U.S. patent number 3,910,281 [Application Number 05/404,297] was granted by the patent office on 1975-10-07 for suture anchor.
This patent grant is currently assigned to Bio-Medicus, Inc.. Invention is credited to Harold D. Kletschka, Edson H. Rafferty.
United States Patent |
3,910,281 |
Kletschka , et al. |
October 7, 1975 |
Suture anchor
Abstract
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.
Inventors: |
Kletschka; Harold D.
(Minneapolis, MN), Rafferty; Edson H. (Excelsior, MN) |
Assignee: |
Bio-Medicus, Inc. (Minnetonka,
MN)
|
Family
ID: |
23599037 |
Appl.
No.: |
05/404,297 |
Filed: |
October 9, 1973 |
Current U.S.
Class: |
606/232; D24/145;
24/18 |
Current CPC
Class: |
A61B
17/0401 (20130101); A61B 2017/0404 (20130101); Y10T
24/1404 (20150115); A61B 2017/0496 (20130101) |
Current International
Class: |
A61B
17/04 (20060101); A61b 017/04 () |
Field of
Search: |
;128/335,335.5,334R
;24/18 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Attorney, Agent or Firm: Merchant, Gould, Smith, Edell,
Welter & Schmidt
Claims
We claim:
1. A suture anchor comprising:
a. a suture having one end adapted for connection to a needle;
b. an enlarged anchoring member connected to the other end of said
suture, the enlarged anchoring member comprising a flat disc having
opposed side surfaces;
c. a cylindrical post projecting from one of said side surfaces and
adapted to be grasped by a surgical instrument during a suture
tying procedure; and
d. a friction slot formed in the cylindrical post to releasably
receive and anchor the suture during the suture tying
procedure.
2. The structure of claim 1, wherein the suture is secured to a
peripheral portion of the disc and extends from the other of said
opposite side surfaces.
3. The structure of claim 1, wherein the post projects
perpendicularly from said one side surface remote from the center
of the disc.
4. The structure of claim 1 wherein said friction slot is formed in
the circumference of said post and extends angularly inwardly
toward the longitudinal axis thereof.
Description
The present invention is directed to an anchoring device for
releasably securing a suture for subsequent tensin adjustments.
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
sutures. 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 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
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 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 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.
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 member 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 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 tie-off 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
precut suture, needle and suture anchor which are integrally formed
together to ensure maximum 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 minimum 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
invention 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 10b through 10e, hereinafter to be
described.
With respect to the anchor assemblies 10b through 10e, 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 10e 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 10b 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 11b. The surgical needle 12b differs from the needle 12 in
that the needle 12b forms an integral longitudinal extension of the
suture 11b. This is accomplished by forming the base of the needle
12b as a hollow tube and inserting one end of the suture 11b
therein, as at 22. The base of the needle 12b is crimped to fixedly
secure the end of the suture 11b 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 surgical 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 11b.
Slit 19b is formed in a hemispherical plane of the sphere 14b and
is disposed so that the juncture of the suture 11b with the sphere
14b is offset from the slit 19b. In the drawings, the juncture of
the suture 11b 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 11b. 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 10d is shown which includes an elongated body 14d
having a reduced waist portion 23d between opposite enlarged ends
thereof. A suture 11d 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 14d. The other end of the anchor
member 14d serves to form a lateral projection 18d 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 14d is formed with
planar opposite side surfaces 15d, 16d which facilitate gripping of
the body member 14d 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 15d, 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 member 14e is formed
with a reduced waist portion 23e between opposite enlarged ends,
which ends are indicated at 24e and 18e. A suture 11e is formed as
an integral part of the anchor member 14e and forms a juncture with
the reduced waist 23e so as to extend transversely from the
longitudinal dimension of the anchor member 14e centrally between
the enlarged opposite ends 24e, 18e. The symmetrical configuration
of the anchor member 14e permits either of the enlarged ends 24e,
18e to serve as the lateral projection of the body member 14e
suitable to be grasped by a surgical tool to steady the body member
14e during the stichforming procedure. Due to the symmetrical
nature of the body member 14e, a slit 19e is formed in each of the
enlarged ends 18e, 24e generally oppositely of the juncture of the
suture 11e and reduced waist 23e. This permits greater versatility
in releasably anchoring the suture 11e during the final tie off
procedure of the stitch as will be hereinafter described.
In the drawings, FIGS. 6 and 7 illustrate a stitch-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 assembly 10e 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 10e is selected for use. In any
case, procedures described in connection with the suture anchor
assembly 10e will apply to the assemblies 10a through 10d except
for slight variations which will be hereinafter noted.
With the aid of a surgical needle, such as 12 or 12b, the suture
11e 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 10d that the anchor member 14 through 14d
comes directly into contact with the point of entry of the sutures
11 through 11d 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 11e to the reduced waist portion
23e, permits this event to occur. when the stitchforming procedure
has advanced to the condition 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 11e and a second forceps, also not shown, is
utilized to grasp and steady the anchor member 14e. In anchor
members 14 through 14d, the lateral projections 18 through 18d are
engaged to steady the respective anchor member 14 through 14d.
However, with respect to anchor member 14e, either of opposite
enlarged ends 18e or 24e can function as the lateral projection for
steadying the anchor member 14e. When each of the anchor member 14e
and suture 11e have been engaged by a forcep, force is applied to
draw the incision 30 to the closed condition of FIG. 7. Thereafter,
the suture 11e is positioned to extend across the incision 30 and,
after proper tension is applied thereto, wrapped about the juncture
of the suture 11e with the reduced waist 23e and thence in a
direction to encircle the reduced waist 23e one or more times.
Finally, the free end of the suture 11e is engaged in a
conveniently positioned one or the other of the slits 19e to
releasably tie off the stitch formed by the suture 11e.
In the suture anchor assembly 10a of FIG. 1, the suture differs in
that the suture 11 is wrapped about the post 18 and finally
releasably secured in the slit 19. With respect to the suture
anchor assemblies 10b through 10d, the tie off procedure is to draw
the suture 11b through 11d tightly across the incision 30 with the
required amount of tension and thereafter wrap same about
respective sutures 11b through 11d for a number of turns. Finally,
the free end of sutures 11b through 11d are releasably engaged
within respective slots 19b through 19d to tie off the stitch
formation. An alternate method of tying off in the case of suture
anchor assemblies 10c and 10d is to make only one turn of the
suture 11c, 11d at the juncture of the sutures with respective
anchor members 14c, 14d. Thereafter, the turns are wrapped about
the reduced waist portion 23, 23d of a respective anchor member
14c, 14d before finally engaging the sutures 11c, 11d in respective
slits 19c, 19d. When the sutures 11 through 11e have been finally
engaged in respective slits 19 through 19e, a desired amount of the
remaining suture material is trimmed therefrom.
Under normal circumstances, the tissue surrounding the incision 40
may undergo swelling or, alternately, a reduction of swelling
during the healing process. In case of the former, undue tension
may be exerted at the points of entry and exit of the suture
material with the result that sufficient pressure may be exerted on
the adjacent skin to cause it to give way and be cut or torn. This,
of course, often results in irritation and subsequent infection to
the damaged are with much discomfort to the individual. In
conventional stitching methods, as well as certain of the prior art
anchoring devices, the only relief from this type of problem was to
cut the stitches, remove same and repeat the stitch applying
procedure.
The present structure obviates the necessity for completeley
removing the stitch and permits tension adjustments to the stitch
by releasing the free end of the suture from the slit end in which
it is engaged. This, of course, is done by first grasping the
anchor member with a forcep as above described to steady same
against lateral movement and possible discomfort to the patient.
When the suture has been released from the slit, sufficient slack
is allowed to compensate for the swelling and the suture reengaged
within the slit. Should the problem be of the latter type (a
reduction in swelling), the above procedure is followed and the
suture is drawn tighter to compensate for the decreased swelling.
In either case, it will be realized that such a tensioning
adjustment may be accomplished within a minimum amount of time and
with a minimum of discomfort to the patient. The structures of the
various disclosed suture anchor assemblies 10a through 10e are of
such configurations as to be easily formed from suitable plastic
materials which do not affect the damaged skin tissue with which
they come into contact. In addition, these suture anchor assemblies
10a through 10e are simple and relatively inexpensive to
manufacture. The increased cost over conventional suture material
is negligible due to the obvious utility of these suture anchor
assemblies.
* * * * *