# US 6,056,772 A · Method and apparatus for positioning a suture anchor > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 6,056,772 A - Document ID: US6056772A - Status: Granted - Kind: A - Application number: 09/084,627 - Filed: 1998-05-26 - Granted: 2000-05-02 - Earliest claimed: 1995-06-06 - Inventors: Peter M. Bonutti - Web page: https://patentgrep.com/patent/US6056772A ## CPC - A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)} - A61B 17/3439: {with means for changing the inner diameter of the cannula, e.g. expandable (A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662)} - A61M 25/0084: {being one or more injection needles} - A61M 25/04: in the body, e.g. expansible {(A61M25/10, A61M16/0488 take precedence)} - A61M 25/06: Body-piercing guide needles or the like - A61M 25/0662: {Guide tubes} - A61B 17/06066: {Needles, e.g. needle tip configurations} - A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)} - A61B 17/3431: {being collapsible, e.g. made of thin flexible material (A61B17/3423 takes precedence)} - A61B 2017/0409: {Instruments for applying suture anchors} - A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening} - A61B 2017/0417: {T-fasteners} - A61B 2017/06052: {Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle} - A61B 2017/3486: {Balloon} - A61M 2025/0024: {Expandable catheters or sheaths} - A61M 2025/0089: {Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip} - A61M 2025/0095: {being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract An inserter assembly is operable between a closed condition blocking movement of a suture anchor through the inserter assembly and an open condition in which the inserter assembly is ineffective to block movement of the anchor. The inserter assembly may have an end portion which pierces body tissue. In one embodiment, a tubular member has a plurality of segments which are moved from a closed condition to an open condition. In another embodiment, a plurality of wires extend along an inner side of a passage in a sheath. As the suture anchor slides along the wires, force is transmitted to the sheath to expand the sheath and operate the inserter assembly from the closed condition to the open condition. If desired, the wires may be omitted and the sheath resiliently expanded by a member which encloses the suture anchor. Indicia may be provided to indicate the depth to which the inserter assembly is inserted into body tissue. ## Claims ### Claim 1 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, positioning an end portion of a tubular member having a sheath which encloses a plurality of wires relative to body tissue, and moving the suture anchor through the end portion of the tubular member into the body tissue with the suture engaging the suture anchor, said step of moving the suture anchor through the end portion of the tubular member into the body tissue includes sliding an outer side surface of the suture anchor along side surfaces of the wires. ### Claim 2 (depends on 1) A method as set forth in claim 1 wherein said step of positioning an end portion of a tubular member having a sheath which encloses a plurality of wires relative to body tissue includes engaging the body tissue with a leading end portion of at least one of the wires and a leading end portion of the sheath and piercing the body tissue with the leading end portion of the one wire and the sheath under the influence of force transmitted through the tubular member. ### Claim 3 (depends on 1) A method as set forth in claim 1 wherein said step of moving the suture anchor through the end portion of the tubular member into the body tissue includes transmitting force from the suture anchor to the side surfaces of the wires and expanding the sheath under the influence of the force transmitted from the suture anchor to the wires. ### Claim 4 (depends on 1) A method as set forth in claim 1 wherein said step of moving the suture anchor through the end portion of the tubular member includes maintaining the outer side surface of the suture anchor in a spaced apart relationship with an inner side surface of the sheath while sliding the suture anchor along side surfaces of the wires. ### Claim 5 (depends on 1) A method as set forth in claim 1 wherein said step of moving the suture anchor through the end portion of the tubular member includes holding longitudinally extending portions of an inner side surface of the sheath spaced apart from an outer side surface of the suture anchor as the suture anchor moves through the end portion of the tubular member. ### Claim 6 (depends on 1) A method as set forth in claim 1 further including moving the suture anchor along a main portion of the tubular member connected with the end portion of the tubular member prior to moving the suture anchor through the end portion of the tubular member, at least a portion of said step of moving the suture anchor along a main portion of the tubular member includes engaging side surfaces of portions of the wires with the suture anchor. ### Claim 7 (depends on 6) A method as set forth in claim 6 wherein the main portion of the tubular member has a first cross-sectional area as viewed in a plane extending perpendicular to a longitudinal central axis of the tubular member and the end portion of the tubular member has a second cross-sectional area as viewed in a plane extending perpendicular to a longitudinal central axis of the tubular member, the first cross-sectional area being greater than the second cross-sectional area, said step of moving the suture anchor through the end portion of the tubular member includes increasing the cross-sectional area of the end portion of the tubular member from the second cross-sectional area to a cross-sectional area which is greater than the second cross-sectional area. ### Claim 8 (depends on 1) A method as set forth in claim 1 wherein the tubular member has a main portion with a first cross-sectional area as viewed in a plane extending perpendicular to a longitudinal central axis of the tubular member, the end portion of the tubular member has a cross-sectional area which is smaller than the first cross-sectional area as viewed in a plane extending perpendicular to the longitudinal central axis of the tubular member, and a transition portion of the tubular member has a cross-sectional area which tapers from the first cross-sectional area to the second cross-sectional area, said method further including moving a leading end portion of the suture anchor along the side surfaces of the wires in the transition portion of the tubular member and expanding at least a portion of the transition portion of the tubular member under the influence of force transmitted to the side surfaces of the wires in the transition portion of the tubular member. ### Claim 9 (depends on 1) A method as set forth in claim 1 wherein said step of positioning an end portion of a tubular member relative to body tissue includes inserting the end portion of the tubular member into body tissue, measuring the distance which the end portion of the tubular member is inserted into body tissue during insertion of the end portion of the tubular member into body tissue, and interrupting said step of inserting an end portion of the tubular member into body tissue in response to measuring of a distance which corresponds to a desired distance of insertion of the tubular member into body tissue. ### Claim 10 (depends on 1) A method as set forth in claim 1 wherein said step of positioning an end portion of a tubular member relative to body tissue includes inserting the end portion of the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 11 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor which has a passage, providing a suture having a first portion which extends through the passage in the suture anchor and a second portion which extends along an outer side of the suture anchor, providing a tubular member having a sheath with a plurality of wires which extend along an inner side of at least a portion of a passage in the sheath, and moving the anchor along the passage in the sheath, said step of moving the anchor along the passage in the sheath being at least partially performed with the first portion of the suture extending through the passage in the suture anchor and the second portion of the suture extending along the outer side surface of the suture anchor at a location between adjacent wires of the plurality of wires. ### Claim 12 (depends on 11) A method as set forth in claim 11 wherein said step of moving the suture anchor along the passage in the sheath includes sliding an outer side surface of the suture anchor along side surfaces of the wires. ### Claim 13 (depends on 11) A method as set forth in claim 11 wherein said step of moving the anchor along the passage in the sheath includes applying force against a trailing end portion of the anchor with a pusher member and applying force against the wires with a leading end portion of the anchor to expand the passage in the sheath. ### Claim 14 (depends on 11) A method as set forth in claim 11 further including the steps of inserting at least a portion of the tubular member into body tissue and piercing the body tissue with the tubular member. ### Claim 15 (depends on 14) A method as set forth in claim 14 wherein said step of piercing the body tissue includes engaging the body tissue with a leading end portion of at least one of the wires and a leading end portion of the sheath. ### Claim 16 (depends on 11) A method as set forth in claim 11 further including the steps of inserting at least a portion of the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 17 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a tubular sheath having a passage and a plurality of wires which extend along an inner side of the passage, inserting an end portion of the sheath and end portions of the wires into body tissue, and moving a suture anchor through the passage in the sheath into the body tissue with a suture engaging the suture anchor, said step of moving the suture anchor through the passage in the sheath into body tissue includes expanding the sheath by applying force against the wires and transmitting force through the wires to the sheath. ### Claim 18 (depends on 17) A method as set forth in claim 17 wherein said step of expanding the sheath includes increasing a cross-sectional size of at least a portion of the passage in the sheath from a first cross-sectional size in which movement of the anchor through at least the portion of the passage in the sheath is blocked to a second cross-sectional size in which the anchor can move through the portion of the passage in the sheath. ### Claim 19 (depends on 17) A method as set forth in claim 17 wherein said step of applying force against the wires includes pressing an outer side surface of the suture anchor against the wires. ### Claim 20 (depends on 17) A method as set forth in claim 17 further including the step of at least partially enclosing the suture anchor with an expansion member during movement of the anchor through the passage in the sheath, said step of applying force against the wires includes pressing an outer side surface of the expansion member against the wires. ### Claim 21 (depends on 17) A method as set forth in claim 17 wherein said step of inserting an end portion of the sheath and end portions of the wires into body tissue includes piercing the body tissue to form an opening in the body tissue and moving the end portion of the sheath and end portions of the wires into the opening in the body tissue. ### Claim 22 (depends on 21) A method as set forth in claim 21 wherein said step of piercing the body tissue to form an opening in the body tissue includes cutting body tissue with a leading end portion of the sheath. ### Claim 23 (depends on 21) A method as set forth in claim 21 wherein said step of piercing the body tissue includes engaging the body tissue with a leading end portion of a t least one of the wires and a leading end portion of the sheath. ### Claim 24 (depends on 21) A method as set forth in claim 21 wherein said step of piercing the body tissue includes initiating the formation of an opening in an imperforate surface area on the body tissue. ### Claim 25 (depends on 17) A method as set forth in claim 17 wherein said step of inserting an end portion of a tubular sheath into body tissue includes covering indicia on the tubular sheath with body tissue as the tubular sheath is inserted into the body tissue, and interrupting said step of inserting the tubular sheath into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular sheath into body tissue. ### Claim 26 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a tubular sheath having a passage which extends through the sheath, inserting an end portion of the sheath into body tissue, expanding the end portion of the sheath inserted into the body tissue, said step of expanding the end portion of the sheath includes moving a tubular member cross-sectional size of the end portion of the sheath from a first cross-sectional size to a second cross-sectional size under the influence of force transmitted from the tubular member to the sheath, and moving a suture anchor through the tubular member into the body tissue while the end portion of the sheath has the second cross-sectional size. ### Claim 27 (depends on 26) A method as set forth in claim 26 wherein said step of inserting an end portion of the sheath into body tissue includes piercing the body tissue with the end portion of the sheath and moving the end portion of the sheath into the body tissue. ### Claim 28 (depends on 26) A method as set forth in claim 26 wherein said step of increasing the cross-sectional size of the end portion of the sheath from a first cross-sectional size to a second cross-sectional size under the influence of force transmitted from the tubular member to the sheath includes transmitting force from the tubular member to the outer side surfaces of the wires and transmitting force from the wires to the sheath. ### Claim 29 (depends on 26) A method as set forth in claim 26 wherein said step of inserting an end portion of the sheath into body tissue includes covering indicia on the sheath with body tissue as the sheath is inserted into the body tissue, and interrupting said step of inserting the sheath into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the sheath into body tissue. ### Claim 30 An apparatus for use in positioning a suture anchor relative to body tissue, said apparatus comprising a tubular member through which the suture anchor is movable and a pusher member which is at least partially disposed in and is movable relative to said tubular member to move the suture anchor relative to said tubular member, said tubular member includes a sheath and an array of wires which extend along an inner side of said sheath, said wires of said array of wires have longitudinally extending surface means for engaging the suture anchor as the suture anchor is moved through said tubular member by said pusher member. ### Claim 31 (depends on 30) An apparatus as set forth in claim 30 wherein said sheath is resiliently expandable under the influence of force transmitted from the suture anchor to said sheath as the suture anchor is moved through said tubular member by said pusher member. ### Claim 32 (depends on 30) An apparatus as set forth in claim 30 wherein said tubular member has an end portion which is operable between a closed condition blocking movement of the suture anchor through the end portion of said tubular member and an open condition in which the end portion of said tubular member is ineffective to block movement of the suture anchor through the end portion of said tubular member into body tissue. ### Claim 33 (depends on 30) An apparatus as set forth in claim 30 wherein at least a portion of each of said wires is integrally formed as one piece with said sheath to interconnect said wires and said sheath. ### Claim 34 (depends on 30) An apparatus as set forth in claim 30 wherein each of said wires includes a longitudinally extending core having a generally circular cross sectional configuration and a jacket which at least partially encloses said core, said surface means for engaging the suture anchor being disposed on said jackets of said wires. ### Claim 35 (depends on 30) An apparatus as set forth in claim 30 wherein said array of wires blocks engagement of the suture anchor with the sheath during movement of the suture anchor relative to at least a portion of said tubular member. ### Claim 36 (depends on 30) An apparatus as set forth in claim 30 wherein said tubular member has a pointed end portion for piercing body tissue, said pointed end portion of said tubular member being formed by said sheath and said wires. ### Claim 37 An apparatus for use in positioning a suture anchor in body tissue, said apparatus comprising a longitudinally extending tubular sheath, a plurality of longitudinally extending wires which are enclosed by said sheath and extend along an inner side of said sheath, and pusher means for transmitting force which moves the suture anchor along said wires and into the body tissue, said wires have surface means for engaging the suture anchor and holding the suture anchor in a spaced apart relationship with said sheath during movement of the suture anchor along said wires. ### Claim 38 (depends on 37) An apparatus as set forth in claim 37 wherein a pair of said wires cooperate with said sheath to at least partially define a longitudinally extending channel, said pusher means being effective to move the suture anchor along said wires with a suture connected with the suture anchor at least partially disposed in the channel. ### Claim 39 (depends on 37) An apparatus as set forth in claim 37 wherein said sheath is formed of a material capable of being extended from a first condition in which at least a portion of a longitudinally extending passage through said sheath has a relatively small cross sectional size to a second condition in which at least a portion of the passage has a relatively large cross sectional size, said pusher means being effective to transmit force which is transmitted from the suture anchor through said wires to said sheath to extend at least a portion of said sheath from the first condition to the second condition during movement of the suture anchor along said wires. ### Claim 40 (depends on 39) An apparatus as set forth in claim 39 wherein said sheath is formed of a material which is resiliently expandable, said sheath being extended from the first condition to the second condition by resilient expansion of the material of said sheath. ### Claim 41 (depends on 37) An apparatus as set forth in claim 37 wherein each of said wires is integrally formed as one piece with said sheath to interconnect said sheath and said wires. ### Claim 42 (depends on 37) An apparatus as set forth in claim 37 wherein each of said wires includes a longitudinally extending core having a generally circular cross sectional configuration and a jacket which at least partially encloses said core, said surface means for engaging the suture anchor being disposed on said jackets of said wires. ### Claim 43 (depends on 42) An apparatus as set forth in claim 42 wherein said jackets are integrally formed as one piece with said sheath to interconnect said wires and said sheath. ### Claim 44 (depends on 37) An apparatus as set forth in claim 37 wherein said plurality of wires extend along the inner side of said sheath between opposite end portions of said sheath. ### Claim 45 (depends on 44) An apparatus as set forth in claim 44 wherein said plurality of wires extend along the inner side of said sheath from a location disposed between opposite end portions of said sheath to one of the end portions of said sheath. ### Claim 46 (depends on 45) An apparatus as set forth in claim 45 wherein said one of said end portions of said sheath has a pointed configuration to facilitate piercing of body tissue. ### Claim 47 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member, said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, moving the suture anchor along a passage in the tubular member with the suture disposed in engagement with the suture anchor, said step of moving the suture anchor along a passage in the tubular member includes sliding the suture anchor along the wires, expanding at least a portion of the passage in the tubular member while moving the suture anchor along the passage in the tubular member, and moving the suture anchor out of the passage in the tubular member into the body tissue with the suture disposed in engagement with the suture anchor. ### Claim 48 (depends on 47) A method as set forth in claim 47 wherein said step of expanding at least a portion of the passage in the tubular member includes transmitting force from a leading end portion of the suture anchor to the tubular member while moving the suture anchor along the passage in the tubular member and expanding at least a portion of the tubular member under the influence of the force transmitted from the leading end portion of the suture anchor to the tubular member. ### Claim 49 (depends on 47) A method as set forth in claim 47 further including the step of inserting the tubular member into the body tissue by piercing the body tissue with an end portion of the tubular member prior to performing said step of expanding at least a portion of the passage in the tubular member. ### Claim 50 (depends on 47) A method as set forth in claim 47 wherein said step of expanding at least a portion of the passage in the tubular member includes resiliently stretching material which forms at least a portion of the tubular member. ### Claim 51 (depends on 47) A method as set forth in claim 47 further including the steps of inserting the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 52 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member, said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, moving the suture anchor along a passage in the tubular member with the suture disposed in engagement with the suture anchor, said step of moving the suture anchor along a passage in the tubular member includes applying force against the suture anchor with a pusher member and sliding the pusher member along the wires, expanding at least a portion of the passage in the tubular member while moving the suture anchor along the passage in the tubular member, and moving the suture anchor out of the passage in the tubular member into the body tissue with the suture disposed in engagement with the suture anchor. ### Claim 53 (depends on 52) A method as set forth in claim 52 wherein said step of expanding at least a portion of the passage in the tubular member includes transmitting force from a leading end portion of the suture anchor to the tubular member while moving the suture anchor along the passage in the tubular member and expanding at least a portion of the tubular member under the influence of the force transmitted from the leading end portion of the suture anchor to the tubular member. ### Claim 54 (depends on 52) A method as set forth in claim 52 further including the step of inserting the tubular member into the body tissue by piercing the body tissue with an end portion of the tubular member prior to performing said step of expanding at least a portion of the passage in the tubular member. ### Claim 55 (depends on 52) A method as set forth in claim 52 wherein said step of expanding at least a portion of the passage in the tubular member includes resiliently stretching material which forms at least a portion of the tubular member. ### Claim 56 (depends on 52) A method as set forth in claim 52 further including the steps of inserting the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 57 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a tubular sheath having a passage which extends through the sheath, said step of providing a tubular sheath includes providing a tubular sheath having a plurality of wires disposed in the passage through the sheath, inserting an end portion of the sheath into body tissue, expanding the end portion of the sheath inserted into the body tissue, said step of expanding the end portion of the sheath includes moving a tubular member into the end portion of the sheath and increasing the cross-sectional size of the end portion of the sheath from a first cross-sectional size to a second cross-sectional size under the influence of force transmitted from the tubular member to the sheath, said step of moving a tubular member into the end portion of the sheath includes sliding an outer side surface of the tubular member along outer side surfaces of the wires, and moving a suture anchor through the tubular member into the body tissue while the end portion of the sheath has the second cross-sectional size. ### Claim 58 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member having a longitudinally extending body portion and an end portion, moving the suture anchor along a passage in the tubular member with the suture disposed in engagement with the suture anchor, expanding at least a portion of the passage in the tubular member while moving the suture anchor along the passage in the tubular member, said step of expanding at least a portion of the passage in the tubular member includes expanding at least a portion of the longitudinally extending body portion of the tubular member while the suture anchor is spaced from the end portion of the tubular member, and moving the suture anchor out of the passage in the tubular member into the body tissue through the end portion of the tubular member with the suture disposed in engagement with the suture anchor. ### Claim 59 (depends on 58) A method as set forth in claim 58 wherein said step of expanding at least a portion of the passage in the tubular member includes expanding the end portion of the tubular member after performing said step of expanding the body portion of the tubular member. ### Claim 60 (depends on 59) A method as set forth in claim 59 wherein said step of moving the suture anchor out of the passage in the tubular member into the body tissue through the end portion of the tubular member is at least partially performed after performing said step of expanding the end portion of the tubular member. ### Claim 61 (depends on 59) A method as set forth in claim 59 wherein said step of expanding the end portion of the tubular member is performed while at least a portion of the longitudinally extending body portion remains expanded. ### Claim 62 (depends on 58) A method as set forth in claim 58 wherein said step of expanding at least a portion of the passage in the tubular member includes transmitting force from a leading end portion of the suture anchor to the tubular member while the suture anchor is spaced from the end portion of the tubular member and while moving the suture anchor along the passage in the tubular member and expanding at least a portion of the tubular member under the influence of the force transmitted from the leading end portion of the suture anchor to the tubular member while the suture anchor is spaced from the end portion of the tubular member. ### Claim 63 (depends on 58) A method as set forth in claim 58 further including the step of inserting the tubular member into the body tissue by piercing the body tissue with an end portion of the tubular member prior to performing said step of expanding at least a portion of the passage in the tubular member. ### Claim 64 (depends on 58) A method as set forth in claim 58 wherein said step of expanding at least a portion of the passage in the tubular member includes resiliently stretching material which at least partially forms the body portion of the tubular member while the suture anchor is spaced from the end portion of the tubular member. ### Claim 65 (depends on 58) A method as set forth in claim 58 wherein said step of moving the suture anchor out of the passage in the tubular member includes moving segments of the tubular member from an initial position in which portions of the segments of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the tubular member are spaced apart from each other. ### Claim 66 (depends on 58) A method as set forth in claim 58 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of expanding at least a portion of the longitudinally extending body portion of the tubular member includes sliding the suture anchor along the wires. ### Claim 67 (depends on 66) A method as set forth in claim 66 wherein said step of expanding at least a portion of the passage in the tubular member includes expanding at least a portion of the sheath under the influence of force applied against the wires by the suture anchor while sliding the suture anchor along the wires while the suture anchor is spaced from the end portion of the tubular member. ### Claim 68 (depends on 58) A method as set forth in claim 58 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of expanding at least a portion of the passage in the tubular member includes applying force against the suture anchor with a pusher member and moving the pusher member along the wires. ### Claim 69 (depends on 58) A method as set forth in claim 58 further including the steps of inserting the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 70 A method of positioning a suture anchor relative to a patient's body tissue, said method comprising the steps of providing a suture anchor formed of body tissue having a suture disposed in engagement with the suture anchor, providing a tubular member, moving the suture anchor formed of body tissue along a passage in the tubular member with the suture disposed in engagement with the suture anchor, and moving the suture anchor formed of body tissue out of the passage in the tubular member into the patient's body tissue with the suture disposed in engagement with the suture anchor formed of body tissue. ### Claim 71 (depends on 70) A method as set forth in claim 70 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from an expansion member to the tubular member while moving the suture anchor formed of body tissue along the passage in the tubular member without transmitting force from the suture anchor formed of body tissue to the tubular member and expanding at least a portion of the tubular member under the influence of the force transmitted from the expansion member to the tubular member. ### Claim 72 (depends on 70) A method as set forth in claim 70 further including the step of forming an opening in the patient's body tissue by piercing the patient's body tissue with an end portion of the tubular member, said step of moving the suture anchor formed of body tissue out of the passage in the tubular member includes moving the suture anchor through an opening in the end portion of the tubular member which pieced the patient's body tissue. ### Claim 73 (depends on 71) A method as set forth in claim 71 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member without transmitting force from the suture anchor formed of body tissue to the tubular member. ### Claim 74 (depends on 70) A method as set forth in claim 70 further including the step of moving segments of the tubular member from an initial position in which portions of the segments of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the tubular member are spaced apart from each other without transmitting force from the suture anchor formed of body tissue to the tubular member. ### Claim 75 (depends on 70) A method as set forth in claim 70 further including the step of providing an inner member, said step of moving the suture anchor formed of body tissue along the passage in the tubular member is performed with the suture anchor formed of body tissue enclosed by the inner member and spaced from the tubular member. ### Claim 76 (depends on 72) A method as set forth in claim 72 further including the step of expanding at least a portion of the passage in the tubular member without transmitting force from the suture anchor formed of body tissue to the tubular member. ### Claim 77 (depends on 75) A method as set forth in claim 75 further including the step of expanding at least a portion of the passage in the tubular member by applying force against the tubular member with the inner member while the suture anchor formed of body tissue is enclosed by the inner member and is spaced from the tubular member. ### Claim 78 (depends on 70) A method as set forth in claim 70 wherein said step of moving the suture anchor formed of body tissue along a passage in the tubular member is performed with at least a portion of the suture anchor formed of body tissue enclosed by an inner member, said method further includes the step of expanding at least a portion of the passage in the tubular member includes transmitting force from the inner member to the tubular member while moving the inner member and the suture anchor formed of body tissue together along the passage in the tubular member. ### Claim 79 (depends on 70) A method as set forth in claim 70 further including the steps of inserting the tubular member into the patient's body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the patient's body tissue, and interrupting said step of inserting the tubular member into the patient's body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into the patient's body tissue. ### Claim 80 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member, inserting the tubular member into body tissue, covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue, moving the suture anchor along a passage in the tubular member with the suture disposed in engagement with the suture anchor, and moving the suture anchor out of the passage in the tubular member into the body tissue with the suture disposed in engagement with the suture anchor while the indicia corresponding the a desired depth of insertion of the tubular member into body tissue is covered with body tissue. ### Claim 81 (depends on 80) A method as set forth in claim 80 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from a leading end portion of the suture anchor to the tubular member while moving the suture anchor along the passage in the tubular member. ### Claim 82 (depends on 80) A method as set forth in claim 80 wherein said step of inserting the tubular member into the body tissue includes piercing the body tissue with an end portion of the tubular member. ### Claim 83 (depends on 80) A method as set forth in claim 80 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member. ### Claim 84 (depends on 80) A method as set forth in claim 80 further including the step of moving segments of the tubular member from an initial position in which portions of the segments of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the tubular member are spaced apart from each other. ### Claim 85 (depends on 80) A method as set forth in claim 80 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of moving the suture anchor along a passage in the tubular member includes sliding the suture anchor along the wires. ### Claim 86 (depends on 85) A method as set forth in claim 85 further including the step of expanding at least a portion of the passage in the tubular member by expanding at least a portion of the sheath under the influence of force applied against the wires by the suture anchor while sliding the suture anchor along the wires. ### Claim 87 (depends on 80) A method as set forth in claim 80 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of moving the suture anchor along a passage in the tubular member includes applying force against the suture anchor with a pusher member and sliding the pusher member along the wires. ### Claim 88 (depends on 80) A method as set forth in claim 80 wherein said step of moving the suture anchor along a passage in the tubular member is performed with at least a portion of the suture anchor enclosed by an expansion member, said method further includes the step of expanding at least a portion of the passage in the tubular member by transmitting force from the expansion member to the tubular member while moving the expansion member and the suture anchor together along the passage in the tubular member. ### Claim 89 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member, inserting the tubular member into body tissue by piercing the body tissue with an end portion of the tubular member and moving at least a portion of the tubular member through an opening formed in the body tissue by piercing the body tissue with the end portion of the tubular member, moving the suture anchor along a passage in the tubular member with the suture disposed in engagement with the suture anchor, and moving the suture anchor out of the passage in the tubular member through the end portion of the tubular member into the body tissue with the suture disposed in engagement with the suture anchor. ### Claim 90 (depends on 89) A method as set forth in claim 89 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from a leading end portion of the suture anchor to the tubular member while moving the suture anchor along the passage in the tubular member. ### Claim 91 (depends on 89) A method as set forth in claim 89 wherein said step of piercing the body tissue includes forming an opening in the body tissue at a location which is free of naturally occurring openings. ### Claim 92 (depends on 89) A method as set forth in claim 89 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member. ### Claim 93 (depends on 89) A method as set forth in claim 89 further including the step of moving segments of the end portion of tubular member which pierced the body tissue from an initial position in which portions of the segments of the end portion of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the end portion of the tubular member are spaced apart from each other. ### Claim 94 (depends on 89) A method as set forth in claim 89 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of moving the suture anchor along a passage in the tubular member includes sliding the suture anchor along the wires. ### Claim 95 (depends on 94) A method as set forth in claim 94 further including the step of expanding at least a portion of the passage in the tubular member under the influence of force applied against the wires by the suture anchor while sliding the suture anchor along the wires. ### Claim 96 (depends on 89) A method as set forth in claim 89 wherein said step of providing a tubular member includes providing a tubular member having a sheath which at least partially encloses a plurality of wires which extend along at least a portion of the passage in the tubular member, said step of moving the suture anchor along a passage in the tubular member includes applying force against the suture anchor with a pusher member and sliding the pusher member along the wires. ### Claim 97 (depends on 89) A method as set forth in claim 89 wherein said step of moving the suture anchor along a passage in the tubular member is performed with at least a portion of the suture anchor enclosed by an expansion member, said method further includes the step of expanding at least a portion of the passage in the tubular member by transmitting force from the expansion member to the tubular member while moving the expansion member a nd the suture anchor together along the passage in the tubular member. ### Claim 98 (depends on 89) A method as set fort h in claim 89 further including the steps of covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue. ### Claim 99 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a suture anchor having a suture disposed in engagement with the suture anchor, providing a tubular member, providing a tubular inner member, at least partially enclosing one end portion and at least a portion of an outer side surface of the suture anchor with the tubular inner member, inserting the tubular inner member into the tubular outer member, moving the suture anchor and the tubular inner member along a passage in the tubular outer member with the suture anchor at least partially enclosed by the tubular inner member, and moving the suture anchor out of the passage in the tubular outer member into the body tissue with the suture disposed in engagement with the suture anchor. ### Claim 100 (depends on 99) A method as set forth in claim 99 further including the step of transmitting force from a leading end portion of the tubular inner member to the tubular outer member while moving the suture anchor along the passage in the tubular outer member and expanding at least a portion of the tubular outer member under the influence of the force transmitted from the leading end portion of the tubular inner member to the tubular outer member. ### Claim 101 (depends on 99) A method as set forth in claim 99 further including the step of inserting the tubular outer member into the body tissue by piercing the body tissue with an end portion of the tubular outer member. ### Claim 102 (depends on 99) A method as set forth in claim 99 further including the step of expanding at least a portion of the passage in the tubular outer member by resiliently stretching material which forms at least a portion of the tubular outer member. ### Claim 103 (depends on 99) A method as set forth in claim 99 further including the step of moving segments of the tubular outer member from an initial position in which portions of the segments of the tubular outer member are disposed in engagement with each other to an extended position in which the portions of the segments of the tubular outer member are spaced apart from each other. ### Claim 104 (depends on 103) A method as set forth in claim 103 wherein said step of moving segments of the tubular outer member from an initial position to an extended position is performed under the influence of force transmitted from the tubular inner member to the segments of the tubular outer member while the suture anchor is spaced from the segments of the tubular outer member. ### Claim 105 A method of positioning a suture anchor relative to body tissue, said method comprising the steps of providing a tubular sheath having a main portion and an end portion, inserting the end portion and at least part of the main portion of the sheath into body tissue, expanding at least the part of the main portion of the sheath which is inserted into the body tissue in a direction transverse to a longitudinal central axis of the sheath, said step of expanding at least the part of the main portion of the sheath which is inserted into the body tissue is at least partially performed while the suture anchor is spaced from the end portion of the sheath, expanding the end portion of the sheath while the end portion of the sheath is inserted into the body tissue, said step of expanding the end portion of the sheath is performed after performing said step of expanding at least part of the main portion of the sheath, and moving the suture anchor along a passage in the sheath and out of the sheath into the body tissue while the end portion and at least part of the main portion of the sheath are inserted into the body tissue. ### Claim 106 (depends on 105) A method as set forth in claim 105 wherein said step of inserting an end portion and at least part of the main portion of the sheath into body tissue includes piercing the body tissue with the end portion of the sheath and moving the end portion and at least part of the main portion of the sheath into the body tissue prior to performing said step of expanding at least part of the main portion of the sheath and prior to performing said step of expanding the end portion of the sheath. ### Claim 107 (depends on 105) A method as set forth in claim 105 wherein said step of providing a tubular sheath includes providing a tubular sheath having a plurality of wires disposed in at least part of the main portion of the sheath, said step of moving the suture anchor along a passage in the sheath includes sliding an outer side surface of the suture anchor along outer side surfaces of the wires. ### Claim 108 (depends on 107) A method as set forth in claim 107 wherein said step of expanding at least part of the main portion of the sheath includes transmitting force from the suture anchor to the outer side surfaces of the wires and transmitting force from the wires to the sheath. ### Claim 109 (depends on 105) A method as set forth in claim 105 wherein said step of inserting an end portion of the sheath into body tissue includes covering indicia on the sheath with body tissue as the sheath is inserted into the body tissue, and interrupting said step of inserting the sheath into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the sheath into body tissue. ### Claim 110 (depends on 105) A method as set forth in claim 105 further including the steps of inserting a tubular member into the sheath, said step of expanding at least part of the main portion of the sheath includes moving the tubular member along the passage in the sheath. ### Claim 111 (depends on 81) A method as set forth in claim 81 wherein said step of expanding at least a portion of the passage in the tubular member includes expanding at least a portion of the sheath under the influence of force applied against the wires by the suture anchor while sliding the suture anchor along the wires.