Patent Description:
The present invention, in some embodiments thereof, relates to suture capturing devices for use in arthroscopic procedures.

Attempts have been made to design suture capturing devices, including the devices described in <CIT>. , the Pivot NanoPass from Stryker Corporation and the EXPRESSEWO III Flexible Suture Passer from DePuy Synthes.

<CIT> discloses "An arthroscopic bone channel forming and sutureing method including forming a first generally straight channel in a bone, formain a second generally straight channel in the bone, the second generally straight channel not intersecting the first generally straight channel, inserting a curved needle into the first generally straignt channel, inserting a suture through the second generally straight channel in the bone to a suture pick-up location, manipulating the curved needle to form a curved junction between the first generally straight channel and the second generally straight channel; and pulling the suture by the curved needle from the suture pick-up location through the junction and through the first generally straight channel" (abstract).

<CIT> discloses an endoscopic needle device comprising "a handle and a catheter sheath connected to the handle, wherein the catheter sheath has at least one lumen, for example a needle lumen and a stabilization lumen, extending therethrough. A needle is selectively movable within the needle lumen between a needle retracted position and a needle extended position and a stabilization element is selectively movable within the stabilization lumen between a stabilizer retracted position and a stabilizer extended position. A linking mechanism may operatively connect the needle and the stabilization element so that when the needle is in the needle retracted position the stabilization element is in the stabilizer extended position and when the needle is in the needle extended position the stabilization element is in the stabilizer retracted position" (abstract).

There is provided in accordance with an embodiment of the invention, as disclosed in appended independent claim <NUM>, a suture capturing device configured to attain multiple preset orientations, comprising: a handle; a hollow shaft coupled to the handle; wherein a distal end of the hollow shaft has a curved end; a rigid needle element configured with a hook for catching a suture, wherein the needle element is arranged along a longitudinal axis and is axially displaceable relative to the hollow shaft and wherein the needle element is operatively coupled to the hollow shaft opposite the handle and configured to be slidable in a first direction to assume an open orientation where the hook is exposed relative to the hollow shaft and in a second direction to assume a closed orientation where the hook is not exposed relative to the hollow shaft; and a needle retaining element that is axially slidable relative to the hollow shaft; wherein a distal end of the needle retaining element is more flexible than other portions of the needle retaining element and/or the shaft.

Further embodiments of the invention are disclosed in the appended dependent claims.

With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example, not necessarily to scale and for purposes of illustrative discussion of embodiments of the invention.

Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details of construction and the arrangement of the components set forth in the following description and/or illustrated in the drawings and/or the Examples. The invention is capable of other embodiments or carried out in various ways.

Reference is now made to <FIG>, which is a simplified exploded view illustration of a suture capturing device constructed and operative in accordance with some embodiments of the present invention.

It is seen in <FIG> that a suture capturing device <NUM> includes a handle element <NUM>, which has two generally identical halves which are attached using a connection pin <NUM>, according to some embodiments. Alternatively, in some embodiments the two halves of the handle element <NUM> can be connected using any other method such as welding or attachment by adhesive or by screw, as examples. The handle element <NUM> has a proximal end <NUM> and a distal end <NUM>.

A hollow shaft <NUM> has a proximal end <NUM> and a distal end <NUM>. The proximal end <NUM> of the hollow shaft <NUM> is coupled with and, in some embodiments, at least partially inserted into the distal end <NUM> of handle element <NUM>, optionally using connecting pins <NUM>. In some embodiments, an adaptor element <NUM> is coupled to or, in some embodiments, integrally made with the hollow shaft <NUM>. It is appreciated that adaptor element <NUM> can be formed in various shapes and angles in order to fit various anatomical locations.

In some embodiments, an actuating lever <NUM> is partially inserted between the two halves of handle element <NUM> and is coupled to the proximal end <NUM> of hollow shaft <NUM>, optionally using a connecting element <NUM>. In some embodiments, the actuating lever <NUM> is coupled to handle element <NUM> using connecting pins <NUM>.

It is also seen that in some embodiments, a biasing spring <NUM> is provided. In some embodiments, the spring is inserted into the distal end <NUM> of handle element <NUM> and optionally at least partially encircles the connecting element <NUM> and/or the proximal end <NUM> of the hollow shaft <NUM>.

In some embodiments, a needle retaining element <NUM> extends within hollow shaft <NUM> and has a proximal end <NUM> and a distal end <NUM>. In some embodiments, the proximal end <NUM> of the needle retaining element <NUM> is coupled to connecting element <NUM>. In some embodiments, the distal end <NUM> of the needle retaining element <NUM> is coupled to or, in some embodiments, integrally made with a needle retaining element adaptor <NUM> having a proximal end <NUM> and a distal end <NUM>. In some embodiments, the proximal end <NUM> of needle retaining element adaptor <NUM> is coupled to the needle retaining element <NUM> and the distal end <NUM> of needle retaining element adaptor <NUM> is coupled to a needle element <NUM>, optionally using a connecting pin <NUM>.

In some embodiments, a locking lever <NUM> is hingedly coupled, optionally using a connecting pin <NUM> to the handle element <NUM>. In some embodiments, a retaining element <NUM> is hingedly coupled to handle element <NUM>, optionally using a connecting pin <NUM> and is generally supported on the locking lever <NUM>. In some embodiments, the retaining element <NUM> is biased to its initial position by a leaf spring <NUM>, which is optionally fixedly locked to a notch formed in handle element <NUM> at one side and is supported on retaining element <NUM> on the other side.

Reference is now made to <FIG>, which are a respective simplified pictorial and side view of the handle element of the suture capturing device <NUM> of <FIG>, according to some embodiments.

As noted hereinabove, in some embodiments the handle element <NUM> has two generally identical halves which are attached using a connection pin <NUM>. The handle element <NUM> has proximal end <NUM> and distal end <NUM>.

It is seen in <FIG> that handle element <NUM> is arranged along a longitudinal axis <NUM>. In some embodiments, the outer surface of handle element <NUM> is formed with gripping surfaces <NUM>.

In some embodiments, a generally semi-circular groove <NUM> is formed at the distal end <NUM> of handle element <NUM> and extends proximally from distal end <NUM> for insertion of the proximal end <NUM> of the hollow shaft <NUM> therethrough.

In some embodiments, a plurality of recesses <NUM> are formed within groove <NUM> for engagement with connecting pins <NUM>.

In some embodiments, a longitudinal recess <NUM> is formed within handle <NUM> and extends proximally from groove <NUM> for insertion of the connecting element <NUM> therein.

In some embodiments, a generally rectangular recess <NUM> is formed adjacent the longitudinal recess <NUM> for insertion of the activation lever <NUM> therein. Optionally, a recess <NUM> is formed in rectangular recess <NUM> for engagement with connecting pin <NUM>.

In some embodiments, an additional recess <NUM> is formed within handle <NUM> and is located adjacent recess <NUM> and extends generally proximally therefrom. In some embodiments, recess <NUM> is configured to encompass the locking lever <NUM>, the retaining element <NUM> and leaf spring <NUM> therewithin. Optionally, recesses <NUM> and <NUM> are formed in recess <NUM> to engage with connecting pins <NUM> and <NUM> respectively.

In some embodiments, a notch <NUM> is formed adjacent and above the proximal end of recess <NUM> for retaining an end of the leaf spring <NUM> therein.

It is also seen in <FIG> that in some embodiments, recesses <NUM> are formed in handle element <NUM> and are longitudinally spaced from each other for engagement with connection pins <NUM> in order to connect the two halves of the handle element <NUM>.

Reference is now made to <FIG>, which are a respective simplified pictorial and side view of the retaining element <NUM> of the suture capturing device <NUM> of <FIG>, according to some embodiments.

In some embodiments, retaining element <NUM> is formed of a generally planar longitudinal portion <NUM> arranged along a longitudinal axis <NUM>, the longitudinal portion <NUM> having a proximal end <NUM> and a distal end <NUM> each of which has a curved portion <NUM> and <NUM> respectively. In some embodiments, curved portion <NUM> is directed generally upwardly with respect to planar longitudinal portion <NUM> and curved portion <NUM> is directed generally downwardly with respect to planar longitudinal portion <NUM>.

In some embodiments, a protrusion <NUM> is formed adjacent the proximal end <NUM> of retaining element <NUM> and is arranged along an axis transverse to longitudinal axis <NUM>. In some embodiments, an opening <NUM> is formed within protrusion <NUM> and extends along the axis that is transverse to longitudinal axis <NUM>. Optionally, opening <NUM> is provided to enable insertion of connection pin <NUM> therethrough and connection thereof with handle element <NUM>, thus providing for hinged engagement of retaining element <NUM> with handle element <NUM>.

Reference is now made to <FIG>, which are a respective simplified pictorial and side view of locking lever <NUM> of the suture capturing device <NUM> of <FIG>, according to some embodiments.

In some embodiments, locking lever <NUM> is formed of a generally longitudinal distally tapered portion <NUM> and is arranged along a longitudinal axis <NUM>, which has a proximal end <NUM> and a distal end <NUM>.

In some embodiments, a protrusion <NUM> is formed adjacent the distal end <NUM> of locking lever <NUM> and is arranged along an axis transverse to longitudinal axis <NUM>. In some embodiments, an opening <NUM> is formed within protrusion <NUM> and extends along the axis that is transverse to longitudinal axis <NUM>. Optionally, opening <NUM> is provided to enable insertion of connection pin <NUM> therethrough and connection thereof with handle element <NUM>, thus providing for hinged engagement of locking lever <NUM> with handle element <NUM>.

Reference is now made to <FIG>, which is a simplified pictorial view of the actuating lever <NUM> of the suture capturing device <NUM> of <FIG> and to <FIG>, which are a respective simplified side view, front view and top view of the actuating lever <NUM> of <FIG>, according to some embodiments.

In some embodiments, actuating lever <NUM> has a generally planar portion <NUM> with an ergonomic pressing surface <NUM> and a generally longitudinal portion <NUM> extending generally perpendicularly to planar portion <NUM> and joined thereto by a curved portion <NUM>.

In some embodiments, a notch <NUM> is formed along a portion of the longitudinal portion <NUM> for engagement with connecting portion <NUM>.

It is additionally seen in <FIG> and <FIG> that in some embodiments, two openings <NUM> are formed through the longitudinal portion <NUM> and extend transversely thereto. Optionally, openings <NUM> are provided for insertion of connecting pins <NUM> thereto in order to enable pivoting displacement of the actuating lever <NUM> relative to handle element <NUM>.

Reference is now made to <FIG>, which is a simplified pictorial view of the connecting element <NUM> of the suture capturing device <NUM> of <FIG> and to <FIG>, which are a respective simplified side view and sectional view of the connecting element <NUM> of <FIG>, section being taken along lines C - C in <FIG>, according to some embodiments.

In some embodiments, connecting element <NUM> is a generally longitudinal element arranged along a longitudinal axis <NUM> and has a proximal end <NUM> and a distal end <NUM>. Extending proximally from the distal end <NUM> is a generally cylindrical portion <NUM>, which is adapted for insertion into handle element <NUM>. In some embodiments, a longitudinal recess <NUM> is formed along cylindrical portion <NUM> for insertion of a connecting pin which provides for connection of the connecting element <NUM> and the hollow shaft <NUM>.

It is also seen in <FIG> that, in some embodiments, extending proximally from the cylindrical portion <NUM> is a generally planar portion <NUM> which is inserted into handle element <NUM> and is optionally fixedly locked between its two halves.

In some embodiments, the planar portion <NUM> defines a downwardly facing wall surface <NUM> extending distally from proximal end <NUM> and a protrusion <NUM> extending downwardly from wall surface <NUM>. In some embodiments, protrusion <NUM> defines a downwardly facing wall surface <NUM> and a proximally facing shoulder <NUM>. Optionally, downwardly facing wall surface <NUM> is located downwardly and generally in parallel to downwardly facing wall surface <NUM>.

In some embodiments, the planar portion <NUM> defines an upwardly facing wall surface <NUM> extending distally from proximal end <NUM> extending distally to a distally tapered surface <NUM> and having a distally tapered notch <NUM> formed in planar portion <NUM>, the notch <NUM> is located proximally to tapered surface <NUM>. In some embodiments, the notch <NUM> is provided for engagement with connecting pin <NUM> in order to enable pivoting displacement of actuating lever <NUM> relative to connecting element <NUM>.

Reference is now made to <FIG>, which is a simplified pictorial view of the hollow shaft <NUM> of the suture capturing device <NUM> of <FIG> and to <FIG>, which are a respective simplified side view and sectional view of the hollow shaft <NUM> of <FIG>, section being taken along lines C - C in <FIG>, according to some embodiments.

In some embodiments, hollow shaft <NUM> is formed as a generally cylindrical element having proximal end <NUM> and distal end <NUM> as noted hereinabove. Optionally, hollow shaft is generally formed as an integral element made of a rigid material, such as for example Titanium or any other biocompatible material and is generally arranged along a longitudinal axis <NUM>. In some embodiments, a relatively widened portion <NUM> is either integrally formed or coupled to the hollow shaft <NUM> and located adjacent proximal end <NUM> of hollow shaft <NUM>. In some embodiments, a plurality of notches <NUM> are formed on widened portion <NUM> for engagement with connecting pins <NUM> in order to connect hollow shaft <NUM> with handle element <NUM>.

In some embodiments, an inner socket <NUM> is formed within hollow shaft <NUM> and extending proximally from distal end <NUM> thereof, provided for engagement and connection of the hollow shaft <NUM> and the adaptor element <NUM>.

Reference is now made to <FIG>, which is a simplified pictorial view of the adaptor element <NUM> of the suture capturing device <NUM> of <FIG> and to <FIG>, which are a respective simplified side view and sectional view of the adaptor element <NUM> of <FIG>, section being taken along lines C - C in <FIG>, according to some embodiments.

As noted hereinabove, adaptor element <NUM> is, in some embodiments, coupled to or integrally made with the hollow shaft <NUM>. It is appreciated that adaptor element <NUM> can be formed in various shapes and angles in order to fit various anatomical locations.

In some embodiments, adaptor element <NUM> is formed as a generally hollow longitudinal element having a proximal end <NUM> and a distal end <NUM>. Optionally, a relatively narrow shaft <NUM> is formed at the proximal end <NUM> of adaptor element <NUM> to enable connection of adaptor element <NUM> and hollow shaft <NUM>.

In some embodiments, two longitudinal apertures <NUM> are formed at the distal end <NUM> of adaptor element <NUM> for engagement with connecting pin <NUM>, this engagement provides for longitudinal displacement of needle element <NUM> relative hollow shaft <NUM> as will be described in detail hereinbelow.

It is additionally seen in <FIG> and <FIG> that in some embodiments two recesses <NUM> are formed along the circumference of the distal end <NUM> of adaptor element <NUM> for engagement with needle element <NUM>. It is appreciated that in some embodiments recesses <NUM> of adaptor element <NUM> are formed with a rounded edge in order to protect the integrity of a surgical suture when it is captured between the adaptor element <NUM> and the needle element <NUM>.

Reference is now made to <FIG>, which is a simplified pictorial view of the needle element <NUM> of the suture capturing device <NUM> of <FIG> and to <FIG>, which are various planar view illustrations of the needle element <NUM> of <FIG>, according to some embodiments.

In some embodiments, needle element <NUM> has a proximal generally cylindrical portion <NUM>, a distal needle-shaped portion <NUM> and a curved joining portion <NUM>. In some embodiments, needle element <NUM> is generally formed as an integral element made of a rigid (non-flexible) material, such as for example Titanium or any other biocompatible material and is generally arranged along a longitudinal axis <NUM>.

In some embodiments, a generally longitudinal opening <NUM> is formed at the proximal end of cylindrical portion <NUM> and extend distally therefrom. Optionally, a through opening <NUM> is formed at the proximal end of cylindrical portion <NUM> extending transversely to longitudinal axis <NUM>. In some embodiments, openings <NUM> and <NUM> are formed in the needle element <NUM> for enabling connection of the needle element <NUM> with the needle retaining element adaptor <NUM> and in turn with needle retaining element <NUM> and in turn with connecting element <NUM>.

In some embodiments, curved joining portion <NUM> defines an inclined generally U-shaped recess <NUM>, forming a hook-like structure, for accommodating a surgical suture therein. Needle shaped portion <NUM> defines a sharp tip <NUM> for penetration of tissue.

Reference is now made to <FIG>, which is a simplified assembled view illustration of the suture capturing device <NUM> of <FIG> shown in an open operative orientation, according to some embodiments.

It is seen in <FIG> that in some embodiments connecting element <NUM> is inserted into handle element <NUM>, specifically cylindrical portion <NUM> of the connecting element <NUM> is inserted into longitudinal recess <NUM> of handle element <NUM>. In some embodiments, the actuating lever <NUM> is partially inserted into handle element <NUM> and is engaged with the connecting element <NUM>, such that planar portion <NUM> of the connecting element <NUM> is inserted through notch <NUM> of the actuating lever <NUM> and the connecting pin <NUM> is seated within notch <NUM> of the connecting element <NUM>, thus providing for a sliding movement of the connecting element <NUM> relative handle element <NUM> along longitudinal axis, such as for example axis <NUM>. In some embodiments, biasing spring <NUM> is seated in recess <NUM> of handle element <NUM> and supported against connecting element <NUM>.

In some embodiments, hollow shaft element <NUM> is partially inserted into handle element <NUM>, namely the proximal end <NUM> of the hollow shaft element <NUM> is inserted into semi-circular groove <NUM> of handle element <NUM> and is optionally fixedly held therewithin by engagement of connecting pins <NUM> with notches <NUM> of hollow shaft <NUM> and recesses <NUM> of groove <NUM> of handle element <NUM>.

In some embodiments, adaptor element <NUM> is fixedly connected to hollow shaft <NUM> or integrally made therewith.

In some embodiments, needle retaining element <NUM> is fixedly inserted within connecting element <NUM>, such that proximal end <NUM> of needle retaining element <NUM> is inserted into longitudinal recess <NUM> of connecting element <NUM>. In some embodiments, needle retaining element adaptor <NUM> is fixedly coupled to needle retaining element <NUM>. Optionally, needle element <NUM> is in turn connected to needle retaining element adaptor <NUM> by means of engagement with connecting pins <NUM>. Optionally, the connecting pins <NUM> are slidable within longitudinal apertures <NUM> of adaptor element <NUM>.

It is a particular feature of some embodiments of the present invention that the sliding movement of the connecting element <NUM> is transferred to needle retaining element <NUM>, in turn to needle retaining element adaptor <NUM> and finally to needle element <NUM>. In some embodiments, due to this transfer and to the fact that connecting pins <NUM> are slidable within longitudinal apertures <NUM> of adaptor element <NUM>, relative axial movement is provided between needle element <NUM> and the distal end <NUM> of adaptor element <NUM>.

In some embodiments, locking lever <NUM> is hingedly connected to handle element <NUM> by means of connecting pin <NUM>. In some embodiments, retaining element <NUM> is hingedly connected to handle element <NUM> by means of connecting pin <NUM> and is enclosed within handle element <NUM> by means of locking lever <NUM>. In some embodiments, leaf spring <NUM> is fixedly inserted into notch <NUM> of handle element <NUM> and biases retaining element <NUM> to engage locking lever <NUM> with curved portion <NUM> and further engage downwardly facing wall surface <NUM> of connecting element <NUM> with curved portion <NUM> thereof, adjacent to but not touching proximally facing shoulder <NUM> of connecting element <NUM>.

It is a particular feature of some embodiments of the present invention that in an open operative orientation of the suture capturing device <NUM> the actuating lever <NUM> is pressed down, the connecting element <NUM> is displaced distally, the biasing spring <NUM> is compressed and the needle element <NUM> is located distally with respect to distal end <NUM> of adaptor element <NUM> and thus providing U-shaped recess <NUM> of the needle element <NUM> for capturing a surgical suture therewithin.

Reference is now made to <FIG>, which is a simplified assembled view illustration of the suture capturing device <NUM> of <FIG> shown in a partially closed operative orientation, according to some embodiments.

It is seen in <FIG> that in some embodiments, connecting element <NUM> remains inserted into handle element <NUM>, specifically cylindrical portion <NUM> of the connecting element <NUM> is inserted into longitudinal recess <NUM> of handle element <NUM>. In some embodiments, the actuating lever <NUM> remains partially inserted into handle element <NUM> and is engaged with the connecting element <NUM>, such that planar portion <NUM> of the connecting element <NUM> is inserted through notch <NUM> of the actuating lever <NUM> and the connecting pin <NUM> is seated within notch <NUM> of the connecting element <NUM>, thus providing for a sliding movement of the connecting element <NUM> relative handle element <NUM> along longitudinal axis, such as for example axis <NUM>. In some embodiments, biasing spring <NUM> is seated in recess <NUM> of handle element <NUM> and supported against connecting element <NUM>.

In some embodiments, hollow shaft element <NUM> remains partially inserted into handle element <NUM>, namely the proximal end <NUM> of the hollow shaft element <NUM> is inserted into semi-circular groove <NUM> of handle element <NUM> and optionally fixedly held therewithin by engagement of connecting pins <NUM> with notches <NUM> of hollow shaft <NUM> and recesses <NUM> of groove <NUM> of handle element <NUM>.

In some embodiments, adaptor element <NUM> remains fixedly connected to hollow shaft <NUM> or integrally made therewith.

In some embodiments, needle retaining element <NUM> remains fixedly inserted within connecting element <NUM>, such that proximal end <NUM> of needle retaining element <NUM> is inserted into longitudinal recess <NUM> of connecting element <NUM>. Needle retaining element adaptor <NUM> remains fixedly coupled to needle retaining element <NUM>. Needle element <NUM> remains in turn connected to needle retaining element adaptor <NUM> by means of engagement with connecting pins <NUM>. Optionally, the connecting pins <NUM> are slidable within longitudinal apertures <NUM> of adaptor element <NUM>.

It is a particular feature of some embodiments of the present invention that the sliding movement of the connecting element <NUM> is transferred to needle retaining element <NUM>, in turn to needle retaining element adaptor <NUM> and finally to needle element <NUM>. Optionally, due to this transfer and to the fact that connecting pins <NUM> are slidable within longitudinal apertures <NUM> of adaptor element <NUM>, relative axial movement is provided between needle element <NUM> and the distal end <NUM> of adaptor element <NUM>.

In some embodiments, locking lever <NUM> remains hingedly connected to handle element <NUM> by means of connecting pin <NUM>. In some embodiments, retaining element <NUM> remains hingedly connected to handle element <NUM> by means of connecting pin <NUM> and is enclosed within handle element <NUM> by means of locking lever <NUM>. In some embodiments, leaf spring <NUM> remains fixedly inserted into notch <NUM> of handle element <NUM> and biases retaining element <NUM> to engage locking lever <NUM> with curved portion <NUM> and further engage downwardly facing wall surface <NUM> of connecting element <NUM> with curved portion <NUM> thereof, adjacent and supported against proximally facing shoulder <NUM> of connecting element <NUM>, thus causing the biasing spring <NUM> to remain partially compressed.

It is a particular feature of some embodiments of the present invention that in a partially closed operative orientation of the suture capturing device <NUM> the actuating lever <NUM> is slightly lifted upwards, the connecting element <NUM> is displaced slightly proximally, the biasing spring <NUM> is partially compressed and the needle element <NUM> is located distally with respect to distal end <NUM> of adaptor element <NUM> but nearly touching distal end <NUM> and thus providing U-shaped recess <NUM> of the needle element <NUM> for fixedly holding the surgical suture between the needle element <NUM> and the distal end <NUM> and prevent the surgical suture from disengagement therefrom, however allows for movement of the surgical suture therewithin.

Reference is now made to <FIG>, which is a simplified assembled view illustration of the suture capturing device <NUM> of <FIG> shown in a closed operative orientation, according to some embodiments.

It is seen in <FIG> that in some embodiments, connecting element <NUM> remains inserted into handle element <NUM>, specifically cylindrical portion <NUM> of the connecting element <NUM> is inserted into longitudinal recess <NUM> of handle element <NUM>. In some embodiments, the actuating lever <NUM> remains partially inserted into handle element <NUM> and is engaged with the connecting element <NUM>, such that planar portion <NUM> of the connecting element <NUM> is inserted through the notch <NUM> of the actuating lever <NUM> and the connecting pin <NUM> is seated within notch <NUM> of the connecting element <NUM>, thus providing for a sliding movement of the connecting element <NUM> relative handle element <NUM> along longitudinal axis, such as for example axis <NUM>. Biasing spring <NUM> is seated in <NUM> of handle element <NUM> and supported against connecting element <NUM>.

In some embodiments, hollow shaft element <NUM> remains partially inserted into handle element <NUM>, namely the proximal end <NUM> of the hollow shaft element <NUM> is inserted into semi-circular groove <NUM> of handle element <NUM> and fixedly held therewithin by engagement of connecting pins <NUM> with notches <NUM> of hollow shaft <NUM> and recesses <NUM> of groove <NUM> of handle element <NUM>.

In some embodiments, needle retaining element <NUM> remains fixedly inserted within connecting element <NUM>, such that proximal end <NUM> of needle retaining element <NUM> is inserted into longitudinal recess <NUM> of connecting element <NUM>. In some embodiments, needle retaining element adaptor <NUM> remains fixedly coupled to needle retaining element <NUM>. Needle element <NUM> remains in turn connected to needle retaining element adaptor <NUM> by means of engagement with connecting pins <NUM>. Optionally, the connecting pins <NUM> are slidable within longitudinal apertures <NUM> of adaptor element <NUM>.

In some embodiments, locking lever <NUM> remains hingedly connected to handle element <NUM> by means of connecting pin <NUM>. In some embodiments, retaining element <NUM> remains hingedly connected to handle element <NUM> by means of connecting pin <NUM> and is enclosed within handle element <NUM> by means of locking lever <NUM>. Leaf spring <NUM> remains fixedly inserted into notch <NUM> of handle element <NUM> and biases retaining element <NUM> to engage locking lever <NUM> with curved portion <NUM> and further engage downwardly facing wall surface <NUM> of connecting element <NUM> with curved portion <NUM> thereof.

It is a particular feature of some embodiments of the present invention that in a closed operative orientation of the suture capturing device <NUM> the locking lever <NUM> is pressed upwardly, thus pushing the retaining element <NUM> against the force of leaf spring <NUM> and causing the curved portion <NUM> to disengage the proximally facing shoulder <NUM> and instead engage downwardly facing wall surface <NUM> of the connecting portion <NUM>. The disengagement of curved portion <NUM> from the proximally facing shoulder <NUM>, provides for release of the biasing spring <NUM> and thus causes movement of the connecting element <NUM> in a proximal direction and lifting upwards of the actuating lever <NUM>. The needle element <NUM> is in turn displaced proximally towards distal end <NUM> of adaptor element <NUM> and thus providing U-shaped recess <NUM> of the needle element <NUM> for locking the surgical suture between the needle element <NUM> and the distal end <NUM> and prevent the surgical suture from disengagement therefrom.

In some embodiments, in this closed operative orientation, engagement is provided between the proximal edges of the needle element <NUM> and recesses <NUM> of adaptor element <NUM>.

It is a further particular feature of some embodiments of the present invention that components holding the surgical suture are rigid, namely the needle element <NUM>, the hollow shaft <NUM> and adaptor element <NUM> are also optionally rigid elements, which provide for a fully controlled operation of the suture capturing device <NUM>.

Reference is now made to <FIG>, which are simplified assembled view illustrations showing the various steps in the method of operation of the suture capturing device <NUM> of <FIG>, according to some embodiments.

In some embodiments, the arthroscopic procedure includes the following actions:
In some embodiments, the suture capturing device <NUM> is positioned at the surgical site; the suture capturing device <NUM> is inserted through the patient's soft tissue. Optionally, several sutures are captured; The surgical suture is captured using the suture capturing device <NUM>; The actuating lever <NUM> is pushed upon in order to secure the surgical suture therein; The locking lever <NUM> is pushed upon in order to lock the surgical suture within the suture capturing device <NUM>; The suture capturing device <NUM> is withdrawn from the soft tissue; The suture capturing device <NUM> is reopened; The surgical suture is removed from the suture capturing device <NUM>.

It is seen in <FIG> that the suture capturing device <NUM> is in an open operative orientation for example as shown in <FIG>. In this open operative orientation, the suture capturing device <NUM> is operative for catching a surgical suture through the u-shaped open recess <NUM> of needle element <NUM>.

It is seen in <FIG> that the suture capturing device <NUM> is still in an open operative orientation for example as shown in <FIG>. In this open operative orientation, it is seen that the surgical suture is already captured by the suture capturing device <NUM>.

It is seen in <FIG> that the suture capturing device <NUM> is a partially closed operative orientation for example as shown in <FIG>. In this open operative orientation, it is seen that the surgical suture is already captured by the suture capturing device <NUM>. The surgical suture is securely held within the suture capturing device <NUM> and prevented from disengagement therefrom, however allows for movement of the surgical suture therewithin.

It is seen in <FIG> that the suture capturing device <NUM> is in a closed operative orientation for example as shown in <FIG>. In this open operative orientation, it is seen that the surgical suture is fixedly locked within the suture capturing device <NUM>, prevented from disengagement therefrom, and prevented from movement relative thereto.

<FIG> is perspective view of a suture capturing device <NUM>, in accordance with an exemplary embodiment of the invention. In an embodiment, the suture capturing device <NUM> includes a handle element <NUM>, configured for use by a medical professional's hand. The handle element <NUM> has a proximal end <NUM> and a distal end <NUM>. The handle element <NUM>, located on a proximal end of the device, is located opposite a suture capturing needle element <NUM>, described in more detail below with respect to <FIG> and <FIG>. Generally speaking, the medical professional uses the distal end of the device <NUM>, the needle element <NUM>, to penetrate body tissue for inserting a suture into the body and/or for capturing and/or removing a suture from the body. Exemplary components/elements of the device <NUM>, modes of operation and methods of use are described herein.

<FIG> is a simplified exploded view of the suture capturing device <NUM> of <FIG>, in accordance with an exemplary embodiment of the invention. Handle element <NUM> includes two counterpart halves <NUM>, <NUM> which are attached using at least one connector <NUM>, such as a screw, according to some embodiments. Alternatively and/or additionally, in some embodiments the two halves of the handle element <NUM> can be connected using any other method such as welding, snap-fit or attachment by adhesive for example.

A hollow shaft <NUM> has a proximal end <NUM> and a distal end <NUM>. The proximal end <NUM> of the hollow shaft <NUM> is coupled with and, in some embodiments, at least partially inserted into the distal end <NUM> of handle element <NUM>, optionally secured into the handle <NUM> using connecting pins, screws, adhesive, compression/snap fit or the like. In some embodiments, additional hollow parts <NUM> are used with shaft <NUM> to provide a conduit for a needle retaining rod <NUM>, described in more detail below.

In some embodiments, an actuating slide <NUM> is partially and slidably inserted between the two halves of handle element <NUM> such that a lower portion of the actuating slide <NUM> is retained within the body of the handle <NUM>, while a user operable portion remains outside of the body of the handle <NUM>. In some embodiments, the bottom of the actuating slide <NUM> is provided with teeth <NUM>, designed to act as counterparts to a toothed wheel, described in more detail below.

In some embodiments, a needle retaining element <NUM> extends within hollow shaft <NUM> and has a proximal end <NUM> and a distal end <NUM>. In some embodiments, the proximal end <NUM> of the needle retaining element <NUM> is hingedly coupled to toothed wheel <NUM>, where the toothed wheel <NUM> is axially and rotatably attached to the halves <NUM>, <NUM> by a pin <NUM>. The toothed wheel <NUM> is provided with teeth which act as counterparts to the teeth <NUM> of the actuating slide <NUM>, such that when the slide <NUM> is moved, the toothed wheel <NUM> rotates clockwise or counterclockwise depending on the direction of movement of the slide <NUM>. In some embodiments, the distal end <NUM> of the needle retaining element <NUM> is configured to be more flexible than the needle retaining element <NUM> and/or the shaft <NUM>. The distal end <NUM> is integrally formed with the needle retaining element <NUM> or is coupled to it, in some embodiments.

In some embodiments, a biasing spring <NUM> is provided. In some embodiments, the spring <NUM> is inserted into the distal end <NUM> of handle element <NUM> until it abuts a distal end of the actuating slide <NUM>. The biasing spring <NUM> is configured to bias the device <NUM> in a closed operative orientation, described elsewhere herein, and shown in <FIG>.

A tab <NUM> is provided to the device <NUM> as a counterpart to a notch <NUM>, shown in more detail in <FIG>, in the actuating slide <NUM>. In an embodiment of the invention, the notch <NUM> is deep enough and the tab <NUM> fills the notch <NUM> enough to prevent sliding of the actuating slide <NUM> solely from force of the biasing spring <NUM> (when the tab is in the notch).

<FIG> are simplified side, cross-sectional views showing the device <NUM> in a closed operative orientation, in accordance with an exemplary embodiment of the invention. In an embodiment, "closed" means that the needle element <NUM> is retracted into the shaft <NUM>, or at least a hollow part <NUM> connected to the shaft <NUM>, such that the pointed distal tip of the needle element <NUM> remains uncovered while suture catching structures (described in more detail with respect to <FIG> and <FIG>) of the needle element <NUM> are covered. In an embodiment, in the closed orientation the actuating slide <NUM> is positioned in a backwards (relative to handle <NUM>) or proximal configuration and where the biasing spring <NUM> is un-compressed. The tab <NUM> is located distally of the notch <NUM>, in some embodiments. It should be understood that the actuating slide <NUM> is slidable distally and proximally (or from the perspective of this Figure, left and right, respectively) and the tab <NUM> remains in a stable position during slide <NUM> movement, held in place by the two halves <NUM>, <NUM>. <FIG> are enlarged views of particular areas of device <NUM>.

<FIG> are simplified side, cross-sectional views of the device of <FIG> showing the device in an open operative orientation, in accordance with an exemplary embodiment of the invention. In an embodiment, "open" means that the needle element <NUM> is extended out of the shaft <NUM>, or at least a hollow part <NUM> connected to the shaft <NUM>, such that the pointed distal tip of the needle element <NUM> and suture catching structures of the needle element <NUM> are fully uncovered. In an embodiment, in the open orientation the actuating slide <NUM> is positioned in a forwards or distal configuration and where the biasing spring <NUM> is compressed, having been pushed by the forward movement of the slide <NUM>. The tab <NUM> is shown being located proximally of the notch <NUM>, the slide <NUM> having moved to the left in this Figure or distally (relative to the handle <NUM>) and over the tab <NUM> past the notch <NUM>. Movement of the slide <NUM> distally translates to movement of teeth <NUM> relative to the toothed wheel <NUM>, effectuating rotation of the toothed wheel <NUM> in a counterclockwise fashion and the extension of the needle element <NUM> out of the shaft <NUM>. <FIG> are enlarged views of particular areas of device <NUM>.

<FIG> are simplified side, cross-sectional views of the device of <FIG> showing the device in a partially closed operative orientation, in accordance with an exemplary embodiment of the invention. In an embodiment, "partially closed" means that the needle element <NUM> is extended out of the shaft <NUM>, or at least a hollow part <NUM> connected to the shaft <NUM>, such that although the pointed distal tip of the needle element <NUM> is fully uncovered, the suture catching structures of the needle element <NUM> are covered sufficiently to prevent them from catching or hooking something. In an embodiment, in the partially closed orientation the actuating slide <NUM> is positioned in a middle configuration relatively, between the open and closed orientations, and where the biasing spring <NUM> is at least slightly less compressed than in the open orientation. The tab <NUM> is shown being located within the notch <NUM>, the notch <NUM> being placed on the slide <NUM> at a pre-determined position which correlates to the suture catching structures of the needle element <NUM> being covered and prevented from catching or hooking something. In an embodiment, the notch <NUM> is at least partially provided to give a user of the device <NUM> a tactile sensation of the location of the pre-determined partially closed orientation. In an embodiment, the slide <NUM> is shown having moved to the right or proximally in this view (with respect to the immediate previous position shown in <FIG>). Movement of the slide <NUM> proximally translates to movement of teeth <NUM> relative to the toothed wheel <NUM>, effectuating rotation of the toothed wheel <NUM> in a clockwise fashion and the partial retraction of the needle element <NUM> into the shaft <NUM>. <FIG> are enlarged views of particular areas of device <NUM>.

<FIG> is a perspective view of a suture capturing needle element <NUM> of the device <NUM>, in accordance with an exemplary embodiment of the invention. In an embodiment, the needle element <NUM> has a distal end <NUM> and a proximal end <NUM>, where the distal end <NUM> is configured with a sharp tip <NUM> to penetrate body tissue and the proximal end <NUM> is configured to mate with a distal end of the needle retaining element <NUM>. In some embodiments, the needle element <NUM> has a hook <NUM> for capturing or hooking something, for example a suture. A space <NUM> is provided to the needle element <NUM> to assist with catching or hooking using the hook <NUM>. In an embodiment, the space <NUM> extends "under" the hook <NUM>, between the hook <NUM> and the main body of the needle element <NUM>.

<FIG> show top, front, side, back and bottom views, respectively, of the suture capturing needle element <NUM>, in accordance with an exemplary embodiment of the invention. In some embodiments, needle element <NUM> is generally formed as an integral element made of a rigid material, such as titanium or any other biocompatible material, and is generally arranged along and/or around a longitudinal axis <NUM>.

<FIG> show in more detail recesses <NUM> configured to accommodate a surgical suture therein, particularly when the suture has been caught by the hook <NUM>. In an embodiment of the invention, the recesses <NUM> form a U-shape with the connecting portion of the U traversing the space <NUM> under the hook <NUM>. <FIG> show the sharp tip <NUM> and its tissue penetrating configuration in more detail. In some embodiments of the invention, a leading edge of the sharp tip <NUM> is curved, optionally to enhance penetrative ability while retaining the ability to spread penetrated tissue after the most distal part of the tip <NUM> has already passed therethrough.

<FIG> show sequentially the device <NUM> configurations and procedure for retrieving a suture from inside body tissue, in some embodiments of the invention. For efficiency, <FIG> are described in conjunction with the flowchart of the method shown in <FIG>.

<FIG> show the device <NUM> placed (<NUM>) in closed orientation for insertion (<NUM>) into body tissue <NUM> in order to catch (<NUM>) a suture <NUM> from the body tissue <NUM>, in accordance with an exemplary embodiment of the invention. It can be seen that in the closed orientation, the slide <NUM> is positioned proximally (to the right, from this perspective) on the device <NUM> of a mid-point indicator <NUM>, the location of which corresponds to the partially closed orientation when the tab <NUM> is within the notch <NUM>.

<FIG> show the device <NUM> inserted (<NUM>) into the body <NUM> and transitioned (<NUM>) to an open orientation for catching (<NUM>) the suture <NUM>, in accordance with an exemplary embodiment of the invention. In the open orientation, the slide <NUM> is moved distally (to the left, from this perspective) and past the indicator <NUM> to extend the needle element <NUM> out of the device <NUM> in anticipation of hooking/catching (<NUM>) the suture <NUM> on the hook <NUM>.

<FIG> show the device <NUM> inserted (<NUM>) into the body <NUM> and changed (<NUM>) to a partially closed orientation having a suture <NUM> captured (<NUM>) by hook <NUM>, in accordance with an exemplary embodiment of the invention. In the partially closed orientation, the device <NUM> is configured so that when the slide <NUM> is aligned with the indicator <NUM>, the tab <NUM> is positioned within the notch <NUM>. In an embodiment, when the device <NUM> is in partially closed orientation the hook <NUM> is drawn to abut the end of the shaft <NUM> or part <NUM> such that a minimal or no gap exists between the hook <NUM> and the shaft <NUM> or part <NUM> (thereby trapping the suture <NUM> within the tip <NUM>).

As described elsewhere herein, movement of the slide <NUM> distally compresses the biasing spring <NUM> such that release by the user of exerted distal pressure on the slide <NUM> results in at least a partial return of the slide <NUM> in a proximal direction. Optionally, release of the exerted pressure on the slide <NUM> returns the device <NUM> to the partially closed orientation. Optionally, release of the exerted pressure on the slide <NUM> returns the device <NUM> to the closed orientation. It should be understood that, in some embodiments of the invention, the suture is slidable through the space <NUM> but is trapped within the space by the hook <NUM> and the shaft <NUM> or part <NUM>. In some embodiments of the invention, when the device <NUM> is in the closed orientation the suture <NUM> is pinned against the tip <NUM> by the shaft <NUM> or part <NUM> and is not slidable.

<FIG> show the device <NUM> having been placed (<NUM>) in a closed orientation for withdrawal (<NUM>) from the body <NUM> and having been actually withdrawn (<NUM>) from the body <NUM>, in accordance with an exemplary embodiment of the invention.

<FIG> show the device <NUM> in an open operative orientation for releasing (<NUM>) the suture <NUM> outside the body <NUM> where the suture <NUM> is unhooked from the hook <NUM>, in accordance with an exemplary embodiment of the invention. In some embodiments, only a portion of the suture <NUM> is retrieved from the body tissue <NUM> and the rest remains inside the body <NUM>.

<FIG> show sequentially the device <NUM> configurations and procedure for inserting a suture into body tissue, in some embodiments of the invention. For efficiency, <FIG> are described in conjunction with the flowchart of the method shown in <FIG>.

<FIG> show the device <NUM> placed (<NUM>) in a closed orientation for insertion (<NUM>) of a suture <NUM> into a body <NUM>, in accordance with an exemplary embodiment of the invention. As described elsewhere herein, the slide <NUM> is proximally located and the needle tip <NUM>, along with the suture <NUM> to be implanted, are in a retracted configuration in the device <NUM>.

<FIG> show the device <NUM> inserted (<NUM>) in a closed orientation into the body <NUM>, in accordance with an exemplary embodiment of the invention.

<FIG> show the device <NUM> changed (<NUM>) to a partially closed orientation in preparation for release (<NUM>) of the suture <NUM>, in accordance with an exemplary embodiment of the invention. In an embodiment, after changing (<NUM>) the suture <NUM> starts to be movable within the tip <NUM> where in the partially closed orientation the suture is slidable within the space <NUM> but is still trapped within the space <NUM> by the hook <NUM> and at least one of the hollow shaft <NUM> or part <NUM>.

<FIG> show the device <NUM> fully transitioned (<NUM>) into an open orientation for releasing (<NUM>) the suture <NUM>, in accordance with an exemplary embodiment of the invention. In an embodiment, the suture <NUM> begins fully releasing out of the hook <NUM> of the tip <NUM> once the device is transitioned (<NUM>).

<FIG> show the device <NUM> withdrawn (<NUM>) from the body <NUM> after being placed (<NUM>) in a closed orientation and after releasing (<NUM>) the suture <NUM> in the body <NUM>, in accordance with an exemplary embodiment of the invention. In some embodiments, only a portion of the suture <NUM> is implanted into the body tissue <NUM> and the rest remains outside the body <NUM>. Optionally, all of the suture <NUM> is inserted into the body <NUM> by the device <NUM>.

It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of various features described hereinabove as well as variations and modifications thereof which are not in the prior art.

Claim 1:
A suture capturing device (<NUM>) configured to attain multiple preset orientations, comprising:
a handle (<NUM>);
a hollow shaft (<NUM>) coupled to said handle;
wherein said hollow shaft (<NUM>) has a curved distal end (<NUM>);
a rigid needle element (<NUM>) configured with a hook (<NUM>) for catching a suture, wherein said needle element is axially displaceable relative to said hollow shaft and wherein the needle element is operatively coupled to the hollow shaft opposite the handle and configured to be slidable in a first direction to assume an open orientation where the hook is exposed relative to the hollow shaft and in a second direction to assume a closed orientation where the hook is not exposed relative to the hollow shaft; and
a needle retaining element (<NUM>) that is axially slidable relative to said hollow shaft;
wherein a distal end of the needle retaining element is more flexible than other portions of the needle retaining element and/or the shaft;
characterized in that said needle element is arranged along a longitudinal axis (<NUM>).