Flat suture banding system and methods

Abstract

A surgical tensioning device for holding separated tissues in contact with one another. The device comprises a frame having two opposing first and second sides and a lower surface and an upper surface, and a band for extending through and around said separated tissues to be held together in conjunction with said frame. The band has two ends releasably attached to the sides of the frame. When the ends are secured to the sides of the frame, the band holds separated tissues together and establishes a path of tension along its length that extends linearly between the two ends of the band.

What is claimed is: 
     
         1 . A surgical tensioning device for holding separated tissues in contact with one another, the device comprising:
 a frame having opposing first and second sides, a lower surface, and an upper surface; and   a band for extending through and around the separated tissues to be held together, in conjunction with said frame,   said band having a first end that is releasably securable to the first side of said frame and a second end that is releasably securable to the second side of said frame, wherein, when the first end is secured to said first side after routing the first end through and around said tissues and the second end is secured to said second side of said frame, said band holds the previously separated tissues in contact with one another and establishes a path of tension along its length that extends linearly between the two ends of the band.   
     
     
         2 . The device of  claim 1 , wherein said first side of said frame comprises a rigid member to which said first end of the band is secured. 
     
     
         3 . The device of  claim 1 , wherein said first end of said band is directly attached to a needle. 
     
     
         4 . The device of  claim 3 , wherein said first side of said frame further comprises an integral slot that is sized and adapted to mate and lock with an attachment mechanism which is disposed on the first end of the band. 
     
     
         5 . The device of  claim 4  wherein said attachment mechanism comprises a tapered face and is sufficiently rigid to promote cutting through said tissue. 
     
     
         6 . The device of  claim 5 , wherein said tapered face of the attachment mechanism is sharpened to promote cutting through said tissue. 
     
     
         7 . The device of  claim 1 , and further comprising a bar movably attached to the second side of said frame via a bar attachment, said bar and bar attachment being adapted to hold said tension by pinching said second band end between said bar and second frame side. 
     
     
         8 . The device of  claim 7  wherein said bar has a circular cross section and said bar attachment is adapted to constrain said bar from rotational movement. 
     
     
         9 . The device of  claim 7  wherein said bar attachment is adapted to mechanically constrain movement of said bar into the inside of said frame and away from said upper surface about the second side of the frame. 
     
     
         10 . The device of  claim 7  wherein said bar is attached inside the frame at the second side via a bar attachment that is adapted to mechanically constrain movement of said bar into the inside of said frame and away from said upper surface about the second side of frame. 
     
     
         11 . The device of  claim 7  wherein said bar is attached outside the second side of said frame via a bar attachment that is adapted to mechanically constrain movement of said bar into the inside of said frame and away from said upper surface about the second side of the frame. 
     
     
         12 . The device of  claim 1  wherein said band is substantially flat. 
     
     
         13 . The device of  claim 12 , where said band comprises suture. 
     
     
         14 . The device of  claim 7  wherein the surfaces of said bar and the inside of said second side of said frame are textured. 
     
     
         15 . The device of  claim 3 , and further comprising weakening mechanisms in the first end of the band for facilitating separation of the needle from the second end of the band. 
     
     
         16 . The device of  claim 15 , wherein said weakening mechanisms comprise notches. 
     
     
         17 . A surgical tensioning device for holding separated tissues in contact with one another, the device comprising:
 a frame, said frame having two opposing first and second sides, said first side comprising a rigid first member, a lower surface, and an upper surface;   a band for extending through and around said separated tissues to be held together in conjunction with said frame, said band having a first end that is releasably securable to the first side of said frame at said first member, and a second end that is releasably securable to the second side of said frame, wherein, when the first end is secured to said first side after routing the first end through and around said tissues and the second end is secured to said second side of said frame, said band holds said separated tissues together and establishes a path of tension along its length that extends linearly between the two ends of the band; and   a bar moveably attached parallel to the second side of said frame via a bar attachment, said bar and attachment being adapted to hold said tension by pinching said second band end between said bar and second frame side.   
     
     
         18 . A method of repairing separated tissues using a tissue tensioning device comprising a frame having opposing first and second sides, a lower surface, and an upper surface, and a band having a first end and a second end, the method comprising:
 routing a needle attached to the second end of the band through the separated tissues and into close proximity to the second side of the frame;   separating the needle from the second end of the band; and   securing the second end of the band to the second side of the frame.   
     
     
         19 . The method as recited in  claim 18 , wherein the separating step is performed by cutting the needle away from the second end of the band. 
     
     
         20 . The method as recited in  claim 18 , wherein the securing step is performed by wrapping the second end of the band around the second side of the frame and tying a knot in the band. 
     
     
         21 . The method as recited in  claim 18 , wherein the separating step is performed by applying tension to the band at a point of weakness in order to break the band. 
     
     
         22 . The method as recited in  claim 21 , wherein the point of weakness comprises a notch formed in the band. 
     
     
         23 . The method as recited in  claim 18 , wherein the securing step comprises inserting an attachment mechanism on the second end of the band into a slot in the second side of the frame. 
     
     
         24 . The method as recited in  claim 23 , wherein the attachment mechanism comprises a tab which moves to an expanded position after the tab passes through the slot, in order to secure the attachment mechanism to the second side of the frame.