Systems and methods for soft tissue reconstruction

Abstract

Suture-based fasteners and fastening methods for soft tissue reconstruction are described that can include a needle tip swaged onto two sutures and loaded onto the end of a curved needle shaft. The needle shaft and tip can be driven through the tissues to be sutured and back out to where the needle tip can make a permanent connection with a locking bead. The needle shaft can be retracted, leaving two sutures extending from the side of the bead. One suture can be of nonabsorbable material and can be brought through the end of the locking bead opposite the tip and pulled to tighten the suture loop. The other suture can be of an absorbable material and can be used to rotate the locking bead under one of the layers of tissue being sutured after the suture loop is tightened. Following rotation, the second suture can be trimmed.

1 . A method of connecting a first layer of tissue and a second layer of tissue, comprising:
 providing a loop in a suture to form a loop end;   driving at least one of the loop end and a combination of the loop end and an end of the suture on a path through the first layer, into the second layer, and back through the first layer;   engaging the loop end with an engaging mechanism located proximate the end of the suture to form a closed ring;   tightening the closed ring by drawing the loop end back along the path; and   rotating the ring to place the engaging mechanism within the second layer.   
   
   
       2 . A system for connecting a first layer of tissue and a second layer of tissue, comprising:
 a suture;   a loop in the suture to form a loop end of the suture;   means for driving at least one of the loop end and a combination of the loop end and an end of the suture on a path through the first layer, into the second layer, and back through the first layer;   engaging means proximate the end of the suture engaging the loop end to form a closed ring;   means for tightening the closed ring by drawing the loop end back along the path; and   means for rotating the ring to place the engaging means within the second layer.   
   
   
       3 . The method of  claim 1 , wherein providing, driving, engaging, tightening, and rotating are performed in the order recited. 
   
   
       4 . The method of  claim 1 , wherein the first layer of tissue defines a lumen on a first side, and the second layer of tissue is located next to another side of the first layer.