Method and apparatus for meniscal repair
An apparatus for suturing tissue includes first and second needles. A first structure associated with the first needle is adapted and configured to pass a leading portion of the suture from a near side of a tissue to a far side of the tissue. A second structure cooperates with the second needle to capture and secure the suture. Proximal movement of the apparatus after the suture is captured moves the suture from the far side of the tissue to the near side of the tissue.
1. Apparatus for suturing tissue, wherein the apparatus comprises:
a housing;
a first needle mounted to the housing;
a second needle mounted to the housing, the second needle defining a slot that extends completely through the second needle, the slot being positioned such that a distalmost end of the slot is positioned proximal to a distalmost end of the second needle;
a suture having a leading portion and a trailing portion, the leading portion mounted to the first needle when the leading portion is in an initial position;
a first structure associated with the first needle for passing the leading portion of the suture from the first needle to the second needle after the first needle, with the leading portion of the suture mounted thereto, has been positioned within the tissue; and
a second structure associated with the second needle, the second structure configured to retain the leading portion of the suture within the slot such that, when the apparatus is removed from the tissue, the leading portion of the suture is carried by the second needle out of the tissue.
2. Apparatus according to claim 1 wherein the first structure comprises a suture holder extendable out of the first needle and comprising a suture engager formed at the end of an angled shaft.
3. Apparatus according to claim 1 wherein the apparatus further comprises a pre-formed, uncinched knot formed in the trailing portion of the suture.
4. Apparatus according to claim 3 wherein the pre-formed, uncinched knot is supported relative to the housing on the near side of the tissue.
5. Apparatus according to claim 3 wherein the pre-formed, uncinched knot is supported about the exterior of the second needle.
6. Apparatus according to claim 3 wherein the apparatus further comprises a support, and wherein the pre-formed, uncinched knot is releasably supported on the support on the near side of the tissue.
7. Apparatus according to claim 6 wherein the support is releasably mounted to the housing.
8. Apparatus according to claim 6 wherein the apparatus further comprises a suture threader movably mounted to the support, wherein the suture threader is configured to selectively pass the leading portion of the suture through the pre-formed. uncinched knot.
9. Apparatus according to claim 8 wherein the suture threader comprises a collapsible loop.
10. Apparatus according to claim 6 wherein the support further comprises a shaft for pushing the pre-formed, uncinched knot off the support.
11. Apparatus according to claim 10 wherein the support further comprises cutting structure for cutting the suture after the pre-formed, uncinched knot is pushed off the support.
12. Apparatus according to claim 11 wherein the cutting structure is configured to cut the suture after the pre-formed, uncinched knot is cinched.
13. Apparatus according to claim 11 wherein the cutting structure comprises an opening in the support and an opening in the shaft, and wherein cutting is effected when the opening in the support and the opening in the shaft are moved out of alignment with one another.