Instrument for applying a surgical fastener particularly for the transoral treatment of gastroesophageal reflux disease (GERD)
First Claim
1. A surgical instrument, comprising:
- a) a tubular control shaft having proximal and distal ends and defining a longitudinal axis;
b) a first control element extending through said control shaft and having proximal and distal ends;
c) a proximal handle including a stationary portion and a first movable portion movable relative to said stationary portion, one of said stationary portion and said first movable portion coupled to said proximal end of said control shaft and the other of said stationary portion and said first movable portion coupled to said proximal end of said first control element, wherein actuation of said handle moves said first movable portion relative to said stationary portion and thereby causes said control shaft and said first control element to be longitudinally moved relative to each other; and
d) a distal end effector coupled to said distal end of said control shaft and said first control element, said end effector including a clevis and first and second jaws mutually rotatable on said clevis between open and closed positions, said first and second jaws having terminal ends and said first and second jaws substantially oriented so that said terminal ends configured to are proximally directed away from said distal end of said control shaft while said first and second jaws are introduced into a said first and second jaws being laterally displaced relative to said longitudinal axis of said control shaft,wherein actuation of said handle effects rotation of said first and second jaws between said open and closed positions.
2 Assignments
0 Petitions
Accused Products
Abstract
A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.
448 Citations
43 Claims
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1. A surgical instrument, comprising:
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a) a tubular control shaft having proximal and distal ends and defining a longitudinal axis; b) a first control element extending through said control shaft and having proximal and distal ends; c) a proximal handle including a stationary portion and a first movable portion movable relative to said stationary portion, one of said stationary portion and said first movable portion coupled to said proximal end of said control shaft and the other of said stationary portion and said first movable portion coupled to said proximal end of said first control element, wherein actuation of said handle moves said first movable portion relative to said stationary portion and thereby causes said control shaft and said first control element to be longitudinally moved relative to each other; and d) a distal end effector coupled to said distal end of said control shaft and said first control element, said end effector including a clevis and first and second jaws mutually rotatable on said clevis between open and closed positions, said first and second jaws having terminal ends and said first and second jaws substantially oriented so that said terminal ends configured to are proximally directed away from said distal end of said control shaft while said first and second jaws are introduced into a said first and second jaws being laterally displaced relative to said longitudinal axis of said control shaft, wherein actuation of said handle effects rotation of said first and second jaws between said open and closed positions. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A surgical instrument for use in applying a fastener to tissue, the fastener including first and second parts lockable relative to each other, the first part having a structure adapted to enter an opening in the second part, said surgical instrument comprising:
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a) a tubular control shaft having proximal and distal ends; b) a first control element extending through said control shaft and having proximal and distal ends; c) a second control element extending through said control shaft and having proximal and distal ends; d) a proximal handle including a stationary portion and first and second movable portions movable relatative to said stationary portion, one of said stationary portion and said first movable portion being coupled to said proximal end of said control shaft, the other of said stationary portion and said first movable portion being coupled to said proximal end of said first control element, and said second movable portion being coupled to said proximal end of said second control element; and e) a distal end effector assembly coupled to said distal ends of said control shaft and said first and second control elements, said end effector assembly including a clevis and first and second jaws mutually rotatable on said clevis between open and closed positions, said first jaw adapted to be coupled to the first part of the fastener, and said second jaw adapted to be coupled to the second part of the fastener, wherein first actuation of said handle which moves said first movable portion relative to said stationary portion effects rotation of said first and second jaws between said open and closed positions, and wherein when said first and second jaws are in said closed position, second actuation of said handle which moves said second movable portion relative to said stationary portion is adapted to lock the first and second parts of the fastener together. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A surgical instrument for use in applying a fastener to tissue, the fastener including first and second parts lockable relative to each other, said surgical instrument comprising:
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a) an end effector including a shaft having a distal end first and second jaws, coupled to said distal end of said at least one of said jaws being movable relative to the other, said first jaw adapted to be coupled to the first part of the fastener and said second jaw adapted to be coupled to the second part of the fastener, said first and second jaws being continuously and movably directed towards a proximal end of said b) first means for moving said first and second jaws relative to each other; and c) second means for reconfiguring the first and second parts of the fastener relative to each other, wherein said first and second means are distinct from each other.
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28. A surgical instrument, comprising:
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a) an end effector including first and second jaws, configured to be proximally directed while said first and second jaws are introduced into a body at least one of said jaws being movable relative to the other, said end effector defining a greatest cross-sectional area; b) a proximal handle; and c) an elongate flexible tubular member extending between said end effector and said handle and defining a greatest outer area of said instrument between said end effector and said handle, said greatest outer area defining a second cross-sectional area, wherein said second cross-sectional area is at least ten percent smaller than said greatest cross-sectional area of said end effector. - View Dependent Claims (29, 30, 31, 32)
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33. A surgical instrument, comprising:
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a) a tubular member having proximal and distal ends; b) a control element having proximal and distal ends and extending through and longitudinally movable relative to said tubular member; c) an end effector coupled to said distal ends of said tubular member and said control element, said end effector including first and second jaws provided with tangs, at least one of said jaws being movable relative to the other between open and closed positions, wherein said jaws are urged into a closed position when said tangs are subject to a force in a first direction; and d) means for applying a force in said first direction to said tangs when said control element is moved relative to said tubular member in a second direction opposite said first direction. - View Dependent Claims (34, 35)
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36. A surgical instrument, comprising:
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a) a flexible tubular control shaft having a proximal end, a distal end, and defining a longitudinal axis; b) a distal end effector coupled to said distal end of said control shaft and including first and second jaws that are configured to be proximally directed and laterally displaced relative to said longitudinal axis while said first and second jaws are introduced into a said jaws having ends; c) a shaft mount rotatably coupled to said distal end effector and fixed to said distal end of said control shaft; d) a control element extending through said control shaft and having proximal and distal ends, said distal end coupled to said distal end effector; and e) a handle means for moving said proximal end of said control element relative to said proximal end of said shaft, wherein when said control element is moved relative to said control shaft to provide an amount of tension on said control element, said distal end effector rotates relative to said mount toward said longitudinal axis. - View Dependent Claims (37, 38)
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39. A surgical instrument, comprising:
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a) a flexible tubular control shaft having a proximal end, a distal end, and a length of at least 30 cm; b) a distal end effector coupled to said distal end of said control shaft including first and second jaws continuously and directed towards said proximal end of said shaft, said end effector being substantially larger in diameter than said control shaft; c) a control element extending through said control shaft and having proximal and distal ends, said distal end coupled to said distal end effector; and d) a handle means for moving said proximal end of said control element relative to said proximal end of said shaft, said proximal end of said control element being rotationally fixed relative to said handle means, wherein rotation of said handle means provides sufficient torque along a length of said instrument to rotate said distal end effector in a substantially 1;
1 ratio relative to said rotation of said handle means. - View Dependent Claims (40, 41)
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42. A surgical instrument, comprising:
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an end effector including first and second jaws configured to be proximally directed while said first and second jaws are introduced into a, at least one of said jaws being movable relative to the other, said end effector defining a greatest cross-sectional area; a proximal handle; and an elongate, flexible, tubular member extending between said end effector and said handle and defining an outer area of said instrument between said end effector and said handle, said outer area being at least ten percent smaller than said greatest cross-sectional area of said end effector.
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43. A surgical instrument, comprising:
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a flexible, tubular control shaft having a proximal end, a distal end, and a length of at least 25 cm; a distal end effector coupled to said distal end of said control shaft including first and second jaws directed towards said proximal end of said shaft, said end effector being larger in diameter than said control shaft; a control element extending through said control shaft and having proximal and distal ends, said distal end coupled to said distal end effector; an actuator for moving said proximal end of said control element relative to said proximal end of said shaft, said proximal end of said control element being rotationally fixed relative to said actuator; and upon rotation of said actuator, said actuator providing sufficient torque along a length of the instrument to rotate said distal end effector in a substantially 1;
1 ratio relative to said rotation of said actuator.
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Specification