Endoscopic fastening system with multiple fasteners
First Claim
1. An endoscopic fastening system for securing tissue internal to the body utilizing an endoscope, comprising:
- an elongate fastener delivery and deployment assembly being provided at a distal end with forceps jaws and at the proximal end with an actuation mechanism for manipulating said jaws between an open and a closed position;
one or more surgical fasteners disposed inside said elongate fastener delivery and deployment assembly, said fasteners having a predetermined position relative to said jaws, said fastener being disposed in a substantially closed pre-firing configuration in said assembly proximally of said jaws prior to an opening of said jaws, said fastener having legs or prongs that are disposed at a predetermined distance from one another in said closed pre-firing configuration; and
a pusher rod member provided for advancing said fasteners in a distally directed motion of said pusher rod member, at least one of said elongate fastener delivery and deployment assembly and said fastener having means for constraining said legs or prongs to have a spacing at all times at most as great as said predetermined distance, whereby said fastener may be moved in a substantially closed configuration into said jaws and from said jaws into target tissue.
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Accused Products
Abstract
An endoscopic fastening system having a diameter sufficiently small so that the fastening system is slidably insertable into a working channel of a flexible or rigid endoscope for performing a stapling, clipping, or other fastening operation, comprises one or more fasteners, and a fastener delivery and deployment assembly. One or more fasteners being disposed in a substantially closed prefiring configuration inside the fastener delivery and deployment system are configured for being delivered and deployed into a target tissue while remaining in a substantially closed configuration throughout the entire operation. Other related embodiments of fasteners and their respective delivery and deployment assemblies enabling fastening operations in conjunction with a flexible or rigid endoscope are described.
279 Citations
42 Claims
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1. An endoscopic fastening system for securing tissue internal to the body utilizing an endoscope, comprising:
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an elongate fastener delivery and deployment assembly being provided at a distal end with forceps jaws and at the proximal end with an actuation mechanism for manipulating said jaws between an open and a closed position;
one or more surgical fasteners disposed inside said elongate fastener delivery and deployment assembly, said fasteners having a predetermined position relative to said jaws, said fastener being disposed in a substantially closed pre-firing configuration in said assembly proximally of said jaws prior to an opening of said jaws, said fastener having legs or prongs that are disposed at a predetermined distance from one another in said closed pre-firing configuration; and
a pusher rod member provided for advancing said fasteners in a distally directed motion of said pusher rod member, at least one of said elongate fastener delivery and deployment assembly and said fastener having means for constraining said legs or prongs to have a spacing at all times at most as great as said predetermined distance, whereby said fastener may be moved in a substantially closed configuration into said jaws and from said jaws into target tissue. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. An endoscopic fastening system for securing tissue internal to the body, comprising:
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an elongate fastener delivery and deployment assembly provided at a distal end with forceps jaws and at a proximal end with an actuation mechanism; and
a surgical fastener, said fastener comprising two legs and a bight portion joining said legs to one another, said fastener being disposed inside said elongate fastener delivery and deployment assembly, said fastener delivery and deployment assembly including an elongate shaft member provided with a channel extending longitudinally therethrough, said channel housing one or more fasteners disposed in a magazine;
said fastener delivery and deployment assembly further including a pusher rod member slidably disposed inside said channel, said pusher rod member being provided for advancing fasteners in a distal direction along said shaft member;
said fastener delivery and deployment assembly further including forceps jaws provided with preformed grooves, and flat surfaces, said jaws being configured for engaging each fastener and approximating tissue respectively, said jaws being provided with pointed tips for easy tissue penetration; and
said actuation mechanism being provided for for at least one action taken from the group consisting of fastener positioning inside said forceps jaws, and effectuating said jaws alternately into opened and closed positions.
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21. A method for performing surgical operations on internal body tissues of a patient, comprising:
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(i) shifting a fastener delivery and deployment assembly in a distal direction towards target tissue, said assembly including forceps jaws disposed in an initial closed configuration at a distal end;
(ii) operating an actuator on said assembly to open said forceps jaws (iii) plunging the opened jaws into said target tissue;
(iv) after the plunging of the opened jaws into said target tissue, closing said forceps jaws to a first closed configuration, thereby causing tissue approximation;
(v) after the closing of said forceps jaws, advancing a first fastener in a distal direction into said forceps jaws in said first closed configuration;
(vi) squeezing said jaws into a second closed configuration wherein said jaws are nearer to one another than in said first closed configuration, thereby bringing said fastener into a fully closed postfiring configuration; and
(vii) after the squeezing of said jaws into said second closed configuration, opening said jaws, thereby releasing said fastener. - View Dependent Claims (22, 23)
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- 24. An endoscopic fastening system comprising an elongate shaft member having an outer diameter sufficiently small to be slidably insertable through an endoscope, said shaft member being provided at a distal end thereof with a pair of forceps jaws, and at a proximal end with an actuation mechanism, a clevis subassembly disposed proximate a proximal aspect of said forceps jaws, said clevis subassembly being operatively coupled with said forceps jaws, said clevis assembly being provided with means to transform a fastener from an open to a closed configuration.
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27. An endoscopic fastening system for securing tissue internal to the body utilizing an endoscope comprising:
an elongate fastener delivery and deployment assembly being provided at a distal end with forceps jaws and at the proximal end with an actuation mechanism for manipulating said jaws between an open and a closed position, one or more surgical fasteners disposed inside said elongate fastener delivery and deployment assembly, said fasteners having a predetermined position relative to said jaws, a pusher rod member provided for advancing said fasteners in a distally directed motion, an inner tubular member configured for housing one or more surgical fasteners disposed in predetermined positions constituting a fastener magazine; and
a clevis subassembly operably coupled proximate said forceps jaws, said clevis subassembly being provided with means for opening a partially closed fastener.
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28. A method for fastening internal body tissues of a patient, comprising:
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(i) inserting an endoscope into a patient'"'"'s body and is used to visually locate a target tissue to be operated upon;
(ii) inserting a fastener delivery and deployment assembly into a working channel of said endoscope and pushing said assembly in a distal direction towards a target tissue;
(iii) manipulating an actuation mechanism to open forceps jaws of said fastener delivery and deployment assembly and pushing said jaws proximate the target tissue;
(iv) advancing a fastener into said forceps jaws, said fastener being forced into an open position by forming rails;
(v) inserting the open forceps jaws with the open indwelling fastener into the target tissue;
(vi) closing said forceps jaws upon the fastener and the target tissue;
(vii) closing said jaws further to bring the fastener into a fully closed postfiring configuration; and
(viii) opening the forceps jaws to release said fastener after said fastener is brought into said fully closed postfiring configuration, said jaws being removed from the target tissue and extracted from the target tissue. - View Dependent Claims (29)
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- 30. An endoscopic fastening system comprising a delivery and deployment assembly, said assembly including a tubular shaft member, and a spring biased surgical fastener disposed in said shaft member, said fastener being in an unstrained state when in a closed configuration.
- 38. A surgical fastener provided with two or more prongs and with a spring portion biasing said prongs to a closed configuration, said spring portion being configured to cause said prongs to shift between from the closed configuration to an open configuration upon an application of a transverse compressive force to said spring portion.
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40. A method for fastening internal body tissues of a patient, comprising:
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(i) inserting an endoscope through an aperture in a patient'"'"'s body and using the endoscope to visually locate a target tissue to be operated upon;
(ii) inserting a fastener delivery and deployment assembly into a working channel of an endoscope and pushing the fastener delivery and deployment assembly in the distal direction proximate the target tissue (iii) operating an actuation means to advance fasteners contained in said fastener delivery and deployment assembly towards a collar member having a restrictive lumen;
(iv) advancing said fastener through said restrictive lumen of said collar member, causing said fastener to assume an open configuration;
(v) pushing the open fastener into target tissue so that said fastener enters said target tissue; and
.(vi) pushing said fastener further in the distal direction until said fastener is released from said restrictive lumen thereby enabling said fastener assume a postfiring closed configuration inside said target tissue.
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41. A method for performing a surgical operation on internal body tissues of a patient, comprising:
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(i) providing a plurality of surgical fasteners having holes or cavities proximate a proximal end, said fasteners being adjoined to one another by a suture thread, said fasteners being preloaded in pairs or in a magazine fashion;
(ii) applying said fasteners in pairs in organic tissue of a patient;
(iii) synching said suture thread together to provide tissue approximation and/or closure.
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42. A surgical fastening instrument with jaws comprising distally rounded tips containing a magazine of staples with similarly rounded tips utilizable, for an example, for ligating tubular structures internal to a patient'"'"'s body, said fastening system being used in conjunction with an endoscope.
Specification