Hernia stapler

Abstract

A surgical stapler for use during an open hernia repair comprises an elongated shaft having a handle at its proximal end and a downwardly disposed staple discharge head at its distal end. A squeeze trigger on the handle is operable to cause a supply of staples to be selectively discharged from the port. One or more mesh manipulators are provided on the head and serve to assist in positioning or otherwise manipulating surgical mesh prior to fixation with the staples. In one form, the stapler includes a chamfered portion, a cantilevered portion, and a retention lip to prevent multiple staples from deploying after a single pull of the trigger. Further, in this form, the stapler prevents incomplete staple formation if side load forces are applied during insertion of a staple in tissue thereby reducing waste of staples.

1 . A method of attaching a surgical mesh comprising:
 providing a surgical stapler having an elongated shaft with a handle at its proximal end and a downwardly disposed staple discharge head at its distal end, wherein the handle is operable to cause a supply of staples to be selectively discharged from the head, the surgical stapler having one or more mesh manipulators near the staple discharge head;   using the mesh manipulator to position the mesh; and   using the stapler to attach the mesh to tissue.   
     
     
         2 . The method of  claim 1  wherein the tissue is the inguinal ligament. 
     
     
         3 . The method of  claim 1  wherein the mesh manipulator comprises one or more prongs extending from the discharge head of the stapler. 
     
     
         4 . The method of  claim 1  wherein the mesh manipulator comprises a wire. 
     
     
         5 . The method of  claim 1  further comprising:
 retaining a single staple from the supply of staples between a pair of forming fingers on a pusher plate disposed in the staple discharge head. 
 
     
     
         6 . The method of  claim 5  further comprising:
 an anvil plate positioned in the discharge head adjacent the pusher plate, the anvil plate having a step with a height that corresponds to about the thickness of the single staple; 
 pushing the pusher plate over the anvil plate; and 
 positioning the single staple under the chamfered portion as the pusher plate passes over the anvil plate. 
 
     
     
         7 . The method of  claim 6  further comprising:
 rotating the single staple away from the supply of staples as the pusher plate passes over the anvil plate. 
 
     
     
         8 . During inguinal hernia repair, a method of attaching a mesh covering a herniated membrane to body tissue adjacent and bordering the site of the herniation, the method comprising:
 inserting a staple discharge head of a stapling apparatus into an opening bordered by said tissue and directing the staple discharge head downward toward said mesh at a near side of said opening and firing staples from the staple discharge head through said mesh into some of said tissue adjacent said herniation, at multiple locations on the near side of said opening;   moving the head of the stapling apparatus in an opening bordered by said tissue; and   directing the staple discharge head upward toward said mesh at a far side of said opening and firing staples from the head through said mesh into some of said tissue, at multiple locations on the far side of said opening.   
     
     
         9 . The method of  claim 8  further comprising:
 engaging said mesh with one or more mesh manipulating members mounted to said head; and 
 moving said mesh with said probe to position said mesh at a location on said tissue where a staple is to be fired into said mesh and said tissue. 
 
     
     
         10 . The method of  claim 8  wherein the mesh manipulating members comprise a plurality of prongs extending from said head. 
     
     
         11 . The method of  claim 8  further comprising:
 the stapling apparatus having a pusher plate positioned in the staple discharge head, the pusher plate including a retention lip adapted to retain a single staple, wherein the pusher plate includes a chamfered portion adapted to engage only the single staple, the stapling apparatus also having an anvil plate positioned in the staple discharge head adjacent the pusher plate, the anvil plate having a step with a height of about the thickness of the single staple; 
 moving the pusher plate over the anvil plate; and 
 retaining the single staple under the chamfered portion of the pusher plate. 
 
     
     
         12 . The method of  claim 11  further comprising:
 rotating the single staple away from the supply of staples as the pusher plate moves over the anvil plate.