Ethicon, Gmbh

Cilag International Gmbh

Anthony S Miksza

Robert Nering

Shailendra Kumar Parihar

Dennis D Jamiolkowski

David R Schiff

Omar J Vakharia

Simon Cohn

Jeremy David Jarrett

Michael Cardinale

Matthew David Daniel

Richard P Fuchs

Matthew Rohr Daniel

Jared Schneider

Doug Souls

Todd Sack

Aaron J Brickner

Erin Elizabeth Wenig

Paul T Marshall

James J Bedi

Jianxin Guo

Jonathan B Gabel

Richard C Smith

Donald M Golden

Steven H Nguyen

Mark D Kenyon

Jose C Deniega

Mark T Gaterud

Martin J Nohilly

Race Eric Thornton

Carl Edward Griffin

James C Hart

Dan Gordon

W Brinton Yorks, Jr

An applicator instrument for dispensing surgical fasteners includes a housing, an elongated shaft, surgical fasteners disposed in the elongated shaft, a firing system for dispensing the surgical fasteners, a firing rod disposed within the elongated shaft and movable within a first plane, and an advancer disposed within the elongated shaft and moveable within a second plane. An actuator is coupled with the advancer for moving the advancer back and forth between retracted and extended positions. A staging assembly at the distal end of the elongated shaft aligns a leading surgical fastener with the first plane. The staging assembly includes a biasing device that is configured to be deflected away from the first plane by the advancer when the advancer is in the extended position and the staging assembly is configured to spring back into alignment with the first plane when the advancer returns back to the retracted position.

Applicator instruments for dispensing surgical fasteners having deflectable staging assemblies

An applicator instrument for dispensing surgical fasteners includes a housing, and an elongated shaft extending from the housing. The elongated shaft has a proximal end secured to the housing, a distal end spaced from the proximal end, and a first axis extending between the proximal and distal ends of the elongated shaft. Surgical fasteners are disposed in the elongated shaft. The surgical fasteners are stacked at an angle relative to the first axis of the elongated shaft. A distal end cap having a surgical fastener dispensing window is secured to the distal end of the elongated shaft. The applicator instrument has a firing system disposed in the housing, and an actuator coupled with the firing system for activating the firing system to dispense the surgical fasteners through the surgical fastener dispensing window.

Applicator instruments having stacked surgical fasteners for off-axis surgical fastener delivery

An applicator instrument for dispensing surgical fasteners including a housing, an elongated shaft extending from the housing, surgical fasteners disposed in the elongated shaft, a firing system for dispensing the surgical fasteners from the distal end of the elongated shaft, and a trigger coupled with the housing for activating the firing system. The firing system includes a firing rod disposed in the elongated shaft and an energy storing element disposed in the housing for building up energy for dispensing the surgical fasteners from the distal end of the elongated shaft. The firing system has a firing cycle including a first stage in which the firing rod advances a leading one of the surgical fasteners toward the distal end of the elongated shaft at a first rate of speed, a second stage in which the firing rod advances the leading one of the surgical fasteners toward the distal end of the elongated shaft at a second rate of speed that is greater than the first rate of speed, and an energy storing stage that occurs before the second stage during which energy is built up in the energy storing element.

Applicator instruments for dispensing surgical fasteners having firing systems with slower piloting stages and faster dispensing stages

An applicator instrument for dispensing surgical fasteners includes a housing having an actuator and an elongated shaft extending from the housing. The applicator instrument includes a top stamping disposed within the elongated shaft, and a bottom stamping disposed within the elongated shaft that opposes the top stamping. The applicator instrument has a firing system for dispensing at least one surgical fastener from the distal end of the elongated shaft. An end cap is assembled with the distal ends of the top stamping, the bottom stamping, and the elongated shaft for stabilizing the distal end of the applicator instrument. The end cap has a distal end face with castling for engaging an opposing surface such as surgical mesh overlying tissue. The castling prevents the distal end of the applicator instrument from sliding or moving relative to the opposing surface.

Applicator instruments for dispensing surgical fasteners having distal end caps with castling for engaging opposing surfaces

An applicator instrument for dispensing surgical fasteners includes a housing, a firing system disposed in the housing, an actuator coupled with the housing for activating the firing system, an elongated shaft extending from the housing, the elongated shaft having a proximal end secured to the housing, a distal end, and a first axis extending between the proximal and distal ends, one or more surgical fasteners disposed in the elongated shaft, and a distal end cap secured to the distal end of the elongated shaft. The distal end cap has a surgical fastener dispensing window for dispensing the one or more surgical fasteners from the distal end cap. The firing system includes a firing rod that extends through the elongated shaft for dispensing the one or more surgical fasteners from the distal end cap. The firing rod has a proximal section that moves along the first axis of the elongated shaft and a distal section that moves along a second axis that defines an angle with the first axis.

Applicator instruments having off-axis surgical fastener delivery

A surgical fastener includes a first leg having a distal end, a proximal end, and a first insertion tip at the distal end of the first leg, the first insertion tip having a first distal piercing point, and a second leg having a distal end, a proximal end, and a second insertion tip at the distal end of the second leg, the second insertion tip having a second distal piercing point. A bridge connects the first and second legs. The first and second distal piercing points are located outside the respective first and second legs. The first and second legs extend along respective longitudinal axes, and the first and second insertion tips are asymmetrical and skewed outwardly relative to said respective longitudinal axes of the first and second legs.

Surgical fasteners for securing prosthetic devices to tissue

Novel stay suture devices and stay suture combinations with meshes are disclosed. The stay suture devices have a clip and a suture. The clip has leg members that are mounted to a hernia mesh implant such that the leg members are locked in a closed configuration. Also disclosed are novel methods of mounting stay sutures to a surgical mesh implant and repairing a body wall defect such as a hernia defect.

Method and means to attach anchor suture onto mesh implants

Novel tissue wound closure devices and applicator instruments are disclosed. The tissue wound closure devices have a filament or strap and a capture device that locks the filament or strap in place after application to approximate a wound in tissue. The applicator instruments have a curved insertion needle.

Tissue wound closure device and applicator instrument

A method of securing a prosthetic device to tissue includes providing an applicator instrument including a housing, a shaft, surgical fasteners, a firing rod for dispensing the surgical fasteners from the shaft, a trigger, and an energy storing element. The method includes positioning a prosthetic device over tissue, juxtaposing a distal end of the shaft with the prosthetic device, and compressing the trigger for piloting the firing rod toward the distal end of the elongated shaft at a first rate of speed. The method includes preventing the firing rod from moving distally while building up energy in the energy storing element, and further compressing the trigger for releasing the firing rod for distal movement and transferring the built up energy for moving the firing rod toward the distal end of the elongated shaft at a second rate of speed that is greater than the first rate of speed.

Methods of using applicator instruments for securing prosthetic devices to tissue

Surgical fastener

A surgical fastener for securing a prosthetic device to tissue includes a first leg having a proximal end, a distal end, a first insertion tip at the distal end, and a first articulating joint that separates said first leg into a proximal segment and a distal segment that is deflectable relative to the proximal segment, and a second leg including a proximal end, a distal end, a second insertion tip at the distal end, and a second articulating joint that separates said second leg into a proximal segment and a distal segment that is deflectable relative to the proximal segment. A bridge connects the proximal ends of the first and second legs for forming a closed end of the surgical fastener. After implantation in tissue, the insertion tips are deflectable away from vessels and nerves to minimize injury to the vessels and nerves, and to minimize patient discomfort and pain.

Surgical fasteners having articulating joints and deflectable tips

A surgical fastener for securing a prosthetic device to tissue includes a first leg having a distal end, a proximal end, and a first insertion tip at the distal end of the first leg, and a second leg including a distal end, a proximal end, and a second insertion tip at the distal end of the second leg. A bridge connects the proximal ends of the first and second legs for forming a closed end of the surgical fastener. The first insertion tip has a first insertion tool seating surface, and the second insertion tip has a second insertion tool seating surface. The first insertion tool seating surface is closer to the distal end of the first leg than the proximal end of the first leg, and the second insertion tool seating surface is closer to the distal end of the second leg than the proximal end of the second leg. The first and second legs extend along respective longitudinal axes, and the first and second insertion tips are skewed outwardly relative to the respective longitudinal axes.

Surgical fasteners, applicator instruments, and methods for deploying surgical fasteners

An applicator instrument for dispensing surgical fasteners includes a housing, an elongated shaft extending from the housing, the elongated shaft having a proximal end coupled with the housing and a distal end remote therefrom, and a firing system for dispensing surgical fasteners from the distal end of the elongated shaft. The firing system includes a firing rod disposed in the elongated shaft, the firing system having a firing cycle with a first stage for advancing the firing rod toward the distal end of the elongated shaft at a first rate of speed and a second stage for advancing the firing rod toward the distal end of the elongated shaft at a second rate of speed that is greater than the first rate of speed.

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Bethlehem, PA, United States of America

Anthony S Miksza