Ethicon, Gmbh

Quill Medical, Inc.

Cilag International Gmbh

Angiotech Pharmaceuticals, Inc.

Andrew Kaplan

Jeffrey C Leung

Gregory L Ruff

Matthew A Megaro

Stanton D Batchelor

A barbed suture including a body with barbs on the periphery, a pointed end, and an anchor at one end to resist movement of the suture in the direction of the pointed end is provided. One or more limbs on the anchor may be provided, which may be arcuate, of varying lengths, and of varying distribution about the periphery of the suture body. Other anchor designs are provided. Methods of placing single-directional and bi-directional barbed sutures to approximate the tissue on each side of a wound and to position and support tissue in the absence of a wound, as in cosmetic surgery, are provided, and may include terminal J-stitches or S-stitches. Methods of placement may be made with sharp, pointed ends, which may be needles, or insertion devices. Sinusoidal patterns of sutures that have amplitudes generally perpendicular to the resultant holding force of the suture are provided.

Suture methods and devices

Endoscopic methods utilize self-retaining sutures to approximate tissue in a cavity of a subject. An endoscopic instrument is provided containing the self-retaining suture. The endoscopic instrument may be provided in combination with an endoscope and/or an endoscopic manipulator. The endoscopic instrument is passed through a cavity wall into a cavity of a patient. The self-retaining suture is deployed, using the endoscopic instrument, into a first tissue portion and a second tissue portion within the cavity. The self-retaining suture may be deployed endoscopically in patterns which include, purse string stitch, alpha stitch, linear stitching, curvilinear stitching, continuous helical stitch, and continuous sinusoidal stitch.

Methods for using self-retaining sutures in endoscopic procedures

Subcutaneous sinusoidal wound-closure techniques use one-way sutures. The one-way sutures have tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is deployed along a curvilinear path which passes alternately through subcutaneous tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Subcutaneous sinusoidal wound closure utilizing one-way suture

An anastomosis procedure utilizes a self-retaining suture to secure one vessel to another vessel. One or more self-retaining sutures are deployed around the interface between the vessels. The self-retaining sutures have tissue-grasping surface features which allow passage of the sutures in one direction through tissue, but not in the opposite direction. The self-retaining sutures may be deployed using a needle attached to the end of the sutures. The anastomosis technique may be performed without using knots.

Anastomosis method using self-retaining sutures

A method for joining and holding closed a wound in bodily tissue, fastening junctions of wounds, tying off wounds, joining a foreign element to tissue, and altering the position of tissue using a barbed suture including sharp pointed ends. Each end of the suture includes barbs on that permit movement in an opposing direction to the barbs on the other end of the suture. This two-way barbed suture is used by the method of the present invention in applications including abdominal surgeries such as a Nissen fundoplication, laparoscopic uses such as stabilizing a bowel structure and performing a closure of a cystostomy, liver to bowel anastomosis, closure of an orifice of a Zenker's Diverticulum, endoscopic uses such as closure of ulcerative lesions or and post-procedural tissue defects, bladder wound closure, valve replacement surgery, device attachment, cosmetic surgery, and blood vessel wound closure.

Suture method

Continuous wound-closure techniques use one-way suture. The one-way suture has tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is passed alternately through tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Continuous stitch wound closure utilizing one-way suture

A suture system has a plurality of barbed sutures each with a plurality of barbs and a body connector that connects said plurality of barbed sutures. The sutures can move relative to the body connector. The body connector can retain tissue.

Multiple suture thread configuration with an intermediate connector

A suture system has a suture with a first plurality of barbs located adjacent to a first end and a second plurality of barbs located adjacent to a second end, and a body located between the first plurality of barbs and the second plurality of barbs. The body provides an anchor that can hold tissue relative to the first end and the second end of the suture. The body can slide and be positioned on said suture.

Suture with an intermediate barbed body

A suture system has a plurality of double ended barbed sutures each with a first plurality of barbs located adjacent to a first end and a second plurality of barbs located adjacent to a second end, and a body connector that connects said plurality of double ended barbed sutures. The body connector is located between the first plurality of barbs and the second plurality of barbs on each of the sutures. The sutures can move relative to the body connector. The body connector can retain tissue.

A suture system has a double ended barbed suture with a first plurality of barbs located adjacent to a first end and a second plurality of barbs located adjacent to a second end, and a body located between the first plurality of barbs and the second plurality of barbs. The body provides an anchor that can hold tissue relative to the first end and the second end of the suture. The body can slide and be positioned on said suture.

Double ended barbed suture with an intermediate body

A suture anchor is provided for approximating tissue to bone or other tissue. The suture anchor comprises an anchor member to fixedly engage the bone for securing the anchor member relative to the bone. A plurality of sutures are mounted to the proximal end of the anchor member so that the sutures extend outwardly from the anchor member. Each suture has a sharp pointed distal end for penetrating the tissue and a plurality of barbs extending from the periphery and disposed along the length of the body of the suture. The barbs permit movement of the sutures through the tissue in a direction of movement of the pointed end and prevent movement of the sutures relative to the tissue in a direction opposite the direction of movement of the pointed end. At least one pointed distal end of at least one suture comprises a needle.

Suture anchor and method

A method is provided for performing a procedure to reposition a portion of a breast using a suture including a plurality of barbs. The barbs on a first portion of the suture adjacent a first end of the suture permit movement of the suture through tissue in a direction of movement of the first end and prevent movement of the suture through tissue in a direction opposite the direction of movement of the first end. The barbs on a second portion of the suture adjacent a second end of the suture permit movement of the suture through tissue in a direction of movement of the second end and prevent movement of the suture through tissue in a direction opposite the direction of movement of the second end. The method comprises the steps of inserting the first end of the suture through a first insertion point and causing the first portion of the suture to engage a tissue, inserting the second end of the suture through the first insertion point and advancing the second end of the suture through breast tissue to a first exit point located on the breast caudally of the first insertion point, and manually grouping and advancing the breast tissue relative to the suture towards the first insertion point to reposition a portion of the breast tissue.

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Hillsborough, NC, United States of America

Andrew Kaplan