Means and method for reversibly connecting an implant to a deployment device

Abstract

The present invention generally relates to devices and methods for reversibly coupling an implant to a deployment device.

Claims

1. A system for closing an aperture in a biological tissue comprising: a first portion of a clip fixedly attached to an arm of a surgical instrument that deploys a surgical implant inside a patient's body, the surgical instrument includes an elongate shaft, wherein the arm and the elongate shaft are parallel in a deployed position and an undeployed position; and a second portion of the clip adapted to releasably receive the surgical implant, wherein the second portion has a first configuration relative to the arm of the surgical instrument that retains the surgical implant and a second configuration relative to the arm of the surgical instrument that releases the surgical implant, the second portion being parallel to the arm of the surgical instrument when in the first configuration and a longitudinal axis of the second portion intersects the arm of the surgical instrument when the second portion is in the second configuration, wherein the clip deforms from the first configuration to the second configuration to release the surgical implant.

2. The system according to claim 1, wherein the clip is made from a resilient material.

3. The system according to claim 1, wherein the clip is made from a deformable material.

4. The system according to claim 1, wherein transformation of the clip from the first configuration to the second configuration is accomplished by an action selected from the group consisting of: downward pulling, backward pulling, and a combination thereof.

5. The system according to claim 1, wherein the first or second portion comprises a shape that prevents early detachment of the surgical implant from the surgical instrument.

6. The system according to claim 1, wherein the clip is composed of a single elastic wire.

7. The system according to claim 6, wherein the single elastic wire is made from a shape memory alloy.

8. The system according to claim 1, wherein the first portion is configured to have a U shape having a protruding portion extending from an end of the U shape.

9. The system according to claim 1, wherein the clip comprises an elastic material, and the second portion of the clip is pre-shaped into the first configuration, wherein the clip is held in a third configuration until contacted with the surgical implant, at which point the second portion of the clip is transformed from the third configuration to the first configuration.

10. A system for closing an aperture in a biological tissue, the system comprising: a handle; an elongate shaft connected to the handle; a deployment scaffold connected to the elongate shaft, the deployment scaffold transitionable between deployed and undeployed configurations, wherein an arm of the deployment scaffold is parallel to the elongate shaft in the deployed and undeployed configurations; and at least one clip connected to the deployment scaffold, the clip including a first portion fixedly coupled to a portion of the deployment scaffold and a second portion extending from the first portion, the second portion transitioning between a first configuration relative to the deployment scaffold and a second configuration relative to the deployment scaffold, the second portion parallel to the deployment scaffold in the first configuration and the second portion defining a longitudinal axis that intersects the deployment scaffold in the second configuration, wherein the system is configured to releasably retain a surgical implant when the second portion of the clip is in the first configuration and the system releases the surgical implant when the second portion of the clip is deformed into the second configuration.

11. The system according to claim 10, wherein the at least one clip has a forward facing orientation.

12. The system according to claim 10, wherein the system deploys and attaches the surgical implant to the biological tissue.

13. The system according to claim 10, wherein the scaffold further comprises: a frame; a plurality of deployment arms hingedly connected to the frame, wherein the plurality of deployment arms are configured to move from a retained position to at least one deployed position; wherein the at least one clip is fixedly attached to the frame.

14. The system according to claim 10, wherein the deployment scaffold is configured to allow for deployment of the surgical implant and retraction of the surgical implant while the scaffold is within a patient's body.

15. The system according to claim 10, wherein the deployment scaffold is configured to allow for a plurality of deployment positions.

16. The system according to claim 10, wherein the deployment scaffold comprises an articulating member that allows for adjustment of a position and an orientation of the surgical implant relative to the aperture in the biological tissue.

17. The system according to claim 10, wherein the surgical implant is a patch.

18. The system according to claim 17, wherein the patch is comprised of surgical mesh.

19. The system according to claim 10, wherein the aperture in the biological tissue is an aperture in an abdominal wall.

20. The system according to claim 10, wherein at least a portion of the elongate shaft is flexible.

21. The system according to claim 10, wherein the elongate shaft is rigid.

22. The system according to claim 10, further comprising at least one stapler adapted to interact with the deployment scaffold.

23. The system according to claim 22, wherein the stapler connects the clip to the deployment scaffold.

24. A system for closing an aperture in a biological tissue comprising: a handle; an elongate shaft connected to the handle; an arm movably coupled to the elongate shaft; and a clip connected to the arm, the clip including a first portion fixedly coupled to a portion of the arm and a second portion extending from the first portion, the second portion transitioning between a first configuration relative to the arm and a second configuration relative to the arm, the second portion parallel to the arm in the first configuration and the second portion defining a longitudinal axis that intersects the arm in the second configuration, wherein the system is configured to releasably retain a surgical implant when the second portion of the clip is in the first configuration and the system releases the surgical implant when the second portion of the clip is deformed into the second configuration, wherein movement of the arm relative to the elongate shaft is parallel movement.

25. The system of claim 24, wherein the surgical implant is released when the second portion of the clip is in the second configuration and the elongate shaft is moved relative to the aperture.

26. The system of claim 24, wherein the surgical implant is released when the second portion of the clip is in the second configuration and the arm is moved relative to the aperture.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:

(2) FIGS. 1A-1G illustrate an embodiment of the connection clips (CC) as provided by the present invention.

(3) FIGS. 1H-1J illustrate an embodiment of said CC 107 which prevents early detachment.

(4) FIGS. 1K-1M illustrate a method for performing the detachment between the distal portion 101 of the PDD 100 and the patch 106 according to one embodiment of the present invention.

(5) FIGS. 1N-1P illustrate a variation of the backward detachment in which early detachment is prevented.

(6) FIG. 2A illustrates an example of the PDD according to one embodiment of the present invention.

(7) FIGS. 2B-2C illustrate the PDD 100 in its deployhed configuration and in its close configuration. The close configuration is described in FIG. 2B while the deployed configuration is describe in FIG. 2C.

(8) FIGS. 3A-3F illustrate another embodiment of the CC 107.

(9) FIGS. 3H-3K illustrate one embodiment of a coupling adding mechanism (CM) 306 which is adapted to enable said reversible attachment.

(10) FIGS. 4A-4H illustrate a clip stapler apparatus (CSA) 401 adapted to assist in creating the reversible attachment.

(11) FIGS. 5A-5F illustrate an alternative method for reversibly connecting the patch to said PDD.

(12) FIGS. 6A-6E illustrate yet another alternative approach to provide said reversible connection.

(13) FIGS. 7A-7C illustrate still yet another alternative approach to provide said reversible connection.

DETAIL DESCRIPTION OF THE SPECIFIC EMBODIMENTS

(14) The following description is provided, alongside all chapters of the present invention, so as to enable any person skilled in the art to make use of the invention and sets forth the best modes contemplated by the inventor of carrying out this invention. Various modifications, however, is adapted to remain apparent to those skilled in the art, since the generic principles of the present invention have been defined specifically to provides means and method for creating a reversible connection between a patch and a patch deployment device.

(15) The present invention provides means in order to provide reversible connection (i.e., attachment and detachment) between a prosthetic patch and a patch deployment device (PDD) wherein said connection can be performed during a surgery at a standard surgery room by the medical staff. Furthermore, the present invention provides means so as to enable the patch to be disconnected from the PDD once it is secured to the tissue.

(16) Furthermore, the present invention provides means enabling a reversible attachment between the patch and the PDD.

(17) The present invention also provides a method for providing said reversible connection between a patch and the patch deployment device (PDD) during a surgery utilizing said means.

(18) It should be emphasized that some of the major advantages of the present invention, with respect to the prior art, is to provide a fast and intuitive method for creating a reliable connection between a patch and a PDD in the surgery room.

(19) The term Hernia refers hereinafter for umbilical hernia, hiatal hernia, ventral hernia, postoperative hernia, epigastric hernia, spiegelian hernia, inguinal hernia and femoral hernia, generally any abdominal wall related hernia.

(20) The term hinge or hinge-like connection refers hereinafter as to a type of bearing that connects two solid objects, typically allowing only a limited angle of rotation between them. Two objects connected by an ideal hinge rotate relative to each other about a fixed axis of rotation (the geometrical axis of the hinge). Hinges may be made of flexible material or of moving components.

(21) The term hinge like connection can refer to a standard hinge or to a living hinge (i.e., a thin flexible hinge (flexure bearing) made from plastic that joins two rigid parts together while allowing them to bend along the line of the hinge).

(22) The term controlled deployment refers hereinafter to a patch deployment which is continuous; i.e., the deployment is not binary but analogousthere are several deployment levels. This is in contrast so conventional deployment system is now days (see for example U.S. Pat. No. 5,370,650), in which the deployment of the patch relies upon the elasticity of a loop member surrounding the patch such that the patch can be either fully folded or fully unfolded. No intermediate are enabled. In the present invention there can be several deployment stages.

(23) The term bidirectional or fully reversible deployment refers hereinafter to the deployment of the patch, which according to the present invention, is fully reversible. In other words, the patch deployment is bidirectional, i.e., the patch can be fully folded (i.e., deployed within the body) and then, if the surgeon desires, the patch can be fully unfolded simply by the reconfiguration of the flexible arms from the initial stage to the final stage and vice versa.

(24) The term minimally invasive surgery refers hereinafter to procedures that avoid open invasive surgery in favor of closed or local surgery with fewer traumas. Furthermore, the term refers to a procedure that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible.

(25) The term articulation refers hereinafter to a joint or juncture between two segments of the device. The articulating means of the present invention provides the ability to better adjust the device to the curvature of the treated tissue.

(26) The term orientation refers hereinafter to the rotation of the mesh within the abdominal cavity so as to fit to the hernia. Usually the mesh is not symmetric in shape (i.e., rectangular or i.e., ellipse)therefore it has different directions. By rotating the mesh within the abdominal cavityone can decide which direction is turned where.

(27) The term adjusting refers hereinafter to rolling, folding and winding of the patch, thus preparing and enabling the insertion of said patch into the abdominal cavity.

(28) The term downward detachment refers hereinafter to the detachment between the patch and the patch deployment device (PDD) obtained by pulling the PDD in the downward directioni.e. away from the treated tissue(as illustrated in FIGS. 1A-1G). In this embodiment each pair of CCs are facing each other.

(29) The term detachment mechanism A refers herein after as a first mechanism adapted to provide the detachment between the patch and the PDD by deformation of the outer frames 104 of the PDD 100. The detachment mechanism A is described in FIGS. 1C-1D.

(30) The term detachment mechanism B refers herein after as a second mechanism adapted to provide the detachment between the patch and the PDD by deformation of the connection clips 107. The detachment mechanism B is described in FIGS. 1E-1G.

(31) The term backward detachment refers hereinafter to the detachment between the patch and the patch deployment device (PDD) obtained by pulling the PDD in the backward/proximally directioni.e. parallel to the treated tissue, and oppesite to the direction in which the connection clips are facing to (as illustrated in FIGS. 1K-1M). In this embodiment the CCs are aligned and face the same direction (namely forwards).

(32) Before explaining the figures, it should be understood that the invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention can be carried out in various ways.

(33) The reversible connection, as provided by the present invention, is performed using at least two and preferably four connection clips (CC), located at the PDD body. The reversible connection can be made either during the device's assembly (i.e. at the factory). In such a case, the device is supplied with an attached patch.

(34) Alternatively, said reversible connection is performed by the medical staff in the surgery room during the surgery. the medical stuff can be aided by coupling adding mechanism (CM) in order to provide proper attachment. Once the patch is connected to the patient's tissue, said reversible connection is canceled and the PDD is disconnected from the patch.

(35) The present invention discloses several embodiments of said CC and said CM in addition to several patch connection and disconnection mechanisms.

(36) It is acknowledged that the coupling adding mechanism (CM) can be selected from a group consisting of staplers or any mechanism that is able to attach and detach the CC to and from the PDD.

(37) Reference is now made to FIGS. 1A-1G which describe an embodiment of said connection clips (CC) 107 and the method of performing the detachment between the PDD 100 and the patch 106, once the patch is attached to the tissue 120.

(38) According to this embodiment said detachment is obtained by pulling the distal portion 101 of the PDD (i.e., the portion which is adapted to be inserted into the patient's body) downward with regards to the patient's tissue 120 once the attachment between the patch 106 and the tissue 120 is obtained (said detachment will be referred hereinafter as the downward detachment).

(39) FIG. 1A illustrates an example of a PDD 100, patch 106 and the protruding portion 201 of each of the CCs 107 which protrudes out from the patch 106. As can be seen from the figure, the CC 107 is crescent shaped.

(40) In general each PDD 100 comprises at least two portions: a distal portion 101 and a proximal portion 102. The proximal portion is adapted to remain outside the body, adjacently to the user and the distal portion 101 is adapted to be inserted into the body. The distal portion comprises at least one outer frame 104 to which the patch is attached.

(41) According to one embodiment each PDD is provided with at least one CC 107. Each of the CCs 107 comprises a body 222 coupled to the outer frames 104 of the PDD 100 and at least one protruding portion 201 protruding out from the outer frames 104 of the PDD 100.

(42) The protruding portion 201 is characterized by a sharp end adapted to penetrate said patch.

(43) The protruding portion 201 is characterized by at least two configurations: (i) An attached configuration in which said protruding portion 201 penetrates the patch 106 and eventually positioned substantially parallel to said patch. In this configuration an attachment between the PDD and the patch is provided; (ii) A detached configuration in which the protruding portion 201 emerges out of the patch. In this configuration a detachment between the PDD and the patch is provided.

(44) As will be described hereinafter, application of forces, vertical or parallel to said patch, on said CC (and mainly on the protruding portion 201) reconfigure said protruding portion 201 from said attached configuration to said detached configuration.

(45) As described, the protruding portion 201 of each CC 107 is inserted through the patch 106 such that said portion 201 is eventually positioned above the patch 106 (see FIG. 1A).

(46) In order to prevent entanglement of each CC 107 with patch 106 during patch rolling and insertion, portion 201 of each CC 107 is bended such that its end 201a is pointing downward toward the outer frames 104 of the PDD 100.

(47) Reference is now made to FIGS. 1B-1G illustrating the detachment between the patch and the PDD once the patch is attached to the tissue.

(48) Once patch 106 is properly connected to the distal portion 101 of the PDD 100 (the distal portion of the PDD is the portion which is to be inserted into the patient's body containing the patch to be deployed therein) utilizing the CCs 107, it can be rolled and inserted into the patient's abdominal cavity via a trocar 114. In the abdominal cavity the patch 106 is deployed and attached to the patient's tissue 120 using a patch-tissue connection means 202 (PTC) (FIG. 1B).

(49) Once said attached is obtained (i.e., attachment between the patch and the tissue), the distal portion 101 of the PDD 100 is detached from the patch 106 in order to enable its extraction outside from the patient's abdominal cavity.

(50) As a result, the patch 106 is disconnected from the distal portion 101 according to any of the following mechanisms:

(51) The first mechanism (refers hereinafter as detachment mechanism A) provides said detachment by bending or deforming the outer frames 104 of the PDD 100. The deformation is provided by applying pulling force. Such bending causes the CCs 107a and 107b to move toward each other, sliding out of the patch; thereby, the patch 106 is disconnected from the distal portion 101 of the PDD 100 (see FIGS. 1C-1D).

(52) The second mechanism (refers hereinafter as detachment mechanism B) provides disconnection by bending the CCs 107 as a result of said pulling force, such that they deform in such a manner that portion 201 become substantially perpendicular to the tissue 120 and slide out of the patch; thereby, the patch 106 is disconnected from the distal portion 101 of the PDD 100 (see FIGS. 1E-1G).

(53) The contribution of each mechanism to said detachment depends on the relative flexibility of the PDD (and in particularly the outer frames 104) and the CCs 107 in addition to their mechanical dimensions.

(54) During the process of patch 106 insertion into the abdominal cavity, the patch 106 may be stretched either toward the proximal portion or toward the distal portion of the PDD 100. This is the result of friction forces between the patch 106 and the trocar 114.

(55) As a result of such forces, the patch 106 may slide out from the CCs 107 prior to the deployment of said patch. Such patch detachment will be referred hereinafter as early detachment of the patch.

(56) FIG. 1H-1J describe an embodiment of said CC 107 which prevents said early detachment. According to this embodiment, said CCs 107 comprises of a slide prevention section (SPS) 203. Said SPS is adapted to prevent said early detachment (see FIG. 1H). The SPS is coupled to the protruding section 201 and is constructed as a slope pointing downward toward the outer frames 104 of the PDD 100.

(57) During patch insertion, the patch 106 is rolled around the distal portion 101 of the PDD and pressed toward the outer frames 104 of the same.

(58) Once the patch is inserted into the trocar, said sliding/friction forces (illustrated as arrow 1000 in FIG. 1I) are applied. As a result, patch 106 is caught in section 203 (illustrated as arrow 2000 in FIG. 1I) instead of sliding out of CC 107 through portion 201 (see FIG. 1I). In such a manner said early detachment is prevented.

(59) It should be pointed out that SPS 203 does not interfere with the desired detachment between patch 106 and the PDD once the patch is attached to the tissue. Once vertical pulling forces are applied during a desired detachment, the patch 106 slides above SPS 203. Once patch 106 slides above SPS 203 it can be extracted from portion 201 according to either one of said detachment mechanism A or detachment mechanism B (FIG. 1J).

(60) Reference is now made to FIGS. 1K-1M which describe yet another method for performing said detachment between the distal portion 101 of the PDD 100 and the patch 106.

(61) According to this embodiment said detachment is obtained by pulling or pushing the distal portion 101 to a direction opposite to the direction of said CC, preferably, backward (i.e., towards the proximal direction). The forces are applied once the attachment between the patch and the tissue 120 is obtained (such detachment embodiment refers hereinafter as backward detachment).

(62) This embodiment utilizes a similar CCs 107 as described in FIG. 1A-1F; however, in this case both the CCs 107 are facing forward (see FIG. 1K).

(63) This configuration ensures that the patch 106 will remain attached to the distal portion 101 while subjected to backward facing forces which are applied during insertion as a result of the friction between patch 106 and the trocar 104. Once the patch is secured to the patient's tissue 120 using PTC 202 (see FIG. 1L), the distal portion can be detached from the patch by backward pulling of the PDD 100 (see FIG. 1M).

(64) FIGS. 1N-1P describe a variation of said backward detachment in which early detachment is prevented.

(65) If during patch insertion the movement is reversed (i.e. the patch is pulled out instead of inserted inside the abdominal cavity) the patch may be detached from the distal portion (i.e. early detachment).

(66) Prevention of said early detachment can be obtained by configuring the CC 107 to be shaped as described in FIGS. 1N-10. As can be seen in FIG. 1N, once patch 106 is subjected to said reverse forces (illustrated in FIG. 1N as arrow 3000), it is held by SPS 203 (illustrated in FIG. 1N as arrow 4000), such that early detachment is prevented.

(67) Once patch 106 is secured to the patient's tissue 120 by PTC 202, a detachment can be obtained by backward pulling of the outer frames 104 while applying downward force (illustrated in FIG. 1O as arrow 5000), see FIGS. 1O-1P.

(68) The above disclosure describes an attachment/detachment mechanisms between the patch and the PDD 100. The following disclosure describes an example of a PDD 100.

(69) Reference is now made to FIG. 2A illustrating an embodiment of the present invention. According to that embodiment a patch deployment device (PDD), 100 is provided along with the connection clips located at the PDD's body.

(70) The PDD 100 comprises two main portions: distal portion 101, and a proximal portion 102. The two portions are connected via a tube 103. The distal portion is adapted to be inserted into a body during the surgery via a trocar. The distal portion is also adapted to deploy and place a prosthetic hernia repair patch 106 onto the patient's tissue 120 surface.

(71) The distal portion comprises of at least two frame arms (FA) 104, at least 4 deployment arms (DA) 108 and a central shaft 105 adapted to reciprocally move within tube 103.

(72) The DAs 108 can be divided into two groups: 2 DAs (108a and 108b) which are proximally located and 2 DAs (108d and 108c) which are distally located.

(73) The proximal DAs 108a and 108b are connected to the tube 103's distal end and to the FA 104. The distal DAs 108c and 108d are connected to the central shaft 105 and to the FAs 104. All said connections are hinge connections.

(74) Each of said DAs (108) is characterized by a plurality of configurations. One of said configuration is a parallel configuration in which the DA is substantially parallel to said central shaft (105). Another one of said configuration is an angled configuration in which said DA are located at an angle A with respect to said central shaft (105). Angle A can be at a range of about 0 degrees to about 180 degrees.

(75) Reference is now made to FIGS. 2B-2C which illustrate the PDD 100 in its deployed configuration and in its close configuration. The close configuration is described in FIG. 2B while the deployed configuration is describe in FIG. 2C.

(76) In the parallel configuration the PDD 100 is in its close configuration and in the perpendicular configuration, the PDD 100 is in its deployed configuration.

(77) The patch/mesh/net 106 is reversibly attached to the FAs 104 by a reversible CC 107 as described above.

(78) According to one embodiment, the distal portion 101 can be rotated laterally (i.e. left and right with regards to tube 103) and vertically (i.e. up and down in relation to the tube 103), such that the patch could be properly aligned and oriented within the abdominal cavity with regards to the hernia. Such rotation is enabled via the articulating means as will be described hereinafter.

(79) The proximal portion 102 comprises (a) a deployment lever 113 which provides the surgeon the ability to control the deployment process; (b) an articulation lever (not shown) which provides the surgeon the ability to control lateral articulation angle of the distal portion; and, (c) a release button (not shown) which provides the surgeon the ability to roll the distal portion to its close configuration prior to its extraction for the patient's body.

(80) As described above, the patch/mesh/net 106 is reversibly attached to the outer frames 104 (and in this exampleto the FAs 104) by a connection clips (CC) 107. The CCs can be an integral part of the FAs 104 or a separate part which is combined and secured to the PDD 100 during the product assembly.

(81) Reference is now made to FIGS. 3A-3F which describe another embodiment of the CC 107 and a method for providing said reversible connection between patch 106 and the distal portion 101 of the PDD 100.

(82) According to this embodiment CC 107 is composed of a single elastic wire, preferably superelastic Nitinol (i.e. NiTi alloy).

(83) The wire is preformed (i.e., was thermally) into its final shape.

(84) The final shape is characterized by a predetermined U-shaped body 222. said body 222 is characterized by a main longitudinal axis, and comprising a distal end 701 and a proximal end 702, said distal end 701 comprising a pre-shaped protruding portion 201 in which said portion 201 is substantially parallel to said main longitudinal axis

(85) The proximal end 702 comprising a securing portion 301 coupled to the U-shaped body 222; said securing portion 301 is adapted to secure said clip to said PDD (see FIG. 3A).

(86) Said protruding portion 201 comprises at least sharp end adapted to be penetrate the patch. Furthermore, said protruding portion 201 is characterized by at least two configurations: (i) said pre-shaped configuration in which said attachment between said patch and said PDD is provided; and, (ii) a detached configuration in which detachment between said patch and said PDD is provided. It should be emphasized that in the deformed configuration the protruding portion 201 are deformed from said pre-shaped configuration such that detachment between said patch and said PDD is provided. Alternatively, in the deformed configuration, the PDD can be deformed such that the detachment between said patch and said PDD will be provided.

(87) Reference is now made to FIGS. 3A-3F which illustrate said U-shape clip and its use:

(88) According to this embodiment the CC 107 is adapted to be inserted into two holes 303, 304 at the FA 104 (FIG. 3B).

(89) Alternatively, as mentioned above, the CC can be partially inserted into said CM (e.g., stapler) which is provided along with the PDD 100.

(90) FIGS. 3C-3F describes a process in which CC 107 is inserted into the FA 104 and patch 106 in order to provide said reversible attachment.

(91) The CC 107 is initially secured to the FA 104 by said securing portion 301, while portion 201 is partially inserted into FA 104 via hole 303 (see FIG. 3C).

(92) Next, patch 106 is placed between FA 104 and a support section 305 (see FIG. 3D), wherein application of vertical forces upon said CC 107 (namely said U-shaped body) towards said patch and said support section 305 enables portion 201 to penetrate through the patch.

(93) Support section 305 is composed of a soft material (e.g. polymeric foam, RTV silicon, rubber), alternatively it can be composed of a rigid material containing a groove into which portion 201 can penetrate.

(94) Once patch 106 is properly placed, CC 107 is pressed into said support section 305 through hole 304 and patch 106 (see FIG. 3E).

(95) Once the support section 305 is removed, portion 201 springs back into its preformed state, therefore providing said reversible connection between said PDD and the patch (see FIG. 3F).

(96) Portion 201 springs back into its preformed state since it is of supper elastic material (e.g. Nitinol).

(97) Reference is now made to FIGS. 3H-3K which illustrate one embodiment of a coupling adding mechanism (CM) 306 adapted to enable said reversible attachment.

(98) In a preferred embodiment, the CM 306 is also a part of the product packaging.

(99) CM 306, composed of a socket section 307, and a connection platform 308 (see FIG. 3H). Said socket section 307 is designed to fit and at least partially encapsulate at least a portion of the proximal portion 102 while holding the PDD 100 in its upside down orientation (i.e., the protruding section of CC 107 is facing towards the connection platform 308).

(100) Said connection platform 308 comprises at least one support section 305, preferably four support sections 305, each of which is located below each CC 107.

(101) According to a preferred embodiment the PDD 100 is preferably supplied within said CM 306. Reference is now made to FIGS. 3I-3K describing the method in which said CM 306 is utilized for providing said reversible attachment.

(102) First, PDD 100 is at least partially lifted and patch 106 is placed onto said connection platform 308, alternatively patch 106 is inserted below distal portion 101 without lifting PDD 100 (see FIG. 3I).

(103) Next, each one of CC 107 (namely the protruding portion 201) is pushed into the dedicated support section 305 through FA 104 and patch 106 (see FIG. 3J).

(104) Once all of the CCs 107 are inserted into the supporting section 305, the PDD 100 and patch 106 are lifted from the CM 306 (FIG. 3K). Hence, a reversible connection between the patch and the PDD is obtained.

(105) Reference is now made to FIGS. 4A-4I which describe clip stapler apparatus (CSA) 401 adapted to assist in creating said reversible attachment.

(106) Said CSA 401 comprises a holding frame body 402. The holding body 402 comprises at least one stapler 403 coupled to said holding body 402 at each of its four ends (see FIG. 4A). In the figure four staplers are shown; however, at least one is needed.

(107) Said holding body 402, is adapted to hold and support the FA 104 in an open state, while aligning it to its proper position.

(108) Each of the staplers, as will be described hereinafter, is characterized by at least two configurations: a closed configuration, in which said two sections are approximated to one another such that said CC penetrates said patch and provides said reversible attachment; and an open configuration in which said two sections are apart from each other.

(109) Each stapler 403 is adapted to insert one CC 107 through patch 106 and FA 104 in order to obtain said reversible attachment.

(110) Each stapler composed a top section 404 and a bottom section 405.

(111) It should be emphasized that the shape of the holding frame body can be selected from a group consisting of H-shaped, O-shaped X shaped, double cross shape or any combination thereof.

(112) Reference is now made to FIG. 4B which describes the initial stage of each CC 107 and its dedicated stapler 403, (i.e. CC initial stage) in which at least a portion of the u-shaped body 222 of the CC 107 is partially located inside a groove 406 in said holding body 402, thereby providing attachment between the FA 104 and the holding body 402.

(113) Furthermore, in such a manner a detachment of distal portion 101 from the holding body before all CC 107 are inserted to FA 104 is prevented.

(114) The bottom section 405 is adapted to apply force on said CC 107 and to push the same through the FA 104.

(115) A groove 407 located at the top surface of the bottom section 405 is adapted to prevent lateral motion of the CC 107 during said clip insertion (FIG. 4C).

(116) Said top section 404 is adapted to press patch 106 against FA 104 during said clip insertion, while enabling portion 201 of CC 107 to enter groove 408 located at its bottom surface.

(117) Reference is now made to FIGS. 4D-4E which describe the process of inserting a single CC 107 through FA 104 and patch 106 utilizing said CSA 401.

(118) First, a patch 106 is places on the FA 104 (see. FIG. 4D).

(119) Next, the bottom section 405 and the top section 404 are presses toward each other, hence, inserting the CC 107 through FA 104 and patch 106 into groove 408 at the top section 404 (see FIG. 4E).

(120) It should be pointed out that once the CC 107 is inserted into groove 408 a portion 222 of said CC 107 is removed from groove 406.

(121) Reference is now made to FIGS. 4F-4H illustrating the process of reversible attaching the patch and the PDD utilizing the CSA 401.

(122) Initially, the FAs 104 of PDD 100 are reversibly coupled to the CSA 401 by inserting them into grooves 410 in the CSA 401; hence, staplers 403 and CC 107 are positioned in said CC initial stage (FIG. 4F). Said coupling operation is preformed prior to the surgery during device assembly.

(123) Next, patch 106 is placed on the FA 104 and below the staplers top sections 404 (see FIG. 4G). Then, patch 106 is reversibly attached to the PDD 100 by inserting all the CCs 107 using their adjacent and dedicated staplers 402.

(124) Once the CCs are fully inserted into the patch and the FAs 104, said reversibly attachment (between the patch and the PDD 100) is obtained and the FAs 104 can be extracted from grooves 410. Next PDD 100, coupled to patch 106, is separated from the CSA 401 (see FIG. 4H).

(125) Staplers 403 can also be used individually, without said holding body 402. According to this embodiment, the staplers are connected directly to the FAs 104, and therefore can be individually removed once clip insertion is performed.

(126) Reference is now being made to FIGS. 5A-5F which describe an alternative method for reversibly connecting said patch to said PDD.

(127) According to this embodiment each CC 107 is fully inserted into the FA 104 and a stapler 501 is utilized for inserting the CC 107 into patch 106.

(128) Stapler 501 comprising a top section 502 and a bottom section 503 connected by a hinge.

(129) Said bottom section is adapted to be coupled with FA 104 by inserting said FA 104 into said bottom section of the stapler 501 through a tubular bore 504 running along the length of the bottom section 503.

(130) A groove 505, located at the top surface of the bottom section, is adapted to house portion 201 of CC 107 while holding it in an upright position (i.e., portion 201 of CC 107 is facing bore 506 of the stapler's top section 502).

(131) The stapler's top section 502 is adapted to press patch 106 against FA 104 while inserting portion 201 into bore 506 at its bottom surface (see FIG. 5A).

(132) Four staplers 50, are connected to each end of FAs 104. Each stapler 501 is adapted to be in communication with merely one CC 107 while maintaining the same in an upright position (see FIG. 5B).

(133) FIGS. 5C-5F describe a method in which each CC 107 is inserted into patch 106 for reversibly attaching said patch to said PDD.

(134) First the FA 104 is inserted into tubular bore 504 of stapler 501. The CC is initially held in an upright position by stapler 501 (see FIG. 5C).

(135) Next, Patch 106 is placed above the FAs 104 and the protruding portion 201 of the CCs 107 (see FIG. 5D).

(136) Next, the stapler's top section 502 is lowered toward the FA 104 while inserting portion 201 into bore 506 through patch 106 (see FIG. 5E).

(137) Once CC 107 is fully inserted into bore 506, the top section 502 is elevated back to its initial position, and stapler 501 is removed from FA 104; as a result CC 107 springs back into its pre-shaped form thereby providing said reversible attachment (see FIG. 5F).

(138) Reference is now made to FIGS. 6A-6E which describe yet another alternative approach to provide said reversible connection.

(139) According to this embodiment, the CCs 107 are made of a rigid deformable material (e.g. stainless steel T304, stainless steel T316).

(140) The CCs 107 are inserted through FAs 104 and patch 106 utilizing several staplers 601. Each stapler is mounted on each edge of the FAs 104.

(141) Stapler 601 comprises a top section 602 a bottom section 603 both connected via a hinge. Stapler 601 also comprises a slide 604 sliding towards and away from said top section.

(142) Each CC 107 is pre-mounted within its dedicated stapler 601 and inserted into dedication holes at FAs 104.

(143) The bottom section comprises a groove into which CC 107 is inserted. Said bottom section is adapted to prevent said CC from any unwanted displacement (mainly lateral displacement of the CC).

(144) Slide 604 is adapted to apply forces on the CC 107 and to press the same through FA 104 and patch 106.

(145) The stapler's top section 602 is characterized by a predetermined shape. Said shape will be the CC's shape. Top section 602 comprises two shaping grooves 605.

(146) The stapler's top section is adapted to apply force and press patch 106 against FA 104 whilst shaping CC 107 into its final shape during the process of clip insertion,

(147) Reference is now made to FIGS. 6B-6E describing a method for utilizing stapler 601.

(148) First, patch 106 is positioned above the FA 104 (FIG. 6B).

(149) Next, the top section 602 is lowered toward FA 104 whilst pressing patch 106 against it (FIG. 6C).

(150) Next, the slide 604 is pushed upward towards the top section 602. Said movement of the slide 604 causes the CC 107 to penetrate the FA 104 and the patch 106. Furthermore, said movement of said slide 604 presses the CC 107 onto the shaping grooves 605; thereby shaping it into said shaping groove's shape.

(151) As a result the edges of CC 107 are bended (and taking the shape of the shaping grooves 605). Said bending provides said reversible attachment (see FIG. 6D). Once said reversible attachment is obtained, stapler 601 is removed from FA 104 (see FIG. 6E).

(152) Reference is now made to FIGS. 7A-7C which illustrate an alternative embodiment of PDD 100, utilizing said reversible attachment. According to this embodiment patch 106 is deployed by a least 2 flexible frame arms (FA) 104.

(153) In the closes configuration of PDD 100, FA 104 are substantially straight and aligned with tube 103, hence enabling insertion of patch 106 through trocar 114 (not shown in the figure). Once the distal portion 101 in fully inserted into the patient's abdominal cavity and outside trocar 114, FA 104 are transformed into their open configuration in which they radiate from tube 103 (into a cone-like configuration), hence deploying patch 106 (see FIG. 7A).

(154) According to this embodiment patch 106 is connected to FA 104 via CC 107 located at the end of each FA 104. Each section 201 of each CC 107 is facing outward with regards to tube 103 (see FIG. 7A).

(155) Once the distal portion 101 along with patch 106 is inserted into the patient's abdominal cavity, patch 106 is attached to the patient's tissue 120 by PTC 202 (see FIG. 7B).

(156) At this point PDD 100 is disconnected from patch 106 by applying pulling forces and distancing the distal portion 101 from the tissue; as a result the FAs 104 are deformed such that each CC 107 is pulled toward tube 103 and hence sliding out of patch 106 to provide said detachment according to said mechanism A.

INCORPORATION BY REFERENCE

(157) References and citations to other documents, such as patents, patent applications, patent publications, journals, books, papers, web contents, have been made throughout this disclosure. All such documents are hereby incorporated herein by reference in their entirety for all purposes.

EQUIVALENTS

(158) The invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The foregoing embodiments are therefore to be considered in all respects illustrative rather than limiting on the invention described herein. Scope of the invention is thus indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.