WO2008053128A1

WO2008053128A1 - Device for linking surgical threads

Info

Publication number: WO2008053128A1
Application number: PCT/FR2007/052285
Authority: WO
Inventors: Denis Guillo
Original assignee: Denis Guillo
Priority date: 2006-10-31
Filing date: 2007-10-30
Publication date: 2008-05-08
Also published as: WO2008053128A9; FR2907658B1; FR2907658A1; EP2083707A1

Abstract

The invention relates to a device for linking surgical threads that comprises first and second passages (2, 3) each having an inlet end (4) and an outlet end 10 (6). Means for blocking (9) the threads (7) in the first and second passages (2, 3) are shaped in order to facilitate the forward sliding of the surgical thread (7) from the inlet end (4) to the outlet end (6) and to prevent any unwanted backward sliding of said surgical thread (7) from said outlet end (6) towards said inlet end (4). At the blocking means (9), the first and second passages (2, 3) each have a bend (8) formed between the inlet end (4) and the outlet end (6) so that said first and second passages (2, 3) move apart from each other between said bend (8) and the inlet end (4) when moving away form said bend (8).

Description

CONNECTING DEVICE FOR SURGICAL THREADS

The present invention relates to a device for binding together one or more surgical threads. More particularly, the invention relates to a device for connecting the strands of surgical threads by blocking them. The present invention also relates to a method of treating, correcting, repairing and / or alleviating physical defects of patients, using a bonding device for the surgical threads involved in this method.

In medicine or surgery, practitioners use surgical threads to perform sutures, bringing the two edges of the lips closer to each other and seaming a wound or incision. Another use of threads is the production of tractions of biological tissues, for example at the level of the face, so as to be able to correct or repair external body defects of patients that can be aesthetic.

These son are secured by nodes, used for example to close sutures. Practitioners have acquired habits and automatic gestures and the sutures thus made are safe and tested. The realization of the nodes represents a technically difficult step of an intervention, because a loosening of the nodes can be at the origin of serious complications, in particular by infection. The necessary multiplication of nodes significantly increases the duration of the intervention and may lead to operative or postoperative complications.

One of the difficulties in making the knots is that the practitioner must exert a tension on the thread to obtain that it wishes at the tissue before ensuring the permanent connection of the two strands of thread by making the knot . The control of the tension of the threads and the realization of the knots themselves are difficult because they must be performed most often in a confined space, which is more particularly the case in minimally invasive surgery.

A difficulty therefore is that the tension to be exerted on the son or son must be controlled, to avoid excessive tightening or conversely insufficient tightening, which would result in both cases by post-intervention complications. Clamping excessive son can cause a break in the wire itself, a pinch of biological tissue to repair or a pull beyond the defined limit to achieve the desired aesthetic effect. Such excessive tightening may result in phenomena of tissue rupture or inflammatory reaction. On the contrary, in case of insufficient tension, the junction between the tissue or the tissue and a prosthesis may be imperfect, and the suture is not waterproof or the aesthetic intervention is not successful.

PRIOR ART Various devices and accessories allowing the connection and the blocking of two or more strands of threads to replace the realization of nodes by the practitioner have been proposed.

Document US-2003 / 0.009.196 describes a device for facilitating the closure of a suture by means of a surgical wire. The device comprises a first element which snaps into a second element. The two strands of a surgical wire, having previously passed through the tissues surrounding the suture, return to the level of the wedging slot located between the first and the second element and emerge at the same slot.

However, such a device proves to be complex to use, due to the presence of two separate parts, jamming one into the other. The risk of losing one or the other parts or not completely blocking one of the strands of wire is not zero.

US-2005 / 0.288.711 discloses a device having a plurality of through holes adapted to receive a surgical wire. The wire comes in and out several times through the holes and remains locked by being held tight against the underside or the upper face of the device, between two holes.

With such a device, the practitioner will have difficulty in getting in and out the wire through the various holes and to ensure optimal tightening during the surgical operation. Once the device is pressed against the fabric, it is difficult to pull the thread through the underside and make it come out again from the top.

US-2004 / 0,260,344 discloses a device for providing a suture closure for use with a suture. The device comprises a circuit in which the suture travels. The circuit comprises two input notches located at the base of the device and two output notches located at the two small lateral sides of the device. Bocage means for the wire are formed on two notches located at the two small lateral sides.

The disadvantage of this device is to present a complex path to achieve during the surgical operation during the passage of the wire. In addition, this device is specifically reserved for closing a suture, in which the tension exerted on the wire between the two lips of this suture is small.

It is also known from US-2006 / 0.135.996 a device for attaching a suture surgical thread, not requiring binding nodes when placed inside the tissues. The device comprises a passage for the wire having anchoring means. The passage can be narrowed at these anchoring means, so as to block the wire inside the passage.

However, because of the anchoring means located at the closing passage, it will be very difficult for the practitioner to change the tightening tension once the same passage closed and the wire blocked.

In all these prior devices, it is still necessary to put the wire in tension to tighten, before connecting and / or block the two strands of wire. During this clamping step, there is no automatic control possible of the tension exerted on the wire by the practitioner. In addition, the blocking of the wires in these proposed devices is irreversible. Moreover, no retightening is possible for a new tensioning or a readjustment of the tension of the threads involved. Presentation of the invention

A main problem to be solved by the invention is to provide a connecting device for attaching a surgical wire. A second problem is to offer an alternative to the realization of nodes, which allows to facilitate the connection between strands or surgical son. A third problem is to provide a device for mechanically connecting one or more strands belonging to one or more surgical threads. A fourth problem is to provide a device that allows to block son quickly and reliably and this semi-automatically. A fifth problem is to be able to easily adjust the tension of the thread with a device, keeping a possibility of readjusting it if necessary. A sixth problem is to be able to orient and control the directions taken by the incoming and outgoing son of the device. Still another problem is that of simplifying the docking of surgical threads in biological tissues.

The invention thus relates to a connecting device for surgical threads, intended to connect a first surgical thread with a second surgical thread, comprising first and second passages, each having an entrance end and an exit end, and through which respectively pass the first and second son, and means for blocking the son, arranged at the first and second passages and shaped to facilitate any forward sliding of the surgical wire from the inlet end to the outlet end and to prevent inadvertent sliding back of said surgical wire from said output end to said input end.

According to one aspect of the present invention, the device is characterized in that, at said blocking means, the first and second passages each have a bend, located between the input end and the output end, of such that these first and second passages move apart from each other between said bend and the inlet end as one moves away from said bend.

By first and second surgical thread means one or more strands or sets of strands belonging to a single surgical thread, returning to the device after having formed a loop, or to several surgical threads, that they are of nature identical or different. In other words, the device comprises unidirectional locking means or anti-return systems for the surgical son or son provided in the two passages.

Thanks to the blocking means, the device forms a particularly interesting alternative to replace the nodes. These unidirectional locking means allow the practitioner to advance in one direction the wire at the passages. The practitioner will be able to adjust the voltage he wants and if necessary to achieve a new adjustment of the voltage, either immediately after the intervention or after a longer period. Any unwanted return of the wire to the input will be prevented.

Particularly advantageously, the exit end of the first passage may be brought closer to the exit end of the second passage. With this conformation, the first and second passages can be assembled so as to converge towards each other. This arrangement of the passages relative to each other makes it possible to orient and converge in a single zone the son passing through these passages. Thanks to the device, the lateral wires are brought back into a single beam.

In order to achieve a fairly flat device, the first and second passages may be arranged in the same plane, symmetrically relative to each other.

The first and second passages may be contiguous in parallel with each other along an area between the outlet end and the elbow. The first and second passages may be coaxially spaced from each other over an area between this bend and the inlet end, i.e. the two passages will present the same axis of revolution. The device may comprise a reinforcement zone disposed between the first and second passages, substantially at the level of the elbow.

In a particularly advantageous embodiment, the locking means may be shaped so as to facilitate any forward sliding of the surgical thread from the entry end to the exit end and also to facilitate any sliding behind this end. output to this end input, while being able to prevent inadvertent sliding back of the surgical wire from this output end to this input end.

The device may preferentially comprise coupling means, in order to make multiple mechanical connections. These coupling means may be able to cooperate with complementary coupling means provided on a second connecting device for surgical threads, substantially similar to that described, and intended to connect a first surgical wire with a second surgical wire.

The coupling means may be formed with a male piece, located at the level of the reinforcing zone of a first device, adapted to engage with a female part situated at the level of the reinforcing zone of a second device. Both devices can then have a back-to-back arrangement.

The coupling means may be formed with a male piece, located at the outlet end, adapted to engage with a female part located at the level of the reinforcing zone. The two devices can then be arranged in line, one behind the other.

In another embodiment, the device may comprise a plurality of first passages arranged parallel to each other and several second passages, arranged parallel to each other.

The device can be made of a bio-compatible material, so that it can be implanted subcutaneously and remain in place in the body of the patient. In order to be introduced into a small incision made by the practitioner, the device can be favorably made of a material having flexibility capabilities.

The device may include a registration element, preferably positioned at the reinforcement zone. This element can be radiopaque, in order to be identified by medical imaging techniques, such as X-rays. To prevent rejection by the patient's immune defenses, the device can be covered by an encapsulation material, preferably selected from the group comprising silicones.

Brief description of the figures The invention will be better understood and its various advantages and different characteristics will become more apparent in the following description, of the non-limiting example of embodiment, with reference to the appended diagrammatic drawings, in which: FIG. plane of a connecting device for surgical son according to the invention; - Figures 2 to 4 each show a partial sectional view of a connecting device with three different locking means; Figures 5 and 6 each show a plan view of a different assembly of two connecting devices; Figure 7 shows a plan view of a connecting device in a second embodiment; Figure 8 shows a partial plan view of a connecting device incorporating a registration element, visible by transparency; Figure 9 shows a partial plan view of a connecting device in a third embodiment; - Figure 10 shows three possibilities of use of the connecting device; and Figures 11 to 15 each represent a perspective view of body parts of a patient, showing the path of the different surgical threads, according to five variants of a treatment, repair, correction and / or attenuation method. default.

Detailed description of the invention

As shown in FIG. 1, a surgical thread binding device (1) is an integral piece, which comprises two passages in the form of two small tubes (2 and 3). The two tubes (2 and 3) have a substantially equal length. Each of these two tubes (2 and 3) has an inlet end (4) and an outlet end (6). The practitioner introduces (see FIGS. 9 and 10 to 15) the surgical thread or threads (7) through the inlet ends (4) of the two tubes (2 and 3) and brings them out by the exit ends (6). two tubes (2 and 3). The two tubes (2 and 3) are arranged symmetrically in mirror relation to each other, on either side of a median plane (M). The two inlet ends (4) and the two outlet ends (6) are located in a single plane and the two tubes (2 and 3) are in this same plane, perpendicular to the median plane (M), conferring on the connecting device (1) a generally flat conformation that is accompanied by a very small footprint of this connecting device (1) and makes it possible to install it easily subcutaneously, within the body of the patient.

The two tubes (2 and 3) are secured to one another, so as to converge one towards the other, giving the connecting device (1) a generally triangular shape. The two inlet ends (4) are spaced from each other and the two outlet ends (6) are then in close proximity to one another.

The two tubes (2 and 3) each have a bend (8), placed generally at a position closer to the inlet end (4) than the outlet end (6).

Between the inlet end (4) and the elbow (8), the two tubes (2 and 3) are configured to diverge relative to each other at an angle substantially equal to 180 °. The two tubes (2 and 3) are located on the same axis of revolution (R), at the two inlet ends (4). The two inlet ends (4) thus open opposite each other in a plane substantially perpendicular to the axis of revolution (R).

Between the bend (8) and the outlet end (6), the two tubes (2 and 3) are contiguous to each other along the median plane (M). Both exit ends (6) open contiguously in a plane substantially perpendicular to the median plane (M). At these two outlet ends (6), the two tubes (2 and 3) open on the same side, substantially in the same direction, which has the particular advantage of greatly facilitating the adjustment of the voltage of or surgical threads (7). The elbow (8) thus allows the two tubes (2 and 3), and consequently the inserted surgical son (7), to bend their direction. The inserted surgical threads (7) arrive in the device (1) opposite each other and emerge from the device (1) one beside the other, thus being connected. For example, the two tubes (2 and 3) have an unfolded length substantially between 20mm and 40mm, for example between 30mm and 40mm. The two tubes (2 and 3) have a diameter substantially equal to 0.5 mm.

The device (1) comprises means (9) for locking the surgical threads (7), which are suture threads adapted to exert traction on the flesh, for example so as to keep a wound closed until it heals. or in the context of a cosmetic surgery operation such as those described in the following.

These locking means (9) have been formed inside each of the two tubes (2 and

3). Surgical son (7) introduced into each of the two tubes (2 and 3) will engage with the locking means (9). The surgical threads (7) will be locked at this point by the locking means (9) present. Thanks to the locking means (9) present in the device (1), the practitioner no longer needs to make knots with the surgical threads (7).

According to the invention, the locking means (9) have a conformation such that they prevent any return back of the introduced son (7). The progression of the surgical wire (7) inside the tube (2 or 3) is only in the direction, from the input end (4) to the output end (6). Any advancement of the surgical wire (7) within the tube (2 or 3) in the direction from the exit end (6) to the entry end (4), i.e. any return is prevented by these locking means (9).

Used for a patient internally or externally, the device (1) will behave similarly to a surgical thread node (7). The device will also have the advantage of being able to allow one or more new adjustments of the tension of these surgical threads (7), if the practitioner deems it necessary, to tighten or remove biological tissue or to tighten a suture of a wound or incision. In this respect, it should be noted that only one of the two surgical wires can be pulled. passing through the tubes (2 and 3), leaving the other surgical thread blocked, which offers great flexibility in operation while allowing multiple successive corrections and high accuracy in the voltage settings.

In a first embodiment (see Figure 2), the locking means (9) comprise a plurality of lateral fins (11) arranged behind each other at regular intervals, inside the tube (2 or 3). The fins (11) deploy from the inner face of the wall (12) of the tube (2 or 3). The fins (11) extend from the inner side formed by the bend (8), are substantially oriented towards the opposite outer side formed by the bend (8), while being inclined towards the outlet end (6).

In a second embodiment (see Figure 3), the locking means (9) comprise a plurality of lateral fins (13) arranged behind each other at regular intervals, inside the tube (2 or 3). The fins (13) deploy from the inner face of the wall (12) of the tube (2 or 3). The fins (13) are grouped in pairs, a first fin being directly opposite to a second fin. The first wing starts from the inner side formed by the bend (8), being substantially oriented towards the opposite outer side formed by the bend (8). And the second wing starts from the outer side formed by the bend (8), being substantially oriented towards the opposite inner side formed by the bend (8). The fins (13) are perpendicular to the tangent respectively to the inner side or to the outer side formed by the bend (8).

In a third embodiment (see FIG. 4), the locking means (9) comprise a plurality of lateral fins (14) arranged behind one another at regular intervals inside the tube (2 or 3). The fins (14) deploy from the inner face of the wall (12) of the tube (2 or 3). The fins (14) are grouped in pairs, a first fin being directly opposite to a second fin. The first vane starts from the inner side formed by the bend (8), is substantially oriented towards the outer side formed by the bend (8), while being inclined towards the outlet end (6). And the second fin leaves the outer side formed by the bend (8), is substantially oriented towards the inner side formed by the bend (8), while being inclined towards the outlet end (6). The pairs of fins (14) form successive retreints. A series of nodules, nodes, or growths (15) may be present (see Figure 8) at regular intervals on the surgical wire (7). These protuberances may have a conical shape, so as to facilitate the advance of the surgical wire (7), but to block its return.

In the three embodiments, and when the surgical wire (7) is pulled (Arrows D in Figure 10) towards the outlet end (6), the protuberances (15) will successively pass the fins (11, 12 or 13) of the three embodiments of the locking means (9). To do this, the fins (11, 13 and 14) have a capacity of flexibility, so as to be folded towards the outlet end (6) and against the wall (12). Due to the inclination of the fins (11, 13 and 14), the protuberances (15) will abut against these fins (11, 13 and 14) and remain firmly attached to it, blocking the surgical wire (7), when the practitioner found the optimal tension.

A variant of the third embodiment of the locking means, a series of funnels or perforated membranes are arranged behind each other at regular intervals, inside the tube (2 or 3). The center of the membranes is pierced with an orifice having a diameter slightly smaller than the average diameter of the protuberances (15) of the surgical wire (17), in order to obtain a locking of the latter, substantially similar to that obtained with the fins (11, 13 and 14).

In order to ensure a rigidity of the two tubes (2 and 3) relative to each other, the device (1) comprises a reinforcing zone (16). The reinforcing zone (16) is provided at the elbow (8) of each of the tubes (2 and 3) and is distributed on either side of the median plane (M). The reinforcing zone (16) is in the form of a plate, reported or not, substantially triangular, or is formed from a surplus of the material constituting the tubes (2 and 3).

The reinforcement zone (16) begins as soon as the two tubes (2 and 3) are no longer joined to each other. This reinforcing zone (16) terminates parallel to the axis of revolution (R) of the two inlet ends (4), for example in the continuity of the wall (12) of the tubes (2 and 3). Two devices (1 and 17) can be assembled to one another, in order to multiply the possibilities of surgical thread connections (7). To achieve these assemblies, each of the two devices (1 and 17) comprise coupling means (18).

To perform a first assembly (see Figure 5), one of the devices (1) comprises a male coupling part, in the form of a protuberance or rod (19), located on the median plane (M ) between the two outlet ends (6) of the two tubes (2 and 3). The rod (19) protrudes beyond the two outlet ends (6) in the extension of the two tubes (2 and 3).

The other of the devices (17) comprises a female coupling part complementary to the male part, in the form of a recess or a cutout (21), located on the median plane (M) in the reinforcement zone (16) between the two tubes (2 and 3). The cutout (21) sinks into the reinforcing zone (16) towards the two exit ends (6). The rod (19) thus enters the cutout (21), which firmly secures the two devices (1 and 17) one behind the other.

To make a second assembly (see Figure 6), a male coupling portion is used in the form of an insert key (22). As for the first assembly described above, the two devices (1 and 17) comprise the complementary coupling female part of the male part, in the form of the recess or the cutout (21). The key (22) thus enters the cutout (21) of each of the two devices (1 and 17), which firmly secures the two devices (1 and 17), one being returned relative to the other.

For the first assembly and the second assembly, the male coupling portion (19 or 22) may have a predetermined length, which will allow the associated device (17) to be maintained at a selected variable distance.

In a second embodiment (see Figure 7), a surgical wire bonding device (23) comprises four passages, in the form of four small tubes (2, 3, 24 and 26). Two first tubes (2 and 3) are similar to the two tubes described for the main embodiment of the device (1) already presented below. above. Two second additional tubes added (24 and 26) are respectively arranged parallel to the first two tubes (2 and 3).

The inlet ends (4) of the four tubes (2 and 3) open in the same plane. The outlet ends (6) of the first two tubes (2 and 3) open in a first plane, and the outlet ends (6) of the two second tubes (24 and 26) open in a second plane, offset in the foreground. The second two tubes (24 and 26) are longer than the first two tubes (2 and 3).

As shown in Figure 8, the device (1) includes a registration element

X-ray opaque (27) molded into the material of the reinforcing zone (16) to be able to be identified after intervention. The registration element (27) has a precise shape, here inverted T, and gives the practitioner information, both from the point of view of the position of the device (1), as from the point of view of its orientation. This registration element (27) is identifiable by a medical imaging technique, such as X-rays, and is useful to the practitioner, especially if it is necessary to consider an explantation of the device (1).

In a third embodiment (see Figure 9), a surgical wire bonding device (28) includes specific locking means (29), which facilitates the voluntary advance and retraction of the surgical wire (7). At their outlet end (6), and in the rectilinear part located side by side and in parallel, the two tubes (2) are formed with two parallel housings (31 and 32).

The first housing (31) is intended for the circulation of the thread (7) with nodules (15). The diameter of the first housing (31) is substantially equivalent to the diameter of the nodules (15).

The second housing is formed by a female hollow cylindrical piece (32) receiving a coaxial male worm cylinder (33) with a tight pitch. The pitch of the male cylinder of this worm (33) is chosen so that the nodules (15) of the wire (7) are placed between the threads. The hollow cylindrical female part (32) is provided with a slot or a notch opening into the first housing (31). The male cylinder (33) is easily rotated by the practitioner. Nodules

(15) of the thread (7) pass through the notch, are wedged between the threads progress longitudinally, at the same time that the male cylinder (33) rotates. Rotation in one direction or in the opposite direction thus makes it possible to advance or retreat (Arrow D) the nodules (15) and consequently the wire (7).

The practitioner has a hand tool (34) for rotating the male cylinder (33). The tool (34) comprises a handle (36) mechanically connected to a key (37) by a hose (38). The key (37) is introduced (Arrow I) in a recess (39) coaxially arranged (shown in dotted lines) in the male cylinder (33). A guide funnel located at the mouth of the cavity (39) facilitates the arrival of the key (37) in the male cylinder (33). The practitioner prints a manual rotation (arrows R), in one direction or another, to the handle (36), which rotates (arrows T) the key (37) in the same direction.

The device (1, 17, 23 and 28) is made of a biocompatible material. The device (1) is covered by an encapsulating material (41), for example silicone (shown in dotted lines in FIGS. 8 and 9).

The device (1) can be used in minimally invasive surgery by being introduced by means of a hollow cylindrical instrument called trocar, by cutaneous and parietal incisions of reduced size. As another use, the device is implantable subcutaneously. An additional cutaneous section is made in order to insert the key (37) to rotate the male cylinder (33) of the device (28) according to the third embodiment.

In order to be introduced by small size incisions and to be able to adapt to any type of implantation configuration, the device (1) is made of a flexible material. Even when this is the case, the tension in the surgical thread (s) (7) does not lead to an uprighting of the elbows (8), because the efforts tending to such an uprighting within the tube (2) and those within the tube (3) compensate each other thanks to the particular arrangement of these tubes (2 and 3) relative to each other. As shown in Figures 10 to 15, several uses are possible for the connecting device (1), for example for aesthetic procedures. The device (1) serves to link (left of Figure 10) a surgical wire (7) provided with nodes (15). By a loop (42) located at one of its free ends, this surgical thread (7) provides traction of secondary son (43). The ends of the secondary wires (43) are provided with barbs or teeth (44). These secondary toothed wires (43) are used to hook and lift tissue by pulling (see also Figures 9 and 10).

The device (1) serves to bind (central portion of Figure 10) a continuous surgical wire (45), one end of which is provided with nodes (15) and whose other free end is furnished with barbs or teeth (44). This form of yarn (7) is preferable because it gives directly and without intermediate access to tensile barbules or teeth (44) and biological tissue and hooked.

The device (1) serves to link (right side of Figure 10) a surgical wire (7) provided with nodes (15). By a first loop (42) located at one of its free ends, the surgical thread (7) serves to provide traction of a second so-called ring loop (46). This second loop (46) serves to shorten, densify and redistribute collapsed tissue (see also Figures 12 to 15).

Several methods in which the connecting device for surgical threads (1, 17, 23 and 28), according to the invention, described above, is used and implanted by a practitioner, will be described below. A method of treating, repairing, correcting and / or alleviating aesthetic defects (see Figures 11-15), includes the steps of:

(a) practicing at least two ports through the patient's skin;

(b) releasing a stripper from a first port to a second port;

(c) capturing the surgical wire (7 and / or 45) with the stripper and bringing it to the second port;

(d) introducing into the orifice the connecting device for surgical threads (1, 17, 23 and 28); (e) passing the surgical thread (7 and / or 45) into the connecting device (1, 17, 23 or 28); and

(f) adjusting the tightening of the surgical thread (7 and / or 45) so as to tension the biological tissues with the aid of the thread (7 and / or 45).

A first variant (Figures 11 and 12) of the method for treating, repairing, correcting and / or alleviating cosmetic defects, applicable to the human face (47), comprises the steps of:

(A) providing at least one apical (48), lateral (49), lateral temporal (51) and / or lateral zygomatic (52) aperture;

(B) releasing the lateral orifice (49, 51 and / or 52) to the apical orifice (41), at a subgaleal depth;

(C) forming and capturing the high loop formed by the upper surgical wire (7), with the stripper and bringing it to the lateral port (49, 51 and / or 52); (D) symmetrizing, on either side of the face (47);

(E) introducing into the apical orifice (48) the connecting device for surgical threads (1);

(F) adjust the high loop;

(G) implanting the lower gear (43) with a hollow needle introduced through the side port (49, 51 and / or 52);

(H) joining the lower gear (43) to the high loop; and (I) adjusting the tightening of the high surgical thread (7) so as to tension the biological tissue passed through and attached by the lower toothed wire (43).

A second variant (FIG. 12) of the method for treating, repairing, correcting and / or attenuating aesthetic defects, applicable to the human face (47), repeats the steps (A) to (F) described above. , and includes the following steps:

(G ') implanting the lower loop (46) with a needle, if necessary circular, introduced through the lateral orifice (49, 51 and / or 52);

(H ') to make a junction between the lower loop (46) and the high loop; and (F) adjusting the tightening of the high surgical thread (7) so as to encircle the biological tissues passed through and held by this lower loop (46).

Claims

A surgical wire connection device for connecting a first surgical wire (7) with a second surgical wire (7), comprising first and second passages (2, 3), each having an entrance end (4). and an outlet end (6), and through which pass respectively the first and second wires (7), and locking means (9) of the wires (7), arranged at the first and second passages (2, 3 ) and shaped to facilitate any forward sliding of the surgical thread (7) from the entry end (4) to the exit end

(6) and to prevent inadvertent sliding back of said surgical wire

(7) from said outlet end (6) towards said inlet end (4), characterized in that, at said blocking means (9), the first and second passages (2, 3) each have an elbow (8), located between the inlet end (4) and the outlet end (6), such that these first and second passages

(2, 3) deviate from each other between said bend (8) and the inlet end (4) as one moves away from said bend (8).

2. Device according to claim 1, characterized in that the two inlet ends (4) are spaced apart from each other and the two outlet ends (6) are close to one another, the first and second passages (2, 3) being convergently connected to one another.

3. Device according to claim 1 or 2, characterized in that the first and second passages (2, 3) are arranged in the same plane (M), symmetrically relative to each other.

4. Device according to any one of the preceding claims, characterized in that each of the first and second passages is formed by a bent tube (2, 3).

5. Device according to any one of the preceding claims, characterized in that the first and second passages (2, 3) are contiguous in parallel one to the other between the outlet end (6) and the elbow (8), and in that the first and second passages (2, 3) are coaxially spaced apart from each other ( 8) and the input end (4).

6. Device according to any one of the preceding claims, characterized in that it comprises a reinforcing zone (16) disposed between the first and second passages (2, 3), substantially at the elbow (8).

7. Device according to any one of the preceding claims, characterized in that the locking means (29) are shaped to facilitate any forward sliding of the surgical wire (7) of the inlet end (4) towards the outlet end (6) and to facilitate any sliding back of said outlet end (6) towards said inlet end (4), while preventing any inadvertent sliding back of said surgical wire from said exit end (6) towards said input end (4).

8. Device according to any one of the preceding claims, characterized in that it comprises coupling means (19), adapted to cooperate with complementary coupling means (21), provided on a second connecting device for substantially similar surgical threads (17).

9. Device according to claim 8, characterized in that the coupling means are formed with a male piece (19, 22) situated at the level of the reinforcement zone (16) or at the exit end ( 6), and adapted to engage with a female part (21) located at the level of the reinforcing zone

(16).

10. Device according to any one of the preceding claims, characterized in that it comprises a plurality of first and second passages (2, 3, 24, 26), arranged parallel to each other.

11. Device according to any one of the preceding claims, characterized in that it is made of a biocompatible material, so as to be implanted subcutaneously.

12. Device according to any one of the preceding claims, characterized in that it is made of a material having flexibility capabilities.

13. Device according to any one of claims 6 to 12, characterized in that it comprises a locating element, preferably positioned at the reinforcing zone (16).

14. Device according to any one of the preceding claims, characterized in that it is covered by an encapsulating material, preferably selected from the group comprising silicones.