Surgery – Instruments – Sutureless closure
Reexamination Certificate
1999-07-12
2001-01-09
Buiz, Michael (Department: 3731)
Surgery
Instruments
Sutureless closure
Reexamination Certificate
active
06171330
ABSTRACT:
The invention relates to a pneumatic surgical instrument for individual distribution and placement of connecting or fastening means, such as a staple, nail or anchor, or other elements of diverse forms, made of absorbable or nonabsorbable materials, used in surgery for fastening, stapling, ligaturing or joining purposes.
Staplers are known which comprise, as described in GB-A-1,328,841, EP-A-0,041,022, and more especially EP-A-0,192,418, a handle body with attachment piece on which an interchangeable terminal stapling element is joined, consisting of a magazine of staples, means for individual distribution of these staples and means for shaping and closure of a staple, the body of the handle containing a pressurized gas reservoir, a pneumatic circuit, a pneumatic thrustor, means for joining to the aforementioned distribution means, and a trigger mechanism.
In EP-A-0,192,418 and U.S. Pat. No. 4,569,469, the handle body is in the form of a pistol handle and the trigger mechanism consists of a pneumatic distributor with slide, which, arranged on a circuit extending from the gas reservoir to the actuating thrustor for the distribution means, is controlled by a push-button protruding from the handle body and on the same side as the attachment piece, like the trigger on a pistol.
In instruments of this type, the activation of the trigger mechanism by the surgeon generates reaction forces which, although slight, are multiplied by the lever arm formed between the longitudinal axis of the handle body and that of the activating push-button. The result of this is that the activation of the push-button by the surgeon generates a tilting moment tending to distance the end of the stapler, distributing the staple, from the stapling zone and thus necessitates manual checking on the part of the surgeon in order to avoid the staple being badly positioned. This disadvantage is even greater in instruments used in celioscopy since the slight displacement of the handle is amplified at the free end of the terminal element, which is in this case much longer, and leads to poor positioning of the connection or staple.
Another disadvantage of the current stapling instruments is that they are for single use only, that is to say they are discarded after use, for the reason that they cannot be correctly sterilized. The purchase price of such instruments increases the cost of the surgical intervention.
The object of the present invention is to remedy this by making available a pneumatic surgical instrument for distribution and placement of connecting or fastening means, not exerting any moment of reaction, affording precise and reliable placement, and of which at least the body can be reused after sterilization.
To this end, in the instrument according to the invention, the handle body constitutes one of the branches of a T, of which the other branch is formed by its attachment piece which is continued by the interchangeable element, and this body includes, on the side toward the interchangeable element, indentations for positioning the fingers of the hand, said indentations being arranged on either side of the attachment piece, and of which one, for positioning the index finger, is equipped with a bore through which there protrudes the push-button for activating the pneumatic distributor.
The body of the instrument has a T-shape which can be comfortably gripped in the surgeon's hand in the same way as a traditional corkscrew top, and which permits precise positioning of the end of the interchangeable element on the zone of the human body requiring stapling, ligaturing, or fastening of an external body. The activation of the push-button for triggering the operation has no effect on the position of the terminal element, first because this push-button directly activates the slide of a pneumatic distributor, causing no reaction force, and also because the force exerted by the surgeon is applied in parallel and counter to the force of application of the end of the terminal element on the operating zone and hence tends, at the very most, to reduce this application force, without modifying its direction.
The omission of any mechanical means which are polluting and difficult to sterilize, in combination with the simple and compact structure of the handle body, makes it possible for this handle body to be sterilized without any problem, and hence to be reused, thereby reducing the cost of using it, in a surgical intervention, to the purchase price of the disposable interchangeable element.
The indentations improve gripping of the handle and, by giving a constant position for each of the fingers of the hand, obliges the surgeon to adopt the same position at all times, which prevents any drift which could lead to tilting moments or to a change in the position of the end of the terminal element.
The attachment piece of the handle body is advantageously cylindrical and includes locking means able to cooperate with complementary means carried by the cylindrical body of the interchangeable element, these means being formed by longitudinal tongues mounted on the body with the possibility of radial elastic clearance, and of which one end is linked to the attachment piece, while the other end is equipped with an indentation protruding substantially radially outward, this indentation being able, on the one hand, to engage in one of the seats formed radially in the tubular body of the interchangeable element and, on the other hand, to cooperate with a frustoconical groove formed in an unlocking ring mounted so as to slide on the rear end of the body.
This method of joining between the handle body and the interchangeable terminal element makes it easier to replace this element, either for adapting its structure and the connecting or fastening means it contains to the operation which is to be performed, or for replacing it when the magazine no longer contains any connecting or fastening means, or, finally, for replacing it with an uncontaminated element, for example, for a new operation carried out reusing the handle body, after sterilization of the latter.
REFERENCES:
patent: 4569469 (1986-02-01), Mongeon et al.
patent: 4943294 (1990-07-01), Knapp
patent: 5257632 (1993-11-01), Turkel et al.
patent: 0 041 022 A1 (1981-12-01), None
patent: 0085931 (1983-02-01), None
patent: 0 085 931 A2 (1983-08-01), None
patent: 0 182 418 A2 (1986-08-01), None
patent: 1 328 841 (1973-09-01), None
Buiz Michael
Ho Tan-Uyen Thi
Oliff & Berridg,e PLC
Sofradim Production
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