Arcuate apparatus for applying two-part surgical fasteners

• US 5,653,373 A
• Filed: 11/18/1994
• Issued: 08/05/1997
• 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): Buiz, Michael
• Assistant Examiner(s): Leonardo, Mark
• Application Number:
  US08/342,323
• Time in Patent Office: 991 Days
• Field of Search: 227/175.1-182.1, 227/19, 606/139
• US Class Current: 227/175.1
• 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 2017/07221 curved
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• 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 an arcuately shaped member for holding a plurality of the fastener portions in generally aligned relation, a correspondingly arcuately shaped member spaced from the fastener portion holding member 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. A fastener driver is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied.

Claims

1. Apparatus for applying at least one row of surgical fasteners, including a frame portion having a handle and an arcuate tissue holding portion extending from the handle, which comprises:

a) first arcuate means disposed on the tissue holding portion for holding said fasteners in at least one row;

b) second arcuate means disposed on the tissue holding portion configured and dimensioned to cooperate with said first arcuate fastener holding means to position tissue between the first and second arcuate means; and

c) fastener driving means slidably disposed on said handle and slidably extending into said first arcuate means for driving said fasteners sequentially along said row into tissue from said first arcuate means toward said second arcuate means.

2. The apparatus of claim 1 wherein said fastener holding means is a fastener cartridge.

3. The apparatus of claim 2 wherein said fasteners are two-part fasteners, including a first fastener portion positioned in said fastener cartridge and a second retainer portion supported by said second arcuate means.

4. The apparatus of claim 2, wherein said second arcuate means includes an anvil surface positioned thereon and adapted to crimp said fasteners.

5. The apparatus of claim 3 wherein said fastener portions and said retainer portions are arranged in alignment with a central arcuate axis.

6. The apparatus of claim 3 wherein said retainer portions are supported by a corresponding plurality of retainer mounting elements positioned in said second arcuate means.

7. The apparatus of claim 6 wherein said second arcuate means includes a retainer cartridge for supporting said retainer portions.

8. The apparatus of claim 7 further comprising means to cut tissue adjacent the location of application of said fasteners.

9. The apparatus of claim 8 wherein said retainer mounting elements are slidably mounted within at least one channel in said retainer cartridge.

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

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

12. The apparatus of claim 11 wherein said driving means sequentially drives said fastener portions of said two-part fasteners into engagement with their respective opposed retainer portions.

13. The apparatus of claim 3 wherein said two-part fasteners are bio-absorbable.

14. Apparatus for applying at least one row of two-part surgical fasteners to body tissue, including a frame portion having a handle and an arcuate tissue holding portion extending from the handle, each surgical fastener having a pronged fastener portion and a retainer dimensioned and configured to receive the pronged fastener portion into engaged relation therewith, which comprises:

a) an arcuately configured fastener holding member disposed on the tissue holding portion and adapted for releasably holding a plurality of said fastener portions;

b) retainer holding means disposed on the tissue holding portion in opposed relation to and spaced from said fastener holding member for releasably holding a plurality of said retainers in positions opposite said respective fastener portions, said retainer holding means being arcuately configured corresponding to said fastener holding member, the fastener holding member and the retainer holding means being adapted to hold tissue therebetween; and

c) means disposed on said handle for sequentially advancing each of said fastener portions toward said retainers so as to cause said fastener portions to engage said retainers while fastening body tissue therebetween.

15. The apparatus of claim 14 wherein said arcuately configured member for holding fastener portions comprises a fastener cartridge attached to an arcuate channel member.

16. The apparatus of claim 15 wherein said fastener cartridge is permanently attached to said channel member.

17. The apparatus of claim 15 wherein said fastener cartridge is removably attached to said channel member.

18. The apparatus of claim 17 wherein said arcuately configured means for holding retainers includes a retainer cartridge attached to an arcuately configured channel member.

19. The apparatus of claim 18 wherein said retainer cartridge is permanently attached to said channel member.

20. The apparatus of claim 18 wherein said retainer cartridge is removably attached to said channel member.

21. 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 a 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 handle portions and separable arcuately configured sections extending from the handle portions, the handle portions and arcuately configured sections being capable of releasable attachment to each other, the arcuately configured sections each defining an elongated finger portion;

b) a fastener carrying cartridge having an arcuate configuration similar to one of said elongated finger portions and mounted along one of said finger portions and carrying a plurality of said fastener portions;

c) a retainer carrying cartridge having an arcuate configuration similar to the other of said elongated finger portions and 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 pronged portions of said fastener portions when said fastener portions are advanced toward said retainer members;

d) means mounted on said handle portions of 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 to cut body tissue adjacent the location of application of said fasteners.

22. The apparatus of claim 21 wherein said two-part frame comprises a pair of channel members having means to releasably attach said members in face to face relation.

23. The apparatus of claim 22 wherein said fastener cartridge comprises two pairs of rows of staggered apertures dimensioned and configured for frictionally holding a plurality of said fastener portions, and fastener pusher members associated with said apertures to push said fastener portions from said cartridge in response to movement of said fastener advancing means.

24. The apparatus of claim 23 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.

25. The apparatus of claim 24 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.

26. The apparatus of claim 25 wherein each said fastener pushers has dual oppositely sloped surfaces.

27. The apparatus of claim 26 wherein a handle is positioned at the proximal end of said frame.

28. The apparatus of claim 27 wherein said fastener holding and retainer holding cartridges curve to the left from said handle to the distal end of said frame.

29. Apparatus for applying at least one row of two-part surgical fasteners, including a frame portion having a handle and an arcuate tissue holding portion extending from the handle, each surgical fastener having a pronged fastener portion and a retainer, which comprises:

a) arcuate means disposed on the tissue holding portion for holding said fastener portions of said two-part surgical fasteners;

b) arcuately configured retainer cartridge disposed on the tissue holding portion having means for holding a plurality of retainers in positions opposite said fastener portions, the fastener holding means and the retainer cartridge being adapted to hold tissue therebetween;

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

d) driving means for sequentially driving said fastener portions of said two-part fasteners through tissue and into engagement with their respective opposed retainers.

30. Apparatus for applying at least one row of surgical fasteners including a frame portion having a handle and an arcuate tissue holding portion extending from the handle, which comprises:

a) first arcuate member disposed on the tissue holding portion for holding at least one row of fasteners;

b) second arcuate member disposed on the tissue holding portion configured and dimensioned to cooperate with the first arcuate fastener member to hold tissue therebetween;

c) a fastener driver slidable along an arcuate path through said tissue holding portion for sequentially driving the fasteners along the row into tissue from the first arcuate member toward the second arcuate member; and

d) a slidable control member disposed on said handle for advancing said fastener driver.

31. The apparatus of claim 30 wherein the first arcuate fastener holding member comprises a fastener cartridge.

32. The apparatus of claim 31 wherein the fasteners are two-part fasteners, a fastener portion positioned in the fastener cartridge and a retainer portion supported by the second arcuate member and adapted to become engagably attached to the fastener portions.

33. The apparatus of claim 31 wherein the second arcuate member includes an anvil surface positioned thereon and adapted to crimp the fasteners.

34. The apparatus of claim 32 wherein the fastener portions and the retainer portions are arranged in alignment with a central arcuate axis.

35. The apparatus of claim 32 wherein the retainer portions are supported by a corresponding plurality of retainer mounting elements positioned in the second arcuate member.

36. The apparatus of claim 35 wherein the second arcuate member comprises a retainer cartridge for supporting the retainer portions.

37. The apparatus of claim 36 further comprising a knife blade to cut tissue adjacent the location of application of the fasteners.

38. The apparatus of claim 37 wherein the retainer mounting elements are slidably mounted within at least one channel in the retainer cartridge and the retainer mounting elements release their respective retainer portions in response to the engagement of the fastener portions with their respective retainer portions.

39. The apparatus of claim 32 wherein the two-part fasteners are bio-absorbable.

40. The apparatus of claim 30 wherein the fastener driver includes at least one cam bar slidable longitudinally to sequentially drive the fasteners.

41. The apparatus of claim 32 wherein the fastener driver includes pair of cam bars positioned for slidable movement distally and proximally within the first arcuate member for sequential engagement with fastener pushers, the cam bars being dimensioned and configured to sequentially advance the fastener pushers toward the fastener portions to effect engagement of the fastener portions with the retainer members.

42. The apparatus of claim 41 wherein each said fastener pusher has dual oppositely sloped surfaces.

43. The apparatus of claim 42 wherein a handle is positioned at the proximal end.

44. Apparatus for applying at least one row of two-part surgical fasteners, including a frame having a handle portion and an arcuate tissue holding portion extending from the handle, each surgical fastener having a pronged fastener portion and a retainer, which comprises:

a) first arcuate means disposed on the tissue holding portion for holding the fastener portions of the two-part surgical fasteners;

b) second arcuately configured member positioned on the tissue holding portion opposite the first arcuate means, the first means and the second member adapted to hold tissue therebetween; and

c) driving means disposed on said handle portion and slidable along an arcuate path into said tissue holding portion for sequentially driving the fastener portions of the two-part fasteners from the first means into engagement with their respective opposed retainers on the second means through tissue position in said tissue holding portion.

45. The apparatus of claim 44 wherein the second arcuately configured member is configured for holding a plurality of retainers.

46. The apparatus of claim 44 wherein the driving means includes at least one elongated cam bar.

47. Apparatus for applying at least one row of surgical fasteners, including a frame portion having a handle and an arcuate tissue holding portion extending from the handle, which comprises:

a) a first arcuate fastener cartridge disposed on the tissue holding portion for holding said fasteners in at least one row;

b) second arcuate means disposed on the tissue holding portion configured and dimensioned to cooperate with said first arcuate fastener cartridge to position tissue between the first arcuate cartridge and the second arcuate means; and

c) driving means disposed on the handle and being slidable from the handle into the tissue holding portion for driving said fasteners into tissue from said first arcuate cartridge toward said second arcuate means;

wherein said fasteners are two-part fasteners, including a first fastener portion positioned in said fastener cartridge and a second retainer portion supported by said second arcuate means.