Powered surgical tack applicator

Abstract

A powered surgical tack applicator is disclosed. A handle assembly for use with a surgical tack applicator includes an actuation assembly and an articulation rod assembly configured to articulate an articulation portion of the surgical tack applicator. The actuation assembly includes a motor, an actuation rod, and an actuation switch configured to actuate the motor. The actuation rod has a first end operably coupled to an output shaft of the motor to rotate simultaneously therewith, and a second end operably coupled to a loading unit of the surgical tack applicator such that rotation of the actuation rod ejects a surgical tack from the loading unit. The articulation rod assembly includes an articulation rod operably coupled to an articulation portion of the surgical tack applicator such that axial displacement of the articulation rod causes articulation of the articulation portion, and an articulation rod operably coupled to the articulation rod.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of and priority to U.S. Provisional Patent Application No. 62 / 734,290, filed September 21, 2018, the entire disclosure of which is incorporated herein by reference. Technical Field

[0003] The present disclosure relates to surgical instruments and, more particularly, to surgical tack applicators for attaching a prosthesis in place in the repair of a tissue defect, such as an inguinal hernia. Background Art

[0004] Various surgical procedures require instruments that can apply fasteners to tissues to form tissue connections or to fix objects to tissues. For example, during hernia repair, it is usually necessary to fasten mesh to tissues. In some hernias, such as direct or indirect inguinal hernias, part of the intestine protrudes through the abdominal wall defect to form a hernial sac. The defect can be repaired using an open surgical procedure, in which a relatively large incision is made and the hernia is closed by suturing outside the abdominal wall. The mesh is attached to the opening of the abdominal wall with sutures to provide reinforcement. However, this can also be achieved by using minimally invasive surgical fasteners (e.g., surgical tacks).

[0005] Therefore, there is a need for a surgical applicator that incorporates the ability for its loading unit to articulate while preventing premature tack ejection and timing issues when attempting to eject the tack. Summary of the invention

[0006] The present disclosure describes a device for applying surgical tacks that demonstrates a practical approach that meets performance requirements and overcomes the usability challenges of applying surgical tacks through surgical mesh and into tissue.

[0007] According to an embodiment of the present disclosure, a handle assembly for use with a surgical tack applicator includes an actuation assembly and an articulation rod assembly. The actuation assembly includes a motor, an actuation rod, and an actuation switch configured to actuate the motor. Specifically, the actuation rod has a first end operably connected to an output shaft of the motor to rotate simultaneously therewith, and a second end operably connected to a loading unit of the surgical tack applicator such that rotation of the actuation rod ejects the surgical tack from the loading unit. The articulation rod assembly is configured to articulate an articulation portion of the surgical tack applicator. The articulation rod assembly includes an articulation rod operably connected to the articulation portion of the surgical tack applicator such that axial displacement of the articulation rod causes the articulation portion to articulate, and an articulation rod operably connected to the articulation rod.

[0008] In one embodiment, the actuation assembly may further include a processor configured to control the motor.

[0009] In another embodiment, the actuation assembly may further include an optical motor encoder configured to count rotations of the motor output shaft to ensure that an appropriate number of rotations are made to insert the surgical tack into tissue. The optical motor encoder may be operably connected to the actuation rod and the processor.

[0010] In another embodiment, the actuation assembly may further include an encoder wheel configured to ensure proper timing of the distal tip of the actuation rod relative to the loading unit.

[0011] In yet another embodiment, the actuation assembly may further include a light emitting diode coupled to the processor to indicate the ejection status of the surgical tack from the loading unit.

[0012] In yet another embodiment, the articulation rod may define a transverse bore sized to receive a drive pin coupled to the articulation lever. The drive pin may define a bore sized to receive an actuation rod therethrough.

[0013] In one embodiment, the handle assembly may further include a battery pack electrically coupled to the motor and the processor.

[0014] In one embodiment, the actuation assembly may further include a piezoelectric element configured to provide an audible sound for proper ejection of the surgical tack from the loading unit.

[0015] In another embodiment, the handle assembly may further include a housing pivotably supporting the hinge rod.

[0016] In yet another embodiment, the hinge lever may include a housing portion and an engagement portion slidably disposed on an engagement surface of the housing.

[0017] In yet another embodiment, the engagement surface may define an arcuate profile to enable the engagement portion to slide in an arc.

[0018] In yet another embodiment, the articulation lever assembly may include a biasing member configured to bias the engagement portion of the articulation lever away from the housing of the handle assembly.

[0019] In another embodiment, the housing may include a stop portion configured to fix the position of the articulated lever relative to the housing of the handle assembly.

[0020] In one embodiment, the articulated lever assembly may further include an articulated pivot arm pivotably secured to the housing of the handle assembly. The articulated pivot arm may be configured to receive a biasing member therebetween.

[0021] In another embodiment, the articulated pivot arm may be received in a housing portion of the articulated lever.

[0022] In yet another embodiment, the articulation rod may define a cavity sized to receive the actuation rod therethrough.

[0023] According to another aspect of the present disclosure, a surgical tack applicator includes a handle assembly and an elongated member. The handle assembly includes an actuation assembly and an articulated rod assembly. The actuation assembly includes a motor, an actuation rod having a first end operably coupled to an output shaft of the motor for simultaneous rotation therewith, and an actuation switch configured to actuate the motor. The articulated rod assembly includes an articulation rod and an articulation rod operably coupled to the articulation rod. The elongated member extends distally from the handle assembly. The elongated member includes a loading unit having a plurality of surgical tacks and an articulation portion configured to pivot relative to a longitudinal axis defined by the elongated member. The articulation rod is operably coupled to the articulation portion of the elongated member such that axial displacement of the articulation rod causes the articulation portion to articulate. The second end of the actuation rod is operably coupled to the loading unit such that rotation of the actuation rod ejects the surgical tack from the loading unit. The actuation rod extends through the articulation rod.

[0024] In one embodiment, the actuation assembly may further include a processor configured to control the motor.

[0025] In another embodiment, the actuation assembly may further include an optical motor encoder configured to count rotations of the motor output shaft to ensure that an appropriate number of rotations are made to insert the surgical tack into tissue. The optical motor encoder may be operably connected to the actuation rod and the processor.

[0026] In another embodiment, the actuation assembly may include an encoder wheel configured to ensure proper timing of the distal tip of the actuation rod relative to the load cell. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] Various aspects of the present disclosure are described below with reference to the accompanying drawings, which are incorporated into and constitute a part of this specification, in which:

[0028] Figure 1 is a perspective view of a handle assembly of a powered surgical tack applicator according to an embodiment of the present disclosure;

[0029] Figure 2 is a partial perspective view of an elongated member of a powered surgical tack applicator;

[0030] Figure 3 for Figure 1 A partial perspective view of a loading unit of a surgical tack applicator illustrating the coil separated from the inner tube;

[0031] Figure 4is a longitudinal cross-sectional view of the distal tip of a powered surgical tack applicator illustrating implantation of a surgical tack through a surgical mesh into underlying tissue;

[0032] Figure 5 For use with Figure 1 A perspective view of a surgical mesh used with a powered surgical tack applicator of the type shown in FIG. 1 , illustrating the use of a plurality of surgical tacks to anchor the surgical mesh to underlying tissue;

[0033] Figure 6 For the case where half of the shell is removed Figure 1 a side view of a handle assembly;

[0034] Figure 7 For the parts to be separated Figure 1 An exploded perspective view of a handle assembly;

[0035] Figure 8 for Figure 1 A partial side view of a handle assembly;

[0036] Fig. 9 A part of the housing is removed Figure 1 A partial side view of a handle assembly;

[0037] Fig.10 for Figure 1 A partial perspective view of a handle assembly of FIG. 1 , illustrating an actuation assembly;

[0038] Fig.11 is a perspective view of a handle assembly for use with a powered surgical tack applicator according to another embodiment of the present disclosure;

[0039] Fig.12 For the case where half of the shell is removed Fig.11 a perspective view of a handle assembly; and

[0040] Fig.13 for Fig.11 A side view of the handle assembly. DETAILED DESCRIPTION

[0041] Embodiments of the surgical instrument of the present disclosure are described in detail with reference to the accompanying drawings, wherein similar reference numerals refer to identical or corresponding elements in each of the several views. As used herein, the term "distal" will generally refer to that portion of an instrument, device, apparatus, or component that is farther from a user, and the term "proximal" will refer to that portion of an instrument, device, apparatus, or component that is closer to a user. In the following description, well-known functions or configurations are not described in detail in order to avoid obscuring the present disclosure with unnecessary detail.

[0042] refer to Figures 1 to 4, a handle assembly for use with a surgical tack applicator for applying surgical tacks 10 suitable for insertion into a surgical mesh "M" and a tissue "T" is generally shown as a handle assembly 200. The surgical tack applicator generally includes a handle assembly 200, an elongated member 50 having a hinged portion 60, and a loading unit 30 selectively connected to the distal end of the elongated member 50. The loading unit 30 is electromechanically coupled to the handle assembly 200 and supports a plurality of surgical tacks 10.

[0043] The loading unit 30 includes an outer tube 32 defining a lumen (not shown), a spiral or coil 36 fixedly disposed within the outer tube 32, and an inner tube 38 rotatably disposed within the coil 36. The inner tube 38 defines a lumen therethrough and includes a first portion 38a and a splined second portion 38b. The second portion 38b of the inner tube 38 is grooved, thereby defining a pair of teeth 38b1 and a pair of channels 38b2. The second portion 38b of the inner tube 38 is configured to support a plurality of surgical tacks 10 within the inner tube 38. Specifically, the surgical tacks 10 are loaded into the loading unit 30 such that a pair of opposing threaded sections 112a of the surgical tacks 10 extend through the corresponding channels 38b2 of the second portion 38b of the inner tube 38 and are slidably disposed within the grooves of the coil 36, and the pair of teeth 38b1 of the second portion 38b of the inner tube 38 are disposed within a pair of grooved sections 116a of the surgical tacks 10. In use, when the inner tube 38 rotates about its longitudinal axis “XX” relative to the coil 36 , the pair of teeth 38 b 1 of the inner tube 38 transmits the rotation to the surgical tack 10 and propels the surgical tack 10 distally when the head threads 114 a of the surgical tack 10 engage with the coil 36 .

[0044] Special References Figure 2 The surgical tack applicator includes an articulated rod assembly 300 (operably coupled to a handle assembly 200) supported in the Figure 6 ) is connected to the articulated portion 60. The articulated portion 60 may include a drive assembly (not shown) having a slidable tube and an articulated arm pivotally connected to the slidable tube. The articulated rod assembly 300 is connected to the slidable tube so that when the articulated rod assembly 300 is actuated, the slidable tube is displaced through the elongated member 50. The longitudinal translation of the slidable tube moves the articulated arm so that the loading unit 30 can be articulated ( Figure 3 Reference may be made to U.S. Patent Nos. 7,867,252 and 8,282,670, and U.S. Patent Application Publication No. 2016 / 0166255, each of which is incorporated herein by reference in its entirety, for a more detailed discussion of the structure and operation of a surgical tack applicator including an articulating portion and a loading unit.

[0045] Reference now Figure 6 The handle assembly 200 includes a housing 202, an articulated portion 60 ( Figure 2 ), an actuation assembly 400 configured to eject the surgical tack 10 out of the loading unit 30 of the elongated member 50, and a battery pack 440 removably attached to the housing 202. The housing 202 includes an ergonomic structure that provides comfort, ease of use, and intuitiveness, so that when the clinician grasps the housing 202, for example, the thumb can be positioned to slide the articulated rod assembly 300, and, for example, the index finger can be positioned to trigger the actuation switch 404 of the actuation assembly 400. Actuation of the actuation assembly 400 ejects the surgical tack 10 ( Figure 4 ) Pop-up loading unit 30 through mesh "M" ( Figure 4 ) and enters human tissue "T".

[0046] refer to Figure 6 and 7 The articulated rod assembly 300 includes an articulated rod 310 and an articulated rod 360 operably coupled to the articulated rod 310. The articulated rod 310 is operably coupled to the articulated portion 60 ( Figure 2 ) connection. The hinge rod 310 is connected by defining a channel 304 ( Figure 8 ) is slidably supported on the housing 202 of the handle assembly 200, and the channel 304 is configured so that the axial displacement of the articulation rod 310 passing therethrough can cause the articulation portion 60 ( Figure 2 Specifically, the articulation rod 310 has a channel 317 ( Figure 8 The hinge rod 310 further defines a transverse hole 314 that is dimensioned to receive a hinge drive pin 316 that is coupled to the hinge rod 360 .

[0047] Continue to refer Figure 6 and 7 , the hinge rod 360 includes a housing portion 362 and an engagement portion 364 that slidably engages the engagement surface 204 of the housing 202. The engagement surface 204 has an arcuate profile so that the engagement portion 364 can travel in an arc, for example. The housing portion 362 is disposed within the housing 202 and is sized to accommodate hinge pivot arms 366a, 366b that fit together to accommodate a biasing member 368 therebetween. Each hinge pivot arm 366a, 366b defines a first hole 370a, 370b, a second hole 372a, 372b, and a slot 374a, 374b. The first hole 370a, 370b is sized to accommodate a hinge pivot pin 378 ( 378 ) that pivotally couples the hinge pivot arms 366a, 366b to the housing 202. Figure 8 ). The second hole 372a, 372b is sized to receive the hinge drive pin 316 extending through the transverse hole 314 of the hinge rod 310. In such a configuration, when the hinge pivot arms 366a, 366b pivot about the hinge pivot pin 378, the hinge drive pin 316 causes the hinge rod 310 to axially displace. The hinge drive pin 316 defines a transverse hole 380 sized to receive the actuation rod 402 of the actuation assembly 400 therethrough. The slots 374a, 374b of the hinge pivot arms 366a, 366b are sized to cam receive a cam pin 384 biased away from the hinge pivot pin 378 by a biasing member 368 sandwiched between the hinge pivot arms 366a, 366b.

[0048] Reference now Figure 7 and 8 , the housing portion 362 of the articulation rod 360 is sized to accommodate the mating articulation pivot arms 366a, 366b. The housing portion 362 defines a slot 363 sized to cam accommodate a cam pin 384 that is cam slidable in the slots 374a, 374b of the articulation pivot arms 366a, 366b. In addition, the housing portion 362 includes teeth 367 configured to engage the stop portion 208 of the housing 202 to prevent the articulation rod 360 from moving relative to the housing 202, thereby locking the axial position of the articulation rod 310, which in turn locks the articulation portion 60 ( Figure 2 ). In this type of configuration, the hinge lever 360 is biased away from the hinge pivot pin 378, so that the teeth 367 of the housing portion 362 engage the stop portion 208. When the engagement portion 364 of the hinge lever 360 is pressed toward the housing 202, the teeth 367 move away from the stop portion 208, allowing the clinician to engage the engagement surface 204 ( Figure 6 ) to slidably move the engagement portion 364 on the surgical tack applicator, thereby enabling the articulated portion 60 of the surgical tack applicator to be articulated to a desired orientation.

[0049] Reference now Fig. 9 , the articulation lever assembly 300 further includes a cam wedge 350 having first, second and third portions 350a, 350b, 350c configured to cam engage a cam pin 384 that is cam-slidable in the slots 374a, 374b of the articulation pivot arms 366a, 366b and the slot 363 of the articulation lever 360. The first, second and third portions 350a, 350b, 350c correspond to the respective stop sections 208a, 208b, 208c of the stop portion 208. In this way, as the cam pin 384 advances along the first, second and third portions 350a, 350b, 350c of the cam wedge 350, the articulation clearance is reduced.

[0050] Return to reference Figure 6 and 7 The actuation assembly 400 includes a loading unit 30 (operably coupled to a surgical tack applicator) Figure 2 ) connected to the actuating rod 402, the motor 420, and the motor 420 configured to actuate the motor 420 to eject the surgical flat head nail 10 ( Figure 4 ) of the actuator assembly 400, a printed circuit board 430 containing a microprocessor (not shown) to control the actuator assembly 400, and a battery pack 440 removably attached to the housing 202 and electrically connected to the motor 420 and the printed circuit board 430. The proximal end of the actuator rod 402 is operably coupled to the output shaft of the motor 420 to rotate simultaneously therewith, so that when the clinician triggers the actuator switch 404, the motor 420 is actuated to apply axial rotation to the actuator rod 402. The distal end of the actuator rod 402 is operably coupled to the inner tube 38 ( Figure 3 ) to rotate with it.

[0051] Reference now Fig.10 , the actuation assembly 400 may further include an encoder assembly 410 operably connected to the actuation rod 402 and the processor of the printed circuit board 430. The encoder assembly 410 may include, for example, an optical motor encoder 405 configured to maintain an accurate count of the rotations of the motor output shaft or the actuation rod 402 to ensure that the appropriate number of rotations are made to insert the surgical tack 10, for example, into the mesh "M" and into the tissue "T" ( Figure 4 ). In addition, the encoder assembly 410 may further include an encoder wheel 407, such as a single notch, configured to ensure that the distal end of the actuator rod 402 is relative to the loading unit 30 ( Figure 2 ) for proper timing. The encoder assembly 410 may further include a light emitting diode ("LED") indicator 409 to indicate the ejection status of each surgical tack 10. For example, a green light may indicate proper application of the surgical tack 10 through the mesh "M" and into the tissue "T", and a red light may indicate improper application of the surgical tack 10, for example due to an erroneous signal from the optical motor encoder 405 or the single notch encoder wheel 407. Alternatively, the encoder assembly 410 may further include a piezoelectric element 411 ( Figure 6 ), which is used to provide an audible sound for proper application of the surgical tack 10.

[0052] Brief reference Figure 6 The handle assembly 200 may further include a release lever 450 slidably attached to the housing 202. The release lever 450 may be operably coupled to the loading unit 30 ( Figure 2 ) so that when the release lever 450 is pulled, the loading unit 30 is disengaged from the elongated member 50 ( Figure 2 ).

[0053] In use, the loading unit 30 is operably mounted to the distal end of the elongated member 50. The loading unit 30 is introduced into the target surgical site in a non-articulated state. The clinician can remotely articulate the loading unit 30 relative to the longitudinal axis "XX" to enter the surgical site. Specifically, the clinician can slide the engagement portion 364 of the articulation rod 360 along the engagement surface 204 of the housing 202. When the articulation rod 310 is axially displaced, the loading unit 30 moves to an articulated orientation relative to the central longitudinal axis "XX". In addition, the clinician can position the surgical mesh "M" adjacent to the surgical site. Once the surgical mesh "M" is properly positioned on the surgical site, the clinician can trigger the actuation switch 404 to eject the surgical tack 10 through the mesh "M" and into the tissue "T". Although the actuation rod 310 is configured for axial displacement, it is further contemplated that the actuation rod 1310 may be rotatably supported by the rotor 1370 such that the actuation rod 1310 outputs an axial rotation that may be utilized by the loading unit 30 to achieve articulation thereof, as may be seen with reference to FIG. Figures 11 to 13 It is further contemplated that the hinge assembly 400 may further include a transmission assembly to selectively apply the rotation of the motor 420 to the actuation rod 1310 .

[0054] Those skilled in the art will appreciate that the structures and methods specifically described herein and shown in the accompanying drawings are non-limiting exemplary embodiments, and that the description, disclosure, and drawings should be interpreted only as illustrative specific embodiments. Therefore, it should be understood that the present invention is not limited to the precise embodiments described, and that those skilled in the art may implement various other changes and modifications without departing from the scope or spirit of the present disclosure.

[0055] In addition, the elements and features shown or described in conjunction with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and such modifications and variations are also included in the scope of the present disclosure. Therefore, the subject matter of the present disclosure is not limited by what has been specifically shown and described.

Claims

1. A handle assembly for use with a surgical tack applicator, comprising: An actuation assembly comprising: Electric motor; an actuating rod having a first end operably coupled to the output shaft of the motor for simultaneous rotation therewith, and a second end operably coupled to a loading unit of the surgical tack applicator such that rotation of the actuating rod ejects a surgical tack from the loading unit; and an actuation switch configured to actuate the motor; and an articulating rod assembly configured to articulate an articulating portion of the surgical tack applicator, the articulating rod assembly comprising: an articulation rod operably coupled to the articulation portion of the surgical tack applicator such that axial displacement of the articulation rod causes the articulation portion to articulate; and an articulated rod operably coupled to the articulated bar, wherein the articulation rod defines a transverse hole, and the articulation rod assembly further comprises a drive pin received in the transverse hole and coupled to the articulation rod, the drive pin defining a hole in which the actuation rod is received, The articulation rod defines a cavity therethrough, and the actuation rod extends through the articulation rod within the cavity. 2 . The handle assembly of claim 1 , wherein the actuation assembly further comprises a processor configured to control the motor.

3. The handle assembly of claim 2, wherein the actuation assembly further comprises an optical motor encoder configured to count rotations of the motor output shaft to ensure that an appropriate number of rotations are made to insert a surgical tack into tissue, the optical motor encoder operably connected to the actuation rod and the processor.

4. The handle assembly of claim 2, wherein the actuation assembly further comprises an encoder wheel configured to ensure proper timing of the distal tip of the actuation rod relative to the loading unit.

5. The handle assembly of claim 2, wherein the actuation assembly further comprises a light emitting diode coupled to the processor to indicate an ejection status of the surgical tack from the loading unit.

6. The handle assembly of claim 2, wherein the handle assembly further comprises a battery pack electrically coupled to the motor and the processor.

7. The handle assembly of claim 1, wherein the actuation assembly further comprises a piezoelectric element configured to provide an audible sound for proper ejection of the surgical tack from the loading unit.

8. The handle assembly of claim 1, further comprising a housing pivotably supporting the hinge rod.

9. The handle assembly of claim 8, wherein the articulated lever comprises a housing portion and an engagement portion slidably disposed on an engagement surface of the housing.

10. The handle assembly of claim 9, wherein the engagement surface defines an arcuate profile to enable the engagement portion to slide in an arc.

11. The handle assembly of claim 10, wherein the articulation lever assembly includes a biasing member configured to bias the engagement portion of the articulation lever away from the housing of the handle assembly.

12. The handle assembly of claim 11, wherein the housing includes a stop portion configured to fix a position of the hinge rod relative to the housing of the handle assembly.

13. The handle assembly of claim 11, wherein the articulated lever assembly further comprises an articulated pivot arm pivotably secured to the housing of the handle assembly, the articulated pivot arm being configured to receive the biasing member therebetween.

14. The handle assembly of claim 13, wherein the articulated pivot arm is received in the housing portion of the articulated lever.

15. A surgical tack applicator comprising: A handle assembly comprising: An actuation assembly comprising: Electric motor; an actuator rod having a first end operably coupled to the output shaft of the motor for simultaneous rotation therewith; and an actuation switch configured to actuate the motor; An articulated rod assembly comprising: an articulation rod defining a lumen therethrough, said actuation rod extending through said articulation rod within said lumen; and an articulation lever operably coupled to the articulation rod; and an elongated member extending distally from the handle assembly, the elongated member including a loading unit having a plurality of surgical tacks, and an articulation portion configured to pivot relative to a longitudinal axis defined by the elongated member, wherein the articulation rod is operably coupled to the articulation portion of the elongated member such that axial displacement of the articulation rod causes the articulation portion to articulate, and a second end of the actuation rod is operably coupled to the loading unit such that rotation of the actuation rod ejects surgical tacks from the loading unit, the actuation rod extending through the articulation rod, The articulation rod defines a transverse hole, and the articulation rod assembly further includes a drive pin received in the transverse hole and coupled to the articulation rod, the drive pin defining a hole in which the actuation rod is received.

16. The surgical tack applicator of claim 15, wherein the actuation assembly further comprises a processor configured to control the motor.

17. The surgical tack applicator of claim 16, wherein the actuation assembly further comprises an optical motor encoder configured to count required rotations of the motor output shaft to ensure that an appropriate number of rotations are made to insert a surgical tack into tissue, the optical motor encoder operably connected to the actuation rod and the processor.

18. The surgical tack applicator of claim 17, wherein the actuation assembly further comprises an encoder wheel configured to ensure proper timing of the distal tip of the actuation rod relative to the loading unit.

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