Meniscal repair systems and methods
A device for repairing a tear in a portion of tissue comprises a proximal actuator portion, a transfer needle extending distally from the proximal actuator portion and a catch needle extending distally from the proximal actuator portion. A suture needle is disposed in the transfer needle, and is extendable from the transfer needle toward the catch needle and retractable from the catch needle toward the transfer needle. An extendable catch plunger is disposed in the catch needle for capturing suture therein when it is transferred from the transfer needle. A retractable insertion sheath is provided for covering the transfer needle and the catch needle when the device is inserted into a procedural site. A depth limiting apparatus limits the depth of insertion of the needle into the procedural site.
1. A method for repairing a tear in a portion of tissue, said method comprising:
inserting a device comprising a proximal actuator portion and a needle having a distal needle portion into a procedural site;
retracting a sheath covering said needle proximally to expose the distal needle portion;
advancing the needle into the tissue to be repaired, so that a distal end of the distal needle portion is disposed beyond the tear, until a depth limiting structure prevents further advancement of the needle, wherein the advancing step comprises advancing a pair of needles into the tissue to be repaired, and the suture loop creating step is performed by dispensing suture from a first one of the needles into a second of the needles, and then releasing a catch plunger to move distally and clamp the suture to retain it in the second needle, wherein the catch plunger is disposed in the second needle and is extendable within the second needle to clamp the suture within the second needle;
creating a suture loop in said tissue to repair the tear;
withdrawing the needle proximally from the procedural site; and
using a pre-tied knot to cinch the suture loop and thereby repair the tear.
2. The method as recited in claim 1 , wherein the depth limiting structure comprises a distal end of the sheath, and the sheath retracting step includes a step of determining a distance through which the sheath is retracted by consulting a depth gauge disposed on the proximal actuator portion.
3. The method as recited in claim 1 , wherein the depth limiting structure comprises a depth limiter which is movable distally along the device toward the tissue to be repaired responsive to a release of force on a force feedback unit disposed on a distal end of the needle.
4. The method as recited in claim 1 , wherein the suture is dispensed, during the suture loop creating step, using a suture needle which is disposed in the first needle and is extendable from the first needle toward the second needle and retractable from the second needle toward the first needle.