Source: http://www.google.fr/patents/US4580712
Timestamp: 2017-10-17 09:51:19
Document Index: 73143885

Matched Legal Cases: ['art 210', 'art 280', 'art 280', 'art 210', 'art 210', 'art 210', 'art 280', 'art 210', 'art 280', 'art 280']

Brevet US4580712 - Surgical fastener applying apparatus with progressive application of fastener - Google Brevets
An apparatus for applying a relatively large number of surgical fasteners to body tissue, application of some fasteners is made to precede application of other fasteners in order to spread out and thereby reduce the peak fastener applying load or force....http://www.google.fr/patents/US4580712?utm_source=gb-gplus-shareBrevet US4580712 - Surgical fastener applying apparatus with progressive application of fastener
Numéro de publication US4580712 A
Numéro de demande US 06/662,679
Date de publication 8 avr. 1986
Date de dépôt 19 oct. 1984
Date de priorité 19 oct. 1984
Autre référence de publication CA1236743A, CA1236743A1, DE3581198D1, EP0198873A1, EP0198873A4, EP0198873B1, WO1986002253A1
Numéro de publication 06662679, 662679, US 4580712 A, US 4580712A, US-A-4580712, US4580712 A, US4580712A
Inventeurs David T. Green
Citations de brevets (15), Référencé par (550), Classifications (9), Événements juridiques (4)
Surgical fastener applying apparatus with progressive application of fastener
US 4580712 A
An apparatus for applying a relatively large number of surgical fasteners to body tissue, application of some fasteners is made to precede application of other fasteners in order to spread out and thereby reduce the peak fastener applying load or force.
1. Apparatus for applying a longitudinal array of surgical fasteners to body tissue comprising:
a plurality of surgical fasteners in a longitudinal array;
fastener pusher means for pushing the fasteners into the tissue along an axis transverse to the longitudinal array, the fastener pusher means including a first rigid longitudinal member parallel to and coextensive with the longitudinal array;
a second member for supplying the work required for pushing the fasteners into the tissue; and
first means for transmitting the work supplied by the second member to the first member so that one end of the first member initially moves parallel to the transverse axis substantially faster than the other end of the first member to cause the fasteners adjacent said one end of the first member to be applied to the tissue in advance of the fasteners adjacent said other end of the first member.
2. The apparatus defined in claim 1 wherein the first means includes second means for increasing the rate of motion of said other end of the first member parallel to the transverse axis as the fasteners are applied.
3. The apparatus defined in claim 2 wherein the first and second means cooperate so that both ends of the first member have moved substantially the same distance parallel to the transverse axis when all the work supplied by the second member has been transmitted to the first member.
4. The apparatus defined in claim 1 wherein the second member supplies the work required for pushing the fasteners into the tissue by moving with a component of motion substantially parallel to the longitudinal array.
third means for mounting the first member relative to the third member so that the first member can only move relative to the third member substantially parallel to the transverse axis, the second member being in sliding contact with the first member substantially parallel to the longitudinal array;
the first means further including first and second cam and cam follower assemblies connected between the second and third members and respectively located adjacent said one and said other end of the first member for causing the second member to move relative to the third member with a component of motion substantially parallel to the transverse axis as the second member moves relative to the third member substantially parallel to the longitudinal array.
6. The apparatus defined in claim 5 wherein the initial portion of the cam surface traversed by the cam follower of the first cam and cam follower assembly is more nearly parallel to the transverse axis than the corresponding cam surface portion of the second cam and cam follower assembly.
7. The apparatus defined in claim 6 wherein after the initial cam surface portion of the first cam and cam follower assembly, there is a portion of said cam surface which is more nearly parallel to the longitudinal array than the corresponding cam surface portion of the second cam and cam follower assembly.
This invention relates to apparatus for applying surgical fasteners to body tissue, and more particularly to apparatus for applying a relatively large number of such fasteners substantially simultaneously.
Instruments for applying relatively large numbers of surgical fasteners simultaneously or substantially simultaneously are known as shown, for example, by Hirsch et al. U.S. Pat. No. 3,275,211, Green U.S. Pat. No. 4,402,444, and Green U.S. Pat. No. 4,402,445. The fasteners may take the form of metal surgical staples as shown in the Hirsch et al. patent, or they may be initially two-part non-metallic surgical fasteners as shown in the Green U.S. Pat. No. 4,402,445. The term "surgical fasteners" is used herein as a generic term for both of these types of fasteners.
Some surgical procedures require the application of a very large number of surgical fasteners. For example, the device shown in the Green U.S. Pat. No. 4,402,444 is adapted to apply 50, 60, or even more fasteners in four closely spaced rows. If all of these fasteners are driven exactly simultaneously, the peak force required can be very large. This necessitates an instrument design which is very strong and correspondingly costly. It also may make this instrument relatively difficult to operate.
It is therefore an object of this invention to reduce the peak force required in instruments which apply relatively large numbers of surgical fasteners.
This and other objects of the invention are accomplished in accordance with the principles of the invention by providing surgical fastener applying apparatus including means for causing one end of a rigid member in the fastener driving assembly to initially move faster in the fastener driving direction than the other end of that member initially moves so that application of the fasteners adjacent said one end of the member precedes application of the fasteners adjacent said other end of the member. In this way the fastener applying load is distributed over time so that the peak force required is reduced as compared to the peak force required for applying all of the fasteners exactly simultaneously.
FIG. 1 is a perspective view of surgical fastener applying apparatus which can be modified in accordance with the principles of this invention.
FIG. 2 is a partial, partly sectional, elevational view of the apparatus of FIG. 1 showing an initial stage in the operating cycle of that apparatus.
FIG. 4 is a view similar to FIG. 2 but showing a subsequent stage in the operating cycle.
FIG. 13 is a view similar to FIG. 10 showing how the apparatus of FIGS. 1-12 can be modified in accordance with the present invention.
Among the environments in which the present invention can be employed are the articulated surgical fastener applying instruments shown in concurrently filed U.S. patent application Ser. No. 662,677. One of those instruments (shown in FIGS. 1-12 herein, which are respectively identical to FIGS. 1-12 in the above-mentioned concurrently filed application) will first be described in detail. Then, modification of that device in accordance with the present invention will be described with reference to FIG. 13.
As shown in FIG. 1, a surgical fastener applying instrument 10 which can be modified in accordance with the present invention includes proximal actuator assembly 20, distal fastener applying assembly 200, and intermediate shaft assembly 100.
Fastener holding part 210 is connected to the distal end of shaft assembly 100 just beyond an articulation or joint 150 in the shaft assembly. In the depicted apparatus, joint 150 comprises a spherical ball 152 (FIG. 2) rotatably secured in a complementary socket 160. Joint 150 allows fastener applying assembly 200 to rotate about each of three mutually orthogonal axes 102, 104, and 106, all of which intersect at the center of ball 152. A few of the possible positions of fastener applying assembly 200 are suggested in phantom lines in FIG. 1. The proximal end of shaft assembly 100 may also be rotatably mounted in actuator assembly 20 for additional rotational motion of assemblies 100 and 200 about axis 102, which is the longitudinal axis of the instrument. Other than joint 150 and the rotational mounting of shaft assembly 100 in actuator assembly 20, shaft assembly 100 is substantially rigid transverse to its longitudinal axis. Shaft assembly 100 is also substantially rigid parallel to axis 102.
When the fasteners are to be applied, safety latch 90 is pivoted down as indicated in phantom lines in FIG. 3. Fastener actuator lever 60 is then pivoted toward handle 30 as also shown in phantom lines in FIG. 3. This causes fastener holding assembly 210 to simultaneously or substantially simultaneously drive the legs of a plurality of metal surgical staples 202 through tissue 12 and against anvil part 280 as shown in FIG. 11. Anvil part 280 clinches or crimps the ends of the staple legs to secure the staples in the tissue. (Although metal staples are employed in the depicted apparatus, it will be understood that two-part plastic fasteners, such as those shown in Green U.S. Pat. No. 4,402,445, can alternatively be used.) The tissue fastening procedure is now complete.
Cam bar 230 is disposed in a proximal-facing channel in pusher actuator member 240 (see FIG. 6). The distal face of cam bar 230 bears on and is slidable along the bottom of this channel in member 240. Pusher actuator member 240 is disposed between two parallel, laterally spaced frame members 250 (FIG. 5) of fastener holding part 210. The distal surface of pusher actuator member 240 bears on the proximal ends of pusher members 260 which have pusher fingers 262 extending into apertures 272 in fastener holder 270 behind staples 202. Pusher actuator member 240 is constrained to move substantially parallel to the axis along which staples 202 are driven by pusher members 260. This constraint is provided by guide pins 242 which extend laterally outward from member 240 into guide slots 252 in frame members 250. It should be noted that pusher actuator member 240 can also pivot about pins 242.
The above-described apparatus can be modified in accordance with the present invention as shown in FIG. 13. Instead of the four identical cam slots 254 employed in the apparatus of FIGS. 1-12, in FIG. 13 the two upper cam slots 354 (only one of which is visible in FIG. 13) may be identical to one another but different from the two identical lower cam slots 454 (only one of which is visible in FIG. 13). In particular, each of lower cam slots 454 has an initial portion 454a which is more steeply inclined in the distal direction than the corresponding initial portion 354a of upper cam slots 354. This causes the lower end of cam bar 230 and the lower end of pusher actuator member 240 to initially move more rapidly in the distal direction than the upper ends of those members. This in turn causes the staples 202 near the bottom of fastener holding part 210 to advance more rapidly toward tissue 12 than the staples 202 near the top of fastener holding part 210. Accordingly, the ends of the staple legs do not all reach anvil part 280 at the same time. Rather, the staples near the bottom of fastener holding part 210 reach anvil part 280 first and begin to clinch against the anvil part before the staples near the top. The maximum force or "peak load" for clinching each staple therefore tends to occur at a different time than the peak loads for clinching the other staples. This distributes over time the individual staple-clinching peak loads, thereby reducing the aggregate total peak load required to drive the staples.
Following their initial portions 354a and 454a, each of cam slots 454 has an intermediate portin 454b which is substantially parallel to or slightly less steeply inclined in the distal direction than the corresponding intermediate portions 354b of cam slots 354. This maintains the condition of the apparatus in which the lower portions of elements 230 and 240 are more distally advanced than the upper portions of those elements until most or all of staples 202 have at least begun to clinch and have therefore passed their peak load requirement.
The final segments 354c and 454c of cam slots 354 and 454 may be somewhat more steeply inclined in the distal direction than the intermediate segments. These final segments are traversed by cam follower pins 232 during the final compression of staples 202 when the force required is substantially less than the peak load. The angle of inclination of cam slot segments 354c may differ from the angle of inclination of cam slot segments 454c so that when both cam follower pins 232 have reached the end of their travel, they will both have moved the same distal distance from their starting positions. This assures that, although during the staple driving stroke members 230 and 240 are deliberately inclined relative to the (vertical) longitudinal axis of anvil part 280, the staple driving stroke ends with members 230 and 240 substantially parallel to that axis. This provides uniform compression of all of the staples.
Although the invention has been illustrated in the context of surgical fastener applying instruments which apply two parallel rows of surgical fasteners, the greater the number of fasteners to be applied, the greater the advantages of the invention become. For example, the invention is even more beneficial in instruments which apply four parallel rows of surgical fasteners as shown, for example, in Green U.S. Pat. No. 4,402,444.
It is to be understood that the invention is not limited in application to surgical fastener applying apparatus of the type shown in FIGS. 1-12 herein. For example, although that apparatus has an articulated shaft assembly, the present invention is equally applicable to instruments with other types of shaft assemblies such as transversely flexible or completely rigid shaft assemblies. Similarly, although metal surgical staples 202 are employed in the depicted apparatus, other types of surgical fasteners, such as two-part plastic fasteners like those shown in Green U.S. Pat. No. 4,402,445, could be used instead. Also, either the metal staples or the plastic fasteners employed can be either biologically inert or biologically absorbable, as is now well known to those skilled in the art.
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Classification aux États-Unis 227/19
Classification internationale A61B17/12, A61B17/28, A61B17/072
Classification coopérative A61B2017/2929, A61B17/072, A61B2017/07214, A61B2017/2927
19 oct. 1984 AS Assignment
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:GREEN, DAVID T.;REEL/FRAME:004331/0892
2 oct. 1989 FPAY Fee payment