US20100191249A1 - Instruments and Methods for Delivering Multiple Implants in a Surgical Procedure - Google Patents
Instruments and Methods for Delivering Multiple Implants in a Surgical Procedure Download PDFInfo
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- US20100191249A1 US20100191249A1 US12/752,725 US75272510A US2010191249A1 US 20100191249 A1 US20100191249 A1 US 20100191249A1 US 75272510 A US75272510 A US 75272510A US 2010191249 A1 US2010191249 A1 US 2010191249A1
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- 239000007943 implant Substances 0.000 title claims abstract description 107
- 238000000034 method Methods 0.000 title claims abstract description 15
- 238000001356 surgical procedure Methods 0.000 title claims description 5
- 238000002513 implantation Methods 0.000 claims abstract description 24
- 230000000717 retained effect Effects 0.000 claims description 7
- 230000000694 effects Effects 0.000 claims description 3
- 210000000988 bone and bone Anatomy 0.000 description 6
- 230000000994 depressogenic effect Effects 0.000 description 3
- 230000005484 gravity Effects 0.000 description 3
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000006641 stabilisation Effects 0.000 description 2
- 238000011105 stabilization Methods 0.000 description 2
- 230000004075 alteration Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 238000007747 plating Methods 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8872—Instruments for putting said fixation devices against or away from the bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8695—Washers
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T279/00—Chucks or sockets
- Y10T279/17—Socket type
- Y10T279/17761—Side detent
- Y10T279/17811—Reciprocating sleeve
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Instruments and methods are provided for delivering multiple implants to locations for implantation in a patient without requiring a second implant to be loaded onto or engaged to the delivery instrument after delivery of a first implant.
Description
- Various types of devices and systems have been used for positioning implants into a patient in surgical procedures. Spinal stabilization systems have employed plating systems, rods, anchors, fusions devices, artificial discs, and other implants along or in the spinal column for rigid, dynamic, and semi-rigid spinal stabilization procedures. Such systems often include multiple implant members that must be engaged for the system to be properly installed. There remains a need for instruments and methods for delivering multiple implants to the implantation location while minimizing the time and complexity associated with handling and positioning such implants during surgery.
- According to one aspect, an instrument for delivering multiple implants to at least one surgical location in a patient includes a mounting member, a retaining mechanism housed in the mounting member, and an actuator coupled to the mounting member. The mounting member includes an elongate tubular portion extending between a distal mounting portion for receiving multiple implants therealong and a proximal end member. The retaining mechanism is movable between a retaining position for retaining the implants along the mounting portion and a dispensing position allowing a distal-most implant on the mounting portion to move distally along the mounting portion for delivery to the at least one surgical location. The actuator includes a proximal engaging end adjacent the proximal end member of the mounting member. The actuator extends from the proximal engaging end through the tubular portion to an actuating end along the mounting portion. The actuator includes a first axial position with the actuating end positioning the retaining mechanism in the retaining position. The actuator is movable in the mounting member to a second axial position with the actuating end positioning the retaining mechanism in the dispensing position.
- According to another aspect, an instrument for delivering multiple implants to at least one surgical location in a patient includes a mounting member, an actuator in the mounting member, and distal and proximal retaining members in the mounting member in contact with the actuator. The mounting member includes an elongate tubular portion extending between a distal mounting portion for receiving multiple implants therealong and a proximal end member. The actuator includes a distal actuating end in the tubular portion of the mounting member and a proximal engaging end received in the end member of the mounting member. The actuator has a first rotational alignment relative to the mounting member wherein the actuator is axially movable in the mounting member between a retaining position and a dispensing position. In the retaining position the distal retaining member projects outwardly from the mounting portion and contacts a distal-most implant to axially retain the multiple implants on the mounting portion and the proximal retaining member is recessed in the mounting portion. In the dispensing position the distal retaining member is recessed into the mounting portion to permit the distal-most implant to advance distally along the mounting portion for implantation and the proximal retaining member projects outwardly from the mounting portion to contact a second implant proximal of the distal-most implant to axially retain the second implant on the mounting portion.
- In another aspect, a surgical system includes a delivery instrument and multiple implants along the delivery instrument. The delivery instrument includes an elongated mounting member having a distal mounting portion and a proximal end member, an actuator in the mounting member including an actuating end in the mounting portion and a proximal engaging end extending proximally from the proximal end member of the mounting member, and a retaining mechanism in the mounting member movable upon axial displacement of the actuator in the mounting member between a retaining position and a dispensing position. The plurality of implants positioned about the mounting portion include a distal-most implant in contact with the retaining mechanism in the retaining position and a proximal most implant in contact with a biasing member biasing the multiple implants distally into contact with the retaining mechanism.
- In yet another aspect, a method for delivering multiple implants to an implantation location comprises: positioning a distal end of a delivery instrument at a first implantation location, the delivery instrument including a first distal-most implant and at least one second implant proximal the first implant positioned about and retained on the delivery instrument; distally advancing the first implant along the delivery instrument for implantation at the implantation location while simultaneously retaining the at least one second implant on the delivery instrument with the delivery instrument; positioning the distal end of the delivery instrument adjacent a second implantation location; and distally advancing the at least one second implant along the delivery instrument for implantation at the second implantation location.
- These and other aspects will also be apparent from the following description.
-
FIG. 1 is an elevation view of a delivery instrument for delivering multiple implants in a surgical implantation location. -
FIG. 2 is an elevation view of the delivery instrument ofFIG. 1 rotated 90 degrees about its longitudinal axis from itsFIG. 1 positioning. -
FIG. 3 is an exploded view of the delivery instrument ofFIG. 1 . -
FIG. 4 is a section view along line 4-4 ofFIG. 3 . -
FIG. 5A is a perspective view of a proximal end of the delivery instrument in a dispensing orientation. -
FIG. 5B is a sectional view of a distal portion of the delivery instrument with the delivery instrument in the dispensing orientation and the actuator and retaining mechanism in a retaining position. -
FIG. 5C is a sectional view of the distal portion of the delivery instrument ofFIG. 5B with the delivery instrument in the dispensing orientation and the actuator and retaining mechanism in a dispense position. -
FIG. 6A is a perspective view of the proximal end of the delivery instrument in a loading orientation. -
FIG. 6B is a sectional view of the distal portion of the delivery instrument with the actuator and retaining mechanism in the loading orientation. -
FIG. 7 is a longitudinal section view of a mounting member of the delivery instrument ofFIG. 1 . -
FIG. 8 is an elevation view of an actuator of the delivery instrument ofFIG. 1 . -
FIG. 9 is an elevation view of the actuator ofFIG. 8 rotated 90 degrees about its longitudinal axis from itsFIG. 8 orientation. -
FIG. 10 is an enlarged view of a distal portion of the actuator ofFIG. 9 . -
FIG. 11 is a longitudinal section view of a housing of the delivery instrument ofFIG. 1 . -
FIG. 12 is a longitudinal section view of a piston member of the delivery instrument ofFIG. 1 . -
FIG. 13 is a perspective view of an alignment pin of the delivery instrument ofFIG. 1 . - For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any such alterations and further modifications in the illustrated devices, and such further applications of the principles of the invention as illustrated herein are contemplated as would normally occur to one skilled in the art to which the invention relates.
- Positioning of multiple implants during a surgical procedure without withdrawing or re-loading the delivery instrument with an implant is facilitated by a delivery instrument that includes a mounting member with multiple implants positioned axially therealong. The multiple implants are axially retained on the mounting portion until positioned adjacent an implantation location. The instrument can be actuated to deliver the distal-most implant from the distal end of the delivery instrument to the implantation location while the next most distal implant is axially retained on the mounting portion. The delivery instrument can then be re-positioned, or maintained in the same position, for delivery of the second implant from the distal end by actuating the delivery instrument. The process can be repeated until all required implants have been delivered or until it is necessary to re-load the delivery instrument with additional implants.
- The delivery instrument can include an actuator that is operable at the proximal end of the delivery instrument to effect delivery and retention of the implants along the distal mounting portion of the delivery instrument. In one embodiment, the actuator includes a dispensing orientation that provides a push-button type control to dispense the implants from the delivery instrument. The actuator is moveable to a loading orientation that allows multiple implants to be loaded about the mounting portion from the distal end of the instrument. After loading of the implants, the actuator is movable to the dispensing orientation where the implants are retained on the mounting portion until the actuator is depressed by the user to deliver the distal-most implant.
- The implantation location can be an implant engageable to bony structure of the patient, such as a spinal plate, a bone screw, a clamp, an interbody device, or any other construct. In one specific technique, the implantation location is a proximally extending post of a bone screw, and the implant is a washer that is positionable about the post. Multiple implants can be delivered to the same location, or to multiple locations in the patient. The washers can facilitate securement of a plate or rod to the bone screw post in a desired position therewith.
- In
FIGS. 1-4 there is shown adelivery instrument 10 extending along a longitudinal axis 11 between a distal mounting end 16 about which multiple implants can be mounted and a proximal actuating end 18 to effectuate delivery of the implants from distal mounting end 16. In the illustratedembodiment delivery instrument 10 includes ahousing 20 to which a mountingmember 40 is mounted. Mountingmember 40 extends throughhousing 20 between aproximal end member 42 proximal ofhousing 20 and a distal mountingportion 44 distal ofhousing 20. Multiple implants 14 (FIG. 5 ) can be mounted aboutdistal shaft portion 44 and retained thereon with aretaining mechanism 120.Retaining mechanism 120 is movable with anactuator 70 between a retaining position to retain the implants on mountingportion 44 and a dispensing position where the distal-most implant is movable axially along mountingportion 44 for delivery from the distal end ofdelivery instrument 10. -
Actuator 70 extends through mountingmember 40 between a proximaluser engaging end 72 and adistal actuating end 74 in mountingmember 40. Engagingend 72 can be manipulated by the user to selectively moveactuator 70 in mountingmember 40 so that actuatingend 74 selectively deploys andrecesses retaining mechanism 120 between the retaining position and the dispensing position. -
Delivery instrument 10 further includes apiston member 30 movably received inhousing 20 and about mountingmember 40 that is distally biased along mountingmember 40 and into contact with the implants along mountingportion 44.Piston member 30 is axially restrained in the distal direction by a distally oriented outer lip aboutpiston member 30 adjacent its proximal end that contacts with a proximally oriented inner lip abouthousing 20 adjacent its distal end. - In the dispensing
orientation actuator 70 is proximally biased in mountingmember 40 when in a first rotational alignment therewith so that it is normally in a retaining position. The user can move actuator 70 axially by pressing engagingend 72 distally in mountingmember 40 to a dispense position. In the dispensingposition actuating end 74 is configured and positioned to manipulateretaining mechanism 120 so that distal-most implant is movable distally along mountingportion 44 for delivery therefrom while the next most distal implant is axially retained on mountingportion 44 by retainingmechanism 120. The distally directed force supplied bypiston member 30 can assist in advancing the implants distally along mountingportion 44, although embodiments without piston member are contemplated where the implants advance solely due to gravity. - In the loading orientation,
actuator 70 can further be configured so that when it is in a second rotational alignment with mountingmember 40 theretaining mechanism 120 is positioned to allow implants to be axially loaded into mountingportion 44. In this loading position, actuatingend 74 is configured and position relative to retainingmechanism 120 so that it is recessed in mountingmember 40, allowing implants to be loaded about mountingmember 40 without interference from retainingmechanism 120.Piston member 30 can be manually restrained in a proximal position about mountingmember 40 as the implants are loaded along mountingportion 44. When actuator 70 is returned to its first rotational alignment in mountingmember 40 in the dispensing orientation,piston 30 can be released to contact the proximal most implant and bias the multiple implants distally into contact with retainingmechanism 120 in its retaining position. - Further details of operation of
actuator 70 to dispense and load implants about mountingmember 40 are shown inFIGS. 5A-6B . InFIG. 5A ,actuator 70 is positioned in the dispensing orientation relative to mountingmember 40. An arrow or other indicator can be provided on the proximal end ofactuator 70 that can align with the word “DISPENSE” or some other indicator on the side of mountingmember 40 to provide the user an indication thatdelivery instrument 10 is rotationally aligned with mountingmember 40 in an orientation that allowsactuator 70 to be axially moved from the retaining position to the dispensing position. When in this first rotational alignment, thedistal actuating end 74 is positioned in a first axial position relative to retainingmembers mechanism 120, as shown inFIG. 5B . In this first axial position, actuatingend 74contacts retaining members members members detents respective detents detents - In the retaining position of
FIG. 5B , proximal retainingmember 120 b is aligned with a retainingmember recess 76 in actuatingend 74 so that it can recess intoproximal detent 44 b of mountingportion 44 and not project outwardly from the outer surface of mountingportion 44. Distal retainingmember 120 a, on the other hand, is in contact with a distalactuating shaft portion 75 of actuatingend 74 and forced intodistal detent 44 a so that distal retainingmember 120 a projects outwardly from the outer surface of mountingportion 44. Distal retainingmember 120 a thus preventsimplants portion 44 from sliding distally along mountingportion 44.Implant 14 a can be located distally of the proximal retainingmember 120 b. The distal end of the second mostdistal implant 14 b, however, is located proximally of proximal retainingmember 120 b.Piston member 30 pushes against the proximal-most implant and forces thedistal-most implant 14 a into contact with retainingmember 120 and the remaining implants into end-to-end contact with one another along mountingportion 44. - In the retaining position of
FIG. 5B , adistal end member 130 ofactuator 70 contacts a distal end wall of mountingmember 40, maintaining the proximallybiased actuator 70 in the retaining position.Actuator 70 can be axially moved toward the dispensing position by axially and distally displacingactuator 70 in mountingmember 40, as shown inFIG. 5C , locating actuatingend 74 in a second axial position relative to mountingportion 44 and spacing distal end member 130 a distance d from a distally oriented end wall of mountingmember 40. In the dispensing position ofFIG. 5C , distal retainingmember 120 a is aligned with retainingmember recess 76 in actuatingend 74 so that it can recess intodistal detent 44 a of mountingportion 44 and not project outwardly from the outer surface of mountingportion 44.Distal implant 14 a can thus move distally along mountingportion 44 by gravity and/or the bias ofpiston member 30 for delivery therefrom. Proximal retainingmember 120 b, on the other hand, is in contact with a proximalactuating shaft portion 77 of actuatingend 74 and pushed intoproximal detent 44 b sufficiently to project outwardly from the outer surface of mountingportion 44. Proximal retainingmember 120 b thus prevents the next mostdistal implant 14 b about mountingportion 44 from sliding distally along mountingportion 44 when the distal-most implant is being delivered. - When the proximal end of
actuator 70 is released, it is spring biased proximally to return actuatingend 74 to its first axial position and to the retaining position shown inFIG. 5B . The next mostdistal implant 14 b moves distally along mountingportion 44 via gravity and/or the bias frompiston member 30 to contact distal retainingmember 120 a, while proximal retainingmember 120 b recesses into mountingportion 44. The process can be repeated for each implant 14 to be dispensed from mountingportion 44 of mountingmember 40. -
FIGS. 6A and 6B showactuator 70 positioned in a second rotational alignment with mountingmember 40 in a loading orientation to permit loading of implants onto mountingportion 44 of mountingmember 40. InFIG. 6A , the proximal end ofactuator 70 is rotated relative to mountingmember 40 180 degrees from its orientation inFIGS. 5A-5C . Mountingmember 40 can be inscribed with the word “LOAD” or include some other indicator to indicate thatactuator 70 is in the loading orientation when the arrow is aligned therewith. In one embodiment,actuator 70 is pressed distally against the proximal bias thereof, and is then rotated to position analignment pin 110 in a keyed portion ofactuator 70. The engagement ofalignment pin 110 in the keyed portion ofactuator 70 allowsalignment pin 110 to maintainactuator 70 in its distally displaced position relative to mountingmember 40 without the application of manual pressure at the proximal end ofactuator 70 to overcome the proximal bias ofactuator 70. - As shown in
FIG. 6B , in the loading positiondistal end member 130 is spaced distance d from the distally oriented end wall of mountingmember 40.Actuating end 74 includes anelongated recess 78 that is aligned withdetents Elongated recess 78 is configured to permit both retainingmembers member 40, avoiding interference with the loading of implants 14 about mountingportion 44.Piston member 30 can be grasped and pulled proximally intohousing 20 against the distal bias ofpiston member 30 to allow the implants to be positioned along mountingportion 44. After loading of the implants,actuator 70 is rotated to its first rotational alignment with mountingmember 40, where it automatically returns toward the position ofFIGS. 5A and 5B to retain the loaded implants on mountingportion 44.Piston member 30 can then be released to contact the proximal most implant 14 along mountingportion 44 and force the distal-most implant 14 into contact with distal retainingmember 120 a. - Further details of the components of
delivery instrument 10 are shown inFIGS. 7-13 . InFIG. 7 mountingmember 40 is shown in longitudinal section view. Mountingmember 40 includesproximal end member 42 defining acylindrical receptacle 43 for receiving a proximal portion ofactuator 70, as discussed further below. A number of holes can be provided aboutend member 42 to facilitate longitudinal movement ofactuator 70 therein without build-up of resistive air pressure. Mountingmember 40 further includes a threadedcollar 46adjacent end member 42, and anelongated tubular portion 48 extending distally fromcollar 46.Tubular portion 48 defines apassage 49 extending therethrough that opens into thereceptacle 43 defined byend member 42 and at the distal end oftubular portion 48. - The distal end of mounting
member 40 includes a threadedtip portion 52 for threadingly receivingpositioning member 140 thereabout, as shown inFIG. 5B for example. Positioningmember 140 includes a proximal internally threadedportion 142 engageable abouttip portion 52 and a distally extendinglocator tip 144.Locator tip 144 includes a reduced diameter or size relative toproximal portion 142 and mountingmember 40, and can be positioned in an implant receptacle or other structure at the surgical site to assist inpositioning delivery instrument 10 in the desired position and orientation relative to the implantation location. In one embodiment,locator tip 144 is smaller in size than mountingportion 44 to assist in placingdelivery instrument 10 in overlapping relation with the implantation location. For example,locator tip 144 can be placed in a tool recess in a proximal end of a bone anchor. The implants can be delivered to the bone anchor without slipping off, fall between or otherwise misaligning with the bone anchor as the implant slides off positioningmember 140. -
Passage 49 can includes aproximal portion 49 b and a reduced sizedistal portion 49 a. Detents 44 a, 44 b are located through the wall oftubular portion 48 in communication withdistal passage portion 49 a.Actuator 70, shown also inFIGS. 8-10 , includes an elongatedproximal shaft portion 80 that is received inproximal portion 49 b ofpassage 49 anddistal actuating end 74 that is received indistal portion 49 a ofpassage 49. The axial positioning ofrecesses shaft actuating portions detents members Actuating end 74 includes a threadeddistal tip 82 for threadinglyengaging end cap 130.End cap 130 can abuttingly engage the adjacent distally oriented wall of mountingmember 40 to assist in maintainingactuator 70 in the retaining position shown inFIG. 5B . - Proximal
user engaging end 72 ofactuator 70 includes a grippingportion 84 and acylindrical portion 86 extending from grippingportion 84 toshaft portion 80. Grippingportion 84 can be tapered in at least one dimension to narrow proximally and can be concavely curved to facilitate gripping by the user to apply the rotational and axial forces to actuator 70.Cylindrical portion 86 is rotatably received inreceptacle 43 defined byend member 42 of mountingmember 40. Actuator biasing member 100 (FIGS. 1-4 ) can be a spring positioned aboutshaft portion 80 and into contact with the distally orientedwall 87 ofcylindrical portion 86.Biasing member 100 also contacts a proximally orientedwall 56 inend member 42 to normallybias actuator 70 proximally relative to mountingmember 40. - Alignment pin 110 (shown in
FIG. 13 ) includes anouter portion 114 engaged inhole 54 ofend member 42 and aninner portion 112 positioned in a keyway incylindrical portion 86. The keyway is formed by anaxial slot portion 86 a and atransverse slot portion 86 b at the proximal end ofaxial slot portion 86 a.Inner portion 112 is received inaxial slot portion 86 a whendelivery instrument 10 is rotationally aligned in the dispensing orientation. With biasingmember 100 normally biasingactuator 70 proximally relative to mountingmember 40,alignment pin 110 normally resides at the distal end ofaxial slot 86 a, positioning actuatingend 74 andretaining mechanism 120 in mountingmember 40 to the retaining position as shown inFIG. 5B . - To advance actuating
member 70 andplace actuating end 74 andretaining mechanism 120 in the dispensing position as shown inFIG. 5C ,user engaging end 72 is depressed against the bias of biasingmember 100, andalignment pin 110 moves alongaxial slot portion 86 a to its proximal end. If it is desired to positiondelivery instrument 10 in the loading orientation, then from the dispensingposition gripping portion 84 can be gripped to rotateactuator 70 in mountingmember 40, advancingalignment pin 110 intotransverse slot portion 86 b. Whenalignment pin 110 has been translated to the end oftransverse slot portion 86 b oppositeaxial slot portion 86 a,actuator 70 is maintained in the depressed condition against the bias of biasingmember 100, and actuatingend 74 is maintained in the axial and rotational position shown inFIG. 6B to permit loading of implants about mountingportion 44. -
Housing 20 is shown in longitudinal section view inFIG. 11 .Housing 20 includes alongitudinal bore 21 extending between and opening through adistal end 22 and aproximal end 24.Proximal end 24 includesinternal threads 26 to threadingly engagecollar 46 of mountingmember 40.Distal end 22 includes aninternal lip 28 extending thereabout. -
Piston member 30 is shown inFIG. 12 , and includes an elongated body extending between adistal end 32 and aproximal end 34.Piston member 30 includes acentral bore 31 sized for positioning abouttubular portion 48 of mountingmember 40.Piston member 30 can include a number ofelongated slots 36 extending therethrough and spaced radially thereabout to facilitate movement ofpiston member 30 betweenhousing 20 and mountingmember 40.Piston biasing member 90 can be in the form of a spring positioned abouttubular portion 48 with a distal end ofpiston biasing member 90 in contact withproximal end 34 ofpiston member 30, and a proximal end ofpiston biasing member 90 in contact withcollar 46. - Biasing
member 90 pushespiston member 30 against the proximal-most implant 14 and forces the distal-most implant 14 into contact with retainingmechanism 120.Piston member 30 further includes anexternal lip 38 adjacentproximal end 34 that contactsinternal lip 28 ofhousing 20 adjacent the distal end ofhousing 20. Contact between thelips piston member 30 abouttubular portion 48 of mountingmember 40 even whenpiston member 30 is fully extended distally fromhousing 20 under the force of biasingmember 90, as shown inFIGS. 1 and 2 . - While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected.
Claims (8)
1-18. (canceled)
19. A method for delivering multiple implants in a surgical procedure, comprising:
positioning a distal end of a delivery instrument at a first implantation location, the delivery instrument including a first distal-most implant and at least one second implant proximal the first implant positioned about and retained on the delivery instrument;
distally advancing the first implant along the delivery instrument for implantation at the implantation location while simultaneously retaining the at least one second implant on the delivery instrument with the delivery instrument;
positioning the distal end of the delivery instrument adjacent a second implantation location; and
distally advancing the at least one second implant along the delivery instrument for implantation at the second implantation location.
20. The method of claim 19 , wherein the implants are biased distally along the delivery instrument.
21. The method of claim 20 , wherein the delivery instrument includes a retaining mechanism comprising a distal retaining member and a proximal retaining member, wherein the retaining members have a first position wherein the distal retaining member projects outwardly from the delivery instrument and contacts the first implant and the proximal retaining member is recessed in the delivery instrument, the retaining members being moveable to a second position wherein the distal retaining member is recessed into the delivery instrument to permit the first implant to advance distally along the delivery instrument for implantation and the second retaining member projects outwardly from the delivery instrument to contact the at least one second implant to retain the at least one second implant on the delivery instrument.
22. The method of claim 21 , wherein the delivery instrument comprises:
a mounting member having a proximal end member and an elongate mounting portion along which the implants are mounted;
an actuator axially movable in the mounting member, the actuator including a proximal engaging end manipulatable to effect axial movement of the actuator, the actuator including an elongate shaft extending from the proximal engaging end through the mounting member to a distal actuating end adjacent the mounting portion; and
the proximal and distal retaining members are positioned in the mounting member and are movable relative thereto between their respective recessed and outwardly projecting positions by contact with the actuating end of the actuator as the actuator is axially moved in said mounting member.
23. The method of claim 22 , wherein the delivery instrument includes:
a housing having a proximal end secured to the proximal end member of the mounting member, the housing extending about the tubular portion of the mounting member to a distal end; and
a piston member within the housing and positioned about the tubular portion of the mounting member, the piston member being biased distally along the tubular portion to extend from the housing and into contact with a proximal-most implant along the mounting portion.
24. The method of claim 23 , wherein the actuator is rotatable about a longitudinal axis
thereof in the mounting member to a loading orientation, wherein in the loading orientation the actuating end of the actuator is structured relative to the mounting portion and the proximal and distal retaining members to recess both the proximal and distal retaining members in the mounting member.
25. The method of claim 19 , wherein the implants are washers.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US12/752,725 US20100191249A1 (en) | 2005-10-19 | 2010-04-01 | Instruments and Methods for Delivering Multiple Implants in a Surgical Procedure |
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US11/253,880 US7717921B2 (en) | 2005-10-19 | 2005-10-19 | Instruments and methods for delivering multiple implants in a surgical procedure |
US12/752,725 US20100191249A1 (en) | 2005-10-19 | 2010-04-01 | Instruments and Methods for Delivering Multiple Implants in a Surgical Procedure |
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US11/253,880 Division US7717921B2 (en) | 2005-10-19 | 2005-10-19 | Instruments and methods for delivering multiple implants in a surgical procedure |
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US20100191249A1 true US20100191249A1 (en) | 2010-07-29 |
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US11/253,880 Active 2029-03-16 US7717921B2 (en) | 2005-10-19 | 2005-10-19 | Instruments and methods for delivering multiple implants in a surgical procedure |
US12/752,725 Abandoned US20100191249A1 (en) | 2005-10-19 | 2010-04-01 | Instruments and Methods for Delivering Multiple Implants in a Surgical Procedure |
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Cited By (1)
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US20160128741A1 (en) * | 2010-01-15 | 2016-05-12 | Pioneer Surgical Technology, Inc. | Low Friction Rod Persuader |
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Also Published As
Publication number | Publication date |
---|---|
US7717921B2 (en) | 2010-05-18 |
US20070088363A1 (en) | 2007-04-19 |
WO2007047710A1 (en) | 2007-04-26 |
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