Strernum closure device and pincers for mounting staples and approximator brackets

• US 20020032465A1
• Filed: 07/13/2001
• Published: 03/14/2002
• Est. Priority Date: 07/27/2000
• Status: Active Grant

• Current Assignee: Haifa Surgical Instruments Limited
• Original Assignee: Haifa Surgical Instruments Limited
• Inventors: Lemer, Joseph
• Granted Patent: US 6,368,342 B1
• Time in Patent Office: Days
• US Class Current: 606/216
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/1691 for the sternum
• CPC Class Codes: A61B 17/1693 for the ribs
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence

Abstract

A sternum closure device for securing parts of severed sternum, such as a human sternum following surgery. The device includes an anvil, capable of forming staples, a bracket positioned, opposite the anvil, an instrument for creating openings in the sternum a clamping mechanism and a mechanism for feeding, mounting and applying the staples. The bracket is joined with the anvil through a displacement mechanism. The instrument for forming opening is designed as a bit brace having a reducing gear and two chucks, to enable concurrent drilling of openings in both severed parts of the severed sternum. The mechanism for feeding and mounting the staples comprises a ribbed bed, a cartridge containing staples and an instrument for mounting the staples. The clamping means enables drilling of openings in both severed parts of sternum, and feeding and mounting the staples. Specially designed pincers are also provided for mounting the staples and other special staples. A plurality of approximator brackets are provided for holding two halves of a severed sternum for stapling.

Claims

1. A sternum closure device for securing two parts of a severed sternum having an external and internal side, said device comprising:

a. an anvil positioned on said internal side of said severed sternum, said anvil being used for forming the staples,

b. a bracket situated on said external side of said severed sternum,

c. an instrument for forming openings in said severed sternum, and

d. a mechanism for feeding and mounting said staples.

2. The sternum closure device as claims in claim 1, wherein said anvil, which serves for forming the staples, is designed in the form of at least one slot.

3. The sternum closure device as claimed in claim 2, wherein said anvil comprises at least one bend.

4. The sternum closure device as claimed in claim 2, wherein said anvil comprises at least one opening.

5. The sternum closure device as claimed in claim 1, wherein said bracket provides:

a post having two openings and a pin mounted on said post, and said post operatively connected to the instrument for forming openings in the severed sternum,

a lock comprising of a housing having a slot, a spring actuated locking element having a handle, said handle being situated in the slot.

6. The sternum closure device as claimed in claim 5, wherein said bracket comprises at least one slot.

7. The sternum closure device as claimed in claim 6, wherein said bracket comprises at least one bend.

8. The sternum closure device as claimed in claim 6, wherein said bracket comprises at least one threaded opening and two through openings.

9. The sternum closure device as claimed in claim 5, wherein said post is installed on said bracket with possibility of its turning, said post being provided with two openings with mutually perpendicular axes and with a pin which is fastened on said post.

10. The sternum closure device as claimed in claim 5, wherein said lock is fastened on said bracket and said lock is constructed from a housing and a locking element with handle.

11. The sternum closure device as claimed in claim 10, wherein said housing of said lock comprises as least one slot.

12. The sternum closure device as claimed in claim 11, wherein said locking element with said handle of said lock is provided with a spring-wise element.

13. The sternum closure device as claimed in claim 1, wherein said anvil and said bracket are joined mutually with a displacement mechanism, said displacement mechanism providing reciprocating displacement of said bracket toward said anvil and in back direction.

14. The sternum closure device as claimed in claim 13, wherein said displacement mechanism comprises a screw with a handle, said screw is arranged in said threaded opening of said bracket and is installed on said anvil to enable its rotation.

15. The sternum closure device as claimed in claim 13, wherein said displacement mechanism comprises at least two guides, said guides being arranged between said bracket and said anvil and being fastened on said anvil.

16. The sternum closure device as claimed in claim 15, wherein said guides are installed in said openings of said bracket to allow displacement of said bracket along said guides.

17. The sternum closure device as claimed in claim 13, wherein said displacement mechanism comprises a spring-wise element situated between said anvil and said bracket, with coaxial arrangement of said spring-wise element with respect to said screw.

18. The sternum closure device as claimed in claim 1, wherein said instrument for forming openings in said sternum comprises one of following mechanisms of the group:

a manual bit brace, a pneumatic bit brace, a laser perforator, or a ultra-sound perforator.

19. The sternum closure device as claimed in claim 18, wherein said instrument for forming the openings is designed as a bit brace with a reducing gear and is provided with at least two chucks for installation of drills.

20. The sternum closure device as claimed in claim 19, wherein said reducing gear comprises a housing with a lug, and at least three gear wheels are positioned inside said reducing gear.

21. The sternum closure device as claimed in claim 20, wherein said lug of said housing comprises at least one opening.

22. The sternum closure device as claimed in claim 20, wherein one of said gear wheels is in engagement with both others.

23. The sternum closure device as claimed in claim 20, wherein one of said gear wheels is installed on a shaft thereby serving to joining with said drive.

24. The sternum closure device as claimed in claim 1, wherein said mechanism for feeding and mounting said staples comprises a carrying element, an assembly for mounting said staples, a cartridge containing said staples, a plurality of stoppers, and a spring-wise element.

25. The sternum closure device as claimed in claim 24, wherein said carrying element is constructed as a bed with at least two ribs, said ribs being arranged perpendicularly to the surface of said bed and being provided with said limit stoppers.

26. The sternum closure device as claimed in claim 25, wherein each of said ribs is provided with at least one slot.

27. The sternum closure device as claimed in claim 25, wherein said surface of said bed is provided with at least one slot.

28. The sternum closure device as claimed in claim 25, wherein said bed comprises at least one lug which is provided with at least one threaded opening and a locking screw.

29. The sternum closure device as claimed in claim 25, wherein said bed comprises at least one face wall which is provided with a handle.

30. The sternum closure device as claimed in claim 24, wherein said cartridge is provided with slots.

31. The sternum closure device as claimed in claim 30, wherein said cartridge is arranged between said ribs of said bed and said cartridge is provided with two pins which are situated in said slots of said ribs.

32. The sternum closure device as claimed in claim 30, wherein said spring-wise element is arranged between said cartridge and said bed.

33. The sternum closure device as claimed in claim 1, wherein the subassembly for mounting said staples comprises at least one lever and at least two posts which are provided with spring-wise elements.

34. The sternum closure device as claimed in claim 1, wherein the anvil and the drilling instrument are controlled by a sliding head.

35. The sternum closure device as claimed in claim 1, further comprising a pincer for mounting the staples.

39. The sternum closure device as claimed in claim 38, wherein said bracket provided a handle is installed on said bracket.

40. The sternum closure device as claimed in claim 39, wherein at least one opening comprising in said bracket is constructed as threaded opening.

41. The sternum closure device as claimed in claim 39, wherein said handle provided a lever, said lever is fastened in said handle with possibility of its turning.

42. The sternum closure device as claimed in claim 41, wherein said lever is fastened on said handle with possibility of its turning.

43. The sternum closure device as claimed in claim 38, wherein said anvil and said bracket are fastened with an axle and are joined mutually with a displacement mechanism.

44. The sternum closure device as claimed in claim 43, wherein said displacement mechanism provides a turning of said bracket relatively of said anvil around of said axle.

45. The sternum closure device as claimed in claim 44, wherein said displacement mechanism comprises a screw with a handle, said screw is arranged in said threaded opening of said bracket, said screw is installed in said opening of said anvil with possibility of its rotation.

46. The sternum closure device as claimed in claim 45, wherein said screw is arranged in said threaded opening of said bracket, said screw is installed in said opening of said anvil with possibility of its rotation.

47. The sternum closure device as claimed in claim 46, wherein said screw is installed in said opening of said anvil with possibility of its rotation.

48. The sternum closure device as claimed in claim 38, wherein said clamping mechanism is installed on said bracket providing reciprocating displacement along said bracket.

49. The sternum closure device as claimed in claim 48, wherein said clamping mechanism comprises:

A carrying element,

An assembly for mounting said staples,

A cartridge containing said staples, and

A lock fixing of said clamping mechanism on said bracket.

50. The sternum closure device as claimed in claim 49, wherein said carrying element is constructed as a bed with at least one rib.

51. The sternum closure device as claimed in claim 50, wherein said rib being arranged perpendicularly to the surface of said bed.

52. The sternum closure device as claimed in claim 51, wherein said rib is provided with at least one cut.

53. The sternum closure device as claimed in claim 50, wherein said bed comprises at least one guide-opening.

54. The sternum closure device as claimed in claim 49, wherein said assembly for mounting said staples is fastened on said carrying element.

55. The sternum closure device as claimed in claim 54, wherein said assembly for mounting said staples is constructed as pressure mechanism.

56. The sternum closure device as claimed in claim 55, wherein said pressure mechanism comprises a pusher with a transmitting element.

57. The sternum closure device as claimed in claim 56, wherein said transmitting element being fastened to said pusher.

58. The sternum closure device as claimed in claim 49, wherein said cartridge is fastened on said carrying element.

59. The sternum closure device as claimed in claim 58, wherein said cartridge comprises a holder of said staples.

60. The sternum closure device as claimed in claim 59, wherein said holder is provided with means for feeding of said staples.

61. The sternum closure device as claimed in claim 49, wherein said lock is fastened on said carrying element.

62. The sternum closure device as claimed in claim 1, wherein said lock is constructed as a housing comprising a locking element with handle.

63. The sternum closure device claimed in claim 1 further comprising a plurality of sternal approximator bracket.

64. The sternum closure device claimed in claim 63 wherein the approximating brackets have a low profile and is useful in holding two halves of a severed sternum until union of the halves is achieved.

36. A pincer for mounting staples, said pincer comprising:

a plurality of handles, each of said handles having a first end extending into a lever, and a second end in the shape of a jaw, the two handles are joined together by an axle at the second end, and a spring mechanisms holds the two levers together.

37. A specially designed staple, said staple comprising:

a plurality of legs, each of said legs having a threaded part,

a holder having two openings, said openings providing entry points for installing the legs, and a spring attached to the holder and being fastened by a nut.

38. A sternum closure device for securing two parts of a severed sternum having an external and internal side, said device comprising:

an anvil positioned on said internal side of said severed sternum, said anvil being used for forming the staples,

a bracket situated on said external side of said severed sternum, and

a clamping mechanism.