US20070208355A1 - Barbed tissue connector - Google Patents

Abstract

A barbed bodily tissue connector for insertion into tissue comprises an elongated body having a substantially polygonal periphery in cross-section including at least three sides. Each side meets an adjacent side at an edge of the elongated body. A plurality of barbs project from the edges of the body. The barbs are configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS
• This application is a continuation application of U.S. patent application Ser. No. 10/420,119, filed on Apr. 2, 2003, which is a continuation application of U.S. patent application Ser. No. 09/629,428, filed on Jul. 31, 2000, now abandoned, which is a continuation application of U.S. patent application Ser. No. 08/324,529, filed on Oct. 18, 1994, now U.S. Pat. No. 6,241,747, which is a continuation-in-part application of U.S. patent application Ser. No. 08/055,989, filed on May 3, 1993, now abandoned.
BACKGROUND OF THE INVENTION
• This invention relates to a barbed tissue connector, and more particularly, to such a connector which can be used to quickly and effectively close a body wound.
• Human wounds are typically repaired with a filament introduced into the tissue by a needle attached to one end. After piercing the opposing faces of the wound, the needle is removed, and the ends of the suture are tied together with at least three overhand knots. Such a technique requires considerable time and expertise on the part of the surgeon. There are also a number of other drawbacks to repairing a wound in this manner. For example, it is very difficult to use sutures to repair wounds where there is insufficient space to properly manipulate the suture, especially those wounds repaired using fiber optic visualization. The suture forms a loop as it is tied, and this loop constricts blood flow to the tissue in its confines, promoting necrosis of the wound margins. Further, if the needle's passage was noncircular, the tissue will be distorted as it is secured by the suture.
• Alternatives to conventional sutures are known in the prior art. Staples, as shown, for example, in U.S. Pat. No. 4,994,073, to Green, are often used for approximating the superficial layer of the wound. Staples, however, are generally unsuitable for deeper layers of tissue.
• The patent to Alcamo, U.S. Pat. No. 3,123,077, discloses a roughened suture which can be passed through tissue in one direction, but resists movement in the opposite direction. The Alcamo suture, however, still must be sewn, as by a conventional technique, and the trailing end must be secured with knots. Thus, although there is less slippage of the suture in the wound, most of the disadvantages of sutures noted above are also found in the Alcamo suture.
• The patent to Tanner, U.S. Pat. No. 3,716,058, discloses a relatively rigid suture with one or more barbs on opposite ends of an arcuate body. One disadvantage of the Tanner suture is that the rigid barbs, which protrude from the suture as it is inserted, will lacerate tissue and prevent retrograde repositioning. Further, since the barbs are only placed at the ends of the suture, the forces applied to the tissue by the barbs will be limited to a relatively small area; this substantially increases the pressure on the blood vessels ensnared by a barb and severely restricts blood flow to the area.
• It will be seen from the foregoing that there is a need for a tissue connector which can be placed more expeditiously than sutures, is self-retaining, obviates distortion of the tissue, can close tissue inaccessible to conventional procedures, and which preserves blood flow by broadly distributing the retention force.
SUMMARY OF THE INVENTION
• It is an object of the present invention to overcome the aforementioned problems in the prior art and to provide an improved tissue connector.
• In accordance with the present invention there is provided a barbed tissue connector comprising: an elongated body having a point formed on one end, the body being formed of a material sufficiently hard for the point to pierce tissue and enable the connector to be inserted in tissue when a substantially axial force is applied to the body; and a plurality of barbs projecting from the body, the barbs being disposed around the periphery of the body along a length of the body which extends from adjacent the one end to a predetermined location on the body, the barbs being configured such that they are yieldable in a direction toward the body and are generally rigid in an opposite direction, and the barbs being sufficiently resilient to return to a predetermined position after deflection therefrom.
• In one embodiment of the present invention, the barbed tissue connector includes an elongated body and a plurality of barbs which are disposed in a helical pattern on the body and extend from a pointed end of the connector to a predetermined location on the body. Each barb includes a first side, which forms an obtuse angle with the body, and a second side which forms an acute angle with the body. The body is substantially rigid and sufficiently resilient to return to a predetermined position after deflection therefrom. When the connector is inserted in tissue to repair a wound, the pointed end pierces tissue and the barbs yield toward the body to facilitate entry of the connector.
• When the connector has been placed in a desired position in tissue, the barbs strongly resist movement away from this position. The connector can be inserted by gripping the connector in the hand and pushing the connector into the tissue, or the connector can be inserted by means of an inserting device which is withdrawn when the connector is in place.
• A principal advantage of the barbed tissue connector of the present invention is that it permits a surgeon to rapidly and securely attach the edges of a wound in human tissue without the necessity for threading and tying numerous individual stitches or for the use of a complicated or elaborate tool to insert the connector. The connector is configured to minimize damage to tissue when inserted and to minimize scarring or tissue necrosis across the wound. The connector is capable of insertion into the faces of a wound, can connect tissue at the bottom of a deep wound, and can connect tissue which is inaccessible to a staple. Finally, the connector of the present invention can be inserted quickly and accurately by a surgeon who only has access to tissue from a small opening or from only one direction, as, for example, during an endoscopic procedure.
• Other features and advantages will become apparent upon reference to the following description of the preferred embodiment when read in light of the attached drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a side view of the connector of the present invention, with a section broken away to more clearly show the arrangement of the barbs;
• FIG. 2 is an end view of the connector shown inFIG. 1;
• FIG. 3 is a side view of another embodiment of the present invention, with a section of a connector broken away;
• FIG. 4 is a side view of another embodiment of the present invention;
• FIG. 5 is a side view of another embodiment of the present invention;
• FIG. 6 is a side view of another embodiment of the present invention;
• FIG. 7 is a sectional view taken along the line7-7 inFIG. 6;
• FIG. 8 is a side view of another embodiment of the present invention;
• FIG. 9 is a sectional view taken along the line9-9 inFIG. 8;
• FIG. 10 is a perspective view of an inserting device for use with a barbed tissue connector of the present invention; and
• FIG. 11 is a view showing the inserting device and connector in a wound.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
• The present invention allows a surgeon to rapidly and securely attach the edges of a wound in human tissue without the necessity for threading and tying numerous individual stitches or for using a complicated or elaborate tool. As used herein, the term “wound” means an incision, laceration, cut, or other condition where suturing, stapling, or the use of another tissue connecting device might be required.
• With reference toFIGS. 1 and 2, there is shown abarbed tissue connector2 constructed in accordance with the present invention.Connector2 includes a body4 which is generally circular in cross section and a plurality of closely-spacedbarbs6 which extend around the periphery of the body4. A pointed end9 is formed on the body4 to facilitate penetration of theconnector2 into tissue. The body4 preferably has sufficient dimensional stability to assume a substantially rigid configuration during use and is sufficiently resilient to return to a predetermined shape after deflection therefrom. In some applications, it may be desirable for the body4 to be flexible and substantially nonresilient so that the shape of an inserted connector will be determined by surrounding tissue.
• Barbs6 serve to hold the connector in tissue and resist retraction of the connector from the tissue. Thebarbs6 can be arranged in any suitable pattern, for example, in a helical pattern as shown inFIG. 1. In a helical pattern ofbarbs6, it is preferable that the number of barbs occupying one revolution not be an integer, thereby avoiding parallel axial rows of barbs; such an arrangement provides a more uniform distribution of forces on the tissue and lessens the tendency of an insertedconnector2 to cut through tissue. If the number of barbs in one revolution is not an integer, the barbs in successive revolutions will be offset, as shown inFIG. 2, and the amount of offset will determine which barbs are in axial alignment. For example, if the barbs in successive revolutions are offset by ½ barb, the barbs in every second revolution will be in axial alignment, and by extension, if the barbs in each successive revolution are offset by 1/x barb, the barbs in every x revolution will be in axial alignment.
• As shown inFIG. 1, eachbarb6 includes afirst side8 which forms an obtuse angle alpha with the body4 and asecond side10 which forms an acute angle beta with the body4. Eachbarb6 tapers to apoint7, and the amount of difference between the angle alpha ofside8 and angle beta ofside10 will control the amount of taper in thebarb6. Abarb6 which tapers from a broad base to a narrow tip can be effective in resisting retraction, yet will yield toward the body4 during insertion to reduce the effort and tissue damage associated with insertion of theconnector2. Thebarbs6 can be generally conical, as shown inFIG. 1, or they can be any other shape which will function in substantially the same manner as the conical barbs.
• The configuration ofbarbs6 and the surface area of the barbs can vary depending upon the tissue in which theconnector2 is used. The proportions of thebarbs6 can remain relatively constant while the overall length of the barbs and the spacing of the barbs are determined by the tissue being connected. For example, if theconnector2 is intended to be used to connect the edges of a wound in skin or tendon, eachbarb6 can be made relatively short to facilitate entry into this rather firm tissue. If theconnector2 is intended for use in fatty tissue, which is relatively soft, the barbs can be made longer and spaced farther apart to increase the holding ability in the soft tissue. As shown inFIG. 1, thebarbs6 onconnector2 have a uniform unidirectional configuration, that is, thebarbs6 are uniformly spaced on body4 and all thesides8 are oriented in the same direction, facing pointed end9.Connector2 can be inserted into tissue with thesides8 of eachbarb6 facing in the direction of motion.Connector2 will prevent movement of tissue in the direction in which it was inserted. A pair ofconnectors2 inserted adjacent to each other and in opposite directions will prevent movement of tissue in either direction across a wound.
• Connector2 can be formed of a material sufficiently hard for point9 to pierce tissue and enable the connector to be inserted in tissue when a substantially axial force is applied to body4.Connector2 is preferably composed of a bioabsorbable compound, such as a polyglycolic acid or polylactic acid polymer or copolymer. The use of a bioabsorbable material eliminates the necessity of removing the connector from the patient, which can be a painful and possibly dangerous process.Connector2 can be formed, for example, by injection molding.
• In one representative example ofconnector2 for use in muscular tissue, the body4 is formed from polyglycolic acid, has a length of 1 to 5 cm, and a diameter of about 1 mm. The diameter of a circle extending around points7 ofbarbs6 will be about 3 mm, and the barbs are spaced apart from each other on body4 by a distance of 1 mm.Side8 forms an angle of 135 degrees with the body4 andside10 forms an angle of 75 degrees with the body4.
• InFIG. 3, there is shown a second embodiment of the present invention in whichbarbs16 are arranged in a uniform bidirectional configuration on abarbed tissue connector12.Barbs16 are constructed in the same manner asbarbs6 onconnector2. A first set ofbarbs15 onconnector12 are arranged in a helical pattern and face apointed end20, and a second set ofbarbs16 onconnector12 are arranged in a helical pattern and face apointed end21. Each of the pointed ends20,21 should be sufficiently hard and sharp to easily penetrate tissue in which the connector is to be used.Connector12 is particularly suitable for applications where the edges of a wound are prone to separate.Connector12 can be used by inserting one of the ends, forexample end20, into a first side of a wound (not shown), spreading the wound slightly to expose the second side of the wound, inserting theend21 of theconnector12 into the second side of the wound, and then pressing the edges of the wound together. Thebarbs15 and16 on the ends of theconnector12 will grasp the tissue on each side of the wound and prevent the edges of the wound from spreading.
• With reference toFIG. 4, there is shown another embodiment of the present invention in which abarbed tissue connector22 has a nonuniform bidirectional configuration.Connector22 comprises apointed end23 and one ormore barbs26 facing a first direction which alternate with one ormore barbs27 facing a second direction. At each axial location, there can be a number, e.g. 4-9, of circumferentially-spacedbarbs26 or27. To insertconnector22 into tissue, the surgeon would use an insertingdevice80 as described below. The arrangement ofbarbs26,27 onconnector22 would prevent any localized movement of tissue relative to the connector in an axial direction.
• With reference toFIG. 5, there is shown another embodiment of the present invention in which a barbed tissue connector32 has a uniform bidirectional configuration. Connector32 comprises abody34 having pointed ends33 and35. A plurality of axially-spaced barbs36 adjacentpointed end33 face towardend35, and a plurality of axially-spacedbarbs37 adjacentpointed end35 face towardend33.Barbs36 and37 can be circumferentially-spaced aroundbody34 at each axial location, or thebarbs36 and37 can be of the same construction and arranged in the same pattern asbarbs6 onconnector2. To insert a connector32, the surgeon would use an insertingdevice80 as described below. If thebody34 of the connector32 is sufficiently rigid, the connector32 would prevent tissue retained by the barbs36 from moving towardend35 and tissue retained bybarbs37 from moving towardend33. It will be apparent that only one end of connector32 needs to be pointed; two pointed ends are preferable, however, so that the surgeon does not have to take the time to insure that connector32 is oriented in the insertingdevice80 with a pointed end protruding from the inserting device.
• With reference toFIGS. 6 and 7, there is shown another embodiment of the present invention in which abarbed tissue connector42 comprises abody44 having apointed end45 for penetration into tissue. Ahead47 is formed on an opposite end ofbody44. A plurality of circumferentially-spacedbarbs46 are formed onbody44 at each of a number of axial locations. As shown inFIG. 7, threebarbs46 are formed at each axial location; however, more or less than threebarbs46 could be used for certain applications.Barbs46 include afirst side48 formed at an obtuse angle to thebody44 and a second side49 which projects frombody44 at an acute angle. Theconnector42 can be forced into tissue by applying a force to thehead47. Theconnector42 can be applied by hand, or it can be inserted using an insertingdevice80 as described below.
• Theconnector42 can be formed entirely of a bioabsorbable material, or thehead47 and thebody44 can be composed of different materials. For example, thebody44 can be composed of a bioabsorbable material, and thehead47 can be composed of metal for superior strength and to facilitate insertion of theconnector42.Head47 can be made flat, as shown inFIG. 6, or the head can be formed by a single ring of barbs (not shown) facing in a direction opposite to that of thebarbs46.
• In use, a series ofconnectors42 can be inserted into tissue, such as along the edges and in the field of a skin graft. After an adequate amount of time has passed for the wound to heal, the tissue beneath eachhead47 could be depressed slightly to permit thehead47 to be cut from thebody44. The tissue would then rise up over the cut end of the body. Such a process would reduce scarring which could result from a long-term projection of thebody44 through tissue and would eliminate the necessity to removeconnectors42 from the patient.
• With reference toFIGS. 8 and 9, there is shown another embodiment of the present invention in which abarbed tissue connector52 has a uniform unidirectional configuration.Connector52 comprises abody54 having a non-circular cross-sectional shape.Body54 includes a plurality ofbarbs56 which are generally triangular in cross section and are equally spaced around the periphery of the body at a series of axial locations. Each of thebarbs56 includes afirst side58 disposed at an obtuse angle tobody54 and a second side60 disposed at an acute angle to the body.Body54 includes apointed end53 to facilitate entry in tissue. Use of a non-circular cross-sectional shape increases the surface area of theconnector52 and facilitates the formation of the multiple barbs on the connector. For example,barbs56 can be formed on a piece of stock having a triangular cross section by removing material at successive axial locations from the three edges of the stock. It will be apparent that a similar process could be used to form barbs on stock of a different cross section (not shown), for example, a rectangular or hexagonal cross section.
• In the use of the disclosed connectors, such asconnectors2 and42, the surgeon can grip the connector in one hand and push the connector into the tissue. As an alternative to directly inserting the connectors into the tissue, the surgeon can use an insertingdevice80 as shown inFIGS. 10 and 11. The insertingdevice80 comprises a circulartubular body82. Thetubular body82 can be generally arcuate in an axial direction, and thebody82 is sufficiently long to contain at least a portion of a barbed tissueconnector C. Device80 has an inwardly tapered leadingend84 and an outwardly tapered, or flared, trailingend86. Ahandle83 is provided onbody82 adjacent trailingend86 to enable the surgeon to manipulate the insertingdevice80.
• In order to facilitate entry of the connector C and thedevice80 into tissue, a connector C is positioned intubular body82 with a pointed end P of the connector C extending from leadingend84. In a preferred embodiment, the interior diameter of thebody82 is made slightly smaller than the outside diameter of the connector C so that the barbs B of a connector C in thebody82 will press against thebody82; as a result, the connector C will be retained in thebody82 during insertion in tissue with the point P properly positioned outside of thebody82. The connector can also be positioned inbody82 with a barb B outside ofbody82 to insure that the connector C will not be pushed back in thebody82 during insertion. In one application ofdevice80, the surgeon inserts thebody82 having connector C therein into the patient'stissue87 until the connector C reaches a desired position, for example, the position shown inFIG. 11.Device80 is then withdrawn in the direction ofarrow90, and a barb, or barbs, B on the connector C penetrates and catches thetissue87 to hold the connector C in the inserted position.
• Use of the insertingdevice80 is particularly recommended when the connector C includes multiple barbs facing more than one direction, such asconnectors22 and32, or when the connector is too flexible for insertion without additional support.
• While the present invention has been described with respect to certain preferred embodiments thereof, it is to be understood that numerous variations in the details of construction, the arrangement and combination of parts, and the type of materials used may be made without departing from the spirit and scope of the invention.

Claims (181)

1. A barbed bodily tissue connector for insertion into tissue comprising:

an elongated body having a first end, a second end, a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body; and

a plurality of barbs, each barb projecting from one of the edges of the body, wherein a first portion of the barbs extend along a first portion of the body and are oriented in one direction, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction.

2. The barbed bodily tissue connector ofclaim 1, wherein one of the first end and the second end comprises an end adapted to penetrate the tissue for facilitating entry of the connector into the tissue.

3. The barbed bodily tissue connector ofclaim 2, wherein the adapted end comprises a pointed end formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

4. The barbed bodily tissue connector ofclaim 3, wherein the body of the connector is formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

5. The barbed bodily tissue connector ofclaim 3, wherein the pointed end of the connector is free of barbs.

6. The barbed bodily tissue connector ofclaim 1, wherein the connector comprises a bioabsorbable material.

7. The barbed bodily tissue connector ofclaim 6, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

8. The barbed bodily tissue connector ofclaim 1, wherein certain adjacent barbs face toward each other.

9. The barbed bodily tissue connector ofclaim 1, wherein one of the first and second ends comprises a head end.

10. The barbed bodily tissue connector ofclaim 1, wherein the body has sufficient dimensional stability to assume a substantially rigid configuration during use thereof.

11. The barbed bodily tissue connector ofclaim 1, wherein the body is sufficiently resilient to return to a predetermined shape after deflection therefrom.

12. The barbed bodily tissue connector ofclaim 1, wherein the body is flexible and substantially nonresilient whereby the shape of an inserted connector will be determined by the surrounding tissue.

13. The barbed bodily tissue connector ofclaim 1, wherein the periphery in cross-section is one of triangular, rectangular, or hexagonal.

14. A barbed bodily tissue connector for insertion into tissue comprising:

an elongated body having a first end, a second end, a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body; and

a plurality of barbs, each barb projecting from one of the edges of the body, wherein a first portion of the barbs extend along a first portion of the body and are oriented in one direction, and wherein a second portion of the barbs extend along a second portion of the body and are oriented in an opposite direction to the first portion of the barbs, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction.

15. The barbed bodily tissue connector ofclaim 14, wherein one of the first end and the second end comprises an end adapted to penetrate the tissue for facilitating entry of the connector into the tissue.

16. The barbed bodily tissue connector ofclaim 15, wherein the adapted end comprises a pointed end formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

17. The barbed bodily tissue connector ofclaim 16, wherein the body of the connector is formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

18. The barbed bodily tissue connector ofclaim 16, wherein the pointed end of the connector is free of barbs.

19. The barbed bodily tissue connector ofclaim 14, wherein the connector comprises a bioabsorbable material.

20. The barbed bodily tissue connector ofclaim 19, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

21. The barbed bodily tissue connector ofclaim 14, wherein certain adjacent barbs face toward each other.

22. The barbed bodily tissue connector ofclaim 14, wherein one of the first and second ends comprises a head end.

23. The barbed bodily tissue connector ofclaim 14, wherein the body has sufficient dimensional stability to assume a substantially rigid configuration during use thereof.

24. The barbed bodily tissue connector ofclaim 14, wherein the body is sufficiently resilient to return to a predetermined shape after deflection therefrom.

25. The barbed bodily tissue connector ofclaim 14, wherein the body is flexible and substantially nonresilient whereby the shape of an inserted connector will be determined by the surrounding tissue.

26. The barbed bodily tissue connector ofclaim 14, wherein

the barbs along a length of the body extending from adjacent the first end to a first axial location on the body face the first end;

the barbs along a length of the body extending from adjacent the second end to a second axial location face the second end; and

the length from adjacent the second end to the second axial location is less than the distance from the second end to the first axial location.

27. The barbed bodily tissue connector ofclaim 14, wherein

the barbs along a length of the body extending from adjacent the first end to a first axial location on the body face the second end;

the barbs along a length of the body extending from adjacent the second end to a second axial location face the first end; and

the length from adjacent the second end to the second axial location is less than the distance from the second end to the first axial location.

28. The barbed bodily tissue connector ofclaim 14, wherein the periphery in cross-section is one of triangular, rectangular, or hexagonal.

29. A method for bringing together one side and an other side of an open wound in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a pointed end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising:

(i) inserting the barbed tissue connector via the pointed end into tissue from one side of the wound,

(ii) penetrating through tissue on the one side of the wound, and

(iii) penetrating into tissue at the other side of the wound such that a portion of the body extends from the tissue at the one side of the wound.

30. The method ofclaim 29, said method comprising:

(iv) inserting another barbed tissue connector, where the other barbed tissue connector has an elongated body, a pointed end, a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue, via the pointed end of the other barbed tissue connector from the other side of the wound,

(v) penetrating through tissue at the other side of the wound, and

(vi) penetrating into tissue at the one side of the wound.

31. The method ofclaim 29, wherein inserting the barbed tissue connector is accomplished with an inserting device.

32. The method ofclaim 31, wherein the inserting device comprises a tubular body.

33. The method ofclaim 29, wherein the barbed tissue connector comprises a bioabsorbable material.

34. The method ofclaim 33, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

35. The method ofclaim 29, wherein the pointed end is free of barbs.

36. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a first pointed end, a second pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, the barbed tissue connector having the barbs oriented in one direction for a first portion of the length of the body and in an opposite direction for a second portion of the length of the body, said method comprising:

(a) at the tissue separation, inserting the barbed tissue connector via the first pointed end into tissue at a position on one side of the tissue separation;

(b) repeating step (a) at the other side of the tissue separation, using the second pointed end of the barbed tissue connector, at a position located across the tissue separation from the position in which the first pointed end of the barbed tissue connector was inserted; and

(c) bringing the two tissue portions together.

37. The surgical method ofclaim 36, wherein bringing the two tissue portions together in step (c) is accomplished by pressing the two tissue portions together.

38. The surgical method ofclaim 36, wherein bringing the two tissue portions together in step (c) is accomplished by pushing the barbed tissue connector through the tissue.

39. The method ofclaim 36, wherein inserting the barbed tissue connector is accomplished with an inserting device.

40. The method ofclaim 39, wherein the inserting device comprises a tubular body.

41. The surgical method ofclaim 36, wherein the two tissue portions comprise two sides of an open wound in skin.

42. The surgical method ofclaim 36, wherein the barbed tissue connector comprises a bioabsorbable material.

43. The surgical method ofclaim 42, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

44. The surgical method ofclaim 36, wherein the two tissue portions comprise portions of a tendon.

45. The surgical method ofclaim 36, wherein:

(a) the two tissue portions comprise two sides of an open wound at the skin of a patient, and

(b) the first pointed end and the second pointed end are free of barbs.

46. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue and permitting movement of the barbed tissue connector through the tissue in the direction the barbed tissue connector is inserted, said method comprising:

(a) at the tissue separation, inserting the barbed tissue connector, via the pointed end, into tissue at one side of the tissue separation,

(b) penetrating through tissue on the one side of the separation, and

(c) penetrating into tissue on the other side of the separation wound such that a portion of the body extends from the tissue at the one side of the tissue separation.

47. The method ofclaim 46, said method comprising:

(d) inserting another barbed tissue connector, where the other barbed tissue connector has an elongated body, a pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue and permitting movement of the barbed tissue connector through the tissue in the direction the barbed tissue connector is inserted, via the pointed end of the other barbed tissue connector from the other side of the tissue separation,

(e) penetrating through tissue on the other side of the of the separation, and

(f) penetrating into tissue on the one side of the separation.

48. The surgical method ofclaim 46, wherein the two tissue portions comprise sections of a tendon.

49. The surgical method ofclaim 46, wherein the two tissue portions comprise two sides of an open wound in skin.

50. The surgical method ofclaim 46, wherein the barbed tissue connector comprises a bioabsorbable material.

51. The surgical method of claim251, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

52. A method for inserting a barbed tissue connector into tissue, where the barbed tissue connector has an elongated body, a pointed end, an opposite end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising inserting the pointed end into tissue by applying force to the opposite end such that a portion of the body extends from the tissue.

53. The method ofclaim 52, wherein the opposite end comprises a head end.

54. The method ofclaim 53, wherein after an adequate amount of time has passed for healing, depressing the tissue beneath the head end and cutting the head end from the elongated body, permitting the tissue to rise up over the cut end of the elongated body.

55. The method ofclaim 52, wherein inserting the barbed tissue connector is accomplished with an inserting device.

56. The method ofclaim 55, wherein the inserting device comprises a tubular body.

57. The surgical method ofclaim 52, wherein the barbed tissue connector comprises a bioabsorbable material.

58. The surgical method ofclaim 57, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

59. A method for bringing together one side and an other side of an open wound in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a pointed end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising:

(i) inserting the barbed tissue connector via the pointed end into tissue from one side of the wound,

(ii) penetrating through tissue on the one side of the wound,

(iii) penetrating into tissue at the other side of the wound such that a portion of the body extends from the tissue at the one side of the wound,

(iv) inserting another barbed tissue connector, where the other barbed tissue connector has an elongated body, a pointed end, a periphery, and a plurality of closely spaced barbs which extend around the periphery of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue, via the pointed end of the other barbed tissue connector from the other side of the wound,

(v) penetrating through tissue at the other side of the wound, and

(vi) penetrating into tissue at the one side of the wound such that a portion of the body of the another barbed tissue connector extends from the tissue at the other side of the wound.

60. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a first pointed end, a second pointed end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, the barbed tissue connector having the barbs oriented in one direction for a first portion of the length of the body and in an opposite direction for a second portion of the length of the body, and the first pointed end and the second pointed end being free of barbs, said method comprising:

(a) at the tissue separation, inserting the barbed tissue connector via the first pointed end into tissue at a position on one side of the tissue separation, wherein the barbed tissue connector comprises a bioabsorbable material;

(b) repeating step (a) at the other side of the tissue separation, using the second pointed end of the barbed tissue connector, at a position located across the tissue separation from the position in which the first pointed end of the barbed tissue connector was inserted wound; and

(c) bringing the two tissue portions together by pressing the two tissue portions together or by pushing the barbed tissue connector through the tissue.

61. A device for insertion into tissue comprising:

a barbed tissue connector having an elongated body, a pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction, and

an inserting device having a closed tubular body, a leading end, and a trailing end, the tubular body being sufficiently long to contain at least a portion of the barbed tissue connector.

62. The device ofclaim 61, wherein the leading end of the inserting device is tapered inwardly.

63. The device ofclaim 61, wherein the trailing end of the inserting device is tapered outwardly.

64. The device ofclaim 61, wherein the tubular body of the inserting device has a circular cross section.

65. The device ofclaim 61, wherein an inside diameter of the tubular body of the inserting device is slightly less than an outside cross-section of the connector.

66. The device ofclaim 61, wherein the tubular body of the inserting device is generally arcuate in an axial direction.

67. The device ofclaim 61, wherein the inserting device has a handle on the tubular body adjacent the trailing end.

68. The device ofclaim 61, wherein at least one barb of the connector protrudes from the leading end of the tubular body of the inserting device.

69. The device ofclaim 61, wherein the body of the connector is formed of a material sufficiently hard for the point to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

70. The device ofclaim 61, wherein the connector comprises a bioabsorbable material.

71. The device ofclaim 70, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

72. The device ofclaim 61, wherein the connector has the barbs oriented at progressively staggered positions along the edges of the body.

73. The device ofclaim 61, wherein the barbs have a unidirectional configuration on the connector.

74. The device ofclaim 61, wherein the connector has the barbs oriented in one direction for a first portion of the length of the body of the connector and in an opposite direction for a second portion of the length of the body of the connector.

75. The device ofclaim 61, wherein the barbs are arranged in a helical pattern on the connector.

76. The device ofclaim 61, wherein the pointed end of the connector is free of barbs.

77. The device ofclaim 61, wherein the connector has an end opposite the pointed end comprising a head end.

78. A device for insertion into tissue comprising:

an inserting device having a closed tubular body, a leading end, and a trailing end, and

a barbed tissue connector having an elongated body, a pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction, and the connector being positioned in the tubular body of the inserting device with the pointed end of the connector protruding from the leading end of the inserting device.

79. The device ofclaim 78, wherein the leading end of the inserting device is tapered inwardly.

80. The device ofclaim 78, wherein the trailing end of the inserting device is tapered outwardly.

81. The device ofclaim 78, wherein the tubular body of the inserting device has a circular cross section.

82. The device ofclaim 78, wherein an inside diameter of the tubular body of the inserting device is slightly less than an outside cross-section of the connector.

83. The device ofclaim 78, wherein the tubular body of the inserting device is generally arcuate in an axial direction.

84. The device ofclaim 78, wherein the inserting device has a handle on the tubular body adjacent the trailing end.

85. The device ofclaim 78, wherein at least one barb of the connector protrudes from the leading end of the tubular body of the inserting device.

86. The device ofclaim 78, wherein the body of the connector is formed of a material sufficiently hard for the point to pierce tissue and enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

87. The device ofclaim 78, wherein the connector comprises a bioabsorbable material.

88. The device ofclaim 87, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

89. The device ofclaim 78, wherein the connector has the barbs oriented at progressively staggered positions along the periphery of the body.

90. The device ofclaim 78, wherein the barbs have a unidirectional configuration on the connector.

91. The device ofclaim 78, wherein the connector has the barbs oriented in one direction for a first portion of the length of the body of the connector and in an opposite direction for a second portion of the length of the body of the connector.

92. The device ofclaim 78, wherein the barbs are arranged in a helical pattern on the connector.

93. The device ofclaim 78, wherein the pointed end of the connector is free of barbs.

94. The device ofclaim 78, wherein the connector has an end opposite the pointed end comprising a head end.

95. A method for bringing together one side and an other side of an open wound in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising:

(iii) inserting the barbed tissue connector into tissue from one side of the wound,

(iv) penetrating through tissue on the one side of the wound, and

(iii) penetrating into tissue at the other side of the wound such that a portion of the body extends from the tissue at the one side of the wound.

96. The method ofclaim 95, said method comprising:

(i) inserting another barbed tissue connector from the other side of the wound, where the other barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue,

(ii) penetrating through tissue at the other side of the wound, and

(vii) penetrating into tissue at the one side of the wound.

97. The method ofclaim 95, wherein inserting the barbed tissue connector is accomplished with an inserting device.

98. The method ofclaim 97, wherein the inserting device comprises a tubular body.

99. The method ofclaim 95, wherein the barbed tissue connector comprises a bioabsorbable material.

100. The method ofclaim 99, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

101. The method ofclaim 95, wherein the barbed tissue connector has the barbs oriented at progressively staggered positions around the periphery of the body.

102. The method ofclaim 95, wherein the barbed tissue connector has an end that is free of barbs.

103. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a first end, a second end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, the barbed tissue connector having the barbs oriented in one direction for a first portion of the length of the body and in an opposite direction for a second portion of the length of the body, said method comprising:

(a) at the tissue separation, inserting the barbed tissue connector via the first end into tissue at a position on one side of the tissue separation;

(b) repeating step (a) at the other side of the tissue separation, using the second end of the barbed tissue connector, at a position located across the tissue separation from the position in which the first end of the barbed tissue connector was inserted; and

(c) bringing the two tissue portions together.

104. The surgical method ofclaim 103, wherein bringing the two tissue portions together in step (c) is accomplished by pressing the two tissue portions together.

105. The surgical method ofclaim 103, wherein bringing the two tissue portions together in step (c) is accomplished by pushing the barbed tissue connector through the tissue.

106. The surgical method ofclaim 103, wherein inserting the barbed tissue connector is accomplished with an inserting device.

107. The surgical method ofclaim 106, wherein the inserting device comprises a tubular body.

108. The surgical method ofclaim 103, wherein the two tissue portions comprise two sides of an open wound in skin.

109. The surgical method ofclaim 103, wherein the barbed tissue connector comprises a bioabsorbable material.

110. The surgical method ofclaim 109, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

111. The surgical method ofclaim 103, wherein the two tissue portions comprise portions of a tendon.

112. The surgical method ofclaim 103, wherein:

(a) the two tissue portions comprise two sides of an open wound at the skin of a patient, and

(b) the first end and the second end are free of barbs.

113. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue and permitting movement of the barbed tissue connector through the tissue in the direction the barbed tissue connector is inserted, said method comprising:

(a) at the tissue separation, inserting the barbed tissue connector into tissue at one side of the tissue separation,

(b) penetrating through tissue on the one side of the separation, and

(c) penetrating into tissue on the other side of the separation such that a portion of the body extends from the tissue at the one side of the tissue separation.

114. The surgical method ofclaim 113, said method comprising:

(d) inserting another barbed tissue connector from the other side of the tissue separation, where the other barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue and permitting movement of the other barbed tissue connector through the tissue in the direction the other barbed tissue connector is inserted,

(e) penetrating through tissue on the other side of the of the separation, and

(f) penetrating into tissue on the one side of the separation.

115. The surgical method ofclaim 113, wherein the two tissue portions comprise sections of a tendon.

116. The surgical method ofclaim 113, wherein the two tissue portions comprise two sides of an open wound in skin.

117. The surgical method ofclaim 113, wherein the barbed tissue connector comprises a bioabsorbable material.

118. The surgical method ofclaim 117, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

119. A surgical method for inserting a barbed tissue connector into tissue, where the barbed tissue connector has an elongated body, an end adapted to penetrate the tissue, an opposite end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising inserting the penetrating end into tissue by applying force to the opposite end such that a portion of the body extends from the tissue.

120. The surgical method ofclaim 119, wherein the opposite end comprises a head end.

121. The surgical method ofclaim 119, wherein after an adequate amount of time has passed for healing, depressing the tissue beneath the head end and cutting the head end from the elongated body, permitting the tissue to rise up over the cut end of the elongated body.

122. The surgical method ofclaim 119, wherein inserting the barbed tissue connector is accomplished with an inserting device.

123. The surgical method ofclaim 122, wherein the inserting device comprises a tubular body.

124. The surgical method ofclaim 119, wherein the barbed tissue connector comprises a bioabsorbable material.

125. The surgical method ofclaim 124, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

126. A method for bringing together one side and an other side of an open wound in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising:

(v) inserting the barbed tissue connector into tissue from one side of the wound,

(vi) penetrating through tissue on the one side of the wound,

(vii) penetrating into tissue at the other side of the wound such that a portion of the body extends from the tissue at the one side of the wound,

(viii) inserting another barbed tissue connector, where the other barbed tissue connector has an elongated body, a periphery, and a plurality of closely spaced barbs which extend around the periphery of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue, from the other side of the wound,

(vii) penetrating through tissue at the other side of the wound, and

(viii) penetrating into tissue at the one side of the wound such that a portion of the body of the another barbed tissue connector extends from the tissue at the other side of the wound.

127. A surgical method for bringing together two tissue portions on either side of a tissue separation in tissue with a barbed tissue connector, where the barbed tissue connector has an elongated body, a first end, a second end, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, the barbed tissue connector having the barbs oriented in one direction for a first portion of the length of the body and in an opposite direction for a second portion of the length of the body, and the first end and the second end being free of barbs, said method comprising:

(d) at the tissue separation, inserting the barbed tissue connector via the first end into tissue at a position on one side of the tissue separation, wherein the barbed tissue connector comprises a bioabsorbable material;

(e) repeating step (a) at the other side of the tissue separation, using the second end of the barbed tissue connector, at a position located across the tissue separation from the position in which the first pointed end of the barbed tissue connector was inserted wound; and

(f) bringing the two tissue portions together by pressing the two tissue portions together or by pushing the barbed tissue connector through the tissue.

128. A device for insertion into tissue comprising:

a barbed tissue connector having an elongated body, a pointed end, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction, and

an inserting device having a closed tubular body, a leading end, and a trailing end, the tubular body being sufficiently long to contain at least a portion of the barbed tissue connector.

129. The device ofclaim 128, wherein the leading end of the inserting device is tapered inwardly.

130. The device ofclaim 128, wherein the trailing end of the inserting device is tapered outwardly.

131. The device ofclaim 128, wherein the tubular body of the inserting device has a circular cross section.

132. The device ofclaim 128, wherein an inside diameter of the tubular body of the inserting device is slightly less than an outside cross-section of the connector.

133. The device ofclaim 128, wherein the tubular body of the inserting device is generally arcuate in an axial direction.

134. The device ofclaim 128, wherein the inserting device has a handle on the tubular body adjacent the trailing end.

135. The device ofclaim 128, wherein at least one barb of the connector protrudes from the leading end of the tubular body of the inserting device.

136. The device ofclaim 128, wherein the body of the connector has a pointed end formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

137. The device ofclaim 128, wherein the connector comprises a bioabsorbable material.

138. The device ofclaim 137, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

139. The device ofclaim 128, wherein the connector has the barbs oriented at progressively staggered positions around the periphery of the body.

140. The device ofclaim 128, wherein the barbs have a unidirectional configuration on the connector.

141. The device ofclaim 128, wherein the connector has the barbs oriented in one direction for a first portion of the length of the body of the connector and in an opposite direction for a second portion of the length of the body of the connector.

142. The device ofclaim 128, wherein the barbs are arranged in a helical pattern on the connector.

143. The device ofclaim 128, wherein the connector has an end free of barbs.

144. The device ofclaim 128, wherein the connector has an end and an opposite end that comprises a head end.

145. A device for insertion into tissue comprising:

an inserting device having a tubular body, a leading end, and a trailing end, and

a barbed tissue connector having an elongated body, a length, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs being configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction, and the connector being positioned in the tubular body of the inserting device with one end of the connector protruding from the leading end of the inserting device.

146. The device ofclaim 145, wherein the leading end of the inserting device is tapered inwardly.

147. The device ofclaim 145, wherein the trailing end of the inserting device is tapered outwardly.

148. The device ofclaim 145, wherein the tubular body of the inserting device has a circular cross section.

149. The device ofclaim 145, wherein an inside diameter of the tubular body of the inserting device is slightly less than an outside cross-section of the connector.

150. The device ofclaim 145, wherein the tubular body of the inserting device is generally arcuate in an axial direction.

151. The device ofclaim 145, wherein the inserting device has a handle on the tubular body adjacent the trailing end.

152. The device ofclaim 145, wherein at least one barb of the connector protrudes from the leading end of the tubular body of the inserting device.

153. The device ofclaim 145, wherein the body of the connector is formed of a material sufficiently hard for the point to pierce tissue and enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

154. The device ofclaim 145, wherein the connector comprises a bioabsorbable material.

155. The device ofclaim 145, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

156. The device ofclaim 145, wherein the connector has the barbs oriented at progressively staggered positions along the edges of the body.

157. The device ofclaim 145, wherein the barbs have a unidirectional configuration on the connector.

158. The device ofclaim 145, wherein the connector has the barbs oriented in one direction for a first portion of the length of the body of the connector and in an opposite direction for a second portion of the length of the body of the connector.

159. The device ofclaim 145, wherein the barbs are arranged in a helical pattern on the connector.

160. The device ofclaim 145, wherein one end of the connector is free of barbs.

161. The device ofclaim 145, wherein the connector has an end and an opposite end comprising a head end.

162. A method for inserting a barbed tissue connector in tissue, where the barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs being sized and shaped to resist retraction of the barbed tissue connector from the tissue, said method comprising:

(i) positioning the barbed tissue connector in an inserting device including a closed tubular body,

(ii) inserting the inserting device into tissue, and

(iii) extracting the inserting device from the tissue while leaving the connector in the tissue.

163. The method ofclaim 162, said method comprising:

(iv) repeating steps (i), (ii), and (iii) with another barbed tissue connector, where the other barbed tissue connector has an elongated body, and a substantially polygonal periphery in cross-section including at least three sides, each side meeting an adjacent side at an edge of the elongated body, and a plurality of barbs, each barb projecting from one of the edges of the body, and being disposed around the periphery of the body along at least a portion of the length of the body, the barbs of the other barbed tissue connector being sized and shaped to resist retraction of the other barbed tissue connector from the tissue.

164. The method ofclaim 162, wherein the barbed tissue connector comprises a bioabsorbable material.

165. The method ofclaim 164, wherein the bioabsorbable material comprises polyglycolic acid polymer, polyglycolic acid copolymer, polylactic acid polymer, or polylactic acid copolymer.

166. The method ofclaim 162, wherein the barbed tissue connector has the barbs oriented at progressively staggered positions around the periphery of the body.

167. The method ofclaim 162, wherein the barbed tissue connector has an end that is free of barbs.

168. The method ofclaim 162, wherein the body of the connector has a pointed end formed of a material sufficiently hard for the pointed end to pierce tissue and to enable the connector to be inserted in tissue when a substantially axial force is applied to the body of the connector.

169. The method ofclaim 162, wherein the connector has the barbs oriented at progressively staggered positions around the periphery of the body.

170. The method ofclaim 162, wherein the barbs have a unidirectional configuration on the connector.

171. The method ofclaim 162, wherein the connector has the barbs oriented in one direction for a first portion of the length of the body of the connector and in an opposite direction for a second portion of the length of the body of the connector.

172. The method ofclaim 162, wherein the barbs are arranged in a helical pattern on the connector.

173. The method ofclaim 162, wherein the connector has an end free of barbs.

174. The method ofclaim 162, wherein the connector has an end and an opposite end that comprises a head end.

175. The method ofclaim 162, wherein the tubular body of the inserting device has a circular cross section.

176. The method ofclaim 162, wherein an inside diameter of the tubular body of the inserting device is slightly less than an outside diameter of the connector.

177. The method ofclaim 162, wherein the tubular body of the inserting device is generally arcuate in an axial direction.

178. The method ofclaim 162, wherein the inserting device has a leading end and at least one barb of the connector protrudes from the leading end.

179. The method ofclaim 162, wherein the inserting device has a leading end that is tapered inwardly.

180. The method ofclaim 162, wherein the inserting device has a trailing end that is tapered outwardly.

181. The method ofclaim 162, wherein the inserting device has a trailing end and a handle adjacent the trailing end.

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