Medical devices for delivering fluids during surgery and methods for their use

Abstract

Provided is a surgical applicator and applicator tip configured to attach in fluid communication, for the delivery of beneficial fluids. The applicator tip may also be configured to reversibly attach, in fluid communication, with a pledget. For example, the applicator tip may include male or female threads, and the pledget has threads that are complementary to the thread configuration of the tip. The applicator tip may further comprise at least one fluid transfer lumen for transfer of a fluid from the tip to the pledget. In one embodiment of the invention, the tip includes male threads and the pledget includes a pledget attachment portion. There are also provided methods for connecting the tip to the pledget. In one embodiment, a tip comprising male threads is attached to the pledget, comprising a pledget attachment portion, by tapping or pressing the tip into the pledget attachment portion. There are also provided methods of use for the attached tip and pledget, including debridement, tissue translocation, delivery of fluid substances, absorption of fluid substances and combinations thereof. In a particular embodiment, the applicator places a thrombin solution into the attached pledget for delivery of an active hemostatic agent to a tissue site.

What is claimed is: 
     
         1 . An applicator for administering a fluid to a surgical site comprising:
 an internal shaft housed within the applicator;   a fluid delivery tube contained within the shaft;   a mechanism that reversibly advances the shaft toward the distal end of the applicator;   wherein the distal end of the applicator is configured to receive and reversibly hold a pledget having a fluid delivery lumen for communicating with the applicator fluid delivery tube; and   wherein upon completion of the administration of the fluid, the shaft is advanced by the mechanism to expel the pledget from the distal end of the applicator.   
     
     
         2 . The applicator of  claim 1 , wherein the internal shaft further comprises:
 at least two spring arms, each having at least one prehensile member at its distal end configured to grasp a pledget; and   a spring arm retraction mechanism that releases the at least one prehensile member from the pledget when the shaft is advanced.   
     
     
         3 . The applicator of  claim 1 , wherein the pledget comprises a flange mount on its proximal end for insertion into the distal end of the applicator. 
     
     
         4 . The applicator of  claim 1 , wherein the mechanism is a piston mechanism that reversibly advances the shaft toward the distal end of the applicator. 
     
     
         5 . The applicator of  claim 1 , wherein the pledget is in fluid communication with the fluid delivery tube. 
     
     
         6 . The applicator of  claim 1 , wherein the exposed pledget may administer the fluid. 
     
     
         7 . The applicator of  claim 1 , wherein the applicator is a laparoscopic applicator. 
     
     
         8 . The applicator of  claim 1 , wherein the pledget is a porous, fluid permeable material. 
     
     
         9 . The applicator of  claim 8 , wherein the pledget is gelatin, a cotton gauze, a sponge, a plastic, fused gelatin beads, or a combination of these. 
     
     
         10 . The applicator of  claim 1 , wherein the pledget is a biocompatible, biodegradable material. 
     
     
         11 . An applicator for administering a fluid to a surgical site comprising:
 a fluid delivery lumen contained within the applicator;   reciprocating means contained within the applicator for reciprocating movement between first and second positions;   prehensile means connected to the reciprocating means for gripping a pledget when the reciprocating means is moved between the first and second positions;   wherein the applicator is configured such that when the prehensile means has gripped a pledget, fluid may be delivered to the pledget via the fluid delivery lumen.   
     
     
         12 . The applicator of  claim 11 , wherein the prehensile means comprise smooth, rounded distal ends. 
     
     
         13 . The applicator of  claim 11 , wherein the applicator is a laparoscopic applicator. 
     
     
         14 . The applicator of  claim 11 , wherein the pledget is a porous, fluid permeable material. 
     
     
         15 . The applicator of  claim 14 , wherein the pledget is gelatin, a cotton gauze, a sponge, a plastic, fused gelatin beads, or a combination of these. 
     
     
         16 . The applicator of  claim 11 , wherein the pledget is a biocompatible, biodegradable material. 
     
     
         17 . A system for delivery of a fluid to a surgical target site comprising:
 an applicator having a proximal end and a distal end;   at least one fluid delivery tube housed within the applicator;   an applicator tip having a proximal end and a distal end, the proximal end of the applicator tip detachably coupled to the applicator distal end;   at least one fluid delivery lumen at the applicator tip proximal end fluidly connected to the at least one fluid delivery lumen in the applicator;   the applicator tip distal end comprising a fluid-permeable material or an opening;   wherein, in use, the system delivers fluid from a source through the applicator delivery lumen and through the tip delivery lumen through the opening or fluid-permeable material to the target delivery site.   
     
     
         18 . The system of  claim 17 , wherein the applicator tip distal end is further configured to attach to a pledget comprising a porous matrix. 
     
     
         19 . The system of  claim 18 , wherein the pledget contains a radio-opaque substance. 
     
     
         20 . The system of  claim 18 , wherein the pledget comprises a biocompatible, biodegradable material.