Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • 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, e.g. tourniquets
  • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
  • A61B2017/0419—H-fasteners
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
  • A61B2017/0488—Instruments for applying suture clamps, clips or locks

Definitions

• the invention relates to an apparatus for distributing and placing surgical "I" fasteners which can, for example, be used to fix parietal and visceral reinforcements.
• a means for example a spring, recalls the plunger and the needle is withdrawn manually.
• the head thereof Under the action of the elasticity of the material constituting the fastener, the head thereof returns to its initial position and returns substantially perpendicular to the connecting filament, ensuring the anchoring of the fastener on the rear face of the sheets. . These are then trapped between the head and the foot of the fastener which also extends transversely, but on the front face of the sheets. It has been envisaged to transpose this type of fastener to ensure surgical ligatures by making the fastener in plastic material and, in particular, in bioresorbable material, and in distributing it by means of an equivalent distributor.
• the object of the present invention is to provide a dispensing device overcoming these drawbacks.
• This dispensing device comprises a handle body equipped with manual control means and a nozzle on which is attached and removably fixed a elongated element for storage and distribution of fasteners.
• the elongated element contains, near its free end, a slide linked, on the one hand, to a control rod actuable by first control means, between a rest position and a working position , and, on the other hand, to return means in the rest position, said slide comprising:
• a longitudinal channel for a pusher actuable by second control means in the extension of the hollow needle and the receiving chamber of the attachment head, a longitudinal channel for a pusher actuable by second control means; said pusher being arranged so that, when the slider is in the rest position, its free end is in the aforementioned receiving chamber and is opposed to the reception of a fastening head and that, when the slider has been moved by the first control means to project the needle out of the elongated element and engage it in the tissues, said end of the pusher is outside this chamber and can, after reception of the attachment head in this chamber and actuation of the second control means, push this head into the needle channel.
• This device is therefore composed of a handle body on which is attached a elongated element which can have all the guarantees of asepsis and contain a quantity of fasteners sufficient for a standard operation, this elongate element being systematically replaced with each new operation.
• the arrangement of the fastener storage store in the elongated element does not increase the overall size of the device and makes it possible to guarantee the sterilization of the fasteners.
• the external diameter of the elongated element is constant over the entire length and compatible with its use in laparoscopy.
• This movement also releases the reception chamber from the head of the first fastener and thus allows this head to come into the dispensing position.
• the actuation of the second control means causes, under the action of the pusher, the displacement of the head of the fastener in the hollow and split needle and, consequently, the transfer of this head beyond the human tissues in front to be assembled.
• return means return the pusher and the magazine to the initial rest position, that is to say retracts the needle in the elongated element by bringing the slide into the position where its distribution chamber is closed by the end of the pusher which opposes the positioning of the head of the next fastener.
• the front end of the fastener storage magazine comprises, facing the slide receiving chamber and in the longitudinal trajectory of the head of the first fastener, a ramp tending to drive said head transversely into the chamber reception.
• the slide comprises, facing a release chamber formed in front of the front end of the magazine and in the path of the attachment feet, an inclined ramp tending to move the foot of the first fastener during the longitudinal displacement of the latter.
• the first control means comprise an “L” lever, articulated near its elbow on the handle body, said lever comprising a large branch, bearing on the end of the slide control rod, and a small branch directed towards the end piece of the body
• the second control means comprise a handle, of general "L" shape, articulated near its elbow in the handle body on an axis distinct from that of the articulation of the aforementioned lever, said handle comprising:
• Figure 1 is a side elevational view of the device when the elongate member is assembled to the handle body.
• Figure 2 is a partial exploded perspective view with partial section of the free end of the elongated element showing the slide and the various control means, distribution and installation.
• Figure 3 is a longitudinal sectional view showing on an enlarged scale and schematically the different functional elements of the device.
• Figures 4, 5 and 6 are views in longitudinal section of the handle body and its connecting means with the elongated element when the handle is respectively in the rest position, in the actuation position of the first control means and in position actuation of the control member of the pusher.
• Figure 7 is a longitudinal sectional view showing on a larger scale the tip of the handle body and the rear end of the filiform element with its connecting means on the tip.
• Figure 8 is a longitudinal sectional view of the elongate element according to VIII respectively. VIII of figure 1.
• Figure 9 is a longitudinal sectional view along IX .IX of Figure 8 showing more particularly the storage store of fasteners.
• Figures 10 to 13 are sectional views along XX of Figure 8 when the device is respectively resting on two assembled fabrics after movement of the needle, during the distribution of a fastener and at the end of distribution after the return slide and pusher to their starting position.
• Figure 14 is a front view of a clip distributable by the device.
• Figure 15 is an enlarged scale view in section along XV-XV of
• This device is intended to distribute and install staples 1, having, as shown in Figure 14, the shape of a "I” lying and composed of a head “T” of a foot “P” and a filament of link "F".
• staples are made of biocompatible material, absorbable or not.
• This device essentially consists of a handle body "A” and a elongated element "B".
• This elongated element is generally independent of the body A. The connection between the two elements will be defined later with reference to FIG. 7.
• the handle body “A” contains control means while the elongated element “ B ”contains means for storing the fasteners and means for distributing and laying the latter.
• the elongated element “B” is composed of a tubular body generally designated by 2 and itself formed by two or four semi-cylindrical shells 2a, 2b, 2c, 2d linked edge to edge and butt to butt by welding ultrasonic. As shown in FIG. 15, the body 2 of the tubular element delimits a cylindrical housing 3 in which protrude longitudinal ribs 4 cooperating with grooves 5 formed longitudinally and on the sides of a slide generally designated by 6.
• the elongate element “B” is internally reinforced by rings of material, the most anterior of which 7a in FIG.
• the cylindrical slide 6 is itself produced in two parts 6a and 6b which are assembled according to one of their diametrical median planes by ultrasonic welding or by bonding.
• the part 6a of the slide 6 is integral with a needle 8, hollow and split longitudinally, projecting from the anterior end of this slide.
• the rear end of the needle 8 is juxtaposed with a receiving chamber 9 of the head "T" of the first fastener to be dispensed.
• the receiving chamber 9 has locally a guide cone 10 formed in a front part 9a of larger diameter.
• This chamber 9 communicates with a channel 12 for guiding a cylindrical plunger 13.
• the channel 12 is formed partly in this slide and partly in an attached wall 14 fitting into a housing 15 of part 6a.
• the other part 6b of the slider 6 comprises, near its front end, the end of a storage magazine 16 bordered by longitudinal channels 16T and 16P respectively, heads "T" and feet “P" of the fasteners arranged in this store.
• the guide groove 16T gives way to a ramp 17 which is arranged opposite the receiving chamber 9 of the other part 6a of the slide and in the trajectory of the head “T »Of the first attachment, for, during the movement of this first attachment la, communicate to its head « T »a transverse translational movement in the direction of the receiving chamber 9.
• the front end of the part 6b of the slide comprises a clearance housing 18 which faces a ramp 19 arranged on the other part 6a and in the path of the foot “P” of the first attach it.
• the reference numeral 20 designates a thrust blade pressing the fasteners 1 towards the front end of the magazine 16 under the action of spring means which will be described later.
• the slide 6 is in the rest position inside the body 2 of the element "B"
• it is returned to abutment against the ring 7a so that the needle digs 8 is fully retracted inside the front end of the elongated element and the receiving chamber 9 is obscured by the front end of the pusher 13.
• a rod control 22 whose hook-shaped front end 22a is coupled to the end rear of said slide, while its rear end 22b protrudes from the rear end of the elongated element "B" to penetrate the handle body "A", opposite the control means.
• a spring 23 (FIG. 3), one end of which is linked to the body 2 of the elongated element "B” and the other end linked to the rod 22 ensures the return to the rest position of the slide.
• the cylindrical pusher 13 is connected, by its rear end, to the front end of a tube 24 slidably mounted in the body of the elongated element “B” and itself serving as a guide element for the control rod 22.
• the guidance of the tube 24 is ensured, among other things, by the various rings 7 internally reinforcing the body 2 of the elongate element and in particular by the ring 7b.
• This tube 24 also protrudes from the rear end of the body of the elongate element “B” to also penetrate the handle body “A. Its rear end is linked, for example by welding or crimping, to a piston 25.
• a helical compression spring 26 is interposed between the head of the piston 25 and the ring 7b to constantly exert on the tube 24, and consequently on the pusher 13, a longitudinal restoring force in the direction of arrow 31.
• the thrust blade 20 of the magazine 16 is connected, by a rod 28, to a ring 29 slidingly mounted inside the body 2 and on the tube 24.
• This ring is permanently subjected to the thrust of a compression spring 30 interposed between it and the partition 7b. This spring exerts on it a restoring force in the direction of arrow 32.
• the rear end of the body 2 of the elongated element "B" is designed to engage in a tip 33, forming part of the handle body.
• This handle body which is produced in two symmetrical parts assembled by rivets or screws 34, has on its end piece 33 a collar 35 and a groove 36. The first is intended to cooperate with stop means carried by a ring 37 which can slide on the rear end of the body 2 and the second with notches 38 formed at the end of elastic tongues 39, carried by this ring.
• control means which are 2 in number and which in this embodiment are manually actuated, as shown in FIGS. 4 to 6.
• the first control means which are intended to actuate the rod 13 causing the displacement of the slide 6, comprise a lever 40 in the form of "L". This lever is articulated near its elbow on an axis 42 journalled in the two elements of the handle body
• the large branch 41 of this lever comprises, near its free end, a cavity 43 by the bottom of which it bears on the head 22b of the rod 22, head which engages in this cavity during introduction of element B in the end piece 33.
• the small branch 44 of the lever 40 is turned towards the front, that is to say substantially towards the end piece 33.
• the second control means comprise a handle 45 having a side view of a general "L" shape, that is to say comprising a large branch
• the large branch 46 of the handle 45 comprises, facing the piston 25, a ramp 50 which, at rest, is distant from this piston.
• This transverse displacement of the head “T” of the fastener la is effected by the combination of the longitudinal thrust SI of the blade 20 and of the part of the ramp 17 generating a component St visible in FIG. 8.
• the assembly is disposable.
• control means arranged in the handle body "A" are replaced by pneumatic means with manual release by push buttons or drawers.

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)

Applications Claiming Priority (3)

Publications (1)

Family

ID=9545374

Family Applications (1)

Country Status (5)

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• 1999
  • 1999-05-05 FR FR9905883A patent/FR2793132B1/fr not_active Expired - Fee Related
• 2000
  • 2000-04-05 AU AU38243/00A patent/AU3824300A/en not_active Abandoned
  • 2000-04-05 EP EP00917128A patent/EP1094757A1/fr not_active Withdrawn
  • 2000-04-05 WO PCT/FR2000/000858 patent/WO2000067644A1/fr not_active Application Discontinuation
  • 2000-04-05 JP JP2000616677A patent/JP2002543866A/ja active Pending

Non-Patent Citations (1)

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