Methods for repairing soft tissue using arthroscopic suture passing devices
A system for transdermal repair of soft tissue includes an instrument comprising a proximal actuator portion, a fixed needle having a lumen and extending distally from the proximal actuator portion, and a movable needle having a lumen and extending distally from the proximal actuator portion. The movable needle is movable axially between an advanced position and a retracted position relative to the proximal actuator portion. A suture needle is disposed within the lumen of one of the fixed and movable needles, and has a length of suture connected thereto. Needle graspers are disposed in the lumen of each needle, for securing the suture needle and assisting in the transfer of the suture needle from one needle to the other to complete a suture passing step.
1. A method of repairing soft tissue, comprising:
introducing an instrument having a curved needle and a movable straight needle, each extending distally from a proximal actuator portion, into an operative site;
piercing tissue to be sutured with a distal end of the curved needle;
advancing the straight needle until a distal end thereof lines up with and meets the distal end of the curved needle:
passing a suture needle disposed in one of said curved and movable straight needles into the other one of said needles, wherein the suture needle is initially clamped on one end by a grasper disposed in said one of said curved and movable straight needles, and the passing step comprises moving the grasper distally to push the suture needle out of said one of said curved and movable straight needles, and into the other of said curved and movable straight needles, the passing step further comprising releasing the one end of the suture needle from the grasper and clamping the other end of the suture needle using a second grasper disposed in the other of said curved and movable straight needles;
retracting the movable straight needle proximally; and
pulling the curved needle back through the tissue, thereby creating a stitch of suture in the tissue.
2. The method as recited in claim 1 , wherein suture is pre-loaded into the straight needle.
3. The method as recited in claim 2 , wherein, during the piercing step, the curved needle is disposed in a suture exit location where one end of the suture emerges.
4. The method as recited in claim 3 , wherein, during the piercing step, the instrument is manipulated so that the location of suture exit is aligned with the straight needle.
5. The method as recited in claim 1 , wherein the straight needle stops during the advancing step at the point wherein the distal end thereof lines up with and meets the distal end of the curved needle.
6. The method as recited in claim 1 , wherein the step of advancing the straight needle is performed by operating a straight needle slider, which moves along a slot in a handle of the instrument.
7. The method as recited in claim 1 , wherein the passing step comprises passing the suture on the suture needle from one of the curved and movable straight needles into the other one of said needles by operating a suture slider on a handle of the instrument.
8. The method as recited in claim 1 , wherein each of said steps are repeated one or more additional times in order to create a corresponding number of additional stitches of suture.