Devices, systems and methods for tissue repair

Abstract

Devices, systems and methods are disclosed for repairing soft tissue. The surgical system allows for the creation of tissue repair by grasping, aligning and sewing or fixing tissue. For example, this system may be used for clipping together excessive capsular tissue and reducing the overall capsular volume. The deployment device includes a central grasping mechanism and an outer clip delivery system. The clip embodiments may be single or multi-component (penetration and locking base components) that penetrate tissue layers and deploy or lock to clip the tissue together. An example of the system is used to reduce the joint capsule tissue laxity and reduces the potential for subluxation or dislocation of the joint by either restricting inferior laxity (anterior or posterior) and resolving or eliminating pathologic anterior or posterior translation.

1 . A system for transdermal repair of soft tissue, the system comprising: 
 a first element to pinch a portion of soft tissue that is to be repaired;    a second element to repair the portion of soft tissue that is pinched by the first element, such portion of soft tissue being accessed transdermally; and    a third element to deploy the first element and the second element in turn to repair the portion of soft tissue that is being pinched.    
     
     
         2 . The system of  claim 1 , wherein the first element pinches the portion of soft tissue and brings it within the second element to be repaired, and wherein the second element has jaws that lock down on the portion of soft tissue when the second element repairs the portion of soft tissue.  
     
     
         3 . The system of  claim 1 , wherein the soft tissue comprises an interior concave surface of a capsular body and the repair comprises plication.  
     
     
         4 . The system of  claim 1 , further comprising a neuro-stimulator to stimulate nerves near the portion of soft tissue so that a user is signaled to the nearby nerve.  
     
     
         5 . The system of  claim 1 , wherein the first and/or second element include abrading tools to abrade the portion of soft tissue to irritate the soft tissue and aid in natural tissue repair.  
     
     
         6 . The system of  claim 5 , wherein the portion of soft tissue to be abraded is a synovium.  
     
     
         7 . The system of  claim 1 , wherein the second element utilizes a suture to repair the portion of soft tissue that is being pinched.  
     
     
         8 . The system of  claim 7 , wherein the suture is still attached to the second element after the tissue is repaired and the jaws of the second element are opened.  
     
     
         9 . The system of  claim 7 , wherein the suture is automatically released from the second element after the tissue is repaired and the jaws of the second element are opened.  
     
     
         10 . The system of  claim 1 , wherein the second element utilizes a tissue locking mechanism to repair the portion of soft tissue being pinched.  
     
     
         11 . The system of  claim 10 , wherein the tissue locking mechanism further comprises: 
 an anchor element having a shaft with two penetrating ends to penetrate soft tissue, wherein each penetrating end has a movable anchor stop that allows the end to penetrate tissue initially and then turns to lock the anchor stop on the side of the tissue that is opposite to the side of the shaft.    
     
     
         12 . The system of  claim 10 , wherein the tissue locking mechanism further comprises: 
 a first anchor element having a shaft with a penetrating end to penetrate soft tissue and a receiving end to accommodate the penetrating end, wherein the first anchor element at least partially contains a metallic interior to assist in the maintenance of its shape, and wherein the penetrating end and the receiving end communicate to plicate the soft tissue held within.    
     
     
         13 . The system of  claim 10 , wherein the tissue locking mechanism further comprises: 
 a penetrating element having a point and a perpendicular stop; and    an accommodating element having a point receiving slot and a perpendicular stop, wherein the penetrating point and the accommodating point plicate tissue between each of the perpendicular stops by mating the point on the penetrating element with the point receiving slot on the accommodating element.    
     
     
         14 . The system of  claim 10 , wherein the tissue locking mechanism further comprises: 
 a substantially planar surface having an opening therein and a plurality of teeth positioned inwardly toward the opening, wherein a portion of soft tissue that is pulled within the opening is plicated therein by the plurality of teeth when the tissue is released.    
     
     
         15 . A system for plicating a capsular structure, the system comprising: 
 a pinching element to pinch a portion of an interior surface of a capsular structure to be plicated;    a plicating element to plicate the portion of the interior surface of the capsular structure that is pinched by the pinching element; and    a deployment element to deploy the pinching element and the plicating element in turn to plicate the portion of the interior surface of the capsular structure that is being pinched.    
     
     
         16 . The system of  claim 15 , further comprising a plicating actuator to lock the plicating element on the portion of the interior surface of the capsular structure that is being pinched.  
     
     
         17 . The system of  claim 15 , wherein the interior surface of the capsular structure has a concave geometry.  
     
     
         18 . The system of  claim 15 , wherein the plicating element includes a suture.  
     
     
         19 . The system of  claim 15 , wherein the plicating element includes a locking mechanism comprising a single body.  
     
     
         20 . The system of  claim 15 , further comprising a neuro-stimulator to stimulate nerves near the portion of the interior surface of the capsular structure so that a user is signaled to the nearby nerve.  
     
     
         21 . The system of  claim 15 , further comprising abrading elements to abrade the portion of the interior surface of the capsular structure and irritate the interior surface to aid in natural tissue repair.  
     
     
         22 . A method for arthroscopic plication of an interior concave surface of a capsular structure, the method comprising: 
 pinching a portion of the interior concave surface of the capsular structure; and    securing the portion of the interior concave surface that is pinched.    
     
     
         23 . The method of  claim 22 , wherein the securing step is carried out by suture.  
     
     
         24 . The method of  claim 22 , wherein the securing step is carried out by a tissue securing device.  
     
     
         25 . The method of  claim 22 , wherein the capsular structure is a joint.  
     
     
         26 . A method for arthroscopic repair of soft tissue within a hollow structure, the method comprising: 
 pinching a portion of soft tissue on an interior surface of the hollow structure; and    fixing the portion of soft tissue that is pinched.    
     
     
         27 . The method of  claim 26 , wherein the fixing step is carried out by suture.  
     
     
         28 . The method of  claim 26 , wherein the fixing step is carried out by a tissue securing device.  
     
     
         29 . The method of  claim 26 , wherein the hollow structure is a joint.