SURGICAL FASTENER APPLIER

• US 20140207152A1
• Filed: 12/19/2013
• Published: 07/24/2014
• Est. Priority Date: 01/18/2013
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Fischvogt, Gregory
• Granted Patent: US 9,351,733 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• 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 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/0688 Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/2903 transferring rotary motion
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion

Abstract

A surgical fastener applier includes a variable drive mechanism disposed within a housing and operably coupled between an input member and an output member, the variable drive mechanism being transitionable between at least a first condition, wherein rotation of the input member by a fixed amount effects rotation of the output member a first amount, and a second condition, wherein rotation of the input member by the fixed amount effects rotation of the output member a second amount different from the first amount.

Claims

1. A surgical fastener applier, comprising:

a housing having an elongated tubular member extending distally from the housing;

a trigger coupled to an input member and extending from the housing, the trigger pivotable relative to the housing from a first position to a second position to rotate the input member a fixed amount;

a drive shaft extending from the housing and rotatably disposed within the elongated tubular member, the drive shaft retaining at least one surgical fastener thereon, the drive shaft coupled to an output member at a proximal end of the drive shaft such that rotation of the output member effects corresponding rotation of the drive shaft to apply a distal-most surgical fastener to tissue; and

a variable drive mechanism disposed within the housing and operably coupled between the input member and the output member, the variable drive mechanism transitionable between at least a first condition, wherein rotation of the input member by the fixed amount effects rotation of the output member a first amount, and a second condition, wherein rotation of the input member by the fixed amount effects rotation of the output member a second amount different from the first amount.

2. The surgical fastener applier according to claim 1, wherein the trigger includes a flange portion defining a plurality of gear teeth and wherein the input member defines a plurality of complementary gear teeth disposed in meshed engagement with the gear teeth of the flange portion of the trigger such that pivoting of the trigger from the first position to the second position rotates the input member the fixed amount.

3. The surgical fastener applier according to claim 1, wherein the drive shaft includes a gear cap disposed at the proximal end of the shaft, the gear cap defining a plurality of gear teeth, and wherein the output member defines a plurality of complementary gear teeth disposed in meshed engagement with the gear teeth of the gear cap such that rotation of output member corresponding rotation of the drive shaft to apply the distal-most surgical fastener to tissue.

4. The surgical fastener applier according to claim 1, further comprising a control knob coupled to the variable drive mechanism and extending from the housing, the control knob selectively manipulatable to transition the variable drive mechanism between the first and second conditions.

5. The surgical fastener applier according to claim 1, wherein at least one of the control knob and the housing includes indicia configured to indicate the condition of the variable drive mechanism.

6. The surgical fastener applier according to claim 1, wherein rotation of the output member by the first amount effects rotation of the drive shaft sufficiently for applying a relatively small-sized surgical fastener, and wherein rotation of the output member by the second amount effects rotation of the drive shaft sufficiently for applying a relatively large-sized surgical fastener.

7. The surgical fastener applier according to claim 6, wherein the variable drive mechanism is transitionable to a third condition, wherein rotation of the input member by the fixed amount effects rotation of the output member a third amount different from the first and second amounts, and wherein rotation of the output member by the third amount effects rotation of the drive shaft sufficiently for applying a relatively medium-sized surgical fastener.

8. The surgical fastener applier according to claim 1, wherein the drive shaft and the at least one surgical fastener comprise a replaceable cartridge, the replaceable cartridge releasably engagable with the surgical fastener applier, wherein the replaceable cartridge includes one of:

a first drive shaft retaining a plurality of small-sized surgical fasteners thereon, and a second drive shaft retaining a plurality of relatively large-sized surgical fasteners thereon.

9. The surgical fastener applier according to claim 1, wherein the variable drive mechanism includes first and second cone members and a disc member, each cone member defining an apex portion and a base portion having a diameter greater than that of the apex portion, the disc member interdisposed between the cone members and contacting each of the cone members such that the disc member imparts rotation of the first cone member to the second cone member, the disc member tiltable relative to the cone members to vary relative contact points between the disc member and the first and second cone members to thereby vary a ratio of rotation of the first cone member as compared to rotation of the second cone member.

10. The surgical fastener applier according to claim 9, wherein the input member is engaged to the first cone member and wherein the output member is engaged to the second cone member such that tilting the disc member varies a ratio of rotation of the input member as compared to rotation of the output member.

11. The surgical fastener applier according to claim 1, wherein the variable drive mechanism is continuously transitionable between at least the first and second conditions.

12. The surgical fastener applier according to claim 1, wherein the variable drive mechanism includes first and second pairs of cone members and a belt member disposed about the first and second pairs of cone members, the cone members of the first pair disposed about a first shaft and movable relative to one another along the first shaft to vary a first diameter about which the belt is disposed at a first end of the belt, the cone members of the second pair disposed about a second shaft and movable relative to one another along the second shaft to vary a second diameter about which the belt is disposed at a second end of the belt, wherein varying the first and second diameters relative to one another varies a ratio of rotation of the first pair of cone member as compared to rotation of the second pair of cone members.

13. The surgical fastener applier according to claim 12, wherein the input member is engaged to the first shaft and wherein the output member is engaged to the second shaft such that varying the first and second diameters relative to one another varies a ratio of rotation of the input member as compared to rotation of the output member.

14. A method of surgery, comprising:

providing a surgical fastener applier including a trigger and a drive assembly, the trigger movable a pre-determined stroke length, the drive assembly including an input member coupled to the trigger, an output member, and a variable drive mechanism operably coupled between the input member and the output member;

coupling a first surgical fastener to the output member, wherein a first amount of rotation of the output member is required to apply the first surgical fastener to tissue;

setting an input to output ratio of the variable drive mechanism in accordance with the first amount of rotation of the output member; and

moving the trigger the pre-determined stroke length to rotate the output member by the first amount of rotation of the output member to apply the first surgical fastener to tissue.

15. The method according to claim 14, further comprising selecting a surgical fastener from the group consisting of:

the first surgical fastener, a second surgical fastener requiring a second amount of rotation of the output member to apply the second surgical fastener to tissue, and a third surgical fastener requiring a third amount of rotation of the output member to apply the second surgical fastener to tissue, before coupling the first surgical fastener to the output member.

16. The method according to claim 15, wherein the first, second, and third surgical fasteners are different sizes.

17. The method according to claim 14, further comprising:

coupling a second surgical fastener to the output member of the surgical fastener applier, wherein a second amount of rotation of the output member, different from the first amount, is required to apply the second surgical fastener to tissue;

setting an input to output ratio of the variable drive mechanism in accordance with the second amount of rotation of the output member; and

moving the trigger the pre-determined stroke length to rotate the output member the second amount of rotation of the output member to apply the second surgical fastener to tissue.

18. The method according to claim 14, wherein the surgical fastener applier further includes a control knob coupled to the variable drive mechanism, and wherein setting the input to output ratio is effected by rotating the control knob.

19. A surgical kit, comprising:

first, second, and third cartridges, each cartridge including a drive member having a plurality of surgical fasteners disposed thereon, the first cartridge including relatively small-sized surgical fasteners requiring a first amount of rotation for applying the relatively small-sized surgical fasteners, the second cartridge including medium-sized surgical fasteners requiring a second amount of rotation for applying the medium-sized surgical fasteners, and the third cartridge including relatively large-sized surgical fasteners requiring a third amount of rotation for applying the relatively large-sized surgical fasteners; and

a surgical fastener applier, including;

a housing having an elongated tubular member extending distally from the housing;

a trigger coupled to an input member and extending from the housing, the trigger pivotable relative to the housing from a first position to a second position to rotate the input member a fixed amount;

an output member configured to relesably engage each of the first, second, and third cartridges; and

a variable drive mechanism disposed within the housing and operably coupled between the input member and the output member, the variable drive mechanism transitionable between a first condition, wherein rotation of the input member by the fixed amount effects rotation of the output member the first amount for applying the relatively small-sized surgical fasteners when the first cartridge is engaged to the output member;

a second condition, wherein rotation of the input member by the fixed amount effects rotation of the output member the second amount for applying the medium-sized surgical fasteners when the second cartridge is engaged to the output member; and

a third condition, wherein rotation of the input member by the fixed amount effects rotation of the output member the third amount for applying the relatively large-sized surgical fasteners when the third cartridge is engaged to the output member.