Surgical Tack and Tack Drive Apparatus

Abstract

A fastener is provided for attaching body tissue to body tissue or another material to body tissue. The fastener includes a head portion, a body portion, and an anchoring element. The anchoring element is on the distal end of the fastener, and has one or more barbs or similar anchoring devices that are configured to prevent removal of the fastener once it is attached to the body tissue. The head is located on the proximal end of the fastener, and anchors the body tissue or other material when the fastener is attached to the body tissue. The disclosure also provides a driver apparatus for inserting the fasteners. The applicator device includes an indexer for sequentially indexing one or more fasteners, and a driver for applying an insertion force to a fastener that is sufficient to insert the fastener and attach it to body tissue. The disclosure also provides a method of using the fastener and applicator device.

1 . A fastener for attaching to a body tissue, having a longitudinal direction, a proximal end, and a distal end, and comprising:
 a head portion disposed near the proximal end of the fastener, and having a proximal surface, a distal surface, and a passage that extends through the head portion from the proximal surface to the distal surface;   a body portion extending from the distal surface of the head portion in the longitudinal direction; and   an anchoring element extending from the body portion, and comprising at least one barb at least partially disposed adjacent the distal end of the fastener.   
     
     
         2 . The fastener of  claim 1 , wherein the at least one barb has a proximal end and a distal end, and wherein the barb's proximal end is wider than the barb's distal end, as measured in a direction orthogonal to longitudinal direction. 
     
     
         3 . The fastener of  claim 1 , wherein the at least one barb further comprises an upper facet and a lower facet, said facets tapering to an angled leading edge. 
     
     
         4 . The fastener of  claim 1 , wherein the anchoring element comprises two barbs disposed on opposite sides of the fastener. 
     
     
         5 . The fastener of  claim 4 , wherein the two barbs are longitudinally offset from each other. 
     
     
         6 . The fastener of  claim 2 , wherein the anchoring element comprises two barbs disposed on opposite sides of the fastener. 
     
     
         7 . The fastener of  claim 6 , wherein distal ends of the two barbs are longitudinally offset from each other. 
     
     
         8 . The fastener of  claim 1 , wherein the head portion further comprises at least one anchor tab disposed on the distal surface of the head portion. 
     
     
         9 . The fastener of  claim 1 , wherein the passage is a bore. 
     
     
         10 . The fastener of  claim 9 , wherein the bore is rectangular. 
     
     
         11 . The fastener of  claim 1 , wherein the fastener is made of absorbable material. 
     
     
         12 . The fastener of  claim 1 , wherein the passage is a channel. 
     
     
         13 . The fastener of  claim 1 , wherein the distal head face and proximal head face are substantially flat surfaces. 
     
     
         14 . An applicator for applying a barbed fastener to a body tissue, the applicator comprising:
 an elongated tubular portion having a longitudinal axis extending from a proximal end to a distal end and having a tube interior accessible by proximal and distal tube openings, the tube interior being sized and configured for receiving the barbed fastener;   an indexer disposed at least partially inside the tube interior, the indexer having an elongated indexer body member and a fastener engaging portion adapted to engage the barbed fastener and move the barbed fastener from an initial fastener position in the tube interior to a firing position as the indexer moves from a first longitudinal position to a second, more distal longitudinal position; and   a driver disposed at least partially inside the tube interior, the driver having a driver engaging portion at its distal end, the driver engaging portion being adapted to engage the barbed fastener in the firing position and selectively apply an ejection force to the barbed fastener, thereby ejecting the barbed fastener from the tube interior through the distal opening.   
     
     
         15 . The applicator of  claim 14 , wherein the ejection force is applied to the barbed fastener by the driver as the driver is moved distally from a pre-firing driver position to a distal-most driver position adjacent the distal tube opening. 
     
     
         16 . The applicator of  claim 15  wherein a biasing force is applied to the driver by a spring when said driver is in the pre-firing driver position, said biasing force serving to bias the driver toward the distal-most driver position. 
     
     
         17 . The applicator of  claim 15  wherein the applicator is configured for operation through a repeatable operation cycle comprising:
 an initial stage, in which the indexer is in its first longitudinal position and the driver is in its distal-most position; 
 a pre-firing stage, in which the indexer is in its second, more distal longitudinal position and the driver is in its pre-firing position; and 
 a post-firing stage, in which the indexer is in its second, more distal longitudinal position, and the driver is in its distal-most position. 
 
     
     
         18 . The applicator of  claim 17 , wherein the indexer and driver are operably coupled with an actuation assembly configured to selectively control and coordinate movement of the indexer and driver from their initial stage positions to their pre-firing stage positions, from their pre-firing stage positions to their post-firing stage positions, and from their post-firing stage positions back to their initial stage positions. 
     
     
         19 . The applicator of  claim 18 , wherein the actuation assembly comprises a trigger configured for rotational movement between an initial trigger position, a pre-firing trigger position and a post-firing trigger position, the trigger and actuation assembly being adapted so that movement of the trigger from the initial trigger position to the pre-firing trigger position causes the indexer and driver to move from their initial stage positions to their pre-firing stage positions, further movement of the trigger to the post-firing trigger position causes the indexer and driver to move from their pre-firing stage positions to their post-firing stage positions, and movement of the trigger back to the initial trigger position causes the indexer and driver to move from their post-firing stage positions back to their initial stage positions. 
     
     
         20 . The applicator of  claim 14 , wherein the barbed fastener comprises a head portion having a fastener passage formed therethrough and wherein the elongated indexer body member is configured for slidable disposition through the fastener passage. 
     
     
         21 . The applicator of  claim 14 , wherein:
 the tube interior is sized and configured for receiving one or more additional fasteners substantially identical to the barbed fastener, the additional fasteners being serially positionable within the tube interior proximal to the barbed fastener along the longitudinal axis,   the indexer has one or more additional engaging portions adapted to engage the additional fasteners and to move each of the additional fasteners from a first longitudinal fastener position to a second more distal longitudinal fastener position at the same time the indexer moves the barbed fastener from its initial fastener position to its firing position.   
     
     
         22 . The applicator of  claim 21 , wherein the second longitudinal position of the distal-most of the additional fasteners is the same as the initial fastener position of the barbed fastener. 
     
     
         23 . The applicator of  claim 21  further comprising: means for preventing the additional fasteners from moving in a proximal direction when the indexer returns from its second, more distal longitudinal position to the first longitudinal position. 
     
     
         24 . The applicator of  claim 21 , wherein the elongated tube portion comprises one or more lance tabs projecting inward from an inner surface of the elongated tube portion at an angle toward the distal end of the elongated tube portion and capable of flexing outward, the lance tabs being configured to engage and prevent the proximal movement of the additional fasteners while allowing their distal movement by the indexer. 
     
     
         25 . A method of applying a fastener to a pre-determined target insertion point on a body tissue, comprising:
 providing a fastener having a head portion having a passage formed therethrough, an anchoring element configured for engaging the body tissue, and a body portion extending distally from the head portion to connect the anchoring element thereto;   providing a fastener applicator comprising
 an elongated tubular portion having a longitudinal axis extending from a proximal end to a distal end and having a tube interior accessible by proximal and distal tube openings, 
 an indexer disposed at least partially inside the tube interior, the indexer being adapted to selectively move the fastener from an initial position to a firing position adjacent the distal tube opening, and 
 a driver disposed at least partially inside the tube interior, the driver being adapted to engage the fastener in the firing position and selectively apply an ejection force to the fastener; 
   placing the fastener in the initial position within the tube interior;   causing the indexer to selectively move the fastener from the initial position to the firing position;   positioning the distal opening of the tube assembly adjacent the target insertion point; and   causing the driver to apply the ejection force to the fastener, thereby ejecting the fastener through the distal opening and into the body tissue at the target insertion point.   
     
     
         26 . The method of  claim 25 , wherein the ejection force is applied to the barbed fastener by the driver as the driver is moved distally from a pre-firing driver position to a distal-most driver position adjacent the distal tube opening. 
     
     
         27 . The method of  claim 26  wherein a biasing force is applied to the driver by a spring when said driver is in the pre-firing driver position, said biasing force serving to bias the driver toward the distal-most driver position. 
     
     
         28 . The method of  claim 25 , wherein the applicator includes an actuation assembly having a trigger configured for rotational movement between an initial trigger position, a pre-firing trigger position and a post-firing trigger position, the trigger and actuation assembly being adapted so that movement of the trigger from the initial trigger position to the pre-firing trigger position causes the indexer to move the fastener from the initial position to the firing position, further movement of the trigger to the post-firing trigger position causes the driver to apply the ejection force to the fastener, thereby ejecting the fastener through the distal opening and into the body tissue at the target insertion point.