Suture winding device and methods of use thereof

[0001] This application claims the benefit to U.S. Provisional Patent Application No. 60/661,184 filed Mar. 11, 2005, the entire disclosure of which is hereby incorporated by reference herein.

[0002] 1. Technical Field

[0003] The present disclosure relates to devices and methods for packaging sutures and, more particularly, to a suture winding device and methods for use thereof.

[0004] 2. Background of Related Art

[0005] Packages for surgical sutures having needles attached at one or both ends are typically constructed according to the nature of the suture material and to how the sutures will be used. Generally, the package holds the suture and attached needles in place, protects them during handling and storage, and allows ready access to the suture for removal with minimum handling at the time the suture is to be used.

[0006] The packages are loaded with one or more needles that have a desired quantity of suture attached. After positioning the needle or needles in the package, the attached suture is generally looped within the package using tracks, rods, posts, or other suitable positioning structures located within the package.

[0007] An example of one such package is disclosed in U.S. Pat. No. 5,123,528 to Brown et al., currently owned and assigned to United States Surgical, that discloses a package having a number of tracks and a needle receiving park. Each track has a suture receiving port and an opposed vacuum port. By applying vacuum to the vacuum receiving ports, a quantity of suture is drawn through the suture receiving port and received in the track. After a predetermined quantity of suture is received by the track, a needle attached to the suture is positioned in the needle receiving park.

[0008] A device for winding a quantity of suture attached to a needle is disclosed in U.S. Pat. No. 5,473,854 to Demarest et al. that discloses an apparatus having a number of workstations for packaging needles with an attached suture. As a turntable of the apparatus rotates, a tool nest attached to the turntable is rotated from one workstation to the next workstation. Each workstation performs a specific task with respect to packaging the needle with attached suture.

[0009] The present disclosure is directed to a suture winding device for use with a suture package or retainer and one or more armed sutures (i.e. a suture needle combination). According to an embodiment, the suture winding device includes a plate having a rotatable base mounted thereon and a holder. An actuator is included in the holder and operates to transition a first arm from a first position to a second position in response to an applied power source (i.e. pneumatic, hydraulic, or electric). A second arm of the holder is stationary relative to the first arm. In the first position, a portion of the suture may extend between the first and second arms, while in the second position, the first and second arms slidably capture a portion of the suture. The holder maintains a desired amount of tension on the suture as the suture is wound in the retainer.

[0010] In one embodiment, the holder is attached to a mounting arm that is also rotatably mounted to the plate. The mounting arm is capable of being positioned independent of the rotatable base. The holder, being attached to the mounting arm, is therefore positionable amongst a plurality of positions including a loading position and an unloading position.

[0011] In another embodiment, the holder is attached to a rail assembly. The rail assembly includes a rail having a carriage slidably mounted thereon. In particular, the holder is attached to the carriage that is positionable on the rail throughout a plurality of positions including a loading position and an unloading position.

[0012] The base includes a plurality of upstanding rods that may form one or more arrays of rods around which the suture may be wound. Additionally, the base may include one or more vacuum connections that are capable of holding the retainer in contact with the base.

[0013] A needle holder is disposed on the base and includes buttons that form at least one needle channel for releasably retaining the at least one needle. A post and an end member are also disposed on the needle holder and define a suture channel thereon. The needle holder is exchangeable with alternate needle holders to accommodate a variety of needle dimensions and/or combinations.

[0014] A first member of the retainer may be positioned atop the base after the at least one needle and attached suture are positioned thereon. Rotation of the base winds the suture about the upstanding rods forming loops of the suture. After a predetermined amount of the suture is wound about the rods, a second member of the retainer is placed on top of the first member. The first and second members of the retainer may be joined together using pressure and/or heat. A heat staking apparatus may be used to provide the pressure and/or heat to join the first and second members to form the retainer. In addition, the first and second members of the retainer include throughholes that slidably receive the rods and align the retainer with the base.

[0015] In another embodiment of the suture winding device, the base includes a plurality of rods arranged in at least one array. The at least one array includes at least one arc having at least one rod. In this embodiment, the at least one rod is positionable between a first position with a tip of the at least one rod being at least flush with a surface of the base and a second position where the at least one rod extends upward from the base (i.e. an upstanding rod). Each arc is independently transitionable from the first position to the second position such that an interior arc may be transitioned and a quantity of suture wound thereon. After the desired quantity of suture is wound about the first arc, a second arc may be transitioned to the second position for winding another quantity of suture thereon. In an embodiment of the suture winding device, multiple arcs may be disposed on the base with each arc having a greater radius as the arcs are located further from a central point on the base.

[0034] Embodiments of the presently disclosed suture winding device will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views.

[0035] Referring initially to FIG. 1, the suture winding device, shown generally as 100, includes a base 10 that is rotatably attached to a support plate 1 and is rotatable about a central point A.

[0036] As shown in FIGS. 1 and 2, base 10 includes a frame 18 and a plate 19 that is attached to a mounting surface 26 of frame 18. In an embodiment of suture winding device 100, frame 18, and plate 19 have a generally oval or elongate elliptical configuration. Other shapes may also be used and are contemplated herein. Base 10 further includes a plurality of vacuum connections 12 where each vacuum connection includes a vacuum port 12a. Each vacuum connection 12 is fluidly coupled to a vacuum source (not shown) such as would be known by a person of ordinary skill in the art. The actuation of vacuum connections 12 (i.e. applying negative pressure or suction to vacuum ports 12a) may be controlled manually or automatically.

[0037] In addition to vacuum connections 12, a plurality of rods 22 is arranged on plate 19 and at least a portion of each rod 22 extends through top surface 24. Each rod 22 includes a tip 23 that is configured and dimensioned to extend beyond a top surface of a mounting member 7 (FIG. 2). In one embodiment, rods 22 include interior rods 22aand exterior rods 22b. In suture winding device 100, the plurality of rods 22 may be arranged to form a first array 20a and a second array 20b. In one embodiment of suture winding device 100, first array 20a and second array 20b are generally arcuate arrangements of exterior rods 22b that are spaced apart along a longitudinal axis of base 10.

[0038] A needle holder 50 is disposed in a central region of mounting member 7 (FIG. 2) and separates first array 20a from second array 20b. Mounting member 7 is disposed on base 10 such that it abuts top surface 24. Needle holder 50 is releasably disposed in mounting member 7 and includes a plate 52 having a plurality of buttons 54 disposed thereon. In an embodiment of suture winding device 100, buttons 54 are arranged in pairs to form one or more needle channels 64. Each needle channel 64 is configured and adapted for releasably engaging a needle 14 (FIG. 5). Needle 14, as is known in the art, has a sharpened tip at one end and a length of suture 16 extending from an opposing end. Disposed on one end of plate 52 are a post 56, a needle guide 58, and an end member 60. Post 56 and end member 60 are spaced apart to form a suture channel 62 therebetween. Needle guide 58 in cooperation with buttons 54 position needle 14 in needle holder 50 such that suture 16 is releasably received in suture channel 62 (FIG. 5). In one embodiment, suture 16 is positioned on mounting member 7 such that it contacts at least one interior rod 22a (FIG. 5). Needle holder 50 may be replaced by alternate embodiments of the needle holder that are configured to receive single needles, double needles, or needles of varying diameters and dimensions regardless of whether the needles are in a single or double configuration.

[0039] A suture package or retainer 70 (FIG. 15) is positionable on base 10 as illustrated in FIGS. 6-8 and 15. A suitable retainer 70 is the subject matter of U.S. patent application Ser. No. 10/891,604 filed on Jul. 15, 2004, currently owned and assigned to Tyco Healthcare Group, the contents of which are hereby incorporated by reference in their entirety. Referring now to FIG. 15, retainer 70 includes a first member 72 and a second member 74. Second member 74 is adapted to attach to first member 72 as will be discussed in further detail below.

[0040] With reference to FIG. 6, first member 72 is shown disposed on mounting member 7 of base 10. In one embodiment, the position of first member 72 with respect to mounting member 7 is maintained by vacuum connections 12 (FIG. 1) that are disposed in base 10. More specifically, vacuum applied through vacuum connections 12 holds first member 72 to vacuum ports 12a. First member 72 is disposed on top of mounting member 7. Positioned between first member 72 and mounting member 7 is needle 14 with a length of suture 16 attached thereto. First member 72 includes a plurality of throughholes 76 arranged to correspond with rods 22 (FIG. 1) of base 10 thereby aligning needle holder 50 with a needle park or needle grip 80 of first member 72. As shown in FIG. 15, first member 72 includes needle park 80 for releasably attaching needle 14 to first member 72. Needle park 80 is positioned on first member 72 such that is aligned with needle holder 50 when first member 72 is positioned on plate 19 by the cooperative arrangement of rods 22 and throughholes 76. As with needle holder 50, needle park 80 may be replaced by alternate embodiments that are configured to receive single needles, double needles, or needles of varying diameters and dimensions regardless of whether the needles are in a single or double configuration.

[0041] Needle park 80 includes a number of tabs 82 and notches 84 that extend from a surface of first member 72 towards plate 19. In one embodiment, needle holder 80 is disposed in a recess 86 on an underside of first member 72. Each tab 82 and its corresponding notch 84 are configured and adapted for releasably gripping needle 14 such that when retainer 70 is removed from base 10, needle 14 separates from needle holder 50 and is releasably attached to retainer 70 by needle park 80. Tabs 82 and notches 84 are biased towards each other for releasably receiving needle 14. A slot 78 is disposed along an edge of first member 72 where slot 78 communicates with recess 86 such that a portion of suture 16 may extend through recess 86 and be accessed from outside retainer 70.

[0042] Transfer of needle 14 from needle holder 50 to needle park 80 is affected by forces applied by an operator in a generally downward direction (i.e. towards plate 19) on first member 72. As first member 72 is urged towards plate 19 and needle holder 50, needle 14 contacts needle park 80 with sufficient force to overcome the bias of tab 82 and notches 84. By overcoming the bias of tabs 82 and notches 84, the space between tab 82 and notches 84 is sufficient to receive needle 14. After first member 72 has moved a predetermined distance, needle 14 no longer urges tab 82 and notches 84 away from each other whereupon the bias of tab 82 and notches 84 act to urge them towards each other for releasably retaining needle 14. In configurations including more than one needle 14, each set of tab 82 and notches 84 is configured as previously described. Alternatively, vacuum applied to first member 72 through vacuum ports 12a may supply the forces that urge needle 14 into releasable engagement with needle park 80 as previously discussed. In another embodiment, a combination of applied vacuum and operator action supply the forces for urging needle 14 into releasable engagement with needle park 80.

[0043] Base 10 is rotatable such that suture 16 contacts each exterior rod 22b sequentially. As base 10 completes each rotation, a loop of suture 16 is formed about exterior rods 22b. A predetermined amount of tension is maintained on suture 16 by a holder 30. Holder 30 is mounted to support plate 1 and is rotatable with respect to base 10. In one embodiment, holder 30 is rotatable amongst a plurality of positions including a loading position (FIG. 1) and an unloading position (FIG. 7). In addition, holder 30 is rotatable amongst the plurality of positions while base 10 is rotating about the central point (i.e. base 10 and holder 30 are independently positionable).

[0044] More specifically, holder 30 is attached to a mounting arm 42 (FIG. 1) that is rotatably attached to plate 1 and is capable of being positioned in at least the loading position and the unloading position of holder 30 and, preferably may be positioned in any position therebetween. Further still, mounting arm 42 is capable of being positioned independently of base 10. In the loading position, holder 30 orients suture 16 such that a desired angle between suture 16 and base 10 is achieved. In the unloading position, holder 30 orients suture 16 such that it is substantially parallel to the longitudinal axis of base 10. The predetermined amount of tension applied to suture 16 is maintained by holder 30 regardless of its position relative to base 10 or whether or not base 10 is being rotated.

[0045] In particular and with reference to FIGS. 3 and 4, holder 30 includes a first arm 32 and a second arm 34. First arm 32 is positionable between an open state and a closed state while second arm 34 is stationary. In particular, second arm 34 is fixedly attached to a block 48 that is, in turn, fixedly attached to a mounting block 47 that is attached to a wall 40.

[0046] Mounting block 47 includes an actuator and a slot 38 therein. Slot 38 is configured and dimensioned for slidably receiving a driver arm 36. First arm 32 is attached to driver arm 36 such that movement of driver arm 36 results in corresponding movement of first arm 32. In one embodiment, driver arm 36 is movable in slot 38 in a substantially vertical direction. In the open state, first arm 32 is spaced apart from second arm 34 defining a gap 45 therebetween (FIG. 3). Gap 45 has sufficient dimensions such that suture 16 may be fed through gap 45 without contacting either first or second arms 32, 34.

[0047] First arm 32 is moved towards second arm 34 during an actuation sequence such that first arm 32 substantially abuts second arm 34. In one embodiment, first and second arms 32, 34 may include respective first and second cushioning members 32a, 34a. During an actuation sequence, a pressure source is fluidly coupled to actuation ports 46 to provide the motive force to operate the actuator. Known pressure sources such as pneumatics (e.g. air, compressed gases, vacuum) or hydraulics (e.g. water, saline, oil) may be used with the actuator. In another embodiment, the actuator may be electrically powered by either AC or DC sources. Pneumatic, hydraulic, or electric actuators are well known to one skilled in this art and will not be discussed in detail herein.

[0048] Upon actuation, the actuator imparts motion to driver arm 36 to move driver arm 36 generally downward thereby transitioning it from its open state to its closed state. In the closed state, first arm 32 abuts second arm 34 and for slidably capturing a section of suture 16 therebetween. The amount of force exerted on suture 16 by first and second arms 32, 34 in the closed state is adjustable such that the amount of pressure applied is sufficient to allow suture 16 to be fed from a source to form the loops as base 10 rotates while maintaining the desired amount of tension on suture 16. Additionally, the amount of pressure applied by first and second arms 32, 34 minimizes drooping of a length of suture 16 extending between holder 30 and first member 72 when base 10 is stationary. By providing holder 30 to supply a predetermined amount of tension to suture 16 during the winding process, suture 16 is disposed within retainer 70 with a substantially uniform amount of applied tension. Additionally, holder 30, in cooperation with a uniform arrangement of rods 22, supplies the desired amount of tension to suture 16 during the winding process thereby distributing suture 16 in retainer 70 in a substantially uniform arrangement.

[0049] After the desired number of loops are formed (i.e. the desired quantity of suture 16 is disposed on first member 72 of retainer 70), rotation of base 10 is halted. Holder 30 is moved from the loading position to the unloading position while still maintaining the desired tension on suture 16. When holder 30 is in the unloading position, first arm 32 transitions to its open state thereby releasing suture 16. Suture 16 is then separated from its source by known techniques such as cutting and a free end of suture 16 is positioned along a surface of first member 72. Alternatively, suture 16 may be separated from its source prior to transitioning first arm 32 to its open state. Second member 74 may then be placed on top of first member 72 thereby forming retainer 70 and securing needle 14 and attached suture 16 within retainer 70. Throughholes 76 in second member 74 are arranged to correspond with and slidingly receive rods 22 thereby aligning first and second members 72, 74.

[0050] In one embodiment, first and second members 72, 74 are press fit together using applied pressure to engage corresponding edge portions of respective first and second members 72, 74 as is known in the art. In another embodiment, first and second members 72, 74 are joined together using a heat stake 110, such as those known in the art and illustrated in FIG. 9. Heat stake 110 includes a die plate 112 that is positionable along a vertical axis of heat stake 110. After retainer 70 is assembled (i.e. second member 74 is placed on top of first member 72), base 10 and retainer 70 are positioned such that die plate 112 is in substantial vertical alignment with retainer 70 by moving plate 1 along a horizontal set of rails or guides 122 that are mounted on plate 120. Plate 1, including base 10, is slidably attached to rails 122 using structures that are known in the art. In the alternative, base 10 may be stationary and heat stake 110 may be positionable along a horizontal set of rails or guides towards or away from base 10.

[0051] Once die plate 112 and base 10, particularly retainer 70, are vertically aligned (FIG. 10), one or both of base 10 or heat stake 110 is locked in position thereby maintaining the vertical alignment between retainer 70 and die plate 112. Die plate 112 includes at least one heating element as is known in the art such that when die plate 112 contacts second member 74 with a desired amount of pressure, a combination of the desired amount of pressure and/or thermal energy from the heating element joins first and second members 72, 74 to form retainer 70 (FIG. 10). In addition, die plate 112 includes a plurality of channels or tubes (not shown) configured and arranged for slidably receiving rods 22. After first and second members 72, 74 are joined to form retainer 70, die plate 112 separates from base 10 (FIG. 11) allowing movement of plate 1 and removal of retainer 70 from base 10.

[0052] A method of winding a needle or an armed needle using the hereinabove described suture winding device 100 will now be discussed in detail. With reference initially to FIG. 5, one or more needles 14 having a quantity of suture 16 attached thereto is positioned in needle holder 50. Specifically, each needle 14 is positioned in a separate needle channel 64 and attached suture 16 is threaded between interior rods 22a and exterior rods 22b such that suture 16 is positioned between at least one interior rod 22a and at least one exterior rod 22b. After threading suture 16 between interior and exterior rods 22a, 22b, suture 16 extends beyond a top surface of mounting member 7. First member 72 of retainer 70 is placed on mounting member 7 such that rods 22 align with throughholes 76. Since rods 22 and throughholes 76 are configured for slidably engaging one another, a minimum amount of downward force is applied to position first member 72 in contact with the top surface of mounting member 7. Suture 16 extends through slot 78 of first member 72 and is accessible from a region exterior to base 10.

[0053] Once first member 72 of retainer 70 is positioned on mounting member 7, vacuum may be applied through vacuum ports 12a thereby holding first member 72 in substantial contact with the top surface of mounting member 7. Suture 16 is placed between first and second arms 32, 34 of holder 30 while first arm 32 is in the open state (FIG. 3). After placing suture 16 between first and second arms 32, 34, the actuator is energized by the selected power source (i.e. pneumatic, hydraulic, or electric) to transition first arm 34 from the open state to the closed state and slidably capturing a portion of suture 16 therebetween.

[0054] Base 10 is rotated as suture 16 is fed from a source (not shown) thereby winding a quantity of suture 16 around rods 22 forming loops of suture 16. After a desired quantity of suture 16 is disposed on first member 72, rotation of base 10 is halted. Holder 30 is then positioned from its loading position shown in FIG. 6 to its unloading position in FIG. 7. By maintaining suture 16 between arms 32 and 34 of holder 30 as it transitions from its loading position to its unloading position, a desired amount of tension is maintained on suture 16 prior to joining first and second members 72, 74 of retainer 70. The desired quantity of suture 16 that is disposed on first member 72 may then be separated from the source of suture 16 by cutting or other techniques known in the art. The separated end of suture 16 is positioned along the top surface of first member 72 prior to placing second member 74 atop first member 72.

[0055] After second member 74 is positioned on top of first member 72, pressure and/or heat may be used to form retainer 70 by joining first and second members 72, 74. As seen in FIG. 9, the assembled retainer 70 sits atop base 10 and plate 1. Plate 1 may be moved along rails 122 for positioning plate 1 and base 10 in alignment with die plate 112 such that vertical movement of die plate 112 will contact second member 74 of retainer 70 to apply a desired amount of pressure and/or thermal energy to join first and second members 72, 74 (FIG. 10). Channels (not shown) in die plate 112 slidably receive rods 22 as die plate 112 contacts second member 74. After joining first and second members 72, 74, die plate 112 is moved away from base 10 in a generally vertical direction (FIG. 11) such that base 10 and retainer 70 may be moved along rails 122. Retainer 70 is now formed and includes needle 14 and the desired quantity of suture 16. The steps are repeatable for each retainer 70 to be formed.

[0056] Referring now to FIGS. 12A-12C, another embodiment of the suture winding device is illustrated and shown generally as 200. Suture winding device 200 includes a base 210 that is rotatably mounted to a plate 201. Holder 30, that was discussed in detail previously with reference to FIGS. 3-4, is rotatably mounted to plate 201. Base 210 is a generally elliptical structure that includes a frame 218 and a plate 219 that is attached to a mounting surface 226 of frame 218. A mounting member 207 is disposed atop plate 219 and provides a surface suitable for positioning a first member 272 of a retainer. Mounting member 207 includes needle holder 50 as previously shown and described with reference to FIG. 2. As in the previous embodiment, needle 14 has a quantity of suture 16 attached thereto and is disposed in needle holder 50. A portion of suture 16 extends beyond base 210 and is threaded through first and second arms 32, 34 of holder 30.

[0057] Suture winding device 200 includes a plurality of rods 222 that is extendable through throughholes 276 of first member 272 where each rod 222 includes a tip 223. In this embodiment, rods 222 are positionable between a first or retracted position and a second or extended position as shown in FIGS. 12A-12C. When in the extended position, rods 222 are capable of forming one or more loops of suture 16 as will be discussed in detail hereinbelow. In the retracted position, tips 223 of rods 222 are substantially flush with a top surface of mounting member 207. Alternatively, tips 223 may exist below the top surface of mounting member 207. In addition, rods 222 are arranged in one or more arrays 230. Each array 230 includes a plurality of rods 222 that are arranged in one or more arcs 240 of rods 222. Furthermore, in an embodiment having two arrays 230, the arrays 230 are spaced apart along a longitudinal axis of base 210. Similar to suture winding device 100, arrays 230 are spaced apart about needle holder 50. Needle holder 50 is releasably mounted in mounting member 207 such that a top surface of plate 52 is substantially flush with the top surface of mounting member 207. As in the previous embodiment, needle holder 50 may be replaced by alternate embodiments of the needle holder that are configured to receive single needles, double needles, or needles of varying diameters and dimensions regardless of whether the needles are in a single or double configuration.

[0058] In FIG. 12A, rods 222 are shown in the extended position and each array 230 includes an arc 240 of rods 222. Additional arcs 240 are illustrated in FIGS. 12B-12C. In FIG. 12B, each array 230 includes two arcs (240a, 240b) while FIG. 12C illustrates suture winding device 200 with three arcs (240a, 240b, 240c) in each array 230. The spatial arrangement and relationship of rods 222, arrays 230, and arcs 240 will now be discussed in further detail. Moving from needle holder 50 towards an outer edge of mounting member 207, arcs 240 have successively larger radii such that rods 222 in arc 240a (i.e. closest to needle holder 50) are spaced closer together than rods 222 in arc 240b (FIG. 12B). In an embodiment including three arcs (FIG. 12C), arc 240c is spaced further away from needle holder 50 than arc 240b and has a larger radii than arc 240b or 240a such that rods 222 in arc 240c are spaced further apart than rods 222 in arc 240a or 240b. In addition, in configurations using more than three arcs, the radius of each arc increases as each arc is spaced further away from needle holder 50 towards the outer edge of mounting member 207 thereby increasing the distance between rods 222 in each arc.

[0059] As previously mentioned, rods 222 are positionable between a retracted position and an extended position. Each rod 222 may be independently positionable. In one embodiment, rods 222 in each arc (240a, 240b, or 240c) are positionable as a group such that all rods 222 in each arc (240a, 240b, or 240c) move substantially simultaneously. In addition, in embodiments having two arrays 230, arcs may be positioned sequentially such that rods 222 in arc 240a are moved substantially in unison from the retracted state to the extended state or vice versa. Furthermore, additional arcs 240b, 240c are positioned similarly such that corresponding arcs in each array 230 (i.e. arc pairs 240a, 240a or 240b, 240b or 240c, 240c) are moved substantially simultaneously.

[0060] Operative force to transition rods 222 from the retracted to the extended position or the extended to the retracted position may be supplied by mechanical, hydraulic, pneumatic, or electric sources as are well known to those of skill in the art. In one embodiment, rods 222 are transitioned from their positions using a number of cams and/or levers. Alternately, hydraulic force supplied by water or oil, pneumatic force supplied by air or other compressed gasses, or electric force supplied by motors or solenoids may be substituted for or combined with the cams and/or levers.

[0061] A method of winding a needle or an armed needle using the hereinabove described suture winding device 200 will now be discussed in detail. With reference initially to FIG. 12A, each array 230 has rods 222 of arc 240a in their extended position. One or more needles 14 having a quantity of suture 16 attached thereto is positioned in needle holder 50 as discussed in detail above with reference to FIG. 5 and first member 272 is placed on mounting member 207 such that rods 222 in the extended position align with throughholes 276. Since rods 222 and throughholes 276 are configured for slidably engaging one another, a slight amount of downward force is required to position first member 272 in contact with the top surface of mounting member 207. Suture 16 extends through slot 278 of first member 272 such that it is accessible from an outside region. Subsequently, suture 16 is positioned such that a portion of suture 16 contacts one or more of rods 222 in arc 240a.

[0062] Suture 16 is then placed between first and second arms 32, 34 of holder 30 while first arm 32 is in the first state (FIG. 3). After placing suture 16 between first and second arms 32, 34, the actuator is energized by the selected power source (i.e. pneumatic, hydraulic, or electric) to transition first arm 34 from the first state to the second state (i.e. towards second arm 34) and slidably capturing a portion of suture 16 therebetween.

[0063] Base 210 is rotated on plate 201 such that a desired quantity of suture 16 is wound about rods 222 in arcs 240a forming loops of suture 16 (FIG. 12A). After one or more loops are formed about arcs 240a, rods 222 in arcs 240b may be transitioned to their extended position (FIG. 12B) while base 210 continues to rotate on plate 201 and rods 222 in arcs 240a remain in their extended position. Once rods 222 of arcs 240b are transitioned to their extended positions, suture 16 now forms loops only about arcs 240b without forming additional loops about arcs 240a. After one or more loops of suture 16 are formed about arcs 240b, rods 222 in arcs 240c may be transitioned to their extended position (FIG. 12C) while base 210 continues to rotate. As base 210 rotates, one or more loops of suture 16 are only formed about arcs 240c without forming additional loops about arcs 240a or 240b. While loops of suture 16 are forming about arcs 240c, rods 222 in arcs 240a and 240b remain in their extended position maintaining the previously formed loops of suture 16.

[0064] After a desired quantity of suture 16 is disposed on first member 72, rotation of base 210 is halted. Holder 30 is then positioned from its loading position shown in FIG. 12A to its unloading position in FIG. 12C. By maintaining suture 16 between arms 32 and 34 of holder 30 as it transitions from its loading position to its unloading position, a desired amount of tension is maintained on suture 16 prior to forming retainer 70. The desired quantity of suture 16 that is disposed on first member 272 may then be separated from the source of suture 16 by cutting or other techniques known in the art. The separated end of suture 16 is positioned along the top surface of first member 272 prior to placing a second member of retainer atop first member 272 similar to the formation of retainer 70 in the previously discussed embodiment.

[0065] Joinder and formation of retainer 70 is substantially similar to that of the previous embodiment using pressure and/or thermal energy from heat stake apparatus 110 as illustrated in FIGS. 9-11 and discussed previously.

[0066] In another embodiment, holder 30 is attached to a rail assembly 300 as shown in FIGS. 13-14. Holder 30 was previously described with reference to FIGS. 3-4. In this embodiment, holder 30 is positionable on rail assembly 300 rather than being rotatably mounted to plate 1 using mounting arm 42 as in the previous embodiment.

[0067] Rail assembly 300 includes a carriage 310 that is slidably mounted to rail 320 using structures and techniques known to those of skill in the art. Holder 30 is attached to carriage 310 thereby allowing holder 30 to be positioned along rail 320 throughout a plurality of positions including a loading position (FIG. 13) and an unloading position (FIG. 14). Holder 30 and rail assembly 300 are adapted for use with either embodiment of the suture winding device and suture winding device 100 is shown in FIGS. 13-14 for illustrative purposes only.

[0068] As suture 16 is wound onto suture winding device 100, as previously shown and described, carriage 310 and holder 30 move along rail 320 from the loading position to the unloading position. Movement of carriage 310 is coordinated and synchronized with the rotation of suture winding device 100 such that the desired amount of tension is maintained on suture 16 during the winding process. After the desired amount of suture 16 is wound onto suture winding device 100 (i.e. holder 30 is in the unloading position), suture 16 may be separated as discussed previously with reference to suture winding device 100.

[0069] Joinder and formation of retainer 70 is substantially similar to that of the previous embodiment using pressure and/or thermal energy from heat stake apparatus 110 as illustrated in FIGS. 9-11 and discussed previously.

[0070] It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.