Meniscal repair systems and methods

Abstract

A device for repairing a tear in a portion of tissue comprises a proximal actuator portion, a transfer needle extending distally from the proximal actuator portion and a catch needle extending distally from the proximal actuator portion. A suture needle is disposed in the transfer needle, and is extendable from the transfer needle toward the catch needle and retractable from the catch needle toward the transfer needle. An extendable catch plunger is disposed in the catch needle for capturing suture therein when it is transferred from the transfer needle. A retractable insertion sheath is provided for covering the transfer needle and the catch needle when the device is inserted into a procedural site. A depth limiting apparatus limits the depth of insertion of the needle into the procedural site.

1 - 15 . (canceled) 
     
     
         16 . A device for repairing a tear in a portion of tissue, comprising:
 a proximal actuator portion;   a needle for dispensing suture into the tissue to be repaired;   a retractable insertion sheath for covering the needle when the device is inserted into a procedural site; and   a depth limiting apparatus for limiting the depth of insertion of said needle into the procedural site;   wherein said proximal actuator portion comprises an insertion sheath actuator for retracting said insertion sheath.   
     
     
         17 . The device as recited in  claim 16 , wherein said depth limiting apparatus comprises a depth gauge disposed on said proximal actuator portion. 
     
     
         18 . The device as recited in  claim 17 , wherein said insertion sheath actuator comprises a button which slides axially along a slot in said proximal actuator portion, said depth gauge comprising graduated markings disposed along said slot, so that a practitioner can retract said sheath by sliding the insertion sheath actuator button a predetermined distance along said slot to control the depth of insertion of said device. 
     
     
         19 . The device as recited in  claim 16 , wherein said depth limiting apparatus comprises a force feedback unit disposed on a distal end of said device. 
     
     
         20 . The device as recited in  claim 19 , wherein said force feedback unit comprises a compression force element disposed on a distal end of said needle. 
     
     
         21 . The device as recited in  claim 20 , wherein said compression force element comprises a plunger. 
     
     
         22 . The device as recited in  claim 19 , wherein said depth limiting apparatus further comprises a depth limiter which is movable distally along said device, responsive to a reduction of force on said force feedback unit. 
     
     
         23 . A method for repairing a tear in a portion of tissue, said method comprising:
 inserting a device comprising a proximal actuator portion and a needle having a distal needle portion into a procedural site;   retracting a sheath covering said needle proximally to expose the distal needle portion;   advancing the needle into the tissue to be repaired, so that a distal end of the distal needle portion is disposed beyond the tear, until a depth limiting structure prevents further advancement of the needle;   creating a suture loop in said tissue to repair the tear;   withdrawing the needle proximally from the procedural site; and   using a pre-tied knot to cinch the suture loop and thereby repair the tear.   
     
     
         24 . The method as recited in  claim 23 , wherein the advancing step comprises advancing a pair of needles into the tissue to be repaired, and the suture loop creating step is performed by dispensing suture from a first one of the needles into a second one of the needles, and then releasing a catch plunger to move distally and clamp the suture to retain it in the second needle. 
     
     
         25 . The method as recited in  claim 23 , wherein the depth limiting structure comprises a distal end of the sheath, and the sheath retracting step includes a step of determining a distance through which the sheath is retracted by consulting a depth gauge disposed on the proximal actuator portion. 
     
     
         26 . The method as recited in  claim 23 , wherein the depth limiting structure comprises a depth limiter which is movable distally along the device toward the tissue to be repaired responsive to a release of force on a force feedback unit disposed on a distal end of the needle. 
     
     
         27 . The method as recited in  claim 24 , wherein the suture is dispensed, during the suture loop creating step, using a suture needle which is disposed in the first needle and is extendable from the first needle toward the second needle and retractable from the second needle toward the first needle.