Surgical screw delivery system and method

Abstract

Various powered screw drivers with screw delivery systems are disclosed. In some embodiments, a device attachable to the powered screw driver includes a housing, a cartridge barrel having multiple barrel chambers, each capable of holding a screw and a drive bit assembly, and a drive shaft assembly. The drive shaft is aligned with the barrel chambers. The drive shaft has a handle sleeved thereon. The handle is coupled to a barrel cam connected to the cartridge barrel. Moving the handle proximally to a retracted position and then distally to a neutral position rotates the cartridge barrel such that the drive shaft is aligned with the barrel chamber adjacent to the previous barrel chamber. Moving the handle distally to a forward position causes the screw to come forward from the port.

Description

[Technical field]

[0001] This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 269,149, entitled "Surgical Screw Delivery System," filed March 10, 2022, the entire contents of which are incorporated herein by reference. [Background technology]

[0002] This application relates to a system for delivering fasteners, such as screws, to a powered medical device, such as a surgical screw driver. The system may include a screw driver attachment that sequentially and / or reciprocally loads screws onto a distal end of a screw driver shaft, allowing each screw to be inserted into a patient with a more efficient workflow.

[0003] In current surgery, the time required for a surgeon to sequentially insert screws into a patient is increased by the time it takes for each screw to be loaded into the driver bit of a surgical screw driver by a technician / nurse on the back table. In addition to the act of loading each screw, time is also lost because the screw driver must be passed from the surgeon to the technician / nurse for loading or reloading the screw and then returned from the technician / nurse to the surgeon after the screw has been loaded. Summary of the Invention [Means for solving the problem]

[0004] There is a need to improve workflow efficiency in surgery because longer times under general anesthesia increase the cost of surgery time and the risk to the patient. Improving workflow efficiency in surgery can reduce the time of surgery or other procedures, which can provide significant benefits. Reducing surgery or procedure time reduces the time that the patient can be exposed to infection. Additionally, reducing surgery or procedure time makes the physician, medical staff, and space (e.g., surgery chamber) available for other procedures and tasks. Surgeons may be financially motivated to improve their workflow efficiency. The time-saving benefits are immediately apparent to the surgeon at low initial cost and do not require expensive studies or trials to prove efficacy. This reduces development costs and risks.

[0005] The screw delivery systems described herein may address one or more of the aforementioned concerns or other concerns. In some embodiments, an apparatus forming part of the screw delivery system or powered screw driver includes a housing configured to be attached to a screw driver body. A shaft assembly may be coupled with the housing. The shaft assembly may have a proximal end and a distal end. A screw cartridge may be coupled with the housing. The screw cartridge includes a cartridge barrel. The cartridge barrel may have a plurality of barrel chambers therein, each configured to hold a screw, and a distal end of the shaft assembly may be substantially coaxially aligned with one of the plurality of barrel chambers.

[0006] In some embodiments, the housing of the device has a cavity, which may be an open cavity (e.g., open to the surrounding environment). The screw cartridge and shaft assembly may be disposed within the cavity of the housing. In some embodiments, the cartridge barrel of the device may be cylindrical with a barrel centerline approximately parallel to the longitudinal direction of the screw delivery system. Multiple barrel chambers may be formed through the cartridge barrel and may be angularly and uniformly distributed within the cartridge barrel, and the distance from each barrel chamber to the barrel centerline may be equal.

[0007] In some embodiments, the cartridge barrel is rectangular in shape with a barrel centerline approximately parallel to the longitudinal axis, and a plurality of barrel chambers are formed through the cartridge barrel, the centerline of each barrel chamber being approximately parallel to the cartridge barrel centerline, and the distance between adjacent barrel chambers being equal.

[0008] In some embodiments, the screw cartridge of the device includes a cylindrically shaped nosepiece substantially coaxial with the cartridge barrel. The nosepiece can have a curved groove thereon and / or can have a cartridge shaft that can be substantially coaxial with the cartridge barrel. Each end of the cartridge shaft can be removably coupled with a snap mechanism disposed about the housing.

[0009] In some embodiments, the shaft assembly of the device comprises a distal shaft at a distal end and a proximal shaft at a proximal end. The distal shaft can have a handle, such as a loading handle, sleeved thereon. The handle can allow the distal shaft to rotate within the handle. A cam pin can be coupled to the handle and engaged with a curved groove in the revolving cam, and moving the handle proximally to a retracted position and then distally to a neutral position can rotate the cartridge barrel about the barrel centerline to a position such that the shaft assembly is substantially coaxially aligned with the next barrel chamber in the cartridge barrel. In some embodiments, a compression spring can be sleeved on the distal shaft proximal to the handle and bias the handle toward the distal end on the distal shaft.

[0010] In some embodiments, the port may be disposed about the distal end of the housing and may be substantially coaxial with the drive shaft assembly, allowing a screw to be delivered through the port.

[0011] In some embodiments, the distal and proximal shafts can be extensibly coupled by a shaft coupler such that the shaft assembly is longitudinally extensible but rotationally fixed, and moving the handle distally to a forward position causes the distal end of the distal shaft to be at least partially pushed into the port.

[0012] In some embodiments, each screw may be configured to be held in a barrel chamber that is pre-attached to the drive bit. The shaft-to-drive bit coupler may be disposed in the port. Both the inner surface of the port and the outer surface of the shaft-to-drive bit coupler may be correspondingly shaped (e.g., cylindrical) to allow the shaft-to-drive bit coupler to rotate within the port. The shaft-to-drive bit coupler may have a prismatic shaped internal channel that matches the external prismatic shape of the distal end of the distal shaft and the external prismatic shape of the drive bit. In some embodiments, the prismatic shape is hexagonal.

[0013] In some embodiments, the proximal shaft can be coupled with at least one bearing, the at least one bearing being coupled to a housing allowing the proximal shaft to rotate freely therein. The proximal end of the proximal shaft may be flattened.

[0014] In some embodiments, the device may be detachably attached to a power screwdriver, power drill, or other surgical or medical handpiece, the power screwdriver further comprising a hand grip, a screwdriver body, and a control panel including user inputs and light signals.

[0015] In certain aspects, the technology includes a method for delivering a plurality of screws, e.g., sequentially or serially. The method can include moving a handle connected to a cartridge and shaft module to a forward position, thereby moving one of the plurality of screws to a forward position, the cartridge and shaft module being detachably integrated with the powered screw driver disclosed above. The method can further include inserting the screw into the substrate, moving the handle proximally to a retracted position, moving the handle distally to a neutral position, and repeating the steps of moving the handle to an advanced position, inserting each screw, moving the handle proximally to a retracted position, and moving the handle distally to the neutral position. The method can further include determining that the screw cartridge is exhausted (e.g., by determining that the screw has not exited the distal end of the port), and replacing the screw cartridge with another screw cartridge.

[0016] In certain aspects, the disclosed surgical screw delivery system includes a housing having a longitudinal axis and a chamber, a handle assembly having a handle and a shaft, the handle assembly configured to slide in a direction generally parallel to the longitudinal axis between a first position and a second position, and a cartridge having a plurality of barrel chambers, each barrel chamber configured with a screw and a bit, the cartridge configured to be removably received within the chamber. The surgical screw delivery system is configured to rotationally interlock from one barrel chamber to another such that the cartridge is aligned with the shaft whenever the handle moves from the first position to the second position.

[0017] Certain features of the present disclosure are described below with reference to the drawings. The illustrated embodiments are for illustrative purposes and not for limiting the embodiments. Various features of different disclosed embodiments can be combined to form further embodiments, which are also part of this disclosure. [Brief description of the drawings]

[0018] [Figure 1] FIG. 1 is a perspective view of one embodiment of a screw delivery system with a screw loaded from a screw cartridge onto a drive shaft and ready for operation. [Diagram 2] FIG. 2 is a perspective view of the screw delivery system of FIG. 1 without a screw loaded onto the drive shaft. [Diagram 3] FIG. 2 is a front view of the screw delivery system of FIG. 1. [Figure 4] FIG. 2 is a top view of the screw delivery system of FIG. 1. [Diagram 5] 2 is a cross-sectional view of the screw delivery system of FIG. 1 showing certain internal structures. [Figure 6] FIG. 2 is a perspective view of a cartridge and shaft module that removably forms part of the screw delivery system of FIG. 1, with a screw loaded and protruding from the delivery port, the cartridge and shaft module having a housing that holds the screw cartridge and drive shaft assembly. [Figure 7] FIG. 7 is a front view of the cartridge and shaft module of FIG. [Figure 8] FIG. 7 is a top view of the cartridge and shaft module of FIG. [Figure 9] FIG. 7 is a cross-sectional view of the cartridge and shaft module of FIG. 6, showing certain internal structures. [Figure 10] FIG. 7 is a perspective view of the cartridge and shaft module of FIG. 6 with a plurality of screws and drive bit assemblies loaded into the screw cartridge. [Figure 11] FIG. 11 is an exploded view of the cartridge and shaft module of FIG. 10 showing certain subassemblies and components. [Figure 12] FIG. 11 is a perspective view of the cartridge and shaft module of FIG. 10 with the housing removed and the handle in a neutral position. [Figure 13]FIG. 11 is a perspective view of the cartridge and shaft module of FIG. 10 with the housing removed and the handle in a retracted position. [Figure 14] FIG. 11 is a perspective view of the cartridge and shaft module of FIG. 10 with the housing removed and the handle and distal shaft in a forward (also called extended) position. [Figure 15] FIG. 11 is a perspective view of a screw cartridge disposed in the cartridge and shaft module of FIG. [Figure 16] FIG. 16 is an exploded view of the screw cartridge of FIG. 15. [Figure 17] FIG. 11 is a perspective view of a drive shaft assembly disposed in the cartridge and shaft module of FIG. [Figure 18] FIG. 18 is an exploded view of the drive shaft assembly of FIG. [Figure 19] FIG. 13 is a perspective view of another embodiment of a screw delivery system with a screw loaded from a screw cartridge into a drive shaft and ready for operation. [Figure 20] FIG. 20 is a perspective view of the screw delivery system of FIG. 19 with the screw shaft in a neutral position. [Figure 21] FIG. 21 is a partial cross-sectional view of the screw delivery system of FIG. 20, showing some of the internal structure of the screw cartridge and drive shaft. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0019] Various features and advantages of the disclosed fastener delivery technology will become more apparent from the following description of several specific embodiments shown in the figures. These embodiments are intended to illustrate the principles of the present disclosure. However, the present disclosure should not be limited to only the illustrated embodiments. Features of the illustrated embodiments can be modified, combined, removed, and / or substituted as would be apparent to one skilled in the art in light of the principles disclosed herein. No feature, structure, or step disclosed herein is essential or required.

[0020] 1. Overview of the First Embodiment Referring to FIG. 1, a perspective view of an exemplary embodiment of a screw delivery system or powered screw driver 100 is shown. The screw delivery system 100 comprises a hand grip 110, a control panel 120, a screw driver body 130, and a cartridge and shaft module 200. In FIG. 1, a longitudinal direction or axis 102 points from a proximal end 104 of the screw delivery system 100 that faces a user (e.g., a surgeon) during a surgical or medical procedure, to a distal end 106 that is the distal end of the screw and shaft module 200. The cartridge and shaft module 200 may be removably attached to the screw delivery system 100. The cartridge and shaft module 200 comprises a screw cartridge 220 configured to be loaded with a plurality of screw and drive bit assemblies 230, and a drive shaft assembly 260. Each of the drive bit assemblies may include a screw 232 and a drive bit 234. The control panel 120 may be located on top of the screw driver body 130. The control panel 120 may include a number of control buttons 122 and a number of LED light signals 124 that indicate the status of the screw delivery system 100 .

[0021] 1, the screw and drive bit assembly 230 (including the screw 232 and the drive bit 234) extends from the screw delivery port 204 and is ready to be inserted into a patient. In this state, a handle 272 can be seen disposed near a first end, such as the distal end 104, or distal end, of the cartridge and shaft module 200. The handle 272 may have a cap or knob thereon for ease of gripping.

[0022] FIG. 2 shows another perspective view of the screw delivery system 100 of FIG. 1 in different operating states from different viewing angles. The difference is that the screw and drive bit assembly 230 does not extend from the delivery port 204 and the handle 272 is located toward the proximal end of the cartridge and shaft module 200. In some embodiments, the housing 210 can have a through slot (see FIG. 5) on the bottom surface to allow the handle 272 to move from the distal position shown in FIG. 1 and the proximal position shown in FIG. 2. As shown, the operating switch 126 can be located on the distal underside of the screw driver body 130 to cooperate with the control panel 120 to operate the screw delivery system 100. For example, in some embodiments, the operating switch 126 can have lateral and / or proximal and distal toggle positions to facilitate various operating functions, including forward and rearward shaft rotation and starting / stopping the screw delivery system 100.

[0023] 3 and 4 are front and top views of the screw delivery system 100 in the operative state shown in FIG. 1 with the screw and drive bit assembly 230 extending from the delivery port 204. As shown, at least the screw (e.g., the distal end) is exposed, which may facilitate accurate placement of the screw or other benefits. As shown, in some embodiments, the entire length of the screw is exposed. The figures further show certain components and features of the screw delivery system 100 in different viewing directions.

[0024] 5 is a cross-sectional view of the screw delivery system 100 of FIG. 1, revealing various internal structures. The interior of the hand grip 110 may house one or more printed circuit boards (PCBs) for operation of the screw delivery system 100, and a battery pack 116 held in a battery box 114. The battery box 114 may have a door that can be opened to access the battery pack 116. The battery pack 116 may include a rechargeable battery that can be charged either inside or outside the hand grip 110, or a replaceable non-rechargeable battery. The hand grip 110 may include a port for connecting to an external power source.

[0025] Inside the screwdriver body 130 there may be a chamber 132 that holds a motor 134, which may be powered by a battery pack 116 and operated by an operating switch 126 and a control button 122 on a control panel 120 in cooperation with the PCB 112. There may be a gripping mechanism in the motor chamber 132 to hold the motor 134 securely so that it does not move rotationally or longitudinally relative to the screwdriver body 130 during operation. A motor shaft 136 extends from the motor 134 at a distal end and couples to a drive shaft assembly 260 by a shaft coupler 138.

[0026] As shown in FIG. 5, the cartridge and shaft module 200 can be coupled to a distal end of the screw driver body 130. In various embodiments, the cartridge and shaft module 200 is removably coupled to the screw driver body 130. For example, the cartridge can be easily removed (e.g., when the screw in the cartridge is deployed) and replaced with another cartridge. In some embodiments, the coupling can be separable and keyed such that the cartridge and shaft module 200 is connected with the screw driver body 130 in a fixed rotational orientation. Details of the cartridge and shaft module 200 and details of the operation of the screw delivery module 200 are further disclosed in subsequent sections.

[0027] 2. Cartridge and shaft module 6, a perspective view of the cartridge and shaft module 200 in the operational state shown in FIGS. 1 and 3-5 is shown, with the screw 232 extending from the delivery port 204 with the integrated drive bit 234. The cartridge and shaft module 200 includes a housing 210 having a cavity 218 that holds the screw cartridge 220 and the drive shaft assembly 260. As shown, the cavity 218 may be open, for example, at the top. A first channel 214 and a second channel 216 may be formed in the wall of the cavity 218 at the distal and proximal ends, respectively, and are configured to receive a cartridge shaft 236 that forms part of the screw cartridge 220.

[0028] 7 and 8 are front and top views of the cartridge and shaft module 200 in the state shown in FIG. 6, showing certain details in different viewing directions. FIG. 9 is a cross-sectional view of the cartridge and shaft module 200 of FIG. 6, revealing certain internal structures. As can be seen, the distal and proximal ends of the cartridge shaft 236 are disposed in the first channel 214 and the second channel 216, respectively. Each of the first channel 214 and the second channel 216 can include a locking mechanism (e.g., elastic snap feature, detent, etc.) for receiving and retaining the end of the cartridge shaft 236. In some embodiments, the locking mechanism can be formed as part of the channel, for example if the cavity 218 of the housing 210 is made of a plastic material. In some embodiments, the locking mechanism can include a spring, for example, a sheet metal or plastic leaf spring. Once snapped into the first channel 214 and the second channel 216, the cartridge shaft 236 can rotate freely with minimal friction.

[0029] 9 also illustrates that the drive shaft assembly 260 is extended by a shaft adapter 266 that can be extendibly coupled to a distal shaft 262 at its distal end and a proximal shaft 264 at its proximal end. When extended, a head portion 263 of the distal shaft 262 can abut and / or contact (e.g., abut) the drive bit 234, with the engagement interface disposed within an internal channel 208 of the shaft-to-drive bit adapter 206. As described below, the internal channel 208 has an inner shape that matches the shape of the drive bit 234 and the shape of the distal shaft head 263, such that rotational motion and torque can be transmitted from the shaft assembly 260 to the drive bit 234 via the shaft-to-drive bit adapter 206.

[0030] 6-9 also show a neck portion 213 formed on the protruding portion 212 at the proximal end of the housing 210. The neck portion 213 can help to facilitate coupling between the cartridge and shaft module 200 and the screw driver body 130.

[0031] Details of the screw cartridge 220 and the drive shaft assembly 260 are further described in later sections.

[0032] 10, a perspective view of the cartridge and shaft module 200 is shown with the screw and drive bit assembly 230 held in the screw cartridge 220. The handle 272 may be positioned toward the proximal end of the cartridge and shaft module 200 as compared to the state shown in FIGS. 6-9. In the state shown in FIG. 10, the screw 232 does not extend from the delivery port 204 as shown in FIG. 2. Again, the handle 272 may have a cap or knob for ease of gripping.

[0033] FIG. 11 is an exploded view of the cartridge and shaft module 200 in the state of FIG. 10. It can be seen that the screw cartridge 220 includes a cartridge barrel 222. The cartridge barrel 222 may be cylindrical with a circular side bounded by a flat surface at a distal end and another flat surface at a proximal end. The cartridge barrel 222 may have a plurality (e.g., 2, 3, 4, 5, 6, or more) of barrel chambers 224 formed over a length generally parallel to a centerline of the cartridge barrel 222. The centerline of the cartridge barrel 222 may be generally parallel to the longitudinal direction or axis 102. In some embodiments, the cartridge barrel 222 may contain more than three or another number of barrel chambers 224.

[0034] 11, each of the barrel chambers 224 can be configured to hold a screw and drive bit assembly 230 within an interior space. The screw and drive bit assembly 230 can be consumed (e.g., used) during a screw delivery operation. An open slit 225 connects each barrel chamber 224 radially outward.

[0035] 11 , the cartridge barrel 222 is integral with the revolver cam 240 and the cartridge shaft 236, both of which are substantially coaxial with the cartridge barrel 222. Thus, when the cartridge barrel 222 is integral, the cartridge barrel 222 and the revolver cam 240 can rotate together with the cartridge shaft 236 about the axis of the cartridge shaft 236. The drive shaft assembly 260 comprises a distal shaft 262 having a sleeve-mounted handle 272 and a spring (e.g., a compression spring) 276, and a proximal shaft 264.

[0036] The housing cap 202 is disposed at the distal end of the housing 210 with a port 204 shown projecting distally. In some embodiments, the port 204 comprises a loading port. The port 204 can have an internal port channel 205. The internal port channel 205 can be generally parallel to the longitudinal direction 102 and can run the length of the port 204 and the housing cap 202. The shaft and drive bit adapter 206 is disposed in the internal port channel 205 as shown in FIGS. 11 and 9. When assembled, there is a small gap between the shaft and drive bit adapter 206 and the internal port channel 205 of the port 204, allowing the shaft and drive bit adapter 206 to rotate within the internal port channel 205 with minimal resistance. The shaft and drive bit adapter 206 can have an internal adapter channel 208 formed therein. As described below, the adapter channel 208 has a shape that matches the shape of the head of the drive bit 234 and the distal head 263 of the distal shaft 262. Thus, as the distal shaft 262 advances to push the screw and drive bit 230 distally into the adapter channel 208, the shaft and drive bit adapter 206 can facilitate or ensure that rotational motion and torque from the distal shaft 262 is effectively transmitted to the drive bit 262 and then to the screw 232.

[0037] 12-14 below, the housing 210 has been removed to reveal certain details of the cartridge and shaft module 200 when the handle 272 is in three different positions during operation of the screw delivery system 100. In FIG. 12, the handle 272 is in a neutral position corresponding to the state depicted in FIGS. 2, 10, and 11, as previously described. In the neutral position, the compression spring 276 is naturally extended and the head 263 of the distal shaft 262 is adjacent to or in contact with the proximal flat surface of the cartridge barrel 222. As can be seen, the distal shaft 262 is generally aligned with one of the barrel chambers 224 in the cartridge barrel 222. Thus, the head 263 of the distal shaft 262 is in contact with and / or substantially coaxially aligned with the head of the drive bit 234 held within the barrel chamber 224. In this neutral position, the screw cartridge 220 is not restricted by the drive shaft assembly 260 and / or can be removed from the cavity 218 of the housing 210, for example, to reload the screw and drive bit assembly 230. As shown in FIG. 12, a cam pin 296 coupled to the handle 272 is engageable with one of a plurality of linear groove portions 246 (e.g., four linear groove portions) on the cylindrical side of the revolving cam 240.

[0038] FIG. 13 shows the retracted position of the handle 272. In this position, the compression spring 276 can be compressed in the retracted length and / or the handle 272 can be positioned toward the proximal shaft 264. This retracted position of the handle 272 is usually caused by moving the handle 272, which slides on the distal shaft 262, toward the proximal end, e.g., by the surgeon or assistant pulling, resulting in compression of the compression spring 276. As seen in FIG. 13, in the retracted position, the cam pin 296 can be positioned in engagement with the proximal end of the second curved groove portion 248. During the process of pulling the handle 272, the cam pin 296 first moves proximally along the straight groove portion 246 and then enters the first curved groove portion 247. The curvature of the first curved groove portion 247 causes the nosepiece cam 240 to rotate about the nosepiece shaft 236. The cam pin 296 then enters the second curved groove portion 248 until it stops at the proximal end of the second curved groove portion 248 .

[0039] When the handle 272 is released from the retracted position, the compression spring 276 expands, urging the handle 272 toward the neutral position shown in FIG. 12. However, the cam pin travels distally along the second curved groove portion 248 and into the straight groove portion 246. The curvature of the second curved groove portion 248 causes the nosepiece 240 to further rotate about the nosepiece shaft 236. As the handle 272 returns to the neutral position, the rotation of the nosepiece cam 240 stops the cartridge barrel 222 in a rotated position, so that the head 263 of the distal shaft 262 is substantially coaxially aligned with the barrel chamber 224 adjacent to the previous barrel chamber 224 before the handle 272 moves to the retracted position. Thus, the action of moving the handle 272 to the retracted position and then back to the neutral position allows the distal shaft 262 to be aligned with the next barrel chamber 224. In this manner, by repeatedly moving the handle 272 to the retracted position and back to the neutral position, the distal shaft 262 can be aligned with all of the barrel chambers 224 within the cartridge barrel 222 (e.g., reciprocally, sequentially, and / or consecutively).

[0040] FIG. 14 shows a forward position, with the handle 272 positioned closer to the housing cap 202 of the screw delivery system 100. This forward position is shown in FIGS. 1 and 3-9. In FIG. 14, the handle 272 is positioned inside one of a plurality (e.g., four) open slits 225 on the cylindrical side of the cartridge barrel 222. The open slits 225 may be linear and / or approximately parallel to the longitudinal direction 102 and / or connected to one of the barrel chambers 224 inside the cartridge barrel 222. The head 263 of the distal shaft 262 may be at least partially positioned inside the internal channel 208 of the shaft-to-drive bit adapter 206.

[0041] To transition from the neutral position shown in FIG. 12 to the forward position shown in FIG. 14, the handle 272 is pushed toward the distal end of the screw cartridge 200 and enters the linear open slit 225, as shown in FIG. 14. Forward movement of the handle 272 stops when the coupling shaft adapter 266 reaches full extension or when the handle 272 hits a hard stop. In some embodiments, the screw delivery system 100 can include a mechanism for immobilizing the forward position such that the drive shaft assembly 260 is longitudinally fixed for inserting the screw 232 into the patient.

[0042] 3.Screw cartridge 15, the screw cartridge 220 is shown in a perspective view. An exploded view of the screw cartridge 220 is shown in FIG. 16, in which the cartridge shaft 236 is configured to mate with a first cartridge shaft bore 226 along the centerline of the cartridge barrel 222 and a second cartridge shaft bore 227 along the centerline of the revolver cam 240. The revolver cam 240 includes a polygonal (e.g., square) head 242 configured to mate with a polygonal (e.g., square) recess 244 on the proximal face of the cartridge barrel 222. The head 242 and the square recess 244 can take other shapes, for example, triangular or pentagonal, so long as rotational motion can be effectively transferred from the revolver cam 240 to the cartridge barrel 222. The nosepiece cam 240 has a straight groove portion 246, a first curved groove portion 247, and a second curved groove portion 248 thereon and is shown to engage with the cam pin 296 to rotate the cartridge barrel 222 as the handle 272 moves from the neutral position to the retracted position and then back to the neutral position. However, the nosepiece cam 240 may be of a different structure to perform the same function.

[0043] 16, the barrel chambers 224 are cylindrical from the distal to the proximal end of the cartridge barrel 222, with the chamber centerlines approximately parallel to the barrel centerline. The barrel chambers 224 may be uniformly distributed within the cartridge barrel 222, with the distance from the centerline of the cartridge barrel 222 to the centerline of each barrel chamber 224 being equal, and with an equal angular division between adjacent barrel chambers 224 about the barrel centerline.

[0044] As shown in FIGS. 15 and 16 , a pair of a screw 232 and a drive bit 234 are assembled to form a screw and drive bit assembly 230. The screw 232 and the drive bit 234 may be held together, for example, by magnetic forces and / or a friction fit between the tip of the screw bit 234 and a recess in the head of the screw 232. When loaded into the barrel chamber 224, the screw and drive bit assembly 230 may be held by friction between the drive bit 234 and the inner surface of the barrel chamber 224. The cartridge barrel 222 may be made of a rubber or elastomeric material such that the size of the barrel chamber 224 can be slightly smaller than the maximum diameter of the drive bit 234 to create a friction fit between the barrel chamber 224 and the drive bit 234. The friction may be low enough that the screw and drive bit assembly 230 can be loaded into the barrel chamber 224 manually or with a hand held tool and pushed distally from the barrel chamber 224 into the shaft and drive bit adapter 206 by the distal shaft 262 with a sufficiently small force, for example, within 1 pound force (lbf), within ½ lbf, or within ¼ lbf. In some embodiments, the cartridge barrel 222 may be made of a rigid material, such as metal, ceramic, or hard plastic, and the inner surface of the barrel chamber 224 may include a soft material layer, such as soft rubber or foam, to achieve a friction fit between the barrel chamber 224 and the drive bit 234.

[0045] In some embodiments, the cartridge barrel 222 can take on other shapes. For example, the cartridge barrel 222 can be rectangular, e.g., with the barrel chambers 224 evenly distributed along one of the sides of the rectangle and / or with equal distances between adjacent barrel chambers 224. In some variations, the cartridge barrel 222 is pentagonal, hexagonal, octagonal, or other shapes.

[0046] 4. Drive shaft Turning to FIG. 17, the drive shaft assembly 260 is shown with the distal shaft 262 and the proximal shaft 264 extensibly coupled by the shaft adapter 266. The drive shaft assembly 260 has a shaft proximal end 261a and a shaft distal end 261b. The direction from the shaft proximal end 261a to the shaft distal end 261b is parallel to the longitudinal direction 102. FIG. 18 is an exploded view of the drive shaft assembly 260 showing the relevant components. Viewed together, FIGS. 17 and 18 show multiple (e.g., three) parts sleeved onto the distal shaft 262, including a handle 272 that may be connected to a tubular portion 274, a compression spring 276, and a shaft collar 278 that may be attached to the proximal end of the distal shaft 262 by a first shaft pin 292. As previously described, when assembled, the handle 272 may slide onto the distal shaft 262. The handle 272 is naturally biased distally by a compression spring 276, pressing against the head 263 of the distal shaft 262. The distal shaft 262 can rotate within the handle 272 and compression spring 276 with minimal frictional resistance.

[0047] The proximal shaft 264 may have a flange bearing 282, a spacer 284, and a second bearing 286 of multiple (e.g., three) parts sleeved thereon. The flange gear 282 is constrained by a distal head on the proximal shaft 264. The flange gear 282 and the second bearing 286, when mounted within the housing 210, may facilitate or ensure that the proximal shaft 264 is securely held within the housing 210 and can rotate freely. The proximal shaft 264 has a proximal head 268 configured to be coupled to the motor shaft 136 with the shaft coupler 138 when the cartridge and shaft module 200 is mounted to the screw driver body 130. As shown, the proximal head 268 may have a flat head screwdriver shape. The proximal head 268 may take other shapes as long as rotational motion and torque can be transmitted from the motor 134 to the drive shaft assembly 260 via the shaft coupler 138.

[0048] At a mid-section, e.g., in the middle, of the drive shaft assembly 260 is a shaft adapter 266. The shaft adapter 266 has a partial recess or notch that forms a generally flat surface 267. At each end of the shaft adapter 266, there may be a beveled edge 269 that extends the shaft from a partial cylinder at the middle section to a full or nearly full cylinder at each end. The distal shaft 262 and the proximal shaft 264 each have a hole along their centerline for receiving the shaft adapter. When attached to the distal shaft 262, the distal end of the shaft adapter 266 is restrained by a first pin 292 inserted into a hole in the shaft collar 278 and the proximal end of the distal shaft 262 because the first pin 292 is in contact with the flat surface 267 of the shaft adapter 266. Thus, the distal head of the shaft adapter 266 is stopped by the first pin 292 at the beveled surface 269 and cannot exit the central hole of the distal shaft 262. The proximal end of the shaft adapter 266 is restrained by a second pin 294 that is inserted into a hole in the distal head of the proximal shaft 264 in the same manner that the distal head of the shaft adapter 266 is restrained by the first pin 292. Thus, the drive shaft assembly 260 is longitudinally extendable. In some embodiments, the engagement of the first and second pins 292 and 294 with the flat surface 267 can facilitate the drive shaft assembly being rotationally stiff and capable of transmitting rotational motion and torque to the drive bit 234 and the screw 232.

[0049] 5.Operation Returning to FIG. 2, once the screw cartridge 220 is loaded, the screw delivery system 100 is ready for immediate use, such as in a surgical procedure or other medical procedure. A user, e.g., a surgeon, can move the handle 272 distally to a forward or extended position. This movement advances the distal shaft 262, thereby forcing the screw and drive bit assembly 230 into the shaft and drive bit adapter 206 disposed in the port 204, as shown in FIGS. 1 and 6-10. The screw and drive bit assembly 230 may be exposed. A user (e.g., a surgeon) can observe whether the screw 232 has been pushed out of the delivery port 204. This position (with the screw pushed out of the port) can be the ready-to-install position of the screw. In various embodiments, in the ready-to-install position, some or all of the screw 232 is exposed and / or is visible to the user, e.g., the distal end, the distal end and threads, the distal end and threads and the proximal head, etc. This allows the user to verify the screw details (e.g., size, quality, material, type, etc.) prior to inserting the screw and / or to accurately place the screw in the patient (e.g., compared to a system where the screw is hidden from view). The user can then proceed to insert the screw into the patient as part of the surgical procedure. In some embodiments, the surgeon can enable a locking mechanism to hold the drive shaft assembly 260 in a forward position during screw insertion.

[0050] If no threads are observed outside the delivery port 204, this means that the barrel chamber 224 into which the distal shaft 262 was advanced is empty. The user then pulls the handle 272 proximally to the retracted position and releases the handle 272 to move the handle 272 distally to the neutral position. As described above, the act of moving the handle 272 proximally to the retracted position and releasing it to the neutral position rotates the nosepiece 240 to align the next barrel chamber 224 with the distal shaft 262. Thus, the cartridge barrel 222 is rotationally geared by the position of one barrel chamber 224. For example, in the illustrated embodiment having four chambers, each pull and release of the handle 272 rotates the cartridge barrel 222 approximately 90°. In some embodiments, the pull and release each rotate the cartridge barrel 222 at least approximately 30°, 45°, 60°, 120°, or other angles.

[0051] The user can repeat the process steps of pushing the handle 272 distally to the forward position and observing whether the screw 232 emerges from the delivery port 204, as described above. If the answer is yes, the user can proceed and insert the screw into the patient. The user can sequentially repeat these steps until all of the screws and drive bit assemblies 230 held in the screw cartridge 220 are consumed. If no screws are observed outside the delivery port 204, it means that the screw cartridge 220 is empty (no longer containing a screw and drive bit assembly 230). The empty cartridge 220 can be replaced and reloaded with a non-empty screw cartridge 220. In some embodiments, this is done by the user (e.g., a surgical assistant) pulling the current screw cartridge 220 out of the housing 210 and installing a new screw cartridge 220 into the housing 210. The user can verify that both ends of the cartridge shaft 236 are snapped or otherwise secured into the snap or securing features in the first and second channels 214, 216. The screw delivery system 100 may be used to continue the surgery or procedure.

[0052] 6. Alternative Embodiments Figure 19 shows a perspective view of a screw delivery system 300 that is an alternative embodiment of the screw delivery system 100 shown in Figure 1. Similar to the screw delivery system 100 of Figure 1, the screw delivery system 300 includes a hand grip 310, a control panel 320 having a number of buttons 322 and a number of LED signals 324, and a screw driver body 330. The screw delivery system 300 can include a cartridge and shaft module 340 that is removable from the screw driver body 330. The screw cartridge 350 of Figure 19 has ten barrel chambers 354, but may be configured to have more or fewer barrel chambers.

[0053] Figure 20 is another perspective view of the screw delivery system 300 shown in Figure 19. However, the cartridge and shaft module 340 shown in Figures 19 and 20 is in a different position. In Figure 19, the cartridge housing 341 is retracted, allowing the screw driver shaft 364 to extend through and out of one of the barrel chambers 354 in the screw cartridge 350.

[0054] The cartridge and shaft module 340 in FIG. 20 is in an extended position. As can be seen, the tip 368 of the screw driver shaft 364 can be coupled with the screw 362, ready for insertion into the patient. The cartridge housing 341 can be slidable distally and proximally when the slider 344 is engaged and slides within the rail channels 342 on either side of the screw delivery system 300. In the extended position shown in FIG. 20, the tip 368 of the screw driver shaft 364 is disposed within the channel 345 of the cartridge housing 341, but the majority of the screw driver shaft 364 may be disposed outside of the cartridge housing 341.

[0055] The distal end of the shaft can have a helical shaped guide feature 366. The guide feature 366 can aid in engaging a tip 368 of the screw driver shaft 364 with the screw 362 for a smooth coupling.

[0056] Also shown in FIGS. 19 and 20 are a first button 346 and a second button 348 coupled to the cartridge and shaft module 340. The first button 346 may function to rotate the screw cartridge 350 in an interlocking manner so that the screw driver shaft 364 has access to all of the barrel chambers 354. In some embodiments, the screw 350 can be rotated in an interlocking manner by moving the first button 346 distally and proximally. In some embodiments, the first button 346 may function to engage or release the screw cartridge 350, for example, by depressing the first button 346. The second button 348 may function to engage or release the screw driver shaft 364.

[0057] FIG. 21 is a partial cross-sectional view showing certain internal structure of the cartridge and shaft module 340 in the extended position shown in FIG. 20, including the screw cartridge 350 and the screw driver shaft 364. As can be seen, the screw cartridge 350 is coupled to the cartridge and shaft housing 340 at a distal end. In this arrangement, the barrel chamber 354 within the screw cartridge 350 is exposed at the distal end. The internal channel 345 can be substantially centered with a screw 362 held within the barrel chamber 354 located near the top of the screw cartridge 350. As the tip 368 of the screw driver shaft 364 enters the internal channel 345, the guide mechanism 366 can facilitate or ensure that the tip 368 is substantially centered with the internal channel 345 and engages the screw 362.

[0058] The internal channel 345 may have a helical groove on its inner surface. As the tip 368 enters the internal channel 345 and moves axially towards the screw 362, the engagement of the helical guide mechanism 366 with the helical groove of the internal channel 345 may cause the tip 368 to rotate slowly. This may be a first stage of engagement. As the tip 368 contacts the screw 362 and begins to push against the screw 362, the slow rotation of the tip 368 relative to the screw 362 helps the tip 368 locate and engage with the head of the screw 362. This may be a second stage of engagement. The tip 368 and screw 362 are then pushed out of the internal channel 345, thereby exposing the screw and / or bit. This may be a third stage of engagement. The slow rotation of the tip 368 stops when the engagement between the helical mechanism 366 and the helical groove in the internal channel 345 stops. In some embodiments, such cessation of slow rotation may occur at a second stage of engagement, and in some embodiments, such cessation of slow rotation may occur at a third stage of engagement. The powered screw driver 300 may be actuated by a user to insert the exposed screw into the patient.

[0059] In some embodiments, in a first stage, the tip enters the channel, moves axially towards the screw, and rotates relative to the screw. The rotation can occur by a helical guide feature engaging a corresponding helical feature in the channel. In some embodiments, in a second stage, the tip contacts the screw and begins to push against the screw, but also continues to rotate relative to the screw (which can aid in placing the bit in the screw head). In some embodiments, in a third stage, the tip and screw are pushed out of the channel, stopping rotation until the powered screw driver is activated to insert the screw into the patient.

[0060] In some embodiments, within each barrel chamber 354 may be a gripping mechanism 356 configured to hold the screw 362 when engaged. The gripping mechanism 356 may be made of a resilient material, such as rubber, or is a spring made of metal or plastic. Thus, when the tip 268 of the screw driver shaft 364 is coupled with the screw 362, the screw driver shaft may push the screw 362 distally out of the barrel chamber 354 as the resilient gripping mechanism 356 flexes outward. The screw 362 and the tip 268 of the screw driver shaft 364 may stay together due to magnetic forces and / or a friction fit between the bit and a recess in the head of the screw 362.

[0061] 7. Specific Terms Orientation terms used herein, such as "top", "bottom", "horizontal", "vertical", "longitudinal", "lateral", and "end", are used in the context of the illustrated embodiment. However, the present disclosure should not be limited to the illustrated orientation. Indeed, other orientations are possible and within the scope of the present disclosure. It should be understood that circular terms, such as diameter or radius, used herein do not require a perfect circular structure, but rather should apply to any suitable structure having a measurable cross-sectional area from side to side. Terms generally relating to shape, such as "circular" or "cylindrical" or "semicircular" or "semi-cylindrical", or any related or similar term, need not strictly follow the mathematical definition of a circle or cylinder or other structure, but can encompass structures that are reasonably close.

[0062] Conditional language such as "can," "could," "might," or "may" is generally intended to convey that a particular embodiment includes or does not include certain features, elements, and / or steps, unless specifically stated otherwise or understood otherwise within the context in which it is used. Thus, such conditional language generally does not imply that the features, elements, and / or steps are in any way required for one or more embodiments.

[0063] Conjunctive language, such as the phrase "at least one of X, Y, and Z," unless otherwise noted, is otherwise understood in the context in which it is generally used to convey that an item, term, etc. can be either X, Y, or Z. Thus, such conjunctive language is generally not intended to suggest that a particular embodiment requires the presence of at least one of X, at least one of Y, and at least one of Z.

[0064] The terms "approximately," "about," and "substantially," as used herein, refer to an amount close to the stated amount that still performs a desired function or achieves a desired result. For example, in some embodiments, as the context may dictate, the terms "approximately," "about," and "substantially" may refer to an amount that is 10% or less of the stated amount. The term "generally," as used herein, refers to a value, amount, or characteristic that primarily includes or tends toward a particular value, amount, or characteristic. As an example, in certain embodiments, as the context may dictate, the term "generally parallel" may refer to something that deviates from exact parallelism by no more than 20 degrees, and the term "generally perpendicular" may refer to something that deviates from exact perpendicular by no more than 20 degrees.

[0065] Unless otherwise noted, articles such as "a" or "an" should generally be construed to include one or more of the listed items. Thus, phrases such as "a device configured to" are intended to include one or more of the listed devices. Such one or more listed devices may be collectively configured to perform the listed enumeration. For example, "a processor configured to perform enumerations A, B, and C" may include a first processor configured to perform enumeration A working in conjunction with a second processor configured to perform enumerations B and C.

[0066] Terms such as "comprising," "including," "having," and the like are synonymous and are used in an inclusive, open-ended manner and do not exclude additional elements, features, acts, operations, etc. Similarly, terms such as "some," "certain," and the like are synonymous and are used in an open-ended manner. Also, the term "or" is used in an inclusive sense (rather than an exclusive sense), e.g., when used to connect a list of elements, the term "or" may mean one, some, or all of the elements in the list.

[0067] In general, the claim language should be interpreted broadly based on the language used in the claims, and is not intended to be limited to the non-exclusive embodiments and examples shown and described in this disclosure or discussed during prosecution of this application.

[0068] 8. Summary The technology of the present disclosure is described in the context of certain embodiments and examples. The technology extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses of the embodiments, as well as certain modifications and equivalents thereof. For example, although certain embodiments are disclosed in the context of a screw delivery system or a power screw driver, the technology may also be applied to other fastener delivery tools. Any two or more of the components of the screw delivery system may be made from a single monolithic part or from separate parts connected to each other. Various features and aspects of the disclosed embodiments may be combined with each other or substituted for each other to form various forms of the invention. The scope of the present disclosure should not be limited by the specific disclosed embodiments described herein.

[0069] Certain features described in this disclosure in the context of separate embodiments may be implemented in combination in a single embodiment. Conversely, various features described in the context of a single embodiment may be implemented separately in multiple embodiments or in any suitable subcombination. Although features may be described above as acting in a specific combination, one or more features from a claimed combination may, in some cases, be deleted from the combination, and the combination may be claimed as any subcombination or any variation of the subcombination.

[0070] Moreover, although operations may be shown in the figures or described herein in a particular order, such operations need not be performed in the particular order shown or in sequential order to achieve desirable results, nor need all operations be performed. Other operations not shown or described may be incorporated into the exemplary methods and processes. For example, one or more additional operations may be performed before, after, simultaneously with, or between any of the described operations. Moreover, in other implementations, operations may be rearranged or reordered. Also, the separation of various system components in the above implementations should not be understood to require such separation in all implementations, and it should be understood that the components and systems described may generally be integrated together in a single product or packaged in multiple products. Moreover, other implementations are within the scope of the present disclosure.

[0071] Some embodiments are described in conjunction with the accompanying drawings. While the drawings are drawn to scale, such scale is not limiting and dimensions and proportions other than those shown are contemplated and are within the scope of the disclosed invention. Distances, angles, etc. are merely illustrative and do not necessarily bear an exact relationship to the actual dimensions and layout of the devices shown. Components can be added, removed, and / or rearranged. Furthermore, any particular features, aspects, methods, properties, characteristics, qualities, attributes, elements, etc. disclosed herein in connection with various embodiments may be used in all other embodiments described herein. Furthermore, any method described herein may be implemented using any device suitable for performing the recited steps.

[0072] In summary, various embodiments and examples of screw delivery systems and related methods have been disclosed. Although the screw delivery systems have been disclosed in the context of those embodiments and examples, the technology of the disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments and / or other uses of the embodiments, as well as certain modifications and equivalents thereof. The disclosure expressly contemplates that various features and aspects of the disclosed embodiments can be combined with or substituted for one another. Thus, the scope of the disclosure should not be limited by the specific disclosed embodiments described above, but should be determined only by a fair reading of the appended claims.

Claims

1. A surgical screw delivery device, A housing configured to be attached to an electric surgical screwdriver, A shaft assembly coupled to a housing, comprising a shaft assembly having a proximal end, a distal end, and a longitudinal axis, A screw cartridge coupled to a housing, comprising a cartridge barrel, the cartridge barrel having a plurality of barrel chambers configured to each hold a screw, Equipped with, A surgical screw delivery device in which the distal end of the shaft assembly is coaxially aligned with one of several barrel chambers.

2. The apparatus according to claim 1, wherein the housing has a cavity, and the screw cartridge and shaft assembly are disposed within the cavity.

3. The apparatus according to claim 2, wherein the cartridge barrel has a cylindrical shape with a barrel centerline substantially parallel to the longitudinal axis, and a plurality of barrel chambers are formed by penetrating the cartridge barrel, each having a centerline substantially parallel to the barrel centerline, and are uniformly distributed at an angle within the cartridge barrel.

4. The apparatus according to claim 2, wherein the cartridge barrel is rectangular with a barrel centerline substantially parallel to the longitudinal axis, and a plurality of barrel chambers are formed penetrating the cartridge barrel, the centerline of each barrel chamber is substantially parallel to the cartridge barrel centerline, and the distance between adjacent barrel chambers is equal.

5. The apparatus according to claim 3, wherein the screw cartridge further comprises a cylindrical revolving cam coaxial with the cartridge barrel, and the revolving cam has a curved groove formed thereon.

6. The apparatus according to claim 5, wherein the screw cartridge further comprises a cartridge shaft coaxial with the cartridge barrel, and each end of the cartridge shaft is detachably coupled to a fixing mechanism arranged around the housing.

7. The apparatus according to claim 6, wherein the shaft assembly comprises a distal shaft at its distal end and a proximal shaft at its proximal end, the distal shaft having a sleeve-fixed handle that allows the distal shaft to rotate, a cam pin coupled to the handle and engaging with a curved groove of the revolving cam, and by moving the handle proximal to a retracted position and then distal to a neutral position, the shaft assembly works together to rotate the cartridge barrel about the barrel centerline to a position where it is coaxially aligned with the next barrel chamber in the cartridge barrel.

8. It is an electric screwdriver, Hand grip and A screwdriver body having a proximal end, a distal end, and a longitudinal axis, A control panel equipped with user input and optical signals, Removable cartridge and shaft module, The removable cartridge and shaft module are A housing designed to be attached to the screwdriver body, A shaft assembly coupled to the housing, A screw cartridge coupled to a housing, comprising a cartridge barrel, the cartridge barrel having a plurality of barrel chambers, each configured to hold a screw, and Equipped with, The distal end of the shaft assembly is aligned coaxially with one of several barrel chambers, as is the case with the electric screwdriver.

9. The electric screwdriver according to claim 8, wherein the housing has a cavity, and the screw cartridge and shaft assembly are disposed within the cavity of the housing.

10. The electric screwdriver according to claim 9, wherein the cartridge barrel is cylindrical in shape with a barrel centerline substantially parallel to the longitudinal axis, and a plurality of barrel chambers are formed penetrating the cartridge barrel, with the centerlines of each barrel chamber substantially parallel to the barrel centerline and uniformly distributed at an angle within the cartridge barrel.

11. The electric screwdriver according to claim 9, wherein the cartridge barrel is rectangular with a barrel centerline substantially parallel to the longitudinal axis, and a plurality of barrel chambers are formed through the cartridge barrel, the centerline of each barrel chamber is substantially parallel to the cartridge barrel centerline, and the distance between adjacent barrel chambers is equal.

12. A method for sequentially feeding out multiple screws, A step of moving the handle connected to the cartridge and shaft module to a forward position, thereby moving one of several screws to a forward position, the cartridge and shaft module being detachably integrated with an electric screwdriver, The removable cartridge and shaft module are A housing configured to be attached to an electric screwdriver, A shaft assembly coupled to the housing, A screw cartridge coupled to a housing, comprising a cartridge barrel, the cartridge barrel having a plurality of barrel chambers, each configured to hold one of a plurality of screws, A port connected to a housing, having an internal channel, Equipped with, The distal end of the shaft assembly is moved to one of several barrel chambers and to align it coaxially with the internal channel of the port. The steps include inserting the screws into the circuit board, A step to move the handlebars in the proximal direction to the retracted position, A step of moving the handle distally to the neutral position, The process involves repeatedly moving the handle to the forward position, inserting each screw, moving the handle to the proximal position (retracted), and moving the handle to the distal position (neutral). A step to determine if the screw cartridge is worn out, The steps to replace one screw cartridge with another, A method that includes this.

13. The method according to claim 12, wherein the housing has a cavity, and the screw cartridge and shaft assembly are disposed within the cavity of the housing.

14. The method according to claim 13, wherein the cartridge barrel is cylindrical with a barrel centerline substantially parallel to the longitudinal direction of a removable cartridge and shaft module, and a plurality of barrel chambers are formed through the cartridge barrel, each having a centerline substantially parallel to the barrel centerline, and are distributed at a uniform angle within the cartridge barrel.

15. The method according to claim 13, wherein the cartridge barrel is rectangular with a barrel centerline substantially parallel to the longitudinal direction of the removable cartridge and shaft module, and a plurality of barrel chambers are formed through the cartridge barrel, the centerline of each barrel chamber is substantially parallel to the cartridge barrel centerline, and the distance between adjacent barrel chambers is equal.

16. The method according to claim 14, wherein the screw cartridge further comprises a cylindrical revolving cam coaxial with the cartridge barrel, the revolving cam having a curved groove formed thereon.

17. The method according to claim 12, wherein the shaft has a proximal end, a distal end, and a longitudinal axis including a distal shaft at the distal end and a proximal shaft at the proximal end, the distal shaft and the proximal shaft are coupled to each other by a shaft coupler, thereby the shaft assembly is extendable in the longitudinal direction but fixed in the rotational direction, and the handle is sleeve-fixed to the distal shaft and biased distally by a compression spring.

18. The method according to claim 17, wherein the proximal shaft is coupled to a bearing, and the bearing is coupled to a housing, allowing the proximal shaft to rotate freely within it.

19. A surgical screw delivery system, A housing comprising a longitudinal axis and a chamber, A handle assembly comprising a handle and a shaft, configured to slide between a first position and a second position in a direction substantially parallel to the longitudinal axis, A cartridge comprising multiple barrel chambers, each barrel chamber configured to include a screw and a bit, and the cartridge being configured to be removably received within the chamber, Equipped with, A surgical screw delivery system is configured such that, each time the handle moves from a first position to a second position, the cartridge rotates in conjunction with the shaft, moving from one barrel chamber to another.

20. The apparatus according to claim 1, further comprising a handle configured to slide substantially parallel to the longitudinal axis between a first position and a second position, wherein each time the handle moves from the first position to the second position, the screw cartridge rotates in conjunction from one of the barrel chambers to another of the barrel chambers so as to align with the shaft.

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