# US 10,117,648 B2 · Surgical fastener delivery and locking mechanism

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- Number: US 10,117,648 B2
- Document ID: US10117648B2
- Status: Granted
- Kind: B2
- Application number: 15/132,861
- Filed: 2016-04-19
- Published: 2016-10-27
- Granted: 2018-11-06
- Earliest claimed: 2015-04-23
- Assignees: Via Surgical Ltd.
- Applicants: Via Surgical Ltd.
- Inventors: Arie Levy; Yehonatan Levin; Lena Levin; Ofek Levin
- Web page: https://patentgrep.com/patent/US10117648B2

## CPC

- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/0485: {Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/0057: {Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect (sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 17/064: Surgical staples, {i.e. penetrating the tissue}
- A61B 2017/00862: {elastic or resilient}
- A61B 2017/00867: {shape memory effect}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/06176: {with protrusions, e.g. barbs}
- A61B 2017/0645: {being elastically deformed for insertion}
- A61B 2017/07214: {Stapler heads}
- A61B 2017/07278: {characterised by its sled or its staple holder}
- A61F 2220/0016: with sharp anchoring protrusions, e.g. barbs, pins, spikes
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

The invention provides a fastening device for laparoscopic hernia repair. The coordinated operation of two insertion members stabilizes a fastener during closure and locking to ensure that the fastener is locked in the intended location before the device releases from the fastener. One of the insertion members includes a pair of prongs that exhibit a closed configuration when they are disposed in a recess at an end of the fastener. The fastener has a hook at one end and a loop at the other end. The insertion members push the fastener out from the device and through the tissue. A curvature in at least one of the insertion members pushes the hook through the loop all while the prongs are in the recess in the fastener, thereby stabilizing the fastener with respect to the device.

## Claims

### Claim 1

A device for delivering a plurality of surgical fasteners, one at a time, into tissue of a patient, the device comprising:
a handle including a trigger;
a shaft extending from the handle and dimensioned for insertion into a patient's abdomen through an incision in the abdomen;
an applicator section at a distal end of the shaft, the plurality of fasteners disposed within the applicator section, each of the plurality of fasteners formed as a single piece comprising a hook at one end and a loop at the other end; and
first and second members operably coupled to the trigger whereby activation of the trigger by a user causes
the first member to engage the loop of one of the fasteners carry the loop through the patient's tissue,
the second member to engage the hook of that fastener, carry the hook through the tissue, and pass the hook through the loop, thereby locking the fastener into a closed loop in the tissue while the loop remains engaged by the first member, and
the first and second members to retract into the applicator section leaving the closed fastener in the tissue.

### Claim 2 (depends on 1)

The devices of claim 1, wherein the shaft is dimensioned for insertion into the abdomen through a trocar placed in the incision.

### Claim 3 (depends on 2)

The device of claim 2, wherein a distal tip of the first member defines a pair of prongs configured to be inserted into a recess at a distal end of the loop of the fastener.

### Claim 4 (depends on 3)

The device of claim 3, wherein the pair of prongs is disposed together in the recess when inserted into the recess.

### Claim 5 (depends on 4)

The device of claim 4, wherein the distal tip of the first member is configured to define an opening corresponding to the loop while the pair of prongs is held together by the recess.

### Claim 6 (depends on 5)

The device of claim 5, wherein the distal tip of the first member comprises a super-elastic material that biases the pair of prongs together, and being withdrawn from the recess the pair of prongs are opened by being dragged over the second member.

### Claim 7 (depends on 6)

The device of claim 6, wherein the super-elastic material comprises nickel titanium alloy.

### Claim 8 (depends on 6)

The device of claim 6, wherein retraction of the first member includes removing the pair of prongs from the recess and withdrawing the distal tip of the first member by allowing the hook end of the fastener to pass through the gap between the pair of prongs.

### Claim 9 (depends on 3)

The device of claim 3, wherein at least one of the first and second members comprises a flexible, pre-shaped portion that moves along a curved path.

### Claim 10 (depends on 9)

The device of claim 9, wherein the flexible portion remains straight when disposed in the shaft and, upon the activation of the trigger, extends from the shaft and moves along the curved path by assuming a curved shape.

### Claim 11 (depends on 10)

The device of claim 10, wherein the at least one of the first and second members moves along a straight path and the curved path.

### Claim 12 (depends on 10)

The device of claim 10, wherein the first and second members are operably coupled to the trigger by first and second push rods, wherein each push rod comprises a distal end engaged with its respective member and a proximal end engaged with a slot wheel in the handle.

### Claim 13 (depends on 12)

The device of claim 12, wherein the applicator section is configured to receive a cartridge loaded with the plurality of fasteners.

### Claim 14 (depends on 13)

The device of claim 13, wherein the cartridge is from a set of cartridges, at least two of the cartridges in the set carrying fasteners of a different size.

### Claim 15 (depends on 14)

The device of claim 14, wherein the device is configured to deliver fasteners of different sizes to different penetration depths within the patient's tissue.

### Claim 16 (depends on 10)

The device of claim 10, wherein the first and second members are configured to penetrate a prosthetic mesh and the patient's tissue.

### Claim 17 (depends on 10)

The device of claim 10, wherein the pair of prongs assumes a closed configuration when disposed within the recess.

### Claim 18 (depends on 17)

The device of claim 17, wherein the closed configuration of the prongs defines a hoop-like structure corresponding to the loop while the pair of prongs is disposed within the recess.

### Claim 19 (depends on 18)

The device of claim 18, wherein the distal tip of the first member comprises a super-elastic material that biases the pair of prongs together, and the pair of prongs spread apart from one another while being retracted due to being drawn over the fastener or second member.

### Claim 20 (depends on 19)

The device of claim 19, wherein the super-elastic material is a nickel-titanium alloy.

### Claim 21 (depends on 18)

The device of claim 18, wherein the distal tip of the first member comprises a material that biases the pair of prong apart from one another such that upon being withdrawn from the recess the pair of prongs springs open to define a gap between the pair of prongs.

### Claim 22 (depends on 21)

The device of claim 21, wherein retraction of the first member includes removing the pair of prongs from the recess and withdrawing the distal tip of the first member by allowing the hook end of the fastener to pass through the gap between the pair of prongs.