Surgical fasteners and fastening devices

Abstract

The invention provides a surgical fastener. The fastener has a first element defining an axis of the fastener, and or more prongs attached to the first element at hinge regions. Deploying the fastener involves bending the prongs at the hinges so as to increase the distance of the prong tips from the axis and locking the fastener in this deployed configuration. The invention also provides a surgical fastening device and a method for attaching a surgical fastener to a site of a body tissue.

1 . A surgical fastener having an undeployed configuration and a deployed configuration, the surgical fastener comprising:
 (a) a first element defining an axis of the fastener; and   (b) two or more prongs, each of the two or more prongs being attached to the first element at a hinge and each of the two or more prongs having a tip;   wherein, in the undeployed configuration, the tip of each of the two or more prongs is at a first distance from the axis that is greater than a distance of the prong's hinge from the axis; and   wherein, in the deployed configuration, the tip of each of the two or more prongs is at a second distance from the axis that is greater than the first distance and wherein the fastener is locked in the deployed configuration.   
     
     
         2 . The surgical fastener according to  claim 1 , further comprising a second element having slots, a tip of one or the two or more prongs being engaged in one of the slots in the undeployed configuration. 
     
     
         3 . The surgical fastener according to  claim 2 , wherein the surgical fastener is locked in the deployed configuration by an engagement between the first element and the second element. 
     
     
         4 . The surgical fastener according to  claim 1 , wherein the surgical fastener is locked in the deployed configuration by an engagement between the first element and the prongs. 
     
     
         5 . The surgical fastener according to  claim 1 , wherein the hinge between the first element and the two or more prongs is a two part hinge. 
     
     
         6 . The surgical fastener according to  claim 2 , wherein the second element is an external sleeve surrounding the first element, and the second element is provided with openings that engage the two or more prongs of the surgical fastener and that achieve the deployed configuration by rotating the first element relative to the second element. 
     
     
         7 . The surgical fastener according to  claim 2 , wherein the first element is includes a first hole and the second element includes a second hole. 
     
     
         8 . The surgical fastener according to  claim 7 , wherein the first hole and the second hole are not coaxial. 
     
     
         9 . A surgical fastening device for deploying one or more surgical fasteners, each of the one or more surgical fasteners having an undeployed configuration and a deployed configuration, each of the one or more surgical fasteners comprising:
 (a) a first element defining an axis of the fastener; and   (b) two or more prongs, each prong being attached to the first element at a hinge and each prong having a tip;   wherein, in the undeployed configuration, the tip of each of the two or more prongs is at a first distance from the axis that is greater than a distance of the prong's hinge from the axis; and   wherein, in the deployed configuration, the tip of each of the two or more prongs is at a second distance from the axis that is greater than the first distance;   the surgical fastening device comprising:
 a. a receptacle adapted to receive the one or more surgical fasteners in the undeployed configuration; and 
 b. a deployment mechanism configured to bring one of the one or more surgical fasteners in the receptacle to its deployed configuration by applying a first force to the first element and a second force to the two or more prongs, wherein the second force is directed in a direction generally opposite to the direction of the first force. 
   
     
     
         10 . The surgical fastening device according to  claim 9 , wherein the receptacle is a sleeve configured to receive a stack of one or more of the surgical fasteners, the sleeve having a proximal end and a distal end. 
     
     
         11 . The surgical fastener according to  claim 10 , configured to deploy one of the one or more surgical fasteners with the surgical fastener oriented with its prongs directed in a distal direction. 
     
     
         12 . The surgical fastener according to  claim 10 , configured to deploy one of the one or more surgical fasteners with the surgical fastener oriented with its prongs directed in a proximal direction. 
     
     
         13 . The surgical fastening device according to  claim 10 , further comprising a plunger having a ramming head located in the sleeve configured to deliver a distally directed force on the proximal-most fastener in the stack. 
     
     
         14 . The surgical fastening device according to  claim 10 , further comprising stops at the distal end of the sleeve, the stops having a first position in which they prevent release of the distal-most fastener in the sleeve. 
     
     
         15 . The surgical fastening device according to  claim 10 , further comprising a releasing mechanism configured to release the distal-most fastener after having been deployed, the releasing mechanism configured to move the stops to a second position in which the stops do not prevent release of the distal-most fastener in the sleeve. 
     
     
         16 . The surgical fastening device according to  claim 15 , wherein the releasing mechanism configured to move the stops to a second position in which the stops do not prevent release of the distal-most fastener in the sleeve. 
     
     
         17 . The surgical fastening device according to  claim 13 , wherein the fasteners are advanced in the sleeve by a ratchet mechanism. 
     
     
         18 . The surgical fastening device according to  claim 13 , in which the fasteners are advanced by a spring. 
     
     
         19 . The surgical fastening device according to  claim 13 , wherein a stack of the one or more surgical fasteners in the receptacle moves distally when the ramming head delivers a distally directed force on the proximal-most fastener in the stack. 
     
     
         20 . The surgical fastening device according  claim 10 , further comprising projections at the distal end configured to grasp a surgical mesh. 
     
     
         21 . The surgical fastening device according to  claim 10 , further comprising a surgical filament delivery system delivering a surgical filament that is grasped by a deployed fastener. 
     
     
         22 . The surgical fastening device according to  claim 21 , further comprising a mechanism to control the length and tension of the filament between fasteners. 
     
     
         23 . A surgical fastening system, comprising:
 (a) a surgical fastening device for deploying one or more surgical fasteners, each of the one or more surgical fasteners having an undeployed configuration and a deployed configuration, each of the one or more surgical fasteners comprising:
 (i) a first element defining an axis of the fastener; and 
 (ii) two or more prongs, each of the two or more prongs being attached to the first element at a hinge and each prong having a tip; 
   wherein, in the undeployed configuration, the tip of each of the two or more prongs is at a first distance from the axis that is greater than a distance of the prong's hinge from the axis; and   wherein, in the deployed configuration, the tip of each of the two or more prongs is at a second distance from the axis that is greater than the first distance;   the surgical fastening device comprising:
 a receptacle adapted to receive the one or more surgical fasteners in the undeployed configuration, 
 a deployment mechanism configured to bring a fastener in the receptacle to its deployed configuration by applying a first force to first element and a second force to the prongs wherein the second force is directed in a direction generally opposite to the direction of the first force; and 
 a releasing mechanism for disengaging the fastening device from the fully deployed fastener; and 
   (b) one or more surgical fasteners, each of the one or more surgical fasteners comprising:
 (i) a first element defining an axis of the fastener; and 
 (ii) two or more prongs, each prong being attached to the first element at a hinge and each prong having a tip; 
   wherein, in the undeployed configuration, the tip of each prong is at a first distance from the axis that is greater than a distance of the prong's hinge from the axis; and wherein, in the deployed configuration, the tip of each prong is at a second distance from the axis that is greater than the first distance.   
     
     
         24 . A method for attaching a surgical fastener to a site of a body tissue, the surgical fastener comprising:
 (a) a first element defining an axis of the surgical fastener; and   (b) two or more prongs, each of the two or more prongs being attached to the first element at a hinge and each of the two or more prongs having a tip;   wherein, in the undeployed configuration, the tip of each of the two or more prongs is at a first distance from the axis that is greater than a distance of the prong's hinge from the axis; and   wherein, in the deployed configuration, the tip of each of the two or more prongs is at a second distance from the axis that is greater than the first distance;   the method comprising:
 applying an extending force to the two or more prongs to fully deploy the surgical fastener by forces exercised within the fastening instrument, wherein the extending prongs pierce a mesh or a graft and the adjacent tissue and the first element of the surgical fastener attach said mesh or graft to the tissue.