Method and apparatus for surgical fastening

• US 20070250064A1
• Filed: 04/21/2006
• Published: 10/25/2007
• Est. Priority Date: 04/21/2006
• Status: Active Grant

• Current Assignee: Davol Incorporated (Becton, Dickinson & Co)
• Original Assignee: Davol Incorporated (Becton, Dickinson & Co)
• Inventors: Stein, Jeffrey, Smith, Barry, Adams, Ray, Lehman, Adam, Felix, Gus, Bachman, Alan, Paul, Joe, Chester, Ed, Darois, Roger
• Granted Patent: US 7,862,573 B2
• Time in Patent Office: Days
• US Class Current: 606/284
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61L 31/148 Materials at least partially resorbable by the body
• CPC Class Codes: B25B 17/00 Hand-driven gear-operated wrenches or screwdrivers ratchet-operated B25B13/46 B25B13/467, B25B15/04; for mounting or dismounting wheels B60B29/005
• CPC Class Codes: B25B 23/065 the magazine being coaxial with the tool axis

Abstract

A surgical fastener system includes a plurality of fasteners having a throughbore with an internally threaded portion. The fasteners may engage with a threaded mandrel that passes through the throughbore of the fasteners. A rotator may rotate the fasteners relative to the mandrel to move at least one of the fasteners along the mandrel, e.g., along the mandrel'"'"'s longitudinal axis. A distal end of the mandrel may be inserted into a material, such as a tissue, prosthetic or other, and a fastener may be deployed from the distal end of the mandrel while the distal end is positioned in the material. The throughbore of the fasteners may include a threaded portion and an unthreaded portion, may include an angled face or other feature to aid in fastener deployment and/or have curved depressions in the head portion.

Claims

1. A surgical fastener comprising:

a barrel portion including a helical thread extending from near a distal end of the barrel portion toward a proximal end of the barrel portion;

a head portion at the proximal end of the barrel portion; and

a throughbore extending through the head portion and the barrel portion, the throughbore including a threaded portion;

wherein the barrel portion and head portion are formed of a bioabsorbable material.

2. The fastener of claim 1, wherein the throughbore includes an unthreaded portion located at a proximal end of the throughbore.

3. The fastener of claim 2, wherein the threaded portion is located at a distal end of the throughbore, and the unthreaded portion extends over approximately half a length of the throughbore.

4. The fastener of claim 1, wherein the head portion includes at least one drive feature adapted to engage with a driver to rotate the barrel portion into tissue.

5. The fastener of claim 4, wherein the at least one drive feature includes opposed flat portions on sides of the head portion.

6. The fastener of claim 1, wherein the helical thread extends from near the distal end of the barrel portion to the head portion.

7. The fastener of claim 1, wherein the helical thread has a thread height that increases from near the distal end of the barrel portion toward the proximal end.

8. The fastener of claim 1, wherein the helical thread has a thread height that decreases toward the proximal end of the barrel portion.

9. The fastener of claim 1, wherein the barrel portion includes a fish mouth feature at the distal end of the barrel portion.

10. The fastener of claim 1, wherein the head portion has a maximum width in a radial direction that is greater than a maximum width of the helical thread.

11. The fastener of claim 1, wherein a pitch of the threaded portion is less than a pitch of the helical thread.

12. The fastener of claim 1, wherein the head portion has a maximum width in a radial direction that is larger than a maximum width of the barrel portion.

13. A surgical fastener comprising:

a barrel portion having a longitudinal axis and including a helical thread extending from near a distal end of the barrel toward a proximal end of the barrel portion, the distal end of the barrel portion being at least partially arranged in a plane transverse to the longitudinal axis;

a head portion attached at the proximal end of the barrel portion, the head portion having a maximum width that is larger than a maximum width of the barrel portion; and

a throughbore extending along the longitudinal axis through the head portion and the barrel portion;

wherein the barrel portion and head portion are formed of a bioabsorbable material.

14. The fastener of claim 13, wherein the distal end of the barrel portion has a face that is angled with respect to the longitudinal axis.

15. The fastener of claim 13, wherein the throughbore includes a threaded portion.

16. The fastener of claim 15, wherein the throughbore includes an unthreaded portion located at a proximal end of the throughbore.

17. The fastener of claim 16, wherein the threaded portion is located at a distal end of the throughbore, and the unthreaded portion extends over approximately half a length of the throughbore.

18. The fastener of claim 13, wherein the head portion includes at least one drive feature adapted to engage with a driver to rotate the barrel portion into tissue.

19. The fastener of claim 18, wherein the at least one drive feature includes opposed flat portions on sides of the head portion.

20. The fastener of claim 13, wherein the helical thread extends from near the distal end of the barrel portion to the head portion.

21. The fastener of claim 13, wherein the helical thread has a thread height that increases from near the distal end of the barrel portion toward the proximal end.

22. The fastener of claim 13, wherein the helical thread has a thread height that decreases toward the proximal end of the barrel portion.

23. The fastener of claim 13, wherein the head portion has a maximum width in a radial direction that is greater than a maximum width of the helical thread.

24. The fastener of claim 13, wherein a pitch of the threaded portion is less than a pitch of the helical thread.

25. A surgical fastener comprising:

a barrel portion having a longitudinal axis and including a helical thread extending from near a distal end of the barrel toward a proximal end of the barrel portion;

a head portion attached at the proximal end of the barrel portion, the head portion having a maximum width in a radial direction that is larger than a maximum width of the barrel portion, opposed sides of the head portion having curved depressions adapted for engaging a rotator to rotate the fastener about the longitudinal axis during deployment; and

a throughbore extending along the longitudinal axis through the head portion and the barrel portion;

wherein the barrel portion and head portion are formed of a bioabsorbable material.

26. A surgical fastener system including:

a plurality of fasteners each having a barrel portion with an external thread and a throughbore extending through the barrel portion with an internal threaded portion;

a mandrel having a threaded portion adapted to engage with the threaded portion of the throughbore of the plurality of fasteners; and

a rotator adapted to engage with and rotate at least one of the plurality of fasteners so as to move the at least one fastener along the mandrel.

27. The system of claim 26, wherein the mandrel has a distal tip and the mandrel is movable to extend the distal tip beyond a distal end of the rotator.

28. The system of claim 27, wherein the mandrel is movable to retract the distal tip inside of the rotator.

29. The system of claim 26, further comprising an outer tube within which the rotator and mandrel are at least partially located.

30. The system of claim 26, wherein the internal threaded portion of each of the plurality of fasteners is located at a distal portion of the throughbore, and a proximal portion of the throughbore is thread-free.

31. The system of claim 26, wherein the mandrel includes a sharpened distal tip adapted to penetrate a material into which a fastener is inserted.

32. The system of claim 26, including a handle at a proximal end of the mandrel and the rotator, the handle including at least one trigger arranged to cause movement of the rotator.

33. The system of claim 32, including a trigger arranged to cause the mandrel to move along a longitudinal axis and extend beyond a distal end of the rotator.

34. The system of claim 32, further comprising a mechanism that converts movement of the at least one trigger into rotation of the rotator.

35. The system of claim 34, wherein the mechanism includes a clutch.

36. A method for deploying a fastener including:

providing a plurality of fasteners mounted on a threaded mandrel, each of the fasteners having a barrel portion with an external thread and a throughbore extending through the barrel portion with an internal threaded portion;

rotating at least one of the fasteners relative to the mandrel to deploy the at least one fastener from a distal end of the mandrel.

37. The method of claim 36, wherein the fasteners mounted on the threaded mandrel are housed within a tube, the method further comprising:

extending the distal end of the mandrel outside of a distal end of the tube.

38. The method of claim 37, wherein the step of rotating comprises rotating the tube so as to rotate fasteners engaged with the tube.

39. The method of claim 37, wherein the distal end of the mandrel is sharp, the method further comprising:

extending the sharp distal end of the mandrel into a material.

40. The method of claim 39, wherein the at least one fastener is deployed from the distal end of the mandrel after the distal end is extended into the material.

41. The method of claim 36, further comprising moving the mandrel along a longitudinal axis.

42. The method of claim 36, further comprising aligning the plurality of fasteners relative to each other based on at least one feature on each head of the fasteners.