SYSTEMS, DEVICES AND METHODS OF MAKING SURGICAL SUTURES HAVING REFORMED, REDUCED DIAMETER, OFFSET TIPS
20220104812 · 2022-04-07
Inventors
Cpc classification
B29L2031/753
PERFORMING OPERATIONS; TRANSPORTING
A61B17/06195
HUMAN NECESSITIES
B29C2791/003
PERFORMING OPERATIONS; TRANSPORTING
B29C43/224
PERFORMING OPERATIONS; TRANSPORTING
B29C69/001
PERFORMING OPERATIONS; TRANSPORTING
A61B2017/06028
HUMAN NECESSITIES
B29C43/40
PERFORMING OPERATIONS; TRANSPORTING
B29L2031/7544
PERFORMING OPERATIONS; TRANSPORTING
International classification
Abstract
A system for making a surgical suture having a reformed tip includes a receiver die having a top surface, a bottom surface, and an elongated channel formed in the top surface that extends between first and second ends of said receiver die. The elongated channel includes a suture channel having a first end and a second end, a first sloping surface that extends downwardly between the first end of the suture channel and the first end of the receiver die, and a second sloping surface that extends downwardly between the second end of the suture channel and the second end of the receiver die. The system includes an upper die having a top surface and a bottom surface that opposes the top surface of the receiver die. The system has an open die position in which the bottom surface of the upper die is spaced away from the top surface of the receiver die and a closed die position in which the bottom surface of the upper die is in contact with the top surface of the receiver die. A cutting element is coupled with the receiver die and the upper die.
Claims
1. A system for making a surgical suture having a reformed tip comprising: a receiver die having a top surface, a bottom surface, and an elongated channel formed in the top surface that extends between first and second ends of said receiver die; said elongated channel including a suture channel having a first end and a second end, a first sloping surface that extends downwardly between the first end of said suture channel and the first end of said receiver die, and a second sloping surface that extends downwardly between the second end of said suture channel and the second end of said receiver die; an upper die having a top surface and a bottom surface that opposes the top surface of said receiver die, wherein said system has an open die position in which the bottom surface of said upper die is spaced away from the top surface of said receiver die and a closed die position in which the bottom surface of said upper die is in contact with the top surface of said receiver die; a cutting element coupled with said receiver die and said upper die.
2. The system as claimed in claim 1, further comprising: a cutting element guide slot that extends through said upper die and said receiver die along a cutting element movement axis that crosses the bottom surface of said upper die and the top surface of said receiver die; said cutting element being adapted to slide within the cutting element movement axis of said cutting element guide slot in a first direction toward the top surface of said upper die and in a second direction toward the bottom surface of said receiver die.
3. The system as claimed in claim 1, wherein said suture channel comprises a suture seating surface that extends in a plane that is parallel with the top surface of said receiver die.
4. The system as claimed in claim 3, wherein said first sloping surface slopes downwardly between the first end of said suture channel and the bottom surface of said receiver channel, and wherein said second sloping surface slopes downwardly between the second end of said suture channel and the bottom surface of said receiver die.
5. The system as claimed in claim 1, further comprising: said cutting element having an upper end, a lower end, a sharpened cutting edge located between the upper and lower ends of said cutting element, and first and second guide legs located on opposite ends of said sharpened cutting edge; a suture reforming assembly including first and second reforming die having an extended position in which said first and second reforming die are joined together between said first and second guide legs of said cutting element and a retracted position in which said first and second reforming die are spaced from one another.
6. The system as claimed in claim 1, further comprising: a first cutting element guide slot formed in said upper die that extends from the top surface to the bottom surface of said upper die; a second cutting element guide slot formed in said elongated channel of said receiver die, wherein said first and second cutting element guide slots are in alignment with one another, and wherein said cutting element is configured for sliding up and down within said first and second cutting element guide slots.
7. The system as claimed in claim 6, wherein said cutting element has an upper end, a lower end, a sharpened cutting edge located between the upper and lower ends of said cutting element, and first and second guide legs located on opposite ends of said sharpened cutting edge, and wherein said first and second guide legs are disposed within said second cutting element guide slot formed in said elongated channel of said receiver die for guiding up and down movement of said cutting element.
8. The system as claimed in claim 7, wherein said second cutting element guide slot has outer ends that are aligned with said first and second sloping surfaces of said elongated channel.
9. The system as claimed in claim 7, wherein said cutting element has an upper end that is disposed with said first cutting element guide slot of said upper die.
10. The system as claimed in claim 7, wherein said cutting element has an angled blade that extends between said first and second guide legs of said cutting element.
11. A surgical suture having an off-axis distal tip comprising: an elongated fiber having a proximal end, a distal end, a central axis extending between the proximal and distal ends thereof, and a first outer surface defining a first cross-sectional dimension; said elongated fiber including a distal tip located at the distal end thereof, said distal tip having a second outer surface that defines a second cross-sectional dimension that is smaller than the first cross-sectional dimension of the first outer surface, wherein said distal tip has a central axis that is offset from the central axis of said elongated fiber.
12. The surgical suture as claimed in claim 11, wherein a portion of the second outer surface of said distal tip is aligned with a portion of the first outer surface of said elongated fiber.
13. The surgical suture as claimed in claim 12, wherein a second portion of the second outer surface of said distal tip is not aligned with the portion of the first outer surface of said elongated fiber.
14. The surgical suture as claimed in claim 12, wherein said elongated fiber further comprises a sloping transition surface extending between the first outer surface of said elongated fiber and the second outer surface of said distal tip.
15. The surgical suture as claimed in claim 14, wherein said sloping transition surface defines an asymmetric conical structure
16. The surgical suture as claimed in claim 11, wherein said elongated fiber comprises a biocompatible polymer.
17. A system for making a surgical suture having a reformed, reduced diameter distal tip comprising: a first roller having a first groove formed therein that extends around the outer perimeter of said first roller; a second roller opposing said first roller, said second roller having a second groove formed therein that extends around the outer perimeter of said second roller; a drive system for bringing said first and second rollers together for contacting opposite sides of an elongated fiber and compressing said elongated fiber between the outer perimeters of said respective first and second rollers as said first and second rollers are driven over a section of said elongated fiber for reforming the section of said elongated fiber into a core mass of said elongated fiber and at least one deformed mass of said elongated fiber; a cutting element for cutting said at least one deformed mass of said elongated fiber from said core mass of said elongated fiber so that only said core mass of said elongated fiber remains for interconnecting first and second ends of said elongated fiber.
18. The system as claimed in claim 17, further comprising a suture reforming assembly including first and second reforming die having an extended position in which opposing faces of said first and second reforming die engage opposite sides of said core mass for reshaping said core mass and a retracted position in which said first and second reforming die are spaced away from one another and not in contact with the opposite sides of said core mass.
19. The system as claimed in claim 18, wherein said first reforming die comprises a first J-shaped structure including a first concave curved surface, and wherein said second reforming die comprises a second J-shaped structure including a second concave curved surface.
20. The system as claimed in claim 17, further comprising a heating element for heating said elongated fiber.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0080] Referring to
[0081] In one embodiment, the system 100 preferably includes a cutting element 110 with an angled blade 112 having a sharpened cutting edge 114 that extends between first and second cutting element guide legs 116, 118 that extend to a lower end of the cutting element 110.
[0082] In one embodiment, the system 100 desirably includes a receiver die 120 that is adapted to receive a suture that will be cut and/or trimmed to form a suture having a reduced diameter tip. The receiver die 120 preferably has a top surface 122 that extends from a first end 124 to a second end 126 of the receiver die. In one embodiment, the receiver die 120 desirably includes an elongated channel 128 formed in the top surface 122 that extends from the first end 124 to the second end 126 of the receiver die. In one embodiment, the elongated channel 128 desirably includes a suture channel 130 that is adapted to seat a suture (e.g., a center region of a suture), whereupon the suture will be trimmed using the cutting element 110. The elongated channel 128 desirably includes a second cutting element guide slot 132 that is adapted to receive the first and second cutting element guide legs 116, 118 of the cutting element 110. In one embodiment, the first cutting element guide slot of the upper die and the second cutting element guide slot of the receiver die are preferably aligned with one another so that the cutting element may slide up and down within the upper die and the receiver die for cutting a laterally extending mass from a suture as part of a tip forming process.
[0083] In one embodiment, the receiver die 120 desirably includes a first sloping ramp 134 formed in the elongated channel 128, which is located at the first end 124 of the receiver die. The receiver die 120 preferably includes a second sloping ramp 136 formed in the elongated channel 128, which is located adjacent the second end 126 of the receiver die. In one embodiment, when a center region of a suture is positioned atop the suture channel 130, the outer ends (e.g., first and second ends that bound the center region) of the suture that are not positioned within the suture channel 130 are free to slope down in the respective first and second sloping ramps 134, 136. A relief form 138 is preferably located at the outer ends of each of the respective sloping ramps 134, 136 for minimizing damage to the elongated body of the suture as the suture is passed through the elongated channel 128 of the receiver die 120.
[0084] Referring to
[0085] Referring to
[0086] In one embodiment, the receiver die 120 preferably includes the first sloping ramp 134 adjacent the first end 124 of the receiver die 120 and the second sloping ramp 136 adjacent the second end 126 of the receiver die 120. The first and second sloping ramps 134, 136 desirably slope down and away from the suture seating surface of the suture channel 130. When the suture 140 is positioned on the suture supporting surface of the suture channel 130, the first and second ends 140B, 140C of the suture may conform to the sloping surfaces of the respective first and second sloping ramps 134, 136.
[0087] In one embodiment, the receiver die 120 preferably includes the second cutting element guide slot 132 that is adapted to receive the cutting element guide legs 116, 118 and the sharpened cutting edge 114 of the cutting element 110 (
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[0097] After the upper die 102 and the receiver die 120 have been moved away from one another to provide the lateral gap G therebetween, a reforming process may be performed on the core mass 143 utilizing first and second reforming dies 150, 152. In one embodiment, the first reforming die 150 has a concave curved surface 54 that includes a lower extension 156 to provide a J-shaped forming face. Similarly, the second reforming die 152 that opposes the first reforming die 150 has a concave curved surface 158 and an extension 160 that defines a J-shaped forming face. In one embodiment, the first and second reforming dies 150, 152 are adapted to move toward one another for pressing and reshaping the core mass 143 of the suture 140 to provide a reformed mass, which may have a cylindrical shaped outer profile.
[0098] Referring to
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[0100] The systems, devices, and methods disclosed herein may be used with any conventional monofilament suture. Examples of commercially available monofilament sutures that may be tipped using the systems, devices and methods disclosed herein include sutures sold under the trademarks PROLENE® suture, PRONOVA® suture, PDS® suture, NUROLON® suture, as well as surgical gut sutures, and stainless steel sutures and the like. The sutures may be made from conventional biocompatible polymeric materials, both synthetic and natural materials such as surgical gut. The sutures may be made from absorbable or non-absorbable polymers, or combinations thereof. The absorbable polymers include conventional biocompatible, polymers such as lactide, polylactic acid, polyglycolic acid, glycolide, polydioxanone, polycaproactone, copolymers and blends thereof and the like. The nonabsorbable polymers include conventional biocompatible polymers such as, polyolefinspolyamides (polyhexamethylene adipamide (nylon 66), polyhexamethylene sebacamide (nylon 610), polycapramide (nylon 6), polydodecanamide (nylon 12) and polyhexamethylene isophthalamide (nylon 61) copolymers and blends thereof), polyesters (e.g. polyethylene terephthalate, polybutyl terephthalate, copolymers and blends thereof), fluoropolymers (e.g. polytetrafluoroethylene and polyvinylidene fluoride), polyolefins (e.g., polypropylene including isotactic and syndiotactic polypropylene and blends thereof, as well as, blends composed predominately of isotactic or syndiotactic polypropylene blended with heterotactic polypropylene (such as are described in U.S. Pat. No. 4,557,264 issued Dec. 10, 1985 assigned to Ethicon, Inc. hereby incorporated by reference) and polyethylene including ultra high molecular weight polyethylene and the like and combinations thereof. The sutures may also be made from conventional biocompatible metals and metal alloys including surgical stainless steel, Nitinol, etc.
[0101] The tipped sutures disclosed herein may have suture sizes ranging from size 5 to size 10-0. In one embodiment, the tipped sutures disclosed herein may be mounted to conventional surgical needles made from conventional biocompatible materials such as metal alloys including surgical stainless steel, tungsten-rhenium alloys, etc. If desired, the surgical needles may be made from other biocompatible materials including ceramics, polymeric materials and composites, etc. The needles will preferably have proximal needle mounting ends having drilled bore holes or channeled features for receiving a distal suture tip and mounting it to the needle. The suture tips may be mounted or secured (i.e., attached) to the proximal suture mounting ends of the surgical needles by conventional attachment techniques including mechanical swaging, gluing, melting, etc. In one embodiment, the maximum outer dimension at the proximal mounting end of the needle after the suture tip has been mounted and secured (i.e., attached) in place will preferably be equal to the maximum diameter of the body of the needle.
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[0104] In certain embodiments of the present patent application, the systems, devices and methods disclosed herein may be utilized to produce surgical sutures having various cross-sectional configurations. Referring to
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[0111] In one embodiment, the elongated fiber has a first transition region 940D that preferably extends between the first end 940A and the center region 940A thereof. In one embodiment, the first transition region 940D has a sloping outer surface 959 that slopes inwardly between the outer surface 955 of the first end 940B of the fiber and the outer surface 957 of the reformed center region 940A of the fiber.
[0112] In one embodiment, the elongated fiber has a second transition region 940E that extends between the second end 940C and the center region 940A thereof. In one embodiment, the second transition region 940E has a sloping outer surface 961 that slopes inwardly between the outer surface 955 of the second end 940C of the fiber and the outer surface 957 of the center region 940A of the fiber.
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[0116] The needle 1002 may be made using conventional manufacturing processes that are adapted to manufacturing surgical needles made from biocompatible metals such as refractory metal alloys. Typically, in a conventional process, wire made from the desired metal alloy is drawn in a wire mill to a desired diameter. The wire is then cut in conventional wire cutting equipment to produce needle blanks having the desired length. The wire then goes through a series of conventional manufacturing process steps including forming, grinding, polishing, cleaning and drilling.
[0117] Needle blanks may be drilled in several ways. The blanks may be mounted in a fixture and a conventional mechanical drill may be used to drill out a bore hole in the proximal end of the needle blank. Although mechanical drilling may be useful to drill bore holes in surgical needles, there are limitations associated with such a drilling process. For example, drills wear out and need to be replaced on a constant basis. In addition, the mechanical drilling process is time consuming and is less desirable for high speed, automated production processes. In addition, mechanical drills cannot typically be used in a cost effective manner for drilling needles made from very hard materials, or those that readily work-harden during the drilling operation. Laser drilling systems have been developed for drilling bore holes in surgical needles. These laser systems typically use Nd:YAG lasers, but any laser type capable of providing the required power density and being focused to the required spot size would be acceptable. Specific cycles are utilized to obtain the desired bore hole diameter and depth by controlling laser beam parameters including beam power, energy density, energy density distribution, pulse shape, pulse duration, and the number of pulses.
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[0119] In one embodiment, during the cutting and reforming steps disclosed herein, heat, produced through resistance heaters, radio frequency generators, plasma, laser or ultrasonic equipment, may be utilized to assist in the mobilization of the polymer based structures to improve the cutting and/or forming operations.
[0120] In one embodiment, the systems, devices and methods disclosed herein may involve a manual process, whereby the elongated fiber is held in a fixed position within a clamping frame, or an automated spool feed type process.
[0121] In one embodiment of an automated spool feed process, a suture fiber to be tipped may be fed from a payout spool into a tip forming system. The leading end of the fiber may be positioned within an indexing head, which may draw the fiber into a heating and forming station. The heating and forming station may be configured with a set of forming dies similar to those disclosed herein. The dies may be mounted for vertical travel and may optionally be heated. Alternatively, the die may be run only in a cooled configuration. The heating of the fiber may be achieved through the use of a heating source that is located at the same axial position as the forming die station along the length of the suture. In one embodiment, the heating source may be positioned in a plane that is rotated 90 degrees relative to the plane of the forming station. For example, if the forming station traverses vertically, then the heating station may be mounted in the horizontal position to provide heating of the fiber while the fiber is positioned within the forming station. Heating sources may include but are not limited to conventional infrared heaters, heated convection mediums such as air streams, or other conductive sources such as heated dies, and the like and equivalents thereof.
[0122] In one embodiment, the systems, devices and methods for reforming a suture tip may use heat and/or pressure for shaping polymeric materials used to make elongated fibers. In one embodiment, the forming die may operate at a lower temperature than the heating source for reshaping the fiber while the die contact serves to cool the fiber during the forming step. In one embodiment, for materials that have a T.sub.g that is lower than room temperature, the heating of the material may not be necessitated and the forming operation may be conducted at ambient room temperature.
[0123] In one embodiment, the fiber may not be exposed to elevated tension during the cutting and reforming operations. In one embodiment, the fiber feeding mechanism may only advance the indexed amount of fiber through both the payout and take-up mechanism maintaining the same relative motion of the fiber.
[0124] In one embodiment, the systems, devices and methods disclosed herein produce surgical sutures having reformed tips that are dimensionally consistent and have an improved degree of precision that may not be attained when using bulk processing techniques such as extrusion or roll forming. The dimensional consistency enables repeatable attachment strengths when surgical needles are swaged onto the reformed suture tips. In certain embodiments, other features, such as indents, corrugations, opposing partial spirals or raised features, may be formed on the suture tip geometry, which may improve the needle attachment strength. Additionally, fiber fibrillation due to overdrawing of the fibers is avoided and the rigidity of the tipped fiber is not increased relative to the main body of the suture.
[0125] The novel process of the present can be utilized with surgical needles made from alloys of refractory metals including tungsten, molybdenum, niobium, tantalum, and rhenium. Surgical needles made from tungsten-rhenium alloys are disclosed in the following references which are incorporated by reference: U.S. Pat. No. 5,415,707 to Bendel et al., and U.S. patent application Ser. Nos. 11/611,353; 11/611,387; 11/756,668; and Ser. No. 11/756,679. In one embodiment, the systems, devices and methods disclosed herein may be used with laser drilled surgical needles made from conventional stainless steel alloys.
[0126] While the foregoing is directed to embodiments of the present invention, other and further embodiments of the invention may be devised without departing from the basic scope thereof, which is only limited by the scope of the claims that follow. For example, the present invention contemplates that any of the features shown in any of the embodiments described herein, or incorporated by reference herein, may be incorporated with any of the features shown in any of the other embodiments described herein, or incorporated by reference herein, and still fall within the scope of the present invention.