Suture passer systems and methods for tongue or other tissue suspension and compression
Suture passer systems for tissue suspension and tissue compression, and more particularly for tongue suspension, are described. The system can include at least a first elongate tubular body or shaft, a needle having a lateral bias carried by the elongate body, and a retrieval element operably connected to the elongate tubular body. The needle can have a substantially straight configuration when located within the elongate tubular body, and be configured to exit an opening at or near a distal end of the elongate tubular body and assume a laterally biased or curved shape to form a path through tissue. The needle is configured to carry a suture. The retrieval element can be configured to retrieve the suture carried by the needle after the needle has formed a curved or otherwise angled path through tissue. The system can also include one or more bone anchors to secure the suture loops. Methods of placing one or more suture loops into tissue, such as the base of the tongue, are also described.
1. A system for treating a patient, comprising:
a bone anchor comprising:
a proximal head portion comprising an eyelet comprising a first side and a second side, wherein the proximal head portion comprises an internally threaded surface extending from an upper surface of the proximal head portion and in communication with the eyelet;
a distal threaded portion extending from the proximal head portion, the distal threaded portion having a threaded exterior surface for engaging a bone, wherein the proximal head portion is enlarged relative to the distal threaded portion, wherein the distal threaded portion extends distally from the proximal head portion; and
a locking screw configured to threadably engage the internally threaded surface of the proximal head portion; and
a suture comprising two free ends and configured to form two strands and a suture arc between the two strands, the suture configured to extend through the eyelet, wherein rotation of the locking screw with respect to the internally threaded surface advances the locking screw distally to decrease the available space within the eyelet such that when the suture extends through the eyelet, the suture is reversibly trapped within the eyelet by the locking screw,
wherein the locking screw is configured to reversibly hold and release the two strands of the suture,
wherein the suture is configured to extend through the eyelet such that the two strands of the suture extend from the first side of the eyelet of the proximal head portion and the suture arc extends from the second side of the eyelet of the proximal head portion.
2. The system of claim 1 , wherein the eyelet comprises a longitudinal axis that is transverse to a longitudinal axis of the bone anchor.
3. The system of claim 1 , wherein the eyelet extends completely through the proximal head portion between two sides of the proximal head portion.
4. The system of claim 1 , wherein the locking screw comprise an indent configured to be engaged by a driver.
5. The system of claim 1 , wherein the eyelet defines a cavity within the bone anchor that the locking screw does not entirely fill.
6. The system of claim 1 , further comprising a driver configured to rotate the locking screw.
7. The system of claim 1 , wherein two strands of the suture are configured to be secured to the bone anchor to suspend tissue.
8. The system of claim 1 , wherein the suture is configured for adjustable tensioning before the suture is reversibly trapped within the eyelet by the locking screw.
9. The system of claim 1 , further comprising a suture passer comprising a first elongate shaft configured to releasably house a suture passing element and a second elongate shaft configured to serve as a retrieval element.
10. A system for treating a patient, comprising:
a bone anchor comprising:
a proximal head portion comprising an eyelet comprising a first side and a second side, wherein the eyelet comprises a longitudinal axis that is transverse to a longitudinal axis of the bone anchor;
a distal threaded portion extending from the proximal head portion, the distal threaded portion having a threaded exterior surface for engaging a bone, wherein the proximal head portion is enlarged relative to the distal threaded portion, wherein the distal threaded portion extends distally from the proximal head portion; and
a locking screw configured to advance distally toward a distal surface of the eyelet, wherein a gap is defined between the distal surface of the locking screw and a distal surface of the eyelet when the locking screw is in a distalmost position within the proximal head portion; and
a suture comprising two free ends and configured to form two strands and a suture arc between the two strands, the suture configured to extend through the eyelet, wherein the gap is sufficiently small that when the suture extends through the eyelet, the suture remains fixed within the eyelet while the locking screw is secured within the eyelet, wherein the gap is configured to minimize damage to the suture,
wherein the locking screw is configured to reversibly hold and release the two strands of the suture,
wherein the suture is configured to extend through the eyelet such that the two strands of the suture extend from the first side of the eyelet of the proximal head portion and the suture arc extends from the second side of the eyelet of the proximal head portion.
11. The system of claim 10 , wherein a height of the gap is between 0.005 inches and 0.02 inches.
12. The system of claim 10 , wherein a minimum pull-out force for the suture is between 4 kgf and 8 kgf.
13. The system of claim 10 , wherein a height of the gap is configured to avoid over-compression of the suture.
14. The system of claim 10 , wherein the bone anchor is configured to be secured to a mandible.
15. The system of claim 10 further comprising a suture passer comprising a first elongate shaft and a second elongate shaft, wherein first elongate shaft and the second elongate shaft are parallel.
16. The system of claim 10 , wherein the suture is configured for adjustable tensioning by applying a tension force to free ends of the suture.
17. A system for treating a patient, comprising:
a bone anchor comprising:
a proximal head portion comprising an eyelet comprising a first side and a second side, wherein the eyelet comprises a sidewall with a distal surface defining a first cavity therein;
a distal threaded portion extending from the proximal head portion, the distal threaded portion having a threaded exterior surface for engaging bone, wherein the proximal head portion is enlarged relative to the distal threaded portion, wherein the distal threaded portion extends distally from the proximal head portion; and
a locking screw having a proximal end and a distal end, wherein the locking screw is configured to fit within a second cavity of the proximal head portion that communicates with the first cavity; and
a suture comprising two free ends and configured to form two strands and a suture arc between the two strands, wherein the suture is configured to be reversibly secured by threading a portion of suture through the eyelet of the bone anchor and by rotating the locking screw to advance the locking screw distally to enter the first cavity to define a height dimension sufficient to prevent movement of the suture within the eyelet, wherein the height dimension is the distance between the distal surface of the first cavity and the distal end of the locking screw, wherein the height dimension is greater than zero,
wherein the locking screw is configured to reversibly hold and release the two strands of the suture,
wherein the suture is configured to extend through the eyelet such that the two strands of the suture extend from the first side of the eyelet of the proximal head portion and the suture arc extends from the second side of the eyelet of the proximal head portion.
18. The system of claim 17 , wherein the height dimension is between 0.005 inches and 0.02 inches.
19. The system of claim 17 , wherein the eyelet is configured for at least one suture to pass therethrough.
20. The system of claim 17 , further comprising a dual-shaft suture passer comprising a single actuator control.