Suture Passing Instrumentation and Methods of Use Thereof

1 . A knot carrier for indirectly coupling a knot to a medical device, the knot carrier comprising:

a knot carrier body configured to slidably engage with a portion of a medical device; and

an obstructing member projecting from a proximal portion of the knot carrier body, the obstructing member having a first configuration for preventing a knot from being deployed from the knot carrier and a second configuration for allowing the knot to be deployed from the knot carrier.

2 . The knot carrier of claim 1 , wherein the obstructing member is resilient and is biased in an inward direction.

3 . The knot carrier of claim 1 , wherein the knot carrier body is tapered towards a distal end thereof for facilitating deployment of the knot from the knot carrier.

4 . The knot carrier of claim 1 , further comprising a retaining element for providing resistance to movement of a segment of a suture strand secured by the retaining element.

5 . The knot carrier of claim 4 , wherein the retaining element secures the segment of the suture strand via friction.

6 . A suture passer for passing a suture through a region of tissue, comprising: a proximal portion for holding a portion of suture therein;

a distal tip coupled to the proximal portion and defining a tissue receiving gap there-between; a suture trap detachably coupled to the distal tip;

a reciprocally moveable suture passing member held within the proximal portion for translating the suture portion between the proximal portion and the suture trap; and

a trigger for causing reciprocal movement of the suture passing member;

wherein upon a first actuation of the trigger the suture passing member is configured to advance distally to a first predetermined position for placing the suture portion into engagement with the suture trap; and

wherein upon a second actuation of the trigger the suture passing member is configured to advance distally to a second predetermined position for engaging the suture trap,

further comprising the knot carrier of claim 1 .

7 . A medical device for controlled deployment of a pre-tied knot, the medical device comprising:

a handle body;

an elongate member extending from the handle body;

a knot carrier comprising a knot carrier body configured to slidably engage with the elongate member and an obstructing member projecting from a proximal portion of the knot carrier body, the obstructing member having a first configuration for preventing a knot from being deployed from the knot carrier and a second configuration for allowing the knot to be deployed from the knot carrier.

and

a pre-tied knot disposed about the knot carrier.

8 . A suture passer for passing a suture through a region of tissue, comprising: a proximal portion for holding a portion of suture therein;

a distal tip coupled to the proximal portion and defining a tissue receiving gap there-between; a suture trap detachably coupled to the distal tip;

a reciprocally moveable suture passing member held within the proximal portion for translating the suture portion between the proximal portion and the suture trap; and

a trigger for causing reciprocal movement of the suture passing member;

wherein upon a first actuation of the trigger the suture passing member is configured to advance distally to a first predetermined position for placing the suture portion into engagement with the suture trap; and

wherein upon a second actuation of the trigger the suture passing member is configured to advance distally to a second predetermined position for engaging the suture trap, further comprising a shaft at the proximal portion of the suture passer and a partially pre-tied knot disposed about the shaft.

9 . The suture passer of claim 8 , wherein the partially pre-tied knot comprises a plurality of suture loops formed around a surface of the shaft.

10 . The suture passer of claim 9 , wherein the partially pre-tied knot comprises a plurality of suture loops formed around a knot carrier, the knot carrier being slidably engaged with the shaft, the knot carrier comprising a knot carrier body and an obstructing member projecting from a proximal portion of the knot carrier body, the obstructing member having a first configuration for preventing a knot from being deployed from the knot carrier and a second configuration for allowing the knot to be deployed from the knot carrier.

11 . The suture passer of claim 10 , further comprising a retaining element coupled, directly or indirectly, to the shaft, for providing resistance to movement of a segment of a suture strand secured by the retaining element.

12 . The suture passer of claim 11 , wherein the retaining element limits motion of a suture strand segment relative to another portion of the suture strand during at least a part of a knot deployment procedure.

13 . The suture passer of claim 11 , wherein the retaining element is located directly on the shaft.

14 . The suture passer of claim 10 , wherein the obstructing member of the knot carrier is sized and configured to transition from the first configuration to the second configuration when the knot carrier is positioned about a tissue receiving gap defined by the suture passer, whereby the obstructing member bends inwardly towards the tissue receiving gap.

15 . The suture passer of claim 11 , wherein the retaining element is configured to retain a suture strand segment against an application of tension on the suture strand segment and to release the suture strand segment when the tension on the suture strand segment exceeds a pre-determined amount.

16 . The suture passer of claim 10 , wherein the knot carrier is coupled to the shaft via a releasable coupling.

17 . The suture passer of claim 16 , further comprising a means for preventing the knot carrier from sliding along the shaft until a predetermined force is applied to the releasable coupling.

18 . The use of a suture passer as claimed in claim 7 for treating a defect in an intervertebral disc.