Methods and apparatus for fixing sheet-like materials to a target tissue
A staple for attaching a sheet-like implant to tissue or bone may include first and second arms, and first and second flukes. In some embodiments, the first arm has a proximal end and a distal end, and the second arm has a proximal end and a distal end. A bridge extends from the proximal end of the first arm to the proximal end of the second arm. The first fluke has a proximal end abutting the distal end of the first arm, and the first fluke extends distally from the first arm. The first fluke has a lateral extent larger than a lateral extent of the first arm and is mounted eccentrically thereto. The first fluke includes a proximal surface projecting at an outward angle in a proximal direction away from the distal end of the first arm to engage the tissue or bone when inserted therein. The second fluke has similar features. This arrangement causes the first and second flukes to rotate in response to a pullout force on the bridge. Methods for attaching a sheet-like implant to a target tissue are also disclosed.
1. A system for attaching a sheet-like implant to tissue or bone comprising:
a stapler including:
a tubular member having a proximal end, a distal end, and a lumen extending therethrough;
an elongate shaft extending through the lumen of the tubular member, the elongate shaft including a first stake and a second stake located at a distal end of the elongate shaft;
a staple including:
a first arm having a proximal end and a distal end;
a second arm having a proximal end and a distal end;
a bridge element extending between the proximal end of the first arm and the proximal end of the second arm;
a first fluke having a proximal end, a proximally facing surface, a distal end, and a distally facing surface, wherein the first fluke defines a first passageway extending into the first fluke from the proximally facing surface of the first fluke;
wherein the first fluke is attached to and extends distally from the distal end of the first arm;
a second fluke having a proximal end, a proximally facing surface, a distal end, and a distally facing surface, wherein the second fluke defines a second passageway extending into the second fluke from the proximally facing surface of the second fluke;
wherein the second fluke is attached to and extends distally from the distal end of the second arm;
wherein the staple is positionable within the lumen of the tubular member of the stapler with the distal portion of the first stake of the elongate shaft inserted into the first passageway and the distal portion of the second stake of the elongate shaft inserted into the second passageway therein, wherein the staple is positioned in the lumen of the tubular member in a deflected state, and wherein the staple reverts towards an unconstrained state when deployed from the tubular member.
2. The system of claim 1 , wherein the first and second flukes are pressed against an interior surface of the tubular member in the deflected state.
3. The system of claim 1 , wherein the proximally facing surface of the first fluke extends at an oblique angle to the first arm and the proximally facing surface of the second fluke extends at an oblique angle to the second arm.
4. The system of claim 3 , wherein the first passageway extends to an opening on the distally facing surface of the first fluke and the second passageway extends to an opening on the distally facing surface of the second fluke.
5. The system of claim 4 , wherein the first fluke includes a distal tip located distal of the opening on the distally facing surface of the first fluke and the second fluke includes a distal tip located distal of the opening on the distally facing surface of the second fluke.
6. The system of claim 1 , wherein the first arm, the bridge element, the second arm, the first fluke, and the second fluke are integrally formed.
7. The system of claim 1 , wherein the first arm, the bridge element, the second arm, the first fluke, and the second fluke are formed from a bioresorbable polymeric material.
8. The system of claim 1 , wherein the bridge element forms an arch between the first arm and the second arm.
9. The system of claim 1 , wherein the first passageway is located laterally outward of the first arm and the second passageway is located laterally outward of the second arm.
10. The system of claim 1 , wherein each of the first and second stakes includes a proximal portion, a distal portion, and a shoulder located between the proximal portion and the distal portion.
11. The system of claim 10 , wherein the distal portion of the first stake is insertable into the passageway of the first fluke with the shoulder contacting the proximally facing surface of the first fluke and the distal portion of the second stake is insertable into the passageway of the second fluke with the shoulder contacting the proximally facing surface of the second fluke.
12. The system of claim 1 , wherein the tubular member includes first and second prongs extending distally therefrom, the first and second prongs configured to retain a position of the stapler during deployment of the staple from the tubular member.
13. The system of claim 12 , wherein the first and second flukes extend radially outward of the first and second prongs when the staple is deployed from the tubular member.