APPLIER FOR FASTENER FOR SINGLE LUMEN ACCESS ANASTOMOSIS

• US 20080221596A1
• Filed: 08/30/2007
• Published: 09/11/2008
• Est. Priority Date: 10/06/2006
• Status: Active Grant

• Current Assignee: Ohio Ethicon Endo-Surgery
• Original Assignee: Ohio Ethicon Endo-Surgery
• Inventors: Ortiz, Mark S., Thompson, Brian James
• Granted Patent: US 7,871,418 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

An applier (1) for an anastomosis ring device (9) having proximal (10), center (11), and distal rings (12) connected by proximal (13) and distal hinged arms (14) which have a generally oblong radially retracted shape when the ring device (9) is un-actuated and a folded radially protruding shape when actuated, wherein the applier (1) comprises an elongate implement portion (2) and a handle (21) connected to the implement portion (2), a distal actuating member (28) comprising catch means (30) which, in a lock position, protrudes radially outward to engage the distal ring (12), a proximal actuating member (32) adapted to engage the proximal ring (10), an actuation mechanism (23, 24) arranged at the handle (21) and configured to cause the proximal and distal actuating members (28, 32) to move towards each other along a longitudinal axis (X) of the implement portion (2) to approximate the proximal and distal rings (10, 12) causing actuation of the hinged arms (13, 14). The distal actuating member (28) is rotatable about the longitudinal axis (X) from the lock position to a release position thereby sliding along a deviating surface (38) at the implement portion (2), which is configured to urge the catch means (30) radially inward to disengage it from the distal ring (12).

Claims

1. An applier (1) for an anastomosis ring device (9) of the type having proximal (10), center (11), and distal rings (12) connected respectively by proximal (13) and distal hinged arms (14), the hinged arms (13, 14) having a generally oblong radially retracted shape when the ring device (9) is un-actuated and a folded radially protruding shape when the ring device (9) is actuated, the applier (1) comprising:

an elongate implement portion (2) and a handle (21) connected to the implement portion (2);

a distal actuating member (28) comprising catch means (30) which, in a lock position, protrudes radially outward to engage the distal ring (12);

a proximal actuating member (32) adapted to engage the proximal ring (10);

an actuation mechanism (23, 24) arranged at the handle (21) and configured to cause the proximal and distal actuating members (28, 32) to move towards each other along a longitudinal axis (X) of the implement portion (2) to approximate the proximal and distal rings (10, 12) causing actuation of the hinged arms (13, 14), characterized in that the distal actuating member (28) is rotatable about said longitudinal axis (X) from said lock position to a release position thereby sliding along a deviating surface (38) at the implement portion (2), which is configured to urge said catch means (30) radially inward to disengage it from the distal ring (12).

2. An applier (1) according to claim 1, wherein the actuation mechanism is adapted to move the proximal actuating member (32) distally and to move the distal actuating member (28) proximally causing actuation of the hinged arms (13, 14) of the ring device (9), while leaving the central ring (11) substantially stationary on the implement portion (2).

3. An applier (1) according to claim 1, wherein the actuating mechanism is adapted to axially translate the proximal actuating member (32) independently from the axial translation of the distal actuating member (28) and vice versa.

4. An applier (1) according to claim 1, wherein the proximal actuating member (32) comprises a distally facing stationary arresting surface (39) formed at the implement portion (2) and adapted to engage the proximal ring (10) and the actuating mechanism (23) is adapted to proximally translate the distal actuating member (28) towards said arresting surface (39).

5. An applier (1) according to any one of the preceding claims, wherein the implement portion (2) comprises a substantially cylindrical housing (25) with axially extending distal window slots (26) and the distal actuating member (28) comprises a shaft (29) slidably received inside the housing (25) and a plurality of distal catches (30) protrude outward from the shaft (29) and extend through the distal window slots (26) such that they engage the distal ring (12) of the anastomotic ring device (9), when in said lock position, said distal catches (30) being configured to be deviated radially inward by lateral edges (38) of the distal window slots (26) in response to rotation of the distal actuating member (28) from said lock position to said release position.

6. An applier (1) according to the preceding claim, wherein the cylindrical housing (25) further comprises a plurality of axially extending proximal window slots (27) and the proximal actuating member (32) comprises a shaft (33) slidably received inside the housing (25) and a plurality of proximal catches (35) protrude outward from the shaft (33) and extend through the proximal window slots (27) such that they engage the proximal ring (10) of the anastomotic ring device (9), when in said lock position, said proximal catches (35) being configured to be deviated radially inward by lateral edges (38) of the proximal window slots (27) in response to rotation of the proximal actuating member (32) from said lock position to said release position.

7. An applier (1) according to claims 5 or 6, wherein said catches (30, 35) are substantially fin shaped and, in the lock position, said fins are inclined in a direction opposite the direction of rotation of the actuating member (28, 32) from the lock position to the release position such as to facilitate the inward deviation of the fins by the lateral edges (38) of the window slots (26, 27).

8. An applier (1) according to claims 5 or 6, wherein the proximal and distal actuating members (32, 29) are arranged axially slidably to one another but coupled in rotation about the longitudinal axis (X) such that the distal and proximal catches (30, 35) can be simultaneously brought in the release position by a single common rotational movement of both actuating members (32, 29) with respect to the housing (25).

9. An applier (1) according to any of the preceding claims, comprising a central actuating member (52) arranged between the proximal (32) and distal actuating member (28) and having catch means (53) adapted to engage the central ring (11) of the ring device to control its position during the actuating movement of the distal and/or proximal actuating members, said central actuating member (52) being rotatable about the longitudinal axis (X) from a lock position to a release position thereby sliding along a deviating surface at the implement portion (2), which is configured to urge the catch means (53) radially inward to disengage it from the central ring (11).

10. An applier (1) according to the preceding claim, wherein the central actuating member (52) itself can also be axially moved proximally towards the proximal actuating member and/or distally towards the distal actuating member by means of a central ring slide control.

11. An applier (1) according to claim 9 or 10, wherein the central (52) and distal (28) actuating members or the central (52), distal (28) and proximal (32) actuating members are arranged in an axially slidable but rotationally coupled relationship, such that the distal central and proximal catches can be simultaneously brought in their release position by a single common rotational movement of all actuating members (28, 32, 52) with respect to the housing (25).

12. An applier (1) according to any one of the preceding claims, comprising a latching mechanism (43, 44, 45) adapted to carry a detachable snapper part (42) separate from the ring device (9) and suitable to snap connect the proximal ring (10) with the distal ring (12) in order to latch the ring device (9) in its actuated configuration.

13. An applier (1) according to the preceding claim, wherein the latching mechanism comprises one or more longitudinally translatable push portions (43) arranged proximally with respect to the proximal catches (35) or the proximal arresting surface (39) and adapted to engage a proximal end surface of the snapper part (42) and to push the snapper part (42) distally in snap engagement with the anastomotic ring device (9).

14. An applier (1) according to the preceding claim, in which the applier is equipped with said snapper part (42) and the snapper part (42) comprises an annular proximal shoulder (46) suitable to engage the proximal end surface of the proximal ring (10) and a longitudinal portion (47) which protrudes distally from the proximal shoulder (46) and forms elastically supported snapper teeth (48) extending radially outwardly from the longitudinal portion (47) to enable snap engagement of the distal ring (12), wherein said longitudinal portion (47) of the snapper part (42) define slots (49) in alignment with the proximal catches (35) or arresting surfaces (39) and with the distal catches (30) such that the snapper part (42) can be pushed in engagement with the ring device (9) without interfering with the actuating members (28, 32).

15. An applier (1) according to claim 14, in which the snapper part (42) is adapted to latch the ring device (9) at different adjustable distances between the proximal ring (10) and the distal ring (12).

16. An applier (1) according to the preceding claim, in which the snapper part (42) comprises a plurality of snapper teeth (48, 48′

) arranged in a row which extends in the longitudinal direction of the longitudinal portion (47) such that the distances between the annular proximal shoulder (46) and the different snapper teeth (48, 48′

) of a same row correspond to different adjustable distances between the proximal and distal rings (10, 12) of the ring device (9).

17. An applier (1) according to claim 15 or 16, in which the annular proximal shoulder (46) of the snapper part (42) comprises a distally projecting externally threaded adjusting portion (50) which mates an internal thread provided at a proximal base (51) of the longitudinal portion (47) such that the distance between the shoulder (46) and the snapper teeth (48) is adjustable by screwing the adjusting portion (50) more or less into the longitudinal portion (47).

18. An applier (1) according to claim 17, in which also the threaded adjusting portion (50) is slotted in order to not interfere with the proximal catches (35) or arresting surfaces (39) during latching of the ring device (9).

19. An applier (1) according to claim 13 or 17, in which the push portions (43) are adapted to rotate about the longitudinal axis (X) and to engage the annular shoulder (46) of the snapper part (42) so that said rotational adjusting movement causes the annular shoulder (46) to adjustable screw in the longitudinal portion (47).