Other

Ethicon, Gmbh

Frank Hoffman

Quill Medical, Inc.

Harry J Buncke

Methods are disclosed for binding together human or animal tissue using one-way sutures having barbs on their exterior surfaces, allowing passage of a needle-drawn suture in one direction through tissue, but not in the opposite direction. In closing a wound, the sutures are passed through tissue at each of the opposed sides of the wound, forming suture pairs in which trailing ends of the sutures are juxtaposed in the wound. The number of suture pairs is selected in accordance with the size of the wound. The wound is closed and ends of the sutures of each suture pair are secured together, which may be by heat bonding or surgical knots. In a variation of this procedure double-armed sutures are used. In another variation detachable needles are used to leave the barbed sutures below the skin. The invention avoids loop stitching, minimizing scarring. In addition to wounds at the skin surface, the method is useful in binding together severed tendons or other internal tissue of a patient, providing considerable tensile strength with a minimum of suturing and locating the tensile support precisely where needed. In facelifts and other cosmetic operations, the sutures are used to provide lines of tissue support beneath the skin.

Surgical methods using one-way suture

A surgical clip applier for use in closing wounds under the microscope in small blood vessels modifies a well-known clip applier system to make more steady and reliable the application of very small clips during surgery on a scale of vessel size of 2 mm in external diameter and smaller. The known device is modified internally so as to be capable of receiving a flexible remote actuation device which can be a cable release such as used for a camera shutter, or which can be a flexible hydraulic or pneumatic line as a force-transmitting device. Thus, the surgeon can hold the clip applier very steadily at the site desired without contracting any intrinsic muscles while the cable release is depressed by another person, or with the surgeon's other hand, or with a foot pedal.

Surgical clip applier with remote operation

A surgical needle is attached to a handle which includes a vibrating device for inducing vibrations in a prescribed frequency range to the needle. The needle's vibration helps avoid damage to major blood vessels and nerves when the needle is pushed through subcutaneous patient tissue. In one form the needle has provision to grip the end of a suture, so that the suture may be attached after the needle is pushed through and emerges out of subcutaneous tissue. In a face-lift operation the needle may be pushed through a path where support is desired, then the end of a one-way suture can be attached to the distal end of the needle, after which the one-way suture can be retracted so that the one-way suture occupies the same path where the needle was inserted. The suture attachment can be via a hollow bore through the needle, with suction applied through the handle, so that the end of the suture can be drawn into the needle from the needle's distal end, retaining the suture to the needle when the needle is retracted from the tissue. After such insertion of a one-way suture, the suture can be tensioned from the distal end so as to pull and maintain the desired tension in the skin tissue.

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Hillsborough, CA, United States of America

Harry J Buncke