Mechanical mesh fixation device and curvilinear tack system

Abstract

Devices and methods for affixing reinforcing material to a fascial incision in an abdominal wall to reinforce and augment closures thereof. The device includes first and second arms, each having a proximal end and a distal end extending away from a housing with a length therebetween. The distal end of the first arm is spaced from the distal end of the second arm such that the first and second arms are engageable with reinforcing material on opposing sides of a fascial incision. One or more fixation elements are deployable from the distal end of at least one of the first and second arms to affix the reinforcing material on opposing sides of the fascial incision.

1 . A device for onlay fixation of reinforcing material to a fascial incision in an abdominal wall to reinforce and augment closures thereof, comprising:
 first and second arms, each having a proximal end and a distal end extending away from a housing with a length therebetween, the first arm distal end and the second arm distal end each including a releasable coupling configured to engage with a reinforcing material, wherein the distal end of the first arm is spaced from the distal end of the second arm such that the first and second arms are configured to engage with the reinforcing material on opposing sides of a fascial incision;   a spreading mechanism coupled to the first arm, the second arm, and the housing, the spreading mechanism comprising an actuator coupled to the housing, wherein the actuator is configured to control a relative distance between the distal ends of the first and second arms; and   one or more fixation elements deployable from the distal end of at least one of the first and second arms in a direction extending away from the housing, the one or more fixation elements configured to affix the reinforcing material to an anterior of abdominal wall fascia on opposing sides of the fascial incision.   
     
     
         2 . The device of  claim 1 , wherein the one or more fixation elements includes a plurality of tacks configured to penetrate reinforcing material and fascia to affix the reinforcing material. 
     
     
         3 . The device of  claim 1 , wherein the first and second arms engage with the reinforcing material on opposing sides of a fascial incision simultaneously. 
     
     
         4 . The device of  claim 1 , further comprising a third arm and a fourth arm each having a proximal end and a distal end extending away from the housing with a length therebetween, wherein the distal end of the third arm is spaced from the distal end of the fourth arm such that the third and fourth arms are engageable with reinforcing material on opposing sides of the fascial incision. 
     
     
         5 . The device of  claim 1 , wherein the distal ends of the first and second arms releasably couple with the reinforcing material upon engagement of the first and second arms with the reinforcing material. 
     
     
         6 . The device of  claim 2 , wherein the first and second arms each define a barrel, and wherein the plurality of tacks are stored within one or more barrel prior to deployment. 
     
     
         7 . The device of  claim 6 , wherein the plurality of tacks are stored within one or more barrel in a stacked configuration, and wherein deployment of one tack places another tack in position for deployment. 
     
     
         8 . The device of  claim 1 , wherein a plurality of tacks are housed in a cartridge, and wherein the cartridge can be removably engaged with at least one of the first and second arms. 
     
     
         9 . The device of  claim 6 , wherein the first and second arms include first and second tack advancing rods insertable within the first and second arms and movable within the first and second arms from a first position to a second position to deploy tacks from the first and second arms. 
     
     
         10 . The device of  claim 9 , wherein the housing includes a firing mechanism coupled to a first end of at least one of the first and second tack advancing rods, wherein the firing mechanism generates an impact load that is transferred to one or more tacks by at least one of the first and second tack advancing rods to deploy one or more tacks. 
     
     
         11 . The device of  claim 10 , wherein the firing mechanism is configured to deploy tacks from the first and second arms simultaneously. 
     
     
         12 . The device of  claim 1 , wherein at least one of the first and second arms is coupled to a spring. 
     
     
         13 . The device of  claim 1 , wherein at least one of the first and second arms is rotatable with respect to the housing. 
     
     
         14 . The device of  claim 1 , wherein the releasable couplings are configured to apply at least 1 lbf of lateral tension to the reinforcing material as a distance between the distal ends of the first and second arms increases. 
     
     
         15 . The device of  claim 1 , wherein the releasable couplings comprise hook and loop. 
     
     
         16 . The device of  claim 1 , wherein the spreading mechanism further comprises a first wedge defined between the first arm and the second arm, and a second wedge extending from a distal end of the housing, wherein the actuator comprises a threaded handle configured to turn to move the second wedge relative to the first wedge. 
     
     
         17 . The device of  claim 1 , wherein the actuator comprises a dial operably coupled to a turnbuckle. 
     
     
         18 . The device of  claim 1 , wherein the actuator comprises a pulley operably coupled to at least one cable. 
     
     
         19 . The device of  claim 1 , wherein the proximal end of each of the first and second arms are fixed to the housing. 
     
     
         20 . A system for onlay fixation of reinforcing material to a fascial incision in an abdominal wall to reinforce and augment closures thereof, comprising:
 a reinforcing material for placement over the fascial incision;   a device having first and second arms, each having a proximal end and a distal end extending away from a housing with a length therebetween, the first arm distal end and the second arm distal end each including a releasable coupling configured to engage with the reinforcing material, wherein the distal end of the first arm is spaced from the distal end of the second arm such that the first and second arms are configured to engage with the reinforcing material on opposing sides of the fascial incision;   a spreading mechanism coupled to the first arm, the second arm, and the housing, the spreading mechanism comprising an actuator coupled to the housing, wherein the actuator is configured to adjust a relative distance between the distal ends of the first and second arms; and   one or more fixation elements deployable from the distal end of at least one of the first and second arms in a direction extending away from the housing, the one or more fixation elements configured to affix the reinforcing material to an anterior of abdominal wall fascia on opposing sides of the fascial incision.