Claims for Patent: 4,621,639

Summary for Patent: 4,621,639

Title:	Surgical instrument with hydraulic actuator
Abstract:	A hand-operated surgical instrument of closing wounds with a fastener. The instrument has a movable operating member extending from a movable handle which actuates the operating member. A hydraulic actuator comprising first and second cylinders is connected between the handle and the operating member for effecting the movement of the operating member when the handle is moved relative to the instrument. A biasing member is provided for returning the operating member and the handle means to the unactuated position. The surgical instrument includes a housing and a needle extending outwardly from one end of the housing. A plurality of fasteners are located within the housing such that when the operating member is actuated, the fasteners are forced out through the needle by the force of the operating member.
Inventor(s):	Transue; James A. (Union, NJ), Golden; Donald M. (Cherry Hill, NJ)
Assignee:	Ethicon, Inc (Somerville, NJ)
Application Number:	06/636,440
Patent Claims:	1. A device for closing a wound or incision in tissue with a fastener by implanting or inserting a fastener through said tissue, said device comprising; (a) a housing by which said device may be grasped; (b) a hollow needle extending outwardly from said housing and having a distal end adapted for piercing said tissue, said needle defining a passage therein for receiving at least a portion of said fastener, said passage extending along the length of said needle from an entrance aperture to a discharge aperture at said distal end; (c) a reciprocative pusher member disposed within said housing for pushing said portion of said fastener through said needle, said pusher member including at least a leading end segment adapted to enter and reciprocate in said needle passage and adapted to engage said portion of said fastener; (d) a fastener magazine means for retaining and guiding a plurality of said fasteners in side-by-side relationships, said magazine means including biasing means for biasing said plurality of fasteners towards the leading end segment of the pusher member immediately prior to said segment entering said needle passage; and (e) actuator means associated with said housing for reciprocating said pusher member leading end segment between (1) a retracted position spaced inwardly from the distal end of said needle wherein the leading end of the pusher member is located behind said fastener and (2) an extended position outwardly along said needle relative to said retracted position wherein said fastener is ejected from the distal end of said needle by said pusher member leading end segment, said actuator means being adapted for amplifying the movement of said pusher member when said apparatus is operated, said actuator means further comprising: first and second connected cylinders in said housing, said first cylinder having a length greater than that of the second cylinder and said first cylinder having a diameter less than that of said second cylinder; first and second pistons slidably disposed in said first and second cylinders, respectively; a substantially incompressible fluid contained within said connected first and second cylinders between said first and second pistons; the projection area of the pressure bearing working surface of said first piston normal to direction of the first piston movement being less than the projection area of the pressure bearing working surface of said second piston normal to the direction of the second piston movement; means connecting said pusher member with said first piston; a handle mounted to said housing and movable relative to said second cylinder between a releasing position and fully actuating position; engaging means associated with said handle for engaging said second piston and being moved by said handle for forcing said second piston along said second cylinder thereby forcing said fluid from said second cylinder into said first cylinder to move said first piston and the connected pusher member whereby said leading end segment of said pusher member is moved to said extended position to eject said fastener from said needle; and first piston biasing means for biasing said first piston along said first cylinder in a direction to return said pusher member leading end segment to said retracted position and to force said fluid from said first cylinder into said second cylinder when said handle is released. 2. The device in accordance with claim 1 in which said first piston biasing means is a helical spring compressively retained between said first piston and an end of said first cylinder. 3. The device in accordance with claim 1 in which said handle is pivotally mounted to said housing and further including a handle biasing means comprising a spring acting to pivot said handle outwardly relative to said housing to said handle releasing position. 4. The device in accordance with claim 1 in which said second piston includes a cam follower on a portion of said second piston that faces away from the second piston pressure bearing working surface area; in which said handle includes a pin; and in which said engaging means associated with said handle includes an arm pivotally mounted to said housing, said arm defining a slot therein for receiving said handle pin, and said arm including an arcuate camming surface engaged with said second piston cam follower whereby movement of said handle to said fully actuating position carries said pin in said arm slot to pivot said arm in a first direction with said arm camming surface engaging said cam follower to force said second piston along said second chamber and whereby, when said handle is released, said arm is free to pivot in a second, opposite direction and said handle pin can move in said arm slot as the handle moves to said releasing position. 5. The device in accordance with claim 1 in which said first cylinder is defined in part by an end wall; in which said end wall defines an aperture therethrough; in which a guide tube is disposed in said first cylinder end wall and projects beyond said end wall away from said first cylinder; and in which at least a portion of said pusher member is slidably disposed within said guide tube. 6. The device in accordance with claim 1 in which said fluid is sterile water. 7. A device for closing a wound or incision in tissue with a fastener, said fastener being of the type comprising a filament member terminated at one end by a first anchoring means and at the end by a second anchoring means, said fastener being applied by said device to remain in the tissue with the filament member transversing the wound or incision through the tissue with said first and second anchoring means maintaining the tissue in approximation at the wound or incision from points on the surface of the tissue on either side of the wound or incision, said device comprising: an elongate housing by which said device may be grasped; a hollow needle extending outwardly from said housing and having a distal end adapted for piercing said tissue, said needle defining a passage therein for receiving said first anchoring means of said fastener, said passage extending along the length of the needle from an entrance aperture to a discharge aperture at said distal end, said needle defining a slot along its length from said entrance aperture to said discharge aperture at the distal end of said needle, said slot communicating with said passage for receiving a portion of said fastener filament member; guide means in said housing and a pusher member slidably disposed within said guide means, said guide means serving to guide the movement of said pusher member along a portion of the length of said housing and into alignment with the entrance aperture and passage of said hollow needle, said guide means defining a fastener dispensing region aligned with said needle entrance aperture for accommodating the admission of said fastener first anchoring means into alignment with said needle passage and entrance aperture; a fastener magazine means for retaining and guiding a plurality of said fasteners in side-by-side relationship, said magazine means including biasing means for biasing said plurality of fasteners towards said dispensing region to present said fasteners seriatim in said dispensing region at said needle entrance aperture with said first anchoring means aligned with said needle passage and with said filament in registry with said needle slot; and actuating means associated with said housing for reciprocating said pusher member between (1) a retracted position wherein the leading end of the pusher member is located behind said dispensing region to permit the first anchoring means of one of said fasteners to be moved into said dispensing region in alignment with said needle entrance aperture and passage and (2) an extended position wherein the leading end of said pusher member is engaged with said fastener first anchoring means for ejecting said fastener from said needle discharge aperture, said actuating means including: first and second connected chambers in said housing; first and second pistons slidably disposed in said first and second chambers, respectively; a substantially incompressible fluid contained within said connected first and second chambers between said first and second pistons; the projection area of the pressure bearing working surface of said first piston normal to the direction of the first piston movement being less than the projection area of the pressure bearing working surface of the said second piston normal to the direction of the second piston movement; means connecting said pusher member with said first piston; a handle mounted to said housing and movable relative to said second chamber between a releasing position and a fully actuating position engaging means associated with said handle for engaging said second piston and being moved by said handle for forcing said second piston along said second chamber thereby forcing said fluid from said second chamber into said first chamber to move said first piston and the connected pusher member whereby said pusher member is moved to said extended position to eject said fastener from said needle; and first piston biasing means for biasing said first piston along said first chamber when said handle is released to return said pusher member to said retracted position and to force said fluid from said first chamber into said second chamber.

Details for Patent 4,621,639

Applicant	Tradename	Biologic Ingredient	Dosage Form	BLA	Approval Date	Patent No.	Expiredate
Merck Sharp & Dohme Corp.	ZOSTAVAX	zoster vaccine live	For Injection	125123	05/25/2006		2003-11-11