THREADED ANCHOR ADVANCER

A surgical anchor delivery device includes a shaft, a plurality of anchors disposed within the shaft, and a threaded rod disposed within the shaft and threadably engaged with the anchors. Rotation of the threaded rod advances the anchors toward the distal end of the shaft without rotating the anchors relative to the shaft. The delivery device may include an actuation mechanism configured to rotate the threaded rod. A method of delivering the anchors may include advancing the distal end of the shaft to a first location, rotating the threaded rod to advance a first anchor out the distal end of the shaft without rotating the first anchor relative to the shaft, repositioning the distal end of the shaft to a second position, and rotating the threaded rod to advance a second anchor out the distal end of the shaft without rotating the second anchor relative to the shaft.

TECHNICAL FIELD

The present disclosure pertains generally to medical devices and methods of using medical devices. More particularly, the present disclosure relates to medical devices and/or systems, and methods of using the same, for arthroscopic placement of multiple surgical anchors in the area of a full or partial thickness tear of a tendon, such as the supraspinatus tendon of the shoulder.

BACKGROUND

With its complexity, range of motion and extensive use, a common soft tissue injury is damage to the rotator cuff or rotator cuff tendons. Damage to the rotator cuff is a potentially serious medical condition that may occur during hyperextension, from an acute traumatic tear or from overuse of the joint. Current procedures for treatment of a torn tendon include affixing a biocompatible implant over the torn tendon. There is an ongoing need to deliver and adequately secure medical implants during an arthroscopic procedure in order to treat injuries to the rotator cuff, rotator cuff tendons, or other soft tissue or tendon injuries throughout a body.

SUMMARY

In one example, a surgical anchor delivery device may comprise an elongate shaft having a lumen extending to a distal end of the elongate shaft, a plurality of surgical anchors disposed within the lumen, and a threaded rod disposed within the elongate shaft and threadably engaged with the plurality of surgical anchors. Rotation of the threaded rod may advance the plurality of surgical anchors within the lumen toward the distal end of the elongate shaft without rotating the plurality of surgical anchors relative to the elongate shaft.

In addition or alternatively to any example described herein, the plurality of surgical anchors is prevented from rotating relative to the elongate shaft.

In addition or alternatively to any example described herein, the lumen includes a noncircular cross-sectional shape.

In addition or alternatively to any example described herein, each surgical anchor of the plurality of surgical anchors includes a noncircular perimeter shape.

In addition or alternatively to any example described herein, each surgical anchor of the plurality of surgical anchors includes a tab extending radially outward from a peripheral edge of the anchor.

In addition or alternatively to any example described herein, the elongate shaft includes a channel extending longitudinally along a wall of the elongate shaft and opening radially inwards.

In addition or alternatively to any example described herein, the tab is configured to extend into the channel when the plurality of surgical anchors is disposed within the lumen.

In addition or alternatively to any example described herein, the plurality of surgical anchors is configured to slide distally within the lumen in response to rotation of the threaded rod.

In addition or alternatively to any example described herein, rotation of the threaded rod is configured to advance the plurality of surgical anchors out of the lumen.

In addition or alternatively to any example described herein, rotation of the threaded rod is configured to drive at least one barb extending distally from each surgical anchor of the plurality of surgical anchors into a target tissue.

In addition or alternatively to any example described herein, a surgical anchor delivery device may comprise a handle including an actuation mechanism, an elongate shaft extending from the handle, the elongate shaft having a lumen extending to a distal end of the elongate shaft, a plurality of surgical anchors disposed within the lumen, and a threaded rod disposed within the lumen and threadably engaged with the plurality of surgical anchors. Rotation of the threaded rod may advance the plurality of surgical anchors within the lumen toward the distal end of the elongate shaft without rotating the plurality of surgical anchors relative to the elongate shaft. The actuation mechanism may be configured to rotate the threaded rod.

In addition or alternatively to any example described herein, the actuation mechanism is configured to rotate the threaded rod in only a single direction.

In addition or alternatively to any example described herein, the actuation mechanism is configured to shift between a starting position and an ending position.

In addition or alternatively to any example described herein, shifting the actuation mechanism from the starting position to the ending position advances only one surgical anchor of the plurality of surgical anchors out of the lumen.

In addition or alternatively to any example described herein, after reaching the ending position, the actuation mechanism disengages from the threaded rod and the actuation mechanism is configured to return to the starting position while disengaged from the threaded rod.

In addition or alternatively to any example described herein, after reaching the ending position, the actuation mechanism is configured to return to the starting position while simultaneously advancing a successive surgical anchor of the plurality of surgical anchors toward the distal end of the elongate shaft without rotating any of the plurality of surgical anchors relative to the elongate shaft.

In addition or alternatively to any example described herein, a method of delivering a plurality of surgical anchors to a treatment site may comprise advancing a distal end of an elongate shaft of a surgical anchor delivery device to a first location at the treatment site, rotating a threaded rod disposed within the elongate shaft in a first direction to advance a first surgical anchor of the plurality of surgical anchors out the distal end of the elongate shaft without rotating the first surgical anchor relative to the elongate shaft, repositioning the distal end of the elongate shaft to a second position at the treatment site, and rotating the threaded rod disposed within the elongate shaft in the first direction to advance a second surgical anchor of the plurality of surgical anchors out the distal end of the elongate shaft without rotating the second surgical anchor relative to the elongate shaft.

In addition or alternatively to any example described herein, the plurality of surgical anchors is disposed within the elongate shaft prior to advancing the distal end of the elongate shaft to the first location.

In addition or alternatively to any example described herein, the threaded rod is only rotatable in the first direction.

In addition or alternatively to any example described herein, rotating the threaded rod includes shifting an actuation mechanism of the surgical anchor delivery device from a starting position to an ending position.

In addition or alternatively to any example described herein, the method may further comprise: after rotating the threaded rod disposed within the elongate shaft in the first direction to advance the first surgical anchor of the plurality of surgical anchors out the distal end of the elongate shaft, resetting the actuation mechanism from the ending position to the starting position before rotating the threaded rod disposed within the elongate shaft in the first direction to advance the second surgical anchor of the plurality of surgical anchors out the distal end of the elongate shaft.

In addition or alternatively to any example described herein, the threaded rod does not rotate while resetting the actuation mechanism from the ending position to the starting position.

The above summary of some embodiments, aspects, and/or examples is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The figures and the detailed description which follows more particularly exemplify these embodiments.

DETAILED DESCRIPTION

The following description should be read with reference to the drawings, which are not necessarily to scale. Like reference numerals indicate like elements throughout the views. The detailed description and drawings are intended to illustrate but not limit the disclosure. Those skilled in the art will recognize that the various elements described and/or shown may be arranged in various combinations and configurations without departing from the scope of the disclosure.

The recitation of numerical ranges by endpoints includes all numbers within that range, including the endpoints (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

Although some suitable dimensions, ranges, and/or values pertaining to various components, features and/or specifications are disclosed, one of skill in the art, enlightened by the present disclosure, would understand desired dimensions, ranges, and/or values may deviate from those expressly disclosed.

Relative terms such as “proximal”, “distal”, “advance”, “retract”, variants thereof, and the like, may be generally considered with respect to the positioning, direction, and/or operation of various elements relative to a user/operator/manipulator of the device, wherein “proximal” and “retract” indicate or refer to closer to or toward the user and “distal” and “advance” indicate or refer to farther from or away from the user. In some instances, the terms “proximal” and “distal” may be arbitrarily assigned in an effort to facilitate understanding of the disclosure, and such instances will be readily apparent to the skilled artisan. Other relative terms, such as “axial”, “circumferential”, “longitudinal”, “lateral”, “radial”, etc. and/or variants thereof generally refer to direction and/or orientation relative to a central longitudinal axis of the disclosed structure or device.

The term “extent” may be understood to mean the greatest measurement of a stated or identified dimension, unless the extent or dimension in question is preceded by or identified as a “minimum”, which may be understood to mean the smallest measurement of the stated or identified dimension. For example, “outer extent” may be understood to mean an outer dimension, “radial extent” may be understood to mean a radial dimension, “longitudinal extent” may be understood to mean a longitudinal dimension, etc. Each instance of an “extent” may be different (e.g., axial, longitudinal, lateral, radial, circumferential, etc.) and will be apparent to the skilled person from the context of the individual usage. Generally, an “extent” may be considered a greatest possible dimension measured according to the intended usage, while a “minimum extent” may be considered a smallest dimension measured according to the intended usage. In some instances, an “extent” may generally be measured orthogonally within a plane and/or cross-section, but may be, as will be apparent from the particular context, measured differently—such as, but not limited to, angularly, radially, circumferentially (e.g., along an arc), etc.

It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment(s) described may include one or more particular features, structures, and/or characteristics. However, such recitations do not necessarily mean that all embodiments include the particular features, structures, and/or characteristics. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it would be within the knowledge of one skilled in the art to implement the particular feature, structure, or characteristic in connection with other embodiments, whether or not explicitly described, unless clearly stated to the contrary. That is, individual elements described herein, even if not explicitly shown in a particular combination, are contemplated as being combinable or arrangeable with each other to form other additional embodiments or to complement and/or enrich the described embodiment(s), as would be understood by one of ordinary skill in the art.

The figures generally illustrate selected components and/or arrangements of medical devices, systems, and/or methods. It should be noted that in any given figure, some features may not be shown, or may be shown schematically, for simplicity. Additional details regarding some elements may be illustrated in other figures in greater detail. It is to be noted that in order to facilitate understanding, certain features of the disclosure may be described in the singular, even though those features may be plural or recurring within the disclosed embodiment(s). Each instance of the features may include and/or be encompassed by the singular disclosure(s), unless expressly stated to the contrary. For example, a reference to features or elements may be equally referred to all instances and quantities beyond one of said feature or element. As such, it will be understood that the following discussion may apply equally to any and/or all of the elements for which there are more than one within the medical devices, systems, and/or methods, unless explicitly stated to the contrary. Additionally, all instances of some elements or features may not be shown in each figure for clarity.

With its complexity, range of motion, and extensive use, a common soft tissue injury is damage to the rotator cuff or rotator cuff tendons. Damage to the rotator cuff is a potentially serious medical condition that may occur during hyperextension, from an acute traumatic tear, or from overuse of the joint. An accepted treatment for rotator cuff tears may include reattaching the torn tendon to the humeral head using sutures. Additionally, in treating rotator cuff tears, an accepted practice may also include the placement of a scaffold over the repaired tendon to mechanically reinforce the repaired tendon and/or to promote tissue reformation. Therefore, there is an ongoing need to deliver, position, and secure medical implants to soft tissue during an arthroscopic procedure in order to treat injuries to the rotator cuff, rotator cuff tendons, or other soft tissue or tendon injuries throughout a body. At least some of those procedures may involve the placement of multiple surgical anchors, and in some cases may involve multiple surgical anchor delivery devices. Repeatedly removing a surgical anchor delivery device to load a new surgical anchor onto the surgical anchor delivery device and then reinserting a surgical anchor delivery device to the treatment site to deliver surgical anchors thereto may extend a procedure, may create opportunity to drop a surgical anchor delivery device thereby causing the surgical anchor delivery device to become unsterile, may cause discomfort to the patient, and/or may cause or aggravate other risks. There is an ongoing need to deliver multiple surgical anchors within a single procedure without exchanging the surgical anchor delivery device and/or removing the surgical anchor delivery device between deployment of surgical anchors.

FIGS.1and2schematically illustrate selected aspects of a shoulder10including an implant12positioned at a treatment site. In at least some embodiments, the implant12may be a sheet-like implant and/or a scaffold configured to reinforce the damaged tissue. In some embodiments, the implant12may include collagen and/or may be collagen based.FIGS.1and2further illustrate a head14of the humerus16mating with a glenoid fossa18of the scapula20. The glenoid fossa18includes a shallow depression in the scapula20. A supraspinatus tendon22is also shown. A distal tendon24of the supraspinatus tendon22meets the humerus16at an insertion point26.

InFIGS.1and2, the distal tendon24includes a damaged portion28located near the insertion point26. The damaged portion28includes a tear30extending partially through the distal tendon24. In some cases, the tear30may be a partial thickness tear. In some cases, the tear30may be a complete thickness tear. The tear30is depicted on the bursal side of the distal tendon24, however, the tear30may also be on the opposite or articular side of the distal tendon24and/or may include internal tears to the distal tendon24not visible on either surface.

FIGS.1and2illustrate that the implant12has been placed over the tear30. In this example, the implant12is placed on the bursal side of the distal tendon24regardless of whether the tear is on the bursal side, the articular side, or within the distal tendon24. Further, the implant12may overlay multiple tears.

In some instances, delivery of the implant12to a treatment site of a patient may require a physician to create an incision in the patient (e.g., in the patient's skin, etc.) sufficient to access the treatment site. After creating this “access site,” the physician may insert an implant delivery system through the incision and/or the access site and position the distal end of the implant delivery system adjacent the treatment site. The physician may then manipulate the implant delivery system to deploy the implant12at and/or adjacent the treatment site.

When positioning the implant12at and/or adjacent the treatment site, a user may orient the implant12such that a proximal portion36may be adjacent (e.g., overlaid) on a portion of the humerus16(e.g., on the bone), while a distal portion38of the implant12may overlay the distal tendon24. Further, once the implant12has been placed appropriately, it may be desirable to utilize a surgical anchor delivery device100to insert a surgical anchor (or multiple surgical anchors) of a plurality of surgical anchors200(e.g.,FIGS.5-8) or a surgical anchor (or multiple surgical anchors) of a plurality of surgical anchors300(e.g.,FIGS.9-10), as seen inFIG.2for example, through the implant12into the distal tendon24and/or the humerus16.

In some embodiments, an access sheath may be used during advancement of the surgical anchor delivery device100to the treatment site. The access sheath may cover a distal end region of the surgical anchor delivery device100, thereby shielding portions of the shoulder10from edges and/or sharp portions of the surgical anchor delivery device100as a distal end of the surgical anchor delivery device100is advanced to the treatment site and/or positioned adjacent the implant12.

Returning briefly toFIG.1, the surgical anchor delivery device100is positioned adjacent to the implant12. In at least some embodiments, once the surgical anchor delivery device100and the access sheath (where present) has been inserted through the incision and/or the access site and advanced to the treatment site, the access sheath may be removed. Removing the access sheath may expose portions of the surgical anchor delivery device100which may be utilized to affix the implant12to the humerus16and/or the distal tendon24. For example, the implant12may be anchored to the humerus16using one or more bone anchors and/or the implant12may be anchored to the distal tendon24using a plurality of surgical anchors200/300arranged around a periphery of the implant12.

Turning now toFIGS.3-4, the surgical anchor delivery device100may comprise an elongate shaft110having a lumen120extending therein to a distal end112of the elongate shaft110. In some embodiments, the surgical anchor delivery device100may comprise a handle140including an actuation mechanism150. In some embodiments, the elongate shaft110may extend distally away from the handle140to the distal end112. In some embodiments, the handle140may include a handle housing142. In some embodiments, the handle housing142may comprise a first housing member and a second housing member designed to mate with one another, in a “clam shell” configuration, for example. Other configurations are also contemplated.

In some embodiments, the handle140may be coupled to the elongate shaft110. In some embodiments, the elongate shaft110may be axially and/or rotationally secured relative to the handle140. In some embodiments, the elongate shaft110may be fixedly attached to the handle140. The elongate shaft110may include a wall defining an outer surface and the lumen120extending therein. In some embodiments, the distal end112of the elongate shaft110may include a distal face114, as seen inFIG.4. In some embodiments, the distal face114may be oriented substantially perpendicular to a central longitudinal axis of the elongate shaft110.

In some embodiments, the elongate shaft110may include at least one tine116extending distally away from the distal end112and/or the distal face114of the elongate shaft110. In at least some embodiments, the at least one tine116may extend parallel to the central longitudinal axis of the elongate shaft110. In some embodiments, the at least one tine116may include exactly one tine, or the at least one tine116may include two tines, three tines, four tines, or more tines as needed or desired.

Collectively, the at least one tine116may define and/or border a passage through which a surgical anchor (not shown inFIG.4) may pass through as the surgical anchor is advanced and/or deployed out of the elongate shaft110. Further, the at least one tine116may be designed to create a pilot hole at the treatment site (e.g., within tissue and/or the implant12). For example, after a user positions and/or aligns the distal end112of the elongate shaft110along the implant12, the user may apply a force to the handle140and/or the elongate shaft110such that the at least one tine116pierces through the implant12and/or into tissue at the treatment site (e.g., the distal tendon24), thereby creating a pilot hole for which a portion of a surgical anchor may be inserted.

In some embodiments, the at least one tine116may include at least one curved side (e.g., a concave surface facing a second opposed tine of the at least one tine116) and a pointed end or tip. In some examples, a curved side of the at least one tine116may be configured to mate with and/or correspond to a portion of the surgical anchor in a complimentary manner. In some embodiments, the at least one tine116may take various shapes, such as spikes, spears, prongs, or other shapes. The at least one tine116may generally have a pointed distal end or tip for piercing tissue or bone.

In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may comprise a trigger152. In some embodiments, the trigger152may be and/or may include a lever, a knob, a button, a slider, etc. In some embodiments, the trigger152may be movable relative to the handle140and/or the handle housing142to activate, operate, and/or actuate the actuation mechanism150. In some embodiments, the trigger152may be secured to the handle140and/or the handle housing142. In some embodiments, the trigger152may be secured to and/or pivotable relative to the handle140and/or the handle housing142at a pivot point154, as seen inFIG.3. Other configurations, while not expressly shown, are also contemplated. For example, in some embodiments, the trigger152may be secured to and/or slidable relative to the handle140and/or the handle housing142. In some embodiments, the trigger152may be secured to and/or movable inward relative to the handle140and/or the handle housing142(e.g., toward an interior of the handle140and/or the handle housing142). In some embodiments, the trigger152may be a touch sensitive structure. Other configurations are also contemplated. It can be appreciated that the handle140may be designed such that a user may grasp the handle140and/or the handle housing142with one hand and actuate and/or depress the trigger152with that same hand (e.g., via squeezing, etc.).

In some embodiments, the actuation mechanism150may be disposed within an interior of the surgical anchor delivery device100, the handle140, the handle housing142, and/or the elongate shaft110. In some embodiments, at least a portion of the trigger152may be disposed within the interior of the surgical anchor delivery device100, the handle140, and/or the handle housing142. At least some additional details pertaining to the actuation mechanism150will be described below.

In some embodiments, the surgical anchor delivery device100may comprise a plurality of surgical anchors200(e.g.,FIG.5-6) or a plurality of surgical anchors300(e.g.,FIGS.6,9) disposed within the lumen120of the elongate shaft110. The surgical anchors will be discussed in more detail herein, but it will be appreciated that features and/or characteristics of the surgical anchors may be combined and/or applied interchangeably between various configurations of the surgical anchors. Further, it shall be understood that the surgical anchor delivery device100may be compatible with and/or may be used with any and/or all surgical anchors disclosed and/or described herein, as well as others. One beneficial aspect of the disclosure is that the plurality of surgical anchors200or the plurality of surgical anchors300may be disposed within the elongate shaft110prior to advancing the distal end112of the elongate shaft110to the treatment site. Accordingly, loading and/or reloading individual surgical anchors during a procedure may be avoided.

FIG.5illustrates selected aspects of one example configuration for a surgical anchor of the plurality of surgical anchors200which may be utilized with the surgical anchor delivery device100described herein. Although the various parts of the surgical anchor of the plurality of surgical anchors200are depicted in relative proportion to other parts of the surgical anchor of the plurality of surgical anchors200, other configurations in size and orientation of the various parts are also contemplated.

In some embodiments, the surgical anchor of the plurality of surgical anchors200includes a first arm270a, a second arm270b, and a bridge271extending between the first arm270aand the second arm270b. In some embodiments, the bridge271may extend transversely relative to the first arm270aand/or the second arm270b. In at least some embodiments, the bridge271may extend from and/or adjacent to a proximal end of the first arm270ato a proximal end of the second arm270b. In some embodiments, the bridge271may abut the proximal end of the first arm270aand the proximal end of the second arm270b. In some embodiments, the bridge271may be integrally formed with and/or may be monolithically formed with the first arm270aand/or the second arm270b.

In some embodiments, the first arm270amay include a first anchor portion267aand the second arm270bmay include a second anchor portion267b. In some embodiments, the first anchor portion267amay include a first projection272aand a second projection273aextending outwardly therefrom. The first anchor portion267a, the first projection272a, and/or the second projection273amay be configured to engage with tissue (e.g., the distal tendon24, etc.). In some embodiments, the second anchor portion267bmay include a first projection272band a second projection (not shown, but similar to the first projection272band/or the second projection273a) extending outwardly therefrom. The second anchor portion267b, the first projection272b, and/or the second projection (not shown) may be configured to engage with tissue (e.g., the distal tendon24, etc.). In some embodiments, the first projection272aand the second projection273aof the first anchor portion267amay define a first notch274apositioned between the first projection272aand the second projection273aof the first anchor portion267a. In some embodiments, the first projection272band the second projection (not shown) of the second anchor portion267bmay define a second notch274bpositioned between the first projection272band the second projection (not shown) of the second anchor portion267b. In some embodiments, a distal end region of the first anchor portion267amay include a sharp and/or pointed end275aconfigured to pierce and/or to aid in piercing though the implant12and/or tissue (e.g., the distal tendon24). In some embodiments, a distal end region of the second anchor portion267bmay include a sharp and/or pointed end275bconfigured to pierce and/or to aid in piercing though the implant12and/or tissue (e.g., the distal tendon24). Other configurations for the surgical anchor of the plurality of surgical anchors200, the first anchor portion267a, and/or the second anchor portion267bare also contemplated.

In some embodiments, a proximal end249of the surgical anchor of the plurality of surgical anchors200may include a flat surface276positioned along a proximal side of the bridge271and/or facing proximally. In some embodiments, the flat surface276may be a planar surface arranged generally perpendicular to the central longitudinal axis of the elongate shaft110of the surgical anchor delivery device100when loaded therein. The bridge271may include a threaded aperture280disposed therein and/or extending therethrough. In some embodiments, the threaded aperture280may be oriented generally parallel to the central longitudinal axis of the elongate shaft110when the surgical anchor of the plurality of surgical anchors200is disposed within the elongate shaft110and/or the lumen120. In some embodiments, the threaded aperture280may be coaxial and/or coincident with the central longitudinal axis of the elongate shaft110when the surgical anchor of the plurality of surgical anchors200is disposed within the elongate shaft110and/or the lumen120. In some embodiments, the threaded aperture280may cooperate with the actuation mechanism150to advance the surgical anchor of the plurality of surgical anchors200toward the distal end112of the elongate shaft110and/or out of the lumen120as discussed herein.

FIG.6is a partial cross-sectional view illustrating selected aspects of the surgical anchor delivery device100. As seen inFIG.6, the elongate shaft110may include the plurality of surgical anchors200or the plurality of surgical anchors300disposed and/or positioned within the lumen120of the elongate shaft110. Additionally, at least a portion of the actuation mechanism150(e.g.,FIG.3,FIG.11) may extend into the elongate shaft110and/or the lumen120of the elongate shaft110. In at least some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150(e.g.,FIG.3,FIG.11) may include a threaded rod130disposed within and/or extending within the elongate shaft110and/or the lumen120of the elongate shaft110. The threaded rod130may be configured to threadably engage with the plurality of surgical anchors200or the plurality of surgical anchors300. In some embodiments, the threaded rod130may be configured to threadably engage with the threaded aperture280of the surgical anchor of the plurality of surgical anchors200(e.g.,FIGS.5-8) or a threaded aperture380(e.g.,FIGS.6,9) of a surgical anchor of the plurality of surgical anchors300.

In the interest of brevity,FIGS.6-8will be described with respect to the plurality of surgical anchors200. However, it shall be understood that the plurality of surgical anchors300may be used in place of the plurality of surgical anchors200with little or no change to the surgical anchor delivery device100.

As seen inFIG.6, the plurality of surgical anchors200may be oriented in longitudinal alignment with the central longitudinal axis of the elongate shaft110with the sharp and/or pointed ends275a/275bof the plurality of surgical anchors200pointed toward the distal end112of the elongate shaft110.

In some embodiments, the plurality of surgical anchors200may be spaced away from one another along the central longitudinal axis of the elongate shaft110and/or within the lumen120of the elongate shaft110such that adjacent surgical anchors of the plurality of surgical anchors200do not directly contact one another. It can be appreciated fromFIG.6that the plurality of surgical anchors200may be spaced apart from one another while threaded onto the threaded rod130. As such, the surgical anchor delivery device100may be initially loaded with the plurality of surgical anchors200, such as two or more surgical anchors, three or more surgical anchors, four or more surgical anchors, six or more surgical anchors, eight or more surgical anchors, etc. for sequential deployment from the surgical anchor delivery device100and/or the distal end112of the elongate shaft110. As discussed herein, the plurality of surgical anchors200may be sequentially advanced out of the distal end112of the elongate shaft110as the actuation mechanism150is manipulated and/or actuated, such as via the handle140and/or the trigger152(e.g.,FIG.3).

In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may advance the plurality of surgical anchors200within the lumen120toward the distal end112of the elongate shaft110. In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may advance the plurality of surgical anchors200within the lumen120toward the distal end112of the elongate shaft110without rotating the plurality of surgical anchors200within the lumen120and/or relative to the elongate shaft110. In some embodiments, the plurality of surgical anchors200may be prevented from rotating relative to the elongate shaft110. In at least some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may be configured to advance the plurality of surgical anchors200out of the lumen120and/or the distal end112of the elongate shaft110. In some embodiments, the plurality of surgical anchors200may be configured to slide distally within the lumen120and/or the elongate shaft110in response to rotation of the threaded rod130within and/or relative to the elongate shaft110.

In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may be configured to drive at least one barb (e.g., the first anchor portion267aand/or the second anchor portion267b, etc.) extending distally from the bridge271of each surgical anchor of the plurality of surgical anchors200into the implant12and/or a target tissue (e.g., the distal tendon24), as seen schematically inFIGS.1-2.

Returning toFIGS.6and7, in some embodiments, the elongate shaft110may include a channel118extending longitudinally along a wall of the elongate shaft110and opening radially inwards. In some embodiments, the elongate shaft110may include a second channel extending longitudinally along the wall of the elongate shaft110and opening radially inwards. The second channel may be disposed opposite the channel118and/or on an opposite side of the lumen120with respect to the central longitudinal axis of the elongate shaft110.

In some embodiments, the channel118and/or the second channel may be formed separately from the elongate shaft110and fixedly attached to the elongate shaft110along an inner surface of the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be fixedly attached to the elongate shaft110with adhesives, welding, mechanical fasteners, friction or interference fit, etc. In some embodiments, the channel118and/or the second channel may be integrally formed with and/or may be monolithically formed with the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be formed in the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be extruded, injection molded, machined, etc. with the elongate shaft110. Other methods of manufacturing and/or assembly are also contemplated.

As seen inFIGS.6and7, the first anchor portion267aand/or the second anchor portion267bmay be disposed adjacent to and/or within the channel118and/or the second channel. In some embodiments, the channel118and/or the second channel may be configured to prevent rotation of the plurality of surgical anchors200within the lumen120and/or relative to the elongate shaft110.

In an alternative configuration shown inFIG.8, in some embodiments, the lumen120and/or the elongate shaft110may include and/or may have a noncircular cross-sectional shape. In some embodiments, each surgical anchor of the plurality of surgical anchors200may include and/or may have a noncircular perimeter shape. In at least some embodiments, the noncircular perimeter shape of the plurality of surgical anchors200may cooperate with the noncircular cross-sectional shape of the lumen120and/or the elongate shaft110to prevent the plurality of surgical anchors200from rotating relative to the elongate shaft110.

FIG.9illustrates selected aspects of one example configuration for a surgical anchor of the plurality of surgical anchors300which may be utilized with the surgical anchor delivery device100described herein. Although the various parts of the surgical anchor of the plurality of surgical anchors300are depicted in relative proportion to other parts of the surgical anchor of the plurality of surgical anchors300, other configurations in size and orientation of the various parts are also contemplated.

In some embodiments, the surgical anchor of the plurality of surgical anchors300includes a first arm370a, a second arm370b, and a bridge371extending between the first arm370aand the second arm370b. In some embodiments, the bridge371may extend transversely relative to the first arm370aand/or the second arm370b. In at least some embodiments, the bridge371may extend from and/or adjacent to a proximal end of the first arm370ato a proximal end of the second arm370b. In some embodiments, the bridge371may abut the proximal end of the first arm370aand the proximal end of the second arm370b. In some embodiments, the bridge371may be integrally formed with and/or may be monolithically formed with the first arm370aand/or the second arm370b. In some embodiments, the bridge371may include a substantially rounded and/or circular perimeter shape. Other configurations are also contemplated.

In some embodiments, the first arm370amay include a first anchor portion367aand the second arm370bmay include a second anchor portion367b. In some embodiments, the first anchor portion367aand the second anchor portion367bmay include features from and/or may be similar to the first anchor portion267aand the second anchor portion267b, respectively. For example, in some embodiments, the first anchor portion367amay include a first projection and a second projection extending outwardly therefrom. The first anchor portion367a, the first projection, and/or the second projection may be configured to engage with tissue (e.g., the distal tendon24, etc.). In some embodiments, the second anchor portion367bmay include a first projection and a second projection extending outwardly therefrom. The second anchor portion367b, the first projection, and/or the second projection may be configured to engage with tissue (e.g., the distal tendon24, etc.).

In some embodiments, a distal end region of the first anchor portion367amay include a sharp and/or pointed end configured to pierce and/or to aid in piercing though the implant12and/or tissue (e.g., the distal tendon24). In some embodiments, a distal end region of the second anchor portion367bmay include a sharp and/or pointed end configured to pierce and/or to aid in piercing though the implant12and/or tissue (e.g., the distal tendon24). Other configurations for the surgical anchor of the plurality of surgical anchors300, the first anchor portion367a, and/or the second anchor portion367bare also contemplated.

In some embodiments, a proximal end349of the surgical anchor of the plurality of surgical anchors300may include a flat surface376positioned along a proximal side of the bridge371and/or facing proximally. In some embodiments, the flat surface376may be a planar surface arranged generally perpendicular to the central longitudinal axis of the elongate shaft110of the surgical anchor delivery device100when loaded therein. In some embodiments, each surgical anchor of the plurality of surgical anchors300may include a tab382extending radially outward from a peripheral edge of the surgical anchor and/or the bridge371.

The bridge371may include a threaded aperture380disposed therein and/or extending therethrough. In some embodiments, the threaded aperture380may be oriented generally parallel to the central longitudinal axis of the elongate shaft110when the surgical anchor of the plurality of surgical anchors300is disposed within the elongate shaft110and/or the lumen120. In some embodiments, the threaded aperture380may be coaxial and/or coincident with the central longitudinal axis of the elongate shaft110when the surgical anchor of the plurality of surgical anchors300is disposed within the elongate shaft110and/or the lumen120. In some embodiments, the threaded aperture380may cooperate with the actuation mechanism150to advance the surgical anchor of the plurality of surgical anchors300toward the distal end112of the elongate shaft110and/or out of the lumen120as discussed herein.

FIG.10is a partial cross-sectional view illustrating selected aspects of an alternative configuration of the surgical anchor delivery device100and/or the elongate shaft110ofFIG.6. The threaded rod130may be configured to threadably engage with the plurality of surgical anchors300. In some embodiments, the threaded rod130may be configured to threadably engage with the threaded aperture380of a surgical anchor of the plurality of surgical anchors300.

Similar to the configuration seen inFIG.6, the plurality of surgical anchors300may be oriented in longitudinal alignment with the central longitudinal axis of the elongate shaft110with the sharp and/or pointed ends of the plurality of surgical anchors300pointed toward the distal end112of the elongate shaft110.

In some embodiments, the plurality of surgical anchors300may be spaced away from one another along the central longitudinal axis of the elongate shaft110and/or within the lumen120of the elongate shaft110such that adjacent surgical anchors of the plurality of surgical anchors300do not directly contact one another. It can be appreciated that the plurality of surgical anchors300may be spaced apart from one another while threaded onto the threaded rod130. As such, the surgical anchor delivery device100may be initially loaded with the plurality of surgical anchors300, such as two or more surgical anchors, three or more surgical anchors, four or more surgical anchors, six or more surgical anchors, eight or more surgical anchors, etc. for sequential deployment from the surgical anchor delivery device100and/or the distal end112of the elongate shaft110. As discussed herein, the plurality of surgical anchors300may be sequentially advanced out of the distal end112of the elongate shaft110as the actuation mechanism150is manipulated and/or actuated, such as via the handle140and/or the trigger152(e.g.,FIG.3).

In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may advance the plurality of surgical anchors300within the lumen120toward the distal end112of the elongate shaft110. In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may advance the plurality of surgical anchors300within the lumen120toward the distal end112of the elongate shaft110without rotating the plurality of surgical anchors300within the lumen120and/or relative to the elongate shaft110. In some embodiments, the plurality of surgical anchors300may be prevented from rotating relative to the elongate shaft110.

In at least some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may be configured to advance the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110. In some embodiments, the plurality of surgical anchors300may be configured to slide distally within the lumen120and/or the elongate shaft110in response to rotation of the threaded rod130within and/or relative to the elongate shaft110.

In some embodiments, rotation of the threaded rod130within and/or relative to the elongate shaft110may be configured to drive at least one barb (e.g., the first anchor portion367aand/or the second anchor portion367b, etc.) extending distally from the bridge371of each surgical anchor of the plurality of surgical anchors300into the implant12and/or a target tissue (e.g., the distal tendon24), as seen schematically inFIGS.1-2.

Returning toFIG.10, in some embodiments, the elongate shaft110may include a channel118extending longitudinally along a wall of the elongate shaft110and opening radially inwards. In some embodiments, the elongate shaft110may include a second channel extending longitudinally along the wall of the elongate shaft110and opening radially inwards. The second channel may be disposed opposite the channel118and/or on an opposite side of the lumen120with respect to the central longitudinal axis of the elongate shaft110.

In some embodiments, the channel118and/or the second channel may be formed along an inner surface of the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be formed within the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be integrally formed with and/or may be monolithically formed with the wall of the elongate shaft110. In some embodiments, the channel118and/or the second channel may be extruded, injection molded, machined, etc. with the elongate shaft110. Other methods of manufacturing and/or assembly are also contemplated.

As seen inFIG.10, the tab382may be disposed adjacent to and/or within the channel118and/or the second channel. In some embodiments, the tab382may be configured to extend into the channel118and/or the second channel. In some embodiments, the channel118and/or the second channel may be configured to prevent rotation of the plurality of surgical anchors300within the lumen120and/or relative to the elongate shaft110. In some embodiments, the tab382may cooperate with the channel118and/or the second channel to prevent rotation of the plurality of surgical anchors300within the lumen120and/or relative to the elongate shaft110.

FIG.11schematically illustrates selected aspects of the surgical anchor delivery device100and/or the actuation mechanism150. As shown, the elongate shaft110may extend from the handle140and/or the handle housing142. The surgical anchor delivery device100and/or the handle140may include the actuation mechanism150. In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may include the trigger152. In the example shown, the trigger152is pivotably coupled to the handle140and/or the handle housing142. However, as discussed herein, the trigger152may take other forms and/or may be subject to other means of actuation.FIGS.12-23illustrate selected aspects related to the operation of the surgical anchor delivery device100and/or the actuation mechanism150and/or various embodiments and/or configurations thereof.

The actuation mechanism150may be configured to rotate the threaded rod130within and/or relative to the handle140, the handle housing142, and/or the elongate shaft110to advance the plurality of surgical anchors200or the plurality of surgical anchors300toward the distal end112(e.g.,FIG.3) of the elongate shaft110. In at least some embodiments, the actuation mechanism150may be configured to rotate the threaded rod130in only a single direction. Accordingly, oscillation of the threaded rod130may be avoided, thereby ensuring that the plurality of surgical anchors200or the plurality of surgical anchors300is only advanced toward the distal end112of the elongate shaft110and the plurality of surgical anchors200or the plurality of surgical anchors300cannot be retracted or moved proximally within the lumen120and/or the elongate shaft110.

In some embodiments, the actuation mechanism150may comprise a plurality of gears170disposed within the handle140and/or the handle housing142. In some embodiments, the actuation mechanism150may comprise a rack156coupled to the trigger152. In some embodiments, the rack156may be fixedly secured and/or fixedly attached to the trigger152. In some embodiments, the rack156may be integrally formed with and/or may be monolithically formed with the trigger152. The rack156may be an elongated structure having a plurality of teeth155extending from one side. In some embodiments, the plurality of teeth155may extend from a distally facing side of the rack156, wherein the elongate shaft110extends distally from the handle140and/or the handle housing142.

The rack156and/or the plurality of teeth155of the rack156may be configured to engage with the plurality of gears170. In some embodiments, the plurality of gears170may comprise a pinion172configured to directly engage the rack156and/or the plurality of teeth155of the rack156. In some embodiments, the plurality of gears170may comprise a first bevel gear174fixedly attached to the pinion172. In some embodiments, the first bevel gear174may be fixedly attached to the pinion172by a first shaft (not visible). In the view shown inFIG.11, the first bevel gear174is disposed below or underneath the pinion172, and the first shaft would extend therebetween. In some embodiments, the plurality of gears170may comprise a second bevel gear176engaged with the first bevel gear174such that rotation of the pinion172and/or the first bevel gear174results in rotation of the second bevel gear176. In some embodiments, the plurality of gears170may comprise a first spur gear178fixedly attached to the second bevel gear176. In some embodiments, the first spur gear178may be fixedly attached to the second bevel gear176by a second shaft177. In some embodiments, the plurality of gears170may comprise a second spur gear180fixedly attached to the threaded rod130. In some embodiments, the second spur gear180may be disposed at a proximal end of the threaded rod130.

In some embodiments, the rack156may include a projection158extending from the rack156. In some embodiments, the projection158may extend from the rack156in a direction generally perpendicular to the plurality of teeth155. In the view shown inFIG.11, the projection158may extend upward out of the page or downward into the page.

In some embodiments, the handle140, the handle housing142, and/or the actuation mechanism150may include a first guide member160and a second guide member162. The first guide member160and/or the second guide member162may be securely coupled to the handle140and/or the handle housing142. In some embodiments, the first guide member160and/or the second guide member162may be fixedly attached to the handle140and/or the handle housing142. In some embodiments, the first guide member160and/or the second guide member162may be integrally formed with and/or may be monolithically formed with the handle140and/or the handle housing142. Other configurations are also contemplated.

In some embodiments, the first guide member160and/or the second guide member162may extend from and/or may be formed with the first housing member. In some embodiments, the first guide member160and/or the second guide member162may extend from and/or may be formed with the second housing member. In some embodiments, the first guide member160and/or the second guide member162may extend from and/or may be formed with the first housing member and the second housing member. Other configurations are also contemplated.

In some embodiments, the handle140, the handle housing142, and/or the actuation mechanism150may include a leaf spring164having a first end fixedly attached to the second guide member162. In some embodiments, the first end of the leaf spring164may be fixedly attached to the second guide member162at and/or adjacent to a first end of the second guide member162. The leaf spring164may extend from the first end thereof and/or from the first end of the second guide member162toward the first guide member160. In some embodiments, a second end of the leaf spring164may engage with and/or may contact the first guide member160. In some embodiments, the second end of the leaf spring164may be biased toward the first guide member160. In some embodiments, the second end of the leaf spring164may be self-biased toward the first guide member160. In some embodiments, the leaf spring164may be self-biased toward a straightened configuration. The second end of the leaf spring164may be engaged with the first guide member160such that the leaf spring164is held in a deflected configuration. Accordingly, the second end of the leaf spring164may be continuously and/or permanently biased toward the first guide member160. However, the second end of the leaf spring164is not fixedly attached to the first guide member160. Instead, the second end of the leaf spring164may be deflected away from the first guide member160when a force is applied to a distally facing surface of the leaf spring164. Other configurations are also contemplated.

FIGS.12-23illustrate selected aspects related to the operation of the surgical anchor delivery device100and/or the actuation mechanism150and/or various embodiments and/or configurations thereof. It should be noted that not all features are shown and the illustrated aspects are shown in a highly schematic manner for ease of illustration and understanding.

FIG.12shows the trigger152and the pivot point154where the trigger152is coupled to the handle140and/or the handle housing142(not shown). The rack156extends away from the trigger152and includes the plurality of teeth155extending in a distal direction. Other configurations are also contemplated. The projection158is shown extending out of the page from the rack156. As discussed herein, this arrangement is not absolute, and in some embodiments, the projection158may extend in an opposite direction (e.g., into the page) from the rack156. The first guide member160and the second guide member162may extend from the handle140and/or the handle housing142. For example, the first guide member160and the second guide member162may extend inward from the first housing member and/or the second housing member. The first guide member160and the second guide member162may serve as guides for the projection158as the actuation mechanism150is actuated and/or operated.

In some embodiments, the actuation mechanism150may be configured to shift between a starting position (e.g.,FIGS.11,12,18,23) and an ending position (e.g.,FIGS.14,20). In the starting position, the plurality of teeth155of the rack156may be engaged with the pinion172(e.g., teeth extending radially outward from the pinion172).

Actuating and/or activating the trigger152(e.g., squeezing the trigger152, translating the trigger152toward the interior of the handle140and/or the handle housing142, etc.) may translate the rack156along its length toward the ending position. As the rack156is translated within the handle140and/or the handle housing142, the pinion172may be rotated by the plurality of teeth155, as seen inFIG.13. In some embodiments, the rack156may be semi-rigid and/or may deflect away from the pinion172as the rack156is translated relative to the pinion172, as also seen inFIG.13. This may result in an internal and/or inherent spring bias within the rack156that urges the rack156toward a straightened configuration. As such, the rack156may be self-biased toward the pinion172, thereby keeping the plurality of teeth155engaged with the pinion172. In some embodiments, actuation of the actuation mechanism150and/or translation of the rack156along and/or in engagement with the pinion172may rotate the threaded rod130(not shown) in a first direction. In some embodiments, the threaded rod130is only rotatable in the first direction.

At some point during translation of the rack156toward the ending position, but before reaching the ending position, the projection158may contact and/or engage the first guide member160. The first guide member160may be angled away from the pinion172. As such, as the projection158moves and/or translates along the first guide member160, the rack156and/or the plurality of teeth155may be angled away from the pinion172and therefore the rack156and/or the plurality of teeth155may become less engaged with the pinion172until the rack156reaches the ending position, seen inFIG.14. While translating the projection158along the first guide member160, the projection158may contact and/or engage a distal side of the leaf spring164. Prior to contacting the leaf spring164, the projection158may be disposed distal of the leaf spring164.

The leaf spring164may deflect and/or be urged away proximally from the first guide member160by the projection158until the protrusion moves past the leaf spring164, at which time and/or point (e.g., the ending position) the leaf spring164may spring and/or snap back distally into position against the first guide member160with the projection158on an opposite side or a proximal side of the leaf spring164, as seen inFIG.14. After reaching the ending position, the rack156and/or the plurality of teeth155may be disengaged from the pinion172.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be disengaged from the threaded rod130(not shown). Accordingly, after reaching the ending position, no further or additional rotation of the threaded rod130occurs until the actuation mechanism150has been reset to the starting position. Additionally, after reaching the ending position and/or after the actuation mechanism150disengages from the threaded rod130, the actuation mechanism150may be configured to return to the starting position while disengaged from the threaded rod130.

In some embodiments, a single actuation and/or a single activation of the actuation mechanism150may shift the actuation mechanism150from the starting position to the ending position. In at least some embodiments, shifting the actuation mechanism150from the starting position to the ending position may advance only one surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110.

Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the trigger152, the rack156, and/or the projection158toward the starting position. Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the projection158along the opposite side or the proximal side of the leaf spring164toward the first end of the leaf spring164, which may further direct the projection158toward and/or into engagement with the second guide member162and/or the first end of the second guide member162. In some embodiments, the projection158may translate along a proximal facing surface of the second guide member162toward a second end of the second guide member162opposite the first end as the actuation mechanism150is returned and/or reset from the ending position toward the starting position, as seen inFIGS.15-16. The second guide member162may cooperate with the projection158to prevent contact between the plurality of teeth155and the pinion172as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. As such, the second guide member162may cooperate with the projection158to maintain the rack156disengaged from the pinion172and/or to maintain the actuation mechanism150disengaged from the threaded rod130as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. In at least some embodiments, the threaded rod130does not rotate while resetting the actuation mechanism150toward and/or to the starting position.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be configured to automatically return to the starting position, thereby resetting the actuation mechanism150to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110during a subsequent actuation and/or a subsequent activation of the actuation mechanism150.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may be biased toward the starting position. In some embodiments, the trigger152and/or the actuation mechanism150may be self-biased toward the starting position. In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may include a spring engaged with the trigger152and/or the actuation mechanism150. In one example, a torsion spring may be disposed within and/or in engagement with the trigger152. The torsion spring may be engaged with the handle140and/or the handle housing142such that the torsion spring biases the trigger152toward the starting position. In another example, a coil spring may be disposed within the handle140and/or the handle housing142, and the coil spring may be engaged with the trigger152to bias the trigger152and/or the actuation mechanism150toward the starting position. Other spring types and/or configurations, and/or other biasing elements, are also contemplated.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may include a ratcheting system or a locking system configured to prevent automatic return to the starting position prematurely. In some embodiments, as the trigger152and/or the actuation mechanism150is translated toward the ending position, the ratcheting system or the locking system may prevent reverse translation back toward the starting position. In some embodiments, the actuation mechanism150and/or the trigger152may only be translatable in a first direction (e.g., toward the ending position) until reaching the ending position and/or until the projection158is disposed on the proximal side of the leaf spring164.

Once the projection158reaches and moves past the second end of the second guide member162, the rack156may move and/or snap back toward the pinion172due to the internal and/or inherent spring bias in the rack156, as seen inFIG.17. The internal and/or inherent spring bias in the rack156urges the rack156back toward the straightened configuration and/or into engagement with the pinion172(e.g., back to the starting position). Once the rack156has returned to the starting position, thereby effectively resetting the actuation mechanism150, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may then be cycled and/or activated again to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out the distal end112of the elongate shaft110and into the treatment site.

FIGS.18-22illustrate selected aspects of an alternative configuration of the actuation mechanism150. The alternative configuration ofFIGS.18-22may be structurally and/or functionally similar to the configurations ofFIGS.12-17, except where noted. In contrast to the configuration shown inFIGS.11and12, in the alternative configuration ofFIG.18the rack156is not fixedly attached to the trigger152. Instead, the rack156is pivotably coupled to the trigger at a pivot point153. In some embodiments, the pivot point153may be a pin, a hinge, or other similar structure. In further contrast the configuration shown inFIGS.11and12, in the alternative configuration ofFIG.18the rack156is substantially rigid and undergoes substantially no deflection as the rack156is translated. As a result of this difference, the rack156does not generate or include any internal and/or inherent spring bias urging the rack156back toward and/or into engagement with the pinion172. Instead, the actuation mechanism150may include a tensioning spring190coupled to the rack156. The tensioning spring190may be coupled to the rack156at a first end and coupled to the handle140and/or the handle housing142at a second end. For the purpose of illustration only, the handle140and/or the handle housing142are not shown completely, but a portion of the handle140and/or the handle housing142is illustrated as an anchoring or coupling point143for the tensioning spring190.

FIG.18shows the trigger152and the pivot point154where the trigger152is coupled to the handle140and/or the handle housing142(not shown). The rack156extends away from the trigger152and includes the plurality of teeth155extending in a distal direction. Other configurations are also contemplated. The projection158is shown extending out of the page from the rack156. As discussed herein, this arrangement is not absolute, and in some embodiments, the projection158may extend in an opposite direction (e.g., into the page) from the rack156. The first guide member160and the second guide member162may extend from the handle140and/or the handle housing142. For example, the first guide member160and the second guide member162may extend inward from the first housing member and/or the second housing member. The first guide member160and the second guide member162may serve as guides for the projection158as the actuation mechanism150is actuated and/or operated.

In some embodiments, the actuation mechanism150may be configured to shift between a starting position (e.g.,FIGS.11,18) and an ending position (e.g.,FIG.20). In the starting position, the plurality of teeth155of the rack156may be engaged with the pinion172(e.g., teeth extending radially outward from the pinion172).

Actuating and/or activating the trigger152(e.g., squeezing the trigger152, translating the trigger152toward the interior of the handle140and/or the handle housing142, etc.) may translate the rack156along its length toward the ending position. As the rack156is translated within the handle140and/or the handle housing142, the pinion172may be rotated by the plurality of teeth155, as seen inFIGS.18-19. In some embodiments, the rack156may be substantially rigid and/or may undergo substantially no deflection as the rack156is translated. In some embodiments, actuation of the actuation mechanism150and/or translation of the rack156along and/or in engagement with the pinion172may rotate the threaded rod130(not shown) in a first direction. In some embodiments, the threaded rod130is only rotatable in the first direction.

The tensioning spring190may be disposed on a distal side of the rack156. The tensioning spring190may be held in tension. As such, the rack156may be biased toward the pinion172, thereby keeping the plurality of teeth155engaged with the pinion172. At some point during translation of the rack156toward the ending position, but before reaching the ending position, the projection158may contact and/or engage the first guide member160. The first guide member160may be angled away from the pinion172. As such, as the projection158moves and/or translates along the first guide member160, the rack156and/or the plurality of teeth155may be angled away from the pinion172and therefore the rack156and/or the plurality of teeth155may become less engaged with the pinion172until the rack156reaches the ending position, seen inFIG.20. As the rack156and/or the plurality of teeth155is angled away from the pinion172and the rack156and/or the plurality of teeth155become less engaged with the pinion172, the tensioning spring190may stretch and/or tension on the tensioning spring190may increase, as seen inFIGS.19-20. While translating the projection158along the first guide member160, the projection158may contact and/or engage a distal side of the leaf spring164. Prior to contacting the leaf spring164, the projection158may be disposed distal of the leaf spring164.

The leaf spring164may deflect and/or be urged away proximally from the first guide member160by the projection158until the protrusion moves past the leaf spring164, at which time and/or point (e.g., the ending position) the leaf spring164may spring and/or snap back distally into position against the first guide member160with the projection158on an opposite side or a proximal side of the leaf spring164, as seen inFIG.20. After reaching the ending position, the rack156and/or the plurality of teeth155may be disengaged from the pinion172.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be disengaged from the threaded rod130(not shown). Accordingly, after reaching the ending position, no further or additional rotation of the threaded rod130occurs until the actuation mechanism150has been reset to the starting position. Additionally, after reaching the ending position and/or after the actuation mechanism150disengages from the threaded rod130, the actuation mechanism150may be configured to return to the starting position while disengaged from the threaded rod130.

In some embodiments, a single actuation and/or a single activation of the actuation mechanism150may shift the actuation mechanism150from the starting position to the ending position. In at least some embodiments, shifting the actuation mechanism150from the starting position to the ending position may advance only one surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110.

Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the trigger152, the rack156, and/or the projection158toward the starting position. Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the projection158along the opposite side or the proximal side of the leaf spring164toward the first end of the leaf spring164, which may further direct the projection158toward and/or into engagement with the second guide member162and/or the first end of the second guide member162. In some embodiments, the projection158may translate along a proximal facing surface of the second guide member162toward a second end of the second guide member162opposite the first end as the actuation mechanism150is returned and/or reset from the ending position toward the starting position, as seen inFIGS.21-22. The second guide member162may cooperate with the projection158to prevent contact between the plurality of teeth155and the pinion172as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. As such, the second guide member162may cooperate with the projection158to maintain the rack156disengaged from the pinion172and/or to maintain the actuation mechanism150disengaged from the threaded rod130as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. In at least some embodiments, the threaded rod130does not rotate while resetting the actuation mechanism150toward and/or to the starting position.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be configured to automatically return to the starting position, thereby resetting the actuation mechanism150to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110during a subsequent actuation and/or a subsequent activation of the actuation mechanism150.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may be biased toward the starting position. In some embodiments, the trigger152and/or the actuation mechanism150may be self-biased toward the starting position. In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may include a spring engaged with the trigger152and/or the actuation mechanism150. In one example, a torsion spring may be disposed within and/or in engagement with the trigger152. The torsion spring may be engaged with the handle140and/or the handle housing142such that the torsion spring biases the trigger152toward the starting position. In another example, a coil spring may be disposed within the handle140and/or the handle housing142, and the coil spring may be engaged with the trigger152to bias the trigger152and/or the actuation mechanism150toward the starting position. Other spring types and/or configurations, and/or other biasing elements, are also contemplated.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may include a ratcheting system or a locking system configured to prevent automatic return to the starting position prematurely. In some embodiments, as the trigger152and/or the actuation mechanism150is translated toward the ending position, the ratcheting system or the locking system may prevent reverse translation back toward the starting position. In some embodiments, the actuation mechanism150and/or the trigger152may only be translatable in a first direction (e.g., toward the ending position) until reaching the ending position and/or until the projection158is disposed on the proximal side of the leaf spring164.

Once the projection158reaches and moves past the second end of the second guide member162, the rack156may move and/or snap back toward the pinion172due to the tension applied to the rack156by the tensioning spring190. The tension applied to the rack156by the tensioning spring190urges the rack156back toward and/or into engagement with the pinion172(e.g., back to the starting position). Once the rack156has returned to the starting position, thereby effectively resetting the actuation mechanism150, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may then be cycled and/or activated again to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out the distal end112of the elongate shaft110and into the treatment site.

FIG.23illustrate selected aspects of an alternative configuration of the actuation mechanism150. The alternative configuration ofFIG.23may be structurally and/or functionally similar to the configurations ofFIGS.18-22, except where noted. In contrast to the configuration shown inFIGS.11and18, in the alternative configuration ofFIG.23the actuation mechanism150may include a compression spring192coupled to the rack156. The compression spring192may be coupled to the rack156at a first end and coupled to the handle140and/or the handle housing142at a second end. For the purpose of illustration only, the handle140and/or the handle housing142are not shown completely, but a portion of the handle140and/or the handle housing142is illustrated as an anchoring or coupling point143for the compression spring192.

Actuating and/or activating the trigger152(e.g., squeezing the trigger152, translating the trigger152toward the interior of the handle140and/or the handle housing142, etc.) may translate the rack156along its length toward the ending position. As the rack156is translated within the handle140and/or the handle housing142, the pinion172may be rotated by the plurality of teeth155. Similar toFIGS.18-22above, the rack156may be substantially rigid and/or may undergo substantially no deflection as the rack156is translated. In some embodiments, actuation of the actuation mechanism150and/or translation of the rack156along and/or in engagement with the pinion172may rotate the threaded rod130(not shown) in a first direction. In some embodiments, the threaded rod130is only rotatable in the first direction.

The compression spring192may be disposed on a proximal side of the rack156. The compression spring192may be held in compression. As such, the rack156may be biased toward the pinion172, thereby keeping the plurality of teeth155engaged with the pinion172. At some point during translation of the rack156toward the ending position, but before reaching the ending position, the projection158may contact and/or engage the first guide member160. The first guide member160may be angled away from the pinion172. As such, as the projection158moves and/or translates along the first guide member160, the rack156and/or the plurality of teeth155may be angled away from the pinion172and therefore the rack156and/or the plurality of teeth155may become less engaged with the pinion172until the rack156reaches the ending position. As the rack156and/or the plurality of teeth155is angled away from the pinion172and the rack156and/or the plurality of teeth155become less engaged with the pinion172, the compression spring192may compress and/or compressive force within the compression spring192may increase. While translating the projection158along the first guide member160, the projection158may contact and/or engage a distal side of the leaf spring164. Prior to contacting the leaf spring164, the projection158may be disposed distal of the leaf spring164.

The leaf spring164may deflect and/or be urged away proximally from the first guide member160by the projection158until the protrusion moves past the leaf spring164, at which time and/or point (e.g., the ending position) the leaf spring164may spring and/or snap back distally into position against the first guide member160with the projection158on an opposite side or a proximal side of the leaf spring164. After reaching the ending position, the rack156and/or the plurality of teeth155may be disengaged from the pinion172.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be disengaged from the threaded rod130(not shown). Accordingly, after reaching the ending position, no further or additional rotation of the threaded rod130occurs until the actuation mechanism150has been reset to the starting position. Additionally, after reaching the ending position and/or after the actuation mechanism150disengages from the threaded rod130, the actuation mechanism150may be configured to return to the starting position while disengaged from the threaded rod130.

In some embodiments, a single actuation and/or a single activation of the actuation mechanism150may shift the actuation mechanism150from the starting position to the ending position. In at least some embodiments, shifting the actuation mechanism150from the starting position to the ending position may advance only one surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110.

Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the trigger152, the rack156, and/or the projection158toward the starting position. Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the projection158along the opposite side or the proximal side of the leaf spring164toward the first end of the leaf spring164, which may further direct the projection158toward and/or into engagement with the second guide member162and/or the first end of the second guide member162. In some embodiments, the projection158may translate along a proximal facing surface of the second guide member162toward a second end of the second guide member162opposite the first end as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. The second guide member162may cooperate with the projection158to prevent contact between the plurality of teeth155and the pinion172as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. As such, the second guide member162may cooperate with the projection158to maintain the rack156disengaged from the pinion172and/or to maintain the actuation mechanism150disengaged from the threaded rod130as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. In at least some embodiments, the threaded rod130does not rotate while resetting the actuation mechanism150toward and/or to the starting position.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be configured to automatically return to the starting position, thereby resetting the actuation mechanism150to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110during a subsequent actuation and/or a subsequent activation of the actuation mechanism150.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may be biased toward the starting position. In some embodiments, the trigger152and/or the actuation mechanism150may be self-biased toward the starting position. In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may include a spring engaged with the trigger152and/or the actuation mechanism150. In one example, a torsion spring may be disposed within and/or in engagement with the trigger152. The torsion spring may be engaged with the handle140and/or the handle housing142such that the torsion spring biases the trigger152toward the starting position. In another example, a coil spring may be disposed within the handle140and/or the handle housing142, and the coil spring may be engaged with the trigger152to bias the trigger152and/or the actuation mechanism150toward the starting position. Other spring types and/or configurations, and/or other biasing elements, are also contemplated.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may include a ratcheting system or a locking system configured to prevent automatic return to the starting position prematurely. In some embodiments, as the trigger152and/or the actuation mechanism150is translated toward the ending position, the ratcheting system or the locking system may prevent reverse translation back toward the starting position. In some embodiments, the actuation mechanism150and/or the trigger152may only be translatable in a first direction (e.g., toward the ending position) until reaching the ending position and/or until the projection158is disposed on the proximal side of the leaf spring164.

Once the projection158reaches and moves past the second end of the second guide member162, the rack156may move and/or snap back toward the pinion172due to the compressive force applied to the rack156by the compression spring192. The compressive force applied to the rack156by the compression spring192urges the rack156back toward and/or into engagement with the pinion172(e.g., back to the starting position). Once the rack156has returned to the starting position, thereby effectively resetting the actuation mechanism150, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may then be cycled and/or activated again to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out the distal end112of the elongate shaft110and into the treatment site.

FIGS.24-29illustrate selected aspects related to the operation of the surgical anchor delivery device100and/or the actuation mechanism150and/or various embodiments and/or configurations thereof. It should be noted that not all features are shown, and the illustrated aspects are shown in a highly schematic manner for ease of illustration and understanding.

FIG.24shows the trigger152and the pivot point154where the trigger152is coupled to the handle140and/or the handle housing142(not shown). The rack156extends away from the trigger152and includes the plurality of teeth155extending in a distal direction. Other configurations are also contemplated. The projection158is shown extending out of the page from the rack156. As discussed herein, this arrangement is not absolute, and in some embodiments, the projection158may extend in an opposite direction (e.g., into the page) from the rack156. The first guide member160and the second guide member162may extend from the handle140and/or the handle housing142. For example, the first guide member160and the second guide member162may extend inward from the first housing member and/or the second housing member. The first guide member160and the second guide member162may serve as guides for the projection158as the actuation mechanism150is actuated and/or operated.

The surgical anchor delivery device100and/or the actuation mechanism150may further comprise a second rack194including a second plurality of teeth195extending in an opposite direction from the plurality of teeth155and/or extending toward the plurality of teeth155. For example, if the plurality of teeth155extends in the distal direction, the second plurality of teeth195may extend in the proximal direction, and vice versa. The actuation mechanism150may further comprise a link196extending between the rack156and the second rack194. In at least some embodiments, the link196may be rigid. In some embodiments, the second rack194may be substantially rigid. In some embodiments, the second rack194may be semi-rigid. The link196may be configured to maintain a generally constant spacing between the rack156and the second rack194. The rack156and the second rack194may be spaced apart by a distance that is greater than a diameter of the pinion172, such that only one of the rack156and the second rack194is engageable with the pinion172at a time.

It should be noted that in order to provide sufficient spacing within the handle140and/or the handle housing142for the second rack194to pass by and/or over the first bevel gear174, the second bevel gear176, etc., the first shaft (not shown) fixedly attaching the pinion172to the first bevel gear174may be extended compared to other configurations disclosed herein, thereby spacing the first bevel gear174farther away from the pinion172. The second bevel gear176, the second shaft177, the first spur gear178, etc. may be offset and/or sized differently to maintain the necessary engagement with the first bevel gear174, the second spur gear180, etc. while permitting the second rack194to pass by and/or pass over them without contact and/or interference.

In some embodiments, the actuation mechanism150may be configured to shift between a starting position (e.g.,FIG.24) and an ending position (e.g.,FIG.26). In the starting position, the plurality of teeth155of the rack156may be engaged with the pinion172(e.g., teeth extending radially outward from the pinion172) and the second plurality of teeth195of the second rack194may be disengaged from the pinion172.

Actuating and/or activating the trigger152(e.g., squeezing the trigger152, translating the trigger152toward the interior of the handle140and/or the handle housing142, etc.) may translate the rack156along its length toward the ending position. As the rack156is translated within the handle140and/or the handle housing142, the pinion172may be rotated by the plurality of teeth155, as seen inFIG.25. In some embodiments, the rack156may be semi-rigid and/or may deflect away from the pinion172as the rack156is translated relative to the pinion172, as also seen inFIG.25. This may result in an internal and/or inherent spring bias within the rack156that urges the rack156toward a straightened configuration. As such, the rack156may be self-biased toward the pinion172, thereby keeping the plurality of teeth155engaged with the pinion172. In some embodiments, actuation of the actuation mechanism150and/or translation of the rack156along and/or in engagement with the pinion172may rotate the threaded rod130(not shown) in a first direction. In some embodiments, the threaded rod130is only rotatable in the first direction. As the rack156deflects away from the pinion172, the second rack194may be pulled and/or translated toward the pinion172by the link196, as seen inFIG.25.

At some point during translation of the rack156toward the ending position, but before reaching the ending position, the projection158may contact and/or engage the first guide member160. The first guide member160may be angled away from the pinion172. As such, as the projection158moves and/or translates along the first guide member160, the rack156and/or the plurality of teeth155may be angled away from the pinion172and therefore the rack156and/or the plurality of teeth155may become less engaged with the pinion172until the rack156reaches the ending position, seen inFIG.26. When the rack156reaches the ending position, the second plurality of teeth195of the second rack194becomes engaged with the pinion172, as seen inFIG.26.

While translating the projection158along the first guide member160, the projection158may contact and/or engage a distal side of the leaf spring164. Prior to contacting the leaf spring164, the projection158may be disposed distal of the leaf spring164.

The leaf spring164may deflect and/or be urged away proximally from the first guide member160by the projection158until the protrusion moves past the leaf spring164, at which time and/or point (e.g., the ending position) the leaf spring164may spring and/or snap back distally into position against the first guide member160with the projection158on an opposite side or a proximal side of the leaf spring164, as seen inFIG.26. After reaching the ending position, the rack156and/or the plurality of teeth155may be disengaged from the pinion172.

In a change from some embodiments, after reaching the ending position, the actuation mechanism150may remain engaged from the threaded rod130(not shown) via the second rack194. Accordingly, after reaching the ending position, further and/or additional rotation of the threaded rod130in the first direction continues to occur until the actuation mechanism150has been reset to the starting position. After reaching the ending position, the actuation mechanism150may be configured to return to the starting position while engaged with the threaded rod130. This may permit additional advancement of the plurality of surgical anchors200or the plurality of surgical anchors300toward the distal end112of the elongate shaft110. For example, after reaching the ending position, the actuation mechanism150may be configured to return to the starting position while simultaneously advancing a successive surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300toward the distal end112of the elongate shaft110without rotating any of the plurality of surgical anchors200or the plurality of surgical anchors300relative to the elongate shaft110. In some embodiments, this arrangement may permit greater spacing between adjacent and/or successive surgical anchors within the elongate shaft110. In some instances, greater spacing between adjacent and/or successive surgical anchors may reduce opportunities and/or chances of misfires and/or jams.

In some embodiments, a single actuation and/or a single activation of the actuation mechanism150may shift the actuation mechanism150from the starting position to the ending position. In at least some embodiments, shifting the actuation mechanism150from the starting position to the ending position may advance only one surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110.

Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the trigger152, the rack156, and/or the projection158toward the starting position. Returning and/or resetting the actuation mechanism150from the ending position to the starting position may include translating the projection158along the opposite side or the proximal side of the leaf spring164toward the first end of the leaf spring164, which may further direct the projection158toward and/or into engagement with the second guide member162and/or the first end of the second guide member162. In some embodiments, the projection158may translate along a proximal facing surface of the second guide member162toward a second end of the second guide member162opposite the first end as the actuation mechanism150is returned and/or reset from the ending position toward the starting position, as seen inFIGS.27-28. The second guide member162may cooperate with the projection158to prevent contact between the plurality of teeth155and the pinion172as the actuation mechanism150is returned and/or reset from the ending position toward the starting position, while the link196pulls and/or biases the second rack194into engagement with the pinion172. As such, the second guide member162may cooperate with the projection158to maintain the rack156disengaged from the pinion172and to maintain the second rack194in engagement with the pinion172as the actuation mechanism150is returned and/or reset from the ending position toward the starting position. In at least some embodiments, the threaded rod130continues to rotate in the first direction while resetting the actuation mechanism150toward and/or to the starting position.

In at least some embodiments, after reaching the ending position, the actuation mechanism150may be configured to automatically return to the starting position, thereby resetting the actuation mechanism150to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or the distal end112of the elongate shaft110during a subsequent actuation and/or a subsequent activation of the actuation mechanism150. In some embodiments, resetting the actuation mechanism150may be configured to advance a subsequent or successive surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300toward the distal end112of the elongate shaft110to prepare the subsequent or successive surgical anchor for implantation during the next actuation and/or cycle of the actuation mechanism150.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may be biased toward the starting position. In some embodiments, the trigger152and/or the actuation mechanism150may be self-biased toward the starting position. In some embodiments, the surgical anchor delivery device100and/or the actuation mechanism150may include a spring engaged with the trigger152and/or the actuation mechanism150. In one example, a torsion spring may be disposed within and/or in engagement with the trigger152. The torsion spring may be engaged with the handle140and/or the handle housing142such that the torsion spring biases the trigger152toward the starting position. In another example, a coil spring may be disposed within the handle140and/or the handle housing142, and the coil spring may be engaged with the trigger152to bias the trigger152and/or the actuation mechanism150toward the starting position. Other spring types and/or configurations, and/or other biasing elements, are also contemplated.

In some embodiments, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may include a ratcheting system or a locking system configured to prevent automatic return to the starting position prematurely. In some embodiments, as the trigger152and/or the actuation mechanism150is translated toward the ending position, the ratcheting system or the locking system may prevent reverse translation back toward the starting position. In some embodiments, the actuation mechanism150and/or the trigger152may only be translatable in a first direction (e.g., toward the ending position) until reaching the ending position and/or until the projection158is disposed on the proximal side of the leaf spring164.

Once the projection158reaches and moves past the second end of the second guide member162, the rack156may move and/or snap back toward the pinion172due to the internal and/or inherent spring bias in the rack156, as seen inFIG.29. The internal and/or inherent spring bias in the rack156urges the rack156back toward the straightened configuration and/or into engagement with the pinion172(e.g., back to the starting position). Once the rack156has returned to the starting position, thereby effectively resetting the actuation mechanism150, the surgical anchor delivery device100, the trigger152, and/or the actuation mechanism150may then be cycled and/or activated again to advance another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out the distal end112of the elongate shaft110and into the treatment site.

In some or all configurations disclosed herein, the actuation mechanism150may be designed to cyclically advance the plurality of surgical anchors200or the plurality of surgical anchors300distally along the threaded rod130such that the plurality of surgical anchors200or the plurality of surgical anchors300may be sequentially deployed out of the lumen120and/or the distal end112of the elongate shaft110.

A method of delivering the plurality of surgical anchors200or the plurality of surgical anchors300to a treatment site may comprise advancing the distal end112of the elongate shaft110of the surgical anchor delivery device100to a first location at the treatment site, as seen schematically inFIG.1. As discussed herein, the plurality of surgical anchors200or the plurality of surgical anchors300may be disposed within the lumen120and/or the elongate shaft110of the surgical anchor delivery device100prior to advancing the distal end112of the elongate shaft110to the first location.

The method may comprise rotating the threaded rod130disposed within the elongate shaft110in a first direction to advance a first surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110without rotating the first surgical anchor within and/or relative to the elongate shaft110. In some embodiments, the method may comprise rotating the threaded rod130relative to the elongate shaft110in the first direction to advance the first surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110without rotating the first surgical anchor within and/or relative to the elongate shaft110.

In at least some embodiments, rotating the threaded rod130to advance the first surgical anchor may include shifting the actuation mechanism150of the surgical anchor delivery device100from the starting position to the ending position. In some embodiments, shifting the actuation mechanism150of the surgical anchor delivery device100from the starting position to the ending position may advance the plurality of surgical anchors200or the plurality of surgical anchors300within the lumen120and/or within the elongate shaft110toward the distal end112of the elongate shaft110to place another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300in position adjacent the distal end112of the elongate shaft110for subsequent deployment. In some embodiments, the plurality of surgical anchors200or the plurality of surgical anchors300only advance toward the distal end112of the elongate shaft110when the threaded rod130is rotated.

The method may comprise repositioning the surgical anchor delivery device100and/or the distal end112of the elongate shaft110to a second position at the treatment site, and rotating the threaded rod130disposed within the elongate shaft110in the first direction to advance a second surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110without rotating the second surgical anchor within and/or relative to the elongate shaft110. In some embodiments, the method may comprise rotating the threaded rod130relative to the elongate shaft110in the first direction to advance the second surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110without rotating the second surgical anchor within and/or relative to the elongate shaft110.

In at least some embodiments, rotating the threaded rod130to advance the second surgical anchor may include shifting the actuation mechanism150of the surgical anchor delivery device100from the starting position to the ending position. In some embodiments, shifting the actuation mechanism150of the surgical anchor delivery device100from the starting position to the ending position may advance the plurality of surgical anchors200or the plurality of surgical anchors300within the lumen120and/or within the elongate shaft110toward the distal end112of the elongate shaft110to place another surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300in position adjacent the distal end112of the elongate shaft110for subsequent deployment. In some embodiments, the plurality of surgical anchors200or the plurality of surgical anchors300only advance toward the distal end112of the elongate shaft110when the threaded rod130is rotated.

In some embodiments, the method may comprise, after rotating the threaded rod disposed within the elongate shaft110in the first direction to advance the first surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110, resetting the actuation mechanism150from the ending position to the starting position before rotating the threaded rod130relative to the elongate shaft110in the first direction to advance the second surgical anchor of the plurality of surgical anchors200or the plurality of surgical anchors300out of the lumen120and/or out of the distal end112of the elongate shaft110without rotating the second surgical anchor within and/or relative to the elongate shaft110. In some embodiments, the threaded rod130does not rotate within and/or relative to the elongate shaft110while resetting the actuation mechanism150from the ending position to the starting position. In some embodiments, the threaded rod130rotates in the first direction within and/or relative to the elongate shaft110while resetting the actuation mechanism150from the ending position to the starting position

The cycle may continue and/or be repeated with a user repositioning the surgical anchor delivery device100and deploying additional surgical anchors of the plurality of surgical anchors200or the plurality of surgical anchors300until all surgical anchors required or present in the surgical anchor delivery device100are deployed, without having to remove the surgical anchor delivery device100from the treatment site.

The materials that can be used for the various components of the medical devices, systems, and various elements thereof disclosed herein may include those commonly associated with medical devices. For simplicity purposes, the following discussion refers to the system. However, this is not intended to limit the devices and methods described herein, as the discussion may be applied to other elements, members, components, or devices disclosed herein, such as, but not limited to, the surgical anchor(s), the surgical anchor delivery device, the elongate shaft, the actuation mechanism, etc., and/or elements or components thereof.

In some embodiments, the system and/or components thereof, may be made from a metal, metal alloy, polymer (some examples of which are disclosed below), a metal-polymer composite, ceramics, combinations thereof, and the like, or other suitable material.

In some embodiments, portions or all of the system and/or components thereof may be doped with, made of, or otherwise include a radiopaque material. Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique (e.g., ultrasound, etc.) during a medical procedure. This relatively bright image aids a user in determining the location of the system. Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, polymer material loaded with a radiopaque filler, and the like. Additionally, other radiopaque marker bands and/or coils may also be incorporated into the design of the system to achieve the same result.