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 device for meshing tissue under the skin, the device comprising
 a platform; and   an array of needles extending from the platform, each of the needles having a cutting tip forming a penetrating end to penetrate the tissue held under tension to create a plurality of cavities in the tissue underlying the skin of the patient;   wherein the needles move in an oscillatory motion to inflict small nicks in the tissue under the skin to provide an expanding inter-digitating scaffold.   
     
     
         41 . The device of  claim 40 , wherein the penetrating ends are configured to provide needle sticks in a 2 mm diameter range. 
     
     
         42 . The device of  claim 40 , wherein the penetrating ends are dimensioned to penetrate the tissue without leaving visible skin scars. 
     
     
         43 . The device of  claim 40 , wherein penetrating ends of at least two of the needles extend at a different level from the platform than other needles to provide a varying depth of insertion to create cavities in different planes. 
     
     
         44 . The device of  claim 40 , wherein a meshing ratio is between 20% to 30%. 
     
     
         45 . The device of  claim 40 , further comprising a hinge mechanism enabling the needles to oscillate around one or more axes. 
     
     
         46 . The device of  claim 40 , wherein the needles translate laterally. 
     
     
         47 . The device of  claim 46 , further comprising rails for slidable movement of the platform to move the needles laterally. 
     
     
         48 . The device of  claim 40 , further comprising stops to limit penetration into tissue of the penetrating ends of the needles. 
     
     
         49 . The device of  claim 40 , wherein the needles are supported by the platform in a staggered arrangement. 
     
     
         50 . The device of  claim 40 , wherein the needles are replaceably loaded on the platform. 
     
     
         51 . The device of  claim 40 , wherein the needles are arranged in a series of longitudinal rows. 
     
     
         52 . The device of  claim 40 , wherein the needles generate a two dimensional or a three dimensional mesh of spaces inside the tissue. 
     
     
         53 . The device of claim  30 , wherein the array of needles move in a parallel oscillatory motion. 
     
     
         54 . A method for meshing tissue under the skin to release restrictive tissue, the method comprising
 providing a device having a platform and an array of needles extending from the platform, each of the needles having a cutting tip forming a penetrating end to penetrate the tissue held under tension to create a plurality of cavities in the tissue underlying the skin of the patient; and   manipulating one or both of the platform or needles to create a mesh structure underlying the skin.   
     
     
         55 . The method of  claim 54 , wherein the step of manipulating one or both of the platform or needles comprises moving the needles in an oscillatory motion to inflict small nicks in the tissue in multiple planes. 
     
     
         56 . The method of  claim 54 , further wherein the step of manipulating one or both of the platform or needles comprises moving the needles in a to and fro translational motion. 
     
     
         57 . The method of  claim 56 , wherein the step of manipulating one or both of the platform or needles comprises moving the needles in an oscillatory motion to inflict small nicks in the tissue in multiple planes. 
     
     
         58 . The method of  claim 54 , further comprising the step of holding the tissue under mechanical tension during manipulating of one or both of the platform or needles. 
     
     
         59 . The method of  claim 54 , wherein the step of manipulating the needles generates a two dimensional or a three dimensional mesh of spaces inside the tissue.