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 - 21 . (canceled) 
     
     
         22 . A system for transdermal repair of soft tissue, the system comprising:
 a first element for securing and moving a portion of soft tissue that is to be repaired, the first element having an undeployed retracted state and a deployed extended state;   a second element for repairing the portion of soft tissue that is secured by the first element, the second element having jaws that clamp down on the portion of soft tissue in order to retain the portion of soft tissue for the transdermal repair; and   a third element for actuating the first element and the second element in turn for performing the transdermal repair;   wherein the first element is disposed within the jaws of the second element when it is in its undeployed retracted state, and is disposed outside of the jaws of the second element when it is in its deployed extended state.   
     
     
         23 . The system as recited in  claim 22 , wherein the first element, in its deployed state, captures the portion of soft tissue and then is retracted to its undeployed state to bring the portion of soft tissue to a location within the jaws of the second element. 
     
     
         24 . The system as recited in  claim 22 , wherein the portion of soft tissue comprises an interior concave surface of a capsular body, and the transdermal repair comprises plication. 
     
     
         25 . The system as recited in  claim 22 , and further comprising a neuro-stimulator for stimulating nerves near the portion of soft tissue, so that a user is signaled of the presence of a nearby nerve. 
     
     
         26 . The system as recited in  claim 25 , wherein said neuro-stimulator comprises a probe element which comprises a portion of said first element. 
     
     
         27 . The system as recited in  claim 22 , wherein at least one of the first and second elements includes abrading tools for abrading the portion of soft tissue in order to irritate the tissue and aid in natural tissue repair. 
     
     
         28 . The system as recited in  claim 22 , wherein the second element utilizes a suture to repair the portion of soft tissue. 
     
     
         29 . The system as recited in  claim 28 , wherein the suture remains attached to the second element after the soft tissue is repaired and the jaws of the second element are opened. 
     
     
         30 . The system as recited in  claim 28 , wherein the suture is automatically released from the second element after the tissue is repaired and the jaws of the second element are opened. 
     
     
         31 . The system as recited in  claim 22 , wherein the second element employs a tissue locking mechanism to repair the portion of soft tissue. 
     
     
         32 . The system as recited in  claim 31 , wherein the tissue locking mechanism comprises:
 an anchor element having a shaft with two penetrating ends for penetrating the soft tissue, wherein each penetrating end has a movable anchor stop which permits the end to penetrate tissue initially, and then turns to lock the anchor stop on the side of the portion of soft tissue that is opposite to the side of the shaft.   
     
     
         33 . The system as recited in  claim 31 , 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.   
     
     
         34 . The system as recited in  claim 31 , 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.   
     
     
         35 . The system as recited in  claim 31 , 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 the captured soft tissue is pulled within the opening and plicated therein by the plurality of teeth when the tissue is released.   
     
     
         36 . A system for plicating a capsular structure, the system comprising:
 a pinching element for pinching and capturing a portion of an interior surface of a capsular structure to be plicated, the pinching element having a deployed extended state and an undeployed retracted state;   a plicating element for plicating the portion of the interior surface of the capsular structure that has been captured by the pinching element; and   a deployment element for actuating the pinching element and the plicating element in turn to plicate the portion of the interior surface of the capsular structure which is captured;   wherein the pinching element is disposed within an interior portion of the plicating element when it is in its undeployed retracted state, and is disposed outside of and a substantial distance from the interior portion of the plicating element when it is in its deployed extended state.   
     
     
         37 . The system as recited in  claim 36 , and further comprising a plicating actuator to lock the plicating element on the portion of the captured portion of the interior surface of the capsular structure. 
     
     
         38 . The system as recited in  claim 36 , wherein the interior surface of the capsular structure has a concave geometry. 
     
     
         39 . The system as recited in  claim 36 , wherein the plicating element includes a suture. 
     
     
         40 . The system as recited in  claim 36 , wherein the plicating element includes a locking mechanism comprising a single body. 
     
     
         41 . The system as recited in  claim 36 , and further comprising a neuro-stimulator for stimulating nerves near the portion of the interior surface of the capsular structure to be captured, so that a user is signaled of the presence of a nearby nerve. 
     
     
         42 . The system as recited in  claim 36 , and further comprising abrading elements for abrading the portion of the interior surface of the capsular structure and thus irritate the interior surface to aid in natural tissue repair.