Laparoscopic instruments and methods
First Claim
1. A laparoscopic tack applicator instrument, comprising:
- elongated cylindrical tube means for insertion through a laparoscopic port, the tube means having a central axis, a distal insertion end and an exterior proximal end;
central shaft means slidably disposed along the central axis, the shaft means including distal sacral tack holder means comprising a pair of lateral arms fixedly spaced apart between their terminal ends to define an open end and also including exterior positioning means for axial and rotational positioning of the shaft relative to the tube to determine the position of the open end of the arms so that the tack holder means may be disengaged from or engaged to a tack by a lateral motion.
1 Assignment
0 Petitions
Accused Products
Abstract
A tacker instrument for laparoscopic applications fits within a cannula and incorporates within a sleeve a positioning and driving system coupled to a tack holder mechanism at the distal end. The tack is held unexposed during entry but then may be extended to a predetermined position for embedment, with position being verifiable through the sleeve. Impact forces for embedding or removing the tack are applied to the positioning and driving mechanism, and the tack and tack holder are configured so that there is lateral disengagement or engagement of the two. In one version the mechanism is linear, while in a second version the distal end of the sleeve device can be angulated for perpendicular tack entry or removal with impelling forces being applied through a flexible shaft segment.
137 Citations
28 Claims
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1. A laparoscopic tack applicator instrument, comprising:
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elongated cylindrical tube means for insertion through a laparoscopic port, the tube means having a central axis, a distal insertion end and an exterior proximal end; central shaft means slidably disposed along the central axis, the shaft means including distal sacral tack holder means comprising a pair of lateral arms fixedly spaced apart between their terminal ends to define an open end and also including exterior positioning means for axial and rotational positioning of the shaft relative to the tube to determine the position of the open end of the arms so that the tack holder means may be disengaged from or engaged to a tack by a lateral motion. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A device foe use in laparoscopic surgery, for embedding a tack in cartilage or bone, comprising the combination of:
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elongated cylindrical tube means having a distal end for insertion in a body cavity through a surface penetration region, the tube means including a proximal end protruding from the body when inserted and means defining a viewing aperture spaced apart from the distal end and interior to the body when inserted; tack retaining means disposed within the distal end region of the tube means; positioning means disposed in the proximal region of the tube means and including shaft means extending through the tube means and coupled to the tack retaining means for positioning a tack therein relative to the distal end of the tube means, the positioning means including means visible through the viewing aperture indicative of the position of the tack retaining means relative to the end of the tube means; and impeller means attachable at the proximal end of the tube means and intercoupled via the shaft means to the tack retaining means, for embedding the tack. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
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18. A sacral tacker for use in laparoscopic surgery comprising:
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an elongated cylindrical tube means for insertion through a laparoscopic port, the tube means having a central axis, an insertion end and a proximal exterior end; a central shaft means disposed along the central axis within the tube means, the shaft means having a distal tack holder comprising a pair of lateral arms spaced apart between their terminal ends; a tack having a shaft and a head attached thereto, the tack head having a circumferential groove thereabout for registration within the lateral arms of the tack holder; said shaft means including a proximal positioning cylinder end at a predetermined spacing from the distal tack holder; positioning sleeve means coupled to said tube means at the proximal exterior end thereof, said positioning sleeve means including a guide slot spaced from the distal end of the tube means by a predetermined distance such that control of tack position relative to the tube means can be established relative to the positioning cylinder position with respect to the guide slot.
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19. A laparoscopic tacking device comprising:
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a tube means having a length for extension through a cannula port into a body cavity in the region of a tacking site and an exterior portion at which an operator can manipulate a device extending through the tube means; shaft means extending through the tube means, said shaft means including tack holder means at the distal end thereof, said tack holder means comprising means for laterally engaging a tack along a predetermined lateral direction and disengaging in the lateral direction opposite thereto, said shaft means further including bicoordinate shaft positioning means in the exterior portion thereof, the positioning means defining polar and axial positions for (1) tack concealment within the distal end of the tube means of a tack;
(2) insertion of a tack; and
(3) engagement and disengagement of a tack with respect to the tack holder means;means associated with the portion of said tube means disposed within the body for viewing the position of the shaft means relative to the tube means; and impeller means engagable to the exterior portion of the shaft means for impacting the shaft means in the axial direction to drive a tack into position.
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20. An instrument for implanting surgical tacks in cartilage during laparoscopic surgery comprising:
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extended tube means having a first central axis and insertable into a body cavity, the tube means including an interior concentric tube within said tube means, said tube means being rotatable about the central axis relative to the interior tube, end tube means having a second central axis nominally collinear with the first central axis and coupled to the distal end of the interior tube, means disposed between the extended tube means and the end tube means for changing the angle of the end tube means central axis relative to the tube means central axis in response to rotation of the tube means; shaft means extending through the tube means and end tube means, the shaft means including a distal tack holder means and a flexible section at least in the region between the tube means and end tube means wherein the flexible section is sufficiently rigid to avoid buckling during tack implementation. - View Dependent Claims (21)
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22. The method, for laparoscopic procedures, of positioning and inserting a sacral tack, having a tack shaft and a tack head, using an instrument having a elongated cylindrical tube and a central reciprocable shaft means wherein the shaft means has receiving arms on a distal end and guide means on an exterior end for positioning the shaft means in insertion, tack implantation, and tack disengagement positions, comprising the steps of:
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sliding the head of the tack into the receiving arms of the reciprocable shaft means; retracting the tack into the tube by moving the guide means into the insertion position; inserting the instrument into a body cavity; positioning the distal end of the tube at the desired tacking site; placing the tack at the tack implantation position by positioning the guide means; implanting the tack into the sacrum; extending the tack outside the tube by moving the guide means to the disengagement position, and disengaging the sacral tacker from the tack. - View Dependent Claims (23)
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24. A method of positioning and removing a sacral tack, having a tack shaft and a tack head, using an applicator having a elongated cylindrical housing and a central reciprocating shaft, wherein the shaft has receiving arms on a distal end and a guide pin extending laterally from the shaft on a proximal end for positioning the shaft into insertion, control, and detachment positions in a guide slot disposed in the housing, comprising the steps of:
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setting a guide pin into the detachment position; sliding the receiving arms of the reciprocating plunger into a circumferential groove in the head of the tack; rotating the housing to align the guide pin in the tack control position; driving the impeller away from the insertion site thereby withdrawing the tack into the housing; and removing the sacral tack applicator from the laparoscopic port.
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25. In a laparoscopic tacking instrument having a tack positioning and driving mechanism movable through a longitudinal hollow cylinder, the combination comprising:
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coupling means coupled at the distal end of a positioning and driving mechanism for attachment of a tack holder device; tack holder cartridge means slidable within a hollow cylinder and including means for releasably engaging to the coupling means, the tack holder cartridge means including means at the distal end thereof for engaging a tack to be driven, and means for retaining the tack against longitudinal movement.
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26. A laparoscopic tack applicator instrument, comprising:
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elongated cylindrical tube means for insertion through a laparoscopic port, the elongated cylindrical tube means having a central axis, a distal insertion end and an exterior proximal end; and central reciprocal shaft means slidably disposed along the central axis, the central reciprocal shaft means including distal sacral tack holder means comprising a pair of lateral arms spaced apart between their terminal ends and also including exterior positioning means for establishing predetermined positions of the shaft means relative to the distal end of the tube means for concealing the tack in the elongated cylindrical tube means, for embedding or removing a tack, and for detaching or attaching a tack, the exterior positioning means including means defining a bicoordinate positioning slot serving as physical reference for the predetermined positions of the shaft means.
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27. A laparoscopic tack applicator instrument, comprising:
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elongated cylindrical tube means for insertion through a laparoscopic port, the elongated cylindrical tube means having a central axis, a distal insertion end, a viewing window spaced from the tack holder means such that the position of a member relative to the tube means can be visualized, and an exterior proximal end; and central reciprocal shaft means slidably disposed along the central axis, the central reciprocal shaft means including distal sacral tack holder means comprising a pair of lateral arms spaced apart between their terminal ends, the shaft means including a reference surface spaced a known distance from the tack holder means and in position to be viewed through the viewing window, including positioning means exterior to the laparoscopic probe for axially and rotationally positioning the central reciprocal shaft means relative to the elongated cylindrical tube means.
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28. A laparoscopic tack applicator instrument, comprising:
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elongated cylindrical tube means for insertion through a laparoscopic port, the elongated cylindrical tube means having a central axis, a distal insertion end, and an exterior proximal end; and central reciprocal shaft means slidably disposed along the central axis, the central reciprocal shaft means including distal sacral tack holder means coupled to the distal end of the shaft means and impactable by the distal end thereof and comprising a pair of lateral arms spaced apart between their terminal ends;
the shaft means also including exterior positioning means for axially and rotationally positioning the central reciprocal shaft means relative to the elongated cylindrical tube means, the shaft means also including mechanical biasing means coupled between the shaft means and the tack holder means for securing a tack in position between the arms of the tack holder means.
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Specification