U.S. patent application number 11/747085 was filed with the patent office on 2007-09-06 for barbed tissue connector.
Invention is credited to Gregory L. Ruff.
Application Number | 20070208355 11/747085 |
Document ID | / |
Family ID | 46255718 |
Filed Date | 2007-09-06 |
United States Patent
Application |
20070208355 |
Kind Code |
A1 |
Ruff; Gregory L. |
September 6, 2007 |
BARBED TISSUE CONNECTOR
Abstract
A barbed bodily tissue connector for insertion into tissue
comprises an elongated body having a substantially polygonal
periphery in cross-section including at least three sides. Each
side meets an adjacent side at an edge of the elongated body. A
plurality of barbs project from the edges of the body. The barbs
are configured such that they are yieldable in a direction toward
the body and resist retraction from tissue in an opposite
direction.
Inventors: |
Ruff; Gregory L.; (Chapel
Hill, NC) |
Correspondence
Address: |
Michael G. Johnston;Moore & Van Allen
Ste. 800
2200 West Main Street
Durham
NC
27705
US
|
Family ID: |
46255718 |
Appl. No.: |
11/747085 |
Filed: |
May 10, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10420119 |
Apr 21, 2003 |
7226468 |
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11747085 |
May 10, 2007 |
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09629428 |
Jul 31, 2000 |
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10420119 |
Apr 21, 2003 |
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08324529 |
Oct 18, 1994 |
6241747 |
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09629428 |
Jul 31, 2000 |
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08055989 |
May 3, 1993 |
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08324529 |
Oct 18, 1994 |
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Current U.S.
Class: |
606/139 ;
606/216 |
Current CPC
Class: |
A61B 17/10 20130101;
A61B 17/083 20130101; A61B 17/0493 20130101; A61B 17/064 20130101;
A61B 17/06109 20130101; A61B 2017/0647 20130101; A61B 2017/06176
20130101 |
Class at
Publication: |
606/139 ;
606/216 |
International
Class: |
A61B 17/03 20060101
A61B017/03 |
Claims
1. A barbed bodily tissue connector for insertion into tissue
comprising: an elongated body having a first end, a second end, a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body; and a plurality of barbs, each barb projecting
from one of the edges of the body, wherein a first portion of the
barbs extend along a first portion of the body and are oriented in
one direction, the barbs being configured such that they are
yieldable in a direction toward the body and resist retraction from
tissue in an opposite direction.
2. The barbed bodily tissue connector of claim 1, wherein one of
the first end and the second end comprises an end adapted to
penetrate the tissue for facilitating entry of the connector into
the tissue.
3. The barbed bodily tissue connector of claim 2, wherein the
adapted end comprises a pointed end formed of a material
sufficiently hard for the pointed end to pierce tissue and to
enable the connector to be inserted in tissue when a substantially
axial force is applied to the body of the connector.
4. The barbed bodily tissue connector of claim 3, wherein the body
of the connector is formed of a material sufficiently hard for the
pointed end to pierce tissue and to enable the connector to be
inserted in tissue when a substantially axial force is applied to
the body of the connector.
5. The barbed bodily tissue connector of claim 3, wherein the
pointed end of the connector is free of barbs.
6. The barbed bodily tissue connector of claim 1, wherein the
connector comprises a bioabsorbable material.
7. The barbed bodily tissue connector of claim 6, wherein the
bioabsorbable material comprises polyglycolic acid polymer,
polyglycolic acid copolymer, polylactic acid polymer, or polylactic
acid copolymer.
8. The barbed bodily tissue connector of claim 1, wherein certain
adjacent barbs face toward each other.
9. The barbed bodily tissue connector of claim 1, wherein one of
the first and second ends comprises a head end.
10. The barbed bodily tissue connector of claim 1, wherein the body
has sufficient dimensional stability to assume a substantially
rigid configuration during use thereof.
11. The barbed bodily tissue connector of claim 1, wherein the body
is sufficiently resilient to return to a predetermined shape after
deflection therefrom.
12. The barbed bodily tissue connector of claim 1, wherein the body
is flexible and substantially nonresilient whereby the shape of an
inserted connector will be determined by the surrounding
tissue.
13. The barbed bodily tissue connector of claim 1, wherein the
periphery in cross-section is one of triangular, rectangular, or
hexagonal.
14. A barbed bodily tissue connector for insertion into tissue
comprising: an elongated body having a first end, a second end, a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body; and a plurality of barbs, each barb projecting
from one of the edges of the body, wherein a first portion of the
barbs extend along a first portion of the body and are oriented in
one direction, and wherein a second portion of the barbs extend
along a second portion of the body and are oriented in an opposite
direction to the first portion of the barbs, the barbs being
configured such that they are yieldable in a direction toward the
body and resist retraction from tissue in an opposite
direction.
15. The barbed bodily tissue connector of claim 14, wherein one of
the first end and the second end comprises an end adapted to
penetrate the tissue for facilitating entry of the connector into
the tissue.
16. The barbed bodily tissue connector of claim 15, wherein the
adapted end comprises a pointed end formed of a material
sufficiently hard for the pointed end to pierce tissue and to
enable the connector to be inserted in tissue when a substantially
axial force is applied to the body of the connector.
17. The barbed bodily tissue connector of claim 16, wherein the
body of the connector is formed of a material sufficiently hard for
the pointed end to pierce tissue and to enable the connector to be
inserted in tissue when a substantially axial force is applied to
the body of the connector.
18. The barbed bodily tissue connector of claim 16, wherein the
pointed end of the connector is free of barbs.
19. The barbed bodily tissue connector of claim 14, wherein the
connector comprises a bioabsorbable material.
20. The barbed bodily tissue connector of claim 19, wherein the
bioabsorbable material comprises polyglycolic acid polymer,
polyglycolic acid copolymer, polylactic acid polymer, or polylactic
acid copolymer.
21. The barbed bodily tissue connector of claim 14, wherein certain
adjacent barbs face toward each other.
22. The barbed bodily tissue connector of claim 14, wherein one of
the first and second ends comprises a head end.
23. The barbed bodily tissue connector of claim 14, wherein the
body has sufficient dimensional stability to assume a substantially
rigid configuration during use thereof.
24. The barbed bodily tissue connector of claim 14, wherein the
body is sufficiently resilient to return to a predetermined shape
after deflection therefrom.
25. The barbed bodily tissue connector of claim 14, wherein the
body is flexible and substantially nonresilient whereby the shape
of an inserted connector will be determined by the surrounding
tissue.
26. The barbed bodily tissue connector of claim 14, wherein the
barbs along a length of the body extending from adjacent the first
end to a first axial location on the body face the first end; the
barbs along a length of the body extending from adjacent the second
end to a second axial location face the second end; and the length
from adjacent the second end to the second axial location is less
than the distance from the second end to the first axial
location.
27. The barbed bodily tissue connector of claim 14, wherein the
barbs along a length of the body extending from adjacent the first
end to a first axial location on the body face the second end; the
barbs along a length of the body extending from adjacent the second
end to a second axial location face the first end; and the length
from adjacent the second end to the second axial location is less
than the distance from the second end to the first axial
location.
28. The barbed bodily tissue connector of claim 14, wherein the
periphery in cross-section is one of triangular, rectangular, or
hexagonal.
29. A method for bringing together one side and an other side of an
open wound in tissue with a barbed tissue connector, where the
barbed tissue connector has an elongated body, a pointed end, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs being sized and shaped
to resist retraction of the barbed tissue connector from the
tissue, said method comprising: (i) inserting the barbed tissue
connector via the pointed end into tissue from one side of the
wound, (ii) penetrating through tissue on the one side of the
wound, and (iii) penetrating into tissue at the other side of the
wound such that a portion of the body extends from the tissue at
the one side of the wound.
30. The method of claim 29, said method comprising: (iv) inserting
another barbed tissue connector, where the other barbed tissue
connector has an elongated body, a pointed end, a substantially
polygonal periphery in cross-section including at least three
sides, each side meeting an adjacent side at an edge of the
elongated body, and a plurality of barbs, each barb projecting from
one of the edges of the body, the barbs of the other barbed tissue
connector being sized and shaped to resist retraction of the other
barbed tissue connector from the tissue, via the pointed end of the
other barbed tissue connector from the other side of the wound, (v)
penetrating through tissue at the other side of the wound, and (vi)
penetrating into tissue at the one side of the wound.
31. The method of claim 29, wherein inserting the barbed tissue
connector is accomplished with an inserting device.
32. The method of claim 31, wherein the inserting device comprises
a tubular body.
33. The method of claim 29, wherein the barbed tissue connector
comprises a bioabsorbable material.
34. The method of claim 33, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
35. The method of claim 29, wherein the pointed end is free of
barbs.
36. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
a first pointed end, a second pointed end, a length, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs being sized and shaped
to resist retraction of the barbed tissue connector from the
tissue, the barbed tissue connector having the barbs oriented in
one direction for a first portion of the length of the body and in
an opposite direction for a second portion of the length of the
body, said method comprising: (a) at the tissue separation,
inserting the barbed tissue connector via the first pointed end
into tissue at a position on one side of the tissue separation; (b)
repeating step (a) at the other side of the tissue separation,
using the second pointed end of the barbed tissue connector, at a
position located across the tissue separation from the position in
which the first pointed end of the barbed tissue connector was
inserted; and (c) bringing the two tissue portions together.
37. The surgical method of claim 36, wherein bringing the two
tissue portions together in step (c) is accomplished by pressing
the two tissue portions together.
38. The surgical method of claim 36, wherein bringing the two
tissue portions together in step (c) is accomplished by pushing the
barbed tissue connector through the tissue.
39. The method of claim 36, wherein inserting the barbed tissue
connector is accomplished with an inserting device.
40. The method of claim 39, wherein the inserting device comprises
a tubular body.
41. The surgical method of claim 36, wherein the two tissue
portions comprise two sides of an open wound in skin.
42. The surgical method of claim 36, wherein the barbed tissue
connector comprises a bioabsorbable material.
43. The surgical method of claim 42, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
44. The surgical method of claim 36, wherein the two tissue
portions comprise portions of a tendon.
45. The surgical method of claim 36, wherein: (a) the two tissue
portions comprise two sides of an open wound at the skin of a
patient, and (b) the first pointed end and the second pointed end
are free of barbs.
46. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
a pointed end, a length, and a substantially polygonal periphery in
cross-section including at least three sides, each side meeting an
adjacent side at an edge of the elongated body, and a plurality of
barbs, each barb projecting from one of the edges of the body, the
barbs being sized and shaped to resist retraction of the barbed
tissue connector from the tissue and permitting movement of the
barbed tissue connector through the tissue in the direction the
barbed tissue connector is inserted, said method comprising: (a) at
the tissue separation, inserting the barbed tissue connector, via
the pointed end, into tissue at one side of the tissue separation,
(b) penetrating through tissue on the one side of the separation,
and (c) penetrating into tissue on the other side of the separation
wound such that a portion of the body extends from the tissue at
the one side of the tissue separation.
47. The method of claim 46, said method comprising: (d) inserting
another barbed tissue connector, where the other barbed tissue
connector has an elongated body, a pointed end, a length, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs being sized and shaped
to resist retraction of the barbed tissue connector from the tissue
and permitting movement of the barbed tissue connector through the
tissue in the direction the barbed tissue connector is inserted,
via the pointed end of the other barbed tissue connector from the
other side of the tissue separation, (e) penetrating through tissue
on the other side of the of the separation, and (f) penetrating
into tissue on the one side of the separation.
48. The surgical method of claim 46, wherein the two tissue
portions comprise sections of a tendon.
49. The surgical method of claim 46, wherein the two tissue
portions comprise two sides of an open wound in skin.
50. The surgical method of claim 46, wherein the barbed tissue
connector comprises a bioabsorbable material.
51. The surgical method of claim 251, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
52. A method for inserting a barbed tissue connector into tissue,
where the barbed tissue connector has an elongated body, a pointed
end, an opposite end, and a substantially polygonal periphery in
cross-section including at least three sides, each side meeting an
adjacent side at an edge of the elongated body, and a plurality of
barbs, each barb projecting from one of the edges of the body, the
barbs being sized and shaped to resist retraction of the barbed
tissue connector from the tissue, said method comprising inserting
the pointed end into tissue by applying force to the opposite end
such that a portion of the body extends from the tissue.
53. The method of claim 52, wherein the opposite end comprises a
head end.
54. The method of claim 53, wherein after an adequate amount of
time has passed for healing, depressing the tissue beneath the head
end and cutting the head end from the elongated body, permitting
the tissue to rise up over the cut end of the elongated body.
55. The method of claim 52, wherein inserting the barbed tissue
connector is accomplished with an inserting device.
56. The method of claim 55, wherein the inserting device comprises
a tubular body.
57. The surgical method of claim 52, wherein the barbed tissue
connector comprises a bioabsorbable material.
58. The surgical method of claim 57, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
59. A method for bringing together one side and an other side of an
open wound in tissue with a barbed tissue connector, where the
barbed tissue connector has an elongated body, a pointed end, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs being sized and shaped
to resist retraction of the barbed tissue connector from the
tissue, said method comprising: (i) inserting the barbed tissue
connector via the pointed end into tissue from one side of the
wound, (ii) penetrating through tissue on the one side of the
wound, (iii) penetrating into tissue at the other side of the wound
such that a portion of the body extends from the tissue at the one
side of the wound, (iv) inserting another barbed tissue connector,
where the other barbed tissue connector has an elongated body, a
pointed end, a periphery, and a plurality of closely spaced barbs
which extend around the periphery of the body, the barbs of the
other barbed tissue connector being sized and shaped to resist
retraction of the other barbed tissue connector from the tissue,
via the pointed end of the other barbed tissue connector from the
other side of the wound, (v) penetrating through tissue at the
other side of the wound, and (vi) penetrating into tissue at the
one side of the wound such that a portion of the body of the
another barbed tissue connector extends from the tissue at the
other side of the wound.
60. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
a first pointed end, a second pointed end, and a substantially
polygonal periphery in cross-section including at least three
sides, each side meeting an adjacent side at an edge of the
elongated body, and a plurality of barbs, each barb projecting from
one of the edges of the body, the barbs being sized and shaped to
resist retraction of the barbed tissue connector from the tissue,
the barbed tissue connector having the barbs oriented in one
direction for a first portion of the length of the body and in an
opposite direction for a second portion of the length of the body,
and the first pointed end and the second pointed end being free of
barbs, said method comprising: (a) at the tissue separation,
inserting the barbed tissue connector via the first pointed end
into tissue at a position on one side of the tissue separation,
wherein the barbed tissue connector comprises a bioabsorbable
material; (b) repeating step (a) at the other side of the tissue
separation, using the second pointed end of the barbed tissue
connector, at a position located across the tissue separation from
the position in which the first pointed end of the barbed tissue
connector was inserted wound; and (c) bringing the two tissue
portions together by pressing the two tissue portions together or
by pushing the barbed tissue connector through the tissue.
61. A device for insertion into tissue comprising: a barbed tissue
connector having an elongated body, a pointed end, a length, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, and being disposed around the
periphery of the body along at least a portion of the length of the
body, the barbs being configured such that they are yieldable in a
direction toward the body and resist retraction from tissue in an
opposite direction, and an inserting device having a closed tubular
body, a leading end, and a trailing end, the tubular body being
sufficiently long to contain at least a portion of the barbed
tissue connector.
62. The device of claim 61, wherein the leading end of the
inserting device is tapered inwardly.
63. The device of claim 61, wherein the trailing end of the
inserting device is tapered outwardly.
64. The device of claim 61, wherein the tubular body of the
inserting device has a circular cross section.
65. The device of claim 61, wherein an inside diameter of the
tubular body of the inserting device is slightly less than an
outside cross-section of the connector.
66. The device of claim 61, wherein the tubular body of the
inserting device is generally arcuate in an axial direction.
67. The device of claim 61, wherein the inserting device has a
handle on the tubular body adjacent the trailing end.
68. The device of claim 61, wherein at least one barb of the
connector protrudes from the leading end of the tubular body of the
inserting device.
69. The device of claim 61, wherein the body of the connector is
formed of a material sufficiently hard for the point to pierce
tissue and to enable the connector to be inserted in tissue when a
substantially axial force is applied to the body of the
connector.
70. The device of claim 61, wherein the connector comprises a
bioabsorbable material.
71. The device of claim 70, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
72. The device of claim 61, wherein the connector has the barbs
oriented at progressively staggered positions along the edges of
the body.
73. The device of claim 61, wherein the barbs have a unidirectional
configuration on the connector.
74. The device of claim 61, wherein the connector has the barbs
oriented in one direction for a first portion of the length of the
body of the connector and in an opposite direction for a second
portion of the length of the body of the connector.
75. The device of claim 61, wherein the barbs are arranged in a
helical pattern on the connector.
76. The device of claim 61, wherein the pointed end of the
connector is free of barbs.
77. The device of claim 61, wherein the connector has an end
opposite the pointed end comprising a head end.
78. A device for insertion into tissue comprising: an inserting
device having a closed tubular body, a leading end, and a trailing
end, and a barbed tissue connector having an elongated body, a
pointed end, a length, and a substantially polygonal periphery in
cross-section including at least three sides, each side meeting an
adjacent side at an edge of the elongated body, and a plurality of
barbs, each barb projecting from one of the edges of the body, and
being disposed around the periphery of the body along at least a
portion of the length of the body, the barbs being configured such
that they are yieldable in a direction toward the body and resist
retraction from tissue in an opposite direction, and the connector
being positioned in the tubular body of the inserting device with
the pointed end of the connector protruding from the leading end of
the inserting device.
79. The device of claim 78, wherein the leading end of the
inserting device is tapered inwardly.
80. The device of claim 78, wherein the trailing end of the
inserting device is tapered outwardly.
81. The device of claim 78, wherein the tubular body of the
inserting device has a circular cross section.
82. The device of claim 78, wherein an inside diameter of the
tubular body of the inserting device is slightly less than an
outside cross-section of the connector.
83. The device of claim 78, wherein the tubular body of the
inserting device is generally arcuate in an axial direction.
84. The device of claim 78, wherein the inserting device has a
handle on the tubular body adjacent the trailing end.
85. The device of claim 78, wherein at least one barb of the
connector protrudes from the leading end of the tubular body of the
inserting device.
86. The device of claim 78, wherein the body of the connector is
formed of a material sufficiently hard for the point to pierce
tissue and enable the connector to be inserted in tissue when a
substantially axial force is applied to the body of the
connector.
87. The device of claim 78, wherein the connector comprises a
bioabsorbable material.
88. The device of claim 87, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
89. The device of claim 78, wherein the connector has the barbs
oriented at progressively staggered positions along the periphery
of the body.
90. The device of claim 78, wherein the barbs have a unidirectional
configuration on the connector.
91. The device of claim 78, wherein the connector has the barbs
oriented in one direction for a first portion of the length of the
body of the connector and in an opposite direction for a second
portion of the length of the body of the connector.
92. The device of claim 78, wherein the barbs are arranged in a
helical pattern on the connector.
93. The device of claim 78, wherein the pointed end of the
connector is free of barbs.
94. The device of claim 78, wherein the connector has an end
opposite the pointed end comprising a head end.
95. A method for bringing together one side and an other side of an
open wound in tissue with a barbed tissue connector, where the
barbed tissue connector has an elongated body, and a substantially
polygonal periphery in cross-section including at least three
sides, each side meeting an adjacent side at an edge of the
elongated body, and a plurality of barbs, each barb projecting from
one of the edges of the body, the barbs being sized and shaped to
resist retraction of the barbed tissue connector from the tissue,
said method comprising: (iii) inserting the barbed tissue connector
into tissue from one side of the wound, (iv) penetrating through
tissue on the one side of the wound, and (iii) penetrating into
tissue at the other side of the wound such that a portion of the
body extends from the tissue at the one side of the wound.
96. The method of claim 95, said method comprising: (i) inserting
another barbed tissue connector from the other side of the wound,
where the other barbed tissue connector has an elongated body, and
a substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs of the other barbed
tissue connector being sized and shaped to resist retraction of the
other barbed tissue connector from the tissue, (ii) penetrating
through tissue at the other side of the wound, and (vii)
penetrating into tissue at the one side of the wound.
97. The method of claim 95, wherein inserting the barbed tissue
connector is accomplished with an inserting device.
98. The method of claim 97, wherein the inserting device comprises
a tubular body.
99. The method of claim 95, wherein the barbed tissue connector
comprises a bioabsorbable material.
100. The method of claim 99, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
101. The method of claim 95, wherein the barbed tissue connector
has the barbs oriented at progressively staggered positions around
the periphery of the body.
102. The method of claim 95, wherein the barbed tissue connector
has an end that is free of barbs.
103. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
a first end, a second end, a length, and a substantially polygonal
periphery in cross-section including at least three sides, each
side meeting an adjacent side at an edge of the elongated body, and
a plurality of barbs, each barb projecting from one of the edges of
the body, the barbs being sized and shaped to resist retraction of
the barbed tissue connector from the tissue, the barbed tissue
connector having the barbs oriented in one direction for a first
portion of the length of the body and in an opposite direction for
a second portion of the length of the body, said method comprising:
(a) at the tissue separation, inserting the barbed tissue connector
via the first end into tissue at a position on one side of the
tissue separation; (b) repeating step (a) at the other side of the
tissue separation, using the second end of the barbed tissue
connector, at a position located across the tissue separation from
the position in which the first end of the barbed tissue connector
was inserted; and (c) bringing the two tissue portions
together.
104. The surgical method of claim 103, wherein bringing the two
tissue portions together in step (c) is accomplished by pressing
the two tissue portions together.
105. The surgical method of claim 103, wherein bringing the two
tissue portions together in step (c) is accomplished by pushing the
barbed tissue connector through the tissue.
106. The surgical method of claim 103, wherein inserting the barbed
tissue connector is accomplished with an inserting device.
107. The surgical method of claim 106, wherein the inserting device
comprises a tubular body.
108. The surgical method of claim 103, wherein the two tissue
portions comprise two sides of an open wound in skin.
109. The surgical method of claim 103, wherein the barbed tissue
connector comprises a bioabsorbable material.
110. The surgical method of claim 109, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
111. The surgical method of claim 103, wherein the two tissue
portions comprise portions of a tendon.
112. The surgical method of claim 103, wherein: (a) the two tissue
portions comprise two sides of an open wound at the skin of a
patient, and (b) the first end and the second end are free of
barbs.
113. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
and a substantially polygonal periphery in cross-section including
at least three sides, each side meeting an adjacent side at an edge
of the elongated body, and a plurality of barbs, each barb
projecting from one of the edges of the body, the barbs being sized
and shaped to resist retraction of the barbed tissue connector from
the tissue and permitting movement of the barbed tissue connector
through the tissue in the direction the barbed tissue connector is
inserted, said method comprising: (a) at the tissue separation,
inserting the barbed tissue connector into tissue at one side of
the tissue separation, (b) penetrating through tissue on the one
side of the separation, and (c) penetrating into tissue on the
other side of the separation such that a portion of the body
extends from the tissue at the one side of the tissue
separation.
114. The surgical method of claim 113, said method comprising: (d)
inserting another barbed tissue connector from the other side of
the tissue separation, where the other barbed tissue connector has
an elongated body, and a substantially polygonal periphery in
cross-section including at least three sides, each side meeting an
adjacent side at an edge of the elongated body, and a plurality of
barbs, each barb projecting from one of the edges of the body, the
barbs of the other barbed tissue connector being sized and shaped
to resist retraction of the other barbed tissue connector from the
tissue and permitting movement of the other barbed tissue connector
through the tissue in the direction the other barbed tissue
connector is inserted, (e) penetrating through tissue on the other
side of the of the separation, and (f) penetrating into tissue on
the one side of the separation.
115. The surgical method of claim 113, wherein the two tissue
portions comprise sections of a tendon.
116. The surgical method of claim 113, wherein the two tissue
portions comprise two sides of an open wound in skin.
117. The surgical method of claim 113, wherein the barbed tissue
connector comprises a bioabsorbable material.
118. The surgical method of claim 117, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
119. A surgical method for inserting a barbed tissue connector into
tissue, where the barbed tissue connector has an elongated body, an
end adapted to penetrate the tissue, an opposite end, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, the barbs being sized and shaped
to resist retraction of the barbed tissue connector from the
tissue, said method comprising inserting the penetrating end into
tissue by applying force to the opposite end such that a portion of
the body extends from the tissue.
120. The surgical method of claim 119, wherein the opposite end
comprises a head end.
121. The surgical method of claim 119, wherein after an adequate
amount of time has passed for healing, depressing the tissue
beneath the head end and cutting the head end from the elongated
body, permitting the tissue to rise up over the cut end of the
elongated body.
122. The surgical method of claim 119, wherein inserting the barbed
tissue connector is accomplished with an inserting device.
123. The surgical method of claim 122, wherein the inserting device
comprises a tubular body.
124. The surgical method of claim 119, wherein the barbed tissue
connector comprises a bioabsorbable material.
125. The surgical method of claim 124, wherein the bioabsorbable
material comprises polyglycolic acid polymer, polyglycolic acid
copolymer, polylactic acid polymer, or polylactic acid
copolymer.
126. A method for bringing together one side and an other side of
an open wound in tissue with a barbed tissue connector, where the
barbed tissue connector has an elongated body, and a substantially
polygonal periphery in cross-section including at least three
sides, each side meeting an adjacent side at an edge of the
elongated body, and a plurality of barbs, each barb projecting from
one of the edges of the body, the barbs being sized and shaped to
resist retraction of the barbed tissue connector from the tissue,
said method comprising: (v) inserting the barbed tissue connector
into tissue from one side of the wound, (vi) penetrating through
tissue on the one side of the wound, (vii) penetrating into tissue
at the other side of the wound such that a portion of the body
extends from the tissue at the one side of the wound, (viii)
inserting another barbed tissue connector, where the other barbed
tissue connector has an elongated body, a periphery, and a
plurality of closely spaced barbs which extend around the periphery
of the body, the barbs of the other barbed tissue connector being
sized and shaped to resist retraction of the other barbed tissue
connector from the tissue, from the other side of the wound, (vii)
penetrating through tissue at the other side of the wound, and
(viii) penetrating into tissue at the one side of the wound such
that a portion of the body of the another barbed tissue connector
extends from the tissue at the other side of the wound.
127. A surgical method for bringing together two tissue portions on
either side of a tissue separation in tissue with a barbed tissue
connector, where the barbed tissue connector has an elongated body,
a first end, a second end, and a substantially polygonal periphery
in cross-section including at least three sides, each side meeting
an adjacent side at an edge of the elongated body, and a plurality
of barbs, each barb projecting from one of the edges of the body,
the barbs being sized and shaped to resist retraction of the barbed
tissue connector from the tissue, the barbed tissue connector
having the barbs oriented in one direction for a first portion of
the length of the body and in an opposite direction for a second
portion of the length of the body, and the first end and the second
end being free of barbs, said method comprising: (d) at the tissue
separation, inserting the barbed tissue connector via the first end
into tissue at a position on one side of the tissue separation,
wherein the barbed tissue connector comprises a bioabsorbable
material; (e) repeating step (a) at the other side of the tissue
separation, using the second end of the barbed tissue connector, at
a position located across the tissue separation from the position
in which the first pointed end of the barbed tissue connector was
inserted wound; and (f) bringing the two tissue portions together
by pressing the two tissue portions together or by pushing the
barbed tissue connector through the tissue.
128. A device for insertion into tissue comprising: a barbed tissue
connector having an elongated body, a pointed end, a length, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, and being disposed around the
periphery of the body along at least a portion of the length of the
body, the barbs being configured such that they are yieldable in a
direction toward the body and resist retraction from tissue in an
opposite direction, and an inserting device having a closed tubular
body, a leading end, and a trailing end, the tubular body being
sufficiently long to contain at least a portion of the barbed
tissue connector.
129. The device of claim 128, wherein the leading end of the
inserting device is tapered inwardly.
130. The device of claim 128, wherein the trailing end of the
inserting device is tapered outwardly.
131. The device of claim 128, wherein the tubular body of the
inserting device has a circular cross section.
132. The device of claim 128, wherein an inside diameter of the
tubular body of the inserting device is slightly less than an
outside cross-section of the connector.
133. The device of claim 128, wherein the tubular body of the
inserting device is generally arcuate in an axial direction.
134. The device of claim 128, wherein the inserting device has a
handle on the tubular body adjacent the trailing end.
135. The device of claim 128, wherein at least one barb of the
connector protrudes from the leading end of the tubular body of the
inserting device.
136. The device of claim 128, wherein the body of the connector has
a pointed end formed of a material sufficiently hard for the
pointed end to pierce tissue and to enable the connector to be
inserted in tissue when a substantially axial force is applied to
the body of the connector.
137. The device of claim 128, wherein the connector comprises a
bioabsorbable material.
138. The device of claim 137, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
139. The device of claim 128, wherein the connector has the barbs
oriented at progressively staggered positions around the periphery
of the body.
140. The device of claim 128, wherein the barbs have a
unidirectional configuration on the connector.
141. The device of claim 128, wherein the connector has the barbs
oriented in one direction for a first portion of the length of the
body of the connector and in an opposite direction for a second
portion of the length of the body of the connector.
142. The device of claim 128, wherein the barbs are arranged in a
helical pattern on the connector.
143. The device of claim 128, wherein the connector has an end free
of barbs.
144. The device of claim 128, wherein the connector has an end and
an opposite end that comprises a head end.
145. A device for insertion into tissue comprising: an inserting
device having a tubular body, a leading end, and a trailing end,
and a barbed tissue connector having an elongated body, a length,
and a substantially polygonal periphery in cross-section including
at least three sides, each side meeting an adjacent side at an edge
of the elongated body, and a plurality of barbs, each barb
projecting from one of the edges of the body, and being disposed
around the periphery of the body along at least a portion of the
length of the body, the barbs being configured such that they are
yieldable in a direction toward the body and resist retraction from
tissue in an opposite direction, and the connector being positioned
in the tubular body of the inserting device with one end of the
connector protruding from the leading end of the inserting
device.
146. The device of claim 145, wherein the leading end of the
inserting device is tapered inwardly.
147. The device of claim 145, wherein the trailing end of the
inserting device is tapered outwardly.
148. The device of claim 145, wherein the tubular body of the
inserting device has a circular cross section.
149. The device of claim 145, wherein an inside diameter of the
tubular body of the inserting device is slightly less than an
outside cross-section of the connector.
150. The device of claim 145, wherein the tubular body of the
inserting device is generally arcuate in an axial direction.
151. The device of claim 145, wherein the inserting device has a
handle on the tubular body adjacent the trailing end.
152. The device of claim 145, wherein at least one barb of the
connector protrudes from the leading end of the tubular body of the
inserting device.
153. The device of claim 145, wherein the body of the connector is
formed of a material sufficiently hard for the point to pierce
tissue and enable the connector to be inserted in tissue when a
substantially axial force is applied to the body of the
connector.
154. The device of claim 145, wherein the connector comprises a
bioabsorbable material.
155. The device of claim 145, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
156. The device of claim 145, wherein the connector has the barbs
oriented at progressively staggered positions along the edges of
the body.
157. The device of claim 145, wherein the barbs have a
unidirectional configuration on the connector.
158. The device of claim 145, wherein the connector has the barbs
oriented in one direction for a first portion of the length of the
body of the connector and in an opposite direction for a second
portion of the length of the body of the connector.
159. The device of claim 145, wherein the barbs are arranged in a
helical pattern on the connector.
160. The device of claim 145, wherein one end of the connector is
free of barbs.
161. The device of claim 145, wherein the connector has an end and
an opposite end comprising a head end.
162. A method for inserting a barbed tissue connector in tissue,
where the barbed tissue connector has an elongated body, and a
substantially polygonal periphery in cross-section including at
least three sides, each side meeting an adjacent side at an edge of
the elongated body, and a plurality of barbs, each barb projecting
from one of the edges of the body, and being disposed around the
periphery of the body along at least a portion of the length of the
body, the barbs being sized and shaped to resist retraction of the
barbed tissue connector from the tissue, said method comprising:
(i) positioning the barbed tissue connector in an inserting device
including a closed tubular body, (ii) inserting the inserting
device into tissue, and (iii) extracting the inserting device from
the tissue while leaving the connector in the tissue.
163. The method of claim 162, said method comprising: (iv)
repeating steps (i), (ii), and (iii) with another barbed tissue
connector, where the other barbed tissue connector has an elongated
body, and a substantially polygonal periphery in cross-section
including at least three sides, each side meeting an adjacent side
at an edge of the elongated body, and a plurality of barbs, each
barb projecting from one of the edges of the body, and being
disposed around the periphery of the body along at least a portion
of the length of the body, the barbs of the other barbed tissue
connector being sized and shaped to resist retraction of the other
barbed tissue connector from the tissue.
164. The method of claim 162, wherein the barbed tissue connector
comprises a bioabsorbable material.
165. The method of claim 164, wherein the bioabsorbable material
comprises polyglycolic acid polymer, polyglycolic acid copolymer,
polylactic acid polymer, or polylactic acid copolymer.
166. The method of claim 162, wherein the barbed tissue connector
has the barbs oriented at progressively staggered positions around
the periphery of the body.
167. The method of claim 162, wherein the barbed tissue connector
has an end that is free of barbs.
168. The method of claim 162, wherein the body of the connector has
a pointed end formed of a material sufficiently hard for the
pointed end to pierce tissue and to enable the connector to be
inserted in tissue when a substantially axial force is applied to
the body of the connector.
169. The method of claim 162, wherein the connector has the barbs
oriented at progressively staggered positions around the periphery
of the body.
170. The method of claim 162, wherein the barbs have a
unidirectional configuration on the connector.
171. The method of claim 162, wherein the connector has the barbs
oriented in one direction for a first portion of the length of the
body of the connector and in an opposite direction for a second
portion of the length of the body of the connector.
172. The method of claim 162, wherein the barbs are arranged in a
helical pattern on the connector.
173. The method of claim 162, wherein the connector has an end free
of barbs.
174. The method of claim 162, wherein the connector has an end and
an opposite end that comprises a head end.
175. The method of claim 162, wherein the tubular body of the
inserting device has a circular cross section.
176. The method of claim 162, wherein an inside diameter of the
tubular body of the inserting device is slightly less than an
outside diameter of the connector.
177. The method of claim 162, wherein the tubular body of the
inserting device is generally arcuate in an axial direction.
178. The method of claim 162, wherein the inserting device has a
leading end and at least one barb of the connector protrudes from
the leading end.
179. The method of claim 162, wherein the inserting device has a
leading end that is tapered inwardly.
180. The method of claim 162, wherein the inserting device has a
trailing end that is tapered outwardly.
181. The method of claim 162, wherein the inserting device has a
trailing end and a handle adjacent the trailing end.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application is a continuation application of U.S.
patent application Ser. No. 10/420,119, filed on Apr. 2, 2003,
which is a continuation application of U.S. patent application Ser.
No. 09/629,428, filed on Jul. 31, 2000, now abandoned, which is a
continuation application of U.S. patent application Ser. No.
08/324,529, filed on Oct. 18, 1994, now U.S. Pat. No. 6,241,747,
which is a continuation-in-part application of U.S. patent
application Ser. No. 08/055,989, filed on May 3, 1993, now
abandoned.
BACKGROUND OF THE INVENTION
[0002] This invention relates to a barbed tissue connector, and
more particularly, to such a connector which can be used to quickly
and effectively close a body wound.
[0003] Human wounds are typically repaired with a filament
introduced into the tissue by a needle attached to one end. After
piercing the opposing faces of the wound, the needle is removed,
and the ends of the suture are tied together with at least three
overhand knots. Such a technique requires considerable time and
expertise on the part of the surgeon. There are also a number of
other drawbacks to repairing a wound in this manner. For example,
it is very difficult to use sutures to repair wounds where there is
insufficient space to properly manipulate the suture, especially
those wounds repaired using fiber optic visualization. The suture
forms a loop as it is tied, and this loop constricts blood flow to
the tissue in its confines, promoting necrosis of the wound
margins. Further, if the needle's passage was noncircular, the
tissue will be distorted as it is secured by the suture.
[0004] Alternatives to conventional sutures are known in the prior
art. Staples, as shown, for example, in U.S. Pat. No. 4,994,073, to
Green, are often used for approximating the superficial layer of
the wound. Staples, however, are generally unsuitable for deeper
layers of tissue.
[0005] The patent to Alcamo, U.S. Pat. No. 3,123,077, discloses a
roughened suture which can be passed through tissue in one
direction, but resists movement in the opposite direction. The
Alcamo suture, however, still must be sewn, as by a conventional
technique, and the trailing end must be secured with knots. Thus,
although there is less slippage of the suture in the wound, most of
the disadvantages of sutures noted above are also found in the
Alcamo suture.
[0006] The patent to Tanner, U.S. Pat. No. 3,716,058, discloses a
relatively rigid suture with one or more barbs on opposite ends of
an arcuate body. One disadvantage of the Tanner suture is that the
rigid barbs, which protrude from the suture as it is inserted, will
lacerate tissue and prevent retrograde repositioning. Further,
since the barbs are only placed at the ends of the suture, the
forces applied to the tissue by the barbs will be limited to a
relatively small area; this substantially increases the pressure on
the blood vessels ensnared by a barb and severely restricts blood
flow to the area.
[0007] It will be seen from the foregoing that there is a need for
a tissue connector which can be placed more expeditiously than
sutures, is self-retaining, obviates distortion of the tissue, can
close tissue inaccessible to conventional procedures, and which
preserves blood flow by broadly distributing the retention
force.
SUMMARY OF THE INVENTION
[0008] It is an object of the present invention to overcome the
aforementioned problems in the prior art and to provide an improved
tissue connector.
[0009] In accordance with the present invention there is provided a
barbed tissue connector comprising: an elongated body having a
point formed on one end, the body being formed of a material
sufficiently hard for the point to pierce tissue and enable the
connector to be inserted in tissue when a substantially axial force
is applied to the body; and a plurality of barbs projecting from
the body, the barbs being disposed around the periphery of the body
along a length of the body which extends from adjacent the one end
to a predetermined location on the body, the barbs being configured
such that they are yieldable in a direction toward the body and are
generally rigid in an opposite direction, and the barbs being
sufficiently resilient to return to a predetermined position after
deflection therefrom.
[0010] In one embodiment of the present invention, the barbed
tissue connector includes an elongated body and a plurality of
barbs which are disposed in a helical pattern on the body and
extend from a pointed end of the connector to a predetermined
location on the body. Each barb includes a first side, which forms
an obtuse angle with the body, and a second side which forms an
acute angle with the body. The body is substantially rigid and
sufficiently resilient to return to a predetermined position after
deflection therefrom. When the connector is inserted in tissue to
repair a wound, the pointed end pierces tissue and the barbs yield
toward the body to facilitate entry of the connector.
[0011] When the connector has been placed in a desired position in
tissue, the barbs strongly resist movement away from this position.
The connector can be inserted by gripping the connector in the hand
and pushing the connector into the tissue, or the connector can be
inserted by means of an inserting device which is withdrawn when
the connector is in place.
[0012] A principal advantage of the barbed tissue connector of the
present invention is that it permits a surgeon to rapidly and
securely attach the edges of a wound in human tissue without the
necessity for threading and tying numerous individual stitches or
for the use of a complicated or elaborate tool to insert the
connector. The connector is configured to minimize damage to tissue
when inserted and to minimize scarring or tissue necrosis across
the wound. The connector is capable of insertion into the faces of
a wound, can connect tissue at the bottom of a deep wound, and can
connect tissue which is inaccessible to a staple. Finally, the
connector of the present invention can be inserted quickly and
accurately by a surgeon who only has access to tissue from a small
opening or from only one direction, as, for example, during an
endoscopic procedure.
[0013] Other features and advantages will become apparent upon
reference to the following description of the preferred embodiment
when read in light of the attached drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 is a side view of the connector of the present
invention, with a section broken away to more clearly show the
arrangement of the barbs;
[0015] FIG. 2 is an end view of the connector shown in FIG. 1;
[0016] FIG. 3 is a side view of another embodiment of the present
invention, with a section of a connector broken away;
[0017] FIG. 4 is a side view of another embodiment of the present
invention;
[0018] FIG. 5 is a side view of another embodiment of the present
invention;
[0019] FIG. 6 is a side view of another embodiment of the present
invention;
[0020] FIG. 7 is a sectional view taken along the line 7-7 in FIG.
6;
[0021] FIG. 8 is a side view of another embodiment of the present
invention;
[0022] FIG. 9 is a sectional view taken along the line 9-9 in FIG.
8;
[0023] FIG. 10 is a perspective view of an inserting device for use
with a barbed tissue connector of the present invention; and
[0024] FIG. 11 is a view showing the inserting device and connector
in a wound.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0025] The present invention allows a surgeon to rapidly and
securely attach the edges of a wound in human tissue without the
necessity for threading and tying numerous individual stitches or
for using a complicated or elaborate tool. As used herein, the term
"wound" means an incision, laceration, cut, or other condition
where suturing, stapling, or the use of another tissue connecting
device might be required.
[0026] With reference to FIGS. 1 and 2, there is shown a barbed
tissue connector 2 constructed in accordance with the present
invention. Connector 2 includes a body 4 which is generally
circular in cross section and a plurality of closely-spaced barbs 6
which extend around the periphery of the body 4. A pointed end 9 is
formed on the body 4 to facilitate penetration of the connector 2
into tissue. The body 4 preferably has sufficient dimensional
stability to assume a substantially rigid configuration during use
and is sufficiently resilient to return to a predetermined shape
after deflection therefrom. In some applications, it may be
desirable for the body 4 to be flexible and substantially
nonresilient so that the shape of an inserted connector will be
determined by surrounding tissue.
[0027] Barbs 6 serve to hold the connector in tissue and resist
retraction of the connector from the tissue. The barbs 6 can be
arranged in any suitable pattern, for example, in a helical pattern
as shown in FIG. 1. In a helical pattern of barbs 6, it is
preferable that the number of barbs occupying one revolution not be
an integer, thereby avoiding parallel axial rows of barbs; such an
arrangement provides a more uniform distribution of forces on the
tissue and lessens the tendency of an inserted connector 2 to cut
through tissue. If the number of barbs in one revolution is not an
integer, the barbs in successive revolutions will be offset, as
shown in FIG. 2, and the amount of offset will determine which
barbs are in axial alignment. For example, if the barbs in
successive revolutions are offset by 1/2 barb, the barbs in every
second revolution will be in axial alignment, and by extension, if
the barbs in each successive revolution are offset by 1/x barb, the
barbs in every x revolution will be in axial alignment.
[0028] As shown in FIG. 1, each barb 6 includes a first side 8
which forms an obtuse angle alpha with the body 4 and a second side
10 which forms an acute angle beta with the body 4. Each barb 6
tapers to a point 7, and the amount of difference between the angle
alpha of side 8 and angle beta of side 10 will control the amount
of taper in the barb 6. A barb 6 which tapers from a broad base to
a narrow tip can be effective in resisting retraction, yet will
yield toward the body 4 during insertion to reduce the effort and
tissue damage associated with insertion of the connector 2. The
barbs 6 can be generally conical, as shown in FIG. 1, or they can
be any other shape which will function in substantially the same
manner as the conical barbs.
[0029] The configuration of barbs 6 and the surface area of the
barbs can vary depending upon the tissue in which the connector 2
is used. The proportions of the barbs 6 can remain relatively
constant while the overall length of the barbs and the spacing of
the barbs are determined by the tissue being connected. For
example, if the connector 2 is intended to be used to connect the
edges of a wound in skin or tendon, each barb 6 can be made
relatively short to facilitate entry into this rather firm tissue.
If the connector 2 is intended for use in fatty tissue, which is
relatively soft, the barbs can be made longer and spaced farther
apart to increase the holding ability in the soft tissue. As shown
in FIG. 1, the barbs 6 on connector 2 have a uniform unidirectional
configuration, that is, the barbs 6 are uniformly spaced on body 4
and all the sides 8 are oriented in the same direction, facing
pointed end 9. Connector 2 can be inserted into tissue with the
sides 8 of each barb 6 facing in the direction of motion. Connector
2 will prevent movement of tissue in the direction in which it was
inserted. A pair of connectors 2 inserted adjacent to each other
and in opposite directions will prevent movement of tissue in
either direction across a wound.
[0030] Connector 2 can be formed of a material sufficiently hard
for point 9 to pierce tissue and enable the connector to be
inserted in tissue when a substantially axial force is applied to
body 4. Connector 2 is preferably composed of a bioabsorbable
compound, such as a polyglycolic acid or polylactic acid polymer or
copolymer. The use of a bioabsorbable material eliminates the
necessity of removing the connector from the patient, which can be
a painful and possibly dangerous process. Connector 2 can be
formed, for example, by injection molding.
[0031] In one representative example of connector 2 for use in
muscular tissue, the body 4 is formed from polyglycolic acid, has a
length of 1 to 5 cm, and a diameter of about 1 mm. The diameter of
a circle extending around points 7 of barbs 6 will be about 3 mm,
and the barbs are spaced apart from each other on body 4 by a
distance of 1 mm. Side 8 forms an angle of 135 degrees with the
body 4 and side 10 forms an angle of 75 degrees with the body
4.
[0032] In FIG. 3, there is shown a second embodiment of the present
invention in which barbs 16 are arranged in a uniform bidirectional
configuration on a barbed tissue connector 12. Barbs 16 are
constructed in the same manner as barbs 6 on connector 2. A first
set of barbs 15 on connector 12 are arranged in a helical pattern
and face a pointed end 20, and a second set of barbs 16 on
connector 12 are arranged in a helical pattern and face a pointed
end 21. Each of the pointed ends 20, 21 should be sufficiently hard
and sharp to easily penetrate tissue in which the connector is to
be used. Connector 12 is particularly suitable for applications
where the edges of a wound are prone to separate. Connector 12 can
be used by inserting one of the ends, for example end 20, into a
first side of a wound (not shown), spreading the wound slightly to
expose the second side of the wound, inserting the end 21 of the
connector 12 into the second side of the wound, and then pressing
the edges of the wound together. The barbs 15 and 16 on the ends of
the connector 12 will grasp the tissue on each side of the wound
and prevent the edges of the wound from spreading.
[0033] With reference to FIG. 4, there is shown another embodiment
of the present invention in which a barbed tissue connector 22 has
a nonuniform bidirectional configuration. Connector 22 comprises a
pointed end 23 and one or more barbs 26 facing a first direction
which alternate with one or more barbs 27 facing a second
direction. At each axial location, there can be a number, e.g. 4-9,
of circumferentially-spaced barbs 26 or 27. To insert connector 22
into tissue, the surgeon would use an inserting device 80 as
described below. The arrangement of barbs 26, 27 on connector 22
would prevent any localized movement of tissue relative to the
connector in an axial direction.
[0034] With reference to FIG. 5, there is shown another embodiment
of the present invention in which a barbed tissue connector 32 has
a uniform bidirectional configuration. Connector 32 comprises a
body 34 having pointed ends 33 and 35. A plurality of
axially-spaced barbs 36 adjacent pointed end 33 face toward end 35,
and a plurality of axially-spaced barbs 37 adjacent pointed end 35
face toward end 33. Barbs 36 and 37 can be circumferentially-spaced
around body 34 at each axial location, or the barbs 36 and 37 can
be of the same construction and arranged in the same pattern as
barbs 6 on connector 2. To insert a connector 32, the surgeon would
use an inserting device 80 as described below. If the body 34 of
the connector 32 is sufficiently rigid, the connector 32 would
prevent tissue retained by the barbs 36 from moving toward end 35
and tissue retained by barbs 37 from moving toward end 33. It will
be apparent that only one end of connector 32 needs to be pointed;
two pointed ends are preferable, however, so that the surgeon does
not have to take the time to insure that connector 32 is oriented
in the inserting device 80 with a pointed end protruding from the
inserting device.
[0035] With reference to FIGS. 6 and 7, there is shown another
embodiment of the present invention in which a barbed tissue
connector 42 comprises a body 44 having a pointed end 45 for
penetration into tissue. A head 47 is formed on an opposite end of
body 44. A plurality of circumferentially-spaced barbs 46 are
formed on body 44 at each of a number of axial locations. As shown
in FIG. 7, three barbs 46 are formed at each axial location;
however, more or less than three barbs 46 could be used for certain
applications. Barbs 46 include a first side 48 formed at an obtuse
angle to the body 44 and a second side 49 which projects from body
44 at an acute angle. The connector 42 can be forced into tissue by
applying a force to the head 47. The connector 42 can be applied by
hand, or it can be inserted using an inserting device 80 as
described below.
[0036] The connector 42 can be formed entirely of a bioabsorbable
material, or the head 47 and the body 44 can be composed of
different materials. For example, the body 44 can be composed of a
bioabsorbable material, and the head 47 can be composed of metal
for superior strength and to facilitate insertion of the connector
42. Head 47 can be made flat, as shown in FIG. 6, or the head can
be formed by a single ring of barbs (not shown) facing in a
direction opposite to that of the barbs 46.
[0037] In use, a series of connectors 42 can be inserted into
tissue, such as along the edges and in the field of a skin graft.
After an adequate amount of time has passed for the wound to heal,
the tissue beneath each head 47 could be depressed slightly to
permit the head 47 to be cut from the body 44. The tissue would
then rise up over the cut end of the body. Such a process would
reduce scarring which could result from a long-term projection of
the body 44 through tissue and would eliminate the necessity to
remove connectors 42 from the patient.
[0038] With reference to FIGS. 8 and 9, there is shown another
embodiment of the present invention in which a barbed tissue
connector 52 has a uniform unidirectional configuration. Connector
52 comprises a body 54 having a non-circular cross-sectional shape.
Body 54 includes a plurality of barbs 56 which are generally
triangular in cross section and are equally spaced around the
periphery of the body at a series of axial locations. Each of the
barbs 56 includes a first side 58 disposed at an obtuse angle to
body 54 and a second side 60 disposed at an acute angle to the
body. Body 54 includes a pointed end 53 to facilitate entry in
tissue. Use of a non-circular cross-sectional shape increases the
surface area of the connector 52 and facilitates the formation of
the multiple barbs on the connector. For example, barbs 56 can be
formed on a piece of stock having a triangular cross section by
removing material at successive axial locations from the three
edges of the stock. It will be apparent that a similar process
could be used to form barbs on stock of a different cross section
(not shown), for example, a rectangular or hexagonal cross
section.
[0039] In the use of the disclosed connectors, such as connectors 2
and 42, the surgeon can grip the connector in one hand and push the
connector into the tissue. As an alternative to directly inserting
the connectors into the tissue, the surgeon can use an inserting
device 80 as shown in FIGS. 10 and 11. The inserting device 80
comprises a circular tubular body 82. The tubular body 82 can be
generally arcuate in an axial direction, and the body 82 is
sufficiently long to contain at least a portion of a barbed tissue
connector C. Device 80 has an inwardly tapered leading end 84 and
an outwardly tapered, or flared, trailing end 86. A handle 83 is
provided on body 82 adjacent trailing end 86 to enable the surgeon
to manipulate the inserting device 80.
[0040] In order to facilitate entry of the connector C and the
device 80 into tissue, a connector C is positioned in tubular body
82 with a pointed end P of the connector C extending from leading
end 84. In a preferred embodiment, the interior diameter of the
body 82 is made slightly smaller than the outside diameter of the
connector C so that the barbs B of a connector C in the body 82
will press against the body 82; as a result, the connector C will
be retained in the body 82 during insertion in tissue with the
point P properly positioned outside of the body 82. The connector
can also be positioned in body 82 with a barb B outside of body 82
to insure that the connector C will not be pushed back in the body
82 during insertion. In one application of device 80, the surgeon
inserts the body 82 having connector C therein into the patient's
tissue 87 until the connector C reaches a desired position, for
example, the position shown in FIG. 11. Device 80 is then withdrawn
in the direction of arrow 90, and a barb, or barbs, B on the
connector C penetrates and catches the tissue 87 to hold the
connector C in the inserted position.
[0041] Use of the inserting device 80 is particularly recommended
when the connector C includes multiple barbs facing more than one
direction, such as connectors 22 and 32, or when the connector is
too flexible for insertion without additional support.
[0042] While the present invention has been described with respect
to certain preferred embodiments thereof, it is to be understood
that numerous variations in the details of construction, the
arrangement and combination of parts, and the type of materials
used may be made without departing from the spirit and scope of the
invention.
* * * * *