# US 10,245,138 B2 · Methods and apparatus for delivering and positioning sheet-like materials in surgery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,245,138 B2 - Document ID: US10245138B2 - Status: Granted - Kind: B2 - Application number: 14/939,517 - Filed: 2015-11-12 - Published: 2016-03-03 - Granted: 2019-04-02 - Earliest claimed: 2011-12-29 - Assignees: Rotation Medical, Inc. - Applicants: Rotation Medical, Inc. - Inventors: Charles L. Euteneuer; Nathaniel Z. Zenz-Olson; John Quackenbush; Jeff Sims - Web page: https://patentgrep.com/patent/US10245138B2 ## CPC - A61F 2/0805: {Implements for inserting tendons or ligaments} - A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers} - A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes} - A61F 2/0811: {Fixation devices for tendons or ligaments} - A61F 2/40: for shoulders - A61B 2090/061: {for measuring dimensions, e.g. length} - A61B 2090/0817: {Spatulas or spatula like extensions} - A61B 2090/3908: {Soft tissue, e.g. breast tissue} - A61B 2090/3937: {Visible markers} - A61F 2/08: Muscles; Tendons; Ligaments - A61F 2002/0072: {Delivery tools therefor} - A61F 2002/0864: {Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon} - F04C 2270/0421: Controlled or regulated - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - F04C: ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS (engines F03C); ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS ## Abstract An implant delivery system for delivering a sheet-like implant is disclosed. The implant delivery system includes a distal guidewire port for receiving the proximal end of guidewire after the guidewire distal end has been affixed to a first point on bone or other tissue. The implant delivery system is tracked over the guidewire to a selected position defined by the guidewire attachment. The device includes an implant spreader assembly disposed proximate the distal end of a delivery shaft. The implant spreader assembly includes a first arm and a second arm. The arms are coupled to the delivery shaft such that the first arm and second arm are moveable between a closed position and an open position. When pivoting to the open position the distal end of each arm travels in a generally transverse direction to spread a sheet-like implant. ## Claims ### Claim 1 A method of attaching a sheet-like implant over a tendon treatment site comprising: attaching a marker proximate the tendon treatment site; thereafter, advancing an implant delivery system to the tendon treatment site; deploying a sheet-like implant from the implant delivery system at the tendon treatment site; aligning a peripheral edge of the sheet-like implant laterally adjacent to the marker, wherein the marker does not penetrate the sheet-like implant; and attaching the sheet-like implant to a tendon of the tendon treatment site. ### Claim 2 (depends on 1) The method of claim 1, further comprising: attaching a second marker proximate the tendon treatment site. ### Claim 3 (depends on 2) The method of claim 2, further comprising: aligning the edge of the sheet-like implant alongside the second marker. ### Claim 4 (depends on 1) The method of claim 1, wherein the marker is attached to the tendon. ### Claim 5 (depends on 4) The method of claim 4, further comprising: inserting the marker through the tendon. ### Claim 6 (depends on 1) The method of claim 1, wherein the tendon is a supraspinatus tendon. ### Claim 7 (depends on 6) The method of claim 6, wherein the marker is attached adjacent to a biceps tendon. ### Claim 8 (depends on 7) The method of claim 7, wherein the marker includes a plurality of flexible arms located at a distal end of the marker. ### Claim 9 (depends on 8) The method of claim 8, wherein the plurality of flexible arms are positioned on an articular side of the supraspinatus tendon. ### Claim 10 (depends on 7) The method of claim 7, further comprising: inserting the marker through the supraspinatus tendon. ### Claim 11 (depends on 10) The method of claim 10, wherein the marker is inserted through the supraspinatus tendon while viewing an articular side of the supraspinatus tendon. ### Claim 12 A method of attaching a sheet-like implant over a tendon treatment site comprising: identifying an edge of the tendon treatment site for attachment of the sheet-like implant; identifying a first marker attachment point at the identified edge of the tendon treatment site; attaching a distal end of a marker at the first marker attachment point; thereafter, advancing an implant delivery system to the tendon treatment site; deploying a sheet-like implant from the implant delivery system at the tendon treatment site; and attaching the sheet-like implant to a tendon of the tendon treatment site with a peripheral edge of the sheet-like implant adjacent to the marker, wherein the marker does not penetrate the sheet-like implant. ### Claim 13 (depends on 12) The method of claim 12, wherein the marker is attached to the tendon. ### Claim 14 (depends on 13) The method of claim 13, wherein the tendon is a supraspinatus tendon. ### Claim 15 (depends on 14) The method of claim 14, further comprising: inserting the marker through the supraspinatus tendon. ### Claim 16 (depends on 15) The method of claim 15, wherein the marker is inserted through the supraspinatus tendon while viewing an articular side of the supraspinatus tendon. ### Claim 17 (depends on 16) The method of claim 16, further comprising: deploying a plurality of flexible arms of the marker on the articular side of the supraspinatus tendon. ### Claim 18 (depends on 12) The method of claim 12, further comprising rotating the sheet-like implant after deployment to align the edge of the sheet-like implant with marker. ### Claim 19 (depends on 18) The method of claim 18, wherein the sheet-like implant is rotated about a fixed pivot point. ### Claim 20 (depends on 12) The method of claim 12, further comprising: identifying a second marker attachment point at the identified edge of the tendon treatment site spaced apart from the first marker attachment point; attaching a distal end of a second marker at the second marker attachment point; and aligning the edge of the sheet-like implant alongside the second marker, wherein the second marker does not penetrate the sheet-like implant.