Method of sequentially firing staples using springs and a rotary or linear shutter

#The present invention relates to medical fastening devices and methods for use in minimally invasive surgery.

#Minimally invasive surgery has been used in many formerly complex medical procedures, such as gall bladder removal, urological and reproductive operations, valve repair and replacement and by-pass operations. Minimally invasive surgery involves inserting tools into a patient through a natural opening or small incision in the body. The surgical tools are then manipulated from outside the patient. This approach to surgery has a number of advantages, including, inter alia, that it is generally less traumatic, smaller incisions, if any, are needed, and the patient has less post-operative pain and a shorter recovery time.

#Minimally invasive surgery requires tools that a surgeon can trust. In particular, a surgeon needs reliable indication of when and how a procedure is completed. Ideally, tactile, audible and visual confirmation of operation is available to surgeons.

#FIG. 1 shows a fastening device according to a first embodiment of the present invention;

#FIG. 2 shows the device of FIG. 1 mounted on a conventional endoscope;

#FIG. 3 shows a side view of the device of FIG. 1;

#As shown in FIGS. 1-5, an apparatus according to a first embodiment of the present invention comprises a fastening device 2 in which springs 1 are used to propel the fasteners 708, shown in FIG. 7, through the material to be fastened. The springs 1 may be packaged in a pre-compressed state beneath pistons 3, as shown in FIG. 1. The compression of each spring at the time of manufacture allows the force to be applied to each staple 708 to be accurately predetermined. The springs may be manufactured from any bio-compatible metal of suitable strength, preferably steel. Those skilled in the art will recognize that the springs may also be fitted into the housing 12 in pre-formed recesses or otherwise fixedly attached to the housing 12.

#The springs 1 are separated from the staples 708 by a shutter 402. The shutter may be a linear shutter as shown in FIG. 1 or a rotary shutter as shown in FIGS. 6a and 6b. As the shutter 402 is pulled from between the springs 1 and the staples 708, the potential energy stored in the springs 1 upon compression is released as a driving force. Each spring moves from a compressed to a decompressed position in a discrete burst, impelling the staples 708 through the staple slits 34 against the staple-forming grooves 19 in the anvil 10, shown in FIG. 5. The shutter may be fabricated from metal or a plastic strong enough to retain the springs in their compressed state. A linear shutter or trip wire may be fabricated from a bio-compatible metal wire or cable, for example, that can be pulled from between each spring and staple pair in the direction of the arrow shown in FIG. 1 and wrapped around a drum in the control handle, similarly to fishing line in a fishing rod. A linear shutter may be used that is only as big as the minimum required active part of the shutter between the staples and the spring. This small linear shutter has the advantage of being physically smaller than other firing mechanisms known in the art. A rotary shutter on the other hand, would be wider, since it would have to be rotated from between the staples and the springs to an open position.

#A rotary shutter would intervene between the springs 1 and the staples 708 and could be removed from therebetween by telescoping open in an iris-like manner, by rotating 180 degrees, or by folding open in an accordian-like manner, as shown in FIGS. 6a and 6b. An iris-type rotary shutter and an accordian-like rotary shutter both have the advantage that once the shutter has been released it is no longer blocking any other devices that may be used in the procedure, such as for example a blade or grasping device.