Source: https://patents.justia.com/patent/6358270
Timestamp: 2020-01-23 20:44:35
Document Index: 398238013

Matched Legal Cases: ['arts 2', 'arts 2', 'arts 2', 'arts 2', 'arts 2', 'arts 2', 'arts 2']

US Patent for Sternum closure device Patent (Patent # 6,358,270 issued March 19, 2002) - Justia Patents Search
Justia Patents Means To Draw Opposed Sides Of Incision Into AppositionUS Patent for Sternum closure device Patent (Patent # 6,358,270)
Jul 27, 2000 - Haifa Surgical Instruments Ltd.
A sternum closure device for securing parts of severed sternum, such as a human sternum following surgery. The device includes an anvil, capable of forming staples, a bracket positioned opposite the anvil, an instrument for creating openings in the sternum and a mechanism for feeding, mounting and applying the staples. The bracket is joined with the anvil through a displacement mechanism. The instrument for forming opening is designed as a bit brace having a reducing gear and two chucks, to enable concurrent drilling of openings in both severed parts of the severed sternum. The mechanism for feeding and mounting the staples comprises a ribbed bed, a cartridge containing staples and an instrument for mounting the staples.
Latest Haifa Surgical Instruments Ltd. Patents:
The present invention relates to medical devices for closure of a severed sternum. In particular, the invention is directed to a sternum closure assemblies and methods for re-approximating split portions of tissue to retain the split portions in adjacent contacting relation to promote healing thereof.
During surgery that involves a median sternotomy, for example, open-heart surgery, the sternum is cut longitudinally to allow access to the organs within the thoracic cavity. A partial or median sternotomy is a procedure by which a saw or other comparable cutting instrument is used to make a midline, longitudinal incision along a portion or the entire axial length of the patient's sternum, allowing two opposing sternal valves to be separated laterally. Upon completion of the surgery, the sternum is rejoined and closed securely.
The strap assemblies known heretofore incorporate clamps, clasps, bands, strips with or without openings and complex locking mechanisms. U.S. Pat. No. 5,356,417; U.S. Pat. No. 5,462,542; and U.S. Pat. No. 6,007,538. The use of compression prevents problems for blood circulation and soft tissues. Other versions of sternum closure devices use tongs, plugs or guns with anvils, to apply staples through the osseous tissue of the sternum. U.S. Pat. No. 4,122,989; and U.S. Pat. No. 4,481,960. However, these devices suffer from several drawbacks, for example, significant force is required to puncture the osseous tissue and insert a staple. In addition, these prior art devices are imprecise in positioning the staples, and do not permit the anvil to bend the staple through 180° angle. Finally, the devices are cumbersome and cause shaking of the organs in the thoraxic cavity.
The present invention provides improved devices and methods of joining with staples, the opposite parts of a severed sternum following a median or partial sternotomy that overcomes the above cited problems inherent in previous sternum closure devices. Generally, the present invention is embodied in an anvil for forming the staples, a bracket positioned opposite the anvil, a means for making openings in the tissue, and a mechanisms for feeding and mounting the staples.
FIG. 7 is a sectional view of the sternum closure device, which is shown in FIG. 2, in the plane of line C—C; this device is in the state preceding drilling the openings in the sternum.
FIG. 7a is a sectional view of the sternum closure device, which is shown in FIG. 2, in the plane of line C—C; this device is in the process of drilling the openings in the sternum.
FIG. 8 is a sectional view of the sternum closure device, which is shown in FIG. 4 in the plane of line G—G; this device is in the state preceding mounting the staples in the sternum.
FIG. 8a is a sectional view of the sternum closure device, which is shown in FIG. 4, in the plane of line G—G; this device is in the process of mounting the staples.
FIG. 9 is a sectional view in the plane of line D—D of a displacement mechanism, which is shown in FIG. 1.
FIG. 11 is a sectional view of the sternum closure device, which is shown in FIG. 7a, in the plane of line H—H.
FIG. 12 is a sectional view of the sternum closure device, which is shown in FIG. 8a, in the plane of line K—K.
Referring to FIGS. 1 to 15, a sternum closure device 1 is shown to provide a system and method for joining two parts 2 and 3, of a severed sternum 4, by means of staples 5, having legs 6 and 7, which are inserted through openings 8 and 9 of the severed sternum 4.
Referring to FIGS. 1, 2, 5, 7 and 7a, an instrument 60 is provided for formation of openings. The instrument 60 is constructed as a bit brace 61 with a pneumatic drive 62 and two chucks 63 and 64. The two chucks are provided for mounting interchangeable drills 65 and 66. The instrument 60 further comprises a reducing gear 71. Reducing gear 71 is installed over housing 72, said housing 72 comprising of a basis 73 and a cover 74. Basis 73 is provided with lug 75, said lug 75 having an openi76 and a slot 77. A driving gear wheel 78 is arranged the space of housing 72, and installed on a driving shaft 79. The driving shaft 79 is mounted on basis 73 of housing 72 by means of bearings 80 and 81. Two driven gear wheels 82 and 83, engaged with the driving gear wheel 78, are installed on a driven shafts 84 and 85. The driven shafts 84 and 85 are mounted on basis 73 of housing 72 by means of bearings 86, 87, 88 and 89. The driving shaft 79 is further joined with the pneumatic drive 62, said drive 62 being designed as a pneumatic motor. Chucks 63 and 64 are installed on driven shafts 84 and 85 and these chucks are used for mounting the interchangeable drills 65 and 66.
Referring to FIGS. 3, 4, 6, 8, 8a and 12, a feeding and staple mounting mechanism 100 comprises of a carrying element constructed as bed 101 having two ribs 102 and 103. These ribs 102 and 103 are perpendicular to bed 101 and each rib is provided with through longitudinal slots 104 and 105. Stoppers 106 and 107 are installed on the internal side of each rib 102 and 103, respectively. Bed 101 is provided with two lugs 108 and 109, said lugs 108 and 109 in turn are provided with through openings 110 and 111 respectively. Bed 101 is further provided with through slot 112, said slot 112 being placed in parallel to sides 113 and 114 of bed 101. Side 113 is provided with lug 115, which in turn has an opening 116 and a locking screw 117 fastened to the opening 116. Wall 118, having an internal side and an external side, is situated in perpendicular to bed 101 on side 114. Handle 119 is locked to wall 118. A cylindrical support 120 is further installed on the internal side of wall 118.
FIG. 14 and FIG. 15 represent a second prototype of the invention in which instead of having a rotatable head for alternating the two functions of the device—i.e., drilling and stapling, the two functions are carried out by a sliding head 201 which is located at one end of a stream lined instrument 200. The net effect of this is quicker and simpler alteration of functions and easier handling of the instrument. The cramping of the staples is performed by compressing the ends of the arms of instrument 200 which is easier to do than the rotatable action required in the first embodiment describer earlier.
OPERATION OF THE STERNUM CLOSURE DEVICE
The mode of operation of the sternum closure device is described herein below.
With rotation of screw 41 by handle 42 in the opposite direction (in this case—in the clock-wise direction), bracket 20 moves progressively along guides 44 and 45 towards anvil 10. This motion is accompanied with compression of spring 43 and decrease of the distance between anvil 10 and bracket 20 to contact with the internal and external parts 2 and 3 respectively, of the severed sternum 4.
Drilling openings 8 and 9 are performed in parts 2 and 3 of the severed sternum 4 (FIGS. 7, 7a) by instrument 60 intended for drilling openings. This instrument is installed on post 26 of bracket 20 to allow its reciprocating motion along post 26. Then the pneumatic motor 62 is switched on. The motor via the driving gear wheel 78 and two driven gear wheels 82 and 83 of reducing gear 71 causes two chucks 63 and 64 to rotate with drills 65 and 66 respectively (FIG. 7). By pushing in direction of arrow PUSH onto cover 74 of reducing gear 71 of instrument 60, the bit brace 61 is displaced along post 26 of bracket 20 toward anvil 10. This displacement is accompanied by compression of spring 161 and drills 65 and 66, which pass via slot 21 of bracket 20. Openings 8 and 9 are drilled simultaneously correspond to two parts 2 and 3 of the severed sternum 4 (FIGS. 7a, 11). The magnitude of displacement of instrument 60 along post 26 is limited by the length of slot 77 and the limiting pin 29 (FIGS. 7, 7a). With completion of drilling opening 8 and 9 (FIG. 11), compression on instrument 60 is stopped. It returns to its initial position by release of spring 161 (FIG. 7).
Mounting staples 5 in the through openings 8 and 9 in respective parts 2 and 3 of the severed sternum 4 (FIGS. 8, 8a) is performed by mechanism 100 of feeding and mounting staples. This is accomplished by locking mechanism 100 on post 26 of bracket 20. Cartridge 131 is filled by staples 5 through slots 133. When mounting the staples 5, the lomechaniis set above the through slot 21 of bracket 20. Staples 5 are forced from cartridge 131 onto stoppers 106 and 107 by spring 132 (FIG. 8). While pushing in direction of arrow PUSH on the short side 147 of the L-shaped lever 142, the lever 142 is displaced along two posts 143 and 144 towards anvil 10. This is accompanied by compression of springs 145 and 146. The long side 150 of the L-shaped lever 142 passes via the through slot 112 and presses out the first staple 5 from the through slot 133 of cartridge 131. This staple is introduced via the through slot 21 of bracket 20 by its two legs 6 and 7 corresponding to openings 8 and 9 in parts 2 and 3 respectively, of the severed sternum 4. With further pushing on the short side 147 of the L-shaped lever 142, legs 6 and 7 of staple 5 pass via openings 8 and 9. The form of legs 6 and 7 is changed with bending owing to slots 11 and 12 of anvil 10, while pulling together parts 2 and 3 of the severed sternum 4 (FIGS. 8a, 12).
1. A sternum closure device for securing two parts of a severed sternum having an external and internal side, said device comprising:
a. an anvil to be positioned on said internal side of said severed sternum, said anvil being used for forming the staples,
b. a bracket to be situated on said external side of said severed sternum,
c. an instrument for forming openings in said severed sternum, and
d. a mechanism for feeding and mounting said staples.
2. The sternum closure device as claimed in claim 1, wherein said anvil, which serves for forming the staples, is designed in the form of at least one slot.
a post having two openings and a pin mounted on said post, and said post operatively connected to the instrument for forming openings in the severed sternum,
a lock comprising of a housing having a slot, a spring actuated locking element having a handle, said handle being situated in the slot.
6. The sternum closure device as claimed in claim 5, wherein said bracket comprises at least one slot.
4122989 October 31, 1978 Kapitanov
4481960 November 13, 1984 Brooks
4585341 April 29, 1986 Woodfield
5462542 October 31, 1995 Alesi
Patent number: 6358270
Assignee: Haifa Surgical Instruments Ltd. (Haifa)
Inventor: Joseph Lemer (Haifa)
Attorney, Agent or Law Firm: Rashida A. Karmali
Application Number: 09/626,802
Current U.S. Class: Means To Draw Opposed Sides Of Incision Into Apposition (606/216); With Means To Assemble Plural Pieces Of Work (227/19); Surgical Stapler (227/175.1)