Apparatus for applying two-part surgical fasteners in laparoscopic or endoscopic procedures

• US 5,573,169 A
• Filed: 06/02/1994
• Issued: 11/12/1996
• Est. Priority Date: 10/02/1992
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Toso, Kenneth, Bolanos, Henry, Green, David T., Kolesa, Michael S.
• Primary Examiner(s): Rada, Rinaldi I.
• Application Number:
  US08/253,208
• Time in Patent Office: 894 Days
• Field of Search: 227/19, 227/176, 227/178, 227/180, 227/181, 227/176.1, 227/177.1, 227/178.1, 227/181.1
• US Class Current: 227/177.1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

Apparatus is disclosed for applying two-part surgical fasteners during endoscopic or laparoscopic procedures. The apparatus includes a handle portion, an elongated endoscopic portion which extends from the handle portion, and structure associated with a distal end portion of the endoscopic portion for applying a two-part surgical fastener. The fastener applying structure includes a camming assembly for driving the fastener portion of the two-part surgical fastener into engagement with the retainer portion of the two-part surgical fastener through a fastener lifting member.

Claims

1. Apparatus for endoscopic application of two-part surgical fasteners, each two-part surgical fastener including a fastener portion and a retainer portion, which comprises:

a) a handle assembly;

b) an endoscopic portion extending distally from said handle assembly and defining a longitudinal axis;

c) first and second support means for respectively supporting a plurality of fastener portions and retainer portions in respective opposed positions along the longitudinal axis;

d) means for simultaneously advancing such fastener portions and retainer portions in a distal direction along said longitudinal axis while maintaining the opposed positions thereof;

e) fastener applying means for individually moving such fastener portions toward such retainer portions in a direction which is generally transverse to the direction of simultaneous advancement and into engagement with one another for application to body tissue; and

f) means for sealing the apparatus to obstruct the passage of gaseous media.

2. Apparatus as recited in claim 1, wherein the means for sealing the apparatus is disposed in the endoscopic portion for inhibiting the egress of insufflation gas therethrough.

3. Apparatus as recited in claim 1, further comprising approximating means for moving the retainer portion support means and the fastener portion support means into close cooperative alignment.

4. Apparatus as recited in claim 3, wherein the support means for respectively supporting the plurality of fastener portions and retainer portions of the two-part surgical fasteners comprises first and second arms adapted for maintaining the retainer and the fastener portions.

5. Apparatus as recited in claim 4, wherein the first support means includes a first channel and the second support means includes a second channel.

6. Apparatus as recited in claim 5, wherein the means for individually moving one of such fastener and retainer portions into engagement with the other includes a linkage assembly operatively connected to the handle assembly.

7. Apparatus as recited in claim 6, wherein the linkage assembly includes a camming link and a pivoting link operatively associated with the camming link, wherein the camming link comprises at least one cam member having an elongated body portion and a head portion depending angularly from the body portion, the head portion having an elongated cam slot defined therein.

8. Apparatus as recited in claim 7, wherein the pivoting link includes at least one elongated rocker member having opposed proximal and distal ends, the rocker member being pivotably connected to the second arm intermediate the proximal and distal ends of the rocker member, the rocker member including lifting means for moving a fastener portion disposed at the distal end thereof and a cam follower connected to the proximal end thereof and adapted for translation relative to the cam slot defined in the cam member.

9. Apparatus as recited in claim 8, wherein the lifting means includes a lift member having a shelf defined therein for accommodating a fastener portion of one of the two-part surgical fasteners and the approximating means is operatively connected to the handle assembly and includes at least one elongated draw bar operatively connected to the first arm, the approximating means further including an elongated cam groove formed in a portion of the second arm and a camming pin connecting the draw bar to the first arm through the cam groove.

10. Apparatus as recited in claim 9, wherein the supporting means includes means for movably supporting the lifting means, the lifting means including a pair of rail members extending generally transversely of the longitudinal axis of the endoscopic portion, and at least two apertures for reception of the rail members to movably support the lifting means.

11. Apparatus for endoscopic application of two-part surgical fasteners each such fastener having a fastener portion and a retainer portion, which comprises:

a) an elongated endoscopic portion defining a longitudinal axis;

b) a plurality of fastener portions and a plurality of retainer portions supported in respective opposed positions along the longitudinal axis;

c) a fastener applying assembly including a mechanism for simultaneously advancing the fastener portions and retainer portions distally along the longitudinal axis defined by the endoscopic portion while maintaining the opposed positions thereof to position a distalmost fastener portion and a distalmost retainer portion for application to body tissue, and a mechanism for individually moving the fastener portions into engagement with the retainer portions in a direction transverse to their direction of simultaneous advancement; and

d) a gaseous seal disposed within the endoscopic portion to inhibit the egress of gas therethrough.

12. Apparatus as recited in claim 11, further comprising an actuating member associated with a proximal end portion of the endoscopic portion for actuating the fastener applier.

13. Apparatus as recited in claim 12, wherein the plurality of fastener portions are aligned relative to the plurality of retainer portions such that a distalmost fastener portion is opposite a distalmost retainer portion.

14. Apparatus as recited in claim 13 further comprising a fastener supporting portion and a retainer supporting portion pivotably mounted with respect to each other to be approximated into close cooperative alignment.

15. Apparatus as recited in claim 14 wherein the fastener supporting portion and the retainer supporting portion are pivotable into close cooperative alignment from a location spaced proximal of the location of application of the fastener to body tissue.

16. Apparatus for endoscopic application of two-part surgical fasteners, each of such two-part surgical fasteners having a fastener portion and a retainer portion, which comprises:

a) a handle assembly;

b) an endoscopic portion extending distally from the handle assembly and defining a longitudinal axis;

c) fastener portion supporting means associated with a distal end portion of the endoscopic portion for supporting a plurality of the fastener portions of such two-part surgical fasteners;

d) retainer portion supporting means for supporting a plurality of such retainer portions of the two-part surgical fasteners in opposed positions relative to the fastener portions to facilitate the cooperative registration thereof;

e) approximating means operatively connected to the handle assembly for moving the retainer portion supporting means and the fastener portion supporting means into close cooperative alignment wherein an outer dimension of the retainer portion supporting means and the fastener portion supporting means is approximately equal to an outer dimension of the endoscopic portion; and

f) driving means operatively connected to the handle assembly for simultaneously advancing the fastener portions and retainer portions distally within the respective fastener supporting means and retainer supporting means along the longitudinal axis while maintaining the opposed positions thereof and for individually moving at least one of such fastener portions and retainer portions into engagement with the other in a direction transverse to their direction of simultaneous advancement.

17. Apparatus as recited in claim 16, wherein the fastener portion supporting means supports a plurality of such fastener portions formed of a bioabsorbable material and the retainer portion supporting means supports a plurality of such retainer portions formed of a bioabsorbable material.

18. Apparatus as recited in claim 17, wherein the bioabsorbable material is selected from a group consisting of polymers of lactide, glycolide, p-dioxanone, polyester and polyamino acid.

19. Apparatus for endoscopic application of two-part surgical fasteners, each two-part surgical fastener including a fastener portion and a retainer portion, which comprises:

a) a handle assembly;

b) an endoscopic portion extending distally from the handle assembly and defining a longitudinal axis;

c) means for supporting a plurality of fastener portions and retainer portions in respective opposed positions along the longitudinal axis;

d) means for simultaneously advancing such fastener portions and retainer portions distally along the longitudinal axis while maintaining the opposed positions thereof prior to application of each of the surgical fasteners to body tissue;

e) fastener applying means for individually moving only the distalmost of the fastener portions toward the distalmost of the retainer portions in a direction transverse to the direction of simultaneous advancement and into engagement for application to body tissue in a single surgical fastener firing sequence; and

f) means for sealing the apparatus to obstruct the passage of gaseous media.

20. Apparatus for endoscopic application of two-part surgical fasteners each having a fastener portion and a retainer portion, which comprises:

a) an elongated endoscopic portion defining a longitudinal axis;

b) a plurality of fastener portions and a plurality of retainer portions supported in respective opposed positions along the longitudinal axis;

c) a fastener applying assembly including a mechanism for simultaneously advancing the fastener portions and the retainer portions distally along the longitudinal axis while maintaining the opposed position thereof to position a distalmost fastener portion and a distalmost retainer portion for application to body tissue prior to application of the surgical fasteners to body tissue, and a mechanism for individually moving only the distalmost of the fastener portions into engagement with the distalmost of the retainer portions in a direction transverse to the direction of their simultaneous advancement in a single surgical fastener firing sequence; and

d) a gaseous seal disposed within the endoscopic portion for inhibiting the egress of gas therethrough.

21. Apparatus as recited in claim 20, further comprising an actuating member associated with a proximal end portion of the endoscopic portion for actuating the fastener applier.

22. Apparatus as recited in claim 21, wherein the plurality of fastener portions are aligned relative to the plurality of retainer portions such that a distalmost fastener portion is opposite a distalmost retainer portion.

23. Apparatus as recited in claim 22 further comprising a fastener supporting portion and a retainer supporting portion pivotably mounted with respect to each other to be approximated into close cooperative alignment.

24. Apparatus as recited in claim 23 wherein the fastener supporting portion and the retainer supporting portion are pivotable into close cooperative alignment from a location spaced proximally from the location of application of the fastener to body tissue.