Arcuate apparatus for applying two-part surgical fasteners

• US 5,156,315 A
• Filed: 04/26/1991
• Issued: 10/20/1992
• Est. Priority Date: 09/17/1990
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Geiste, Robert J., Bolanos, Henry, Young, Wayne P., Green, David T., Rende, Frank M. III, Gerry, Stephen W.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US07/692,177
• Time in Patent Office: 543 Days
• Field of Search: 227/19, 227/175-180, 606/220
• US Class Current: 227/178.1
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00446 for use only by lefthanded or only by righthanded persons
• CPC Class Codes: A61B 2017/00451 by lefthanded persons
• CPC Class Codes: A61B 2017/07221 curved
• CPC Class Codes: A61B 2017/07228 Arrangement of the staples
• CPC Class Codes: A61B 2090/08021 of the patient or his organs

Abstract

Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied. A method for applying fasteners to body tissue on the apparatus of the invention along an arcuate path is also disclosed.

Claims

1. Apparatus for applying a plurality of rows of fasteners to body tissue which comprises a first member having a fastener cartridge for supporting at least two rows of fasteners and a second member disposed opposite said first member, said first and second members adapted to be assembled in a manner to position body tissue between said cartridge and said second member, means adapted to be advanced distally to sequentially drive said fasteners into the body tissue toward said second member, knife means including a knife bar and a cutting edge at a distal end thereof and movable between a proximal position and a distal position to cut body tissue between said at least two rows of fasteners when said fasteners are driven into the body tissue, and means for contacting said knife bar to block movement thereof to said distal position after advancement of said knife bar to cut tissue and subsequent retraction to said proximal position.

2. Apparatus of claim 1 wherein said knife bar lags said fastener drive means when said fastener drive means are advanced toward said distal positions.

3. Apparatus of claim 2 wherein said knife bar includes a hook-like configuration for engaging said contacting means.

4. Apparatus of claim 1 wherein said fastener cartridge is removably mounted with respect to said first member.

5. Apparatus of claim 4 wherein said contacting means is spring biased.

6. Apparatus of claim 5 wherein said contacting means engages a portion of said knife bar.

7. Apparatus of claim 1 wherein said contacting means engages a portion of said knife bar.

8. Apparatus of claim 7 wherein said contacting means is disposed proximally of said distal end of said knife bar.

9. Apparatus of claim 8 wherein said fastener cartridge is removably mounted in said apparatus.

10. Apparatus for applying a plurality of rows of fasteners to body tissue which comprises a first member having a fastener cartridge for supporting at least two rows of fasteners and a second member disposed opposite said first member, said first and second members adapted to be assembled in a manner to position body tissue between said cartridge and said second member, a pair of bars movable between proximal positions and distal positions to sequentially drive said fasteners into the body tissue toward said second member a knife bar movable between a first position and a second position for cutting body tissue between said at least two rows of fasteners when said fasteners are advanced into the body tissue and toward said second member, and means for engaging said knife bar to prevent movement of said knife bar to said second position after said fasteners are advanced and said knife bar is retracted to said first position.

11. Apparatus of claim 10 wherein said knife bar comprises a knife edge at the distal end thereof.

12. Apparatus of claim 10 wherein said fastener cartridge is removably mounted with respect to said first member.

13. Apparatus of claim 12 wherein said knife bar lags said fastener driving bars when said fastener driving bars are advanced toward said distal positions.

14. In an apparatus for applying a plurality of rows of fasteners to body tissue, the apparatus comprising a first member having a fastener cartridge adapted for supporting a plurality of fasteners and a second member disposed opposite said first member, said first and second members being adapted to be assembled in a manner to permit positioning of body tissue between said cartridge and said second member, means adapted to be advanced distally to drive said fasteners into the body tissue toward said second member, means to cut body tissue generally between at least two pairs of rows of said fasteners when said fasteners are advanced into the body tissue and toward said second member, and means for engaging said tissue cutting means to prevent distal movement thereof after said fasteners are advanced and said driving means is retracted to a proximal position.

15. The apparatus of claim 14 wherein a first hook member is positioned and adapted for movement at least with said cutting means when said cutting means is advanced distally.

16. The apparatus of claim 15 wherein said first hook member is integral with said cutting means.

17. The apparatus of claim 16 wherein a second hook member is fixedly positioned with respect to said fastener driving means and adapted to engage said first hook member associated with said cutting means when said cutting means is withdrawn to the proximal position after said fastener driving means has been advanced to the distalmost position to drive said fasteners and returned to the proximal position with said cutting means, said first and second hook members being configured and positioned to prevent hooked engagement with each other prior to advancing said fastener driving means.

18. The apparatus of claim 17 wherein clamp means is provided to selectively clamp said first member to said second member.

19. The apparatus of claim 18 wherein said first hook member is attached to the proximalmost end portion of said cutting means.

20. The apparatus of claim 19 wherein said second hook member comprises a resiliently mounted hook-shaped tongue positioned and adapted to engage the upper edge of the proximalmost portion of said cutting means during distal advancement thereof when said fastener closure means is advanced distally, said resiliently mounted tongue being biased toward a second position whereby said tongue engagably hooks said hook member of said cutting means when said cutting means is withdrawn to the proximal position after effecting closure of said fasteners to thereby prevent further advancement of said cutting means.

21. A surgical fastening apparatus adapted for single use application of at least four rows of fasteners to body tissue which comprises:

a) a first channel member adapted to support a single use fastener cartridge, said fastener cartridge supporting at least two pairs of rows of fasteners positioned in staggered relation;

b) a second channel member adapted to be assembled with said first channel member;

c) pivotally mounted locking means to securely attach said first and second channel members together in a manner to grip body tissue between said fastener cartridge and said second channel member;

d) knife means positioned between said two pairs of rows of fasteners to cut body tissue generally medially of said rows of fasteners while said fasteners are applied to the body tissue;

e) a pusher assembly comprising at least two cam bars dimensioned and configured to effect sequential movement of said fasteners toward said fastener closure means in directions generally transverse to the direction of movement of said cam bars, said pusher assembly being attached to said knife means and adapted to be slidably advanced in the distal direction to simultaneously advance said cam bars and said knife means;

f) a hook member disposed on the proximal end portion of said knife means;

g) a resilient locking clip fixed to at least one of said channel members and having a hook member biased, dimensioned and arranged to engage and hook said knife means hook to prevent distal advancement of said knife means after retraction of said pusher assembly after firing the fasteners; and

h) blocking means adapted to prevent said resilient locking hook from engagably hooking said knife means hook prior to advancing said fasteners toward said second channel member whereby advancing said knife means and said fasteners toward the distalmost portion to apply said fasteners to body tissue and to cut the body tissue is permitted and advancement of said knife means and pusher assembly in a distal direction is prevented after withdrawal thereof to a proximal position after applying said fasteners to body tissue.

22. The apparatus of claim 21 wherein said first channel member is arcuately configured and said second channel means is arcuately configured similar to said first channel member.

23. The apparatus of claim 22 further comprising means to prevent separation of said first and second channel members after initiating movement of said fasteners toward said fastener closure means.