Device for delivering grafts at a surgical site and method

Abstract

A device and method for delivering a synthetic mesh or graft for anatomical repair at a defect site. A plurality of flexible arms is connected to the synthetic mesh or graft. Grasping jaws are individually controlled at or near a proximal end of the device for connection of the graft and release of the graft at the surgical site. The flexible arms, with graft attached are positioned through a surgical incision to the defect site. An actuator positions the flexible arms to assume a radial array at the surgical site, unfolding and spreading the graft for attachment. The length of each flexible arm is individually adjustable to adapt to the size and shape of the graft selected for installation at the defect site to repair the defect.

What is claimed is: 
     
         1 . A device for delivery of a graft for attachment to tissue, comprising:
 an actuator;   a plurality of flexible arms, wherein the plurality of flexible arms is in communication with and moves in response to movement of the actuator, wherein distal ends of the plurality of flexible arms extend out of an opening in a distal end of a shaft and movement of the actuator forms the plurality of flexible arms as divergent from each other and divergent from a center to form the distal ends of the plurality of flexible arms in a radial array, wherein the center is the opening in the distal end of the shaft;   wherein a distal end of a first flexible arm of plurality of flexible arms is length adjustable relative to a length of a distal end of another flexible arm of the plurality of flexible arms to differentiate a length of the distal end of the first flexible arm from the length of the distal end of the another flexible arm of the plurality of flexible arms.   
     
     
         2 . A device for delivery of a graft for attachment to tissue as described in  claim 1 , further comprising a brake, wherein each of the plurality of flexible arms frictionally engages the brake, and wherein the brake contacts the plurality of flexible arms and resists length adjustability of the plurality of flexible arms. 
     
     
         3 . A device for delivery of a graft for attachment to tissue as described in  claim 1 , further comprising a brake, wherein the brake comprises a plurality of channels formed therein, and each of the plurality of flexible arms engages a channel of the plurality of channels of the brake, and wherein each of the plurality of flexible arms frictionally engages the brake, and wherein the brake contacts the plurality of flexible arms and resists length adjustability of the plurality of flexible arms. 
     
     
         4 . A device for delivery of a graft for attachment to tissue as described in  claim 1 ,
 the plurality of flexible arms comprising three flexible arms,   wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms, and   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array.   
     
     
         5 . A device for delivery of a graft for attachment to tissue as described in  claim 1 ,
 the plurality of flexible arms comprising three flexible arms, wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms,   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the connectors and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array,   wherein each connector of each of the three flexible arms is constructed to open and close separately from every other connector, and   a housing in which the actuator is contained comprising three connector actuators, wherein closing of each connector is remotely actuated by a corresponding connector actuator of the three connector actuators.   
     
     
         6 . A device for delivery of a graft for attachment to tissue as described in  claim 1 ,
 the plurality of flexible arms comprising three flexible arms, wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms, and   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the connectors and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array,   wherein each connector of each flexible arm of the three flexible arms is constructed to open and close separately from every other connector,   a housing in which the actuator is contained comprising three connector actuators, wherein opening of each connector is remotely actuated by a corresponding connector actuator of the three connector actuators, and each of the three connector actuators operates independently of each of the other connector actuators and independently of the actuator that forms the distal ends of the plurality of flexible arms into the radial array,   wherein the housing comprises a release actuator, wherein the release actuator actuates tension on a connector linkage and causes the connector to close.   
     
     
         7 . A device for delivery of a graft for attachment to tissue as described in  claim 1 ,
 wherein the actuator comprises a rack and pinion, and rotation of the pinion by a lever of the actuator actuates movement of the rack, and   wherein the rack communicates with the plurality of flexible arms and movement of the lever and the rack of the actuator forms the distal ends of the plurality of flexible arms into the radial array.   
     
     
         8 . A device for delivery of a graft for attachment to tissue as described in  claim 1 , further comprising a sheath positioned at an end of the shaft and having a longitudinal split along a length thereof, wherein the sheath is constructed to accommodate and surround the distal ends of the plurality of flexible arms positioned generally parallel to each other and a graft connected to the plurality of flexible arms. 
     
     
         9 . A device for delivery of a graft for attachment to tissue as described in  claim 1 ,
 the plurality of flexible arms comprising three flexible arms and a connector at the distal end of each of the three flexible arms, wherein each connector is constructed to open and close, and each connector is constructed to close on a graft,   the device for delivery of a graft for attachment to tissue further comprising a sheath having a longitudinal split along a length thereof, wherein the sheath is constructed to accommodate and surround the distal ends of the three flexible arms and a graft connected to the three flexible arms; and   wherein the distal ends of each of the three flexible arms are positioned within the sheath in a generally parallel relationship, and the sheath is constructed and arranged to be inserted into a trocar.   
     
     
         10 . A device for delivery of a graft for attachment to tissue as described in  claim 1 , wherein the plurality of flexible arms are positioned as a radial array as the shaft is removed from a surgical site to remove the flexible arms from the surgical site. 
     
     
         11 . A device for delivery of a graft for attachment to tissue, comprising:
 an actuator;   a plurality of flexible arms and a plurality of sleeves, wherein each sleeve of the plurality of sleeves surrounds a portion of one of the flexible arms of the plurality of flexible arms, and a distal end of each of the flexible arms extends out of a distal end of the sleeve of the plurality of sleeves that surrounds the flexible arm;   wherein the plurality of sleeves are in communication with and move in response to movement of the actuator, wherein distal ends of the sleeves extend out of an opening in a distal end of a shaft, and movement of the actuator forms the distal ends of the plurality of sleeves as divergent from a center to form the distal ends of the plurality of flexible arms in a radial array, wherein the center is the opening in the distal end of the shaft;   wherein a distal end of a first flexible arm of plurality of flexible arms is length adjustable relative to a length of a distal end of another flexible arm of the plurality of flexible arms to differentiate a length of the first flexible arm from the length of the another flexible arm of the plurality of flexible arms.   
     
     
         12 . A device for delivery of a graft for attachment to tissue as described in  claim 11 , further comprising a brake, wherein each of the plurality of flexible arms frictionally engages the brake, and wherein the brake contacts the plurality of flexible arms and resists length adjustability of the plurality of flexible arms. 
     
     
         13 . A device for delivery of a graft for attachment to tissue as described in  claim 11 , further comprising a brake, wherein the brake comprises a plurality of channels formed therein, and each of the plurality of flexible arms engages a channel of the plurality of channels of the brake, and wherein each of the plurality of flexible arms frictionally engages the brake, and wherein the brake contacts the plurality of flexible arms and resists length adjustability of the plurality of flexible arms. 
     
     
         14 . A device for delivery of a graft for attachment to tissue as described in  claim 11 ,
 the plurality of flexible arms comprising three flexible arms,   wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms, and   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array.   
     
     
         15 . A device for delivery of a graft for attachment to tissue as described in  claim 11 ,
 the plurality of flexible arms comprising three flexible arms, wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms,   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the connectors and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array,   wherein each connector of each of the three flexible arms is constructed to open and close separately from every other connector, and   a housing in which the actuator is contained comprising three connector actuators, wherein closing of each connector is remotely actuated by a corresponding connector actuator of the three connector actuators.   
     
     
         16 . A device for delivery of a graft for attachment to tissue as described in  claim 11 ,
 the plurality of flexible arms comprising three flexible arms, wherein each of the three flexible arms comprises a connector at the distal end of each of the three flexible arms, and   wherein each connector is constructed to open and close, and each connector is constructed to close on a graft, and the connectors and the three flexible arms hold the graft in the radial array when the actuator forms the distal ends of the plurality of flexible arms into the radial array,   wherein each connector of each flexible arm of the three flexible arms is constructed to open and close separately from every other connector,   a housing in which the actuator is contained comprising three connector actuators, wherein opening of each connector is remotely actuated by a corresponding connector actuator of the three connector actuators, and each of the three connector actuators operates independently of each of the other connector actuators and independently of the actuator that forms the distal ends of the plurality of flexible arms into the radial array,   wherein the housing comprises a release actuator, wherein the release actuator actuates tension on a connector linkage and causes the connector to close.   
     
     
         17 . A device for delivery of a graft for attachment to tissue as described in  claim 11 , wherein the actuator comprises a rack and pinion, and rotation of the pinion by a lever of the actuator actuates movement of the rack, and wherein the rack communicates with the plurality of flexible arms and movement of the lever and the rack of the actuator forms the distal ends of the plurality of flexible arms into the radial array. 
     
     
         18 . A device for delivery of a graft for attachment to tissue as described in  claim 11 , further comprising a sheath positioned at an end of the shaft and having a longitudinal split along a length thereof, wherein the sheath is constructed to accommodate and surround the distal ends of the plurality of flexible arms positioned generally parallel to each other and a graft connected to the plurality of flexible arms. 
     
     
         19 . A device for delivery of a graft for attachment to tissue as described in  claim 11 ,
 the plurality of flexible arms comprising three flexible arms and a connector at the distal end of each of the three flexible arms, wherein each connector is constructed to open and close, and each connector is constructed to close on a graft,   the device for delivery of a graft for attachment to tissue further comprising a sheath having a longitudinal split along a length thereof, wherein the sheath is constructed to accommodate and surround the distal ends of the three flexible arms and a graft connected to the three flexible arms; and   wherein the distal ends of each of the three flexible arms are positioned within the sheath in a generally parallel relationship, and the sheath is constructed and arranged to be inserted into a trocar.   
     
     
         20 . A device for delivery of a graft for attachment to tissue as described in  claim 11 , wherein the actuator applies a pulling force to the plurality of sleeves, and the pulling force forms the distal ends of the plurality of sleeves as divergent from the center to form the distal ends of the plurality of flexible arms into the radial array.