Surgical tools and methods for their use

Abstract

Surgical tools and kits for performing methods include a grommet with cylindrical shaft, cutting tip, annular flange with suture retaining anchoring fixture; a grommet jig for extending between adjacent grommets and guiding a needle therebetween; a family of needles with single and double pointed ends, reinforced eyelets, stops to limit inadvertent exiting, double shaft construction with a longitudinal gap and sharpened, slicing ends, including a “J” shape embodiment; a bone anchor with ring to secure sutures about a patient's clavicle; a tissue dissector having radially extending cones to nick taut connecting tissues; a tissue rasp having a series of crisscrossing grooves along an end; a tissue mesher comprising one or more blocks having a matrix of holes for clamping a plurality of needles and a supporting framework; and a kit device and a method of surgically inserting an internal mesh brassiere under the breast skin.

1 - 39 . (canceled) 
     
     
         40 . A tissue mesher, comprising:
 a handling device having a first surface; and   a plurality of cylindrical rods extending from the first surface of the handling device, wherein at least one of the plurality of cylindrical rods extends a distance from the first surface that is different than a distance that another one of the plurality of cylindrical rods extends from the first surface, and wherein the plurality of rods are offset from one another in a predetermined pattern,   wherein each of the plurality of rods has a first penetrating end with a cutting tip and a second mounting end mounted on the handling device, and   wherein the plurality of rods are configured to cut a plurality of tissue anchoring fibers along multiple planes when percutaneously applied to a region of tissue.   
     
     
         41 . The tissue mesher of  claim 40 , wherein the first surface has a plurality of holes, and wherein the plurality of rods are mounted in the plurality of holes. 
     
     
         42 . The tissue mesher of  claim 41 , wherein the plurality of holes includes at least 3 holes. 
     
     
         43 . The tissue mesher of  claim 40 , wherein the plurality of rods are hollow. 
     
     
         44 . The tissue mesher of  claim 43 , wherein the plurality of rods are hypodermic needles. 
     
     
         45 . The tissue mesher of  claim 44 , wherein the hypodermic needles are configured to connect with a pump system for receiving a fluid from the pump system. 
     
     
         46 . The tissue mesher of  claim 40 , wherein each of the plurality of rods extends between about 0.5 cm to about 3 cm from the first surface. 
     
     
         47 . The tissue mesher of  claim 40 , wherein the plurality of rods are spaced approximately 1 cm apart from each other on the first surface. 
     
     
         48 . The tissue mesher of  claim 40 , wherein each of the plurality of rods is approximately 2 mm in diameter. 
     
     
         49 . The tissue mesher of  claim 40 , further comprising a plurality of stops configured to limit the depth of penetration of the plurality of rods. 
     
     
         50 . A medical device for augmenting tissue, comprising:
 a platform; and   a plurality of cutting needles extending from a surface of the platform so that at least one of the plurality of cutting needles extends a distance from the platform that is different than a distance that another one of the plurality of cutting needles extends from the platform, wherein the plurality of cutting needles are offset relative to one another, and wherein the plurality of cutting needles are configured to percutaneously penetrate a region of tissue at two or more different depths for puncturing the tissue along multiple planes.   
     
     
         51 . The medical device of  claim 50 , wherein each of the plurality of cutting needles is configured to percutaneously cut a plurality of anchoring fibers that restrict movement of the tissue. 
     
     
         52 . The medical device of  claim 50 , wherein each of the plurality of cutting needles is configured to percutaneously cut a plurality of aponeurosis. 
     
     
         53 . The medical device of  claim 50 , wherein each of the plurality of cutting needles is part of a disposable cartridge mounted to the platform. 
     
     
         54 . The medical device of  claim 50 , wherein each of the plurality of cutting needles is a hollow needle. 
     
     
         55 . The medical device of  claim 54 , wherein each of the plurality of cutting needles is a hypodermic needle. 
     
     
         56 . The medical device of  claim 55 , wherein each of the hypodermic needles is configured to connect with a pump system for receiving a fluid from the pump system. 
     
     
         57 . The medical device of  claim 50 , wherein each of the plurality of cutting needles is a solid needle. 
     
     
         58 . The medical device of  claim 50 , wherein each of the plurality of cutting needles extends between about 0.5 cm to about 3 cm from the surface of the platform. 
     
     
         59 . The medical device of  claim 50 , wherein the surface of the platform is rounded. 
     
     
         60 . The medical device of  claim 50 , wherein the surface of the platform is substantially flat. 
     
     
         61 . The medical device of  claim 50 , wherein the plurality of cutting needles are mounted on the platform in at least one of a substantially linear, triangular, quadrangular, hexagonal, or rounded orientation. 
     
     
         62 . The medical device of  claim 50 , further comprising a plurality of needle stops configured to limit a depth of penetration of the plurality of cutting needles into the region of tissue. 
     
     
         63 . The medical device of  claim 50 , wherein the plurality of cutting needles are spaced approximately 1 cm apart from each other on the platform. 
     
     
         64 . The medical device of  claim 50 , wherein the platform includes a plurality of openings each having a cutting needle mounted therein. 
     
     
         65 . The medical device of  claim 64 , wherein each of the plurality of cutting needles is slideably mounted within the plurality of openings. 
     
     
         66 . The medical device of  claim 64 , further comprising swivel or articulated couplings for mounting the plurality of cutting needles within the plurality of openings. 
     
     
         67 . The medical device of  claim 64 , wherein the plurality of openings includes at least 3 openings and less than 20 openings. 
     
     
         68 . The medical device of  claim 50 , wherein the platform includes a plurality of blocks secured together, and the plurality of blocks cooperate to define a plurality of openings in the platform. 
     
     
         69 . The medical device of  claim 68 , wherein one or more of the plurality of openings is located at a border formed by two of the plurality of blocks. 
     
     
         70 . The medical device of  claim 68 , wherein part of a first opening of the plurality of openings is defined by a first block of the plurality of blocks, and part of the first opening is defined by a second block of the plurality of blocks. 
     
     
         71 . A tissue mesher, comprising:
 a handling device;   a disposable cartridge mounted on the handling device, wherein the disposable cartridge has a first surface; and   a plurality of cutting needles each having a diameter of approximately 2 mm and extending about 0.5 cm to about 3 cm from the first surface of the cartridge so that at least one of the plurality of cutting needles extends a distance from the platform that is different than a distance that another one of the plurality of cutting needles extends from the platform;   wherein each of the plurality of cutting needles has a first penetrating end with a cutting tip and a second mounting end mounted on the cartridge at the second end;   wherein the plurality of cutting needles are offset from one another in a pattern, and   wherein the plurality of cutting needles are configured to percutaneously penetrate a region of tissue at two or more different depths for puncturing the tissue along multiple planes.   
     
     
         72 . The tissue mesher of  claim 71 , wherein the plurality of cutting needles are configured to percutaneously cut a plurality of anchoring fibers that restrict movement of the tissue.