Device and method for tacking a prosthetic screen

Abstract

Prosthetic screen tacking device including a filament with at least one barb and one or more of a perpendicular foot at one end, a loop at the other end and a needle at the other end. When a needle and loop are present, the loop is situated between the barbs and the needle. The barbs are situated near the foot and angulated to permit movement of the device through a prosthetic screen and body tissue in one direction, but prevent movement in the opposite direction toward the foot. When the loop, or another form of an expanded portion of the filament, is present, it prevents the premature retrograde dislodgement of the filament from the abdominal wall after the loop has been forwardly passed through the abdominal wall and before the barbs engage with the abdominal wall. Methods of using the device with and without an associated button are disclosed.

1 . A surgical tacking device suitable for the fixation of a prosthetic screen to body tissue, said device comprising: 
 a filament having a first end and a second end;    at least one barb arranged on said filament between said first and second ends, said at least one barb being configured and angulated to allow said filament to pass through body tissue when said first end is pulled but to prevent said filament from passing through body tissue when said second end is pulled; and    first means on said filament above said at least one barb in a direction toward said first end for enabling the surgical tacking device to remain in place with at least a portion of the surgical tacking device above the body tissue and said at least one barb entirely below the body tissue.    
     
     
         2 . The device of  claim 1 , wherein said first means are situated at said first end of said filament.  
     
     
         3 . The device of  claim 1 , wherein said first means comprise an expanded portion of said filament.  
     
     
         4 . The device of  claim 1 , wherein said first means comprise a loop of said filament.  
     
     
         5 . The device of  claim 1 , wherein said first means are arranged to forwardly pass through the body tissue when said first end is pulled and prevent or inhibit backward passage through body tissue once said first means has been forwardly passed through the body tissue.  
     
     
         6 . The device of  claim 1 , wherein said filament, said at least one barb and said first means are formed in one piece.  
     
     
         7 . The device of  claim 1 , further comprising second means on said filament below said at least one barb in a direction toward said second end for preventing said second end of said filament from passing through the prosthetic screen.  
     
     
         8 . The device of  claim 7 , wherein said second means are at said second end of said filament.  
     
     
         9 . The device of  claim 8 , wherein said second means comprise a foot.  
     
     
         10 . The device of  claim 9 , wherein said foot is substantially planar and substantially linear, circular or elliptical.  
     
     
         11 . The device of  claim 9 , wherein said foot is substantially spherical or ellipsoid.  
     
     
         12 . The device of  claim 7 , wherein said second means comprise a bead attached to said filament.  
     
     
         13 . The device of  claim 1 , further comprising a needle on said first end of said filament, said first means being arranged between said at least one barb and said needle.  
     
     
         14 . The device of  claim 13 , wherein said needle is swaged to said filament.  
     
     
         15 . The device of  claim 13 , wherein said first means comprise a barb configured and angulated to have at least one point facing said second end of said filament.  
     
     
         16 . The device of  claim 13 , wherein said first means comprise a spherical bead.  
     
     
         17 . The device of  claim 13 , further comprising second means on said filament below said at least one barb in a direction toward said second end for preventing said second end of said filament from passing through the prosthetic screen.  
     
     
         18 . The device of  claim 17 , wherein said second means are at said second end of said filament.  
     
     
         19 . The device of  claim 1 , wherein said at least one barb tapers from a maximum transverse dimension on a side away from said first means to a minimum transverse dimension on a side more proximate said first means.  
     
     
         20 . The device of  claim 1 , wherein said at least one barb has a rearward facing point and a rearward facing surface extending at an angle greater than 90 degrees to said filament such that said at least one barb has a transverse dimension from said rearward facing point that first increases and then decreases moving forward along said at least one barb.  
     
     
         21 . The device of  claim 1 , wherein said first end of said filament is a forward end and said second end of said filament is a rear end, said at least one barb having a forward-facing surface inclined from a surface of said filament and at least one sharp point arranged at a rearward end of said forward-facing surface.  
     
     
         22 . The device of  claim 21 , wherein said at least one barb further includes a rearward-facing surface extending at an angle from a surface of said filament and which meets said forward-facing surface at said at least one point.  
     
     
         23 . The device of  claim 1 , wherein said at least one barb comprises a plurality of barbs.  
     
     
         24 . A method for affixing a prosthetic screen to the wall of the abdomen, comprising: 
 attaching a plurality of surgical tacking devices to the screen, each tacking device including a filament having a first end and a second end, and at least one barb between the first and second ends;    delivering the screen with attached tacking devices to the peritoneal cavity;    passing a portion of each tacking device through the abdominal wall; then    pulling the portion of the tacking device to draw more filament through the abdominal wall until the at least one barb of each tacking device lodges in the abdominal wall and affixes the screen to the abdominal wall; and    constructing each tacking device to enable it to remain in place with at least a portion of the tacking device above the abdominal wall and said at least one barb entirely below the abdominal wall.    
     
     
         25 . The method of  claim 24 , wherein the step of constructing each tacking device to enable it to remain in place comprises arranging an expanded portion between the at least one barb and the first end.  
     
     
         26 . The method of  claim 24 , wherein the step of constructing each tacking device to enable it to remain in place comprises arranging a loop of the filament at the first end or between the at least one barb and the first end.  
     
     
         27 . The method of  claim 24 , wherein the step of constructing each tacking device to enable it to remain in place comprises arranging a barb on the filament angulated to allow passage of the filament through the abdominal wall in a direction toward the first end, but impede passage of the filament through the abdominal wall in a direction toward the second end.  
     
     
         28 . The method of  claim 24 , further comprising forming the tacking devices to prevent the second end of the filament from passing through the screen when the filament is drawn through the abdominal wall.  
     
     
         29 . The method of  claim 28 , wherein the step of forming the tacking devices to prevent the second end of the filament from passing through the screen comprises arranging a foot at the second end of the filament.  
     
     
         30 . The method of  claim 24 , further comprising cutting the tacking devices at a point between the first and second ends after the screen is affixed to the abdominal wall so that when the surgical procedure is concluded no parts of the tacking devices penetrate into or through the skin.  
     
     
         31 . The method of  claim 24 , further comprising arranging a needle at the first end of each tacking device, the step of passing a portion of each tacking device through the abdominal wall comprising passing the needle of each tacking device through the abdominal wall from inside to outside.