摘要:
A surgical apparatus for attaching two portions of cutaneous body tissue includes a pair of opposed elongated members having jaws which have tissue gripping members 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 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 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 are carded 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 portions 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 is provided with fasteners stacked in a sloped fashion and having a coil spring to bias the fasteners toward the ejection position. Another embodiment includes a rack and gear teeth arrangement 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.
摘要:
Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed. A locking mechanism can be provided in the form of a hook which engages the cam bar retainer after firing the staples to prevent forward movement of the cam bar retainer.
摘要:
Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed.
摘要:
A handle for a laparoscopic instrument is provided for manipulating a distal laparoscopic tool. The handle includes a casing, a pivot handle pivotally attached to the casing, and an actuating shaft mechanism extending outward from the casing. Attached at the distal end of the actuating shaft opposite the casing is the laparoscopic surgical tool. The actuating shaft mechanism is longitudinally movable in a first direction by a pivotal movement of the pivot handle for manipulating the laparoscopic tool. A detent carried by the casing allows movement of the shaft longitudinally in the first direction while restraining longitudinal movement of the shaft in a second opposite direction. A thumb wheel attached to the actuating shaft mechanism allows the actuating shaft mechanism to be rotated for further manipulating the laparoscopic tool.
摘要:
Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes an arcuately shaped member for holding a plurality of the fastener portions in generally aligned relation, a correspondingly arcuately shaped member spaced from the fastener portion holding member for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. A fastener driver is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied.
摘要:
A handle for a laparoscopic instrument is provided for manipulating a distal laparoscopic tool. The handle includes a casing, a pivot handle pivotally attached to the casing, and an actuating shaft mechanism extending outward from the casing. Attached at the distal end of the actuating shaft opposite the casing is the laparoscopic surgical tool. The actuating shaft mechanism is longitudinally movable in a first direction by a pivotal movement of the pivot handle for manipulating the laparoscopic tool. A detent carried by the casing allows movement of the shaft longitudinally in the first direction while restraining longitudinal movement of the shaft in a second opposite direction. A thumb wheel attached to the actuating shaft mechanism allows the actuating shaft mechanism to be rotated for further manipulating the laparoscopic tool.
摘要:
Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed.
摘要:
Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied. A method for applying fasteners to body tissue on the apparatus of the invention along an arcuate path is also disclosed.
摘要:
Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied. A method for applying fasteners to body tissue on the apparatus of the invention along an arcuate path is also disclosed.
摘要:
An endoscopic surgical stapling apparatus is disclosed. The apparatus comprises a frame and a generally elongated endoscopic section connected to the frame and extending distally therefrom. The endoscopic section includes a mechanism for storing a plurality of staples, a mechanism for advancing the staples for positioning adjacent body tissue and a mechanism for at least partially closing each staple. A low pressure pneumatic system disposed in the frame provides the forces to at least partially activate the staple advancing mechanism. The apparatus has particular application in attaching mesh to body tissue as in laparoscopic hernia repair.