Apparatus for applying two-part surgical fasteners

• US 5,156,614 A
• Filed: 11/14/1991
• 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:
  US07/794,596
• Time in Patent Office: 341 Days
• Field of Search: 606/220, 227/19, 227/175-182
• US Class Current: 606/220
• 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 2090/08021 of the patient or his organs

Abstract

Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, 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. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed.

Claims

1. Apparatus for applying at least one row of two-part surgical fasteners, each surgical fastener having a fastener portion and a retainer, which comprises:

a) means for holding said fastener portions of said two part surgical fasteners;

b) a retainer cartridge having means for holding a plurality of retainers in positions opposite said fastener portions;

c) a plurality of retainer mounting elements located in said retainer cartridge for releasably engaging and holding said retainers; and

d) means for sequentially driving said fastener portions of said two part fasteners into engagement with their respective opposed retainer.

2. The apparatus of claim 1 wherein the fastener portions and retainers are arranged in longitudinal alignment with the axis of the apparatus.

3. The apparatus of claim 2 adapted to fasten body tissue and further comprising means to cut the body tissue adjacent the location of application of said fasteners.

4. The apparatus of claim 1 wherein said retainer mounting elements are slidably mounted within at least one channel in the retainer cartridge.

5. The apparatus of claim 4 further comprising backstop means for bracing the retainers when engaging with the fastener portions.

6. The apparatus of claim 5 wherein said backstop means comprises a horizontal shelf portion of the cartridge upon which said retainers at least partially rest.

7. The apparatus of claim 6 wherein said retainer cartridge includes lower and upper channels having vertical side walls, and wherein the lower channel is of lesser width than the upper channel and located below said upper channel thereby forming at least one shelf portion.

8. The apparatus of claim 7 wherein said lower channel has a plurality of vertical guide rails and said retainer mounting elements each have at least one vertical notch for cooperating with a respective one of said vertical guide rails.

9. The apparatus of claim 1 wherein said retainer mounting elements release their respective retainers in response to the engagement of the fastener portions with their respective retainers.

10. The apparatus of claim 1 wherein the retainer mounting elements each comprise a base portion and at least one upright post for engaging an aperture in the retainer and frictionally holding said retainer.

11. The apparatus of claim 10 wherein a surface portion of said upright post is inclined on at least one vertical side.

12. The apparatus of claim 1 wherein said two-part surgical fastener portions are bio-absorbable.

13. Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a fastener portion and a retainer dimensioned and configured to receive the fastener portion into engaged relation therewith, which comprises:

a) means for releasably holding a plurality of said fastener portions;

b) means spaced from said fastener holding means for releasably holding a plurality of said retainers in positions opposite the respective fastener portion; and

c) means for sequentially advancing each said fastener portion toward said retainers so as to cause said fastener portion to engage said retainers while fastening body tissue therebetween.

14. Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of said pronged fastener portion in interference fit therewith for gripping the body tissue therebetween which comprises:

a) means for holding a plurality of said fastener portions in generally aligned relation;

b) means spaced from said fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of said retainers in generally aligned relation and positioned opposite said fastener portions when the body tissue is positioned therebetween; and

c) means for sequentially advancing said pronged fastener portions toward said aperture retainers to cause said fastener portions to pierce the body tissue and to be received within the apertures of said retainers in engaged interference relation so as to cause said fastener portions and said retainers to be engaged while gripping the body tissue therebetween.

15. Apparatus for applying at least two rows of two-part surgical fasteners to body tissue and for cutting the body tissue, each said surgical fastener having at least two pronged fastener portion for piercing body tissue, and a retainer member dimensioned and configured to receive said fastener portion in engaged relation such that the fastener portion and the retainer member are respectively positioned on opposite sides of the body tissue, which comprises:

a) a two part frame having separable sections capable of releasable attachment to each other and each having an elongated finger portion;

b) a fastener carrying cartridge mounted along one of said finger portions and carrying a plurality of said fastener portions;

c) a retainer carrying cartridge mounted along said other finger portion opposite said fastener cartridge and carrying a plurality of said retainer members positioned opposite said fastener portions, each said retainer member having apertures dimensioned and positioned for reception of said pronged portions of said fastener portions when said fastener portions are advanced toward said retainer members;

d) means mounted on said frame for sequentially advancing said fastener portions toward said retainer members while piercing body tissue positioned therebetween to effect application of said two-part fasteners to the body tissue; and

e) means associated with said fastener advancement means to cut body tissue adjacent the location of application of said fasteners.

16. The apparatus of claim 15 wherein said two-part frame comprises a pair of channel members having means to releasably attach said members in face to face relation.

17. The apparatus of claim 16 wherein said fastener cartridge comprises two pairs of rows of staggered apertures dimensioned and configured for frictionally holding a plurality of said fastener portions.

18. The apparatus of claim 17 wherein said retainer cartridge comprises a plurality of openings correspondingly dimensioned and positioned for holding a like plurality of fastener retainer members having fastener reception openings correspondingly positioned opposite said fastener members for inception of said pronged fastener portions therein when said fastener portions are advanced toward said retainer members.

19. The apparatus of claim 18 further comprising a plurality of retainer holders positioned in said retainer cartridge, said holders having means to support said retainer members in position for reception of said fastener portions.

20. The apparatus of claim 19 further comprising a plurality of fastener pushers positioned above said fastener portions on the side opposite said retainer members, said fastener pushers being dimensioned and positioned such that advancement thereof toward said fastener portions cause said fastener portions to engage said retainer members.

21. The apparatus of claim 20 further comprising a pair of cam bars positioned for slidable movement distally and proximally within said frame for sequential engagement with said fastener pushers, said cam bars being dimensioned and configured to sequentially advance said fastener pushers toward said fastener portions to effect engagement of said fastener portions with said retainer members.

22. The apparatus of claim 21 wherein each said fastener pushers has at least one camming surface for effecting movement thereof in a direction substantially perpendicular to the movement of said cam bars.

23. The apparatus of claim 22 wherein each said fastener, pushers has dual oppositely sloped surfaces.

24. The apparatus of claim 23 wherein means are provided in said retainer cartridge for releasably supporting said retainer members in upright position with respect to said fastener portions of said fasteners.

25. The apparatus of claim 24 wherein said retainer support means comprises a plurality of retainer support members having upright posts dimensioned for insertion into said apertures of said retainer members, said retainer support members being dimensioned to be frictionally supported within said retainer cartridge.

26. The apparatus of claim 25 wherein said retainer support upright posts are engagable by said pronged portions of said fastener portions during engagement of said fastener portions and said retainer members such that said fastener portions cause said retainer support members to be released from said retainer means during engagement of said fastener portions and said retainer means.

27. The apparatus of claim 26 wherein means is associated with said cam bars to prevent separation of said frame sections after said cam bars are advanced in the fastener advancement direction a predetermined distance.

28. The apparatus of claim 27 wherein said frame comprises a generally U-shaped shoe plate provided between each said fastener and retainer cartridge and the respective channel members of said frame.

29. The apparatus of claim 28 wherein each said shoe plate defines a channel for reception of a respective shoe associated with said cam bars, said respective shoes preventing separation of said frame members when said cam bars are advanced a predetermined distance due to the entry of said shoes associated therewith into said channels defined by said shoe plates.

30. The apparatus of claim 29 wherein said means to support said retainer members in position for reception of said fasteners comprises at least two side rails extending longitudinally of said retainer cartridge and dimensioned to interfere with downward movement of said retainers so as to support said retainers firmly during engagement with said fastener portions.

31. The apparatus of claim 15 wherein said fastener carrying cartridge is removable.

32. The apparatus of claim 31 wherein said retainer carrying cartridge is removable.

33. Method for applying at least one row of two-part surgical fasteners, each surgical fastener having a pronged fastener portion and a retainer, comprising:

a) holding said fastener portions of said two-part surgical fasteners;

b) releasably holding a plurality of retainers in positions opposite said fastener portions; and

c) sequentially driving said fastener portions of said two-part fasteners into engagement with their respective opposed retainers.

34. Method for applying at least one row of two-part surgical fasteners, each surgical fastener having a pronged generally u-shaped fastener portion, and an apertured retainer dimensioned for engaged reception of said fastener portion, comprising:

a) holding a plurality of said fastener portions of said two-part surgical fasteners;

b) releasably holding a plurality of said retainers in positions opposite said fastener portions such that the apertures thereof face the pronged portions of said fastener portions; and

c) sequentially driving said fastener portions of said two-part fasteners toward said retainers so as to cause said pronged portions to be engagably received within said apertures of said retainers.

35. The method for applying at least one row of two-part surgical fasteners according to claim 34 further comprising positioning tissue to be fastened between said rows of fastener portions and retainers such that sequentially driving said fastener portions toward said retainers causes said fastener portions to be driven through the tissue so as to grip the tissue between said fastener portions and said retainers.

36. The method according to claim 35 further comprising cutting the tissue while driving said fastener portions toward said retainers.

37. The method according to claim 36 wherein said cutting step is performed between said two rows of said two-part fasteners.

38. The method of claim 37 wherein said tissue fastening step is accomplished on an apparatus which permits release of the tissue after the fastening and engagement of said two-part fasteners is complete.

39. The method of claim 36 wherein at least two pairs of parallel rows of fastener portions are held in position for fastening and at least two corresponding pairs of parallel rows of retainers are positioned opposite said fastener portions, and said cutting step is performed between said two pairs of parallel rows of fasteners.

40. The method according to claim 35 wherein at least two rows of said fastener portions are held in first positions, and at least two corresponding rows of said retainers are held in positions opposite said first two rows of fastener portions.

41. A method for applying at least two pairs of rows of two-part surgical fasteners to body tissue, each surgical fastener including a fastener portion having a U-shaped configuration having a pair of prongs and a mating retainer having a pair of members defining apertures for engaged reception of said prongs, comprising:

a) holding a plurality of said fastener portions in two pairs of spaced apart generally parallel rows on one part of a two-part apparatus;

b) releasably holding a plurality of said retainers in two pairs of correspondingly spaced apart generally parallel rows on a second part of said two-part apparatus in a manner such that said apertured members of said retainers face said pairs of prongs of said fastener portions when said two-part apparatus is assembled;

c) positioning tissue to be fastened between said respective two parts of said apparatus and locking said two parts together;

d) sequentially driving said fastener portions of said two-part fasteners toward said retainers by advancing fastener driving means sufficient to cause said pronged portions to be driven through the tissue and to be engagably received within said apertures of said retainer members while cutting the tissue generally medially between said rows of pairs of fastener portions, said fastener driving means preventing separation of said half portions of said apparatus during the step of driving said fastener portions; and

e) withdrawing said fastener driving means so as to release said half portions of said apparatus to permit separation thereof for removal of the fastened tissue.

42. The method of claim 41 wherein said retainers are firmly supported on support means while driving said fastener portions into engagement therewith.

43. The method of claim 42 wherein said support means comprises at least two rails defining retainer support shelves and extending longitudinally of said apparatus.