Thoracic Closure Device and Methods
First Claim
Patent Images
1. A thoracic closure device, comprising:
- a base member having a first end, a second end, an internal surface, and a feed path defined between the first and second ends along the internal surface, the feed path terminating in an opening at one or both of the first and second ends;
a handle member having a first end and a second end, the handle member being mounted on the base member for rotation about a first generally horizontally-extending axis of rotation between (1) a first position, in which the second end of the handle member is angularly displaced from the base member, and (2) a second position in which the second end of the handle member is proximate to the base member;
an elongate pawl arm having a first end mounted for rotation about a second generally horizontally-extending axis of rotation, a second end opposite the first end, an engaging structure disposed at the second end of the pawl arm, and a cam surface on a trailing side of the pawl arm, the cam surface extending between the first and second ends of the pawl arm; and
an elastic member mounted within the thoracic closure device, the elastic member being arranged to bear between the handle member and the pawl arm to place the handle member in a driving relationship with respect to the pawl arm such that (1) the pawl arm is biased toward the internal surface of the base member and, if a toothed closure tie is in the feed path, the engaging structure of the pawl arm engages the teeth of the closure tie, and (2) as the handle member is moved between the first and second positions, the pawl arm is driven to rotate in such a way as to advance the closure tie unidirectionally along the feed path before the elastic member resiliently returns the pawl arm to a position in which the engaging structure is in engagement with the teeth of the toothed closure tie.
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Abstract
A thoracic closure device. The device has a handle member, a base member, and a feed path, and is designed to accept and, with a ratcheting mechanism, tension a toothed closure tie. A guide member is also provided, and assists in the placement of a closure tie prior to tensioning. Methods of closing a median sternotomy using toothed closure ties are also disclosed.
199 Citations
20 Claims
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1. A thoracic closure device, comprising:
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a base member having a first end, a second end, an internal surface, and a feed path defined between the first and second ends along the internal surface, the feed path terminating in an opening at one or both of the first and second ends;
a handle member having a first end and a second end, the handle member being mounted on the base member for rotation about a first generally horizontally-extending axis of rotation between (1) a first position, in which the second end of the handle member is angularly displaced from the base member, and (2) a second position in which the second end of the handle member is proximate to the base member;
an elongate pawl arm having a first end mounted for rotation about a second generally horizontally-extending axis of rotation, a second end opposite the first end, an engaging structure disposed at the second end of the pawl arm, and a cam surface on a trailing side of the pawl arm, the cam surface extending between the first and second ends of the pawl arm; and
an elastic member mounted within the thoracic closure device, the elastic member being arranged to bear between the handle member and the pawl arm to place the handle member in a driving relationship with respect to the pawl arm such that (1) the pawl arm is biased toward the internal surface of the base member and, if a toothed closure tie is in the feed path, the engaging structure of the pawl arm engages the teeth of the closure tie, and (2) as the handle member is moved between the first and second positions, the pawl arm is driven to rotate in such a way as to advance the closure tie unidirectionally along the feed path before the elastic member resiliently returns the pawl arm to a position in which the engaging structure is in engagement with the teeth of the toothed closure tie. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A thoracic closure device, comprising:
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a base member having a first end, a second end, an internal surface, and a feed path defined between the first and second ends along the internal surface, the feed path terminating in an opening at one or both of the first and second ends;
a handle member having a first end and a second end, the handle member being mounted on the base member for rotation about a first generally horizontally-extending axis of rotation between (1) a first position, in which the second end of the handle member is angularly displaced from the base member, and (2) a second position in which the second end of the handle member is proximate to the base member;
an elongate pawl arm having a first end mounted for rotation about a second generally horizontally-extending axis of rotation, a second end opposite the first end, an engaging structure disposed at the second end of the pawl arm, and a cam surface on a trailing side of the pawl arm, the cam surface extending between the first and second ends of the pawl arm;
an elastic member mounted within the thoracic closure device, the elastic member being arranged to bear between the handle member and the pawl arm to place the handle member in a driving relationship with respect to the pawl arm such that (1) the pawl arm is biased toward the internal surface of the base member and, if a toothed closure tie is in the feed path, the engaging structure of the pawl arm engages the teeth of the closure tie, and (2) as the handle member is moved between the first and second positions, the pawl arm is driven to rotate in such a way as to cause the pawl arm to advance the closure tie unidirectionally along the feed path before the elastic member resiliently returns the pawl arm to a position in which the engaging structure is in engagement with the teeth of the toothed closure tie; and
an elongate guide member mounted on the handle member for rotation about a third generally horizontally-extending axis of rotation between extended positions, in which an end of the elongate guide member extends outwardly of the thoracic closure device and retracted positions, in which the elongate guide member is substantially contained within the handle member. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A thoracic closure device, comprising:
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a base member having a first end, a second end, a bottom, and a feed path defined between the first and second ends along the bottom, the feed path originating at a first opening in the first end and terminating at a second opening in the bottom;
a handle member having a first end and a second end, the handle member being mounted on the base member for rotation about a first generally horizontally-extending axis of rotation between (1) a first position, in which the second end of the handle member is angularly displaced from the base member, and (2) a second position in which the second end of the handle member is proximate to the base member;
an elongate pawl arm having a first end mounted for rotation about a second generally horizontally-extending axis of rotation defined by a post in the handle member, a second end opposite the first end, an engaging structure disposed at the second end of the pawl arm, and a cam surface on a trailing side of the pawl arm, the cam surface extending between the first and second ends of the pawl arm; and
an elastic member mounted within the handle member, the elastic member being arranged to bear between the handle member and the pawl arm to place the handle member in a driving relationship with respect to the pawl arm such that (1) the pawl arm is biased toward the bottom of the base member and, if a toothed closure tie is in the feed path, the engaging structure of the pawl arm engages the teeth of the closure tie, and (2) as the handle member is moved from the first position toward the second position, the pawl arm is driven to rotate in such a way as to advance the closure tie unidirectionally along the feed path by engagement of the engaging structure and the closure tie before the cam surface moves the engaging structure out of engagement with the closure tie and the elastic member resiliently returns the pawl arm to a position in which the engaging structure is in engagement with the teeth of the toothed closure tie.
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Specification