APPLICATORS FOR DISPENSING SURGICAL FASTENERS, COMPRISING HINGE BARRELS AND HINGED ROTATION CONTROL ELEMENTS Russian patent published in 2020 - IPC A61B17/68 

FIELD: medicine.

SUBSTANCE: group of inventions refers to medical equipment, namely to applicators, systems and methods, in which hinge barrels are used for deployment of surgical fasteners. Applicator for dispensing surgical fasteners comprises a handle, a hinge shaft, a hinged rotation control element and an incompressible element. Handle has a distal end. Hinge shaft extends from the distal end of the handle. Hinge barrel comprises a proximal shaft section, a distal barrel section and a hinged joint. Proximal section of the shaft comprises a proximal external tube and a proximal internal element located inside the proximal external tube. Proximal internal element is rigidly fixed on a distal end of the handle, and the proximal external tube is made with possibility of sliding along a longitudinal axis in a distal and proximal directions in relation to the proximal internal element. Distal section of the shaft comprises a distal external tube and a distal internal element located inside the distal external tube. Distal internal element has a distal end surface having a window for dispensing surgical fasteners. Hinged joint comprises a first hinge joint and a connecting element. Pivotal rotation control element is connected to the proximal external tube to move the proximal external tube along the longitudinal axis in the distal and proximal directions. Distal movement of the proximal external tube results in hinged rotation of the distal section of the shaft relative to the proximal section of the shaft by means of a hinged joint. Incompressible element connects proximal internal element and distal internal element to maintain fixed distance between distal end surface of distal internal element and distal end of handle. Distance between the distal end of the distal external tube and the distal end of the handle varies as the articulated shaft moves between the forward configuration and the pivotally turned configuration. Incompressible element is configured to maintain fixed distance between distal end surface of distal inner element and distal end of handle. In a second embodiment, the applicator for delivering surgical fasteners comprises the above handle, articulated shaft, pivotal control element and an incompressible member. Hinge barrel comprises a proximal shaft section, a distal barrel section and a hinged joint. Proximal section of the shaft comprises a proximal external tube which is configured to slide in the distal and proximal directions along the longitudinal axis, and a proximal internal element located inside the proximal external tube, which is rigidly fixed on the distal end of the handle. In the third embodiment, the applicator for dispensing surgical fasteners comprises a handle, an articulated shaft, a trigger system, an actuator, a hinged rotation control element and an incompressible element. Method for treating a hernia defect involves inserting a mesh into an abdominal cavity of a patient; placing the mesh over the hernial defect; providing an applicator for dispensing surgical fasteners; the applicator comprising a handle, a hinge and a hinged rotation control element; introduction of the distal end of the hinge in the patient's abdominal cavity when the articulated shaft is in a direct configuration, so that the proximal and distal sections of the shaft extend along the longitudinal axis; engaging hinged rotation control element for hinged rotation of the distal section of the shaft relative to the proximal shaft section, so that the distal section of the shaft passes along the second axis forming an angle with the longitudinal axis; providing abutment of the distal end of the articulated shaft to the mesh and pressing the trigger to dispense at least one surgical fastener through the mesh and into the patient's abdominal wall.

EFFECT: use of inventions makes it possible to provide unilateral tension of the grid and manoeuvrability both inside and outside of it.

21 cl, 27 dwg