Patent ID: 6860887
Filing Date: 2005-03-01
Classification: A61B

Abstract:
1. A suture management method for aiding a surgeon while tying knots in sutures during surgery in a manner to preclude suture tangling comprising, in combination, the steps of: providing a bone of a patient having an exterior surface with a tendon normally attached thereto; providing a tendon of a patient having an end previously attached to the surface of the bone; providing a tubular guide with an anchoring screw having a threaded lower end and an upper end removably supported by the guide and with an eyelet between the upper and lower ends; providing a pair of sutures including a first suture of a first color and a second suture of a second color, each suture having two free ends and a central portion there between, the central portion of both sutures positioned through the eyelet of the screw; providing a pair of primary sleeves including a first sleeve and a second sleeve, each sleeve being hollow with an interior diameter to receive there through one suture and with an exterior diameter less than half the interior diameter of the tubular guide and a length less than the distance between the free ends and the eyelet; providing a pair of supplemental sleeves including a first supplemental sleeve and a second supplemental sleeve, each supplemental sleeve being hollow with an interior diameter to receive one suture there through and an exterior diameter and a length less than the distance between the free ends and the eyelet; providing a clip to apply a holding force to one supplemental sleeve with a suture therein so as to preclude relative movement there between; providing a slender plastic lasso having a proximal end constituting a handle and a distal end formed as a resilient loop adapted to maintain an opening when not under restraint by its positioning within a supplemental sleeve, the lasso having of a length greater than the supplemental sleeve; introducing a cannula into a patient and then introducing the tubular guide with the screw and the pair of sutures through the cannula into the patient and then attaching the screw and sutures into the surface of the bone with the screw and central portions of the sutures beneath the surface of the bone such that the ends of the sutures extend through the cannula to outside the patient with the suture of each color being individually constrained by a primary sleeve; retracting the tubular guide from the screw and from the cannula; contacting the tendon with the distal end of a supplemental sleeve to provide a temporary reduction for holding the tendon to where it is intended to be positioned until a knot is formed for a final fixation; removing the first primary sleeve from the first suture and from the cannula; manipulating the first suture as by forming a stitch in the tendon; positioning the first supplemental sleeve through the cannula and then extending the lasso through the first supplemental sleeve and capturing the first suture with the lasso and then pulling the lasso and the first suture exterior of the patient; applying the slip to the first supplemental sleeve and first suture to create a holding force there between and thereby preclude relative movement; removing the second primary sleeve from the second suture and from the cannula; manipulating the second suture as by forming a stitch in the tendon; positioning the second supplemental sleeve through the cannula and then extending the lasso through the second supplemental sleeve and capturing the second suture with the lasso and then pulling the lasso and the second suture exterior of the patient; removing a supplemental sleeve and manipulating a suture as may be needed; and trimming the sutures and removing the trimmed ends of the sutures and the supplemental sleeves and lasso through the cannula and from the patient.