Apparatus and methods for delivering fasteners during valve replacement

• US 8,147,504 B2
• Filed: 05/05/2008
• Issued: 04/03/2012
• Est. Priority Date: 05/05/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ino, Takashi Harry, Drews, Michael J., Gurskis, Donnell W., Knab, Dwight J. Jr.
• Primary Examiner(s): Woo, Julian
• Assistant Examiner(s): Templeton, Christopher L
• Application Number:
  US12/115,543
• Publication Number:
  US 20090036903A1
• Time in Patent Office: 1,429 Days
• Field of Search: 606/139, 606/142, 606/143, 606/219, 606/75, 606/153, 2271751-1821, 227/82, 227/85
• US Class Current: 606/143
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/1222 Packages or dispensers therefor clip magazines incorporated in a clip-applying instrument A61B17/128; for surgical articles A61B50/30
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/0053 Loading magazines or sutures into applying tools
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442

Abstract

A fastener delivery tool includes a belt including pairs of features for releasably engaging tines of respective fasteners in a relaxed state defining a loop. The tool includes a loading chamber for receiving a fastener from the belt, a retaining member for limiting movement of the fastener within the loading chamber, an ejection track communicating with the loading chamber, a handle including an actuator, and a tongue and pusher member coupled to the actuator. Activation of the actuator advances the tongue to transform the fastener from the relaxed state to a U-shaped constrained state, and advances the pusher member to direct the fastener from the loading chamber down the ejection track.

Claims

1. A fastener delivery tool, comprising:

a belt comprising a pair of features configured to releasably engage tines of a fastener in a relaxed state;

a retaining member configured to receive the fastener and to retain the fastener in a first position with respect to the fastener delivery tool;

a tongue configured to transform the fastener into a constrained state by spreading the tines apart by advancing distally along inner surfaces of the tines while the fastener is retained in the first position;

a pusher member configured to advance distally in unison with the tongue to push the fastener from the first position to a second position;

wherein the retaining member is configured to release the fastener in response to interaction of a cam with the pusher member.

2. The fastener delivery tool of claim 1, wherein the pusher member is configured to advance distally with respect to the tongue to eject the fastener from a distal tip of an ejection track.

3. The fastener delivery tool of claim 1, further comprising a fastener comprising tines,

wherein, in the relaxed state, the tines of the fastener overlap one another to define a loop, and, in the constrained state, the fastener defines a U-shape.

4. The fastener delivery tool of claim 1, further comprising an ejection track comprising side walls configured to constrain the fastener in the constrained state as the fastener is advanced down the ejection track to the second position.

5. The fastener delivery tool of claim 4, wherein, in the second position, the tines are exposed distally beyond the ejection track without being ejected completely from the ejection track.

6. The fastener delivery tool of claim 1, wherein the retaining member is configured to retain the fastener by protruding through a loop of the fastener.

7. The fastener delivery tool of claim 6, wherein the retaining member is coupled to at least one of the tongue and the pusher member such that the retaining member is configured to release the fastener in response to advancement of the pusher member.

8. The fastener delivery tool of claim 1, further comprising a staging section including a plurality of fasteners disposed therein.

9. The fastener delivery tool of claim 8, wherein the plurality of fasteners are carried by a cartridge receivable in the staging section.

10. The fastener delivery tool of claim 1, wherein the cam is located on the retaining member.

11. The fastener delivery tool of claim 1, further comprising a spreader configured to transform the fastener into a partially constrained state by spreading the tines.

12. The fastener delivery tool of claim 1, wherein the tongue is configured to transform the fastener into the constrained state by advancing distally along inner surfaces of the tines from a proximal end of the fastener to a distal end of the fastener.

13. The fastener delivery tool of claim 1, wherein the pusher member and the tongue are configured to advance in response to movement of an actuator.

14. A fastener delivery tool, comprising:

a housing comprising an actuator;

a cartridge assembly extending from the housing and carrying a plurality of fasteners, the cartridge assembly comprising a belt comprising pairs of features releasably engaging tines of respective fasteners in a relaxed state, each of the fasteners defining a loop in the relaxed state;

a loading chamber for successively receiving a fastener from the belt in the relaxed state;

a retaining member configured to retain the fastener within the loading chamber;

an ejection track communicating with the loading chamber;

a tongue coupled to the actuator and configured to transform the fastener into a U-shaped constrained state by spreading the tines apart by advancing distally along inner surfaces of the tines in response to activation of the actuator; and

a pusher member coupled to the actuator and configured to advance distally in unison with the tongue to advance the fastener from the loading chamber down the ejection track in response to activation of the actuator,

wherein the belt is configured to deliver another fastener within the loading chamber in response to activation of the actuator.

15. The fastener delivery tool of claim 14, wherein the cartridge assembly is removable from the housing such that a new cartridge assembly carrying a plurality of fasteners is connectable to the housing.

16. The fastener delivery tool of claim 14, wherein the cartridge assembly is connectable to the housing, and wherein the belt, retaining member, tongue, and pusher member are configured to be coupled to the actuator after the cartridge assembly is connected to the housing.

17. The fastener delivery tool of claim 14, wherein the actuator comprises a first actuator configured to advance the tongue and the pusher member, and a second actuator configured to eject the fastener from the ejection track.

18. The fastener delivery tool of claim 14, wherein the actuator comprises an air cylinder.

19. The fastener delivery tool of claim 14, wherein the cartridge assembly is connectable to the housing, and wherein the housing comprises a lockout feature that prevents actuation of the actuator when the cartridge assembly is not connected to the housing.

20. The fastener delivery tool of claim 19, wherein the lockout feature comprises a lever arm that is locked to prevent the actuator from being actuated before the cartridge assembly is connected to the housing, the lever arm being coupled to a latch when the cartridge assembly is connected to the housing such that activation of the actuator activates the latch to deliver a fastener from the ejection track.

21. The fastener delivery tool of claim 14, wherein the cartridge assembly comprises a frame comprising first and second ends, the second end disposed adjacent the loading chamber, and wherein the belt comprises a pair of endless bands extending between the first and second ends of the frame, each band comprising a plurality of features disposed adjacent features of the other band.

22. The fastener delivery tool of claim 21, further comprising a cross-bar coupling movement of the pair of endless bands together, and a pushrod coupled to the actuator and configured to advance the cross-bar to simultaneously advance the pair of endless bands.

23. The fastener delivery tool of claim 14, wherein the features comprise one of hooks and clips defining recesses configured to releasably receive the tines therein.

24. A fastener delivery tool, comprising:

a housing comprising an actuator;

an elongate shaft extending from the housing and terminating in a distal tip, the shaft comprising a belt assembly therein comprising pairs of features releasably engaging tines of respective fasteners in a relaxed state, each of the fasteners defining a loop in the relaxed state;

a loading chamber in the distal tip for successively receiving a fastener from the belt in the relaxed state;

a retaining member configured to retain the fastener within the loading chamber;

an ejection track communicating with the loading chamber;

a tongue coupled to the actuator and configured to transform the fastener into a U-shaped constrained state by spreading the tines apart by advancing distally along inner surfaces of the tines in response to activation of the actuator; and

a pusher member coupled to the actuator and configured to advance distally in unison with the tongue to advance the fastener from the loading chamber down the ejection track in response to activation of the actuator,

wherein the belt is configured to deliver another fastener within the loading chamber in response to activation of the actuator.

25. The fastener delivery tool of claim 24, wherein the belt assembly comprises a pair of endless bands, each band comprising a plurality of features disposed adjacent features of the other band.

26. The fastener delivery tool of claim 25, further comprising a cross-bar coupling movement of the pair of endless bands together, and a pushrod coupled to the actuator and configured to advance the cross-bar to simultaneously advance the pair of endless bands.

27. The fastener delivery tool of claim 24, wherein the features comprise one of hooks and clips defining recesses configured to releasably receive the tines therein.

28. The fastener delivery tool of claim 24, wherein the features comprise nonmetallic material.

29. The fastener delivery tool of claim 24, further comprising a removable cover on the elongate shaft overlying the belt assembly.

30. The fastener delivery tool of claim 29, wherein the belt assembly is removably secured within the elongate shaft.