EP0558031A2
Expired / Lapsed
EP
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Apparatus and method for subcuticular stapling of body tissue
Assignee: United States Surgical Corp
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Filing: 1993-02-26
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Granted: —
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Expires: 2013-02-26
Abstract
Abstract A surgical apparatus 10 for attaching two portions of cutaneous body tissue includes a pair of opposed elongated members having jaws 12 which have tissue gripping members 18 thereon at one end and which are movable toward each other to a closed position to engage two body tissue portions positioned within the members to move the body tissue portions into close approximation. Manually gripping systems of several alternative configurations are provided to actuate a mechanical transmission system to close the jaws. In a preferred embodiment, a fork 70 is movable from a first position to a second position by manually operable devices to move the jaws toward each other. A pair of cam faces 68 is located adjacent the opposite ends of the jaws. As the fork moves to its second position, the tines of the fork engage against the cam faces to move the opposed jaws to their closed position. A plurality of rod-like fasteners 78 are carried in a stacked configuration proximally of the jaws such that, when the jaws are in their closed position and the two body tissue portions are held in close approximation, each rod-like fastener is movable to a position in ingress to penetrate the body tissue to attach the body tissue portions together. In another preferred embodiment, the elongated members are biased outwardly by a coil spring and a unique plate-like fastener drive member is provided to facilitate driving a fastener after the jaws are closed. A fastener cartridge 106 is provided with fasteners 108 stacked in a sloped fashion and having a coil spring 110 to bias the fasteners toward the ejection position. Another embodiment includes a rack and gear teeth arrangement 298 for approximating the jaws and for firing the fasteners. The rack and gear teeth function somewhat like a linear analog of a set of rotary gears. A method of attaching cutaneous body tissue portions is also disclosed.
Inventors
- 👤 David T. Green
- 👤 Henry Bolanos
- 👤 Diego Fontayne
- 👤 Henry Sienkiewicz
- 👤 Maria Lopez-Isa
- 👤 Marc J. Theroux
- 👤 John Charles Robertson
- 👤 Joseph M. Paul
- 👤 Stephen W. Gerry
- 👤 Wayne P. Young
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 19:14
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/04; A61B17/064; A61B17/068; A61B17/28; A61B17/2812; A61B17/282; A61B17/56; A61B17/58; A61B17/68
Claims Analysis
Total Claims: 35
Claim 1
Independent Claim
127 words
Surgical apparatus for attaching at least two end portions of body tissue, which comprises: a) a pair of opposed shaped jaws; b) body tissue engaging means extending from each jaw and facing said opposed jaw and adapted to engage the respective end portions such that when said jaws are moved toward each other said engaging means causes said two end portions of the body tissue to be displaced toward each other and engage at an interface thereof so as to assume an irregular shape whereby a fastening member may be directed generally medially of said body tissue interface to thereby attach the opposed portions of the body tissue; c) actuating means; and d) means actuated by said actuating means for moving said opposed jaws toward each other.
Claim 2
Dependent Claim
24 words
Apparatus as claimed in claim 1, wherein said actuating means comprises at least one pivotally mounted handle manually movable to actuate said moving means.
Claim 3
Dependent Claim
85 words
Apparatus as claimed in claim 2, further comprising a) a rack having a plurality of teeth; and b) a drive member attached to said pivotal handle and having a plurality of teeth dimensioned and adapted to mesh with said teeth of said rack and arranged for engagement with said teeth of said rack such that when said pivotal handle is pivoted toward another handle, said engagement of said teeth of said rack by said teeth of said drive member causes said rack to move distally.
Claim 4
Dependent Claim
44 words
Apparatus as claimed in claim 2 or 3 wherein initial movement of said at least one handle moves said jaws toward each other and further movement of said handles causes ejection of said at least one fastener into the interface of said body tissue.
Claim 5
Dependent Claim
16 words
Apparatus as claimed in any one of the preceding claims including a plurality of fastening members.
Claim 6
Dependent Claim
43 words
Apparatus as claimed in claim 5 wherein the fastening members are constituted by rod-like members carried in a stacked configuration proximally of said jaws, as by a cartridge, each rod-like member being individually movable to penetrate said body tissue portions when drawn together.
Claim 7
Dependent Claim
73 words
Apparatus as claimed in any one of the preceding claims further comprising: a) a plurality of rod-like fastener members positioned for sequential ejection generally medially of said jaws when said jaws are moved toward each other; and b) manually operable gripping means adapted to move said jaws toward each other for gripping the adjacent end portions of the body tissue and for ejecting at least one of said fasteners into the body tissue.
Claim 8
Dependent Claim
43 words
Apparatus as claimed in claim 6 or 7, wherein said apparatus further comprises plunger means engagable with at least one of said rod-like members and movable from a first position to a second position to move said rod-like member into said body tissue.
Claim 9
Dependent Claim
83 words
Apparatus as claimed in any one of the preceding claims further comprising: cam means associated with at least one of said jaws; cam engaging means movable from a first position to a second position to engage said cam means so as to move at least one of said opposed jaws toward the other jaw to said second position to move at least one of the body tissue portions toward the other to a position wherein said body tissue portions are in close approximation.
Claim 10
Dependent Claim
40 words
Apparatus as claimed in claim 9 wherein said apparatus further comprises: a frame; and a pair of opposed handles extending generally away from said frame with at least one of the handle being movable toward and away from the other.
Claim 11
Dependent Claim
69 words
Apparatus as claimed in claim 10, and including means interconnecting said handles and said cam engaging means, said link means being movable by the movement of at least one of said handles toward the other, said link means adapted to transfer the movement of at least one of said handles toward said cam engaging means to move said cam engaging means from its first position to its second position.
Claim 12
Dependent Claim
73 words
Apparatus as claimed in claim 10, and including a parallelogram shaped transmission pivotally interconnected at opposite ends thereof to said handles so that the movement of said handles toward and away from each other allows said parallelogram to expand and contract, said transmission interconnecting with said cam engaging means to translate the motion of said handles toward each other to move said cam engaging means from its first position to its second position.
Claim 13
Dependent Claim
78 words
Apparatus as claimed in claim 10 wherein said opposed handles extend generally transversely from said frame; and a rack carried by said frame is movable longitudinally by the rotative motion of a pinion, said cam engaging means being connected with said rack for longitudinal motion therewith, said pinion being rotated by the movement of said handle toward the other to move said rack longitudinally to move said cam engaging means from its first position to its second position.
Claim 14
Dependent Claim
60 words
Apparatus as claimed in any one of claims 9 to 13, as dependent on claim 8, wherein said cam engagable means is movable from its second position to a third porition to move said plunger means to its second position, said second position of said cam engagable means is intermediate said first and third positions of said cam engagable means.
Claim 15
Dependent Claim
96 words
Apparatus as claimed in any one of the preceding claims, further comprising: a pair of spaced tissue stabilizer means positioned adjacent said jaws and in close approximation thereto when said jaws are moved toward each other to their closed position, said stabilizer means being positioned along the axis of said path extending transversely between said closed jaws and positioned to contact body tissue portions adjacent the ends of said overlapping waveform when said jaws are moved to their closed position to stabilize said jaws in a position suitable for attachment of the portions of body tissue.
Claim 16
Dependent Claim
62 words
Apparatus as claimed in any one of the preceding claims wherein said body tissue means engaging comprises a pair of spaced gripping members on one of said jaws, and at least one gripping member positioned to the other of said jaws which is positioned between said first mentioned pair of spaced gripping members when said jaws are moved to their closed position.
Claim 17
Dependent Claim
75 words
Apparatus as claimed in any one of the preceding claims further comprising: a) a pair of support members for supporting said jaws; b) resilient means positioned between said support members to bias said support members and said jaws in opposed directions; and c) means configured and adapted for advancement in a distal direction in a manner to engage said support members whereby said support members and said jaws are caused to move toward each other.
Claim 18
Dependent Claim
73 words
Apparatus as claimed in any one of the preceding claims, further comprising: a) at least two pairs of dual sharp tipped body tissue engaging members extending from each jaw and facing said opposed jaw whereby a fastener member may be directed generally medially of said body tissue interface; and b) a plurality of rod-like fastener members positioned for sequential ejection generally medially of said jaws when said jaws are moved toward each other.
Claim 19
Dependent Claim
27 words
Apparatus as claimed in claim 18 wherein a plate member having a fastener driving member attached thereto is movable distally to individually eject said rod-like fastener members.
Claim 20
Dependent Claim
28 words
Apparatus as claimed in any one of the preceding claims, further comprising a means to provide a visual indication when a predetermined number of fasteners have been ejected.
Claim 21
Dependent Claim
37 words
Apparatus as claimed in claim 20, wherein said visual indication means is a flexible member movable between a first position prior to firing a first stored fastener to a second position after firing a last stored fastener.
Claim 22
Dependent Claim
50 words
Apparatus as claimed in any one of the preceding claims further comprising a platelike platform positioned adjacent said jaws and dimensioned and arranged for engagement with body tissue surrounding an opening in the tissue to facilitate stabilizing the position and orientation of said jaws with respect to the body tissue.
Claim 23
Dependent Claim
77 words
Apparatus as claimed in any one of the preceding claims further comprising: a) a fastener drive plate positioned proximally of a leading fastener; and b) a member associated with said jaw approximating means and adapted to engage said fastener drive plate when said jaws are approximated into adjacent relation whereby further actuation of said mechanical means cause advancement of said fastener drive plate to eject said leading fastener into the medium and generally medially of the interface.
Claim 24
Dependent Claim
19 words
Apparatus as claimed in claim 23 wherein said fastener drive plate is fabricated of metal having super elastic properties.
Claim 25
Dependent Claim
59 words
Apparatus as claimed in any one of the preceding claims, comprising yoke means supporting a pair of rollers and adapted for movement distally whereby said rollers engage respective surface portions of elongate members in manner to approximate said members and said jaws and movable proximally whereby said members and said jaws are permitted to move away from each other.
Claim 26
Dependent Claim
20 words
Apparatus as claimed in claim 25 including a first spring for urging the jaws to move away from each other.
Claim 27
Dependent Claim
28 words
Apparatus as claimed in claim 25 or 26, as dependent upon claim 13, wherein the rack is attached to said yoke means to cause said jaws to approximate.
Claim 28
Dependent Claim
48 words
Apparatus as claimed in claim 25, 26 or 27 as dependent on claim 23, wherein said yoke means includes a member adapted to be advanced into engagement with said fastener drive plate to drive the leading fastener through said fastener aperture whan said yoke means is advanced distally.
Claim 29
Dependent Claim
53 words
Apparatus as claimed in any one of claim 25 to 28, further comprising a strap-like member having a connector portion at a distal end thereof connected to said yoke means, said strap-like member movable by movement of said actuating means between positions whereby said yoke means moves between corresponding proximal and distal positions.
Claim 30
Dependent Claim
43 words
Apparatus as claimed in claim 29, further comprising means engagable with said strap-like member when said member is moved toward said distal position, said engaging means adapted to prevent proximal movement of said strap-like member when movement of said actuating means is discontinued.
Claim 31
Dependent Claim
24 words
Apparatus as claimed in claim 30 wherein said means engageable with said strap-like member is a pawl pivotally supported independently of said strap-like member.
Claim 32
Dependent Claim
61 words
Apparatus as claimed in any one of the preceding claims and further comprising: a) resilient means for biasing at least one elongate rod-like fastener toward a fastener ejection position; b) a plate-like ejection means for ejecting said elongate fastener in a first direction; and d) means for altering the direction of said elongate fastener prior to insertion into the body tissue.
Claim 33
Dependent Claim
66 words
Apparatus as claimed in any one of the preceding claims further comprising: a) means for advancing an elongate fastener member along a path at least a portion of which is non-linear path so as to direct said fastener member into the end portions and attach the end portions together; and b) stabilizer adjacent said tissue holding means to facilitate positioning and orienting said tissue approximating means.
Claim 34
Dependent Claim
46 words
A surgical fastening apparatus for attaching two adjacent portions of cutaneous body tissue comprising: at least one elongate rod-like fastener; ejection means for ejecting an elongate fastener in a first direction; and means for altering the direction of said elongate fastener insertion into the body tissue.
Claim 35
Dependent Claim
21 words
Apparatus as claimed in any one of the preceding claims and including a removable cartridge from which the fasteners are disposed.
References Cited (Backward Citations)
No citation records indexed.
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