Medical device for joining materials

Abstract

A medical device for joining materials is provided. The device comprises a piercing element configured to penetrate materials to be joined. The piercing element is sufficiently sharp to penetrate materials to be joined and comprises a hollow interior along at least a portion of its length configured to distal advancement of a fastener therethrough; and an open tip through which the fastener can be pushed. The device can be used for fastening materials including tissue, synthetic mesh, and biologic mesh (e.g., ADM).

1 . A fastening device comprising:
 a shaft;   a handle;   a needle extending from the shaft, the needle comprising a slot extending along at least a portion of the needle,   the device configured to receive a fastener comprising a first bar and a second bar connected by a bar connector, the first bar positioned within the needle and the second bar positioned outside the needle within the shaft; and   a push member configured to push the fastener out of the needle.   
     
     
         2 . The device of  claim 1 , further comprising a fastener positioned such that the first bar is positioned within the needle and the second bar is positioned outside the needle within the shaft. 
     
     
         3 . The device of  claim 1 , further comprising a fastener reservoir within the shaft, wherein the fastener is configured to convey down the reservoir. 
     
     
         4 . (canceled) 
     
     
         5 . The device of  claim 1 , further comprising at least one deflector near a distal end of the device, the deflector configured to reorient the second bar while the fastener is pushed distally. 
     
     
         6 . The device of  claim 1 , further comprising a stop positioned at a fixed or adjustable distance proximal to the distal end of the needle and configured to control an insertion depth of the needle. 
     
     
         7 . The device of  claim 1 , further comprising a trigger configured to deploy a fastener by engaging the push member. 
     
     
         8 .- 23 . (canceled) 
     
     
         24 . The device of  claim 1 , comprising a first deflector extending from a surface on one side of the needle, the first deflector extending away from the surface and configured to lift the bar connector and second bar to another side of the needle as the fastener is being pushed distally. 
     
     
         25 . The device of  claim 1 , further comprising a deflector extending towards the needle and configured to rotate the second bar as the fastener is being pushed distally, such that the second bar is moved towards an orientation approximately parallel to a material being fastened. 
     
     
         26 . The device of  claim 1 , further comprising a surface configured to maintain the rotated position of the second bar. 
     
     
         27 . (canceled) 
     
     
         28 . (canceled) 
     
     
         29 . (canceled) 
     
     
         30 . (canceled) 
     
     
         31 . The device of  claim 1 , wherein edges of the needle slot comprise rounded, broken, polished, or other non-sharp edge configurations. 
     
     
         32 . The device of  claim 1 , wherein a size of an inner diameter of the needle and a size of an outer diameter of the needle are selected to provide a sufficiently sized passageway through the material to be joined so the fastener's bar and bar connector pass through the material to be joined with minimal force. 
     
     
         33 . The device of  claim 32 , wherein the size of the inner diameter and outer diameter of the needle is selected to provide minimal insertion force in the material to be joined. 
     
     
         34 . The device of  claim 1 , wherein a bevel angle of the needle tip is configured to provide minimal insertion force in the material to be joined. 
     
     
         35 . The device of  claim 34 , wherein the bevel angle of the needle tip is configured to withstand repeated use. 
     
     
         36 . The device of  claim 1 , wherein a length of the needle is selected to minimize trauma to tissue and structures surrounding a repair site. 
     
     
         37 . The device of  claim 1 , wherein the length of the needle is selected to be suitable for depositing one end or more than one end of the fastener in tissue. 
     
     
         38 .- 60 . (canceled) 
     
     
         61 . A method for fastening an onlay material to tissue comprising;
 piercing the onlay material and tissue with a needle comprising a slot, the needle forming part of a fastening device; and   advancing a fastener comprising a first bar positioned within the needle, the first bar connected to a second bar by a connector.   
     
     
         62 . The method of  claim 61 , further comprising using a stop to control the insertion depth of the needle. 
     
     
         63 . The method of  claim 61 , further comprising withdrawing the needle out of the tissue from a first location in tissue, positioning or tensioning the material on the needle, and piercing the tissue at a second location. 
     
     
         64 . The method  claim 61 , further comprising reorienting the second bar. 
     
     
         65 . The method of  claim 61 , wherein advancing the fastener comprising activating a deployment mechanism trigger on the fastening device. 
     
     
         66 . The method of  claim 61 , further comprising maintaining/stabilizing the position of the needle within the onlay material and tissue while deploying the fastener. 
     
     
         67 . The method of  claim 61 , wherein reorienting the second bar comprises using one or more deflectors ramps positioned near a distal end of the device. 
     
     
         68 . The method of  claim 61 , wherein reorienting the second bar comprises moving the second bar to avoid engaging the slot of the needle. 
     
     
         69 . The method of  claim 61 , wherein reorienting the second bar comprises moving the second bar towards a position approximately parallel to a surface of the onlay material or tissue. 
     
     
         70 . The method of  claim 61 , wherein reorienting the second bar comprises rotating the second bar such that the second bar moves towards being approximately parallel to the surface of the onlay material or tissue. 
     
     
         71 . The method of  claim 61 , further comprising deploying the first bar within the tissue. 
     
     
         72 . The method of  claim 61 , further comprising deploying the second bar such that it rests adjacent to the onlay material. 
     
     
         73 . The method of  claim 61 , further comprising deploying the fastener such that the tissue and onlay material are approximated and fixed together by the fastener. 
     
     
         74 . The method of  claim 61 , further comprising withdrawing the needle from the onlay material and tissue after the fastener is deployed. 
     
     
         75 . The method of  claim 61 , further comprising supporting the onlay material and tissue while withdrawing the needle. 
     
     
         76 .- 346 . (canceled) 
     
     
         347 . The device of  claim 1 , wherein the slot extends through a distal end of the needle. 
     
     
         348 . The device of  claim 1 , wherein the needle comprises a sharp tip. 
     
     
         349 . A system comprising the device of  claim 1  and a fastener comprising a first bar; a second bar; and a connector joining the first bar to the second bar, wherein the connector is configured to be strong enough to withstand deployment of the first bar. 
     
     
         350 . The system of  claim 349 , wherein at least one of a height, length, or width of the second bar is different from a corresponding dimension of the first bar. 
     
     
         351 . The system of  claim 349 , wherein at least one of the first and second bar has one or more blunt ends. 
     
     
         352 . The system of  claim 349 , wherein at least one of the first bar, the second bar, and the connector comprises a rectangular cross section. 
     
     
         353 . The method of  claim 61 , further comprising deploying the fastener by advancing the fastener within the needle and out of the distal end of the needle such that the connector extends through the slot and exits the slot at the distal end of the needle. 
     
     
         354 . The method of  claim 61 , wherein the only material comprises acellular dermal matrix (ADM). 
     
     
         355 . The method of  claim 61 , wherein piercing the onlay material comprises piercing the onlay material with a sharp tip of the needle.