[go: up one dir, main page]

WO2015131362A1 - Appareils pour appliquer des attaches chirurgicales - Google Patents

Appareils pour appliquer des attaches chirurgicales Download PDF

Info

Publication number
WO2015131362A1
WO2015131362A1 PCT/CN2014/072951 CN2014072951W WO2015131362A1 WO 2015131362 A1 WO2015131362 A1 WO 2015131362A1 CN 2014072951 W CN2014072951 W CN 2014072951W WO 2015131362 A1 WO2015131362 A1 WO 2015131362A1
Authority
WO
WIPO (PCT)
Prior art keywords
rack
trigger
handle housing
surgical fastener
fastener applying
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2014/072951
Other languages
English (en)
Inventor
Xiliang Zhang
Zhaokai Wang
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien China Medical Devices Technology Co Ltd
Covidien LP
Original Assignee
Covidien China Medical Devices Technology Co Ltd
Covidien LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien China Medical Devices Technology Co Ltd, Covidien LP filed Critical Covidien China Medical Devices Technology Co Ltd
Priority to CN201480076407.0A priority Critical patent/CN106102618B/zh
Priority to PCT/CN2014/072951 priority patent/WO2015131362A1/fr
Publication of WO2015131362A1 publication Critical patent/WO2015131362A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • A61B2017/0648—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks threaded, e.g. tacks with a screw thread

Definitions

  • the present disclosure relates to a surgical instrument, device and/or system for performing surgical procedures and methods of use thereof. More specifically, the present disclosure relates to a surgical fastener applying apparatus, device and/or system for performing surgical procedures, which is selectively loadable with disposable or reusable loading units containing absorbable or permanent surgical fasteners.
  • Various surgical procedures require instruments capable of applying fasteners to tissue to form tissue connections or to secure objects to tissue.
  • tissue connections For example, during hernia repair it is often desirable to fasten a mesh to body tissue.
  • hernias such as direct or indirect inguinal hernias
  • a part of the intestine protrudes through a defect in the abdominal wall to form a hernial sac.
  • the defect may be repaired using an open surgery procedure in which a relatively large incision is made and the hernia is closed outside the abdominal wall by suturing.
  • the mesh is attached with sutures over the opening in the abdominal wall to provide reinforcement.
  • Minimally invasive, e.g., endoscopic or laparoscopic, surgical procedures are currently available to repair a hernia.
  • laparoscopic procedures surgery is performed in the abdomen through a small incision while in endoscopic procedures, surgery is performed through narrow endoscopic tubes or cannulas inserted through small incisions in the body.
  • Laparoscopic and endoscopic procedures generally utilize long and narrow instruments capable of reaching remote regions within the body and configured to seal with the incision or tube they are inserted through. Additionally, the instruments must be capable of being actuated remotely, that is, from outside the body.
  • surgical fasteners e.g., surgical tacks, staples, and clips
  • Surgical fasteners are often applied through an elongate instrument for delivery to the mesh, and are manipulated from outside a body cavity.
  • the laparoscopic or endoscopic instruments are typically loaded with either permanent fasteners or bioabsorbable fasteners. Additionally, these laparoscopic or endoscopic instruments are typically disposed of following a surgical procedure.
  • the present disclosure relates to surgical devices for performing surgical procedures.
  • the surgical devices are selectively connectable with loading units, which are loaded with absorbable or permanent surgical fasteners.
  • a surgical fastener applying instrument includes a handle assembly and a loading unit selectively connectable to the handle assembly.
  • the handle assembly includes a handle housing, a trigger operatively coupled to the handle housing, a drive mechanism and trigger return mechanism each disposed within the handle housing.
  • the handle housing extends from a proximal end to a distal end and defines a longitudinal axis therebetween.
  • the drive mechanism is disposed within the handle housing and actuatable by the trigger.
  • the trigger return mechanism is disposed within the handle housing and coupled to the drive mechanism.
  • the trigger return mechanism includes a rack and a biasing member.
  • the rack is disposed within the proximal end of the handle housing and movably connected to the drive mechanism.
  • the biasing member has a first end connected to the rack and a second end in abutting engagement with a top inner surface of the handle housing such that the biasing member extends transversely relative to the longitudinal axis.
  • Movement of the trigger from an un-actuated configuration to an actuated configuration drives an actuation of the drive mechanism, which drives movement of the rack to compress the biasing member between the rack and the top inner surface of the handle housing such that the trigger is resiliently biased to the un-actuated configuration.
  • the trigger return mechanism may further include a rod connected to a first end of the rack.
  • the biasing member may be coiled about the rod.
  • the biasing member may have a second end extending beyond a second end of the rod.
  • the rod may be fixed with the proximal end of the handle housing and the rack may be slidingly engaged to the rod such that the rack and biasing member slide relative to the rod upon actuation of the trigger.
  • the rack may include a geared linear surface in geared connection with a geared arcuate surface of the drive mechanism. Rotation of the geared arcuate surface of the drive mechanism upon actuation thereof by the trigger may translate the rack along the geared arcuate surface.
  • the top inner surface of the handle housing may include a transverse extension.
  • a second end of the biasing member may be secured by the transverse extension such that movement of the second end of the biasing member is resisted.
  • the handle assembly may further include a rotatable drive shaft connected to the drive mechanism.
  • the drive mechanism may interconnect the trigger and the drive shaft.
  • the loading unit may include an outer tube having a proximal end and a distal end and defining a lumen therebetween.
  • An inner tube may be rotatably supported in the outer tube.
  • the inner tube may define a lumen therethrough configured for disposal of a plurality of surgical fasteners.
  • a distal end of the inner tube may include a pair of opposed longitudinally extending tines defining a pair of opposed longitudinally extending notches.
  • the outer tube may have a helical thread disposed within the lumen thereof.
  • Each surgical fastener may include a threaded body portion, and a head portion defining a pair of opposed radial outer threads and a pair of opposed radial recesses.
  • the pair of radial recesses of each head portion may receive respective tines of the inner tube.
  • the pair of opposed radial outer threads of each head portion may project from the pair of opposed longitudinally extending notches of the inner tube and engage the helical thread of the outer tube.
  • an embodiment of a surgical fastener applying instrument includes a handle assembly, a ferrule configured to be rotatably engaged to a distal end of the handle assembly, and a loading unit selectively connectable to a distal end of the ferrule.
  • the handle assembly includes a handle housing, a trigger operatively connected to the handle housing, and a drive mechanism disposed within the handle housing.
  • the handle housing extends from a proximal end to a distal end and defines a longitudinal axis therebetween.
  • the drive mechanism is disposed within the handle housing and actuatable by the trigger.
  • the drive mechanism includes a bevel gear having a notch formed therein.
  • a lockout mechanism extends from the distal end of the handle housing through the ferrule.
  • the lockout mechanism includes a rack translatably supported in the handle housing and a rotatable shaft.
  • the rotatable shaft has a first gear supported on a proximal end thereof and in geared connection with the rack and a second gear supported on a distal end thereof and in rotatable connection to the ferrule. Rotation of the ferrule rotates the rotatable shaft to translate the rack between a locking position and an un-locking position. In the locking position, the rack is disposed within the notch of the bevel gear such that rotation of the bevel gear is resisted. In the un-locking position, the rack is disposed outside of the notch of the bevel gear such that the bevel gear is rotatable.
  • the handle assembly may further include a trigger return mechanism disposed within the handle housing and coupled to the drive mechanism.
  • the trigger return mechanism may include a rack and a biasing member.
  • the rack may be disposed within a proximal end of the handle housing and be movably connected to the drive mechanism.
  • the biasing member may have a first end connected to the rack of the return mechanism and a second end in abutting engagement with a top inner surface of the handle housing such that the biasing member extends transversely relative to the longitudinal axis. Movement of the trigger from an un-actuated configuration to an actuated configuration compresses the biasing member between the rack of the return mechanism and the top inner surface of the handle housing such that the trigger is resiliently biased to the un-actuated configuration.
  • the trigger return mechanism may further include a rod connected to a first end of the rack of the return mechanism and the biasing member may be coiled about the rod.
  • the biasing member may have a second end extending beyond a second end of the rod.
  • the rod may be fixed with the proximal end of the handle housing and the rack of the return mechanism may be slidingly engaged to the rod such that the rack and biasing member slide relative to the rod upon actuation of the trigger.
  • the rack of the return mechanism may include a geared linear surface in geared connection with a geared arcuate surface of the drive mechanism. Rotation of the drive mechanism upon actuation thereof by the trigger may translate the rack of the return mechanism along the geared arcuate surface.
  • the top inner surface of the handle housing may include a transverse extension. A second end of the biasing member may be secured by the transverse extension such that movement of the second end of the biasing member is resisted.
  • the drive mechanism may further include a first pinion gear coupled to the trigger and a second pinion gear spaced from the first pinion gear and coupled to the rack of the return mechanism.
  • FIG. 1 is a perspective view of an illustrative embodiment of a surgical fastener applying instrument in accordance with the present disclosure
  • FIG. 2 is a perspective, cutaway view of the surgical fastener applying instrument shown in FIG. 1 ;
  • FIG. 3 is an enlarged, cutaway view of the surgical fastener applying instrument shown in FIG. 2, with parts removed;
  • FIG. 4 is an enlarged, cutaway view of the surgical fastener applying instrument shown in FIG. 2, with parts removed;
  • FIG. 5 is a side, cross-sectional view of the surgical fastener applying instrument shown in FIG. 1 , as taken through section line 5-5 of FIG. 1 ;
  • FIG. 6 is a perspective view of a loading unit of the surgical fastener applying instrument shown in FIG. 1 with an outer tube and a coil removed therefrom, shown with surgical fasteners separated therefrom;
  • FIG. 7 is a perspective view of the loading unit of the surgical fastener applying instrument shown in FIG. 1 with the outer tube and the coil removed therefrom, shown with surgical fasteners loaded therein;
  • FIG. 8 is a cross-sectional view of the loading unit of the surgical fastener applying instrument shown in FIG. 1 , as taken through section line 8-8 of FIG. 1 , illustrating the loading unit during a firing stroke of the surgical fastener applying instrument;
  • FIG. 9 is a perspective view of an illustrative embodiment of a surgical fastener for use in a surgical fastener applying instrument in accordance with the present disclosure
  • FIG. 10 is a side, elevational view of the surgical fastener shown in FIG. 9.
  • FIG. 1 1 is an illustration of surgical fasteners of the present disclosure fixing a surgical mesh in place.
  • distal refers to those portions of the surgical fastener applying instruments that are farther from the user
  • proximal refers to those portions of the surgical fastener applying instruments that are closer to the user.
  • Tack applier 200 includes a handle assembly 210, and a removable elongate loading unit 300 (e.g., single use loading unit SULU) extending from a ferrule 280 of handle assembly 210.
  • Loading unit 300 is configured to have a plurality of tacks 100 (FIGS. 9-1 1) loaded or packed therein and to selectively release or fire the plurality of tacks 100 therefrom via actuation of a trigger 214.
  • handle assembly 210 includes a handle housing 212, a trigger 214, and a ferrule 280 interconnecting the handle housing 212 with loading unit 300.
  • Handle housing 212 extends from a proximal end 213 to a distal end 215 and defines a longitudinal axis "L" therebetween.
  • Handle housing 212 is formed from a hollow lower body portion 212a and a top portion 212b slidably removable from hollow body portion 212a. Hollow body portion 212a and top portion 212b of handle housing 212 may be slidingly joined to one another using know methods by those of skill in the art.
  • Hollow body portion 212a and top portion 212b of handle housing 212 may be joined to one another such that a fluid-tight seal is provided therebetween.
  • Hollow body portion 212a of handle housing 212 defines a fixed handle portion 216 having a free end 216a.
  • Handle assembly 210 also includes a trigger 214 for actuating a firing of surgical fasteners, such as, for example, tacks 100 from loading unit 300.
  • Trigger 214 has a bottom end 214a pivotably coupled to free end 216a of handle portion 216, at a pivot point "P."
  • Bottom end 214a includes a pair of laterally extending pins 214c configured for pivotable engagement in slots of free end 216a of fixed handle portion 216.
  • Trigger 214 includes a top end 214b spaced a distance from fixed handle portion 216 when trigger 214 is in an extended or un-actuated configuration.
  • Top end 214b of trigger 214 includes a trigger rack 218 being at least partially disposed within handle housing 212 and being designed and adapted for converting trans latory motion into rotary motion.
  • Trigger rack 218 includes a plurality of gear teeth 218a on an upper surface thereof configured for meshing engagement with gear teeth of a gear train 220.
  • handle assembly 210 supports a drive mechanism or gear train 220 operative ly and rotatably disposed within handle housing 212.
  • Gear train 220 interconnects a rotatable drive shaft 270 with trigger rack 218 of trigger 214 such that drive shaft 270 is actuatable upon an actuation of trigger 214.
  • Gear train 220 includes a first gear 222 and a second gear 224 spaced from, and non-rotatably coupled to, first gear 220, such that first and second gears 222, 224 are rotatable together.
  • First gear 222 may be in the form of a pinion gear or the like having a plurality of gear teeth formed along a radial outer edge thereof and being in meshing engagement with gear teeth 218a of trigger rack 218 such that translational motion of trigger rack 218, initiated upon actuation of trigger 214, is converted into rotational motion of first gear 222.
  • Second gear 224 may also be in the form of a pinion gear or the like having a plurality of gear teeth formed along a radial outer edge thereof being in meshing engagement with gear teeth of a rack 242 of a trigger return mechanism 240, as described in further detail below.
  • Gear train 220 further includes a bevel gear 230 non-rotatably engaged/associated to second gear 224 of gear train 220 such that bevel gear 230 is rotatable with first and second gears 222, 224.
  • bevel gear 230 may be in the form of a crown gear or the like.
  • Bevel gear 230 is configured for meshing engagement with a pinion gear 276 of drive shaft 270, as described in further detail below.
  • Bevel gear 230 has a notch 232 (FIGS. 3 and 4) formed in an outer surface thereof making up a component of a lockout mechanism 290, as described in further detail below.
  • handle assembly 210 further includes a trigger return mechanism 240 disposed within handle housing 212 and coupled to gear train 220.
  • Trigger return mechanism 240 is designed and adapted to resiliently bias trigger 214 to an un- actuated configuration such that trigger 214 can return from an actuated configuration to the un- actuated configuration without a user applying a force to trigger 214.
  • Trigger return mechanism 240 includes a rack 242, a biasing member 250, and a rod 260.
  • Rack 242 is disposed within proximal end 213 of handle housing 212 and movably connected to second gear 224 of gear train 220.
  • Rack 242 extends from a first end 242a to a second end 242b.
  • Rack 242 defines a first wall 244a, a second wall 244b, and a third wall 244c.
  • First wall 244a includes a first section having a substantially squared configuration and a second section having a substantially triangular configuration.
  • First wall 244a has a first side and a second side.
  • first wall 244a may be variously shaped, such as, for example, those alternatives described herein.
  • first wall 244a defines a geared linear surface 246 extending along a length thereof.
  • Geared linear surface 246 is in geared connection with a geared arcuate outer surface 224a of second gear 224 of gear train 220 such that rotation of second gear 224 moves or translates rack 242 of trigger return mechanism 240 along geared arcuate outer surface 224a of second gear 224.
  • the second side of first wall 244a is connected to second wall 244b in a substantially perpendicular orientation.
  • Third wall 244c is connected to proximal ends 242a of first and second walls 244a, 244b and defines an opening 248 therethrough configured for sliding disposal of rod 260.
  • trigger return mechanism 240 includes a biasing member, such as, for example, a spring 250, and a rod 260.
  • Rod 260 is slidingly disposed within opening 248 of third wall 244c of rack 242.
  • Rod 260 extends from a first end 262 fixedly connected to proximal end 213 of handle housing 212 and a second end 264 such that rack 242 slides relative to and along rod 260 upon actuation of trigger 214, as described herein.
  • Rod 260 extends at an angle (i.e., transverse) relative to the longitudinal axis "L" of handle housing 212 such that second end 264 thereof abuts top portion 212b of handle housing 212.
  • Spring 250 is coiled about rod 260 and has a first end 252 supported on, abutting, or otherwise connected to third wall 244c of rack 242. A second end 254 of spring 250 extends a distance beyond second end 264 of rod 260. Second end 254 of spring 250 is in abutting engagement with a top inner surface 217 of top portion 212b of handle housing 212. Top inner surface 217 of handle housing 212 includes a transverse extension or hub 217a configured to capture or secure second end 254 of spring 250 such that second end 254 of spring 250 is resisted from moving relative to handle housing 212.
  • trigger 214 is moved from an un-actuated configuration to an actuated configuration by rotating upper end 214b of trigger 214 about pivot point "P,” in a direction indicated by arrow "A" in FIG. 3.
  • Rotation of trigger 214 from the un-actuated configuration to the actuated configuration drives an actuation of gear train 220 via a conversion of translational movement of trigger rack 218 into rotational movement of first gear 222 of gear train 220.
  • second gear 224 Upon rotation of first gear 222, second gear 224 also rotates due to the non-rotatable connection of second gear 224 with first gear 222.
  • second gear 224 drives movement or translation of rack 242 of trigger return mechanism 240 relative to and along rod 260, in a direction indicated by arrow "B" in FIG. 3, via the connection between geared linear surface 246 of trigger return mechanism 240 and second gear 224 of gear train 220.
  • the translation of rack 242 of trigger return mechanism 240 along rod 260 results in the concomitant translation of first end 252 of spring 250 to compress spring 250 between third wall 244c of rack 242 and transverse extension 217a of top inner surface 217 of top portion 212b of handle housing 212.
  • spring 250 resiliently biases trigger 214 to the un- actuated configuration.
  • spring 250 axially expands between transverse extension 217a of top portion 212b and third wall 244c of rack 242, to translate rack 242, in a direction indicated by arrow "C" in FIG. 3.
  • the translation of rack 242 results in the concomitant rotation of second gear 224 of gear train 220 and, in turn, first gear 222 of gear train 220.
  • Rotation of first gear 222 of gear train 220 results in the concomitant rotation of trigger 214, in a direction indicated by arrow "D" in FIG. 3, to return trigger 214 from the actuated configuration to the un-actuated configuration.
  • trigger 214 may be moved from the actuated configuration back to the un-actuated configuration by a biasing member that acts on a component of tack applier 200 other than trigger 214.
  • tacker 200 includes a rotatable drive shaft
  • Drive shaft 270 which spans between proximal and distal ends 282, 284 of ferrule 280.
  • Drive shaft 270 has a proximal end 272 and a distal end 274. Proximal end 272 of drive shaft 270 is disposed in distal end 215 of handle housing 212.
  • Drive shaft 270 includes a gear, such as, for example, a pinion gear 276 non-rotatably disposed at proximal end 272 thereof.
  • Distal end 274 of drive shaft 270 is coupled with a proximal end of loading unit 300.
  • Drive shaft 270 transfers torque from bevel gear 230 to loading unit 300 to fire tacks 100 from loading unit 300 upon actuation of trigger 214.
  • bevel gear 230 rotates, in a direction indicated by arrow "E” in FIG. 3, to drive a rotation of drive shaft 270, in a direction indicated by arrow “F” in FIG. 3.
  • Rotation of drive shaft 270 in direction “F” can result in a firing of tacks 100 from loading unit 300, as described in further detail below.
  • tacker 200 further includes a ferrule or collar 280 rotatably and removably supported on distal end 215 of handle housing 212.
  • Ferrule 280 defines a distal opening 286 that is axially aligned with drive shaft 270.
  • Ferrule 280 has a proximal end 282 connected to distal end 215 of handle housing 212 and a distal end 284 detachably connected with loading unit 300.
  • loading unit 300 is fixedly connected to distal end 284 of ferrule 280.
  • tacker 200 further includes a lockout mechanism 290 extending from distal end 215 of handle housing 212.
  • Lockout mechanism 290 selectively locks gear train 220 to resist and/or prevent a firing of tacks 100 from loading unit 300 upon an inadvertent actuation of trigger 214, and to permit a connection/disconnection of loading unit 300 to/from handle assembly 210.
  • Lockout mechanism 290 includes a rack 292 and a rotatable shaft 294.
  • Rack 292 of lockout mechanism 290 has a substantially linear configuration and is translatably disposed within handle housing 212.
  • Rack 292 of lockout mechanism 290 is disposed in substantially perpendicular relation to longitudinal axis "L" of handle housing 212.
  • Rack 292 of lockout mechanism 290 and the notch 232 defined in bevel gear 230 are in coaxial alignment with one another when trigger 214 is in the un-actuated configuration, as shown in FIG. 3. In this way, with trigger 214 in the un-actuated configuration, rack 292 can be translated into and out of notch 232 defined in bevel gear 230.
  • Shaft 294 of lockout mechanism 290 runs in parallel relation to longitudinal axis
  • Shaft 294 has a first gear 296a supported on a proximal end thereof and a second gear 296b supported on a distal end thereof.
  • First gear 296a of shaft 294 is in geared connection with rack 292 of lockout mechanism 290 such that a rotation of shaft 294 of lockout mechanism 290 drives a translation of rack 292 of lockout mechanism 290, in a direction substantially perpendicular to longitudinal axis "L.”
  • Second gear 296b of shaft 294 is in rotatable connection with an inner, arcuate geared surface 288 of ferrule 280 such that a rotation of ferrule 280 results in a concomitant rotation of shaft 294 of lockout mechanism 290.
  • ferrule 280 is rotated, in a direction indicated by arrow "G" in FIG. 5, which results in the concomitant rotation of shaft 294 of lockout mechanism 290, via the meshed engagement of inner, arcuate geared surface 288 of ferrule 280 and second gear 296b of shaft 294 of lockout mechanism 290.
  • the rotation of shaft 294 of lockout mechanism 290 results in the concomitant translation of rack 292.
  • rack 292 of lockout mechanism 290 and notch 232 defined in bevel gear 230 are in coaxial alignment when trigger 214 is in the fully un-actuated configuration.
  • rack 292 can only be translated into and out of notch 232 of bevel gear 230 when trigger 214 is in the fully un-actuated configuration.
  • rack 292 of locking mechanism 290 In a locking position, rack 292 of locking mechanism 290 is captured or disposed within notch 232 to resist and/or prevent rotation of bevel gear 230, and thus a firing of tacks 100 from loading unit 300.
  • loading unit 300 may be connected/disconnected to/from handle assembly 210.
  • rack 292 of locking mechanism 290 In an un-locking position, rack 292 of locking mechanism 290 is disposed outside of notch 232 of bevel gear 230 such that bevel gear 230 is free to rotate upon actuation thereof by the actuation of trigger 214.
  • loading unit 300 includes an outer tube 310, an inner tube 320 rotatably disposed within outer tube 310, a guide coil or spring 330 disposed between outer tube 310 and inner tube 320, and a plurality of surgical fasteners or tacks 100 loaded within inner tube 310.
  • Outer tube 310 of loading unit 300 includes a proximal end portion 310a and a distal end portion 310b, and defines a lumen 310c therethrough.
  • Loading unit 300 further includes a guide coil or spring 330 fixedly disposed within at least distal portion 310b of outer tube 310.
  • Inner tube 320 is rotatably disposed within coil 330.
  • Inner tube 320 includes a proximal end portion 320a and a splined distal end portion 320b, and defines a lumen 320c therethrough.
  • Proximal end portion 320a is non-rotatably coupled with drive shaft 270 of handle assembly 210 such that a rotation of drive shaft 270 via actuation of trigger 214, as described above, causes a rotation of inner tube 320.
  • Distal end portion 320b of inner tube 320 is slotted, defining a pair of opposed tines 320bi and a pair of opposed channels or notches 320b 2 .
  • Distal end portion 320b of inner tube 320 is capable of accepting a plurality of tacks 100 therein.
  • tacks 100 are loaded into loading unit 300 such that a pair of opposing threaded sections 1 12a, 1 12b of tacks 100 (FIGS.
  • the pair of tines 320bi of inner tube 320 transmit the rotation to tacks 100 and advance tacks 100 distally or proximally due to helical head threads 1 14a, 1 14b of tacks 100 (FIGS. 9-1 1) engaging with coil 330.
  • Tack 100 includes a head section 1 10, a mesh retention section 120, and a threaded tissue- snaring section 130.
  • Head section 1 10 includes a pair of opposing threaded sections 1 12a, 1 12b having respective radial, outer, helical head threads 1 14a, 1 14b, and a pair of opposing open or slotted sections 1 16a, 1 16b.
  • a distal surface of head section 1 10 is formed onto or integral with a proximal end of mesh retention section 120.
  • Mesh retention section 120 of tack 100 extends from and between a distal end or surface of head section 1 10 and a proximal end of tissue-snaring section 130.
  • Mesh retention section 120 functions to lock, anchor or otherwise retain a surgical mesh 140 with tack 100 when tack 100 is screwed into the mesh 140 to a depth past a proximal-most segment of tissue-snaring section 130. This is achieved because there is no thread located in mesh retention section 120 that would allow tack 100 to be unscrewed or backed out from the mesh 140.
  • Mesh retention section 120 has a cylindrical or conical transverse cross-sectional profile.
  • Mesh retention section 120 includes a transverse radial dimension, relative to a central longitudinal axis of tack 100, that is smaller than a transverse radial dimension of head section 1 10, and smaller than a transverse radial dimension of the proximal-most segment of tissue- snaring section 130.
  • Threaded tissue-snaring section 130 of tack 100 includes helical threads 132 formed onto a tapered truncated body section 134.
  • a distal point or tip 136 defines the terminus of the distal most tissue-snaring thread 132.
  • Body section 134 of tissue-snaring section 130 is tapered, i.e., becoming smaller toward the distal end of threaded tissue-snaring section 130, and terminates or truncates to a distal truncation point prior to reaching an apex or tip of tack 100.
  • Body section 134 includes a concave taper such that, for a given length, a minimum diameter of body section 134 is defined upon truncation thereof which is approximately less than 0.01 inches.
  • Tack 100 includes a transverse dimension of a distal-most thread in the threaded tissue-snaring section 130 which is as large as design constraints will allow or approximately greater than 0.040 inches.
  • a small truncated body diameter and a large value of the transverse dimension minimizes tissue indentation.
  • the tissue- snaring threads 132 terminate at distal tip 136, which is distal of the truncation point of body section 134.
  • Tack 100 is non-cannulated and is constructed from a suitable bioabsorbable material, such as, for example, polylactide, polyglycolide.
  • Tack 100 may be formed from a proprietary biocompatible co-polymer (Lactomer USS LI , Boehringer Ingelheim LR 704 S, or Boehringer Ingelheim LG-857).
  • Tack 100 may also be constructed from suitable non- bioabsorbable materials, or permanent material, such as, for example, stainless steel, titanium and the like.
  • the components of surgical tacker 200, and tacks 100 are dimensioned such that a single complete and full actuation of trigger 214 results in a firing of a singe tack 100 from loading unit 300.
  • loading units 300 may be provided, wherein loading units may be available which are loaded with surgical fasteners fabricated from different materials (e.g., bioabsorbable, permanent, etc.), or loading units may be available having different lengths (e.g., short, medium, long, etc.) wherein the particular length loading unit is loaded with a respective number of surgical fasteners.
  • the surgeon may select any one or combination of loading units desired or needed, and the surgeon may interchange or exchange loading units as needed or desired during the surgical procedure.
  • all of the loading units may have the same length, but be loaded with varying numbers of surgical fasteners therein. In this manner, the surgeon may choose a loading unit loaded with fewer or more surgical fasteners depending on the type of surgical procedure to be performed.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument pour appliquer des attaches chirurgicales comprenant un ensemble de poignée. L'ensemble de poignée comprend un boîtier de poignée, un mécanisme de détente, un mécanisme d'entraînement et un mécanisme de retour de déclenchement. Le mécanisme de retour de déclenchement comprend une crémaillère et un élément de sollicitation. La crémaillère est disposée à l'intérieur du boîtier de poignée et reliée de manière déplaçable au mécanisme d'entraînement. L'élément de sollicitation a une première extrémité reliée à la crémaillère et une seconde extrémité venant en butée contre une surface interne supérieure du boîtier de poignée. Le déplacement de la détente d'une configuration non actionnée vers une configuration actionnée entraîne un actionnement du mécanisme d'entraînement, qui entraîne le mouvement de la crémaillère, pour comprimer l'élément de sollicitation entre la crémaillère et la surface intérieure supérieure du boîtier de la poignée de telle sorte que le déclencheur est sollicité de manière élastique vers la configuration non actionnée.
PCT/CN2014/072951 2014-03-06 2014-03-06 Appareils pour appliquer des attaches chirurgicales Ceased WO2015131362A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201480076407.0A CN106102618B (zh) 2014-03-06 2014-03-06 外科紧固件施加器械
PCT/CN2014/072951 WO2015131362A1 (fr) 2014-03-06 2014-03-06 Appareils pour appliquer des attaches chirurgicales

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2014/072951 WO2015131362A1 (fr) 2014-03-06 2014-03-06 Appareils pour appliquer des attaches chirurgicales

Publications (1)

Publication Number Publication Date
WO2015131362A1 true WO2015131362A1 (fr) 2015-09-11

Family

ID=54054369

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2014/072951 Ceased WO2015131362A1 (fr) 2014-03-06 2014-03-06 Appareils pour appliquer des attaches chirurgicales

Country Status (2)

Country Link
CN (1) CN106102618B (fr)
WO (1) WO2015131362A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019094834A1 (fr) * 2017-11-09 2019-05-16 Inceptus Medical LLC Système de couplage/découplage de boucle de verrouillage pour déployer des dispositifs d'implant vasculaire
US10653507B2 (en) 2013-07-24 2020-05-19 Covidien Lp Expanding absorbable tack

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10932776B2 (en) * 2018-01-10 2021-03-02 C.R. Bard, Inc. Surgical fasteners for articulating surgical instruments
CN110269655B (zh) * 2019-06-26 2024-07-12 北京博辉瑞进生物科技有限公司 一种具有取钉功能的修补固定器
CN115005900B (zh) * 2022-08-09 2022-11-04 生一科技(北京)有限公司 微创手术器械组件及微创手术器械

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1199038A2 (fr) * 2000-10-19 2002-04-24 Ethicon Endo-Surgery, Inc. Instrument chirurgical avec un mécanisme de verrouillage rotatif
US20090043302A1 (en) * 2004-06-21 2009-02-12 Curon Medical, Inc. Systems and methods for treating tissue regions of the body
EP2055241A2 (fr) * 2007-10-31 2009-05-06 Ethicon Endo-Surgery, Inc. Dispositif rechargeable de déploiement de fixateur de laparoscopie destiné à une utilisation dans une intervention de réduction du volume gastrique
US20130303845A1 (en) * 2012-05-11 2013-11-14 Ethicon, Inc. Applicator instruments with imaging systems for dispensing surgical fasteners during open repair procedures

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2008230841B2 (en) * 2007-03-26 2013-09-12 Covidien Lp Endoscopic surgical clip applier
US7819299B2 (en) * 2007-06-04 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical instrument having a common trigger for actuating an end effector closing system and a staple firing system
US8920439B2 (en) * 2009-05-12 2014-12-30 Ethicon, Inc. Applicator instruments having curved and articulating shafts for deploying surgical fasteners and methods therefor
WO2011044343A2 (fr) * 2009-10-09 2011-04-14 Ethicon Endo-Surgery, Inc. Instrument chirurgical

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1199038A2 (fr) * 2000-10-19 2002-04-24 Ethicon Endo-Surgery, Inc. Instrument chirurgical avec un mécanisme de verrouillage rotatif
US20090043302A1 (en) * 2004-06-21 2009-02-12 Curon Medical, Inc. Systems and methods for treating tissue regions of the body
EP2055241A2 (fr) * 2007-10-31 2009-05-06 Ethicon Endo-Surgery, Inc. Dispositif rechargeable de déploiement de fixateur de laparoscopie destiné à une utilisation dans une intervention de réduction du volume gastrique
US20130303845A1 (en) * 2012-05-11 2013-11-14 Ethicon, Inc. Applicator instruments with imaging systems for dispensing surgical fasteners during open repair procedures

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10653507B2 (en) 2013-07-24 2020-05-19 Covidien Lp Expanding absorbable tack
WO2019094834A1 (fr) * 2017-11-09 2019-05-16 Inceptus Medical LLC Système de couplage/découplage de boucle de verrouillage pour déployer des dispositifs d'implant vasculaire
US10531877B2 (en) 2017-11-09 2020-01-14 Inceptus Medical LLC Interlocking loop coupling/decoupling system for deploying vascular implant devices
US11298137B2 (en) 2017-11-09 2022-04-12 Inceptus Medical LLC Interlocking loop coupling/decoupling system for deploying vascular implant devices

Also Published As

Publication number Publication date
CN106102618A (zh) 2016-11-09
CN106102618B (zh) 2018-11-27

Similar Documents

Publication Publication Date Title
US11266401B2 (en) Articulating apparatus for endoscopic procedures with timing system
CA2915984C (fr) Appareil articule pour procedures endoscopiques
US10188387B2 (en) Articulating apparatus for endoscopic procedures
US10335146B2 (en) Surgical fastener applying apparatus, kits and methods for endoscopic procedures
CA2857855C (fr) Appareil articule pour procedures endoscopiques
EP3207881A1 (fr) Instrument chirurgical comprenant un effecteur d'extrémité rotatif et une structure de limitation de rotation
US20210378664A1 (en) Surgical fastener applying device, kits and methods for endoscopic procedures
WO2015131362A1 (fr) Appareils pour appliquer des attaches chirurgicales
WO2016011594A1 (fr) Appareil d'application de fixation chirurgicale, kits et procédés pour procédures endoscopiques
WO2016000255A1 (fr) Appareil d'application d'agrafes chirurgicales et procédés pour procédures endoscopiques
WO2015135193A1 (fr) Instruments et dispositifs d'application d'attache chirurgicale pour charger des attaches chirurgicales

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 14884435

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 14884435

Country of ref document: EP

Kind code of ref document: A1