Surgical instrument and method for tensioning and securing a flexible suture
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61B-017/10
A61B-017/88
A61B-017/04
A61B-019/00
A61B-017/82
출원번호
US-0436926
(2009-05-07)
등록번호
US-8888791
(2014-11-18)
발명자
/ 주소
Jaramillo, Jorge
Goertzen, Doug
Chaplin, Kevin
Gelbart, Dan
Garben, Ian
Spisar, Monica
출원인 / 주소
Kardium Inc.
대리인 / 주소
Rossi, Kimms & McDowell LLP
인용정보
피인용 횟수 :
3인용 특허 :
37
초록▼
A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used
A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.
대표청구항▼
1. A medical instrument comprising: a base comprising a bone contacting surface that in use contacts at least one bone;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bo
1. A medical instrument comprising: a base comprising a bone contacting surface that in use contacts at least one bone;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone, anda second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture when the at least part of the second device is rotated with respect to the base, andwherein the base comprises a threaded portion and an open slot, the open slot arranged to intercept the bone contacting surface, and the open slot of the base extends through the threaded portion of the base, and wherein the second device comprises a threaded portion threadedly coupled to the threaded portion of the base, the threaded portion of the second device including a respective open slot extending therethrough, the respective open slots of the base and the second device each of which only partially surround the at least one flexible suture during use. 2. The medical instrument of claim 1 wherein the open slot of the base extends continuously from a location where the at least one flexible suture exits the base to a location where the second device is physically mounted to the base. 3. The medical instrument of claim 1 wherein the first device is physically mounted to the second device. 4. A medical instrument comprising: a support;a first device operable to apply tension to at least one flexible suture extending around at least a portion of at least one bone,a second device, at least a part of the second device rotatably mounted to the support to rotate with respect thereto to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture when the at least part of the second device is rotated with respect to the support; anda third device arranged to reduce the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture, and wherein the at least one flexible suture is a metal wire suture; anda flexible suture retaining structure arranged to retain a portion of the at least one flexible suture by the medical instrument, wherein a distance between a location of the flexible suture retaining structure where the portion of the at least one flexible suture is retained and a location where the at least one flexible suture exits the support decreases when the at least a part of the second device is rotated with respect to the support. 5. The medical instrument of claim 4 wherein the at least a part of the second device is threadedly coupled to the support. 6. The medical instrument of claim 4 wherein the second device comprises a twisting head in which the at least one flexible suture is retained, the twisting head rotatable in use with respect to the support while the flexible sutures are retained therein. 7. The medical instrument of claim 4 wherein the second device comprises a twisting head rotatably mounted to the support for rotation with respect thereto about a first axis and a torsion shaft comprising the flexible suture retaining structure, the torsion shaft rotatably mounted to the twisting head to rotate with respect thereto about a second axis, the second axis non-parallel to the first axis. 8. The medical instrument of claim 4, further comprising at least a first spring and a second spring, the second spring oppositely wound to at least the first spring. 9. The medical instrument of claim 4 wherein the support comprises a first threaded portion and the second device comprises a second threaded portion threadedly coupled to the first threaded portion of the support, the first and the second threaded portions each including a respective open slot extending therethrough, the respective open slots of the first and second threaded portions each of which only partially surround the at least one flexible suture during use. 10. The medical surgical instrument of claim 4 wherein a torsion spring physically couples a handle to the flexible suture retaining structure to cause the flexible suture retaining structure to wind up the at least one flexible suture in response to a rotation of the handle. 11. A medical instrument comprising: a support;a first device operable to apply tension to at least one flexible suture extending around at least a portion of at least one bone,a second device, at least a part of the second device rotatably mounted to the support to rotate with respect thereto to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture when the at least part of the second device is rotated with respect to the support;a third device arranged to reduce the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture, and wherein the at least one flexible suture is a metal wire suture; andwherein the third device comprises an elastic member arranged to be tensioned when the first device is operated to apply tension to the at least one flexible suture extending around the at least a portion of the at least one bone and arranged to be untensioned when at least the part of the second device is rotated with respect to the support. 12. A medical instrument, comprising: a base comprising a bone contacting surface that in use contacts at least one bone and does not move relative to the base;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone, anda second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture,wherein the second device comprises a threaded portion threadedly coupled to the base and the at least part of the second device comprises a twisting head rotatably mounted to the base via the threaded portion to rotate with respect to the base about a first axis, and the flexible suture retaining structure comprises a torsion shaft rotatably mounted to the twisting head to rotate with respect thereto about a second axis, the second axis non-parallel to the first axis. 13. A medical instrument, comprising: a base comprising a bone contacting surface that in use contacts at least one bone and does not move relative to the base;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone, anda second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture,wherein the second device comprises a threaded portion threadedly coupled to the base and the at least a part of the second device comprises a twisting head rotatably mounted to the base via the threaded portion to rotate with respect to the base, and the at least part of the first device comprises a torsion shaft rotatably mounted to the twisting head. 14. The medical instrument of claim 13, further comprising: a one-way clutch and wherein the at least a part of the first device comprises a handle physically coupled to the torsion shaft and the one-way clutch. 15. The medical instrument of claim 14 wherein the one-way clutch comprises a clutch spring physically coupled between the handle and the twisting head to restrict rotation of the handle to a single rotational direction. 16. The medical instrument of claim 13, further comprising: a torsion spring arranged to physically couple the handle to the torsion shaft and which transfers a rotation of the handle into a rotation of the torsion shaft. 17. A medical instrument, comprising: a base comprising a bone contacting surface that in use contacts at least one bone;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone,a second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture; anda spring arranged to provide an increasing amount of spring force when the at least a part of the first device is moved with respect to the base and to provide a decreasing amount of spring force when the at least part of the second device is rotated with respect to the base to apply the plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture. 18. A medical instrument, comprising: a base comprising a bone contacting surface that in use contacts at least one bone;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone,a second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture; anda spring arranged to increase force applied to the at least one flexible suture when the at least a part of the first device is moved with respect to the base to increase tension in the at least one flexible suture and to reduce the force applied to the at least on flexible suture when the at least a part of the second device is rotated with respect to the base to apply the plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture. 19. A medical instrument, comprising: a base comprising a bone contacting surface that in use contacts at least one bone;first means for applying tension to at least one flexible suture extending around at least a portion of the at least one bone when the first means is moved with respect to the base wherein the at least one flexible suture is a metal wire suture;second means for applying a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture when the second means for applying a plurality of twists to the at least one flexible suture is rotated with respect to the base, wherein each of the first means for applying tension to at least one flexible suture and the second means for applying a plurality of twists to the at least one flexible structure is movably coupled to the base; andthird means for reducing the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture, andwhere the second means for applying a plurality of twists to the at least one flexible suture comprises a flexible suture retaining structure to retain the at least one flexible suture and the third means for reducing the tension applied to the at least one flexible suture varies a distance between a location where the at least one flexible suture exits the base and a location where the at least one flexible suture is retained by the flexible suture retaining structure. 20. A medical instrument, comprising: a support;a first device operable to apply tension to at least one flexible suture extending around at least a portion of at least one bone,a second device, at least a part of the second device rotatably mounted to the support to rotate with respect thereto to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture; anda third device arranged to reduce the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture;a flexible suture retaining structure arranged to retain a portion of the at least one flexible suture by the medical instrument, wherein a distance between a location of the flexible suture retaining structure where the portion of the at least one flexible suture is retained and a location where the at least one flexible suture exits the support is varied when the third device reduces the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture. 21. A medical instrument to secure at least one flexible suture to at least one body part, the medical instrument comprising: a base;a twisting head rotatably coupled to the base to rotate with respect thereto to secure portions of the at least one flexible suture together;a flexible suture retaining structure in which the at least one flexible suture is retained, the flexible retaining structure movably coupled to the twisting head; anda tension decreasing device arranged to apply a decreasing tension to the at least one flexible suture during the securing of the portions of the at least one flexible suture together, and wherein the tension decreasing device varies a distance between a location where the at least one flexible suture exits the base and a location of the flexible suture retaining structure. 22. A medical instrument to secure at least one flexible suture to at least one body part, the medical instrument comprising: a base;a twisting head rotatably coupled to the base to rotate with respect thereto to secure portions of the at least one flexible suture together;a flexible suture retaining structure in which the at least one flexible suture is retained, the flexible retaining structure movably coupled to the twisting head; anda tension decreasing device arranged to apply a decreasing tension to the at least one flexible suture during the securing of the portions of the at least one flexible suture together, and wherein the tension decreasing device comprises a threaded portion of the twisting head and a threaded portion of the base, the threaded portion of the twisting head threadedly engaging the threaded portion of the base to vary a distance between the flexible retaining structure and a location where the at least one flexible suture exits the base in response to rotation of the twisting head relative to the base. 23. The medical instrument of claim 22, further comprising: a torsion spring physically coupled to the flexible suture retaining structure to wind up the at least one flexible suture in response to the distance between the flexible suture retaining structure and the location where the at least one flexible suture exits the base decreasing in response to rotation of the twisting head relative to the base. 24. A medical instrument to secure at least one flexible suture to at least one body part, the medical device comprising: a base;a twisting head, the twisting head rotatably mounted to the base to rotate with respect thereto about a first axis to secure portions of the at least one flexible suture together;a torsion shaft having a flexible suture retaining structure arranged to retain a portion of the at least one flexible suture, the torsion shaft rotatably mounted to the twisting head to rotate with respect thereto about a second axis to apply tension to the at least one flexible suture, the second axis non-parallel to the first axis; anda handle selectively moveable by a user,wherein a distance between a location of the flexible suture retaining structure where the portion of the at least one flexible suture is retained and a location where the at least one flexible suture exits the base decreases when the twisting head is rotated with respect to the base. 25. The medical instrument of claim 24, further comprising a one-way clutch spring, the one-way clutch spring physically coupled to limit rotation of the handle to a single rotational direction. 26. The medical instrument of claim 24, further comprising a first torsion spring which transfers a rotation of the handle into a rotation of the torsion shaft and a second torsion spring, the second torsion spring oppositely wound to the first torsion spring. 27. The medical instrument of claim 24, further comprising a device arranged to apply a decreasing tension to the at least one flexible suture while the twisting head is rotated with respect to the base. 28. A medical instrument comprising: a base comprising a bone contacting surface that in use contacts at least one bone;a first device, at least part of the first device movable with respect to the base to tension at least one flexible suture extending around at least a portion of the at least one bone,a second device physically mounted to the base and comprising a flexible suture retaining structure arranged to retain at least a portion of the at least one flexible suture, at least a part of the second device rotatable with respect to the base to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture; anda flexible suture retaining structure arranged to retain a portion of the at least one flexible suture by the medical instrument, wherein a distance between a location of the flexible suture retaining structure where the portion of the at least one flexible suture is retained and a location where the at least one flexible suture exits the base decreases when the at least a part of the second device is rotated with respect to the base. 29. A medical surgical instrument comprising: a support;a first device operable to apply tension to at least one flexible suture extending around at least a portion of at least one bone,a second device, at least a part of the second device rotatably mounted to the support to rotate with respect thereto to apply a plurality of twists to the at least one flexible suture to encircle at least the portion of the at least one bone with the at least one flexible suture when the at least part of the second device is rotated with respect to the support; anda third device arranged to reduce the tension applied to the at least one flexible suture as the plurality of twists are applied to the at least one flexible suture, and wherein the at least one flexible suture is a metal wire suture; anda torsion spring is physically coupled to the flexible suture retaining structure to cause the flexible suture retaining structure to further wind up the at least one flexible suture in response to a distance between a location of the flexible suture retaining structure where the portion of the at least one flexible suture is retained and a location where the at least one flexible suture exits the support decreasing when the at least a part of the second device is rotated with respect to the support.
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