Non-return loader

Abstract

The invention relates to a non-return loader. A suture check system for loading a full suture check onto a suspension system in a bone tunnel. The suture non-return system has a non-return member having a first end and a second end each extending in a distal direction. The system includes a first through longitudinal element interwoven through the check such that a first loop is formed in the first through longitudinal element and extends from the first end of the check. Similarly, the system also includes a second pass-through longitudinal element interwoven through the check such that a second loop is formed in the second pass-through longitudinal element and extends from the second end of the check. The first through longitudinal element and the second through longitudinal element are attached to the distal end of the handle. The first end and the second end of the check are positioned in a first direction in an undeployed configuration and in a second direction different from the first direction in a deployed configuration.

Description

[0001] This application is a divisional application of the patent application with application number "201980062861.3", application date "September 24, 2019", and invention name "Stop-return loader".

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims priority to U.S. Provisional Patent Application Serial No. 62 / 735,284, filed on September 24, 2018, and entitled “Backstop Loader,” which is incorporated herein by reference in its entirety. Background Art 1. Technical Field

[0005] The present invention relates generally to surgical devices for repairing and reconstructing soft tissue injuries, and more particularly to a suture stop system for loading a full suture stop onto a suspension system in a bone tunnel.

[0006] 2. Description of related technologies

[0007] Many common surgical procedures involve the repair and reconstruction of torn or damaged soft tissues. For example, in common arthroscopic surgery, a replacement graft ligament is fixed to the site of the original ligament that is now damaged. Repairing and reconstructing torn or damaged soft tissues is a common surgical procedure. For example, a replacement graft ligament can be fixed to the site of the original ligament. The operation generally includes drilling a bone tunnel in the adjacent bone of the original ligament site, and fixing the graft ligament in these bone tunnels. In many applications, such as in the knee joint, such operations can be performed using arthroscopy. The graft ligament can be an autologous graft, an allograft, a xenograft, or can be completely synthetic. For example, common anterior cruciate ligament (ACL) graft types include grafts that can be autologous or allogenic bone-patellar tendon-bone or soft tissue (such as semitendinosus tendon and gracilis tendon), and both types are obtained by techniques well known to those skilled in the art.

[0008] Graft ligaments can be secured within the bone tunnel in a variety of ways. Most important is the degree to which they can withstand pullout forces before complete healing. For example, it is known to use interference screws inserted parallel to the tunnel axis to press the ends of the graft ligament against the wall of the bone tunnel to secure the graft ligament and promote tissue ingrowth.

[0009] Suspension graft fixation devices have been developed to fix the graft ligament in the bone tunnel. One such device is described in U.S. Pat. No. 8,852,250 (Lombardo et al.), assigned to the assignee, entitled Graft Fixation Implant, which is incorporated herein by reference in its entirety. The working principle of the suspension graft fixation device is to be placed laterally through the opening of the bone tunnel and is generally in the form of an elongated anchoring member that suspends the graft retaining collar from a fixed point on the surface of the bone (in this case, the femur) to which the graft is attached. The elongated member has an axis and a pair of suture receiving holes symmetrically located on the axis on opposite sides of the center of the elongated member. In ACL surgery, the elongated member (commonly referred to as a fastener) is adapted to be positioned laterally through the exit of the bone tunnel of the lateral cortex of the femur so that a support collar, generally made of suture material, can be suspended from the fastener and can extend from the suture receiving hole of the fastener into the bone tunnel. The suture collar supports one end of the graft ligament passing through the collar.

[0010] As used herein, the term "suture" can be any type of filamentous material that can provide the loop support and friction resistance required by the devices described herein, such as biocompatible or bioabsorbable filaments, ribbons, strips, woven or nonwoven materials. In arthroscopic surgery such as ACL reconstruction, the elongated anchoring member is initially aligned with the axis of the bone tunnel and is pulled through the tunnel to the exit at the distal end of the lateral femur. In order for such a hanging graft fixation device to support the graft ligament and be properly positioned laterally at the exit of the bone tunnel, the suture loop and bone tunnel must be long enough to enable the elongated member to "flip" from an axially aligned orientation to a lateral orientation as it exits the bone tunnel.

[0011] Since the support collar of such a suspension device generally has a fixed length, graft fixation requires preparation of a graft ligament of a predetermined length. In addition, since conventional art suspension graft fixation devices have a fixed collar length, they are prepared in a variety of sizes (e.g., in the case of XO manufactured by ConMed Corporation, Largo, Fla. For implants, the loop length ranges from 15 mm to 60 mm in 5 mm increments to accommodate a variety of graft and tunnel lengths that may be encountered during surgical procedures. Fixed graft lengths and variations in tunnel and loop lengths can make traditional suspension ligament fixation difficult.

[0012] However, when using a button (or other backstop), the surgeon loads the suture tail through the button and then ties the construction. In order to use an all-suture construction such as a suture braid as a button, the user must pierce or braid the all-suture construction with the suture tail to form the button. This is a complex process that may require multiple, time-consuming steps.

[0013] Therefore, there is a need for a suture backstop system that can quickly and easily load a full suture button or other backstop onto a suture.

[0014] Related Art Section Disclaimer Description: With respect to specific patents / publications / products discussed above in the Related Art section description or elsewhere in this disclosure, such discussion should not be considered an admission that the discussed patents / publications / products are prior art for patent law purposes. For example, some or all of the discussed patents / publications / products may not be sufficiently early in time, may not reflect subject matter that was developed early enough in time, and / or may not be sufficient to achieve prior art equivalents for patent law purposes. With respect to specific patents / publications / products discussed above in the Related Art section description and / or throughout the application, their descriptions / disclosures are incorporated herein by reference in their respective entireties. Summary of the invention

[0015] Embodiments of the present invention relate to a suture check system for loading a full suture check into a suspension system in a bone tunnel. According to one aspect, the suture check system has a check having a first end and a second end both extending in a distal direction. The system includes a first through longitudinal element (such as a wire (e.g., nitinol) or other element that is harder than a suture, but may also be a suture) that is interwoven through the check so that a first loop is formed in the first through longitudinal element and extends from the first end of the check. Similarly, the system may also include a second through longitudinal element (similar to the first through longitudinal element) that is interwoven through the check so that a second loop is formed in the second through longitudinal element and extends from the second end of the check. The first through longitudinal element and the second through longitudinal element may be attached to the distal end of the handle.

[0016] According to another aspect, a suture check system has a check having a first end and a second end. The first end and the second end are positioned and extend in a first direction in an undeployed configuration, and are positioned and extend in a second direction different from the first direction in a deployed configuration. The system includes a first through-longitudinal element that is interwoven through the check so that a first loop is formed in the first through-longitudinal element and extends from the first end of the check. Similarly, the system also includes a second through-longitudinal element that is interwoven through the check so that a second loop is formed in the second through-longitudinal element and extends from the second end of the check.

[0017] According to another aspect, the present invention is a method for suspending a first body in a position relative to a second body. The method comprises the following steps: (i) providing a suspension system comprising a length of suture having a pair of free branches positioned to pass through an anchoring body; (ii) passing the free branches through a proximal first body and an adjacent distal second body such that the free branches extend from a proximal surface of the first body and a portion of the anchoring body is positioned on a distal surface of the second body; (iii) providing a suture check system comprising: a check having a first end and a second end both extending in a distal direction; a first longitudinal element interlaced through the check so that a first loop is formed in the first longitudinal element and extends from the first end of the check; and a second longitudinal element interlaced through the check. The invention relates to a method for passing the backstop so that a second loop is formed in the second through longitudinal element and extends from the second end of the backstop; and a handle having a distal end attached to the first through longitudinal element and the second through longitudinal element; (iv) passing the free branch through the first loop and the second loop; (v) pulling the free branch in the distal direction and pulling the handle in the proximal direction so that the first loop and the second loop pull the free branch through the backstop; (vi) removing the handle from the backstop; (vii) positioning the backstop at the proximal surface of the first proximal body by pulling the free branch, wherein pulling the free branch deploys the backstop on the proximal surface of the first proximal body; (ix) tying a knot in the free branch near the backstop; (x) cutting the free branch near the knot.

[0018] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] One or more aspects of the present invention are particularly pointed out and clearly claimed as examples in the claims at the end of the specification. The foregoing and other objects, features and advantages of the present invention will become apparent from the following description in conjunction with the accompanying drawings, in which:

[0020] Figure 1 is a top perspective schematic diagram of a suture check system according to one embodiment;

[0021] Figure 2 is a schematic side view of a suture check system in a partially deployed configuration according to one embodiment;

[0022] Figure 3 is another side schematic view of a suture check system in a partially deployed configuration according to one embodiment;

[0023] Figure 4 is an additional side schematic view of a suture check system in a partially deployed configuration according to one embodiment;

[0024] Figure 5 is a schematic side view of a backstop in a deployed configuration according to one embodiment;

[0025] Figure 6 is a side schematic view of a suspension system in a partially deployed configuration according to one embodiment;

[0026] Figure 7 is another side schematic view of a suspension system in a partially deployed configuration according to one embodiment;

[0027] Figure 8 is a schematic side view of a backstop loaded onto a suspension system according to one embodiment; and

[0028] Fig. 9 is a schematic side view of a backstop and suspension system in a deployed configuration according to one embodiment. DETAILED DESCRIPTION

[0029] Aspects of the present invention and certain features, advantages and details thereof are explained more fully below with reference to the non-limiting examples shown in the accompanying drawings. Descriptions of known structures are omitted so as not to unnecessarily obscure the present invention in detail. However, it should be understood that the detailed description and specific non-limiting examples, although indicating aspects of the present invention, are given only in an illustrative manner, rather than in a limiting manner. Various substitutions, modifications, additions and / or arrangements within the spirit and / or scope of the basic concepts of the present invention will be apparent to those skilled in the art in light of this disclosure.

[0030] Referring now to the drawings, wherein like reference numerals refer to like parts throughout, Figure 1A schematic top perspective view of a suture check system 10 according to one embodiment is shown. The suture check system 10 includes a check member 12 having a pair of longitudinal elements (such as a first through line 14 and a second through line 16 shown in this example) interwoven therethrough. The check member 12 may be a button, a hanging fixture, or other anchor composed of any soft, flexible suture anchoring material (similar to that discussed with respect to the anchor body 112—including the functions described—with respect to the following Figure 6 to Figure 7 ). The purpose of using the full suture anchor stop 12 and the full suture button 112 is to minimize irritation and discomfort caused to the patient at the surgical site. In the depicted embodiment, the stop 12 can be composed of a suture braid. In an alternative embodiment, the stop 12 can be composed of non-radiopaque fibers so that the stop 12 can be seen in an X-ray. The full suture stop 12 can minimize irritation and discomfort caused to the patient at the surgical site. The through wires 14, 16 can be composed of any suitable wire material, including but not limited to Nitinol (which should be understood and recognized by a person of ordinary skill in the art in conjunction with the review of this disclosure), as understood by a person of ordinary skill in the art in conjunction with the review of this disclosure, such as Nitinol.

[0031] Still reference Figure 1 , the threading wires 14, 16 are interwoven through the backstop 12 such that a first loop 18 is formed in the first threading wire 14 and extends distally from a first end 20 of the backstop 12, and a second loop 22 is formed in the second threading wire 16 and extends distally from a second end 24 of the backstop 12. In one embodiment, the first threading wire 14 is folded in half to form the first loop 18, and the branches of the first threading wire 14 are interwoven in the proximal direction through the backstop 12. Similarly, the second threading wire 16 is folded in half to form the second loop 22, and the branches of the second threading wire 16 are interwoven in the proximal direction through the backstop 12.

[0032] In the depicted embodiment, the pass wires 14, 16 pass through the check 12 six (6) times (but the number of passes can vary and can be an even number on one side of the check 12 and an odd number on the other side (or both even or both odd)). Specifically, the first loop 18 extends distally from the first end 20 of the check 12, and the first pass wire 14 is interwoven proximally through the check 12 at three pass locations 26, 28. The first pass wire 14 is woven so that it extends from the check 12 at a first center pass location 28 (as used herein, "center" describes a location on the check 12 that is closer to the midpoint or center of the check 12 than the first end 20 or the second end 24 of the check 12).

[0033] As with the first loop 18, the second loop 22 extends distally from the second end 24 of the backstop 12, and the second threading wire 16 is interwoven proximally through the backstop 12 at three threading locations 30, 32. The second threading wire 16 is woven so that it extends from the backstop 12 at a second central threading location 32 that is adjacent to the first central threading location 28, as shown in FIG. Figure 1 Therefore, in Figure 1 In the illustrated pre-deployment configuration, the backstop 12 is folded such that the first and second ends 20, 24 are adjacent the first and second loops 18, 22, both extending in the distal direction, while the first and second threading wires 14, 16 extend in the proximal direction.

[0034] Figure 1 The suture check system 10 also includes a handle 34. In the depicted embodiment, the handle 34 is rectangular; however, any other suitable geometric shape may be used. In addition, the handle 34 may be molded so that it includes one or more ridges 36 (or other protrusions) for the user to enhance grip control. As shown, the first threading line 14 extending from the first ring 18 and the second threading line 16 extending from the second ring 22 are attached to the distal end 38 of the handle 34. When the suture check system 10 is in the pre-deployment configuration, as shown in FIG. Figure 1 As shown, the suture backstop system 10 can be used to load the backstop 12 onto a suspension system to suspend or tension a first body in a desired position relative to a second body.

[0035] Briefly go to Figure 6 to Figure 7 , shows a schematic side view of a suspension system 100 in a partially deployed configuration according to one embodiment. As shown, the suture suspension system 100 includes a length of suture 114 interwoven through an anchor body 112, as described in U.S. Patent Application No. 15 / 711,192, assigned to the assignee of the present application, which is incorporated herein by reference in its entirety. In the depicted embodiment, the anchor body 112 is in an expanded position ( Figure 6 ) and in compressed position ( Figure 5) of a full suture button. In another embodiment, the anchor body 112 can be a hanging fixture as described in U.S. Patent No. 9,700,403 assigned to the assignee herein, which patent application is incorporated herein by reference in its entirety. In short, an embodiment of the hanging fixture can include an elongated anchoring member (which may or may not have preformed suture receiving holes, at least one of which may but need not necessarily be recessed into the surface of the elongated anchoring member) and a suture passing through at least one hole. In an alternative embodiment, the anchor body 112 can be any soft suture anchor material (as will be understood by a person of ordinary skill in the art in conjunction with the review of this disclosure). In short, because soft anchors are often made entirely of suture material, they are sometimes referred to as "full suture" anchors, and typically include a fiber construction anchor body portion (or a fiber, braided or woven fabric-type structure, such as a flexible mesh, as described in U.S. Patent No. 9173652) and a suture or filament portion. The fiber construction can be flat, non-flat and / or tubular or non-tubular. Another example of a "soft" all-suture anchor is Device. See, e.g., U.S. Pat. No. 9,826,971. Such all-suture anchors also utilize Poisson's ratio, which captures the following cause / effect relationship: compressing a material in a first direction causes the material to expand in a direction perpendicular to the first direction (i.e., if compressed in the x-direction, the material will expand in the y-direction and / or z-direction), and stretching / elongating the material in the first direction causes the material to contract in a direction perpendicular to the first direction. In the aforementioned embodiment, the suture 114 is interwoven through the anchoring body 112 so that two free branches 116 of the suture 114 extend from the anchoring body 112. In another embodiment, the anchoring body 112 can be a hanging fixture as described in U.S. Pat. Nos. 9,700,403 and 9,931,197, assigned to the assignee herein, the entirety of which is incorporated herein by reference. In an alternative embodiment, the anchoring body 112 can be any soft suture anchor material. The suture 114 is interwoven through the anchor body 112 such that two free branches 116 of the suture 114 extend from the anchor body 112 .

[0036] To utilize the suspension system 100, a single hole 118-1 is formed through the first body 118, and a single hole 120-1 is formed through the adjacent second body 120. The first body 118 and the second body 120 may be soft tissue, bone, or a graft. In the illustrated embodiment, each of the first body 118 and the second body 120 is bone. Figure 6 to Figure 7 As shown in FIG. 1 , a length of suture 114 is positioned through bone hole 118-1, through bone hole 120-1, through full suture button 112, and then advanced back through bone holes 120-1 and 118-1 to form Figure 6 to Figure 7, wherein the length of suture 114 is shown as having two free branches 116 extending proximally from opposing / proximal / top surfaces 128 of the bone 118, the full suture button 112 extending distally from the distal surface 122 of the second bone 120, and the length of suture 114 forming a bridge between the first bone 118 and the second bone 120.

[0037] like Figure 7 As depicted in FIG. 1 , the free branch 116 of the suture 114 is pulled proximally from the first bone 118 to set the full suture button 112 against the distal surface 122 of the second bone 120. When the suture 114 is pulled proximally, the full suture button 112 is moved from the expanded position (at Figure 6 ) to the compressed position (in Figure 7 In the compressed position, the full suture button 112 covers a surface area on the distal side 122 of the second bone 120 that is larger than the diameter of the bone hole 120-1 in the second bone 120. Once the full suture button 112 is in the compressed position, the tension in the suture 114 can be used to form a hanging configuration between the first bone 118 and the second bone 120 by deploying the stop from the expanded position to the compressed position.

[0038] Reference now Figure 2 , which is a side view schematic diagram of a suture check system 10 in a partially deployed configuration according to one embodiment. As described above, the check member 12 of the suture check system 10 can be used to form a suspension ( Figure 6 to Figure 7 During deployment of the suture check system 10, the free branches 116 of the suture 114 are pulled through the bone hole 118-1 so that they extend proximally from the proximal surface 128 of the first body 118. The free branches 116 of the suture 114 are then passed through the first ring 18 and the second ring 22 in the suture check system 10, as shown in FIG. Figure 2 shown.

[0039] Now go to Figure 3 , which shows another side schematic view of the suture check system 10 in a partially deployed configuration according to one embodiment. After the free branch 116 of the suture 114 passes through the first loop 18 and the second loop 22, the free branch 116 of the suture 114 is tensioned distally, and the handle 34 is simultaneously pulled proximally. By pulling the handle 34 proximally, the first loop 18 and the second loop 22 are pulled through the passing locations 26, 28, 30, 32 on the check member 12. Since the free branch 116 of the suture 114 has already passed through the first loop 18 and the second loop 22, when the first loop 18 and the second loop 22 are pulled through the check member 12, the free branch 116 is also pulled through the passing locations 26, 28, 30, 32 in the check member 12, resulting in Figure 3Partially deployed configuration shown. Still referring to Figure 3 , the check member 12 is now loaded onto the suture 114 of the suspension system 100 ( Figure 6 to Figure 7 In addition, the free branch 116 of the suture 114 extends distally toward the proximal surface 128 of the first bone 118 ( Figure 6 to Figure 7 ).

[0040] Reference now Figure 4 , which shows an additional side schematic diagram of a suture check system 10 in a partially deployed configuration according to one embodiment. Figure 6 to Figure 7 ) After that, the handle 34 is pulled in the proximal direction again so that the free branch 116 of the suture 114 slides through the stop member 12 to form Figure 4 The partially deployed configuration is shown. Thereafter, the handle 34 is discarded or otherwise removed from the suture check system 10 .

[0041] Now go to Figure 8 , the stop 12 has been transferred to the free branch 116 of the suture 114 and is shown moving distally along the suture 114 until it abuts the proximal surface 128 of the first bone 118. Once the stop 12 abuts the proximal surface 128 of the first bone 118, the additional tension in the free branch 116 in the proximal direction causes the stop 12 to move from the expanded position to the compressed position. Figure 4 In the expanded position shown in FIG. 1 , the ends 20, 24 of the check member 12 are in a first direction along the longitudinal axis. When the check member 12 is moved to the compressed position, the ends 20, 24 of the check member 12 can be rotated to a second direction different from the first direction, such as Figure 5 and Figure 4 1 (but not necessarily, they can face the same direction during / after the described movement). Other compression positions are contemplated, wherein the backstop 12 covers a surface area on the proximal surface 128 of the first bone 118 that is larger than the diameter of the bone hole 118-1. The structure, configuration, positioning, and related functions of the backstop 12 include preventing the suture 114 from being pulled out of the first bone hole 118-1 and maintaining tension in the suture 114 between the backstop 12 and the full suture button 112.

[0042] like Figure 5 As shown, according to one embodiment, the stop 12 is in a deployed configuration. The free branch 116 of the suture 114 is tied to the stop 12 in a compressed position, thereby forming a knot 130. The knot 130 forces the stop 12 to be tightly placed on the proximal surface 128 of the first bone 118, particularly the bone hole 118-1 ( Figure 8 ) to form the button and complete the repair. Fig. 9A schematic side view of a knot 130 is shown, which is formed in the free branch 116 of the suture 114, proximal to the backstop 12, i.e., the deployed configuration of the suspension system 100. Tying the knot 130 in the free branch 116 secures the backstop 12 in the compressed and deployed position. The excess portion of the free branch 116 of the suture 114 extending from the knot 130 can be trimmed and removed to reduce the possibility of irritation and discomfort.

[0043] All definitions, as defined and used herein, should be understood to control over dictionary definitions, definitions in documents incorporated by reference, and / or ordinary meanings of the defined terms.

[0044] Although various embodiments have been described and shown herein, a person of ordinary skill in the art will readily conceive of various other devices and / or structures for performing functions and / or obtaining results and / or one or more of the advantages described herein, and each of such variations and / or modifications is considered to be within the scope of the embodiments described herein. More generally, it will be readily understood by those skilled in the art that all parameters, dimensions, materials, and configurations described herein are exemplary, and that actual parameters, dimensions, materials, and / or configurations will depend on the teachings of the present invention for one or more specific applications thereof. Using only routine experiments, those skilled in the art will recognize or be able to determine many equivalents of the specific embodiments described herein. Therefore, it should be understood that the foregoing embodiments are given only by way of example, and within the scope of the appended claims and their equivalents, embodiments may be practiced in a manner different from that specifically described and protected by the claims. The embodiments of the present disclosure relate to each individual feature, system, article, material, kit, and / or method described herein. In addition, if these features, systems, articles, materials, kits, and / or methods are not mutually contradictory, any combination of two or more such features, systems, articles, materials, kits, and / or methods is also included within the scope of the present disclosure.

[0045] The terms used herein are only used for the purpose of describing specific embodiments and are not intended to limit the present invention. As used herein, unless the context clearly indicates otherwise, the singular forms "a", "an" and "the" are also intended to include plural forms. It should also be understood that the terms "comprise" (and any form of "comprise", such as "comprises" and "comprising"), "have" (and any form of "have", such as "has" and "having"), "include" (and any form of "include", such as "includes" and "including"), and "contain" (and any form of "contain", such as "contains" and "containing") are open-ended copulas. Therefore, "including", "having", "including" or "containing" a method or device of one or more steps or elements. Likewise, a method step or an apparatus element that "comprises," "has," "includes," or "contains" one or more features has those one or more features, but is not limited to having only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.

[0046] All means or steps in the following claims plus corresponding structures, materials, operations, and equivalents of functional elements, if any, are intended to include any structure, material, or operation for performing a function in combination with other claimed elements as specifically claimed. The description of the present invention has been given for the purpose of illustration and description, but the description is not exhaustive or limits the invention to the disclosed form. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the invention. The embodiments are selected and described in order to best explain the principles and practical applications of one or more aspects of the invention, and to enable others of ordinary skill in the art to understand one or more aspects of the invention for various embodiments with various modifications suitable for the specific purposes contemplated.

Claims

1. A suture non-return system, comprising: a backstop having a first end and a second end both extending in a distal direction; a first through longitudinal element interwoven through the backstop such that a first loop is formed in the first through longitudinal element and extends from the first end of the backstop; a second through longitudinal element interlaced through the backstop such that a second loop is formed in the second through longitudinal element and extends from the second end of the backstop; as well as a handle having a distal end attached to the first and second through longitudinal elements; wherein each of the first through longitudinal element and the second through longitudinal element is formed of Nitinol; The first ring and the second ring are each formed in a square shape and are positioned symmetrically to each other. 2 . The suture backstop system according to claim 1 , wherein the first passing longitudinal element and the second passing longitudinal element are interwoven through the backstop at a plurality of passing locations.

3. The suture backstop system according to claim 1, wherein the first passing longitudinal element is interwoven through the backstop at three passing locations, and the second passing longitudinal element is interwoven through the backstop at another three passing locations.

4. The suture check system of claim 1, wherein the first passing longitudinal element extends proximally from the check at a first central passing location, and the second passing longitudinal element extends proximally from the check at an adjacent second central passing location.

5. The suture check system of claim 1, further comprising one or more ridges on the handle. The suture backstop system according to claim 1 , wherein the backstop is composed of suture material.

7. A suture non-return system, comprising: A backstop comprising a fiber construction having a first end and a second end, the fiber construction comprising: a first state, wherein the fiber construction is uncompressed and extends along a first longitudinal axis; and a second state wherein the fiber construction is compressed and stretched in a direction perpendicular to the longitudinal axis; a first through longitudinal element interwoven through the backstop such that a first loop is formed in the first through longitudinal element and extends from the first end of the backstop; and a second through longitudinal element interlaced through the backstop such that a second loop is formed in the second through longitudinal element and extends from the second end of the backstop; wherein each of the first through longitudinal element and the second through longitudinal element is formed of Nitinol; The first ring and the second ring are each formed in a square shape and are positioned symmetrically to each other.

8. The suture check system of claim 7, further comprising a handle having distal ends attached to the first and second passing longitudinal elements.

9. The suture backstop system according to claim 7, wherein the first passing longitudinal element and the second passing longitudinal element are interwoven through the backstop at a plurality of passing locations.

10. The suture backstop system according to claim 7, wherein the first passing longitudinal element is interwoven through the backstop at three passing locations, and the second passing longitudinal element is interwoven through the backstop at another three passing locations.

11. The suture check system of claim 7, wherein the first passing longitudinal element extends proximally from the check at a first central passing location, and the second passing longitudinal element extends proximally from the check at an adjacent second central passing location.

12. The suture backstop system of claim 7, wherein the backstop is comprised of suture material.

13. The suture check system of claim 8, further comprising one or more ridges on the handle.

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