Tissue repair device and method
Embodiments of the invention include a tissue repair system and related components and associated methods that provide for suturing of tissue using three or more suture anchoring implants, including multiple pairs of connected implants in some embodiments, all of which may be deployed from a single device. Some embodiments achieve this by employing a push mechanism capable of being activated to advance the push mechanism incrementally to discrete positions within the device and deploy implants one at a time from the device.
1. A method of suturing tissue comprising:
measuring the tissue to be sutured at a first location and setting a first depth for a needle of a tissue repair device to penetrate the tissue based on a first measurement, the tissue repair device comprising:
a cylindrical base with a proximal end, a distal end, and a longitudinal axis extending between the proximal and distal ends;
an actuator disposed about and movable relative to the base along the longitudinal axis of the base;
a push mechanism extending through the base, the push mechanism selectively engageable with the actuator to be moved distally by the actuator relative to the base;
the needle coupled to the distal end of the base and through which a distal portion of push mechanism moves distally when the push mechanism is moved distally relative to the base;
a spring disposed about the base between the base and the actuator, the spring configured to bias the actuator proximally relative to the base; and
a keeper defined by a u-shaped slot in an annular outer surface of the base, such that the keeper has an annular outer surface and a hook portion extending into an interior of the base, the keeper configured to allow distal movement of the push mechanism relative to the base but to limit proximal movement of the push mechanism relative to the base;
inserting the needle through the tissue to be sutured;
moving the actuator distally relative to the base to engage the push mechanism, the push mechanism configured to move a first implant coupled to a first suture out of a distal end of the needle;
allowing the actuator to move proximally relative to the base, thereby moving the actuator proximally relative to the push mechanism such that the push mechanism is in position to move a second implant from the tissue repair device when the actuator is moved distally again; and
using the first implant coupled to the first suture to repair the tissue.
2. The method of claim 1 , wherein measuring the tissue to be sutured at the first location includes observing indicia on the needle.
3. The method of claim 1 , wherein setting the first depth for the needle of the tissue repair device to penetrate the tissue based on the first measurement includes setting a depth tube relative to the needle.
4. The method of claim 1 , wherein moving the actuator includes moving the actuator linearly.
5. The method of claim 1 , wherein moving the actuator includes moving the actuator against the spring bias between the base and the actuator.
6. The method of claim 1 , wherein moving the actuator distally relative to the base to engage the push mechanism includes engaging teeth of the push mechanism with the hook portion of the keeper.
7. The method of claim 1 , wherein moving the actuator distally relative to the base causes the keeper to be pushed laterally.
8. The method of claim 1 , wherein moving the actuator distally relative to the base causes the push mechanism to push against the first and second implants and to move the first and second implants distally relative to the needle to move the first implant out of the distal end of the needle.
9. The method of claim 1 , wherein allowing the actuator to move proximally relative to the base includes allowing the spring bias between the actuator and the base to move the actuator proximally.
10. The method of claim 1 , wherein allowing the actuator to move proximally relative to the base includes pushing the actuator proximally relative to the base.
11. The method of claim 1 , wherein allowing the actuator to move proximally relative to the base causes a driver of the actuator to flex laterally to disengage from the push mechanism.
12. The method of claim 11 wherein, when the driver of the actuator is flexing laterally to disengage from the push mechanism, the keeper is engaged with the push mechanism to prevent the push mechanism from moving proximally relative to the needle.
13. The method of claim 1 , further comprising:
measuring the tissue to be sutured at a second location and setting a second depth for the needle of the tissue repair device to penetrate the tissue based on a second measurement;
inserting the needle through the tissue to be sutured;
moving the actuator of the tissue repair device distally relative to the base to engage the push mechanism, the push mechanism configured to move the second implant coupled to the first suture out of the distal end of the needle;
allowing the actuator to move proximally relative to the base, thereby moving the actuator proximally relative to the push mechanism such that the push mechanism is in position to move a third implant from the tissue repair device when the actuator is moved distally again; and
using the second implant coupled to the first suture to repair the tissue.
14. The method of claim 13 , wherein measuring the tissue to be sutured at the second location includes observing indicia on the needle.
15. The method of claim 13 , wherein setting the second depth for the needle of the tissue repair device to penetrate the tissue based on the second measurement includes setting a depth tube relative to the needle.
16. The method of claim 13 , wherein moving the actuator includes moving the actuator linearly.
17. The method of claim 13 , wherein moving the actuator includes moving the actuator against the spring bias between the base and the actuator.
18. The method of claim 13 , wherein moving the actuator distally relative to the base to engage the push mechanism includes engaging teeth of the push mechanism with the hook portion of the keeper.
19. The method of claim 13 , wherein moving the actuator of the tissue repair device distally relative to the base causes the keeper to be pushed laterally.
20. The method of claim 13 , wherein moving the actuator distally relative to the base causes the push mechanism to push against the second and third implants to move the second and third implants distally relative to the needle to move the second implant out of the distal end of the needle.
21. The method of claim 13 , wherein allowing the actuator to move proximally relative to the base includes allowing the spring bias between the actuator and the base to move the actuator proximally.
22. The method of claim 13 , wherein allowing the actuator to move proximally relative to the base includes pushing the actuator proximally relative to the base.
23. The method of claim 13 , wherein allowing the actuator to move proximally relative to the base causes a driver of the actuator to flex laterally to disengage from the push mechanism.
24. The method of claim 23 , wherein, when the driver of the actuator is flexing laterally to disengage from the push mechanism, the keeper is engaged with the push mechanism to prevent the push mechanism from moving proximally relative to the needle.
25. The method of claim 23 , further comprising pulling a free end of one or both of the first suture and a second suture to tighten a loop or a length of the first and/or second sutures.