Knotless collapsible sutures and methods for suturing

Abstract

Various exemplary methods and devices are provided for improved surgical sutures, suture systems, and methods for suturing. In general, the sutures, suture systems, and methods can allow a suture to form a secure, closed loop without tying a knot. The suture can include a barbed portion configured to be threaded through a hollow portion. The barbed portion can have a plurality of barbs thereon, which can grasp onto an inner wall of the hollow portion when disposed therein to help secure the loop at a desired size. The barbs can all be oriented in one direction that corresponds to a direction of movement of the suture when the loop is being tightened. Thus, the barbs can be configured to allow for a size of the loop to be easily reduced to any desired size to approximate tissue, but can be configured to resist subsequent expansion of the loop to ensure that the tissue remains in place.

What is claimed is: 
     
         1 . A suturing system, comprising:
 a flexible suture having leading and trailing ends, the suture having a first partial longitudinal length with a plurality of unidirectional barbs, and a second partial longitudinal length having a hollow portion, the hollow portion being located between the trailing end of the suture and the plurality of unidirectional barbs, and the leading end of the suture being configured to pass through the hollow portion so as to move at least one of the barbs into the hollow portion such that the at least one of the barbs grasps onto the suture within the hollow portion thereof.   
     
     
         2 . The system of  claim 1 , wherein, when the at least one of the barbs is positioned within the hollow portion, the first partial longitudinal length is coaxial with the hollow portion of the second partial longitudinal length. 
     
     
         3 . The system of  claim 1 , wherein the first partial longitudinal length of the suture is longer than the hollow portion of the second partial longitudinal length of the suture. 
     
     
         4 . The system of  claim 3 , wherein a third partial longitudinal length of the suture extends between the barbs and the leading end, and wherein the third partial longitudinal length is longer than each of the first and second partial longitudinal lengths of the suture. 
     
     
         5 . The system of  claim 1 , wherein the suture comprises a single strand including the barbs and the hollow portion. 
     
     
         6 . The system of  claim 1 , wherein the barbs are configured to grasp soft tissue so as to prevent movement of the suture relative to the soft tissue in a direction opposite to the unidirection of the barbs. 
     
     
         7 . The system of  claim 1 , further comprising a threader positioned within the hollow portion of the suture, the leading end of the suture being configured to mate to the threader and the threader being configured to be pulled through the hollow portion with the leading end mated therewith so as to pass the leading end of the suture into the hollow portion and move the leading end therethrough such that at least one of the barbs is moved into the hollow portion. 
     
     
         8 . The system of  claim 1 , further comprising a cannula, the suture being configured to pass through the cannula, into a soft tissue, and pass back through the cannula so as to position a free end of the suture outside the cannula and to position the barbs outside the soft tissue, the free end positioned outside the cannula being configured to be moved relative to the cannula so as to move the barbs into the soft tissue and into the hollow portion of the suture. 
     
     
         9 . A suturing system, comprising:
 a flexible suture having a free end configured to enter into a hollow portion of the suture and pass through the hollow portion in a first direction so as to move a plurality of unidirectional barbs extending outward from the suture along a length of the suture into the hollow portion, the barbs being configured to grasp onto the suture within the hollow portion so as to prevent the length of the suture from moving within the hollow portion in a second direction that is opposite to the first direction.   
     
     
         10 . The system of  claim 9 , wherein the barbs extend along a length of the suture that is greater than a length of the hollow portion such that all of the barbs cannot be simultaneously positioned within the hollow portion. 
     
     
         11 . The system of  claim 9 , wherein the barbs positioned within the hollow portion that grasp onto the suture within the hollow portion are configured to lock the length of the suture in a fixed position relative to the hollow portion of the suture. 
     
     
         12 . The system of  claim 9 , wherein, when a length of the suture is positioned within the hollow portion, the length of the suture is coaxial with the hollow portion of the suture. 
     
     
         13 . The system of  claim 9 , wherein the barbs are configured to grasp soft tissue so as to prevent movement of the suture relative to the soft tissue in a direction opposite to the unidirection of the barbs. 
     
     
         14 . The system of  claim 9 , further comprising a threader positioned within the hollow portion of the suture, the free end of the suture being configured to mate to the threader, and the threader being configured to be pulled through the hollow portion with the free end mated therewith to thereby pull the free end of the suture into the hollow portion and position one or more of the barbs within the hollow portion. 
     
     
         15 . The system of  claim 9 , further comprising a cannula, the suture being configured to pass through the cannula, into a soft tissue, and pass back through the cannula so as to position a free end of the suture outside the cannula and to position the barbs outside the soft tissue, the free end positioned outside the cannula being configured to be moved relative to the cannula so as to move the barbs into the soft tissue and into the hollow portion of the suture. 
     
     
         16 . A surgical method, comprising:
 advancing a leading end of a suture into a first tissue;   advancing the leading end of the suture into a second tissue;   advancing the leading end of the suture into a hollow portion of the suture so as to form a loop; and   pulling the leading end of the suture relative to the hollow portion, the first tissue, and the second tissue so as to advance a plurality of unidirectional barbs formed on the suture through the first tissue, through the second tissue, and into the hollow portion, the plurality of unidirectional barbs grasping the suture within the hollow portion so as to lock the suture in position relative to the first and second tissues.   
     
     
         17 . The method of  claim 16 , wherein a length of the suture extending through the hollow portion is coaxial with the hollow portion. 
     
     
         18 . The method of  claim 16 , wherein the leading end of the suture is advanced into the hollow portion of the suture after the leading end of the suture has been advanced into the first tissue and advanced into the second tissue. 
     
     
         19 . The method of  claim 16 , further comprising, advancing the leading end of the suture through a cannula prior to advancing the leading end into the first tissue, and advancing the leading end of the suture back into the cannula after advancing the leading end into the second tissue. 
     
     
         20 . The method of  claim 16 , wherein pulling the leading end of the suture causes the first and second tissues to be drawn together.