Multiple member interconnect for surgical instrument and absorbable screw fastener

• US 20080281336A1
• Filed: 05/10/2007
• Published: 11/13/2008
• Est. Priority Date: 06/13/2003
• Status: Active Grant

• Current Assignee: Earl M. Zergiebel
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Zergiebel, Earl M.
• Granted Patent: US 8,926,637 B2
• Time in Patent Office: Days
• US Class Current: 606/142
• 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 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2090/0814 Preventing re-use

Abstract

An absorbable surgical screw fastener is provided which includes a head and a tapered shaft extending distally of the head. Buttress threads are provided about the tapered shaft to secure the fastener in tissue. The fastener includes slots formed in the head and buttress threads. A gap is provided between the buttress threads in the head to secure a prosthetic. There is also provided a surgical instrument having novel lockout structure to prevent inadvertent actuation.

Claims

1. A surgical instrument for delivering a fastener, comprising:

a housing including an actuation assembly;

an elongate tubular member extending distally from the housing, the elongate tubular member being arranged to receive a plurality of fasteners therein and to carry at least one band having a first position for allowing the passage of at least one fastener and at least a second position for engaging a distal-most fastener; and

wherein actuation of the actuation assembly forces a distal face of the at least one band towards the lead fastener which forces the distal-most fastener to move distally.

2. The surgical instrument of claim 1, wherein the housing includes a fixed handle and a movable handle pivotably attached thereto and wherein moving the movable handle towards the fixed handle actuates the actuation assembly to move the distal-most fastener distally.

3. The surgical instrument of claim 2, further including a rack in mechanical cooperation with the movable handle and at least a portion of the actuation assembly for providing a mechanical connection therebetween.

4. The surgical instrument of claim 1, further including a gear assembly disposed at least partially within the housing and being actuable to rotate the elongate tubular member and the distal-most fastener.

5. The surgical instrument of claim 4, wherein the housing includes a fixed handle and a movable handle pivotably attached thereto and wherein moving the movable handle towards the fixed handle actuates the actuation assembly and the gear assembly to move the distal-most fastener distally and to rotate the distal-most fastener and whereby a complete actuation stroke is defined by moving the movable handle a sufficient distance to eject the distal-most fastener from the elongate tubular member.

6. The surgical instrument of claim 5, wherein the gear assembly includes a planetary gear and a plurality of planets disposed in mechanical engagement therewith, the planetary gear and the plurality of planets enable the distal-most fastener to be rotated a plurality of times in response to a complete actuation stroke.

7. The surgical instrument of claim 6, wherein the planetary gear and the plurality of planets enable the distal-most fastener to be rotated approximately 11 times in response to a complete actuation stroke.

8. The surgical instrument of claim 5, wherein the actuation assembly returns to its pre-actuated position when the movable handle returns to its pre-fired position.

9. The surgical instrument of claim 5, further including a pawl disposed in mechanical cooperation with a portion of the gear assembly and which prevents the movable handle from moving to its pre-fired position until a complete actuation stroke has been performed.

10. The surgical instrument of claim 5, further including a clutch in mechanical engagement with a portion of the gear assembly and which prevents at least a portion of the elongate tubular member from rotating in an opposite direction when the movable handle returns to its pre-fired position.

11. The surgical instrument of claim 1, further including a lockout disposed in mechanical cooperation with the elongate tubular member, the lockout being movable from a first position where it prevents proximal movement of the movable handle to a second position where it allows proximal movement of the movable handle, and whereby applying an appropriate amount of distal pressure to the surgical instrument against a surface causes the lockout to move from its first position to its second position.

12. The surgical instrument of claim 1, further including an introducer disposed at least partially within the elongate tubular member.

13. The surgical instrument of claim 1, further including a visual indicator showing that the elongate tubular member includes no fasteners therein.

14. A surgical instrument for delivering a fastener, comprising:

a housing including an actuation assembly and a gear assembly;

an elongate tubular member extending distally from the housing and including an outer tube and an inner tube, the elongate tubular member being configured to receive at least one fastener therein;

a handle assembly in mechanical cooperation with the housing and including a fixed handle and a movable handle, the movable handle being movable between a pre-fired position and an actuated position;

a lockout disposed in mechanical cooperation with the elongate tubular member, the lockout being movable from a first position where it prevents relative movement between the movable handle and the fixed handle to a second position where it allows relative movement of the movable handle with respect to the fixed handle, and whereby moving the outer tube proximally a distance x causes the lockout to move from its first position to its second position; and

wherein moving the movable handle from its pre-fired position towards its actuated position actuates the actuation assembly which forces a distal-most fastener to move distally and actuates the gear assembly which causes the distal-most fastener to rotate and wherein a complete actuation stroke is defined by moving the movable handle a sufficient distance to eject the distal-most fastener from the elongate tubular member.

15. The surgical instrument of claim 14, further comprising an introducer disposed at least partially within the elongate tubular member.

16. The surgical instrument of claim 14, wherein the elongate tubular member being arranged to carry at least one band having a first position for allowing the passage of at least one fastener and at least a second position for engaging a distal-most fastener and wherein actuation of the actuation assembly forces a distal face of the at least one band towards the lead fastener thus forcing the distal-most fastener to move distally.

17. The surgical instrument of claim 14, wherein the gear assembly includes a planetary gear and a plurality of planets disposed in mechanical engagement therewith, the planetary gear and the plurality of planets enable the distal-most fastener to be rotated a plurality of times in response to a complete actuation stroke.

18. The surgical instrument of claim 14, further including a pawl disposed in mechanical cooperation with a portion of the gear assembly and which prevents the movable handle from moving to its pre-fired position until a complete actuation stroke has been performed.

19. The surgical instrument of claim 14, further including a clutch in mechanical engagement with a portion of the gear assembly and which prevents the elongate tubular member from rotating in an opposite direction when the movable handle returns to its pre-fired position.

20. The surgical instrument of claim 14, wherein the movable handle is biased in its pre-fired position.

21. The surgical instrument of claim 14, wherein the gear assembly includes a first bevel gear disposed on a first axis and a second bevel gear disposed on a second axis, the first axis being transverse to the second axis.

22. A method for delivering a surgical fastener, comprising:

providing a surgical instrument, including;

a housing having an actuation assembly and a gear assembly and the housing having a fixed handle and a movable handle pivotably attached thereto;

an elongate tubular member extending distally from the housing and being configured to receive at least one fastener therein; and

an introducer disposed at least partially within the elongate tubular member;

advancing the introducer from the elongate tubular member; and

advancing a distal-most fastener over the introducer.

23. The method of claim 22, wherein the surgical instrument includes a lockout disposed in mechanical cooperation with the elongate tubular member, the lockout being movable from a first position where it prevents proximal movement of the movable handle to a second position where it allows proximal movement of the movable handle.

24. The method of claim 23, further including the step of moving the lockout from its first position to its second position before the advancing the introducer step.

25. The method of claim 24, wherein the lockout is moved from its first position to its second position by translating at least a portion of the elongate tubular member proximally.