Adjustable Suture Loop for Single-Incision Tissue Approximation
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current minimally invasive tissue approximation techniques require establishing a subcutaneous plane to retrieve suture limbs, leading to complex knot tying and potential tissue disruption, especially in procedures like meniscal repair and soft tenodesis.
Innovation Solution
A surgical method using a suture filament with an adjustable loop, inserted through a single incision, allows for approximating tissue without a subcutaneous plane by creating a mattress stitch with a luggage tag knot configuration, minimizing tissue disruption and eliminating the need for multiple incisions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If current techniques are used to pass a mattress stitch, then tissue approximation can be achieved, but multiple incisions and establishment of subcutaneous plane are required, increasing tissue trauma and procedure complexity
Solution Approach 1:
The suture construct is divided into distinct functional segments: a reusable inserter device and a disposable suture filament with adjustable loop. This segmentation allows the complex insertion mechanism to be separated from the tissue approximation function, reducing overall procedure complexity while minimizing tissue trauma through precise, controlled delivery.
Solution Approach 2:
The inserter acts as an intermediary tool that delivers the suture filament through tissue without requiring multiple incisions or subcutaneous plane establishment. The inserter's needle-like distal end creates a controlled pathway, reducing tissue trauma while simplifying the overall procedure by eliminating the need for complex knot tying through multiple openings.
2Reliability
If traditional knot tying methods are used, then suture security can be achieved, but multiple knots and throws are required, increasing time consumption and potential tissue interference
Solution Approach 1:
The suture filament is pre-configured with an adjustable loop that is already positioned and sized for immediate tissue approximation. This preliminary preparation eliminates the need for time-consuming knot throwing sequences, as the loop is ready to capture and secure tissue directly upon insertion through the single incision.
Solution Approach 2:
The adjustable loop provides dynamic adaptability, allowing the suture to be tightened or loosened as needed during the procedure. This dynamic adjustment mechanism replaces the static, multi-knot securing method, reducing both time consumption and the potential for tissue interference while maintaining suture security through controlled tension application.
3Ease of operation
If multiple incisions are made for suture retrieval, then suture manipulation can be performed, but tissue disruption and scarring increase
Solution Approach 1:
The single incision serves multiple functions: it provides access for inserter insertion, allows suture filament delivery, enables tissue approximation, and facilitates suture retrieval through the same opening. This multi-functional approach eliminates the need for separate incisions for each operation, reducing tissue disruption and scarring while maintaining ease of manipulation.
Solution Approach 2:
The suture filament is nested within the inserter device during insertion, allowing controlled delivery through the single incision. The inserter acts as a container that protects the suture filament during passage through tissue, enabling manipulation and retrieval through the same opening without requiring additional tissue disruption.
Data Source
Figure 1A
Figure 1B
Figure 1C
AI summary
A minimally invasive surgical method of approximating tissue includes coupling an adjustable loop of suture around an inserter. The loop can be coupled to the inserter by applying tension to a tail of the suture to collapse the loop around the inserter, then the inserter and loop are passed through a first location in tissue. The loop is decoupled from the inserter, the inserter is retracted from the first location, and reinserted into a second location in the tissue, after which the loop is recoupled to the inserter while the loop is distal of the tissue. The decoupling, retraction, and reinsertion can occur without withdrawing the inserter from the patient's body. The inserter and loop are then withdrawn together from the tissue through this second location and outside of the patient's body. The tails and loop can form a luggage knot to be reduced around the tissue.