skin 31 and deeper layers of tissue 32, 33 until such time as the anchor member 14e comes into engagement with the skin 31. It will be noted with respect to anchor assemblies 10a through lOd that the anchor member 14 through 14d
4"* comes directly into contact with the point of entry of the sutures 11 through lie? into the skin 31. On occasions, it is desirous to permit a maximum access of air to such a point of entry to prevent irritation and infection or festering of this area. The particular configuration of the body member 14e, together with the method of integral connection of the suture 11c to the reduced waist portion 23e, permits this event to occur, when the stitchforming procedure has advanced to the condition
5g of FIG. 6, a surgical instrument, such as a forceps or the like, not shown, is utilized to grasp the free end of the suture 11c and a second forceps, also not shown, is utilized to grasp and steady the anchor member 14c. In anchor members 14 through 14d, the lateral projections 18 through 18a1 are engaged to steady the respective anchor member 14 through I4d. However, with respect to anchor member 14c, either of opposite enlarged ends 18c or 24c can function as the lateral projection for steadying the anchor member 14e. When
6j each of the anchor member 14e and suture lie have been engaged by a forcep, force is applied to draw the incision 30 to the closed condition of FIG. 7. Thereafter, the suture 11c is positioned to extend across the in
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