WO2007145614A2 - Suture instrument and method of suturing in cosmetic surgery - Google Patents

Suture instrument and method of suturing in cosmetic surgery Download PDF

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Publication number
WO2007145614A2
WO2007145614A2 PCT/US2006/022240 US2006022240W WO2007145614A2 WO 2007145614 A2 WO2007145614 A2 WO 2007145614A2 US 2006022240 W US2006022240 W US 2006022240W WO 2007145614 A2 WO2007145614 A2 WO 2007145614A2
Authority
WO
WIPO (PCT)
Prior art keywords
suture
hollow tubular
tubular member
sutures
tissue
Prior art date
Application number
PCT/US2006/022240
Other languages
French (fr)
Other versions
WO2007145614A3 (en
Inventor
Sorin Eremia, M.D.
Original Assignee
Eremia Sorin M D
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Eremia Sorin M D filed Critical Eremia Sorin M D
Priority to PCT/US2006/022240 priority Critical patent/WO2007145614A2/en
Publication of WO2007145614A2 publication Critical patent/WO2007145614A2/en
Publication of WO2007145614A3 publication Critical patent/WO2007145614A3/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00792—Plastic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A61B2017/06176—Sutures with protrusions, e.g. barbs

Definitions

  • the invention relates to a two component suture having a main
  • surgically treated areas include the face, the breast/chest region, the buttocks, the thighs and
  • cross sutures or suture anchors 70a to 7Of are connected to the main suture 60 in
  • suture opening 26 is positioned at a distance Ll of 5.5 mm ⁇ 1 mil from the distal end 24 of
  • fourth suture opening 36 is positioned at a distance L2 of 3 mm ⁇ 1 mil from the distal end
  • the first and second hollow tubular members 20 and 30 are made from polished
  • the main suture 60 has a length of 40 cms ⁇ 5 cms and a diameter of 0.2 mm ⁇ .1 mil.
  • the spaced-apart, movable cross sutures 70a to 7Of have a spaced distance D of 10 mm ⁇
  • the main suture 60 is a clear 2-0 monofilament
  • new method includes the following steps:
  • continuous main suture 60 having thereon a plurality of spaced-apart, movable cross sutures
  • first and second hollow tubular members 20 and 30 are substantially parallel to each other
  • cross sutures 70a to 7Of are movable from a non-anchoring first position P j to an
  • suture 60 which operates to further pull the facial tissue 12 and the facial fold line 15 more
  • an advantage of the present invention is that it provides for a two
  • first hollow tubular member having a first hollow tubular member and a second hollow tubular member for receiving the
  • suture having a main suture and a plurality of spaced-apart, movable .cross sutures thereon
  • suspension suture wherein the multiple cross sutures move to a substantially perpendicular
  • sutures that can be mass produced in an automated and economical manner and is readily

Abstract

A method of treating a patient in cosmetic surgery as seen in Figure 1, using first and second hollow tubular surgical members and a suture to be surgically inserted under the patient's facial skin, including the following steps cutting a single incision in the patienfs facial skm adjacent to the area of the ear, threading the first (20) and second hollow (30) tubular members with a continuous suture having thereon a plurality of spaced-apart, movable cross sutures, inserting the insertion tip with the threaded suture through the incision and under the facial skin, toward the patient's fold line in the nasal area, removing the second hollow tubular member from the first hollow tubular member and from the nasal area and out through the single incision, while leaving in place the suture (28) and the plurality of cross sutures so they are disposed in the facial tissue, pulling on the proximal tip of the suture which is extending out of the incision in order to pull the plurality of cross sutures in the facial tissue which causes the cross sutures to move from their substantially parallel relationship to the suture so that they are moved to a position which is substantially perpendicular to the suture in order to engage and anchor the cross sutures in the facial tissue, pulling and tying off the suture in the area of the incision which operates to pull the facial tissue and the facial fold line more tightly in order to minimize the appearance of the facial fold line in the nasal area.

Description

SUTURE INSTRUMENT AND METHOD OF SUTURING IN COSMETIC SURGERY
FIELD OF THE INVENTION
The present invention relates to a novel suture instrument and a novel method of
suturing using the novel suture instrument in cosmetic, plastic, or reconstructive plastic
surgery. More particularly, the invention relates to a two component suture having a main
suture and a plurality of cross sutures thereon, wherein a two member suture instrument is
used to perform a single entry incision (point) for placing the two component suture therein.
BACKGROUND OF THE INVENTION
Cosmetic, facial, plastic and reconstructive surgeons have constantly sought new and
improved surgical devices, sutures and methods of surgery to aid in the support of physical
anatomical structures that have lost their natural tension and support. The most often
surgically treated areas include the face, the breast/chest region, the buttocks, the thighs and
other anatomical areas that lose tension and sag. Current surgical devices and methods are
not adequate in providing optimum natural-looking physical appearance to prevent such loss
of tension in these structures.
There remains a need for a suturing system and method having a plurality of spaced-
apart, cross sutures thereon that support body tissue being augmented by facial surgery,
breast surgery, or buttock surgery, using a novel two member surgical (cosmetic) instrument
on the patient. Suspension sutures, anchor sutures, suture implements, and suturing instruments
having various designs, configurations, structures and materials of construction have been
disclosed in the prior art. For example, U.S. Patent No. 5,480,405 to YOON discloses an
anchor applier instrument for use in suturing tissue. The suturing instrument extends through
a portal in the anatomical cavity wall for manipulating a needle to penetrate the tissue to form
a looped portion of a length of suture material at an exit point in the tissue and to back the
needle out of the tissue, and the anchor applier instrument extends through another portal in
the anatomical cavity wall for positioning an anchor in engagement with the looped portion
of the suture material to allow the suture material to be tensioned and secured to adjustably
approximate the tissue. This prior art patent does not disclose or teach the structure and
configuration of the two member suture instrument of the present invention, or its method
of use.
U.S. Patent No.6,599,310 to LEUNG et al. discloses a method for joining and holding
closed a wound in bodily tissue using a barbed suture including sharp pointed ends. This
prior art patent does not disclose or teach the structure and configuration of the two member
suture instrument of the present invention, or its method of use.
laminated materials which are used to provide support under tension for body structures.
These laminated devices can be used in methods for facial, plastic, cosmetic and
reconstructive surgery. This prior art patent does not disclose or teach the structure and
configuration of the two member suture instrument of the present invention, or its method
of use.
None of the aforementioned prior art patents teach or disclose a two component
suspension suture having a main suture and a plurality of spaced-apart, movable cross sutures
thereon for use with a two member suture instrument.
Accordingly, it is an object of the present invention to provide a two member suture
instrument that allows for a single entry incision (point) in order to place a two component
suture in the facial tissue, breast tissue or buttock tissue, for use in cosmetic, plastic, facial
and reconstructive plastic surgery.
Another object of the present invention is to provide a suture instrument having a first
hollow tubular member and a second hollow tubular member for receiving the two
component suture therethrough.
Another object of the present invention is to provide a two component suspension
suture having a main suture and a plurality of spaced-apart, movable cross sutures thereon
that support the tissue being augmented by the surgery using the two member suture
instrument. suture wherein the multiple cross sutures move to a substantially perpendicular position
having a wider cross suture after tension is applied to the suspension suture which engages
the facial tissue at multiple points as the tissue is being pulled to tighten it.
Another object of the present invention is to provide a two component suspension
suture wherein the main suture and cross suture system resolves existing problems of
dimpling, back slippage of the pulled facial tissue, and/or strangulating and cutting off the
blood supply of the pulled tissue, or trapping of a nerve within the pulled tissue when using
classic suturing techniques (the suture is passed through the tissue and then doubled back to
pull the tissue up like a pulley).
Another object of the present invention is to provide a two member suture instrument
in conjunction with a two component suspension suture having a plurality of cross sutures
that can be mass produced in an automated and economical manner and is readily affordable
by patients, surgeons and hospitals.
In accordance with the present invention, there is provided a method of treating a
patient in cosmetic surgery, using first and second hollow tubular surgical members and a
suture to be surgically inserted under the patient's facial skin, including the following steps:
cutting a single incision in the patient's facial skin adjacent to the area of the ear; threading
the first and second hollow tubular members with a continuous main suture having thereon
a plurality of spaced-apart, movable cross sutures; inserting the insertion tip with the
threaded suture through the incision and under the facial skin, toward the patient's fold line
in the nasal area; removing the second hollow tubular member from the first hollow tubular
member and from the nasal area and out through the single incision, while leaving in place
the main suture and the plurality of cross sutures so they are disposed in the facial tissue;
pulling on the proximal tip of the suture which is extending out of the incision in order to pull
the plurality of cross sutures in the facial tissue which causes the cross sutures to move from
their substantially parallel relationship to the suture to a position which is substantially
perpendicular to the suture in order to engage and anchor the cross sutures in the facial tissue;
pulling and tieing off the suture in the area of the incision which operates to pull the facial
tissue and the facial fold line more tightly in order to minimize the appearance of the facial
fold line in the nasal area. Further objects, features and advantages of the present invention will become apparent
upon the consideration of the following detailed description of the presently preferred
embodiment when taken in conjunction with the accompanying drawings, wherein:
Figure 1 is a perspective view of the two member suture instrument and the two
component suspension suture system of the preferred embodiment of the present invention
showing the major component parts in an assembled state being in operational use thereof;
Figure 2 is a perspective view of the two member suture instrument and the two
component suspension suture system of the present invention showing a first hollow tubular
member and a suspension suture having a main suture and a plurality of cross sutures for
anchoring or attaching within the facial tissue;
Figure 3 is a perspective view of the two member suture instrument and the two
component suspension suture system of the present invention showing the first hollow
tubular member and the multiple cross sutures or anchoring sutures being anchored or
attached within the facial tissue adjacent to the facial fold line;
Figure 4 is a perspective view of the two component suspension suture system of the
present invention showing the pulled facial tissue from the attached and pulled multiple cross
sutures of the suspension suture in its pulled up position; present invention showing the pulled up fold line within the facial tissue using three
suspension suture systems;
Figure 6 is a perspective view of the two member suture instrument and the two
component suspensions suture system of the present invention showing a first hollow tubular
member, a second hollow tubular member and a suspension suture having thereon a plurality
of spaced-apart, movable cross sutures for threading within the first and second hollow
tubular members;
Figure 7 A is an enlarged perspective view of the two member suture instrument of the
present invention showing distal ends of the first and second hollow tubular members being
interconnected with each other;
Figure 7B is an enlarged perspective view of the two member suture instrument of the
present invention showing distal ends of the first and second hollow tubular members being
interconnected with each other; and
Figure 8 is a detailed perspective view of the two component suspension suture system
of the present invention showing the main suture having a plurality of cross sutures thereon.
The two member surgical instrument 10 and its component parts of the preferred
embodiment of the present invention are represented in detail by Figures 1 through 8 of the
patent drawings. The two member surgical instrument 10 and the two component suspension
suture system 60 are used in cosmetic, plastic, facial and reconstructive plastic surgery for
the augmentation of facial tissue 12 or other tissue, as shown in Figures 1 through 5.
As shown in Figures 1, 6 and 7, the surgical instrument 10 of the present invention
includes a first hollow tubular member 20 having a proximal end 22 and a distal end 24, with
a first suture opening 2& therethrough, as well as a second hollow tubular member 30 having
a proximal end 32 and a distal end 34, with a second suture opening 36 therethrough. The
distal end 24 of the first hollow tubular member 20 also includes a suture outlet opening 28
for allowing the suspension suture 60 to pass through outlet opening 28. The distal end 34
of the second hollow tubular member 30 further includes a suture opening 38 and a conical
tip 39 being adj acent to suture opening 38. The suture opening 38 is used for receiving insert
tip 29 of distal end 24 of the first hollow tubular member 20 for forming a j oint insertion tip
40, as shown in Figure 7 of the drawings, for inserting into an incision 13.
The two component suspension suture system 60 includes a first end 62, a second end
64, and a mid-section 66. First end 62 includes a needle tip 68 fixedly attached to the first
end 62, as shown in Figure 1. The main suture 60 also includes along the mid-section 66 a
plurality of spaced-apart, movable cross sutures or suture anchors 70a, 70b, 70c, 7Od, 7Oe and main suture 60 is threaded through respective suture openings 26, 28, 38 and 36 of first and
second hollow tubular members 20 and 30, respectively, such that the needle tip 68 is
inserted in the proximal end 22 of tubular member 20 where then the needle tip 68 passes out
of the suture opening 28 at the distal end 24 of tubular member 20. The needle tip 68 is then
inserted into the opening 38 at the distal end 34 of tubular member 30 and then the needle
tip 68 passes out of the opening 36 of tubular member 30. The foregoing steps are referred
to herein as the threading operation.
A "cross suture" Or "suture anchor" is defined as a short piece of cross suture 70a or
70b connected to the main suture 60 by:
a) knots 72 on the main suture 60 being spaced apart a distance D of 10mm ± 5mm;
b) welding a short piece of cross suture 70 to the main suture 60;
c) a short piece of cross suture 70 having [ — o — ] the configuration 74 of a suture ring
76 in the center of two opposite suture pieces 78a and 78b, with the suture ring 76 having an
opening 80 for receiving the main suture 60 therethrough (See Figure 8); and
d) cross sutures or suture anchors 70a to 7Of are connected to the main suture 60 in
any of the following ways: by knots, or laser welding, or gluing G, or epoxy gluing.
diameter (1 mm ± 1 mil), and a wall thickness of 2 mils ± 0.5 mil. The second suture opening
26 has an oval shape with a width of 1 mm ± 1 mil and a length of 2 mm ± 1 mil. The second
suture opening 26 is positioned at a distance Ll of 5.5 mm ± 1 mil from the distal end 24 of
the first hollow tubular member 20.
The second hollow tubular member 30 has a length of 12 cms ± 2 cm, an 14 gauge
diameter (2 mm ± 1 mil) and a wall thickness of 2 mils ± 0.5 mil. The fourth suture opening
36 has an oval shape with a width of 1.5 mm ± 1 mil and a length of 6 mm ± 1 mil. The
fourth suture opening 36 is positioned at a distance L2 of 3 mm ± 1 mil from the distal end
34 of the second hollow tubular member 30.
The first and second hollow tubular members 20 and 30 are made from polished
stainless steel (re-sterilizeable) or from disposable (throw away) and sterilizeable hard
plastics.
The main suture 60 has a length of 40 cms ± 5 cms and a diameter of 0.2 mm ± .1 mil.
The spaced-apart, movable cross sutures 70a to 7Of have a spaced distance D of 10 mm ±
5 mm between the cross sutures 70a to 7Of. The main suture 60 is a clear 2-0 monofilament,
slow dissolving suture (comparable to a PDS) having a straight (3A inch to 1 inch) needle 68
attached thereto, or it can be a permanent suture. The new method of treating a patient 11 using cosmetic surgery is shown in Figures
1 to 5 of the drawings. The method uses the new instrument 10 of the present invention and
the new suture 60. Using the new method, the first and second hollow tubular members 20
and 30 and the suture 60 are surgically inserted under the patient's facial skin 12, and the
new method includes the following steps:
a) cutting a short single incision 13 (about 1 1A inches in length) in the patient's
facial skin 12 adjacent to the area of the ear 14;
b) threading the first and second hollow tubular members 20 and 30 with the
continuous main suture 60 having thereon a plurality of spaced-apart, movable cross sutures
or suture anchors 70a to 7Of so that the cross sutures 70a to 7Of are disposed in the second
hollow tubular member 30 with the cross sutures 70a to 7Of substantially parallel to the axis
of the second tubular member 30;
c) placing the distal 24 end of the first hollow tubular member 20 into an
opening 38 formed near the distal end 34 of the second hollow tubular member 30 so that the
first and second hollow tubular members 20 and 30 are substantially parallel to each other
and in contact with each other and thereby form an insertion tip 40 and a proximal tip 42;
d) inserting the insertion tip 40 with the threaded suture 60 through the incision
13 and under the facial skin 12, toward the patient's fold line 15 in the nasal area 16; member 20 and from the nasal area 16 and out through the single incision 13, while leaving
in place the suture 60 and the plurality of cross sutures 70a to 7Of so they are disposed in the
facial tissue and being substantially parallel to the first hollow tubular member 20 which is
still in place;
f) pulling on the proximal tip 62 of main suture 60 which is extending out of
the incision 13 in order to pull the plurality of cross sutures 70a to 7Of in the facial tissue 12
which causes the cross sutures 70a to 7Of to move from their substantially parallel
relationship to the main* suture 60 to a position which is substantially perpendicular to the
main suture 60 in order to engage and anchor the cross sutures 70a to 7Of in the facial tissue
12; the cross sutures 70a to 7Of are movable from a non-anchoring first position Pj to an
anchoring second position P2 within the facial tissue 12 of a patient 11;
g) removing the first hollow tubular member 20 from the nasal area 16 and out
through the single incision 13 while leaving in place in the facial tissue 12 the main suture
60 and the plurality of anchored cross sutures 70a to 7Of;
h) pulling and tieing off the proximal tip of the main suture 60 in the area of
the incision 13 which operates to pull the facial tissue 12 and the facial fold line 15 more
tightly in order to minimize the appearance of the facial fold line 15 in the nasal area 16; and or more additional main sutures 60' and 60" and their respective cross sutures 70a' to 7Of
and 70a" to 7Of" in the facial tissue 12 in a substantially parallel relationship to the main
suture 60 which operates to further pull the facial tissue 12 and the facial fold line 15 more
tightly in order to minimize the appearance of the facial fold line 15 in the nasal area 16.
ADVANTAGES QF THE PRESENT INVENTION
Accordingly, an advantage of the present invention is that it provides for a two
member suture instrument that allows for a single entry incision (point) in order to place a
two component suture in the facial tissue, breast tissue or buttock tissue, for use in cosmetic,
plastic, facial and reconstructive plastic surgery.
Another advantage of the present invention is that it provides for a suture instrument
having a first hollow tubular member and a second hollow tubular member for receiving the
two component suture therethrough.
Another advantage of the present invention is that it provides for a two component
suture having a main suture and a plurality of spaced-apart, movable .cross sutures thereon
that support the tissue being augmented by the surgery using the two member suture
instrument.
suspension suture wherein the multiple cross sutures move to a substantially perpendicular
position having a wider cross suture after tension is applied which engages the facial tissue
at multiple points as the tissue is being pulled to tighten it.
Another advantage of the present invention is that it provides for a two component
suspension suture wherein the main suture and cross suture system resolves existing
problems of dimpling, back slippage of thevpulled facial tissue, and/or strangulating and
cutting off the blood supply of the pulled tissue, or trapping of a nerve within the pulled
tissue when using classic suturing techniques (the suture is passed through the tissue and then
doubled back to pull the tissue up like a pulley).
Another advantage of the present invention is that it provides for a two member suture
instrument in conjunction with a two component suspension suture having a plurality of cross
sutures that can be mass produced in an automated and economical manner and is readily
affordable by patients, surgeons and hospitals.
A latitude of modification, change, and substitution is intended in the foregoing
disclosure, and in some instances, some features of the invention will be employed without
a corresponding use of other features. Accordingly, it is appropriate that the appended claims
be construed broadly and in a manner consistent with the spirit and scope of the invention
herein.

Claims

1. A method of treating a patient using cosmetic surgery, using first and second
hollow tubular members and a suture to be surgically inserted under the patient's facial skin,
including the following steps:
a) cutting a single incision in the patient' s facial skin adj acent to the area of the
ear;
b) threading the first and second hollow tubular members with a continuous
first suture having thereon a plurality of spaced-apart, movable cross sutures so that said
cross sutures are disposed in said second hollow tubular member with the cross sutures
substantially parallel to the axis of said second tubular member;
c) placing the distal end of the first hollow tubular member into an opening
formed near the distal end of the second hollow tubular member so that the first and second
hollow tubular members are substantially parallel to each other and in contact with each other
and thereby form an insertion tip and a proximal tip;
d) inserting the insertion tip with the threaded first suture through the incision
and under the facial skin, toward the patient's fold line in the nasal area;
e) removing the second hollow tubular member from the first hollow tubular
member and from the nasal area and out through the single incision, while leaving in place
the suture and the plurality of cross sutures so they are disposed in the facial tissue and being
substantially parallel to the first hollow tubular member which is still in place; incision in order to pull the plurality of cross sutures in the facial tissue which causes the
cross sutures to move from their substantially parallel relationship to the suture so that the
cross sutures under traction are moved to a position which is substantially perpendicular to
the suture in order to engage and anchor the cross sutures in the facial tissue;
g) removing the first hollow tubular member from the nasal area and out
through the single incision while leaving in place in the facial tissue the suture and the
plurality of anchored cross sutures;
h) pulling and tieing off the first suture in the area of the incision at the
proximal tip of the suture which operates to pull the facial tissue and the facial fold line more
tightly in order to minimize the appearance of the facial fold line in the nasal area; and
i) repeating steps b) through h) recited above one or more times to place one
or more additional sutures and their respective cross sutures in the facial tissue in a
substantially parallel relationship to the first suture which operates to further pull the facial
tissue and the facial fold line more tightly in order to minimize the appearance of the facial
fold line in the nasal area.
2. A method of treating a patient using cosmetic surgery in accordance with Claim 1,
wherein the step of pulling includes moving said plurality of cross sutures from a non-
anchoring position to an anchoring position within the facial tissue of a patient. tubular members and a suture to be surgically inserted under the patient's skin, including the
following steps:
a) cutting a single incision in the patient's skin;
b) threading the first and second hollow tubular members with a continuous
first suture having thereon a plurality of spaced-apart, movable cross sutures so that said
cross sutures are disposed in said second hollow tubular member with the cross sutures
substantially parallel to the axis of said second tubular member;
c) placing4 the distal end of the first hollow tubular member into an opening
formed near the distal end of the second hollow tubular member so that the first and second
hollow tubular members are substantially parallel to each other and in contact with each other
and thereby form an insertion tip and a proximal tip;
d) inserting the insertion tip with the threaded first suture through the incision
and under the skin;
e) removing the second hollow tubular member from the first hollow tubular
member and out through the single incision, while leaving in place the first suture and the
plurality of cross sutures so they are disposed in the tissue and being substantially parallel
to the first hollow tubular member which is still in place; incision in order to pull the plurality of cross sutures in the tissue which causes the cross
sutures to move from their substantially parallel relationship to the first suture so that the
cross sutures are moved to a position which is substantially perpendicular to the first suture
in order to engage and anchor the cross sutures in the tissue;
g) removing the first hollow tubular member and out through the single
incision while leaving in place in the tissue the first suture and the plurality of anchored
cross sutures;
h) pulling and tieing off the first suture in the area of the incision at the
proximal tip of the first suture which operates to pull the tissue more tightly in order to
minimize the appearance of the fold line; and
i) repeating steps b) through h) recited above one or more times to place one
or more additional sutures and their respective cross sutures in the tissue in a substantially
parallel relationship to the first suture which operates to further pull the tissue more tightly
in order to minimize the appearance of the fold line.
4. A method of treating a patient using cosmetic surgery in accordance with Claim 3,
wherein the step of pulling includes moving said plurality of cross sutures from a non-
anchoring position to an anchoring position within the tissue of a patient. surgery, comprising:
a) a first hollow tubular member having a first proximal end and a first distal
• end;
b) said first proximal end of said first hollow tubular member having a first
suture opening, and said first distal end of said first hollow tubular member having an insert
tip and a second suture opening adjacent to said insert tip;
c) said first hollow tubular member for receiving a suspension suture
therethrough; <
d) said insert tip at said first distal end of said first hollow tubular member
being offset from the longitudinal axis of said first hollow tubular member;
e) a second hollow tubular member having a second proximal end and a second
distal end;
f) said second proximal end of said second hollow tubular member having a
third suture opening, and said second distal end of said second hollow tubular member
having a conical tip and a fourth suture opening adjacent to said conical tip;
g) said second hollow tubular member for receiving said suspension suture
therethrough; tubular member for receiving said insert tip of said first distal end of said first hollow tubular
member such that said first and second hollow tubular members are substantially parallel
with each other and in contact with each other in order to form an insertion tip for inserting
into an incision in the tissue of a patient;
i) said suspension suture including a first suture end, a mid-section and a
1 second suture end;
j) said mid-section of said suspension suture having thereon a plurality of
spaced-apart, movable cross sutures; and
k) said plurality of spaced-apart, movable cross sutures being movable from
a non-anchoring first position to an anchoring second position within the tissue of a patient.
6. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said first hollow tubular member has a length of 12 cms ± 2 cms, a
diameter of 1.0 mm ± 1 mil and a wall thickness of 2.0 mils ± 0.5 mil.
7. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said second suture opening of said first hollow tubular member has an oval
shaped opening. Claim 5, wherein said second suture opening has a width of 1.0 mm ± 1 mil and a length of
2.0 mm ± 1 mil.
9. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said second suture opening is positioned at a distance of 5.5 mm ± 1 mil
from said distal end of said first hollow tubular member.
10. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said second hollow tubular member has a length of 12 cms ± 2 cms, a
diameter of 2.0 mm ± 1 mil, and a wall thickness of 2.0 mils ± 0.5 mil.
11. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said fourth suture opening of said second hollow tubular member has an
oval shaped opening.
12. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said fourth suture opening has a width of 1.5 mm ± 1 mil and a length of
6.0 mm ± 1 mil. Claim 5, wherein said fourth suture opening is positioned at a diameter of 3.0 mm ± 1 mil
from said distal end of said second hollow tubular member.
14. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said first and second hollow tubular members are made from sterilizeable
polished stainless steel.
15. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said first and second hollow tubular members are made from sterilizeable
disposable hard plastics.
16. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said distal end of said first hollow tubular member has a conically-shaped
tip.
17. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said distal end of said second hollow tubular member has a conically-
shaped tip. Claim 5, wherein said suspension suture has a length of 40 cms ± 5 cms and a diameter 0.2
mm ± 1 mil.
19. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said movable sutures have a spaced distance between said movable cross
sutures of 10 mm ± 5 mm.
20. A suture instrument in combination with a suspension suture in accordance with
Claim 5, wherein said first suture end of said suspension suture includes a detachably
connected needle.
PCT/US2006/022240 2006-06-08 2006-06-08 Suture instrument and method of suturing in cosmetic surgery WO2007145614A2 (en)

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US8652170B2 (en) 2002-08-09 2014-02-18 Ethicon, Inc. Double ended barbed suture with an intermediate body
US8734485B2 (en) 2002-09-30 2014-05-27 Ethicon, Inc. Sutures with barbs that overlap and cover projections
US8793863B2 (en) 2007-04-13 2014-08-05 Ethicon, Inc. Method and apparatus for forming retainers on a suture
US8876865B2 (en) 2008-04-15 2014-11-04 Ethicon, Inc. Self-retaining sutures with bi-directional retainers or uni-directional retainers
US8875607B2 (en) 2008-01-30 2014-11-04 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
US8916077B1 (en) 2007-12-19 2014-12-23 Ethicon, Inc. Self-retaining sutures with retainers formed from molten material
US8926659B2 (en) 2001-08-31 2015-01-06 Ethicon, Inc. Barbed suture created having barbs defined by variable-angle cut
US8932328B2 (en) 2008-11-03 2015-01-13 Ethicon, Inc. Length of self-retaining suture and method and device for using the same
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US10420546B2 (en) 2010-05-04 2019-09-24 Ethicon, Inc. Self-retaining systems having laser-cut retainers
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US10548592B2 (en) 2004-05-14 2020-02-04 Ethicon, Inc. Suture methods and devices
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US8926659B2 (en) 2001-08-31 2015-01-06 Ethicon, Inc. Barbed suture created having barbs defined by variable-angle cut
US8652170B2 (en) 2002-08-09 2014-02-18 Ethicon, Inc. Double ended barbed suture with an intermediate body
US8679158B2 (en) 2002-08-09 2014-03-25 Ethicon, Inc. Multiple suture thread configuration with an intermediate connector
US8690914B2 (en) 2002-08-09 2014-04-08 Ethicon, Inc. Suture with an intermediate barbed body
US8734485B2 (en) 2002-09-30 2014-05-27 Ethicon, Inc. Sutures with barbs that overlap and cover projections
US8795332B2 (en) 2002-09-30 2014-08-05 Ethicon, Inc. Barbed sutures
US8852232B2 (en) 2002-09-30 2014-10-07 Ethicon, Inc. Self-retaining sutures having effective holding strength and tensile strength
US9248580B2 (en) 2002-09-30 2016-02-02 Ethicon, Inc. Barb configurations for barbed sutures
US11723654B2 (en) 2004-05-14 2023-08-15 Ethicon, Inc. Suture methods and devices
US10779815B2 (en) 2004-05-14 2020-09-22 Ethicon, Inc. Suture methods and devices
US10548592B2 (en) 2004-05-14 2020-02-04 Ethicon, Inc. Suture methods and devices
US8793863B2 (en) 2007-04-13 2014-08-05 Ethicon, Inc. Method and apparatus for forming retainers on a suture
US8915943B2 (en) 2007-04-13 2014-12-23 Ethicon, Inc. Self-retaining systems for surgical procedures
US9498893B2 (en) 2007-09-27 2016-11-22 Ethicon, Inc. Self-retaining sutures including tissue retainers having improved strength
US8916077B1 (en) 2007-12-19 2014-12-23 Ethicon, Inc. Self-retaining sutures with retainers formed from molten material
US9044225B1 (en) 2007-12-20 2015-06-02 Ethicon, Inc. Composite self-retaining sutures and method
US8875607B2 (en) 2008-01-30 2014-11-04 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
US9125647B2 (en) 2008-02-21 2015-09-08 Ethicon, Inc. Method and apparatus for elevating retainers on self-retaining sutures
US8641732B1 (en) 2008-02-26 2014-02-04 Ethicon, Inc. Self-retaining suture with variable dimension filament and method
US8876865B2 (en) 2008-04-15 2014-11-04 Ethicon, Inc. Self-retaining sutures with bi-directional retainers or uni-directional retainers
US8961560B2 (en) 2008-05-16 2015-02-24 Ethicon, Inc. Bidirectional self-retaining sutures with laser-marked and/or non-laser marked indicia and methods
US8932328B2 (en) 2008-11-03 2015-01-13 Ethicon, Inc. Length of self-retaining suture and method and device for using the same
US10441270B2 (en) 2008-11-03 2019-10-15 Ethicon, Inc. Length of self-retaining suture and method and device for using the same
US11234689B2 (en) 2008-11-03 2022-02-01 Ethicon, Inc. Length of self-retaining suture and method and device for using the same
TWI601548B (en) * 2010-03-11 2017-10-11 李喜永 Injection needle for plastic surgery prefilled with surgical thread
US10420546B2 (en) 2010-05-04 2019-09-24 Ethicon, Inc. Self-retaining systems having laser-cut retainers
US10952721B2 (en) 2010-05-04 2021-03-23 Ethicon, Inc. Laser cutting system and methods for creating self-retaining sutures
US11234692B2 (en) 2010-05-04 2022-02-01 Cilag Gmbh International Self-retaining system having laser-cut retainers
US9955962B2 (en) 2010-06-11 2018-05-01 Ethicon, Inc. Suture delivery tools for endoscopic and robot-assisted surgery and methods
US11007296B2 (en) 2010-11-03 2021-05-18 Ethicon, Inc. Drug-eluting self-retaining sutures and methods relating thereto
US10492780B2 (en) 2011-03-23 2019-12-03 Ethicon, Inc. Self-retaining variable loop sutures
US11690614B2 (en) 2011-03-23 2023-07-04 Ethicon, Inc. Self-retaining variable loop sutures

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