Suture-based assembly for tissue repair, and associated devices and methods
The present technology is directed to systems, methods, and devices for anchoring suture devices into a target patient tissue to treat a medical condition. For example, in some embodiments the present technology includes a tissue-support system including an applicator device and a suture device. The applicator device is configured to deploy and anchor the suture device in a target tissue. In some embodiments, the suture device is deployed such that an anchor of the suture device is positioned external to the tissue it is anchored to.
1 . A method of anchoring a suture device, the method comprising:
advancing an applicator device releasably carrying the suture device toward a first target tissue of the patient, wherein the suture device includes an anchor, a suture element, and an end region spaced apart from the anchor by the suture element, wherein the applicator device includes a distal complex having a proximal portion and a distal portion, the proximal portion having a needle carrying the anchor, and wherein the first target tissue is a first anatomical structure;
positioning the first target tissue at least partially within a gap in the distal complex between the proximal portion and the distal portion;
advancing the needle from the proximal portion toward the distal portion, wherein advancing the needle causes the needle to (a) enter the first target tissue at a first region adjacent the proximal portion, (b) create a passageway through the first target tissue, and (c) exit the first target tissue at a second region adjacent the distal portion, and wherein the needle carries the anchor and at least a portion of the suture element from the first region to the second region through the passageway as it advances;
with a distal portion of the needle outside the first target tissue at the second region, deploying the anchor from the needle;
retracting the needle through the passageway from the distal portion of the distal complex to the proximal portion of the distal complex,
wherein, after retracting the needle, the anchor remains external to the first target tissue at the second region, a portion of the suture element extends through the passageway between the first region and the second region, and the end region of the suture device is not engaged with the first target tissue; and
coupling the end region of the suture device to a second target tissue, wherein the second target tissue is a second anatomical structure that is a different type of tissue than the first anatomical structure.
2 . The method of claim 1 wherein the first target tissue includes bone and periosteum, and wherein advancing the needle through the first target tissue includes advancing the needle through the periosteum without contacting the bone such that the first region, the second region, and the passageway are all located within the periosteum.
3 . The method of claim 2 wherein, after retracting the needle, the anchor remains external to the periosteum and the portion of the suture element extends through the periosteum.
4 . The method of claim 1 wherein the end region of the suture device includes a suture needle, and wherein coupling the end region of the suture device to the second target tissue comprises:
piercing the second target tissue with the suture needle;
at least partially elevating the second target tissue along the suture element toward the first target tissue; and
retaining the second target tissue in the at least partially elevated position.
5 . The method of claim 4 wherein the suture element includes barbs, and wherein the second target tissue is retained in the at least partially elevated position by virtue of the barbs.
6 . The method of claim 4 wherein retaining the second target tissue in the at least partially elevated position includes advancing a suture locking element over the suture element and securing the suture locking element to the suture element.
7 . The method of claim 1 wherein the first target tissue is a periosteum, and wherein the second target tissue is a periurethral vaginal wall.
8 . The method of claim 1 wherein the first target tissue is a sacrospinous ligament, and wherein the second target tissue is rectal tissue.
9 . A system, comprising:
a suture device, having:
an anchor,
a suture element extending from the anchor element, and
an end region spaced apart from the anchor by the suture element; and
an applicator device configured to anchor the suture device in a first anatomical structure of a patient, and the applicator device comprising:
a proximal complex having a handle and an actuator,
a distal complex having a proximal portion and a distal portion, the proximal portion and the distal portion defining a gap therebetween configured to receive the first anatomical structure when the applicator device is positioned within the patient, and
a needle positioned within the proximal portion of the distal complex, wherein the needle is configured to releasably carry the anchor of the suture device;
wherein the applicator device is configured such that, upon actuation of the actuator, the needle advances from the proximal portion toward the distal portion across the gap, and
wherein, during operation, the applicator device is further configured to deploy the suture device through the first anatomical structure such that (i) the anchor is positioned external to the first anatomical structure, (ii) at least a portion of the suture element passes through the first anatomical structure, and (iii) the end region of the suture device is not engaged with the first anatomical structure such that it can be attached to a second anatomical structure that is a different type of tissue than the first anatomical structure.
10 . The system of claim 9 , further comprising a suture locking element, wherein the suture locking element is configured to be advanced over the free region of the suture device and secured thereto.
11 . An applicator device configured to anchor a suture device in a target tissue of a subject, the applicator device comprising:
a proximal complex having a handle and an actuator;
a distal complex having a proximal portion and a distal portion, the proximal portion and the distal portion defining a gap therebetween configured to receive the target tissue of the subject;
a curved needle positioned within the proximal portion of the distal complex, wherein the curved needle is configured to releasably carry at least a portion of a suture device, the suture device having an anchor and a suture element,
wherein the applicator device is configured such that, upon actuation of the actuator, the curved needle advances from the proximal portion toward the distal portion across the gap along a curved path, and
wherein, during operation, the applicator device is further configured to deploy the suture device through the target tissue such that (i) the anchor is positioned external to the target tissue, and (ii) at least a portion of the suture element passes through the target tissue, and wherein the curved needle is configured to carry the anchor of the suture device from the proximal portion toward the distal portion across the gap, and wherein the curved needle is further configured to release the anchor after the curved needle has advanced across the gap.
12 . The applicator device of claim 11 wherein the curved needle includes a hollow tip portion configured to hold the anchor of the suture device.
13 . The applicator device of claim 12 wherein the hollow tip portion includes a slit configured to permit egress of the suture element of the suture device.
14 . The applicator device of claim 11 wherein the distal portion includes a slot configured to receive the curved needle upon actuation of the actuator.
15 . The applicator device of claim 11 wherein the proximal portion includes a slot configured to permit egress of the suture element from the proximal complex.