CA1236743A - Surgical fastener applying apparatus with progressive application of fastener - Google Patents

Surgical fastener applying apparatus with progressive application of fastener

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Publication number
CA1236743A
CA1236743A CA000493366A CA493366A CA1236743A CA 1236743 A CA1236743 A CA 1236743A CA 000493366 A CA000493366 A CA 000493366A CA 493366 A CA493366 A CA 493366A CA 1236743 A CA1236743 A CA 1236743A
Authority
CA
Canada
Prior art keywords
fasteners
cam
parallel
fastener
longitudinal array
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000493366A
Other languages
French (fr)
Inventor
David T. Green
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
United States Surgical Corp
Original Assignee
United States Surgical Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by United States Surgical Corp filed Critical United States Surgical Corp
Application granted granted Critical
Publication of CA1236743A publication Critical patent/CA1236743A/en
Expired legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

Abstract

SURGICAL FASTENER APPLYING APPARATUS
WITH PROGRESSIVE APPLICATION OF FASTENERS

Abstract of the Disclosure In apparatus for applying a relatively large number of surgical fasteners to body tissue, application of some fasteners is made to precede application of other fasteners in order to spread out and thereby reduce the peak fastener applying load or force.

Description

~2~

This invention relates to apparatus for applying surgical fasteners to body tissue, and more particularly to apparatus Eor applying a relatively large number of such fasteners substantially simultaneously.
Instruments Eor applying relatively large numbers of surgical fasteners simultaneously or substantially simultaneously are known as shown, for example, by Hirsch et al. United States Patent 3,275,211, Green United States Patent 4,402,444, and Green United States Patent 4,402,~45. The fasteners may take the Eorm oE metal surgical staples as shown in the Hirsch et al. patent, or they may be initially two-part non-metallic surgical fasteners as shown in the Green '445 patent. The term "surgical fasteners" is used herein as a generic term for both of these types of fasteners.
Some surgical procedures require the application of a very large number of surgical fasteners. For example, the device shown in the Green '444 patent is adapted to apply 50, 60, or even more fasteners in four closely spaced rows. If all of these fasteners are driven exactly simultaneously, the peak force required can be very large. This necessitates an instrument design which is very strong and correspondingly costly. It also may make the instrument relatively difficult to operate.
It is therefore an object oE this invention to reduce the peak force required in instruments which apply relatively large numbers of surgical fasteners.
The present invention provides apparatus for applying a longitudinal array of surgical fasteners to body tissue comprising a plurality oE surgical fasteners in a longitudinal array, fastener pusher means for pushing the Easteners into the tissue along an ax;s transverse to the longitudinal array, the fastener pusher means including a first rigid longitudinal member parallel to and coextensive with the longitudinal array, a second member for supplying the worlc required for pushing the Easteners into the tissue, and first means for transmitting the work supplied by the second member to the
-2-first member so that one end of the first member initially moves parallel to the transverse axis substantially Easter than the other end of the first member to cause the fasteners adjacent the one end of the first member to be applied to the tissue i.n advance of the fasteners ad~acent the other end of the first member.
Thus, the invention may provide surgical fastener applying apparatus including means :for causing one end of a rigid member in the fastener driving assembly to initially move faster in the fastener driving di.rection than the other end of that member initially moves so that application of the fasteners adjacent said one end of the member prece~es application of the fasteners adjacent said other end of the member. In this way the fastener applying load is distributed over time so that the peak force required is reduced as compared to the peak force required for applying all of the fasteners exactly simultaneously.
The invention will be more apparent from the following description of an embodiment thereof when taken with reference to the accompanying drawings, in which:
Figure l is a perspective view of surgical fastener applyiny apparatus which can be modified in accordance with the principles of this invention.
Figure 2 is a partial, partly sectional, elevati.onal view oE the apparatus of Figure l showing an i.niti.al stage in the operating cycle of that apparatus.
Figure 3 is a view similar to Figure 2 but showing a subsequent stage in the operating cycle.
Figure 4 is a partial exploded perspective view o.E the apparatus of Figures 1-3.
E`igures 5-7 are exploded perspective views of various portions of the apparatus o:F Figures 1-~.
Figure 8 is a partly sectional, elevational view of a portion of the apparatus of Figures l-7 showing an i.ni.tial stage in the operating cycle of that apparatus.

~Z3~

Figures 9-12 are views similar to Figure 8 showing successive stages in the operating cycle of the apparatus.
Figure 13 is a view similar to Figure 10 showing how the apparatus of Figures 1-12 can be modified in accordance with an embodiment of the present invention.
Among the environments in which the present invention can be employed are the articulated surgical fastener applying instruments shown in the applicant's concurrently filed Canadian Patent Application Serial No.
493,368. One of those instruments (shown in Figures 1-12 herein, which are respectively identical to Figures 1-12 herein in the above-mentioned concurrently filed application) will first ~e described in detail. Then, modification of that device in accordance with the present invention will be described with reference to Figure 13.
As shown in Figure 1, a surgical fastener applying instrument 10 which can be modified in accordance with the present invention includes proximal actuator assembly 20, distal fastener applying assembly 200, and intermediate shaft assembly 100.
Fastener applying assembly 200 includes proximal fastener holding part 210 and distal anvil part 280.
Anvil part 280 is mounted for limited pivotal and translational motion relative to fastener ~æ3~

holding part 210 so that anvil part 280 can be trans-lated and pivoted away from fastener holding par-t 210 as shown in solid lines in Figure l ko permi-t the tissue 12 that is to be fastened to be inserted be--tween the distal surface of ~as-tener holding part 210 and -the proximal surface of anvil par-t 280.
Fastener holding part 210 is connected to th~ distal end of shaft assembly 100 just beyond an articulation or joint 150 in the shaft assembly. In the depicted apparatus, join-t 150 comprises a spher-:ical ball 152 (~igure 2) rotatably secured in a com-plementary socket 160. Joint 150 allows fastener applying assembly 2~0 to rotate abouk each of three mutually orthogonal axes 102, 104, and 106, all of which intersect a-t the center of ball 152. A few of the possible positions of fastener applying assem-bly 200 are sugges-ted in phantorn lines in Figure 1.
The proximal end of shaf-t assernbly lO0 may also be rotatably mounted in actua-tor assembly 20 for addi-tional rotational motion of assernblies lO0 and 200 about axis 102, which is the longitudinal axis o~
the instrument. other than joint 150 and the rota-tional mounting of shaft assembly lO0 in actua-tor assembly 20, shaft assembly lO0 is substantially rigid transverse -to its longitudinal axis. Shaf-t assembly 100 is also substantially rigid parallel to axis 102.
Actuator assembly 20 includes pro~imal handle 30, manually operable clamp actuator lever 40, and manually operable fastener actuator lever 60.
Pivoking clamp actuator lever 40 down in-to actuator assembly 20 pulls -the lower por-tion of anvil part 2~0 toward fastener holdirlg part 210. Squeezing fastenex actuator lever 60 -toward handle 30 causes fas-tener holding part 210 to drive the surgical fasteners contained in that part in -the distal direction toward anvil par-t 280. Fastener actuator lever 60 cannot be opera-ted until safety latch 90 is pivoted down ~3~

away from lever 60 as shown in phantom lines in F'igure 3.
Before considering the construction of -the apparatus in more de-tail, a brief description of its overall operation will be given. The initial condition of the apparatus is shown in Figures 1, 2, and ~.
Fastener applying assembly 200 is rotated, if desired, by any desired amount about any of axes 102, 10~, and 106 so that fastener applying assembly 200 has any desired angular orientation relative to actuator assembly 20. Joint 150 and the rota-tional connection between shaft assembly 100 and ac-tuator assembly 20 are preferably tight enough so that during subsequen-t operation of -the appara-tus, assemblies 20 and 200 main-tain whatever relative angular orienta-tion they are placed in.
The tissue 12 to be astened is placed between anvil part 280 and fastener holding part 210.
The upper portion of anvil part 280 is manually moved toward the opposite upper por-tion of fas-tener holding part 210 as shown in Figure 9, and latch button 212 is manually pushed in the distal direction so tha-t latch 214 engages ca-tch 282 in anvil part 280. This holds the upper end of anvil part 280 against the upper end of fastener holding part 210 to begin, the clamping of the tissue between those par-ts.
The next operating step is to pivot clamp actua-tor lever ~0 clown into actua-tor assembly 20 as shown in Figure 3. This pulls the lower end of anvil part 280 in against the lower end of fas-tener holding assembly 210 as shown in Figures 3 and 10. Parts 210 and 280 are now substan-tially parallel to one another with tissue 12 firmly clamped between the opposing surfaces of those parts. The ti,ssue is now ready to be fastened.
When the fasteners are to be applied, safety latch 90 is pivoted down as indicated in phantom lines in Figure 3. Fastener actuator lever 60 is :91 23~ 3 then pivoted toward handle 30 as also shown in phantom lines in Figure 3. This causes fastener holding assembly 210 to simul-taneously or substantially simul-taneowsly drive the legs of a plurali-ty of me-tal surgical s-taples 202 through tissue 12 and against anvil part 280 as shown in Figure 11. Anvil par-t 280 clinches or crimps the ends of the s-taple legs to secure the staples in the tissue. (Although metal s-taples are employed in the depic-ted apparatus, i-t will be understood that two-part plas-tic fasteners, such as those shown in Green U.S. pa-ten-t 4,402,445, can al-ternatively be used.) The tissue fas-tening procedure is now complete.
The fastened tissue is removed from the apparatus by manually pushing up on latch but-ton 212 as shown in Figure 12. This causes latch 214 to release catch 282, thereby allowing anvil part 280 to pivot away from fastener holding part 210.
The fastened tissue can now be removed from the apparatus.
Considering now the internal construction and operation of the apparatus, first with reference to Figure 2, clamp actuator lever 40 is pivotally connected -to actuator assembly frame 22 by pivot pin 42. One end of toggle link ~4 is pivotally connected to lever 40 by pin 46. The other end of toggle link 44 is pivotally connected to slide 50 by pin 48. Slide 50 is mounted for longitudinal reci-proca:L motion in slots 24 in frame 22 (see also Figure 4). When lever 40 is pivoted out from the remainder of actua-tor assembly 20 as shown in Figures 2 and 4, slide 50 is in its distal posi-tion in slots 24. When lever 40 is pivoted down toward the remainder of actuator assembly 20 as shown in Figure 3, slide 50 moves proximally in slots 24. In the fully operated posi-tion of lever 40, pin 46 has moved slightly past a straight line through pins 42 ~3~;7~3 and 48 so that lever 40 tends to remain in the fully operated position.
The proximal end of a first transversely flexible member 110 is connected to slide 50.
Member 110 may be a metal wire or cable, and ~or convenience herein, member 110 will be referred to as cable 110. Cable 110 passes through the hollow tubular shaft 120 which is the outer member of most of the lenyth of shaft assembly 100. Cable 110 also passes through longitudinal aperture 154 (Figure 7) in ball 152 and into fastener applying assembly 200.
The distal end of cable 110 is connected ~o anvil part 280 (see also Figure 5). Accordingly, when lever 40 is pivoted do~n toward the remainder of actuator assembly 20, cable 110 pulls the lower end of anvil part 280 in toward fastener holding part 210. Cable 110 is transversely flexible so that i-t does not interf~re with the pivoting of join-t 150. It should also be noted that cable 110 passes through the point of intersection of axes 102, 104, and 106 (Figure 1) so that even when placed in tension by operation of lever 40, cable 110 does not tend to alter the relative rotational orienta-tion of assemblies 20 and 200.
Returning to Figure 2, fastener ac-tuator lever 60 is pivotally connected to frame 22 by pin 26.
Safety latch 90 is similarly pivotally connected to handle 30 by pin 28. The proximal end of a second -transversely Elexible member 112 is fixedly at-tached to rame 22 at anchor ].14. Member 112 may be similar to cable 110 and is therefore referred to as cable 112.
~ proximal por-tion of cable 112 passes around roller 62 which i.s rotatably mounted on lever 60 by means of axle 64. AEter passing roller 62, cable 112 passes distally thro~lgh shaEt 120 and joint 150 and into .Eastener holding par-t 210. As is best seen in Figures 5 and 8, as cable 112 en-ters ~astener holding part 210, it passes around roller 220. Roller 220 redirects cable 112 up to anchor 222 which connects the distal en~ of cable 112 to cam bar 230. Accord-ingly, when lever 60 is pivoted toward handle 30, cable 112 pulls down on cam bar 230. Like cable 110, cable 112 passes through the poin-t of intersec-tion of axes 102, 104, and 106 and is sufficientl.y trans-versely flexible so -that it does not interfere with the pivoting of joint 150 or tend to alter the rela-tive rotational orientation of assemblies 20 and 200 even when placed in tension by operation of lever 60.
Cam bar 230 is disposed in a proximal-facin~
channel in pusher actuator member 240 (see Figure 6).
The distal face of cam bar 230 bears on and is slidable along the boktom of this channel in member 240.
Pusher actuator member 240 is disposed between two parallel, laterally spaced frame members 250 (Fi~-ure 5) of fastener holding part 210. The dis-tal surface of pusher actuator member 240 bears on the proximal ends of pusher members 260 which have pusher fingers 262 extending into apertures 272 in fastener holder 270 behind staples 202. Pusher actuator mem ber 240 is constrained to move subs-tantially parallel to -the axis along which staples 202 are driven by pusher members 26C. This constraint is provided by guide pins 242 which extend laterally ou-tward from member 240 into guide slots 252 in frame members 250.
~t should be noted that pusher actuator member 240 can also pivot about pins 242.
As cam bar 230 is pulled down by cable 112, it is also forced to move in the distal direct:ion by operation of cam follower pins 232 which pass through cam bar 230 and project laterally in-to cam slots 254 in frame members 250. Cam slots 254 are inclined so tha-t as cam bar 230 moves down in response to the motion of cable 112, it al.so moves distally. Cam bar 230 slides longitudinally along pusher actuator member 2~0 so that only the distal motion of cam bar 230 is imparted -to member 240. As member 240 ~236~3 g moves distally, it drives pusher membexs 260 and therefore staples 202 in -the distal direction. Thus elements 230, 232, 240, 242, 250, 252, 254, and 260 constitute means for convertiny -the downward motion of the distal end of cable 112 into dis-tal mo~ion oE
staples 202.
The connection between shaft assembly 100 and ac-tuator assembly 20 which permits relative rota-tion of -those assemblies is best seen in Figure 4.
The proximal end of shaf-t 120 is rotatably mounted in a cylindrical socke-t 80 formed in the -two mirror image halves 70a and 70b of the outer shell of actu-ator assembly 20. Shell halves 70 are held together by any suitable means such as rivets, adhesive, or the like. Annular collar 122 on shaEt 120 is received in annular enlargement 82 of socket 80 to retain shaft 120 in the proper longitudinal position rela--tive to ac-tuator assembly 20. If desired, -the amount of rotation of shaft 120 relative -to actuator assem-bly 20 may be limited by cooperating stops 124 on shaft 120 and 84 on actuator assembly shell 70.
Shell halves 70 preferably engage shaft 120 with sufficient force to frictionally maintain the rela-tive angular orientation of shaft 120 and actua-tor assembly 20 established by the user of the appara-tus.
The detailed construc-tion of jOiIIt 150 is shown in F.igure 7. Ball 152 is formed a-t the distal en~ of hollow, generally frustoconical pedestal 156.
A hollow cylindrical shank 15~ extends proximally from the base of pedestal 156. Shank 15~ is force-~itted in-to the distal end oE sha~t 120. Ball 152 fits snugly in-to socket 160, -the construc-tion of which is best seen in Figure 9. Socket 160 includes distal seat member 162 which carries roller 220 on axle 224 and which is fi~edly attached -to frame mem-bers 250 by pins 164 (Figure 7). Seat member 162 is hollow and has a proximal-facing annular sea-t surface 166 for receiving the distal end portion of
3~

ball 152. The proximal portion of the cylindrical outer surface of seat member 162 is threaded to receive collar 170. Collar 170 forces an annular retaining ring 172 aga;nst a proximal portion of the surface of ball 152.
Accordingly, ball 152 is captured between seat surface 166 and retaining ring 172 but can rotate relative to those members about each of axes 102, 104 and 106. Surfaces 166 and ]72 preEerably engage ball 152 with sufficient force to Erictionally maintain whatever relative angular orientation of assemblies 20 and 200 is established by the user oE the apparatus. In a particularly preferred embodiment, ball 152 is steel and members 162 and 172 are made of a thermoplastic material such as nylon.
Anvil part 280 is pivotally connected to fastener holding part 210 by means of pin 290 in elongated slots 256 in frame members 250. Slots 256 are elongated parallel to the longitudinal axis of the apparatus so that anvil part 280 can both pivot about pin 290 and translate parallel to slots 256. Anvil part 280 is resiliently biased away from fastener holding part 210 by compression coil spring 292 which is compressed between those parts.
Latch 214 is resiliently biased in the proximal direction as shown, for example, in Figure 8 by compression coil spring 216 acting between latch 214 and the body of fastener holding part 210.
The above-described apparatus can be modiEied in accordance with an embodiment oF the present invention as shown in E'igure 13. Instead of the Eour identical cam slots 254 employed in the apparatus of Figures 1-12, in Figure 13 the two upper cam slots 354 jonly one of which is visible in Figure 13) may be identical to one another but different from the two identical lower cam slots 454 (only one oE which is visible in Figure 13). In particular, each of lower cam slots 454 has an initial portion 454a which is ~316~3 more steeply inclined in the distal direction than the corresponding initial portion 354a of upper cam slots 3S4. This causes the lower end of cam bar 230 and the lower end of pusher ac-tuator member 240 to initially move more rapidly in the dis-tal direc-tion than the upper ends of those members. This in turn causes the staples 202 near the bottom of fastener holdiny part 210 to advance more rapidly toward tis-sue 12 than khe staples 202 near -the top oE fas-tener holding part 210. Accordingly, the ends of the staple legs do not all reach anvil part 280 at the same time. Rather, the staples near the bot~om of fastener holding part 210 reach anvil par-t 280 firs-t and begin to clinch against the anvil part before the staples near the top. The maximum force or "peak load" for clinching each staple therefore tends to occur at a different time than the peak loads for clinching the other staples. This distributes over time the individ-ual staple-clinching peak loads, -thereby reducing the aggregate total peak load required to drive the staples.
Following their initial portions 354a and 454a, each of cam slots 454 has an in-termediate por~
tion 454b which is substantially parallel to or slightly less steeply inclined in -the distal direction than the corresponding intermedia-te portions 354b of cam slo-ts 354. This main-tains the condi-tion of the appara-tus in which the lower portions of elements 230 and 240 are more distally advanced than -the upper por-tions of those elements un-til most or all of staples 202 have at least begun to clinch and have therefore passed -their peak load re~uirement.
The final segmen-ts 354c and 454c of cam slots 354 and 454 may be somewha-t more steeply in~
clined in -the dis-tal direc-tion than the inter~ediate segmen-ts. These final segments are traversed by cam follower pins 232 during the final compression of staples 202 when the force required is subs-tantially less than the peak load. The angle of inclination of cam slot segments 354c may differ from the angle of inclination of cam slot segments 454c so that when both cam Follower pins 232 have reached the end oE their travel, they will both have moved the same d;stal distance frorn their starting positions. This assures that, allhough during the staple driving stroke members 230 and 240 are del;berately inclined relative to the (vertical) lonyitudinal axis of anvil part 280, the staple driving stroke ends with members 230 and 240 substantially parallel to that axis. This provides uniform compression oE all of the staples.
Although an embodiment of the invention has been illustrated in the context of surgical Eastener applying instruments which apply two parallel rows of surgical fasteners, the greater the number of Easteners to be applied, the greater the advantages of the invention become. For example, the invention is even more beneficial in instruments which apply four parallel rows of surgical fasteners as shown, for example, in Green United States Patent ~,402,444.
It is to be understood that the invention is not limited in application to surgical fastener applying apparatus of the type shown in Figures 1-12 herein. For example, although that apparatus has an articulated shaEt assembly, the present invention is equally applicable to instruments with other types of shaft assemblies such as transversely flexible or completely rigid shaEt assemblies. Similarly, although metal surgical staples 202 are employed in the depicted apparatus, other types of surgical fasteners, such as two-part plastic fasteners like those shown in Creen United States Patent 4,402,445, could be used instead. Also, either the meta] staples or the plastic fasteners employed can be either biologically inert or biologically absorbable, as is now wel:L known to those skilled in the art.

Claims (7)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. Apparatus for applying a longitudinal array of surgical fasteners to body tissue comprising:
a plurality of surgical fasteners in a longitudinal array;
fastener pusher means for pushing the fasteners into the tissue along an axis transverse to the longitudinal array, the fastener pusher means including a first rigid longitudinal member parallel to and coextensive with the longitudinal array;
a second member for supplying the work required for pushing the fasteners into the tissue; and first means for transmitting the work supplied by the second member to the first member so that one end of the first member initially moves parallel to the transverse axis substantially faster than the other end of the first member to cause the fasteners adjacent said one end of the first member to be applied to the tissue in advance of the fasteners adjacent said other end of the first member.
2. The apparatus defined in claim 1 wherein the first means includes second means for increasing the rate of motion of said other end of the first member parallel to the transverse axis as the fasteners are applied.
3. The apparatus defined in claim 2 wherein the first and second means cooperate so that both ends of the first member have moved substantially the same distance parallel to the transverse axis when all the work supplied by the second member has been transmitted to the first member.
4. The apparatus defined in claim 1 wherein the second member supplies the work required for pushing the fasteners into the tissue by moving with a component of motion substantially parallel to the longitudinal array.
5. The apparatus defined in claim 4 fur-ther comprising:
a third member; and third means for mounting the first member relative to the third member so that the first member can only move relative to the third member substantially parallel to the transverse axis, the second member being in sliding contact with the first member substantially parallel to the longitudinal array;
the first means further including first and second cam and cam follower assemblies connected between the second and third members and respectively located adjacent said one and said other end of the first member for causing the second member to move relative to the third member with a component of motion substantially parallel to the transverse axis as the second member moves relative to the third member substantially parallel to the longitudinal array.
6. The apparatus defined in claim 5 wherein the initial portion of the cam surface tra-versed by the cam follower of the first cam and cam follower assembly is more nearly parallel to the transverse axis than the corresponding cam surface portion of the second cam and cam follower assembly.
7. The apparatus defined in claim 6 wherein after the initial cam surface portion of the first cam and cam follower assembly, there is a portion of said cam surface which is more nearly parallel to the longitudinal array than the corre-sponding cam surface portion of the second cam and cam follower assembly.
CA000493366A 1984-10-19 1985-10-18 Surgical fastener applying apparatus with progressive application of fastener Expired CA1236743A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US662,679 1984-10-19
US06/662,679 US4580712A (en) 1984-10-19 1984-10-19 Surgical fastener applying apparatus with progressive application of fastener

Publications (1)

Publication Number Publication Date
CA1236743A true CA1236743A (en) 1988-05-17

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA000493366A Expired CA1236743A (en) 1984-10-19 1985-10-18 Surgical fastener applying apparatus with progressive application of fastener

Country Status (10)

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US (1) US4580712A (en)
EP (1) EP0198873B1 (en)
JP (1) JPS61501894A (en)
AT (1) ATE59276T1 (en)
AU (1) AU569954B2 (en)
BR (1) BR8507000A (en)
CA (1) CA1236743A (en)
DE (1) DE3581198D1 (en)
GB (1) GB2183526B (en)
WO (1) WO1986002253A1 (en)

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EP0198873A4 (en) 1988-04-06
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AU569954B2 (en) 1988-02-25
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US4580712A (en) 1986-04-08
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WO1986002253A1 (en) 1986-04-24
ATE59276T1 (en) 1991-01-15
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