Patent Publication Number: US-11653911-B2

Title: System and method for making tapered looped suture

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 16/706,888, filed Dec. 9, 2019, which is a continuation of U.S. patent application Ser. No. 16/426,269, filed May 30, 2019, now U.S. Pat. No. 10,531,873, which is a continuation of U.S. patent application Ser. No. 15/689,066, filed Aug. 29, 2017, now U.S. Pat. No. 10,314,576, which is a continuation of U.S. patent application Ser. No. 14/694,089, filed Apr. 23, 2015, now U.S. Pat. No. 9,775,606, which is a divisional of U.S. patent application Ser. No. 13/480,614 filed May 25, 2012, now U.S. Pat. No. 9,038,688, which is a continuation-in-part of U.S. patent application Ser. No. 13/051,544, filed Mar. 18, 2011, now abandoned, which is a continuation-in-part of U.S. patent application Ser. No. 12/751,456, filed Mar. 31, 2010, now U.S. Pat. No. 8,590,588, which claims benefit of and priority to U.S. Provisional Application Ser. No. 61/173,719, filed Apr. 29, 2009, the disclosures of which are incorporated by reference herein in their entirety. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to a system of forming a looped suture. More particularly, the present disclosure relates to an automated system of forming a looped suture having a tapered cut. 
     Background of Related Art 
     The forming of a loop in a suture is known, as are methods of forming the loop. A loop may be formed in a suture for a number of reasons. For example, during manufacture a loop may be formed in the suture to assist in further processing of the suture, e.g., for holding the suture as barbs are formed along the length thereof. Alternatively, a loop formed in a suture during manufacture may be used to secure the suture to tissue. In this manner, once the non-looped end of the suture is inserted through tissue, that end may be threaded through the loop to form a slip knot-like configuration that may be tied to secure tissue. In another application, a loop may be formed in a suture in place of a knot. This requires the use of a handheld instrument that may be brought into an operating room. 
     Therefore, it would be beneficial to have a system and method of forming a looped suture to include a taper cut. 
     SUMMARY 
     Accordingly, an active anvil assembly for use in forming a looped suture is disclosed. The active anvil assembly includes an anvil member, a first sensor operably connected to the anvil member, and a control assembly. The first sensor is configured for providing force feedback. The anvil member may be configured to operate with an ultrasonic welding horn to join a first length of a thread and a second length of the thread to form a loop in the thread. In particular, the loop may be formed at the distal end of the thread. In one embodiment, the anvil member includes a channel configured to selectively receive at least a portion of a first length of a thread. 
     The control assembly includes a motor which may be configured to move a mounting member in relation to the ultrasonic welding horn. The control assembly may be configured to vertically move the anvil member. In certain embodiments, the mounting member is configured to move the anvil member. The anvil member may be selectively movable in at least first and second directions relative to the ultrasonic welding horn. Further, the control assembly may be configured to move the mounting member in relation to a mounting base. The anvil member may be configured for approximation towards and away from the ultrasonic welding horn. The active anvil assembly may further include a first adjustable stage configured to translate laterally relative to the ultrasonic welding horn and/or a second adjustable stage configured to translate forwards and backwards relative to the ultrasonic welding horn. 
     Also disclosed is system for forming a looped suture. The system includes an active anvil assembly configured for retaining the suture during welding of the loop and a trimming assembly for removing excess thread from the loop in the thread. The active anvil assembly includes an anvil member operably connected to a first sensor and a control assembly configured for movement of the anvil member. The system may further include one or more of a flipper gripping assembly configured for creating a loop in the thread, a carriage assembly configured for advancing the thread through the loop forming process, a cutter assembly for severing the thread upon completion of the loop forming process, a thread lengthening assembly configured for extending the length of the thread, and a monitoring assembly configured for monitoring the forming process. 
     Additionally, a method of forming a looped suture is disclosed. The method includes the step of providing a system including a welding assembly and a trimming assembly, wherein the welding assembly includes an ultrasonic welding horn and an active anvil assembly. The method further includes the steps of receiving a first length of thread adjacent a second length of thread between the ultrasonic welding horn and the active anvil assembly, approximating at least one of an anvil member of the active anvil assembly and the ultrasonic welding horn towards the other, activating the ultrasonic welding horn, joining the adjacent first and second lengths of thread, and approximating at least one of the anvil member and the ultrasonic welding horn away from the other of the ultrasonic welding horn and anvil member. 
     In one of the disclosed methods, at least one of the anvil member and the ultrasonic welding horn is approximated towards the other of the ultrasonic welding horn and anvil member until a predefined torque value is sensed by a sensor disposed in the active anvil assembly. In a second embodiment, at least one of the anvil member and the ultrasonic welding horn is approximated towards the other of the ultrasonic welding horn and anvil member until a predefined force value is sensed by a sensor disposed in the active anvil assembly. In a third embodiment, at least one of the anvil member and the ultrasonic welding horn is approximated towards the other of the ultrasonic welding horn and anvil member as predefined distance is sensed. In a fourth embodiment, the anvil member and the ultrasonic welding horn is approximated towards the other of the ultrasonic welding horn and anvil member as a predefined force value is sensed. 
     The method of forming a looped suture may further include the steps of operably engaging the joined first and second lengths of thread with a gripping anvil of the trimming assembly, approximating at least one of the gripping anvil and an ultrasonic cutter towards the other of the ultrasonic cutter and the gripping anvil, removing excess thread from the joined first and second lengths of thread, and approximating the gripping anvil away from the ultrasonic cutter. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein: 
         FIG.  1 A  is a side view of a looped suture including a tapered portion; 
         FIG.  1 B  is a cross-sectional end view of the looped suture of  FIG.  1 B , taken along line  1 B- 1 B; 
         FIG.  1 C  is an enlarged side view of  FIG.  1 A ; 
         FIG.  2    is a side view of a tapered loop forming system of the present disclosure; 
         FIG.  3    is an enlarged side view of a suture supply assembly of the tapered loop forming system of  FIG.  2   ; 
         FIG.  4    is an enlarged sectional side view of the tapered loop forming system of  FIG.  2   ; 
         FIG.  5    is an enlarged side view of carriage assembly of the tapered loop forming system of  FIG.  2   ; 
         FIG.  6 A  is an enlarged side view of embodiments of portions of the welding assembly and the trimming assembly of  FIG.  2   ; 
         FIG.  6 B  is a perspective view of portions of the active anvil assembly and trimming assembly of  FIG.  4   ; 
         FIG.  6 C  is a perspective view of portions of the active anvil assembly of  FIGS.  6 A and  6 B ; 
         FIG.  7 A  is an enlarged cross-sectional side view of welding assembly of the loop forming system of  FIG.  2   , in a partially activated position; and 
         FIG.  7 B  is an enlarged cross-sectional side view of the welding assembly of  FIG.  7 A , in a fully activated position. 
     
    
    
     DETAILED DESCRIPTION 
     A system and method for forming a looped suture including a tapered cut is described herein. Referring initially to  FIG.  1 A , a looped suture formed in accordance with the method of the present disclosure is shown generally as looped suture  10 . Suture  10  is formed from a monofilament thread  11 , however, it is envisioned that suture  10  may include braided threads, multifilament threads and other surgical fibers. Although shown having a circular cross-sectional geometry, the cross-sectional geometry of thread  11  may be of any suitable shape. For example, thread  11  may be round, elliptical, square, flat, triangular, octagonal, and rectangular. Thread  11  may be formed of degradable materials, non-degradable materials, and combinations thereof. Thread  11  may be formed using any technique within the purview of those skilled in the art, such as, for example, extrusion, molding and/or solvent casting. 
     With reference to  FIGS.  1 A- 1 C , looped suture  10  includes a loop  12  formed on a distal end  10   b  of the suture  10 . Loop  12  forms a substantially teardrop shape and may be formed of any size. Although a substantially teardrop-shaped loop  12  is illustrated, other variations, such as circular, oval and spherical-shaped loops are envisioned. A first section  13  of monofilament thread  11  overlays a second section  14  of thread  11  to form loop  12 . The adjacent surfaces of first and second sections  13 ,  14  form a joined segment or joint  15 . As shown, joined segment  15  extends beyond first section  13  of thread  11 . In this manner, first and second sections  13 ,  14  of thread  11  are less likely to separate or peel away from each other as looped suture  10  is pulled through tissue (not shown). 
     As will be described in further detail below, first and second sections  13 ,  14  of thread  11  are welded together to form joined section  15 . In this manner, first and second sections  13 ,  14  of thread  11  are locally heated until each fuses to form joined segment  15 . Various types of energy may be used to locally heat first and second sections  13 ,  14  to form joined segment  15 , including, radiofrequency (RF), ultrasonic, laser, electrical arc discharge, and thermal. Alternatively, first and second sections  13 ,  14  of thread  11  may be joined using glue, epoxy or other adhesive. 
     With particular reference to  FIG.  1 C , a proximal end  13   a  of first section  13  is angled to form a tapered surface  17 . Tapered surface  17  angles downwardly towards proximal end  10   a  ( FIG.  1 A ) of looped suture  10 . Tapered surface  17  may form an angle between zero degrees (0°) and ninety degrees (90°), and preferably between about fifteen degrees (15°) to about sixty degrees (60°). Tapered surface  17  facilitates insertion of loop  12  into or through tissue. Tapered surface  17  may be formed prior to, during or following the joining of first and second sections  13 ,  14 . 
     Although shown having a substantially planar taper, tapered surface  17  may include any number of configurations. For example, tapered surface  17  may be beveled, may include a laterally and longitudinally concave taper, may include a laterally and longitudinally convex taper, or may include any combination thereof. Tapered surface  17  may be selected depending on the tissue being sutured and/or the depth loop  12  is desired to be received within the tissue. 
     A system for forming loop  12  on distal end  10   b  of looped suture  10  will now be described with reference to  FIGS.  2 - 7 B , and is shown generally as tapered loop forming system  100 . Although shown as being automated, it is envisioned that various components and/or process within tapered loop forming system  100  may manually completed. Referring initially to  FIG.  2   , system  100  includes a suture supply assembly  200 , an initial gripping assembly  300 , a flipper gripping assembly  400 , a carriage assembly  500 , a welding assembly  600 , a trimming assembly  700 , a cutter assembly  800 , and may optionally include a thread lengthening assembly  900  and a monitoring assembly  2000 . 
     With reference now to  FIG.  3   , supply assembly  200  is configured to provide thread  11  to initial gripping assembly  300 . Supply assembly  200  includes a spool  202 , a first guide member  203 , a roller assembly  204 , first and second rollers  205 ,  206  and a second guide member  207 . First guide member  203  is configured to direct thread  11  from spool  202  to roller assembly  204 . Roller assembly  204  includes a set of fixed rollers  204   a  and a set of adjustable rollers  204   b . Roller assembly  204  is configured to receive thread  11  about fixed and adjustable rollers  204   a ,  204   b  a plurality of times. As shown, rollers  204   a ,  204   b  are configured to receive thread  11  thereabout four ( 4 ) times, however, roller assembly  204  may be configured to receive thread  11  thereabout more or less than four times. First and second rollers  205 ,  206  are positioned to direct thread  11  through second guide member  207 . Although shown including supply assembly  200  for providing a continuous supply of thread  11  from spool  202 , alternative supply assemblies are known and may be modified for use with system  100 . For example, thread  11  may be provided in fixed or predetermined lengths rather than continuously from a spool. In this manner, the aspects of the present disclosure should not be read as limited to the supply assembly herein disclosed. 
     Turning now to  FIG.  4   , initial gripping assembly  300  includes an initial gripper  302  configured to selectively engage and selectively grasp thread  11  throughout the loop end forming process. Initial gripping assembly  300  translates on a diagonal, in the direction of arrows “A”. During the looped end forming process, initial gripping assembly  300  is activated to grasp a proximal end of thread  11  when tension is applied to a distal end of thread  11  to prevent excess thread from being pulled from supply assembly  200 . In this manner, initial gripping assembly  300  may include any device or apparatus capable of selectively grasping thread  11 . 
     With reference still to  FIG.  4   , flipper gripping assembly  400  is configured to create loop  12  in thread  11 . Gripping assembly  400  includes a rotating gripper  402  configured to selectively grasp a first end of thread  11 . A mandrel  408  extends from rotating gripper  402  and includes a slot (not shown) configured to receive a hook  508  from carriage assembly  500  ( FIG.  5   ). Rotating gripper  402  is configured to rotate relative to mandrel  408 , in the direction of arrow “B”, to loop thread  11  around mandrel  408 . Flipper gripping assembly  400  is configured to move horizontally, in the direction of arrows “C”, and vertically, in the direction of arrows “D”. 
     With reference now to  FIG.  5   , carriage assembly  500  is configured to translate thread  11  through the loop forming process. Carriage assembly  500  includes a support member  502  having a tag end gripper  504  and a hook assembly  506 . A hook  508  extends from hook assembly  506  and is configured to receive thread  11  thereabout. Carriage assembly  500  optionally includes a tensioning cylinder (not shown) for tensioning thread  11  with a predetermined force to test the strength of weld  15  ( FIG.  1 B ). Carriage assembly  500  is configured to move horizontally, in the direction of arrows “E”, and vertically, in the direction of arrows “F”. 
     With reference to  FIGS.  4  and  6 A- 6 C , welding assembly  600  is configured to weld joined segment  15  in thread  11  to form loop  12  ( FIG.  1 A ). Welding assembly  600  includes an active anvil assembly  2600  configured for selective engagement with an ultrasonic welding horn  604 . In one embodiment, ultrasonic welding horn  604  may be manufactured by Branson Ultrasonics Corporation (Danbury, Conn.). The term ultrasonic as used herein includes high frequency vibrations which are applied to workpieces being held together to create a solid state weld. Further, it should be understood that the term “welding horn” as used herein includes any component which transmits the mechanical vibrations (of a converted electrical signal) to the parts to be welded, e.g., a thread or suture. Active anvil assembly  2600  includes an anvil member  2602 , a first sensor  2610   a  and a control assembly  1020 . 
     With reference to  FIGS.  7 A and  7 B , ultrasonic welding horn  604  includes a flat die  606  configured to engage first section  13  of thread  11  during the welding step. As shown, anvil member  2602  defines a channel  2602   a  configured to receive the entire width of second section  14  and more than half the width of first section  13  of thread  11 . In an alternative embodiment, flat die  606  may include a channel or recess (not shown) for receiving at least a portion of first section  13  of thread  11  instead of or in addition to the channel  2602   a  in the anvil member  2602 . 
     Turning to  FIGS.  6 A- 6 C , the active anvil assembly  2600  will be described in greater detail. As described hereinabove, the active anvil assembly  2600  includes an anvil member  2602  and a first sensor  2610   a  which is operably connected to the anvil member  2602 . The first sensor  2610   a  is incorporated within the anvil base  2610  and the first sensor  2610   a  interacts with and provides feedback to a control assembly  1020  (later described), effecting movement of the active anvil assembly  2600  during the loop forming process. First sensor  2610   a  is operably connected to the anvil member  2602  and may be configured to measure force, torque, distance and/or other conditions within active anvil assembly  2600 . In particular, first sensor  2610   a  is configured to provide force feedback to active anvil assembly  2600 . First sensor  2610   a  is disposed above first and second adjustable stages,  2620  and  2630 , respectively. Either or both of anvil member  2602  and adjustable stages  2620 ,  2630 , may be configured for movement in one or more directions prior to, during, or following the respective joining and trimming processes. 
     With particular reference to  FIG.  6 B , anvil base  2610  operably engages first adjustable stage  2620  and is configured to be selectively positioned relative thereto, as indicated by arrows “L.” As shown in the drawings, first adjustable stage  2620  is configured to move the anvil base  2610  in a forward/backward or front/back direction. First adjustable stage  2620  operably engages second adjustable stage  2630  and is configured to be selectively positioned relative thereto, as indicated by arrows “K.” As shown in drawings, second adjustable stage  2630  is configured to move anvil base  2610  in a lateral or side to side direction. Second adjustable stage  2630  operably engages a mounting member  1010  of mounting assembly  1000 . It should be noted that although the adjustable stages  2620  and  2630  provided herein are described as part of the active anvil assembly  2600 , it is envisioned that the adjustable stages  2620  and  2630  may be provided as separate assemblies and/or may operate separately from anvil member  2602  and anvil base  2610 . 
     With particular reference to  FIG.  6 A , the active anvil assembly  2600  further includes a mounting assembly  1000 . Mounting assembly  1000  includes a mounting base  1002 , mounting member  1010 , and control assembly  1020 . The mounting member  1010  is configured to further move the anvil member  2602 . In particular, mounting member  1010  is operably engaged with mounting base  1002  and is configured to be raised and lowered relative to mounting base  1002 , as indicated by arrows “J” to raise and lower anvil member  2602  relative to ultrasonic welding horn  604 . As shown, mounting member  1010  is moved relative to mounting base  1002  by a control assembly  1020 . A locking pin  1004  is configured for selective engagement with mounting member  1010 . In particular, the locking pin  1004  is configured to prevent movement of mounting member  1010  relative to mounting base  1002 . 
     Control assembly  1020  includes a motor  1024  that is configured to cause the raising and lowering, in other words, the vertical movement of mounting member  1010  relative to base  1002  and relative to the ultrasonic welding horn  604 . Motor  1024  may include pneumatic or hydraulic cylinders, as shown, or any other mechanism suitable for selectively raising and/or lowering mounting member  1010  relative to base  1002 . In one embodiment, motor  1024  includes a commercially available Allen Bradley servo motor. Control assembly  1020  may further include a second sensor  1024   a  for providing feedback, which may be used to position anvil member  2602  of active anvil assembly  2600  relative to ultrasonic welding horn  604  ( FIG.  4   ). In particular, second sensor  1024   a , may be configured to measure force, torque, distance, and/or other conditions experienced by active anvil assembly  2600 . More specifically, second sensor  1024   a  is configured to provide torque and/or distance feedback to active anvil assembly  2600 . Control assembly  1020  may also include one or more ports  1022  for selectively connecting control assembly  1020  with monitoring assembly  2000  ( FIG.  2   ), a command station (not shown), a power source (not shown), and/or any other device or network (not shown). 
     With reference back to  FIG.  6 B , trimming assembly  700  is configured to cut tapered surface  17  of looped end portion  10 . Trimming assembly  700  includes a trimming blade  702 , which may be powered by an ultrasonic horn  704 . Trimming assembly  700  further includes a trim gripper  706  for gripping thread  11  as trimming blade  702  engages thread  11 . Trim gripper  706  is configured to move laterally or side to side, in the direction of arrows “G,” vertically or up and down, in the direction of arrows “H,” and front and back, in the direction of arrow “I.” Trim blade  702  is also configured to move laterally or side to side, vertically or up and down, and front and back, in the direction of arrows “G,” “H,” and “I.” The speed, path, and frequency at which ultrasonic horn  704  and/or trimming blade  702  move, may be adjusted to affect the configuration of tapered surface  17 . Further, trim blade  702  is configured to be advanced and retracted relative to trim gripper  706 . In one embodiment, trimming blade  702  is configured to be rotated one-hundred and eighty degrees (180°) about its longitudinal axis such that both cutting surfaces thereof may be used. Although shown adapted for use as an ultrasonic cutter, trimming assembly  700  may be configured cut tapered surface  17  without the use of ultrasonic energy. In an alternate embodiment, a laser may be used to cut tapered surface  17 . Alternatively, trimming blade  702  may be heated to assist in the cutting of thread  11 . 
     With reference still to  FIG.  6 B , trimming assembly  700  further includes a trimming base  710  securely connected with base  1002  of mounting assembly  1000 . Base assembly  710  may be operably connected to control assembly  1022 , monitoring assembly  2000  ( FIG.  2   ), a command station (not shown), a power source (not shown), and/or any other device or network (not shown). 
     With reference back to  FIG.  4   , cutter assembly  800  is configured to cut thread  11  upon completion of the looped end forming process. Cutter assembly  800  includes a cutting blade  802 . Cutter assembly  800  is configured to move parallel to initial gripper assembly  300 , in the direction of arrows “A”. Cutter assembly  800  is configured to cut thread  11  once thread  11  has attained an appropriate length. Cutter assembly  800  may be configured to cut a straight or tapered end on a proximal end  10   a  ( FIG.  1 A ) of suture  10 . 
     With reference to  FIGS.  2  and  4   , lengthening assembly  900  is configured to increase the length of thread  11  prior to thread  11  being cut by cutter assembly  800 . As shown, lengthening assembly  900  includes a set of fixed rollers  902  and a set of adjustable rollers  904 . Although shown including three and two rollers, respectively, sets of fixed and adjustable rollers  902 ,  904  may include any number of rollers. When thread  11  is received between fixed and adjustable rollers  902 ,  904 , movement of adjustable rollers  904  relative to fixed rollers  902 , in the direction of arrows “I”, causes thread  11  to lengthen. The greater the number of rollers  902 ,  904 , the less relative movement between rollers  902 ,  904  is necessary to lengthen thread  11 . 
     Monitoring assembly  2000  is configured to monitor the various steps of the looped end forming process. Monitoring assembly  2000  includes a screen  2002  and a control panel  2004 . 
     The operation of forming station  100  will now be described with reference to  2 - 6 B. Thread  11  extends from spool  202  through first guide member  203  before being received about roller assembly  204 . Thread  11  is wrapped around fixed rollers  204   a  and adjustable rollers  204   b  of roller assembly  204  four times, and is then received about first and second rollers  205 ,  206  before being received through second guide member  207 . The number of times thread  11  is wrapped around each rollers  204   a ,  206  may vary depending on the size and/or composition of thread  11 . 
     With continued reference to  FIGS.  2 - 6 B , thread  11  extends through second guide member  207  where it is grasped by initial gripper  302  prior to being grasped by rotating gripper  402 . Initial grippers  302  then releases thread  11  and flipper gripping assembly  400  translates towards anvil member  2602  of active anvil assembly  2600  as carriage assembly  500  translates towards anvil member  2602  from the opposite direction. Flipper gripping assembly  400  and carriage assembly  500  are configured such that as carriage assembly  500  nears flipper gripping assembly  400 , hook  508  of hook assembly  506  is received in the slot (not shown) of mandrel  407 . Once hook  508  is received within the slot, rotating gripper  402  rotates, in the direction of arrow “B”, to loop thread  11  about mandrel  407 . Flipper gripping assembly  400  and carriage assembly  500  then move to position first and second sections  13 ,  14  of thread  11  within channel  2602   a  of anvil member  2602 . As carriage assembly  500  approximates away from flipper gripping assembly  400 , hook  508  extends from within the slot formed in mandrel  407  with thread  11  received thereabout. 
     In one embodiment, once first and second sections  13 ,  14  of thread  11  are received with channel  2602   a  of anvil member  2602 , ultrasonic horn  604  is activated and flat die  606  is approximated towards anvil member  2602 , in the direction of arrow “E”. Engagement of flat welding die  606  with first section  13  of thread  11  causes first and second sections  13 ,  14  to weld together to form joined segment  15  ( FIG.  1 B ). Alternatively, ultrasonic horn  604  may be positioned relative to anvil member  2602  prior to activating ultrasonic horn  604 . 
     As discussed above with reference to  FIGS.  6 A and  6 B , anvil member  2602  may instead, or additionally, be raised/lowered (arrows “J”), moved laterally (arrows “K”) and/or moved front/back (arrows “L”), relative to ultrasonic horn  604  to position anvil member  2602  relative ultrasonic horn  604 . Ultrasonic horn  604  may be activated prior to, during or after positioning of anvil member  2602  relative to ultrasonic horn  604 . The positioning of anvil member  2602  may be accomplished using any number of methods. In each of the below disclosed methods, movement of anvil member  2602  is determined by the compressive force acting on first and second sections  13 ,  14  of thread  11  and is not a function of the initial position of ultrasonic horn  604 . Additionally, in each of methods, ultrasonic horn  604  is not activated until anvil member  2602  is stationary. 
     In a first method, anvil member  2602  is moved relative to ultrasonic horn  604  until second sensor  1024   a  in control assembly  1020  senses a predefined torque value, at which point, the movement of anvil member  2602  is stopped and ultrasonic horn  604  is activated. In a second method, movement of anvil member  2602  stops when a predefined torque value is achieved, and then anvil member  2602  is moved an additional user defined distance. In yet a third method, anvil member  2602  is moved until a force feedback provided by first sensor  2610   a  of active assembly  2600  achieves a predefined set point, at which point, the movement of anvil member  2602  is stopped and ultrasonic horn  604  is activated. In a fourth method, movement of anvil member  2602  stops when a predefined force value, as measured by first sensor is achieved, and then anvil member  2602  is moved an additional user defined distance. The torque and/or force values and/or the additional user defined distance may vary depending on the size and type of thread being used and/or to effect different weld characteristics. 
     It is envisioned that ultrasonic horn  604  and anvil member  2602  may be moved simultaneously and/or individually to cause the forming of joined segment  15  and/or to effect the characteristics of joined segment  15  ( FIG.  1 A ). Subsequent joining of first and second sections  13 ,  14  of thread  11 , either or both of anvil member  2602  and ultrasonic horn  604  are approximated away from one another. 
     Once anvil member  2602  and ultrasonic horn  604  have been repositioned such that anvil member  2602  is spaced from ultrasonic horn  604 , tail end gripper  504  of carriage assembly  500  grips a tail end (distal end) of thread  11  and rotating gripper  402  releases thread  11 . Carriage assembly  500  then moves to position welded first and second section  13 ,  14  of thread  11  within gripping anvil  706  of trimming assembly  700 . Gripping anvil  706  maintains thread  11  as trimming blade  704  of ultrasonic horn  702  is moved to cut tapered surface  17  ( FIG.  1 A ) into first section  13  of thread  11 . Alternatively, and discussed above with reference to  FIGS.  6 A and  6 B , during forming of cut tapered surface  17 , gripping anvil  706  may be raised/lowered (arrows “H”), moved laterally (arrows “G”), and/or moved front/back (arrows “I”), relative to trimming blade  702 , to affect the characteristics of cut tapered surface  17  ( FIG.  1 A ). Gripping anvil  706  then releases thread  11  and carriage assembly  500  continues to translate away from supply assembly  200  to extend the length of thread  11 . It is envisioned that ultrasonic horn  702  and gripping anvil  706  may be moved simultaneously and/or individually to form cut tapered surface  17 . Cutting assembly  900  is then activated to cut thread  11 . Prior to the cutting of thread  11 , tension is applied to loop  12  ( FIG.  1 A ) of thread  11  by the tensioning cylinder (not shown) located within carriage assembly  500  to test the strength of weld  15 . Optionally, thread  11  may engage lengthening assembly  800  to extend the length of thread  11  prior to cutting. 
     Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, it is to be understood that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure. For example, it is envisioned that system  100  may include more than one welding assembly  600  and/or trimming assembly  700  to produce more than one suture  10  per activation.