Devices, system, and methods for guiding an operative tool into an interior body region

Abstract

A guide device establishes a guide passage through a guide tube, through which an operative tool can be deployed into an interior body region for use. A steering assembly, in use, deflects or bends the distal end region of the guide tube, so that the operative tool can be placed in a desired orientation with respect to tissue. The steering assembly is desirable configured for single handed operation by the clinician. The steering assembly is also desirably configured to provide a mechanical advantage sufficient to translate relatively small increments of clinician control an to relatively larger increments of guide tube deflection. In one arrangement, the steering assembly includes a rack and pinion linkage system. In another arrangement, the steering assembly includes a pivoting lever system.

1 - 10 . (canceled) 
     
     
         11 . A handheld tack applier system for securing a prosthesis to underlying soft tissue, the tack applier system, comprising,
 a handle assembly including:
 a handle; 
 a guide tube extending from the handle, the guide tube including a deflectable distal end, the guide tube defining a longitudinal axis; 
 a drive mechanism supported by the handle; 
 a fastener driver rotatably coupled to the drive mechanism and extending through the guide tube, the fastener driver rotatable within the guide tube by the drive mechanism, the fastener including a coupling feature configured and adapted to rotate a fastener supported at a distal end thereof; 
   a fastener disposed at the distal end of the fastener driver, the fastener including:
 a continuous stainless steel helical coil with a sharpened leading tip at a distal end thereof; and 
 a rotation receiving feature configured to receive rotational forces from the fastener driver; 
   wherein the fastener driver rotates the fastener when the drive mechanism is actuated.   
     
     
         12 . The handheld tack applier system according to  claim 11 , wherein the handle assembly includes a steering assembly for deflecting the distal end of the guide tube relative to the longitudinal axis of the guide tube, the steering assembly including:
 an actuator supported on the handle of the handle assembly; and   a deflecting component operatively connected at a first end thereof to the actuator, and at a second end thereof to the distal end of the guide tube;   wherein actuation of the actuator acts on the deflecting component to deflect the distal end of the guide tube relative to the longitudinal axis of the guide tube.   
     
     
         13 . The handheld tack applier system according to  claim 12 , wherein the deflecting component of the steering assembly is a wire extending between and interconnecting the actuator and the distal end of the guide tube. 
     
     
         14 . The handheld tack applier system according to  claim 11 , wherein the fastener includes a cap secured to a proximal end of the helical coil thereof, the cap being constructed from an implantable polymer. 
     
     
         15 . The handheld tack applier system according to  claim 14 , wherein the cap is non-rotatably and selectively connected to the drive member of the elongate fastener assembly. 
     
     
         16 . The handheld tack applier system according to  claim 15 , wherein the handle assembly further comprises:
 a drive member supported on a distal end of the fastener driver, the drive member being configured to engage the cap of the fastener and impart rotation to the fastener.   
     
     
         17 . The handheld tack applier system according to  claim 16 , wherein the helical coil of the fastener has a diameter and defines a coil lumen extending axially therethrough. 
     
     
         18 . The handheld tack applier system according to  claim 17 , wherein the cap of the fastener defines a central opening axially aligned with the coil lumen of the helical coil. 
     
     
         19 . The handheld tack applier system according to  claim 18 , wherein the cap of the fastener defines at least one rotation receiving feature for receiving rotational forces from the fastener driver. 
     
     
         20 . The handheld tack applier system according to  claim 19 , wherein the at least one rotation receiving feature is defined in an outer surface of the cap of the fastener. 
     
     
         21 . The handheld tack applier system according to  claim 11 , wherein the guide tube includes is a multi-lumen tubular member. 
     
     
         22 . A surgical system, comprising:
 a surgical prosthesis; and   a handheld tack applier system for securing the prosthesis to underlying soft tissue, the tack applier system, including,
 a handle assembly including:
 a handle; 
 a guide tube extending from the handle, the guide tube including a deflectable distal end, the guide tube defining a longitudinal axis; 
 a drive mechanism supported by the handle; 
 a fastener driver rotatably coupled to the drive mechanism and extending through the guide tube, the fastener driver rotatable within the guide tube by the drive mechanism, the fastener including a coupling feature configured and adapted to rotate a fastener supported at a distal end thereof; 
 
 a fastener disposed at the distal end of the fastener driver, the fastener including:
 a continuous stainless steel helical coil with a sharpened leading tip at a distal end thereof; and 
 a rotation receiving feature configured to receive rotational forces from the fastener driver; 
 
 wherein the fastener driver rotates the fastener when the drive mechanism is actuated. 
   
     
     
         23 . The surgical system according to  claim 22 , wherein the handle assembly includes a steering assembly for deflecting the distal end of the guide tube relative to the longitudinal axis of the guide tube, the steering assembly including:
 an actuator supported on the handle of the handle assembly; and   a deflecting component operatively connected at a first end thereof to the actuator, and at a second end thereof to the distal end of the guide tube;   wherein actuation of the actuator acts on the deflecting component to deflect the distal end of the guide tube relative to the longitudinal axis of the guide tube.   
     
     
         24 . The surgical system according to  claim 23 , wherein the deflecting component of the steering assembly is a wire extending between and interconnecting the actuator and the distal end of the guide tube. 
     
     
         25 . The surgical system according to  claim 23 , wherein the fastener includes a cap secured to a proximal end of the helical coil thereof, the cap being constructed from an implantable polymer. 
     
     
         26 . The surgical system according to  claim 25 , wherein the cap is non-rotatably and selectively connected to the drive member of the elongate fastener assembly. 
     
     
         27 . The surgical system according to  claim 26 , wherein the handle assembly further comprises:
 a drive member supported on a distal end of the fastener driver, the drive member being configured to engage the cap of the fastener and impart rotation to the fastener.   
     
     
         28 . The surgical system according to  claim 27 , wherein the helical coil of the fastener has a diameter and defines a coil lumen extending axially therethrough. 
     
     
         29 . The surgical system according to  claim 28 , wherein the cap of the fastener defines a central opening axially aligned with the coil lumen of the helical coil. 
     
     
         30 . The surgical system according to  claim 29 , wherein the cap of the fastener defines at least one rotation receiving feature for receiving rotational forces from the fastener driver. 
     
     
         31 . The surgical system according to  claim 30 , wherein the at least one rotation receiving feature is defined in an outer surface of the cap of the fastener. 
     
     
         32 . The surgical system according to  claim 22 , wherein the guide tube includes is a multi-lumen tubular member.