WO2004112619A1

WO2004112619A1 - Tendon suture aid

Info

Publication number: WO2004112619A1
Application number: PCT/GB2004/002532
Authority: WO
Inventors: Samuel Charles Richards
Original assignee: Glasgow School Of Art
Priority date: 2003-06-14
Filing date: 2004-06-11
Publication date: 2004-12-29
Also published as: GB0313822D0

Abstract

The invention relates to a medical device that assists in the gripping, locating and suturing of severed tendon ends. In particular, the device aids the gripping, locating and suturing of severed ends of flex tendons, resulting in less tendon damage during surgery, as there is less dragging, pulling and lengthy clamping of the tendon ends.

Description

Tendon Suture Aid

The present invention relates to a medical device that assists in the gripping, locating and suturing of severed tendon ends. In particular, the device aids the gripping, locating and suturing of severed ends of flexor tendons .

Surgery involving the treatment of lacerated or severed tendons is a delicate procedure, requiring great skill and dexterity from the surgeon. It also requires delicate instrumentation to prevent further damage to the patient. When a tendon is lacerated, tendon repair is required to reconnect the free ends. In certain cases, a graft is required to lengthen the damaged tendon. Typically an incision is made and the two ends of the tendon located and sutured together. If a graft is required, this will be included to lengthen the tendon and typically the tendon graft is taken from the same part of the body.

Tendon repair can be performed using a local anaesthetic, a regional anaesthetic or a general anaesthetic. The invasive nature of the operation means there is increased risk of bleeding and infection during the surgery. Additional risks include the formation of scar tissue which prevents smooth movements and adequate tendon gliding, and partial loss of function involved in the joint. The devices currently used to allow the surgery to take place can themselves cause damage to tendons, resulting in the described problems and damage.

It can be seen that it would be beneficial to provide a medical device that could be used by surgeons in theatre to improve the operative procedure of flexor tendon repair, in the event of tendon laceration.

It is a first object of the present invention to provide a medical device that can delicately handle tendons during surgery.

It is a further object of the present invention to provide a medical device that can aid in the process of gripping, locating and suturing severed ends of flexor tendons.

A yet further object of the present invention is to provide a medical device that is disposable in nature.

According to a first aspect of the present invention, there is provided a tendon suture aid comprising a pair of tendon gripping means and a position adjuster means, wherein the gripping means are able separably to attach to the adjuster means, such that they are held substantially parallel to each other, and such that the position adjuster means can be lengthened or shortened to widen or lessen the distance between the two gripping means .

Preferably the gripping means is a syringe clamp.

Preferably the adjuster means is a clamp.

Optionally the syringe clamps comprise a stem section and a tip section.

Optionally the stem section is covered by a sleeve section.

Optionally the tip section may comprise a needle.

Preferably the tip section is provided with one or more protruding elements which extend substantially perpendicular to the syringe clamp.

Preferably a detachable tendon band is provided which is able to attach to the protruding elements, such that the band at least partially surrounds the tip section of the syringe clamp.

Preferably the tip section of the syringe clamp is shaped such that the lower profile fits the profile of a tendon.

Preferably the position adjuster means is provided with a ratchet mechanism.

Preferably the ratchet mechanism is a thumb wheel. Preferably the action of turning the thumb wheel in one direction will result in the position adjuster means shortening, and the action of turning the thumb wheel in the opposite direction will result in the position adjuster means lengthening.

Preferably the needle is made of stainless steel .

Preferably the components of the position adjuster means and gripping means are made from one or more from a list of polycarbonate, polysulfone and silicone.

According to a second aspect of the present invention, there is provided a method of using a tendon suture aid as in the first aspect, wherein the gripping means are used to grip the free ends of a damaged tendon; the gripping means are then attached to the adjuster means, such that the gripping means are held substantially parallel to each other; and the position adjuster means are then used to draw the gripping means and the free ends of the damaged tendon closer together.

In order to provide a better understanding of the present invention, we will describe the embodiments of the invention by way of example only and with reference to the following drawings, in which:

Figure 1 shows the components that make up a syringe clamp;

Figure 2 is a diagram indicating how the syringe clamp and the position adjuster clamp can be combined to provide the suture device in one form; Figure 3 is a side view of the suture aid according to the present invention;

Figure 4 is a front view of the suture aid according to the present invention;

Figure 5 is a top view of the suture aid according to the present invention;

Figure 6 is a perspective view of the suture aid according to the present invention;

Figure 7 is a diagram of the tip of the syringe clamp according to the preferred embodiment of the present invention; and

Figure 8 shows the sequence of events that would typically occur during tendon repair using a device according to the present invention.

In the present invention, the tendon suture aid 1 is used to locate, grip and suture the severed ends of tendon 2. In one embodiment, the tendon 2 is a flexor tendon 2 located in the hand or forearm. In order to grip the tendon 2, firstly the point of the needle 3 is inserted into the tendon 2, and the upper surface of the tendon 2 locates on the tendon profiled face of a syringe clamp tip 4. A tendon band 5 is then looped underneath the tendon 2 and is attached at both ends to the studs 6 that protrude from the syringe clamp tip 4. Once the tendon 2 is held in position, the tendon band 5 is tightened around the tendon 2 by means of a syringe action. The stem 6 comprises a sleeve element 7 which rises up the stem 6 using a ratchet mechanism 8. The ratchet mechanism 8 prevents the tendon band 5 from slackening when the syringe actuation force is removed. This results in the tendon 2 being gently and automatically gripped to allow the manipulation of the tendon 2 during the suture process.

In an alternative embodiment, the sleeve 7 is not a separate element and the stem 6 is formed from a single body piece. The ratchet mechanism 8 is removed and instead the tendon band 5 has multiple holes at each end which can be attached to the stem, such that the band 5 can be tightened or loosened by attachment via different sets of holes.

The tendon 2 is securely held by the tendon needle 3. The tendon band 5 prevents the needle 3 from being withdrawn from the tendon 2 during manipulation. The needle 3 also prevents the tendon 2 from distorting as the suture is applied and prevents the ends of the tendon 2 from buckling and bunching up as the suture is tightened and several tendons end 2 bunch up together.

Once the tendon ends 2 have been located by each separate syringe clamp 9, the sleeve 7 of the syringe clamp 9 can be attached to a position adjuster clip. In the preferred embodiment, two syringe clamps 9 are used to find the separated tendon ends 2 of a severed tendon and then, once the severed ends 2 have been located and held securely, the two syringe clamps 9 are attached to the position adjuster clip 10.

The position adjuster 10 comprises two holding sections 11 into which each of the two syringe clamps 9 can be fitted. The holding sections 11 are held at a fixed position apart by a positioning section 12 that joins the two together. The positioning section 12 is able to act as a screw in the preferred embodiment, and comprises a thumb wheel 13 at one end. The thumb wheel 13 when turned results in the holding sections being moved closer together or further apart. Therefore, when the syringe clamps 9 are placed in the holding sections 12, their distance from each other can be changed by turning the thumb wheel 13. This allows a surgeon to have very accurate control over the tendon ends 2, pulling them together in a careful and controlled manner. This makes the operation of flexor tendon repair much simpler to perform than in the prior art, and results in much less tendon damage, as there is less dragging, pulling and lengthy clamping of the tendon ends 2.

It can be seen that the present invention provides a number of benefits over the prior art, in particular with regard to the control and delicate manoeuvring that the device allows.

It should also be noted that the embodiments disclosed above are merely exemplary of the present invention, which may be embodied in different forms. Therefore, the details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and for teaching as to the various uses of the present invention in an appropriate manner. In particular, it should be noted that the protruding elements on the tip can be positioned higher up the stem of the syringe clamps, and the materials that are described can be changed for other suitable materials, if required.

Claims

1. A tendon suture aid comprising a pair of tendon gripping means and a position adjuster means, wherein the gripping means are able to separably attach to the adjuster means, such that the gripping means are held substantially parallel to each other, and such that the position adjuster means can be lengthened or shortened to widen or lessen the distance between the two gripping means.

2. A tendon suture aid as in Claim 1, wherein the gripping means is a syringe clamp.

3. A tendon suture aid as in Claims 1 or 2, wherein the adjuster means is a clamp.

4. A tendon suture aid as in Claims 2 or 3 , wherein the syringe clamp comprises a stem section and a tip section.

5. A tendon suture aid as in Claim 4, wherein the stem section is covered by a sleeve section.

6. A tendon suture aid as in Claims 4 or 5, wherein the tip section comprises a needle.

7. A tendon suture aid as in Claims 4 to 6, wherein the tip section is provided with one or more protruding elements which extend substantially perpendicular to the syringe clamp.

8. A tendon suture aid as in Claims 4 to 7 , wherein the tendon suture aid is provided with a detachable tendon band which is able to attach to the protruding elements, such that the band at least partially surrounds the tip section of the syringe clamp .

9. A tendon suture aid as in Claims 4 to 8 , wherein the tip section of the syringe clamp is shaped such that the lower profile fits the profile of a tendon.

10. A tendon suture aid as in any of the previous Claims, wherein the position adjuster means is provided with a ratchet mechanism.

11. A tendon suture aid as in Claim 10, wherein the ratchet mechanism is in the form of a thumb wheel.

12. A tendon suture aid as in Claim 11, wherein the action of turning the thumb wheel in one direction will result in the position adjuster means shortening, and the action of turning the thumb wheel in the opposite direction will result in the position adjuster means lengthening.

13. A tendon suture aid as in Claims 6 to 12, wherein the needle is made of stainless steel.

14. A tendon suture aid as in any of the previous Claims, wherein the components of the position adjuster means and gripping means are made from one or more from a list of polycarbonate, polysulfone and silicone.

5. A method of using a tendon suture aid, as described in any of Claims 1 to 14, wherein during surgery the gripping means are used to grip the free ends of the damaged tendon; the gripping means are then attached to the adjuster means, such that the gripping means are held substantially parallel to each other; and the position adjuster means are then used to draw the gripping means and therefore the free ends of the damaged tendon closer together.