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
  • A61B17/064—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
  • A61B2017/0647—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 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 loadable with loading units loaded with absorbable or permanent surgical fasteners.
• a surgical fastener applying instrument includes a rotatable drive shaft having a proximal end and a distal end.
• the surgical fastener applying instrument further includes a handle assembly and an elongate loading unit coupled thereto.
• the handle assembly includes a handle housing and a trigger operatively coupled to the handle housing for actuating a loading and a firing of surgical fasteners.
• a surgical fastener firing mechanism is disposed in the handle housing.
• the firing mechanism is configured to be coupled with the proximal end of the drive shaft, and actuatable by the trigger.
• a surgical fastener loading mechanism is disposed in the handle housing.
• the loading mechanism is configured to be coupled with the proximal end of the drive shaft, and actuatable by the trigger.
• a switch is movably disposed on the handle housing and operatively coupled to one of the drive mechanism and the loading mechanism.
• the switch is movable between a firing position and a loading position.
• the firing position the firing mechanism is coupled to the proximal end of the drive shaft and the loading mechanism is uncoupled from the proximal end of the drive shaft such that the drive shaft is rotated in a first direction upon trigger actuation.
• the loading position the loading mechanism is coupled to the proximal end of the drive shaft and the firing mechanism is uncoupled from the proximal end of the drive shaft such that the drive shaft is rotated in a second direction upon trigger actuation.
• the elongate loading unit includes an outer tube connected to the handle housing, and an inner tube rotatably disposed within the outer tube.
• the inner tube has a proximal end coupled to the distal end of the drive shaft.
• a distal end of the inner tube is configured for loading of the surgical fasteners therein when the switch is in the loading position and firing of the surgical fasteners therefrom when the switch is in the firing position.
• the drive shaft may include a gear non-rotatably disposed at the proximal end thereof.
• the firing mechanism may include a geared inner face in geared connection with the gear of the drive shaft when the switch is in the firing position.
• the loading mechanism may include a geared inner face in geared connection with the gear of the drive shaft when the switch is in the loading position.
• the switch may include a rod slidingly engaged with the handle housing and oriented transverse to the drive shaft.
• the switch may further include a first actuator and a second actuator.
• the first actuator may be fixed with a first end portion of the rod.
• the first actuator may protrude from a first lateral side of the handle housing.
• the second actuator may be fixed with a second end portion of the rod.
• the second actuator may protrude from a second lateral side of the handle housing, opposite the first lateral side.
• the switch may include a first nut threadedly engaged to the first end portion of the rod and a second nut threadedly engaged to the second end portion of the rod such that the switch may alternate between a locked configuration and an un-locked configuration.
• the switch In the locked configuration, the switch is fixed relative to the handle housing. In the un-locked configuration, the switch is slidable relative to the handle housing.
• the handle housing may further include a gear train interconnecting the trigger with the geared inner face of the loading mechanism and the geared inner face of the firing mechanism.
• the geared inner face of the firing mechanism may rotate in a first direction upon actuation thereof by the trigger to fire surgical fasteners from the elongate loading unit.
• the geared inner face of the loading mechanism may also rotate in the first direction upon actuation thereof by the trigger to load surgical fasteners into the elongate loading unit.
• the inner tube of the elongate loading unit may define a lumen therethrough.
• the 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 a 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 inner helical thread of the outer tube.
• a handle assembly of a surgical fastener applying instrument includes a handle housing.
• a trigger is operatively coupled to the handle housing for actuating a loading and a firing of surgical fasteners.
• a surgical fastener firing mechanism is disposed in the handle housing configured to be coupled with a proximal end of a rotatable drive shaft, and actuatable by the trigger.
• a surgical fastener loading mechanism is disposed in the handle housing configured to be coupled with the proximal end of the drive shaft, and actuatable by the trigger.
• a switch is movably disposed on the handle housing and coupled to one of the drive mechanism and the loading mechanism.
• the switch is movable between a firing position and a loading position.
• the firing position the firing mechanism is coupled to the proximal end of the drive shaft and the loading mechanism is uncoupled from the proximal end of the drive shaft such that the drive shaft is rotated in a first direction upon trigger actuation.
• the loading position the loading mechanism is coupled to the proximal end of the drive shaft and the firing mechanism is uncoupled from the proximal end of the drive shaft such that the drive shaft is rotated in a second direction upon trigger actuation.
• the drive shaft may include a gear non-rotatably disposed at the proximal end thereof.
• the firing mechanism may include a geared inner face in geared connection with the gear of the drive shaft when the switch is in the firing position.
• the loading mechanism may include a geared inner face in geared connection with the gear of the drive shaft when the switch is in the loading position.
• the switch may include a rod slidingly engaged with the handle housing and oriented transverse to the drive shaft.
• the switch may include a first actuator fixed with a first end portion of the rod.
• the first actuator protrudes from a first lateral side of the handle housing.
• the switch may also include a second actuator fixed with a second end portion of the rod.
• the second actuator protrudes from a second lateral side of the handle housing, opposite the first lateral side.
• the switch may include a first nut threadedly engaged to the first end portion of the rod and a second nut threadedly engaged to the second end portion of the rod such that the switch alternates between a locked configuration and an un-locked configuration.
• the switch In the locked configuration, the switch is fixed relative to the handle housing.
• the switch In the un-locked configuration, the switch is slidable relative to the handle housing.
• the handle housing may further include a gear train interconnecting the trigger with the geared inner face of the loading mechanism and the geared inner face of the firing mechanism.
• the geared inner face of the firing mechanism may rotate in a first direction upon actuation thereof by the trigger.
• the geared inner face of the loading mechanism may rotate in a second direction, opposite the first direction, upon actuation thereof by the trigger.
• a surgical fastener loading device includes a platform, a drive shaft, a third gear, and a loading dock.
• the platform has a first end and a second end.
• the drive shaft has a first end rotatably disposed with the first end of the platform and a second end rotatably disposed with the second end of the platform.
• the first end of the drive shaft includes a first gear and a crank attached thereto.
• the second end of the drive shaft includes a second gear.
• the third gear is in geared connection with the first gear and is configured for connection with a proximal end of an elongate loading unit for housing surgical fasteners.
• the loading dock is disposed with the second end of the platform.
• the loading dock includes a fourth gear in geared connection with the second gear of the drive shaft.
• the loading dock further includes a first driven shaft extending from the fourth gear and a second driven shaft non-rotatable relative to the first driven shaft.
• the second driven shaft is threadedly connected to the first driven shaft of the loading dock and configured for engagement with a plurality of surgical fasteners. Actuation of the crank translates the second driven shaft of the loading dock towards the first end of the platform to load a plurality of surgical fasteners into a lumen of an elongate loading unit.
• the second driven shaft may be slidingly disposed with a frame of the loading dock.
• the loading device includes a platform, a drive shaft, a third gear, and a loading dock.
• the platform has a first end and a second end.
• the drive shaft has a first end rotatably disposed with the first end of the platform and a second end rotatably disposed with the second end of the platform.
• the first end of the drive shaft includes a first gear and a crank attached thereto.
• the second end of the drive shaft includes a second gear.
• the third gear is in geared connection with the first gear and is configured for connection with a proximal end of an elongate loading unit for housing surgical fasteners.
• the loading dock is disposed with the second end of the platform.
• the loading dock includes a fourth gear in geared connection with the second gear of the drive shaft.
• the fourth gear is configured to be non- rotatably coupled to a surgical fastener magazine having a plurality of surgical fasteners disposed therein. Actuation of the crank simultaneously rotates an elongate loading unit connected to the third gear and a surgical fastener magazine coupled to the fourth gear to transfer the surgical fasteners from surgical fastener magazine into a lumen of the elongate loading unit.
• the loading dock may include an outer tube coupled to the fourth gear.
• the outer tube may have a helical thread disposed within a lumen thereof configured to slidingly receive an inner tube having a plurality of surgical fasteners disposed therein. Rotation of the outer tube may drive the surgical fasteners in a distal direction out of the inner tube of the magazine and into the loading unit.
• FIG. 1 is a side view of an embodiment of a surgical fastener applying instrument in accordance with the present disclosure
• FIG. 2 is a rear view of the surgical fastener applying instrument shown in FIG. 1 ;
• FIG. 3 is a perspective, cutaway view of the surgical fastener applying instrument shown in FIG. 1 , with parts removed;
• FIG. 4 is a perspective, cutaway view of the surgical fastener applying instrument shown in FIG. 1 ;
• FIG. 5 is a front view of the surgical fastener applying instrument shown in FIG.
• FIG. 6 is a front view of the surgical fastener applying instrument shown in FIG.
• FIG. 7 is a perspective view of a loading unit of a surgical fastener applying instrument with an outer tube and a coil removed therefrom, shown with surgical fasteners separated therefrom;
• FIG. 8 is a perspective view of the loading unit of the surgical fastener applying instrument with the outer tube and the coil removed therefrom, shown with surgical fasteners loaded therein;
• FIG. 9 is a cross-sectional view of the loading unit of the surgical fastener applying instrument, as taken through section line 9-9 of FIG. 1 , illustrating the loading unit during a firing stroke and a loading stroke of the surgical fastener applying instrument;
• FIG. 10 is a perspective view of the surgical fastener applying instrument of
• FIGS. 1-6 illustrating a loading of surgical fasteners into the loading unit
• FIG. 1 1 is a perspective view of a surgical fastener for use in a surgical fastener applying instrument in accordance with the present disclosure
• FIG. 12 is a side, elevational view of the surgical fastener shown in FIG. 1 1 ;
• FIG. 13 is an illustration of surgical fasteners of the present disclosure fixing a surgical mesh in place
• FIG. 14 is a perspective view of an embodiment of a loading device in accordance with the present disclosure.
• FIG. 15 is a perspective view of another embodiment of a loading device in accordance with the present disclosure.
• 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, as described in detail with reference to FIGS. 1 1- 13, 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
• Handle housing 212 is formed from a first half-section or first lateral side 212a and a second half section or second lateral side 212b joined to one another.
• First half-section 212a and second half section 212b of handle housing 212 may be joined to one another using know methods by those of skill in the art, including and not limited to ultrasonic welding, fasteners (i.e., screws) and the like.
• First half-section 212a and second half section 212b of handle housing 212 are joined to one another such that a fluid-tight seal is provided therebetween.
• Handle housing 212 defines a fixed handle portion 216 having a free end 216a.
• Handle assembly 210 includes a trigger 214 operatively coupled to handle housing 212, at a pivot point disposed within handle housing 212, for actuating a loading and a firing of surgical fasteners, such as, for example, tacks 100.
• Trigger 214 includes a free end 214a spaced a distance from fixed handle portion 216 when trigger 214 is in an extended or un-actuated condition.
• Trigger 214 includes a pivot end 214b extending therefrom and extending into handle housing 212 through a side of handle housing 212.
• a fluid-tight seal may be provided between pivot end 214b of trigger 214 and handle housing 212.
• an X-ring or the like, including an o-ring, etc., (not shown) may be used between pivot end 214b of trigger 214 and handle housing 212.
• handle assembly 210 supports a gear train 220 within handle housing 212.
• Gear train 220 includes a drive gear 222 keyed to or non-rotatably connected to pivot end 214b of trigger 214.
• Drive gear 222 is a two tiered gear including a first drive gear 222a, and a second drive gear 222b.
• First drive gear 222a may be in the form of a quadrant gear or the like having a plurality of gear teeth formed along a radial outer edge thereof and extending along an arcuate length of first drive gear 222a.
• Second drive gear 222b also defines a plurality of gear teeth formed along a radial outer edge thereof.
• Gear train 220 further includes a transmission gear assembly 224 pivotably supported in handle housing 212.
• Transmission gear assembly 224 is a three tiered gear including a first transmission gear 224a, a second transmission gear 224b, and a third transmission gear 224c each rotatably supported on a common pivot axis.
• First transmission gear 224a may be in the form of a pinion gear or the like having a plurality of gear teeth 224ai formed along a radial outer edge thereof and being in meshing engagement with gear teeth 222ai of first drive gear 222a.
• Second transmission gear 224b may be in the form of a quadrant gear or the like having a plurality of gear teeth 224bi formed along a radial outer edge thereof and extending along an arcuate length of second transmission gear 224b.
• Third transmission gear 224c 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 of second drive gear 222b.
• Gear train 220 also includes a clutch gear 226 pivotably and slidably supported on a cylindrical rod 227 in handle housing 212.
• Clutch gear 226 may be in the form of a pinion gear or the like having a plurality of gear teeth 226a formed along a radial outer edge thereof and being in meshing engagement with gear teeth 224bi of second transmission gear 224b.
• Handle housing 212 further includes a surgical fastener firing mechanism 228a and a surgical fastener loading mechanism 228b disposed therein.
• Gear train 220 interconnects both the firing mechanism 228a and the loading mechanism 228b with trigger 214 such that the firing mechanism 228a and the loading mechanism 228b are actuatable upon an actuation of trigger 214.
• Firing mechanism 228a includes a geared inner face in the form of a first bevel gear 230a pivotably and slidably supported on a rod or shaft 227 of a switch 250, as described below.
• first bevel gear 230a is in the form of a crown gear of the like.
• First bevel gear 230a is non-rotatably engaged/associated with a first side 226a of clutch gear 226 such that first bevel gear 230a rotates with clutch gear 226.
• First bevel gear 230a is also rotatably supported on a first actuator 252 of switch 250, as described in further detail below. It is contemplated that first bevel gear 230a can be non-rotatably fixed with first actuator 252 of switch 250 such that first actuator 252 rotates with first bevel gear 230a.
• loading mechanism 228b includes a geared inner face in the form of a second bevel gear 230b pivotably and slidably supported on rod 227 of switch 250.
• Second bevel gear 230b is spaced along rod 227 relative to first bevel gear 230a such that the gear teeth of second bevel gear 230b are oriented in a direction facing the gear teeth of first bevel gear 230a.
• Second bevel gear 230b is non-rotatably engaged/associated with a second side 226b of clutch gear 226 such that clutch gear 226 non-rotatably connects first and second bevel gears 230a, 230b to one another.
• first and second bevel gears 230a, 230b rotate in the same direction and together upon actuation thereof by trigger 214.
• Second bevel gear 230b is rotatably supported on a second actuator 254 of switch 250, as described in further detail below. It is contemplated that second bevel gear 230b can be non- rotatably fixed with second actuator 254 of switch 250 such that second actuator 254 rotates with second bevel gear 230b.
• handle assembly 210 includes a switch 250.
• Switch 250 is configured for alternating tack applier 200 between a surgical fastener firing mode and a surgical fastener loading mode, as described in further detail below.
• Switch 250 is movably disposed on handle housing 212 and operatively coupled to one of first and second bevel gears 230a, 230b such that switch 250 can translate bevel gears 230a, 230b into and out of engagement with a pinion gear 276 of a drive shaft 270, consequently alternating tack applier 200 between the surgical fastener firing mode and the surgical fastener loading mode.
• switch 250 includes a rod or shaft 227 slidingly engaged with handle housing 212 and oriented transverse to a drive shaft 270, as described below.
• Rod 227 has a first end portion 227a protruding from first lateral side 212a of handle housing 212 and a second end portion 227b protruding from second lateral side 212b of handle housing 212.
• First and second end portions 227a, 227b have threaded outer surfaces for threaded engagement with nuts 262a, 262b of switch 250.
• Switch 250 includes a first actuator 252 fixed adjacent first end portion 227a of rod 227.
• First actuator 252 protrudes from first lateral side 212a of handle housing 212.
• First actuator 252 includes a disc-shaped base (not shown) and an arm 252a extending therefrom designed and adapted to be actuated by a hand of a surgeon.
• the base of first actuator 252 defines a central passageway therein having first end portion 227a of rod 227 extending therethrough.
• Arm 252a includes a first post 256 and a second post 258 spaced along the base of actuator 252 and protruding perpendicularly therefrom, and a bridge 260 connecting first and second posts 256, 258.
• Switch 250 includes a second actuator 254 fixed adjacent second end portion
• Second actuator 254 protrudes from second lateral side 212b of handle housing 212.
• Second actuator 254 includes a disc-shaped base 255 (FIG. 4) disposed within handle housing 212 and an arm 252b extending therefrom designed and adapted to be actuated by a hand of a surgeon.
• Base 255 of actuator 254 defines a central passageway therein having second end portion 227b of rod 227 extending therethrough.
• Arm 252b includes a first post 257 and a second post 259 spaced along base 255 of actuator 252 and protruding perpendicularly therefrom, and a bridge 261 connecting first and second posts 257, 259.
• Switch 250 further includes a first nut 262a threadedly engaged to first end portion 227a of rod 227 and a second nut 262b threadedly engaged to second end portion 227b of rod 227.
• Nuts 262a, 262b can be used to alternate switch 250 between a locked configuration, in which switch 250 is fixed relative to handle housing 212, and an un-locked configuration, in which switch 250 is slidable relative to handle housing 212.
• At least one of nuts 262a, 262b is rotated in a counter-clockwise direction with respect to end portions 227a, 227b of rod 227, to axially translate at least one of nuts 262a, 262b away from and out of engagement with first lateral side 212a and/or second lateral side 212b of handle housing 212.
• switch 250 can be moved between the firing position, in which tacks 100 are fired from loading unit 300 upon actuation of trigger 214, and the loading position, in which tacks 100 can be loaded or packed into loading unit 300 upon actuation of trigger 214, as described in further detail below.
• tacker 200 includes a rotatable drive shaft 270, which spans between proximal and distal ends 282, 284 of ferrule 280.
• Drive shaft 270 is oriented perpendicular to rod 227 of switch 250.
• Drive shaft 270 has a proximal end 272 and a distal end 274.
• Proximal end 272 of drive shaft 270 is disposed in a distal end of handle housing 212 between first and second bevel gears 230a, 230b.
• 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 first bevel gear 230a or second bevel gear 230b to loading unit 300 to either fire tacks 100 from loading unit 300 or load/pack tacks 100 into loading unit 300 depending on whether switch 250 is in the firing position or loading position.
• first bevel gear 230a is operatively coupled to a first radial side of pinion gear 276 of drive shaft 270 and second bevel gear 230b is uncoupled from a second radial side of pinion gear 276 such that upon actuation of trigger 214, first bevel gear 230a rotates in a first direction, indicated by arrow "A” in FIG. 3, to drive a rotation of drive shaft 270, in a direction indicated by arrow "B” in FIG. 3. Rotation of drive shaft 270 in direction "B” can result in a firing of tacks 100 from loading unit 300, as described below.
• second bevel gear 230b is operatively coupled to the second radial side of pinion gear 276 of drive shaft 270 and first bevel gear 230a is uncoupled from the first radial side of pinion gear 276 such that upon actuation of trigger 214, second bevel gear 230b rotates in direction "A” to drive a rotation of drive shaft 270, in a direction indicated by arrow "C” in FIG. 3, opposite direction “B.” Rotation of drive shaft 270 in direction "C” can result in a loading of tacks 100 into loading unit 300, as described below.
• Tacker 200 further includes a ferrule or collar 280 rotatably and removably supported on 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 the distal end 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.
• 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.
• Loading unit 300 also includes an inner tube 320 rotatably disposed within coil
• 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 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 extend through respective notches 320b 2 of distal end portion 320b of inner tube 320 and are slidably disposed within the groove of coil 330, and the pair of tines 320bi of distal end portion 100.
• inner tube 320 In use, as inner tube 320 is rotated via actuation of trigger 214, about its longitudinal axis, with respect to coil 330, 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. 1 1- 13) engaging with coil 330.
• tack applier 200 can be set in either a tack applying mode or a tack loading mode.
• switch 250 is unlocked in the manner described above. With switch 250 in the unlocked configuration, switch 250 is moved, translated, or slid from second lateral side 212b to first lateral side 212a of handle housing 212, in a direction indicated by arrow "D" in FIG. 5, such that first bevel gear 230a is uncoupled from pinion gear 276 of drive shaft 270 and second bevel gear 230b engages pinion gear 276 of drive shaft 270.
• switch 250 With switch 250 in the loading position, one of nuts 262a, 262b is rotated to capture handle housing 212 between nuts 262a, 262b, placing switch 250 in the locked configuration such that switch 250 is prevented from moving out of the loading position.
• tacker 200 is manipulated such that a distal end 324 of loading unit 300 is engaged with a tack 100 of a pack of tacks 101 , as shown in FIG. 10.
• trigger 214 of tack applier 200 is actuated, causing drive gear 222 to be rotated.
• drive gear 222 causes first transmission gear 224a and third transmission gear 224c to be rotated about the pivot axis thereof.
• Second transmission gear 224b rotates with first and third transmission gears 224a, 224c resulting in concomitant rotation of clutch gear 226 about a pivot axis thereof.
• Rotation of clutch gear 226 results in concomitant rotation of first and second bevel gears 230a, 230b in the second direction, as indicated by arrow "A.”
• second bevel gear 230b coupled with pinion gear 276 of drive shaft 270 and first bevel gear 230a uncoupled from pinion gear 276, rotation of second bevel gear 230b results in concomitant rotation of drive shaft 270 in direction "C” via pinion gear 276, which transmits the rotation to inner tube 320 of loading unit 300 via coupling of distal end 274 of drive shaft 270 with proximal end portion 320a of inner tube 320.
• the pair of tines 320ai of inner tube 320 transmit the rotation to the tack 100 engaged with distal end portion 320b of inner tube 320 of loading unit 300 and advances the tack 100 proximally, owing to head threads 1 14a, 1 14b of tack 100 (FIGS. 1 1- 13) engaging with coil 330.
• Repeated actuation of trigger 214 is continued until the desired amount of tacks 100 have been loaded into loading unit 300.
• tack applier 200 can be changed from the tack loading mode to the tack firing mode by unlocking switch 250, in the manner described above, and moving, translating, or sliding switch 250 from the loading position to the firing position, in the manner also described above.
• switch 250 enables tack applier 200 to both fire and load tacks 100 via actuation of the same trigger 214 via translating switch 250 relative to handle housing 212, which moves first bevel gear 230a or second bevel gear 230b into and out of engagement with pinion gear 276 of drive shaft 270.
• 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 or a loading of a single tack 100 into 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.
• a surgical fastener loading device 400 is provided, which is configured for loading/packing surgical fasteners, such as, for example, tacks 100 described above, into loading units, such as, for example, loading unit 300 described above.
• Loading device 400 includes a platform 410, a drive shaft 420, a pinion gear 430, and a loading dock 440.
• Platform 410 has a first end 412 and a second end 414 and can be any support structure, such as a base, a rectangular concrete slab, or a stainless steel table.
• platform 410 can be variously shaped and can include various materials that provide loading device 400 with strength and integrity for load-bearing capability.
• platform 410 is a base mountable to a support structure, such as a table.
• Drive shaft 420 has a first end 422 rotatably disposed with first end 412 of platform 410 and a second end 424 rotatably disposed with second end 414 of platform 410.
• First end 422 of drive shaft 420 includes a first gear 426 and a crank 428 attached thereto.
• Second end 424 of drive shaft 420 includes a second gear 429 non-rotatably supported thereon such that a rotation of crank results in a rotation of first gear 426, drive shaft 420, and second gear 429.
• a third gear such as, for example, a pinion gear 430 is rotatably disposed with first end 412 of platform 410 and is in geared connection with first gear 426 of drive shaft 420.
• Pinion gear 430 is configured for connection with a proximal end of an elongate loading unit, such as, for example, loading unit 300 described above.
• Loading dock 440 includes a frame 442 fixed with second end 414 of platform
• Loading dock 440 includes a fourth gear 444 disposed with first end 412 of platform 410 and in geared connection with second gear 429 of drive shaft 420.
• Loading dock 440 further includes a first driven shaft 446 extending from fourth gear 444 and a second driven shaft 448 non-rotatable relative to first driven shaft 446.
• Second driven shaft 448 has a first end threadedly connected to first driven shaft 446 of loading dock 440 and a second end configured for engagement with a tack magazine 321 , similar in form to inner tube 320 of loading unit 300, having a plurality of surgical fasteners, such as, for example, tacks 100 disposed therein.
• Second driven shaft 448 has a non-circular outer surface slidingly disposed with frame 442 of loading dock 440 such that second driven shaft 448 is resisted and/or prevented from rotating relative thereto.
• a proximal end 322 of a loading unit 300 is non-rotatably coupled to pinion gear 430 such that loading unit 300 rotates therewith.
• a tack magazine 321 having a plurality of tacks 100 disposed therein, is non- rotatably coupled to the second end of second driven shaft 448 such that tack magazine 321 is in coaxial alignment with second driven shaft 448.
• crank 428 is actuated, first and second gears 426, 429 of drive shaft 420 rotate about an axis of drive shaft 420, and loading unit 300 rotates about an axis thereof.
• Second gear 429 of drive shaft 420 results in a concomitant rotation of fourth gear 444 and in turn first driven shaft 446 of loading dock 440. Due to the threaded engagement of first driven shaft 446 with second driven shaft 448, and second driven shaft 448 being non-rotatably supported in loading dock 440, second driven shaft 448 translates away from first driven shaft 446 upon relative rotation of first driven shaft 446. Axial translation of second driven shaft 448 translates tack magazine 321 into engagement with a distal end 324 of loading unit 300 to load a plurality of tacks 100 into a lumen of loading unit 300.
• a surgical fastener loading device 500 is provided, similar to loading device 400 described above with reference to FIG. 14.
• Loading device 500 is configured for loading/packing surgical fasteners, such as, for example, tacks 100 described above, into loading units, such as, for example, loading unit 300 described above.
• Loading device 500 includes a platform 510, a drive shaft 520, a pinion gear 530, and a loading dock 540.
• Platform 510 has a first end 512 and a second end 514.
• Drive shaft 520 has a first end 522 rotatably disposed with first end 512 of platform 510 and a second end 524 rotatably disposed with second end 514 of the platform 510.
• First end 522 of drive shaft 520 includes a first gear 526 and a crank 528 attached thereto.
• Second end 524 of drive shaft 520 includes a second gear 529 non-rotatably supported thereon such that a rotation of crank 528 results in a rotation of first gear 526, drive shaft 520, and second gear 529.
• a third gear such as, for example, a pinion gear 530 is rotatably disposed with first end 512 of platform 510 and is in geared connection with first gear 526 of drive shaft 520.
• Pinion gear 530 is configured for connection with a proximal end of an elongate loading unit, such as, for example, loading unit 300 described above.
• Loading dock 540 includes a frame 542 fixed with second end 514 of platform
• Loading dock 540 includes a fourth gear 544 disposed with first end 512 of frame 510 and in geared connection with second gear 529 of drive shaft 520.
• Loading dock 540 further includes a tack magazine 546, similar to loading unit 300 described above, rotatably supported thereon.
• Tack magazine 546 includes an outer tube 548, similar to outer tube 310 of loading unit 300 described above, and an inner tube (not shown) disposed therein, similar to inner tube 320 described above.
• Outer tube 548 includes a helical thread or coil, similar to coil 330 described above, disposed within a lumen thereof configured to slidingly receive the inner tube.
• Outer tube 548 is non-rotatably coupled to fourth gear 544 such that outer tube 548 rotates with fourth gear 544.
• the inner tube is pre-loaded with a plurality of tacks 100 to be transferred from tack magazine 546 to a loading unit, such as, for example, loading unit 300 described above.
• proximal end 322 loading unit 300 is coupled to pinion gear 530 of loading device 500.
• Tack magazine 546 fully loaded with tacks 100, is coupled to fourth gear 544 of loading dock 540 such that the inner tube of tack magazine 546 or outer tube 548 of tack magazine 546 rotates therewith.
• Crank 528 is actuated, which simultaneously rotates loading unit 300 and the inner tube or outer tube 548 of tack magazine 546 via gears 426, 429, 430, 444.
• Rotation of the inner tube or outer tube 548 of tack magazine 546 advances tacks 100 in a distal direction out of the inner tube, via a mechanism similar to that described above with reference to FIGS. 7-9, into inner tube 320 of loading unit 300.

Priority Applications (2)

Applications Claiming Priority (1)

Publications (1)

Family

ID=54070821

Family Applications (1)

Country Status (2)

Families Citing this family (3)

Citations (3)

Family Cites Families (8)

• 2014
  • 2014-03-14 CN CN201480076402.8A patent/CN106061403B/zh active Active
  • 2014-03-14 WO PCT/CN2014/073419 patent/WO2015135193A1/en active Application Filing

Patent Citations (3)

Also Published As

Similar Documents

Legal Events