Apparatus and method for subcuticular stapling of body tissue.

摘要

A surgical apparatus 10 for attaching two portions of cutaneous body tissue includes a pair of opposed elongated members having jaws 12 which have tissue gripping members 18 thereon at one end and which are movable toward each other to a closed position to engage two body tissue portions positioned within the members to move the body tissue portions into close approximation. Manually gripping systems of several alternative configurations are provided to actuate a mechanical transmission system to close the jaws. In a preferred embodiment, a fork 70 is movable from a first position to a second position by manually operable devices to move the jaws toward each other. A pair of cam faces 68 is located adjacent the opposite ends of the jaws. As the fork moves to its second position, the tines of the fork engage against the cam faces to move the opposed jaws to their closed position. A plurality of rod-like fasteners 78 are carried in a stacked configuration proximally of the jaws such that, when the jaws are in their closed position and the two body tissue portions are held in close approximation, each rod-like fastener is movable to a position in ingress to penetrate the body tissue to attach the body tissue portions together. In another preferred embodiment, the elongated members are biased outwardly by a coil spring and a unique plate-like fastener drive member is provided to facilitate driving a fastener after the jaws are closed. A fastener cartridge 106 is provided with fasteners 108 stacked in a sloped fashion and having a coil spring 110 to bias the fasteners toward the ejection position. Another embodiment includes a rack and gear teeth arrangement 298 for approximating the jaws and for firing the fasteners. The rack and gear teeth function somewhat like a linear analog of a set of rotary gears. A method of attaching cutaneous body tissue portions is also disclosed. <IMAGE>