Arthroscopic Suturing Instrument for Multi-Pass Fibrous Tissue Repair
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Solution Overview
Problem
Current surgical suturing devices and techniques struggle to effectively place complex sutures in cramped or tight surgical environments, leading to high failure rates, particularly in procedures like arthroscopic rotator cuff repairs, due to the difficulty in manipulating and securing sutures in stout, sheet-like tissues.
Innovation Solution
The development of surgical instruments that manipulate tissues by rolling, wrinkling, folding, or tucking them to allow multiple passes of a needle, enabling complex locking and grasping suture configurations, such as passing sutures through tissues multiple times to enhance repair stability.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If simple mattress or Mason-Allen suture configurations are used with current arthroscopic sewing instruments, then the surgical procedure is easier to perform, but the repair strength is insufficient and sutures pull out of the tissue
Solution Approach 1:
The suture configuration is segmented into multiple passes through the tissue, creating multiple anchoring points. The needle passes through the tissue multiple times in a sequence, dividing the suture path into segments that collectively provide superior grip and resistance to pull-out forces compared to a single-pass suture.
Solution Approach 2:
The suture technique transitions from a simple planar path to a multi-dimensional configuration by passing the needle through the tissue at different angles and depths. This creates a three-dimensional suture pattern that interlocks with the tissue fibers more effectively, increasing repair strength while maintaining arthroscopic accessibility.
2Strength
If complex suture configurations are attempted with current instruments, then repair strength may improve, but the difficulty of operation increases significantly in cramped surgical environments
Solution Approach 1:
The arthroscopic sewing instrument is designed with multi-functionality, incorporating features that enable both simple and complex suture configurations through a single device. The instrument can perform multiple needle passes, tissue manipulation, and suture securing functions, allowing complex high-strength sutures to be placed through standard arthroscopic portals without requiring multiple specialized instruments.
Solution Approach 2:
The instrument acts as an intermediary between the surgeon and the tissue, providing mechanical advantage and precise control in the cramped arthroscopic environment. The instrument's design translates the surgeon's external manipulations into precise internal suture placement, enabling complex suture configurations to be achieved despite limited surgical access.
3Reliability
If multiple needle passes through tissue are performed to create complex sutures, then suture stability improves, but the time required for the surgical procedure increases
Solution Approach 1:
The instrument is prepared and positioned in advance with the needle ready for multiple passes. The tissue is manipulated and held in the optimal position before suture placement, allowing the needle to be passed through multiple times without requiring repeated repositioning or re-grasping operations, thereby reducing the time penalty associated with complex multi-pass sutures.
Solution Approach 2:
The suture placement process maintains continuity by keeping the needle and suture material engaged with the tissue throughout multiple passes. The instrument allows seamless transition between needle passes without requiring withdrawal and reinsertion, maintaining continuous useful action that reduces procedural time while achieving stable multi-pass suture configurations.
Data Source
AI summary
Instruments for placing complex sutures into biological tissues, including instruments useful in arthroscopic surgical techniques which minimize incision size. The instruments manipulate tissue by, for example, rolling, wrinkling, folding, bending, or tucking the tissue so that a needle can be placed through the tissue more than once. Sutures are placed, for example from top-to-bottom and bottom-to-top with a single pass of a straight needle. In addition, the instruments can roll, wrinkle, fold, bend, or tuck the flat tissue so that a needle can be placed through the tissue more than once and a loop can be sutured through the tissue so that another suture can pass through resulting in sewing both sides of the tissue. This will allow surgeons to place complex locking and grasping suture configurations that will significantly improve the repair.