WO2001015606A1 - Appareil pour appliquer des attaches chirurgicales - Google Patents

Appareil pour appliquer des attaches chirurgicales Download PDF

Info

Publication number
WO2001015606A1
WO2001015606A1 PCT/GB2000/003132 GB0003132W WO0115606A1 WO 2001015606 A1 WO2001015606 A1 WO 2001015606A1 GB 0003132 W GB0003132 W GB 0003132W WO 0115606 A1 WO0115606 A1 WO 0115606A1
Authority
WO
WIPO (PCT)
Prior art keywords
supply means
passage
incision
support member
surgical device
Prior art date
Application number
PCT/GB2000/003132
Other languages
English (en)
Inventor
Russell David Waters
Original Assignee
Biocomposites Limited
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 Biocomposites Limited filed Critical Biocomposites Limited
Priority to EP00953313A priority Critical patent/EP1207790A1/fr
Priority to GB0203319A priority patent/GB2369577A/en
Priority to AU65827/00A priority patent/AU6582700A/en
Publication of WO2001015606A1 publication Critical patent/WO2001015606A1/fr

Links

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
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0646—Surgical staples, i.e. penetrating the tissue for insertion into cartillege, e.g. meniscus

Definitions

  • the invention relates to an apparatus for applying surgical devices to a body, and particularly but not exclusively surgical devices such as pins or tacks.
  • One type of surgical device which may be in the form of a pin or tack, comprises a shaft which can be inserted into the body, with formations on the shaft to prevent removal or ejection thereof from the body.
  • a head may be provided on the shaft.
  • fixation device In surgical procedures which use such a fixation device for closing meniscal lesions, there is usually a requirement for insertion tooling.
  • the purpose of this tooling is to enable the surgeon to conveniently, accurately and effectively dispense one or a combination of soft tissue fixation devices to the surgical site.
  • This procedure is often performed under arthroscopic control.
  • a cannula is frequently employed.
  • a fixation device is inserted into the cannula and an obturator is used to push the fixation device along the bore of the cannula to the proximal end of the cannula and into the meniscal soft tissue.
  • a sharp needle may be used prior to insertion of the fixation device to prepare and form a track into the meniscus for the fixation device to penetrate.
  • the procedure of inserting the tack into the cannula can be fiddly and time consuming for the surgeon.
  • insertion instrumentation requires withdrawal from the surgical site to enable further pre-loading with fixation devices prior to subsequent device insertion.
  • the fixation devices are loaded manually into the cannula. This can lead to contamination of the fixation device which can then result in inflammation of the tissue.
  • apparatus for applying surgical devices comprising device inserting means which includes guide means in the form of a passage along which a surgical device is moveable, the passage comprising in use inner and outer ends; and a supply means including means for holding one or more surgical devices, the supply means being moveable relative to the inserting means such that in a first condition the holding means is aligned with the passage outer end such that a surgical device held by the supply means is moveable into the passage, and in a second condition free access is allowed to the outer end.
  • the supply means may be releasably mountable on the inserting means.
  • the supply means may be movably mountable on the inserting means, and may be rotatably or slidably mountable.
  • the inserting means may comprise a support member which may be manually engageable by a user.
  • the support member may be provided at or adjacent the passage outer end.
  • the supply means may be mountable on the support member.
  • the passage may extend through the support member.
  • the inner end of the passage may be shaped to aid positioning and may comprise one or more pointed parts.
  • the support member may include a pivot pin upon which the supply means is pivotally mountable, and desirably about a hole in the supply means.
  • the support member may be generally in the form of a disc, and the pivot pin is preferably spaced from the disc axis.
  • the supply means is preferably mountable on the support member so as to at least generally overlie the outer end of the passage.
  • One or more first holes may be provided in the supply means, in which first hole or holes a surgical device is wholly locatable, with the or each first hole selectively alignable with the outer end of the passage to permit transfer of the device into the passage.
  • One or more second holes and/or recesses may be provided in the supply means through which second hole or holes or recesses free access is provided to the outer end of the passage.
  • Preferably a plurality of first holes are provided in the supply means.
  • the first hole or holes may have substantially the same diameter as the internal diameter of the passage.
  • the supply means may comprise a disc.
  • the supply means may be shaped to facilitate manual turning thereof.
  • the supply means may comprise a plurality of lobes surrounding an axis, with a first hole provided in at least some of the lobes. At least some of the lobes may be spaced apart to define recesses therebetween.
  • the supply means is slidably mountable on the support member.
  • the support member may comprise a track along which the supply means is slidable.
  • the apparatus may also comprise a pushing means, engageable with a surgical device in the passage to push the device therealong.
  • the pushing means may comprise an elongate member, which desirably slidingly fits through the passage, and may have a handle part on one end.
  • the elongate member may be flexible.
  • the end of the pushing means engageable with a surgical device may be contoured, and may be concave.
  • the apparatus may also comprise an incision means extendible through the passage for creating an incision.
  • the incision means preferably comprises an elongate member, with an incision formation at one end, and desirably a handle at the other end.
  • the elongate member may be flexible.
  • a method of applying a surgical device into a body comprising using apparatus according to any of the preceding twelve paragraphs.
  • the surgical device is initially located in the supply means, and this may be before the supply means is mounted on the inserting means.
  • a plurality of surgical devices may be mounted on the supply means.
  • An incision may initially be made in the body using an incision means as previously described, extending through the guide means. Whilst the incision means extends through the guide means, the holding means is preferably arranged such that a second hole or recess therein overlies the guide means, and through which said second hole or recess the incision means can freely extend.
  • the incision means is preferably removed.
  • the supply means is preferably moved until a surgical device held therein overlies the guide means.
  • the device is preferably subsequently urged into the guide means and therealong subsequently into the body using a pushing means as hereinbefore defined.
  • Fig. 1 is a diagrammatic side view of part of apparatus for applying surgical devices according to the invention
  • Fig. 2 is a diagrammatic side view of a further part of apparatus according to the invention.
  • Fig. 3 is a diagrammatic side view of a still further part of apparatus according to the invention.
  • Figs. 4 to 7 are respectively diagrammatic end views of different embodiments of a part of the invention.
  • Fig. 8 is a diagrammatic side view of the part of Fig. 4;
  • Fig. 9 is a diagrammatic end view of part of the apparatus of Fig. 1;
  • Fig. 10 is a diagrammatic end view of part of a further embodiment of the invention.
  • the drawings show apparatus 10 for applying a surgical device such as a pin or tack into a body.
  • the apparatus 10 comprises an inserting device 12 (Fig. 1) in the form of an elongate cylindrical passage 14 extendible into a body.
  • the proximal end 16 is shaped to provide diametrically opposite points 18 to assist with location of the end 16 in a body.
  • a grippable part 20 is provided on the distal end 22 of the passage 14.
  • the part 20 has a through hole 24 through which the distal end 22 extends such that the end 22 is clear and open.
  • the part 20 has a generally D-shape, with the hole 24 towards the stem of the D.
  • a mounting pin 26 is provided on the part 20 centrally aligned and further from the stem than the hole 24. The pin 26 points away from the proximal end 16.
  • the apparatus 10 also comprises a pushing member 28 or obturator.
  • the member 28 comprises a solid elongate shaft 30 slidably extendible through the passage 14, and of a greater length thereof.
  • the proximal end 32 of the shaft 30 is concave to help locate the end of a surgical device thereagainst.
  • a handle 34 is provided on the distal end of the shaft 30 to define a generally T- shape configuration with the shaft 30.
  • the apparatus 10 further provides an incision member 36.
  • the member 36 is similar to the pushing member 28 with a similar shaft 38 and handle 40.
  • an incision part 44 is provided, which in this instance is an elongate blade. Other shape incision parts could be used as is required.
  • the apparatus 10 further comprises a holding member three examples 46, 48, 50 of which are shown in Figs. 4 and 8, Fig. 5, and Fig. 6.
  • Each of the holding members 46, 48, 50 is in the form of a disc with a central hole 52 which is removably and rotatably locatable on the pin 26 to mount the holding member 46, 48, 50 on the inserting device 12.
  • Each of the holding members 46, 48, 50 comprises a plurality of through holes 54 and one or more circumferentially open recesses 56. The holes 54 and recesses 56 are spaced from the central hole 52 so as to be alignable with the passage 14.
  • the holding member 46 has three holes 54 and one recess 56, whilst the holding member 48 has two holes 54 and two recesses 56, and the holding member 50 has three holes 54 and three recesses 56.
  • Fig. 7 shows a further possible holding member 58.
  • the holding member 58 comprises a central hole 52 surrounded by a core part 60, and from which part 60 four similar equispaced lobes 62 radially extend.
  • a through hole 54 is provided substantially centrally in each lobe 62.
  • the lobes 62 are sufficiently spaced from each other to define recesses 56 therebetween.
  • the shape of the member 58 facilitates ready gripping and turning thereof.
  • the apparatus 10 can be used in the following manner.
  • the holding member 46, 48, 50, 58 is loaded with appropriate surgical devices in the through holes 54.
  • the thickness of the holding member 46, 48, 50, 58 is chosen such that an appropriate surgical device is wholly locatable without protuberance in the holes 54.
  • the holding member 46, 48, 50, 58 can then be mounted on the pin 26, or can subsequently be mounted on the pin 26 during an operation.
  • the inserting device 12 is inserted in an appropriate part of the body to extend to an area where surgery is required.
  • the points 18 help to locate and retain the device 12 in this position. If the holding member 46, 48, 50, 58 is not already mounted on the device 12, this can be accomplished once the device 12 is in position.
  • An incision can then be made for receiving a surgical device. This is achieved by aligning a recess 56 in the holding member 46, 48, 50, 58 with the passage 14. The incision member 36 is then slid through the respective recess 56 and the passage 14 until the incision part 44 extends beyond the proximal end 16 to permit an incision to be made.
  • the incision member 36 is withdrawn.
  • the holding member 46, 48, 50, 58 is then rotated until a one of the through holes 54 which bears a surgical device is aligned with the passage 14.
  • the pushing member 28 is then used to push the surgical device from the holding member 46, 48, 50, 58 into the passage 14 and therealong to locate in the incision. Once the surgical device is located the pushing member 28 is removed.
  • the provision of a number of through holes 54 in the holding member 46, 48, 50, 58 allows the apparatus 10 to be used for locating a further surgical device without loading.
  • Fig. 10 shows a further arrangement of a grippable part 64 and a holding member 66.
  • the part 64 is in the form of a disc with a central opening 68.
  • a transverse track 70 is provided in a face of the part 64.
  • the holding member 66 is elongate with rounded ends.
  • Three equispaced through holes 72 are provided in the member 66.
  • This arrangement can be used in a similar manner to that described above, with surgical devices wholly located in the holes 72. To insert a surgical device the member 66 is slid along the track until a filled hole 72 overlies the opening of 68. When it is required to use the incision member 36, an empty hole 72 would overlie the opening 68, or the member 66 would be slid clear of the opening 68.
  • the holding members can be filled with surgical devices prior to any operation and in clean conditions. This greatly eases what can be a fiddly job and particularly in operating circumstances.
  • the holding member permits a number of surgical devices to be applied with the same apparatus without pre-loading required.
  • the provision of a recess or recesses on the holding member permits an incision to be made without any obstruction or inconvenience caused by the holding member.
  • a different holding member perhaps including further or different surgical devices could be exchanged with one already on the apparatus, during an operation.
  • the apparatus is of relatively simple construction and can thus be inexpensively and robustly manufactured in appropriate materials.
  • the holding members may take many different forms, and rather than the recesses described may comprise further through holes through which the incision member can extend.
  • the incision member may take many different forms. Other tools may be provided which can extend through the apparatus.
  • the grippable part may have a different shape or form, and the holding members could be differently mounted thereon.
  • the inserting device may be curved rather than straight, as conditions require.
  • the pushing member and/or incision member may be hollow and/or flexible, and particularly for use with a curved inserting device.
  • the handles on the pushing member and/or incision member may have a different shape.

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 appareil et un procédé pour appliquer au corps d'un patient des dispositifs chirurgicaux tels que des épingles et des pointes. L'appareil comprend un dispositif d'insertion (12) ayant la forme d'un passage cylindrique oblong (14) rentrant par l'une des extrémités (16) dans le corps du patient alors que l'autre extrémité (22) comprend un élément de soutien préhensible (20) que traverse ledit passage cylindrique (14). Un disque (46, 48, 50), monté rotatif sur l'élément de soutien, comprend plusieurs trous (54) permettant de localiser un dispositif chirurgical ainsi qu'un ou plusieurs enfoncements (56). Le disque (46, 48, 50) est monté de manière à pouvoir pivoter pour se mettre dans une position dans laquelle soit un trou (54) soit un enfoncement (56) se trouve en face du passage (14) afin de permettre l'introduction d'un dispositif chirurgical ou d'un instrument dans le dispositif d'insertion (12) et, partant, dans le corps du patient.
PCT/GB2000/003132 1999-09-02 2000-08-11 Appareil pour appliquer des attaches chirurgicales WO2001015606A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP00953313A EP1207790A1 (fr) 1999-09-02 2000-08-11 Appareil pour appliquer des attaches chirurgicales
GB0203319A GB2369577A (en) 1999-09-02 2000-08-11 Apparatus for applying surgical fasteners
AU65827/00A AU6582700A (en) 1999-09-02 2000-08-11 Apparatus for applying surgical fasteners

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9920623.7 1999-09-02
GBGB9920623.7A GB9920623D0 (en) 1999-09-02 1999-09-02 Apparatus for applying surgical devices

Publications (1)

Publication Number Publication Date
WO2001015606A1 true WO2001015606A1 (fr) 2001-03-08

Family

ID=10860133

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2000/003132 WO2001015606A1 (fr) 1999-09-02 2000-08-11 Appareil pour appliquer des attaches chirurgicales

Country Status (4)

Country Link
EP (1) EP1207790A1 (fr)
AU (1) AU6582700A (fr)
GB (2) GB9920623D0 (fr)
WO (1) WO2001015606A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5843084A (en) * 1995-11-17 1998-12-01 Innovasive Devices, Inc. Surgical fastening system and method for using the same
EP0913123A1 (fr) * 1997-10-29 1999-05-06 Arthrex Inc Dispositif de réparation du tissu méniscal
WO1999022650A2 (fr) * 1997-10-31 1999-05-14 The University Court Of The University Of Dundee Dispositif permettant l'introduction d'outils chirurgicaux pour endoscopes
WO1999026544A1 (fr) * 1997-11-26 1999-06-03 Bionx Implants Oy Dispositif servant a placer un element de fixation dans des tissus

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5843084A (en) * 1995-11-17 1998-12-01 Innovasive Devices, Inc. Surgical fastening system and method for using the same
EP0913123A1 (fr) * 1997-10-29 1999-05-06 Arthrex Inc Dispositif de réparation du tissu méniscal
WO1999022650A2 (fr) * 1997-10-31 1999-05-14 The University Court Of The University Of Dundee Dispositif permettant l'introduction d'outils chirurgicaux pour endoscopes
WO1999026544A1 (fr) * 1997-11-26 1999-06-03 Bionx Implants Oy Dispositif servant a placer un element de fixation dans des tissus

Also Published As

Publication number Publication date
EP1207790A1 (fr) 2002-05-29
GB9920623D0 (en) 1999-11-03
GB0203319D0 (en) 2002-03-27
AU6582700A (en) 2001-03-26
GB2369577A (en) 2002-06-05

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