U.S. patent application number 11/800382 was filed with the patent office on 2007-09-06 for tack and tack applier.
This patent application is currently assigned to Tyco Healthcare Group LP. Invention is credited to Helmut Kayan.
Application Number | 20070208358 11/800382 |
Document ID | / |
Family ID | 29251218 |
Filed Date | 2007-09-06 |
United States Patent
Application |
20070208358 |
Kind Code |
A1 |
Kayan; Helmut |
September 6, 2007 |
Tack and tack applier
Abstract
A surgical tack is disclosed for securing a surgical mesh
material to body tissue. The tack includes a pair of legs and an
arcuate cross-member. A surgical tack applier is also disclosed,
for applying the surgical tack. The applier includes an elongate
tubular portion having a jacket with a main channel and a pair of
longitudinally extending sub channels. A rotatable drive rod having
a helical thread is coupled to the applier, and the sub channels
receive the legs of the tack. The helical thread receives the
arcuate cross-member of the surgical tack. Rotation of the drive
rod drives the tack from the distal end of the applier.
Inventors: |
Kayan; Helmut; (Redwood
City, CA) |
Correspondence
Address: |
UNITED STATES SURGICAL,;A DIVISION OF TYCO HEALTHCARE GROUP LP
195 MCDERMOTT ROAD
NORTH HAVEN
CT
06473
US
|
Assignee: |
Tyco Healthcare Group LP
|
Family ID: |
29251218 |
Appl. No.: |
11/800382 |
Filed: |
May 4, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10421170 |
Apr 22, 2003 |
7229452 |
|
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11800382 |
May 4, 2007 |
|
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60374672 |
Apr 22, 2002 |
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Current U.S.
Class: |
606/151 |
Current CPC
Class: |
A61B 17/0682 20130101;
A61F 2/0063 20130101; A61B 2017/00867 20130101; A61B 17/0644
20130101 |
Class at
Publication: |
606/151 |
International
Class: |
A61B 17/08 20060101
A61B017/08 |
Claims
1. A surgical tack for securing a mesh material to body tissue,
comprising: a pair of legs each having a proximal end and a free
distal end, the legs defining a centerline therebetween, the
centerline being substantially equidistant between the proximal
ends of the legs and between the free distal ends of the legs; and
an arcuate cross-member interconnected to the proximal ends of the
legs, wherein the free distal ends of the legs are spaced apart
from the centerline in a first condition and overlap the centerline
in a second condition.
2. The surgical tack of claim 1, wherein the pair of legs further
define a vertical plane.
3. The surgical tack of claim 2, wherein the arcuate cross-member
defines a plane at an angle with respect to the vertical plane
defined by the legs.
4. The surgical tack of claim 2, wherein the arcuate cross-member
is oriented substantially orthogonal to the vertical plane defined
by the pair of legs.
5. The surgical tack of claim 1, wherein the free distal ends are
approximated towards one another in the second condition.
6. The surgical tack of claim 1, wherein the free distal end of the
legs are provided with a pointed tip.
7. The surgical tack of claim 1, wherein the surgical tack is made
from a shape memory material.
8. The surgical tack of claim 1, wherein the surgical tack is made
from a bio-absorbable material.
9. The surgical tack of claim 1, wherein the bio-absorbable
material is selected from the group consisting of polyglycolic
acid, polylactic acid, and polyglycolide.
10. The surgical tack of claim 6, wherein the free distal end of
the legs are configured to deflect from the first condition to the
second condition upon a change in temperature.
11. A method of securing mesh material to body tissue, the method
comprising the steps of: providing a surgical tack in first
condition, the surgical tack including: a pair of legs each having
a proximal end and a free distal end, the legs defining a
centerline therebetween, the centerline being substantially
equidistant between the proximal ends of the legs and between the
free distal ends of the legs; and an arcuate cross-member
interconnected to the proximal ends of the legs, wherein the free
distal ends of the legs are spaced apart from the centerline in a
first condition and overlap the centerline in a second condition;
advancing the free distal ends of the legs of surgical tack through
surgical mesh and into tissue, and simultaneously deflecting the
free distal ends of the legs towards one another.
12. The method of claim 11, further including the step of removing
the surgical tack.
13. The method of claim 11, wherein the surgical tack is
bio-absorbable.
14. The method of claim 11, wherein the surgical tack is made from
a shape memory material.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority from and the benefits of
U.S. provisional application No. 60/374,672 filed on Apr. 22,
2002.
BACKGROUND
[0002] 1. Technical Field
[0003] The present disclosure relates to a novel tack and, more
particularly to a low profile tack having deformable legs for
securing a surgical mesh to body tissue. In addition, the present
disclosure relates to a surgical tack applier and, more
particularly to a surgical tack applier adapted to accommodate and
apply a plurality of the surgical tacks of this disclosure.
[0004] 2. Background of Related Art
[0005] A number of surgical procedures require instruments that are
capable of applying a surgical fastener to tissue in order to form
tissue connections or to secure objects to tissue. For example,
during hernia repair it is often desirable to fasten a surgical
mesh to the underlying body tissue. In certain hernias, such as
direct or indirect inguinal hernias, a part of the intestine
protrudes through a defect or an opening in the supporting
abdominal wall to form a hernial sac. The opening can be repaired
using an open surgical procedure where a relatively large incision
is made in the patient and the hernia is closed outside the
abdominal wall by suturing. Often, a mesh is attached with sutures
over the opening to provide reinforcement.
[0006] Less invasive surgical procedures are currently available
for hernia repair. In laparoscopic procedures, surgery is performed
in the abdomen through a small incision, while in endoscopic
procedures surgery is performed through narrow endoscopic tubes
inserted through small incisions in the body. Laparoscopic and
endoscopic procedures generally require long and narrow instruments
capable of reaching deep within the body and configured to form a
seal with the incision or tube through which they are inserted.
[0007] Currently, endoscopic techniques for hernia repair utilize
fasteners, such as surgical staples or clips, to secure the mesh to
the tissue thereby providing reinforcement of the repair and
providing structure for the encouragement of tissue ingrowth. These
staples or clips need to be compressed against the tissue and mesh
in order to secure the two together thereby requiring a tool which
is positioned on either side of the mesh and tissue in order to
deform the staple or clip.
[0008] Another type of fastener suited for use in affixing mesh to
tissue, during procedures such as hernia repair, is a coil fastener
having a helically coiled body portion terminating in a tissue
penetrating tip, in which the helical fastener is screwed into the
mesh and body tissue. An example of this type of fastener is
disclosed in U.S. Pat. No. 5,258,000 to Gianturco.
[0009] Yet another type of fastener suited for use in affixing
surgical mesh to body tissue is a surgical tack that is driven
through the surgical mesh and buried into the body tissue. In some
embodiments, the tack comprises a pair of substantially parallel
legs interconnected by a suture. Many different instruments for
applying the surgical tacks through the surgical mesh and into the
body tissue are known.
[0010] A need exists for a different surgical tack that firmly
secures a surgical mesh to underlying body tissue and is readily
removable without damaging the underlying tissue. A need exists for
a tack having a low profile that when applied, is substantially in
flush contact with the surface of the mesh. A need also exists for
a tacking apparatus adapted for securing a surgical mesh to
underlying body tissue utilizing the surgical tacks of the present
disclosure. A need exists for such a tack applier, wherein each of
a plurality of tacks can be applied with a single pull of a
trigger, and for a tack applier that can apply a plurality of tacks
seriatim through a replaceable tubular portion or jacket or
cartridge.
SUMMARY
[0011] This invention is directed to a surgical tack for securing a
mesh material to body tissue including a pair of legs where each
leg has a proximal end and a free distal end. The legs of the
surgical tack define a vertical plane. An arcuate cross-member is
interconnected to the proximal ends of the legs and defines a
centerline existing in the vertical plane where the centerline is
substantially equidistant between the proximal ends of the legs and
the arcuate cross-member defines a plane at an angle with respect
to the vertical plane defined by the legs. The arcuate cross-member
can be oriented substantially orthogonal to the vertical plane as
defined by the pair of legs. The distal ends the legs can be
provided with a pointed tip. The legs can be substantially parallel
to one another and substantially parallel to the centerline. At
least one leg of the legs does not have to be parallel to the
centerline. The surgical tack can be made from a shape memory
material or a bio-absorbable material, such as polyglycolic acid,
polylactic acid, and polyglycolide.
[0012] The invention is also directed to a surgical fastener
applier including a housing and an elongate tubular portion having
a proximal end and a distal end. The elongate tubular portion
further includes a bore therethrough and an elongate jacket having
an inner surface defining a longitudinal main channel extending
through the jacket, the main channel being adapted to receive a
surgical tack having a pair of depending legs and an arcuate
cross-member interconnecting proximal ends of the legs, the main
channel having an inner surface that includes a pair of
longitudinally extending sub channels formed along the inner
surface, each of the pair of sub channels being adapted to receive
at least a portion of a respective one of a pair of legs of the
surgical fastener therein. A rotatable drive rod having a proximal
end and a distal end extends axially through the jacket, the drive
rod including a longitudinally extending helical thread, the
helical thread defining a groove that is adapted to receive the
arcuate cross-member of the surgical fastener therein. A mechanism
is operatively connected to the drive rod for rotating the drive
rod to drive fasteners, legs first, from the distal end of the
drive rod and from the distal end of the tubular portion. The pair
of sub channels of the jacket can be diametrically opposed. The
jacket can include a plurality of pairs of sub channels formed
along the inner surface where each pair of sub channels can be at
least less than 180 degrees apart from one another. The mechanism
can include a trigger pivotably coupled to the surgical applier.
The applier may further include a mechanical deforming means
operatively coupled to a distal end of the jacket, where the
deforming means is adaptable to deflect the pair of legs of the
surgical fastener toward one another as the surgical fastener is
expelled from the distal end of the elongate tubular member. The
mechanical deforming means can include radially inwardly directed
lips.
[0013] This invention is further directed to a surgical fastener
system including a surgical fastener having a pre-formed
configuration and a formed configuration, the preformed
configuration including a pair of legs and an arcuate cross-member
interconnecting proximal ends of the legs and a surgical fastener
applier including a housing having a reciprocating mechanism
adapted for advancing the surgical fastener, an elongate tubular
portion extending from the housing and having a bore therethrough,
a jacket disposed within the bore and fixed to the elongate tubular
portion, the jacket having an inner surface defining a
longitudinally extending main channel extending therethrough and
including a pair of longitudinally extending sub channels formed
along the inner surface, each of the sub channels being configured
and adapted to receive at least a portion of a respective one of a
pair of legs of the surgical fastener in the pre-formed
configuration therein, and a rotatable drive rod operatively
coupled to the reciprocating mechanism and extending axially
through the main channel of the jacket, the drive rod including a
helical thread extending longitudinally along a length thereof, the
helical thread defining a groove therein, the groove being adapted
to receive the arcuate cross-member of the surgical fastener
therein and, by rotating, to advance the surgical fastener distally
through the tubular portion, the surgical fastener exiting the
distal end of the tubular portion in the formed configuration. The
drive rod can be adapted to receive a plurality of the surgical
fasteners in the pre-formed configuration. The drive rod can be
releasably attached to the reciprocating mechanism. The surgical
fastener applier can be adapted and configured for releasably
receiving a cassette, where the cassette can include a quantity of
the surgical fasteners in the pre-formed configuration. The
reciprocating mechanism may be a trigger pivotably coupled to the
housing. The applier can have a distal end and a mechanical
deforming means disposed at the distal end of the applier.
[0014] This invention is also directed to a surgical fastener
applier including a housing, an elongate tubular portion having a
proximal end and a distal end, the tubular portion having an
elongate channel, the channel having an inner surface and a pair of
longitudinally extending sub channels formed into and along the
inner surface, each of the sub channels being adapted to receive at
least a portion of a respective one of the legs of the surgical
fastener therein, a rotatable drive rod having a proximal end and a
distal end, the drive rod extending axially through the main
channel, the drive rod including a longitudinally extending helical
thread, the helical thread defining a groove that is adapted to
receive the arcuate cross-member of the surgical fastener therein,
and a mechanism operatively connected to the drive rod for rotating
the drive rod to drive fasteners legs first from the distal end of
the drive rod and from the distal end of the tubular portion. The
pair of sub channels of the jacket can be diametrically opposed.
The main channel can include a plurality of pairs of sub channels
formed along the inner surface thereof, wherein each pair of sub
channels can be at least less than 180 degrees apart from one
another. The mechanism may include a trigger pivotably coupled to
the surgical applier. The applier can include a mechanical
deforming means operatively coupled to a distal end of the elongate
tubular portion where the deforming means can be adapted to deflect
the pair of legs of the surgical fastener toward one another as the
surgical fastener is expelled from the distal end of the elongate
tubular member. The mechanical deforming means can include radially
inwardly directed lips.
[0015] It is an object of the present disclosure to provide a
surgical tack that overcomes drawbacks of prior art surgical
tacks.
[0016] It is an object of the present disclosure to provide a
surgical tack which secures a surgical mesh to underlying body
tissue and which is removable without damaging tissue.
[0017] It is another object of the present disclosure to provide a
surgical tack with a low profile for substantially flush contact
with the surface of the surgical mesh after installation.
[0018] It is another object of the present disclosure to provide a
surgical tack applier that is adapted to apply the surgical tacks
of the present disclosure to an operative site.
[0019] It is another object of the present disclosure to provide a
surgical tack applier that is adapted to prevent rotation of a
surgical tack as it is being expelled from the applier.
[0020] It is another object of the present disclosure to provide a
tack that can be easily removed from tissue to which it has been
applied.
[0021] These objects, together with other objects of the
disclosure, are met by the tack and tack applier described, shown,
and claimed herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] The accompanying drawings, which are incorporated in and
constitute a part of this specification, illustrate embodiments of
the disclosure and, together with a general description of the
disclosure given above, and the detailed description of the
embodiments given below, serve to explain the principles of the
disclosure.
[0023] FIG. 1 is a top perspective view of a surgical tack in
accordance with the present disclosure;
[0024] FIG. 2 is a front elevational view of the surgical tack
shown in FIG. 1;
[0025] FIG. 3 is a side elevational view of the surgical tack shown
in FIG. 1;
[0026] FIG. 4 is a top plan view of the surgical tack shown in FIG.
1;
[0027] FIG. 5 is a perspective view of a preferred embodiment of a
tack applier in accordance with the present disclosure;
[0028] FIG. 5A is a side cross-sectional view of the tack applier
of FIG. 5;
[0029] FIG. 6 is a partial cross-sectional perspective view of a
distal end of the tack applier shown in FIG. 6 with a surgical
tack, shown in FIG. 1, partially fired through a surgical mesh and
into body tissue;
[0030] FIG. 6A is a top cross-sectional view of the distal end of
the tack applier of FIG. 6 showing a single tack disposed in the
channels;
[0031] FIG. 7 is a partial cross-sectional perspective view of a
distal end of the tacker shown in FIG. 5 with a surgical tack shown
in FIG. 1 completely fired into the surgical mesh and the body
tissue;
[0032] FIG. 8 is a perspective view of a surgical tack, in
accordance with the present disclosure, as it would appear after
having been driven into body tissue;
[0033] FIG. 9 is a front elevational view of the surgical tack
shown in FIG. 8; and
[0034] FIG. 10 is a top plan view of the surgical tack shown in
FIG. 8.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0035] Preferred embodiments of the presently disclosed surgical
tack will now be described in detail with reference to the drawing
figures wherein like reference numerals identify similar or
identical elements. Referring now in detail to FIGS. 1-4, a
surgical fastener or tack in accordance with the present disclosure
is generally designated as 100. As used herein, the term "distal"
refers to that portion of the tack, tacker, or applier which is
further from the user while the term "proximal" refers to that
portion which is closer to the user.
[0036] Surgical tack 100 includes a pair of legs 102 and an arcuate
cross-member 104 whose ends are interconnected to or joined with
proximal ends 108 of legs 102. Legs 102 are substantially parallel
to one another in a spaced apart relationship and each terminates
at a distal end in a sharpened tip 106. While it is shown that each
leg 102 has a generally circular cross-sectional profile, other
cross-sectional profiles can be employed, e.g., rectangular,
triangular, oval, etc. Although each tip 106 is shown as sharpened
and conical, other tip profiles can be employed, e.g., rectangular,
angled, rounded or the like. A centerline 120 bisects cross-member
104 and is substantially equidistant from the proximal ends of 108
of legs 102.
[0037] Arcuate cross-member 104 is oriented such that a plane
defined by arcuate cross-member 104 is substantially orthogonal to
the planes defined by respective legs 102. In particular, with
reference to FIG. 3, the plane of arcuate cross-member 104 is
disposed at an angle .theta. with respect to the plane defined
between the pair of legs 102. In the preferred embodiment shown,
angle .theta. is 90.degree. such that the underlying surface of
cross-member 104 can rest flush against a surgical mesh and
underlying body tissue when surgical tack 100 is fully inserted
into the same. Less preferably, the plane of cross-member 104 can
be oriented at either an acute or an obtuse angle with respect to
the plane defined by legs 102.
[0038] As seen in FIG. 2, each leg 102 is disposed at an angle
.phi. with respect to the plane of arcuate cross-member 104. In the
preferred embodiment, angle .phi. is 90.degree.. However, it is
envisioned that the distal end of each leg 102 can be spaced
further apart than the distance between proximal ends, 108 of legs
102 (i.e., having an angle .phi. greater than 90.degree.), be
spaced closer together than the distance between proximal ends 108
(i.e., having an angle .phi. less than 90.degree.) or be shifted a
distance laterally with respect to proximal ends 108 (i.e., having
an angle .phi. of one leg which is less than 90.degree. and an
angle .phi. of the other leg which is greater than 90.degree.).
[0039] It is contemplated in the preferred embodiment that surgical
tack 100 is made from a semi-stiff pliable wire, such as titanium.
Examples of other materials that can be used in constructing
surgical tack 100 include titanium alloys, stainless steel, nickel,
chrome alloys, and any other biocompatible implantable metals.
Other options for materials include liquid crystal polymers such as
polyglycolic acid, polylactic acid, and polyglycolide
(poly(hydroxyacetic acid)) all of which are bioabsorbable
materials. It may be desired to coat the surgical tack, or a
portion thereof, with a biocompatible lubricious material that
provides for easier delivery of the surgical tack into the body
tissue.
[0040] It is further contemplated that surgical tack 100 can be
made of a shape memory alloy. The surgical tack would have a pair
of evenly spaced apart parallel legs while stored in the applying
apparatus and, as the surgical tack contacts the warm body tissue
or fluid during insertion, the shape memory of the surgical tack
material would cause the pair of legs of the surgical tack to be
drawn in toward one another. Alternately, the surgical tack made
from the shape memory alloy could cause the pair of legs of the
surgical tack to diverge apart from one another when the surgical
tack contacts the warm body tissue or fluid during insertion.
[0041] With respect now to FIGS. 5-7 and initially with respect to
FIG. 5, there is disclosed a preferred embodiment of a surgical
tack applier generally designated 200. Surgical tack applier 200 is
provided to secure a surgical mesh to tissue during surgical
procedures such as hernia repair. Tack applier 200 generally
includes a housing 202 and a handle portion 204 extending from
housing 202. A trigger 206 is pivotably connected to housing 202
with a free end of trigger 206 spaced from a free end of handle
portion 204.
[0042] Tack applier 200 (FIG. 5A) further includes an elongated
tubular portion 208 having a distal tip 234 and extending distally
from housing 202. Elongated tubular portion 208 is provided to
house or retain a plurality of surgical tacks 100, in accordance
with the present disclosure, for application to body tissue.
Elongated tubular portion 208 is preferably dimensioned to fit
through conventional cannula structures used in hernia repair
techniques. Proximal portion 202 includes handle portion 204 and an
actuator 232 operably connected to a drive rod 218 disposed inside
of elongated tubular portion 208 and having a plurality of surgical
tacks 100 mounted therein. In general, through the manipulation of
actuator 232, surgical tacks 100 are ejected, one by one, out of
distal tip 234 and into body tissue. Tack applier 200, hereinafter
described in more detail, is equally proficient in driving each of
the embodiments of surgical tacks 100 set forth above into tissue.
In the preferred embodiment of the proximal portion 202 of the tack
applier, a trigger 206 is pivotally connected about a midpoint 256
to handle portion 204. A first end 254 of trigger 206 is to be
configured for gripping by hand. A second end 260 of trigger 206 is
to be adapted for pivotally engaging a nut driver 262.
[0043] Nut driver 262 of tack applier 200 travels upon a high helix
lead screw 264 that is rotatably mounted within proximal portion
202. In the preferred embodiment, a longitudinal axis of high helix
lead screw 264 is coaxial with a longitudinal axis extending
through distal tip 234 of tack applier 200. Upon manipulation of
trigger 206, nut driver 262 travels along lead screw 264 causing it
to rotate. Through a connection of lead screw 264 to drive rod 218
(see FIG. 6), the action of lead screw 264 causes drive rod 218 to
rotate. Lead screw 264 may be connected to drive rod 218 by any
conventional means. For instance, lead screw 264 can have an
internal bore receiving and engaging an end of drive rod 218.
Further, the length of travel of nut driver 262 along lead screw
264 is chosen such that it causes the rotator to rotate a
predetermined number of times so that with each full throw of
trigger 206, one of the plurality of surgical tacks 100 is ejected
from tack applier 200.
[0044] Additionally, in the preferred embodiment, trigger 206
further includes a midsection extension 266. Pivotally attached to
midsection extension 266 of trigger 206 is contemplated to be a
spring loaded pawl 268 adapted to releasably engage gear teeth 278
formed in the interior of handle portion 204. Spring loaded pawl
268 is configured to prohibit trigger 206 from backstroking until
it has been completely depressed. Upon complete depression of
trigger 206, pawl 268 clears gear teeth 278 and the spring biasing
of pawl 268 rotates pawl 268 away from teeth 278, thereby allowing
trigger 206 to return to its undepressed condition.
[0045] In operation, upon complete depression of trigger 206, nut
driver 262 travels a pre-determined distance along lead screw 264,
causing drive rod 218 to rotate a pre-determined number of
revolutions corresponding to a number of turns needed to advance a
particular distalmost surgical tack 100 from distal end 234 of
tubular portion 208. As drive rod 218 rotates, surgical tacks 100
are retained in the groove of drive rod 218, advance distally in
the groove of drive rod 218 toward distal end 234, and the most
distal surgical tack 100 is threaded out of distal tip 234 of tack
applier 200 and into tissue. Moreover, where trigger 206 is only
partially depressed, spring loaded pawl 268 operates to hold
trigger 206 stationary and will continue to function to hold
trigger 206 stationary until trigger 206 has been completely
depressed. In this way, the delivery of surgical tacks 100 into
body tissue is controlled so that only one of the plurality of
surgical tacks 100 may be completely ejected out of tack applier
200 and pressed into body tissue at a time.
[0046] In the preferred embodiment, proximal portion 202 is
fabricated to have a reusable handle that can be re-sterilized, and
tubular portion 208 is made disposable. Thus, upon discharge of all
surgical tacks 100 from distal tip 234, tubular portion 208 can be
discarded and replaced. The handle could be reused up to a limited
number of procedures.
[0047] Referring now in particular to FIGS. 6, 6A, and 7, elongated
tubular portion 208 retains a plurality of surgical tacks 100 and
is adapted to drive surgical tacks 100 into tissue. As seen in
FIGS. 6 and 7, elongated tubular portion 208 can be or include a
generally tubular sleeve 210 defining a bore 212 therethrough, a
jacket 214 having a main channel 215 and which is preferably brazed
or welded to an inner surface 216 of tubular sleeve 210, and a
rotatable drive rod 218 having protruding helical threads and
extending concentrically longitudinally through tubular sleeve 210
and main channel 215 of jacket 214. While jacket 214 has been
disclosed as being brazed or welded within tubular sleeve 210, it
is envisioned that any means for fixing jacket 214 within tubular
sleeve 210 can be used, for example, peening, gluing, male/female
fixation or attachment, etc. Alternately, jacket 214 and tubular
sleeve 210 may be of unitary construction.
[0048] Main channel 215 of jacket 214 includes a pair of
longitudinally extending sub channels 220 formed into an inner
surface of main channel 215. Each sub channel 220 preferably
extends substantially the entire length of tubular sleeve 210 is
adapted to receive at least a portion of a respective one of legs
102 of surgical tack 100 therein. Preferably, sub channels 220 are
oriented 180 degrees apart. However, it is envisioned that the
radial angular orientation of the pair of sub channels 220 can be
any radial distance. Depending on the radial angular orientation of
the pair of sub channels 220, the radial angular length of arcuate
cross member 104 is selected such that each leg 102 of surgical
tack 100 is received in a respective one of said pair of sub
channels 220. Accordingly, it is envisioned that if the radial
angular length between the pair of sub channels 220 is less than
180 degrees, two pairs of longitudinally extending sub channels
(not shown) can be formed along the inner surface of jacket 214
such that two offset columns of surgical tacks 100 can be arranged
within and applied from the same elongate tubular portion 208, even
substantially simultaneously.
[0049] Another embodiment for providing a supply of surgical tacks
100 includes providing interchangeable or replaceable tubular
portions 208. Interchangeable tubular portions 208 may have
threaded connections for attachment to housing 202 of tack applier
200. In addition, quick-release connections that are known in the
art may also be used for attaching tubular portion 208 to tack
applier 200. An alternate embodiment includes cassettes or other
easily replaceable containers or cartridges containing a quantity
of surgical tacks 100 that are configured and adapted for feeding
surgical tacks 100 to drive rod 218. Preferably, the replaceable
items would include drive rod 218, with tacks 100 engaged its
helical threads and jacket 214 encompassing the tacks and rod.
Clips, screws, snaps, and other suitable means can be employed for
removably attaching jacket 214 to tubular portion 208.
[0050] Drive rod 218 preferably includes a thread 224 extending
longitudinally along the entire outer surface thereof. Thread 224
defines a helical groove 226 having a depth and a pitch selected to
receive arcuate cross member 104 of surgical tack 100 therein.
Preferably, surgical tacks 100 will be adapted such that each of
the pair of legs 102 is received in a respective sub channel 220 of
jacket 214 and such that the angle .phi. of the arcuate cross
member 104 with respect to legs 102 is equal to the pitch of thread
224.
[0051] As best shown in FIG. 6, a plurality of surgical tacks 100
may be arranged longitudinally along the length of drive rod 218
with each surgical tack 100 having a respective leg 102 positioned
within a respective sub channel 220 and arcuate cross member 104
positioned within helical groove 226. In this loaded position,
surgical tack 100 is defined as being in a pre-formed configuration
and ready for use.
[0052] The operation of tack applier 200 is best seen with
reference to FIGS. 6 and 7. Initially as seen in FIG. 6, the distal
end of elongate tubular portion 208 is pressed into contact against
surgical mesh M and body tissue T. Drive rod 218 is then rotated by
squeezing trigger 206 against handle portion 204. Since legs 102 of
surgical tack 100 are seated within sub channels 220 of jacket 214,
surgical tacks 100 are prevented from rotating together with drive
rod 218 within jacket 214 and tubular sleeve 210 and surgical tack
100 is moved distally and eventually expelled therefrom. Meanwhile,
arcuate cross member 104 of surgical tack 100 is seated within
helical groove 226 thereby causing surgical tack 100 to be advanced
distally through tubular sleeve 210 by the rotational force applied
to surgical tacks 100 by drive rod 218. Initially, as the pair of
legs 102 of surgical tack 100 is driven through surgical mesh M and
into body tissue T, the legs 102 remain parallel to one another.
Left alone, the legs will tend to remain in that disposition as
they are driven into the mesh and tissue. However, as surgical tack
100 advances further into body tissue T by exiting distal tip 234
of tubular portion 208, each leg 102 can be deflected by an optimal
radially inwardly tapered or concavely curved lip "L" (dashed line)
toward centerline 120 of surgical tack 100 defining a formed
configuration of surgical tack 100. Preferably, each tip 106
crosses centerline 120 thereby better securing surgical tack 100 in
body tissue T (see FIG. 7). In other words, by the pair of legs 102
crossing one another, surgical mesh M and body tissue T are trapped
therebetween. Since legs 102 are merely deflected towards one
another and not deformed into a different shape, surgical tack 100
can be withdrawn from body tissue T without or with minimum damage
thereto.
[0053] As discussed above, surgical tacks 100 can be formed of a
shape memory material such that, when legs 102 of surgical tack 100
contact the warm body tissue T, the legs will automatically deflect
towards one another or diverge away from each other. Alternatively,
it is envisioned that mechanical deflecting means, e.g., lip "L"
can be provided at the distal end of jacket 214 or of the elongated
tubular portion 208, to urge the pair of legs 102 of surgical tack
100, whether or not made of shape memory material, towards one
another as the pair of legs 102 begin to pass through surgical mesh
M and begin to penetrate body tissue T.
[0054] FIGS. 8-10 show a surgical tack 100, after having been
driven through surgical mesh M and into body tissue T and having
had its legs 102 deflected towards one another. While the legs 102
have been shown as overlapping one another, it is envisioned that
the pair of legs 102 can be simply brought closer to one
another.
[0055] It will be understood that various modifications may be made
to the embodiments disclosed herein. For example, it is envisioned
that surgical tack applier 200 is provided with a removable
cartridge (not shown) including a removable jacket having a drive
rod and a plurality of surgical tacks 100. The jacket can be
removable attached to elongated tubular member 208 by any suitable
means including snaps, clips, hooks, bolts, etc. Alternatively,
elongate tubular portion 208 of applier 200, that has expelled all
of its surgical tacks 100, is replaceable with another tubular
portion 208 filled with new surgical tacks 100. Thus, the above
description should not be construed as limiting, but merely as an
exemplification of preferred embodiments. Those skilled in the art
will envision other modifications within the scope and spirit of
the claims appended hereto.
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