Apparatus for applying two-part surgical fasteners

• US 5,253,793 A
• Filed: 02/06/1991
• Issued: 10/19/1993
• 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:
  US07/651,594
• Time in Patent Office: 986 Days
• Field of Search: 227/19, 227/175-180, 227/8, 606/220
• US Class Current: 227/178.1
• 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 2017/07228 Arrangement of the staples
• 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. A locking mechanism can be provided in the form of a hook which engages the cam bar retainer after firing the staples to prevent forward movement of the cam bar retainer.

Claims

1. A surgical fastening apparatus comprising:

a channel member;

a pusher assembly slidably mounted within said channel member, said pusher assembly having at least one cam bar longitudinally movable through said channel member for sequentially firing fasteners, and a cam bar retainer for mounting said cam bar;

a projection extending from an outer surface of said cam bar retainer; and

hook means positioned proximal of said projection and out of engagement therewith, said hook means being dimensioned and configured for engagement with said projection upon retraction of said cam bar retainer after firing the fasteners to thereby block distal movement of said cam bar retainer.

2. A surgical fastening apparatus as recited in claim 1, wherein said projection is substantially teardrop shaped.

3. A surgical fastening apparatus as recited in claim 1, wherein said outer surface is a bottom surface of said cam bar retainer.

4. A surgical fastening apparatus as recited in claim 3, wherein said channel member includes a vertical side wall and said hook means is secured to said side wall.

5. A surgical fastening apparatus as recited in claim 1, further comprising a knife assembly mounted to said cam bar retainer.

6. A surgical fastening apparatus as recited in claim 4, wherein said hook means is integral with said side wall.

7. A surgical fastening apparatus as recited in claim 6, wherein said projection is disposed at a distal portion of said cam bar retainer.

8. A surgical fastening apparatus as recited in claim 1, wherein each of said fasteners comprises a pronged fastener portion and a retainer for receiving said pronged fastener portion.

9. A surgical fastening apparatus as recited in claim 1, wherein said pusher assembly is mounted in a fastener cartridge, said fastener cartridge being removable.

10. A surgical fastening apparatus comprising:

a channel member for mounting a fastener cartridge;

a pusher assembly mounted within said channel member, said pusher assembly having at least one cam bar for sequentially firing fasteners and a cam bar retainer for mounting said cam bar; and

means for engaging a bottom surface of said can bar retainer upon retraction of said cam bar retainer after firing the fasteners to thereby block forward movement of said cam bar retainer.

11. A surgical fastening apparatus as recited in claim 10, wherein said engaging means comprises a hook having a distal portion engageable with a projection formed on said bottom surface of said cam bar retainer.

12. A surgical fastening apparatus as recited in claim 11, wherein said hook is secured to a side wall of said channel member.

13. A surgical fastening apparatus as recited in claim 10, wherein said fastener cartridge is removable.

14. A surgical fastening apparatus for applying at least one row of two-part surgical fasteners, each surgical fastener having a pronged fastener portion and a retainer, which comprises:

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

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

means for sequentially driving said fastener portions of said two part fasteners into engagement with their respective opposed retainers; and

locking means for preventing reactuation of the driving means after firing of the fasteners.

15. A surgical fastening apparatus as recited in claim 14, wherein said driving means comprises at least one cam bar, said cam bar mounted in a cam bar retainer, and said locking means comprises means for engaging said cam bar retainer to block distal movement of said cam bar retainer.

16. A surgical fastening apparatus as recited in claim 15, wherein said locking means comprises a hook which engages a projection extending from said cam bar retainer to block distal movement of said cam bar retainer.

17. A surgical fastening apparatus as recited in claim 16, wherein said hook engages said cam bar retainer when said cam bar retainer is retracted to a proximal position after firing the fasteners.

18. A surgical fastening apparatus as recited in claim 17, wherein said projection is formed on a bottom surface of said cam bar retainer.

19. A surgical fastening apparatus as recited in claim 14, wherein said means for holding said pronged fastener portions comprises a fastener cartridge, said fastener cartridge being removable.

20. A surgical fastening apparatus for applying two part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion and a retainer dimensioned to receive the pronged fastener portion, said apparatus comprising:

a channel member for mounting a fastener cartridge having a plurality of pronged fastener portions;

a pusher assembly mounted within said channel member and having a cam bar retainer mounted therein for sliding movement between a proximal position and a distal position;

at least one cam bar mounted to said cam bar retainer and engagable with said pronged fastener portions to sequentially drive said pronged fastener portions in a direction substantially perpendicular to the direction of movement of said cam bar retainer when said cam bar retainer is slid to said distal position;

a retainer cartridge having a plurality of retainers mounted therein in positions opposite said respective pronged fastener portions, said retainers engaging said pronged fastener portions when said pronged fastener portions are driven to said cam bar; and

a locking mechanism engagable with said cam bar retainer to prevent distal movement of said cam bar retainer after said pronged fastener portions have been fired.

21. A surgical fastening apparatus as recited in claim 20, wherein said locking mechanism engages said cam bar retainer when said cam bar retainer is retracted proximally from said distal position.

22. A surgical fastening apparatus as recited in claim 21, wherein said locking mechanism comprises hook means engagable with said cam bar retainer.

23. A surgical fastening apparatus as recited in claim 22, further comprising a projection formed on an outer surface of said cam bar retainer, said hook means engagable with said projection.

24. A surgical fastening apparatus as recited in claim 23, wherein said hook means is secured to a vertical side wall of said channel member and said projection is formed on a bottom surface of said cam bar retainer.

25. A surgical fastening apparatus as recited in claim 22, wherein said fastener cartridge is removable.

26. A surgical fastener comprising:

an elongate member for supporting fastener holding means;

a pusher assembly mounted to said elongate member and having at least one cam bar for sequentially firing fasteners;

cam bar retainer means for mounting said cam bar;

a projection extending from said cam bar retainer;

engaging means fixedly positioned with respect to said elongate member and extending generally inwardly from one side portion thereof and adapted to engage said projection of said cam bar retainer after firing fasteners so as to block distal movement of said cam bar retainer.

27. A surgical apparatus for firing fasteners comprising:

a first section having means for receiving a fastener cartridge;

a second section adapted to be positioned opposite said first section to grip tissue between said first and second sections;

a pusher assembly slidably mounted within said first section and having first and second cam bars movable longitudinally therein from a first position to a second position distal of said first position for sequentially firing fasteners;

a retainer member having a first aperture for receiving at least a portion of said first cam bar and a second aperture for receiving at least a portion of said second cam bar, said retainer member having a projecting surface extending toward said second section;

an engaging member engagable with said projecting surface, said projecting surface positioned distal of said engaging member at least when said apparatus is in a first condition prior to firing the fasteners;

means for advancing said first and second cam bars to sequentially fire the fasteners;

said engaging member engagable with said projecting surface after retraction of said cam bars after firing the fasteners to thereby prevent distal movement of said cam bars to said second position.

28. The surgical apparatus according to claim 27 further comprising a knife assembly and said retainer member further comprises a third aperture to receive at least a portion of said knife assembly.

29. The surgical apparatus according to claim 28 wherein said retainer member is positioned in a proximal portion of said first half section.

30. The surgical apparatus according to claim 29 wherein said retainer member is slidably mounted in said first half section.

31. The surgical apparatus according to claim 30 wherein said hook member is secured to a side wall of said first half section.

32. A surgical fastening apparatus comprising:

a channel member having at least one side wall;

a pusher assembly slidably mounted within said channel member, said pusher assembly having at least one cam bar longitudinally movable through said channel member for sequentially firing fasteners, and a cam bar retainer for mounting said cam bar;

a projection formed on a bottom surface of said cam bar retainer; and

hook means secured to said at least one side wall and engagable with said projection upon retraction of said cam bar retainer after moving said cam bar retainer distally to fire the fasteners, said engagement between said hook means and said projection thereby blocking distal movement of said cam bar retainer.

33. A surgical apparatus as recited in claim 32 wherein said hook means is integral with said at least one side wall.

34. A surgical fastening apparatus comprising:

a channel member;

a pusher assembly slidably mounted with respect to said channel member, said pusher assembly having at least one cam bar longitudinally movable with respect to said channel member for sequentially firing fasteners, and a cam bar retainer for mounting said cam bar;

a projection extending from one surface portion of said cam bar retainer; and

means positioned proximal of said projection and engagable with said projection upon proximal retraction of said cam bar retainer after moving said cam bar retainer distally to fire the fasteners so as to thereby block distal movement of said cam bar retainer.

35. A surgical fastening apparatus comprising:

a channel member;

a pusher assembly slidably mounted within said channel member, said pusher assembly having at least one cam bar longitudinally movable through said channel member for sequentially firing fasteners, and a cam bar retainer for mounting said cam bar;

hook means fixedly positioned relative to said channel member and movable in directions generally transverse to the direction of movement of the fasteners;

interference means associated with said cam bar retainer and positioned to avoid engagement with said hook means when said hook means is in the normal position, said interference means being dimensioned, configured and positioned for engagement by said hook means upon retraction of said cam bar retainer after firing the fasteners to thereby block distal movement of said cam bar retainer.

36. A surgical fastening apparatus comprising:

a channel member;

a pusher assembly slidably mounted within said channel member, said pusher assembly having at least one cam bar longitudinally movable through said channel member for sequentially firing fasteners, and a cam bar retainer for mounting said cam bar;

engaging means positioned relative to said channel member and movable in directions generally transverse to the direction of movement of the fasteners;

a projection extending from one surface portion of said cam bar retainer and over a minor portion of the widthwise dimension of said surface portion, said projection being dimensioned, configured and positioned for engagement by said engaging means upon retraction of said cam bar retainer after firing the fasteners to thereby block distal movement of said cam bar retainer.