Apparatus and method for the multi-axial placement of surgical fasteners

• US 7,322,943 B2
• Filed: 12/20/2002
• Issued: 01/29/2008
• Est. Priority Date: 12/21/2001
• Status: Expired due to Fees

• Current Assignee: EMI (Entegris Incorporated)
• Original Assignee: EMI (Entegris Incorporated)
• Inventors: Trout, Hugh H. III, Tanner, Howard M.
• Primary Examiner(s): TRUONG, KEVIN THAO
• Application Number:
  US10/323,661
• Publication Number:
  US 20030167066A1
• Time in Patent Office: 1,866 Days
• Field of Search: 600/104, 600/107, 600/139, 600/585, 606/46, 606/47, 606/49, 604/20, 604/501
• US Class Current: 600/585
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• 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
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation

Abstract

Several embodiments of a penetration apparatus and methods for using the same during a surgical procedure are disclosed. The penetration apparatus comprises a thin elongated body having a first end, a second end, and a central longitudinal axis extending there between. The first end opposes the second and is aligned within a vessel matrix during the surgical procedure. The second end of the body is substantially free and may be rotated around the axis. The penetration apparatus may also be housed within a catheter that has a cavity that precisely accommodates the penetration apparatus. Activation and advancement of the penetration apparatus within the catheter forms an incision through a vessel matrix enabling the placement of a fastener or a plurality of fasteners therein.

Claims

1. A penetration apparatus for use during a surgical procedure, comprising:

a thin elongated body having a first end, a second end, and a central longitudinal axis;

the first end opposes the second end on the body, and is aligned with a vessel matrix during the surgical procedure;

the second end is substantially free;

the longitudinal axis spans the body from the first to the second end wherein the body rotates around the axis for placement of an incision within the vessel matrix;

a first optical fiber and a second optical fiber, the first optical fiber is located above the central longitudinal axis and the second optical fiber is located below the central longitudinal axis and an outer cladding disposed between the first and second optical fibers wherein the outer cladding axially joins the first and the second optical fibers.

2. The penetration apparatus of claim 1, wherein the thin elongated body is oblong.

3. The penetration apparatus of claim 1, wherein the elongated body further comprises at least one optical fiber.

4. The penetration apparatus of claim 1, wherein the first end is flattened.

5. The penetration apparatus of claim 4, wherein the second end is flattened.

6. The penetration apparatus of claim 5, wherein the elongated body is attached to a laser light source.

7. The penetration apparatus of claim 6, wherein the laser light source comprises a Holmium Yag.

8. The penetration apparatus of claim 1, wherein the elongated body further comprises a piezoelectric device.

9. The penetration apparatus of claim 1, further comprising at least one fastener coupled with the elongated body.

10. The penetration apparatus of claim 9, wherein the fastener corresponds with the elongated body.

11. The penetration apparatus of claim 1, further comprising a fastener assembly having at least one fastener.

12. A catheter derivative for use during a surgical procedure, comprising:

a catheter with at least one cavity;

a penetration apparatus comprising a thin elongated body having a first end, a second end and a central longitudinal axis;

the first end opposes the second end and is aligned with a vessel matrix during the surgical procedure;

the second end is substantially free; and

the longitudinal axis spans the body from the first end to the second end wherein the body may rotate around the axis for placement;

wherein the penetration apparatus is slideably housed within the cavity of the catheter;

a first optical fiber and a second optical fiber, the first optical fiber is located above the central longitudinal axis and the second optical fiber is located below the central longitudinal axis and an outer cladding disposed between the first and second optical fibers wherein the outer cladding axially joins the first and the second optical fibers.

13. The catheter derivative of claim 12, wherein the catheter further comprises an articulation device for angular placement.

14. The catheter derivative of claim 12, wherein the catheter further comprises an apposition device for placement within the vessel matrix.

15. The catheter derivative of claim 12, wherein the catheter further comprises an articulation device for placement within the vessel and an apposition device for angular placement.

16. The catheter derivative of claim 12, wherein the cavity corresponds with the penetration apparatus.

17. The catheter derivative of claim 12, wherein the elongated body is oblong.

18. The catheter derivative of claim 12, wherein the elongated body further comprises at least one optical fiber.

19. The catheter derivative of claim 12, wherein the first end is flattened.

20. The catheter derivative of claim 19, wherein the second end is flattened.

21. The catheter derivative of claim 12, wherein the elongated body is attached to a laser light source.

22. The catheter derivative of claim 21, wherein the laser light source comprises a Holmium Yag.

23. The catheter derivative of claim 12, wherein the elongated body further comprises a piezoelectric device.

24. The catheter derivative of claim 12, further comprising at least one fastener coupled with the elongated body.

25. The catheter derivative of claim 24, wherein the fastener corresponds with the elongated body.

26. The catheter derivative of claim 12, further comprising a fastener assembly having at least one fastener.

27. The catheter derivative of claim 26, further comprising a divider interposed between the penetration apparatus and the fastener assembly.

28. The catheter derivative of claim 12, further comprising a thin-walled sheath slideably positioned therein, wherein the penetration apparatus is enclosed by the thin walled sheath and the catheter.

29. The catheter derivative of claim 28, further comprising a fastener assembly having at least one fastener.

30. The catheter derivative of claim 29, further comprising a divider interposed between the penetration apparatus and fastener assembly.

31. A method of using a penetration apparatus during a surgical procedure which comprises the steps of:

providing a thin elongated body having a first end, second end, and a central longitudinal axis;

the first end opposes the second on the body and is aligned with a vessel matrix during the surgical procedure;

the second end is substantially free;

the longitudinal axis spans the body from the first to the second end wherein the body rotates around the axis for placement of an incision within the vessel matrix;

a first optical fiber and a second optical fiber, the first optical fiber is located above the central longitudinal axis and the second optical fiber is located below the central longitudinal axis and an outer cladding disposed between the first and second optical fibers wherein the outer cladding axially joins the first and the second optical fibers;

positioning the penetration apparatus within the vessel matrix; and

activating and advancing the penetration apparatus to form an incision in the vessel matrix.

32. The method of using the penetration apparatus of claim 31, further comprising the step of coupling a fastener to the penetration apparatus wherein the fastener surrounds a cross section of the penetration apparatus prior to positioning the penetration apparatus;

and

deploying the fastener through the incision in the vessel matrix after activating the penetration apparatus.

33. A method of using a penetration apparatus with a catheter derivative during a surgical procedure which comprises the steps of:

providing a thin elongated body having a first end, second end, and a central longitudinal axis;

the first end opposes the second on the body and is aligned with a vessel matrix during the surgical procedure;

the second end is substantially free;

the longitudinal axis spans the body from the first to the second end wherein the body rotates around the axis for placement of an incision within the vessel matrix;

a first optical fiber and a second optical fiber, the first optical fiber is located above the central longitudinal axis and the second optical fiber is located below the central longitudinal axis and an outer cladding disposed between the first and second optical fibers wherein the outer cladding axially joins the first and the second optical fibers;

inserting the penetration apparatus into the catheter;

positioning the catheter within the vessel matrix;

activating and advancing the penetration apparatus through the catheter in the vessel matrix; and

withdrawing the penetration apparatus.

34. The method of claim 33, further comprising advancing a thin walled sheath of the catheter derivative through the vessel matrix prior to activating and advancing the penetration apparatus.

35. The method of claim 33, wherein the penetration apparatus has at least one fastener, which further comprises the step of deploying the fastener through an incision in the vessel matrix prior to withdrawing the penetration apparatus.

36. The method of claim 33, wherein the catheter derivative has a fastener assembly, which further comprises the step of activating and advancing the fastener assembly through the catheter after withdrawing the penetration apparatus;

and deploying a fastener through an incision in the vessel matrix.

37. A method of placing at least one fastener during a surgical procedure fasteners which comprises the steps of:

providing a thin elongated body having a first end, second end, and a central longitudinal axis;

the first end opposes the second on the body and is aligned with a vessel matrix during the surgical procedure;

the second end is substantially free;

the longitudinal axis spans the body from the first to the second end wherein the body rotates around the axis for placement of an incision within the vessel matrix;

a first optical fiber and a second optical fiber, the first optical fiber is located above the central longitudinal axis and the second optical fiber is located below the central longitudinal axis and an outer cladding disposed between the first and second optical fibers wherein the outer cladding axially joins the first and the second optical fibers;

gaining access to a surgical site with a catheter derivative;

positioning the catheter derivative within the vessel matrix;

inserting a penetration apparatus into the catheter;

activating and advancing the penetration apparatus to form a treatment specific incision in vessel matrix; and

deploying a fastener through the incision of the vessel matrix.

38. The method of claim 37, further comprising the step of inserting a fastener assembly into the catheter after inserting the penetration apparatus;

withdrawing the penetration apparatus prior to deploying the fastener; and

activating and advancing the fastener assembly within the vessel matrix.