Fixation device delivery system and methods
A fixation device delivery system is described. The system includes a driver and a cooperating fixation element featuring a barb which becomes active upon deployment in the inner abdominal wall.
1. A mesh fixation system comprising a tack and a delivery instrument, wherein the tack comprises:
a body section having a distal section and a proximal section, a helical threaded element extending outwardly from the body section and at least partially extending longitudinally from the distal section towards the proximal section and engagement elements configured to operably engage and interact with the delivery instrument, wherein the proximal section defines a lumen for receipt of at least a portion of the delivery instrument, the body section further defining a mouth to the lumen that extends along a longitudinal axis of the body section and which, on removal of the at least a portion of the delivery instrument from the lumen defines a barb.
2. The system of claim 1 , wherein the tack comprises contact surfaces configured to engage with the delivery instrument and against which the delivery instrument can operably exert deployment forces.
3. The system of claim 2 , wherein the contact surfaces are configured to allow forces to be transmitted from the delivery instrument to the tack.
4. The system of claim 1 , wherein the delivery instrument comprises a distal end and a proximal end, and a shaft connecting the distal end and proximal end, wherein the distal end comprises an element dimensioned to be inserted into the lumen and the delivery instrument further comprises force application elements through which forces can exerted on the proximal end of the tack.
5. The system of claim 4 , wherein the delivery instrument and tack are configured to allow only rotational forces in one direction to be transmitted to the tack from the delivery instrument.
6. The system of claim 1 , wherein the tack comprises a torque mating profile configured to operably engage with the delivery instrument and through which transmission of torque from the delivery instrument to the tack is affected.
7. The system of claim 1 , wherein the delivery instrument comprises a ballnose tip.
8. The system of claim 1 , wherein the tack lumen is curved to retain it on the delivery instrument.
9. The system of claim 1 , wherein a tip of the tack is offset from a centerline of the tack.
10. The system of claim 1 , wherein the mouth extends at least 50% of a total length of the body section along a longitudinal axis of the body section.
11. A method of fixing a mesh within an abdominal cavity, the method comprising:
providing a tack and a delivery instrument, wherein the tack comprises
a body section having a distal section and a proximal section, a helical threaded element extending outwardly from the body section and at least partially extending longitudinally from the distal section towards the proximal section and engagement elements configured to operably engage and interact with the delivery instrument, wherein the proximal section defines a lumen for receipt of at least a portion of the delivery instrument, the body section further defining a mouth to the lumen that extends along a longitudinal axis of the body section and which, on removal of the at least a portion of the delivery instrument from the lumen defines a barb;
placing the tack on a step-down portion of the delivery instrument;
inserting a shaft of the delivery instrument through a trocar or port to a desired location to place the tack to fix the mesh;
deploying the tack at the desired location by applying pressure and rotating the delivery instrument;
placing another tack on a step-down portion of the delivery instrument and repeating the placing, inserting, and deploying until a user is satisfied that the mesh is sufficiently fixed; and
removing the delivery instrument from the trocar or port.
12. The method of claim 11 , wherein the delivery instrument is reusable.
13. The method of claim 11 , wherein the delivery instrument further comprises a cartridge in which multiple tacks are operably stored.
14. The method of claim 11 , wherein a tip of the distal section or other section of the tack lumen is operably offset from an engaged driver device to prevent premature deployment of the tack from the driver device.
15. The method of claim 11 , wherein the tack comprises a secondary barb or surface configured to assist in deployment of the tack.
16. The method of claim 11 , wherein 50% or more of the tack lumen is exposed along a longitudinal axis of the tack body to promote tissue ingrowth after delivery.
17. The method of claim 11 , wherein the delivery instrument comprises a non-deformable core wire.
18. The method of claim 11 , wherein the delivery instrument comprises a non-deformable core wire rotatable helical tip.
19. The method of claim 11 , wherein a handle is electrically or pneumatically controlled to rotate and/or advance and retract an accommodated tack relative to the shaft.
20. The method of claim 11 , wherein the tack comprises a dissecting tip with a triangular profile configured to assist in delivery of the tack.