Vorrichtung zum Anbringen chirurgischer Klammern zur Befestigung eines Gegenstandes auf Körpergewebe

摘要

An apparatus 10 is disclosed for endoscopic application of surgical staples adapted to attach surgical mesh to body tissue in laparoscopic hernia surgery. The apparatus includes a frame 12, and a generally elongated endoscopic section 14 connected to the frame and extending distally therefrom. A staple storage cartridge 16 is removably supported on a pivotal support system at the distal end portion of the endoscopic section with each staple being configured and adapted to attach the mesh to the body tissue. An elongated pusher system 24 formed of several assembled components and extending from the frame to the endoscopic section is provided for individually advancing at least one staple at a time distally for positioning adjacent the surgical mesh and the body tissue. The pusher system also includes a trigger system 20 to actuate the pusher. The trigger system is provided with perceptible tactile sensing means to indicate when the legs of the staple 110 being advanced are exposed so as to be visible to the user for positioning and orientation purposes. Anvil means 116, 118 provides for individually closing each staple to encompass at least a portion of the surgical mesh and to penetrate the body tissue in a manner to attach the portion of the mesh to the body tissue. Projecting distally of the cartridge support system is a pair of legs which are dimensioned and configured to engage the staple during closure to prevent unwanted roll or deformation outside of the plane of the staple. The staple storage cartridge may be pivoted with respect to the longitudinal axis of the endoscopic section from 0 DEG to about 32.5 DEG and about 65 DEG . Further, the cartridge may be rotated from a proximal location about its own axis independent of the endoscopic section while pivoted to any of the predetermined angles relative to the longitudinal axis of the endoscopic section.