Tissue fixation delivery apparatus

A method of deploying a tissue fixation apparatus of the type including first and second tissue anchors coupled together by an adjustable suture assembly, the tissue fixation apparatus being pre-loaded onto a delivery tool with the first tissue anchor disposed within an interior chamber of a needle cannula of the delivery tool, the method comprising:

• inserting a sharpened distal tip of the needle cannula into target tissue at a first location;
• advancing a push rod distally within the needle cannula to eject the first tissue anchor from the needle cannula within the target tissue at the first location;
• withdrawing the needle cannula from the first location and inserting the sharpened distal tip into the target tissue at a second location;
• withdrawing the push rod with respect to the needle cannula to allow the second tissue anchor to be pushed into the interior chamber of the needle cannula under the operation of a resilient band disposed about the needle cannula and the second tissue anchor;
• advancing the push rod distally within the needle cannula to eject the second tissue anchor from the needle cannula within the target tissue at the second location;
• and
• withdrawing the needle cannula from the tissue and tightening the tissue fixation apparatus.

A tissue fixation system comprising:

• a handle mechanism including:
• a handle body having a proximal end and a distal end and an internal cavity disposed therebetween;
• a tubular shaft extending distally from the handle body and having a distal end;
• a plunger slidably and rotatably coupled to the body having a proximal end and a distal end, the proximal end positioned external to and proximal to the handle body, the distal end positioned within the internal cavity of the body;
• and
• a handle push rod extending distally from the plunger and slidably and rotatably disposed within the tubular shaft, the handle push rod including a distal mating feature;
• and
• a kit including a needle cartridge assembly and a tissue fixation apparatus coupled thereto;
• the needle cartridge assembly including:
• a needle cannula having an outer wall defining a proximal portion, an opposite sharpened distal tip having a distal opening, an internal chamber extending from the proximal portion through the distal opening, and a needle side opening through the outer wall;
• a tubular sleeve fixedly disposed about a portion of the needle cannula having a proximal end and a distal end, the proximal end of the tubular sleeve configured to mate with the distal end of the tubular shaft of the handle mechanism for coupling the handle mechanism and the needle cartridge assembly, and further including a groove and a sleeve side opening radially and axially aligned with the needle side opening;
• a cartridge push rod slidably and rotatably disposed within the internal chamber of the needle cannula including a proximal mating feature configured to engage the distal mating feature of the handle push rod;
• and
• a resilient band disposed about the tubular sleeve within the groove and over the side opening;
• and
• the tissue fixation apparatus including a first tissue anchor, a second tissue anchor, and an adjustable suture assembly coupling the first and second tissue anchors together, the adjustable suture assembly including an adjustable suture loop and a tension line, wherein the first and second tissue anchors are coupled to the adjustable suture loop, and wherein the tension line is operable to reduce a dimension of the adjustable suture loop between the first and second tissue anchors, wherein the first tissue anchor is disposed within the internal chamber of the needle cannula, and wherein the second tissue is disposed external to the internal chamber and within the needle and sleeve side openings, and wherein the resilient band is disposed about the tubular sleeve over the second tissue anchor so as to urge the second tissue anchor toward the internal chamber through the needle and sleeve side openings, and wherein the cartridge push rod is positioned so as to prevent the second tissue anchor from entering the internal chamber,
• wherein upon coupling the tubular shaft of the handle mechanism and the tubular sleeve of the needle cartridge assembly together, and further wherein upon coupling the mating features of the handle and needle push rods together, the plunger and the handle and cartridge push rods are configured to operate between at least one extended position and at least one retracted position, wherein in the at least one extended position the cartridge push rod is located so as to eject the first tissue anchor from the internal chamber through the distal opening of the needle cannula while preventing the second tissue anchor from entering the internal chamber, and wherein in the at least one retracted position the cartridge push rod is positioned proximal to the side opening in the sleeve so as to allow the second tissue anchor to be urged into the internal chamber through the needle side opening by the resilient band.