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

An applicator instrument for dispensing surgical fasteners, comprising:

• a housing;
• an elongated shaft extending from the housing, the elongated shaft having 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;
• a plurality of surgical fasteners disposed in the elongated shaft, wherein the surgical fasteners are stacked in a first slot extending along the first axis;
• a distal end cap secured to the distal end of the elongated shaft, the distal end cap having a surgical fastener dispensing window offset with respect to the first slot, a distal end of the distal end cap including a plurality of projections configured to engage a surgical mesh;
• a firing system disposed in the housing, the firing system including a flexible firing rod that extends through the elongated shaft to contact a distal-most one of the surgical fasteners so that distal movement of the firing rod dispenses the distal-most surgical fastener through the surgical fastener dispensing window the firing rod includes a proximal section that moves along the first axis, a distal section that moves along a second axis, and a joining portion of the firing rod coupled between the proximal and distal sections, the joining portion flexing to bend from the first axis to the second axis, the distal section of the firing rod comprising an insertion fork;
• and
• an actuator coupled with the firing system for activating the firing system to dispense the surgical fasteners distally through the surgical fastener dispensing window.