Summary of the invention
The present invention relates to the surgical devices for executing surgical procedure.Surgical device can selectively be inhaled with being mounted withIt receives or the load units of permanent surgical fastener connects.
According to aspects of the present invention, a kind of surgical fastener application instrument is provided.The surgical fastener applies instrument packetIt includes Handleset and can be operatively connected to the load units of the Handleset.The Handleset includes handle casing,It is operably linked to the trigger of the handle casing, the driving mechanism and trigger being arranged in the handle casing return to machineStructure.
The handle casing proximally extends to distal end and defines therebetween longitudinal axis.The driving mechanism is arranged in instituteIt states in handle casing and can be by described trigger-acted.The trigger gigback is arranged in the handle casing and couplesTo the driving mechanism.The trigger gigback includes rack gear and biasing member.The rack gear is arranged in the handle casingProximal end in and be removably couplable to the driving mechanism.The biasing member has the first end for being connected to the rack gearPortion and the second end engaged against with the top inner surface of the handle casing make the biasing member relative to described verticalAxis extends transversely with.The trigger never actuation configuration is moved to actuation configuration and drives the actuating of the driving mechanism, instituteState driving mechanism actuating drive the movement of the rack gear with the top inner surface of the rack gear and the handle casing itBetween compress the biasing member trigger made to be resiliently biased non-actuation configuration.
In embodiment, the trigger gigback can also include the bar for being connected to the first end of the rack gear.InstituteStating biasing member can wind around the bar.The biasing member can have the of the second end for extending beyond the barTwo ends.The bar can be fixed with the proximal end of the handle casing and the rack gear can be slidably engaged into the bar makesThe rack gear and the biasing member are slided relative to the bar when the proper actuating trigger.
In some aspects of the invention, the rack gear may include the gear type curved surfaces gear with the driving mechanismThe gear type linear surface of connection.The driving mechanism by it is described trigger-acted when the driving mechanism the gear type arcThe rotation on shape surface can be such that the rack gear translates along the gear type curved surfaces.
In some embodiments, the top inner surface of the handle casing may include lateral extensions.The bias structureThe second end of part can be fixed by the lateral extensions so that preventing the movement of the second end of the biasing member.
It is contemplated that the Handleset can also include the rotatable drive shaft for being connected to the driving mechanism.InstituteThe trigger and the drive shaft can be interconnected by stating driving mechanism.
In embodiment, the load units may include outer tube, and the outer tube is with proximally and distally and therebetweenLimit inner cavity.Inner tube can be pivotally supported in the outer tube.Said inner tube can limit be disposed for arranging it is multipleThe perforative inner cavity of surgical fastener.The distal end of said inner tube may include be defined as pair relative to longitudinally extending slot mouth, atPair relatively longitudinal extend tine.The outer tube, which can have, is arranged in helical thread intracavitary in it.Each surgery fasteningPart may include threaded body part, and the relatively radially external screw thread being defined as pair and the pairs of head being relatively radially recessedPoint.The pairs of radial depressions on each head point can receive the corresponding tine of said inner tube.Each head portion it is pairs ofRelatively radially external screw thread from the pairs of opposite longitudinally extending slot mouth protrusion of said inner tube and can engage the spiral shell of the outer tubeRevolve shape screw thread.
According to another aspect of the present invention, a kind of embodiment of surgical fastener application instrument is provided.The surgery fasteningIt includes Handleset that part, which applies instrument, is configured to be rotatably engaged the cuff of the distal end of the Handleset, and may be selectedProperty it is connected to the load units of the distal end of the cuff.The Handleset includes handle casing, is operably connected to instituteThe trigger of handle casing is stated, and the driving mechanism being arranged in the handle casing.
The handle casing proximally extends to distal end and defines therebetween longitudinal axis.The driving mechanism is arranged in instituteIt states in handle casing and can be by described trigger-acted.The driving mechanism includes the cone tooth with notch formed thereinWheel.Locking mechanism extends through the cuff from the distal end of the handle casing.
The locking mechanism includes the rack gear being supported in the handle casing translatablely and rotatable axis.It is described canThe first gear and support on its distal end simultaneously that there is the axis of rotation support to connect on its proximal end and with the rack pinionAnd it is rotatably connected to the second gear of the cuff.The rotation of the cuff makes the rotatable axis rotation to lockThe rack gear is translated between position and unlocked position.In latched position, the rack gear is arranged in the notch of the bevel gearSo that preventing the rotation of the bevel gear.In unlocked position, the outside that the rack gear is arranged in the notch of the bevel gear makesIt is rotatable to obtain the bevel gear.
In embodiment, when the trigger is in non-actuation configuration, the rack gear and the notch can be with coaxial alignments.
In some aspects of the invention, the Handleset can also include being arranged in the handle casing and joiningIt is connected to the trigger gigback of the driving mechanism.The trigger gigback may include rack gear and biasing member.The toothItem can be arranged in the proximal end of the handle casing and be removably couplable to the driving mechanism.The biasing member canThere is the first end for the rack gear for being connected to the gigback and engaged against with the top inner surface of the handle casingThe second end the biasing member is extended transversely with relative to the longitudinal axis.The trigger never actuation configuration is mobileTo actuation configuration movement compressed between the rack gear of the gigback and the top inner surface of the handle casing it is described partiallyPressure component makes the trigger be resiliently biased non-actuation configuration.
In embodiment, the trigger gigback can also include the first end for being connected to the rack gear of the gigbackThe bar in portion and the biasing member can surround the bar and wind.The biasing member, which can have, extends beyond the barThe second end of the second end.The bar can be fixed with the proximal end of the handle casing and the rack gear of the gigback canMake the rack gear and the biasing member when activating the trigger sliding relative to the bar to be slidably engaged into the barIt is dynamic.
It is contemplated that the rack gear of the gigback may include the gear type curved surfaces gear with the driving mechanismThe gear type linear surface of connection.Driving mechanism by it is described trigger-acted when the driving mechanism rotation can make described returnThe rack gear for going back to mechanism is translated along the gear type curved surfaces.
In a further embodiment, the top inner surface of the handle casing may include lateral extensions.The biasThe second end of component can be fixed by the lateral extensions so that preventing the movement of the second end of the biasing member.
In some aspects of the invention, the driving mechanism can also include the first pinion gear for being connected to the triggerWith with first pinion gear interval and be connected to the gigback rack gear the second pinion gear.
Below with reference to the accompanying drawings the other details and aspect for the exemplary embodiment that the present invention will be described in more detail.
Specific embodiment
The embodiment that presently disclosed surgical fastener applies instrument is described in detail by referring to the drawings, wherein similar attached drawingIdentical or corresponding element in each of several views of label mark.Term " distal side " refers to as used hereinSurgical fastener applies those of farther from the user part of instrument, and term " nearside " refers to that surgical fastener applies instrumentPart those of closer to the user.
Referring now to Fig. 1-8, the surgical fastener in the form of surgical staples applicator or staplers applies instrument generallyIt is shown as 200.Following closely applicator 200 includes Handleset 210, and elongated from can remove for the cuff 280 of Handleset 210 extensionLoad units 300 (for example, load units SULU that single uses).Load units 300 are configured to have and load or be packaged in100 (Fig. 9-11) of multiple nails therein and be selectively released from or fire via the actuating of trigger 214 it is multiple nail 100.
As shown in figures 1-5, Handleset 210 includes handle casing 212, trigger 214, and by 212 He of handle casingThe cuff 280 that load units 300 interconnect.Handle casing 212 proximally 213 extends to distal end 215 and limits between the twoLongitudinal axis " L ".Handle casing 212 slideably can remove by lower hollow main part 212a and from hollow body part 212aTop part 212b formed.Art technology can be used in the hollow body part 212a and top part 212b of handle casing 212Method known to personnel is slidably coupled each other.The hollow body part 212a and top part 212b of handle casing 212 can be with thoseThis is coupled so that providing fluid tight sealing therebetween.The hollow body part 212a of handle casing 212, which is limited, has free endThe fixed handle part 216 of 216a.
Handleset 210 also includes for activating surgical fastener (for example, nail 100) from the percussion of load units 300Trigger 214.Trigger 214 has the bottom end for the free end 216a that handle portion 216 is pivotally coupled at pivoting point " P "214a.Bottom end 214a includes in the slit for be disposed for being pivotally engaged in the free end 216a of fixed handle part 216Pairs of extend laterally pin 214c.Trigger 214 include when trigger 214 be in extend or when non-actuation configuration with fixed handle portionDivide 216 top 214b spaced apart.The top 214b of trigger 214 includes trigger rack gear 218, is at least partly arrangedIn handle casing 212 and it is designed to and is suitable for translational motion being converted into rotary motion.Trigger rack gear 218 is included in itMultiple gear teeth 218a on upper surface are disposed for being engaged with the gear teeth of gear train 220.
As seen in figs. 2-5, Handleset 210 is supported operationally or is rotatably disposed in handle casing 212Driving mechanism or gear train 220.Gear train 220 by the trigger rack gear 218 of rotatable drive shaft 270 and trigger 214 interconnect so thatWhen actuated triggers 214, drive shaft 270 is actuatable.
Gear train 220 includes first gear 222 and is spaced with first gear 222 and is nonrotatably coupling to the first toothThe second gear 224 of wheel, so that the first and second gears 222,224 are rotatable together.First gear 222 can be in pinion gear etc.Form, there are multiple gear teeth for being formed along its radially outward edge and nibbled with the gear teeth 218a of trigger rack gear 218Splice grafting closes so that the translational motion of the trigger rack gear 218 started when actuated triggers 214 is converted into the rotation fortune of first gear 222It is dynamic.Second gear 224 can also be in the form of pinion gear etc., simultaneously with the multiple gear teeth formed along its radially outward edgeAnd be engaged with the gear teeth of the rack gear of trigger gigback 240 242, as described in further detail below.
Gear train 220 further includes bevel gear 230, non-rotatably engages/be associated with the second gear of gear train 220224 make bevel gear 230 rotatable with the first and second gears 222,224.In some embodiments, bevel gear 230 can be withIn the form of crown gear etc..Bevel gear 230 is disposed for being engaged with the pinion gear 276 of drive shaft 270, such as it is following intoOne step is described in detail.Bevel gear 230 has the notch 232 (Fig. 3 and 4) being formed in its outer surface, forms locking mechanism290 component, as described in further detail below.
With continued reference to Fig. 2-5, Handleset 210 further includes being arranged in handle casing 212 and being connected to gear train 220Trigger gigback 240.Trigger gigback 240 is designed to and is suitable for being resiliently biased to not activate by trigger 214 matchingIt sets and trigger 214 is exerted a force without user to trigger 214 from actuation configuration back to non-actuation configuration.
Trigger gigback 240 includes rack gear 242, biasing member 250 and bar 260.Rack gear 242 is arranged in handle casing212 proximal end 213 is interior and is removably couplable to the second gear 224 of gear train 220.Rack gear 242 is from first end 242aExtend to the second end 242b.Rack gear 242 limits the first wall 244a, the second wall 244b and third wall 244c.First wall 244a packetInclude the first section with generally square configuration and the second section with general triangular configuration.First wall 244a has theSide and second side.In embodiment, the first wall 244a can have various shape, for example, those of described herein optionalShape.The fixed gear type linear surface 246 extended along its length of the first lateral confinement of first wall 244a.Gear type linear surface246 connect the rotation so that second gear 224 with the gear type arc-shaped outer surface 224a gear of the second gear 224 of gear train 220Turn that the rack gear 242 of trigger gigback 240 is made to move or translate along the gear type arc-shaped outer surface 224a of second gear 224.Second side of first wall 244a is connected to the second wall 244b to be approximately vertically oriented.Third wall 244c is connected to the first and second wallsThe sliding arrangement that the proximal end 242a of 244a, 244b and limiting is disposed for bar 260, which passes through, therein is open 248.
As described above, trigger gigback 240 includes biasing member, such as spring 250 and bar 260.Bar 260 is slidablyIt is arranged in the opening 248 of third wall 244c of rack gear 242.Bar 260 is from the proximal end 213 for fixedly connecting to the handle shell 212First end 262 extend to the second end 264 make when 214 hour rack 242 of actuated triggers relative to and along bar 260 it is slidingIt is dynamic, as described herein.Bar 260 relative to handle casing 212 longitudinal axis " L " it is angled extend (that is, laterally) so that itsTop part 212b of two ends 264 against handle casing 212.
Spring 250 wind and have around bar 260 support, against or be in another manner connected to the third of rack gear 242The first end 252 of wall 244c.The second end 254 of spring 250 extends beyond 264 certain distance of the second end of bar 260.BulletThe top inner surface 217 of the top part 212b of the second end 254 and handle casing 212 of spring 250 engages against.Handle casing212 top inner surface 217 includes lateral extensions or hub 217a, is configured to the second end of capture or fixed spring 250254 to prevent the second end 254 of spring 250 mobile relative to handle casing 212.
In use, by rotating trigger 214 upward around pivoting point " P " in the side by arrow " A " instruction in Fig. 3Upper end 214b, the never actuation configuration of trigger 214 are moved to actuation configuration.The never actuation configuration of trigger 214 rotates to actuation configurationVia the translational motion of trigger rack gear 218 be converted into the first gear 222 of gear train 220 rotary motion and gear train220 actuating.When first gear 222 rotates, due to the non-rotatable connection of second gear 224 and first gear 222, theTwo gears 224 also rotate.The rotation of second gear 224 via trigger gigback 240 gear type linear surface 246 and gearBe 220 second gear 224 between connection driving trigger gigback 240 rack gear 242 relative to along bar 260 byMovement or translation on the direction of arrow " B " instruction in Fig. 3.The rack gear 242 of trigger gigback 240 is along the flat of bar 260Moving causes the adjoint translation of the first end 252 of spring 250 on the top of the third wall 244c of rack gear 242 and handle casing 212Compressed spring 250 between the lateral extensions 217a of the top inner surface 217 of part 212b.
Under compression, trigger 214 is resiliently biased to non-actuation configuration by spring 250.In this way, when user's release is pulledWhen machine 214, spring 250 is axially swollen between the lateral extensions 217a of top part 212b and the third wall 244c of rack gear 242It is swollen with by Fig. 3 arrow " C " instruction direction on translating rack 242.The translation of rack gear 242 leads to the of gear train 220The accompanying rotation of the first gear 222 of two gears 224 and in turn gear train 220.The rotation of the first gear 222 of gear train 220Transduction cause the accompanying rotation of the trigger 214 in the direction by arrow " D " instruction in Fig. 3 with by trigger 214 from actuation configurationBack to non-actuation configuration.As a result, it is possible to achieve continuing to be actuated into non-actuation configuration without by trigger 214 for trigger 214Non- actuation configuration is manually moved back to from actuation configuration.Moreover, trigger 214 can be by acting on removing for nail applicator 200The biasing member of component except trigger 214 from actuation configuration moves back to non-actuation configuration.
With continued reference to Fig. 2-5, staplers 200 include rotatable drive shaft 270, across cuff 280 proximal end andDistally between 282,284.Drive shaft 270 has proximal end 272 and distal end 274.The proximal end 272 of drive shaft 270 is arranged in outside handleIn the distal end 215 of shell 212.Drive shaft 270 includes gear, for example, non-rotatably arranging the pinion gear at 272 at its proximal end276.The distal end 274 of drive shaft 270 couples with the proximal end of load units 300.When actuated triggers 214, drive shaft 270 will be come fromThe torque of bevel gear 230 is transmitted to load units 300 with from 300 percussion nail 100 of load units.
In use, when actuated triggers 214, bevel gear 230 rotates in the direction by arrow " E " instruction in Fig. 3It is rotated with driving up drive shaft 270 in the side by arrow " F " instruction in Fig. 3.Rotation of the drive shaft 270 on direction " F "Nail 100 can be caused to fire from load units 300, as described in further detail below.
With specific reference to Fig. 1,2 and 5, staplers 200 further include rotatably and being removably supported upon handle casing 212The distally cuff or collar 280 on 215.Cuff 280 limits the distal openings 286 axially aligned with drive shaft 270.Cuff 280Proximal end 282 and the distal end 284 detachably connected with load units 300 with the distal end 215 for being connected to handle casing 212.In some embodiments, load units 300 are fixedly connected to the distal end 284 of cuff 280.
With continued reference to Fig. 2-5, staplers 200 further include the locking mechanism 290 extended from the distal end of handle casing 212 215.When accidental activation trigger 214 locking mechanism 290 selectively locking teeth train 220 to prevent and/or anti-non-magnetic shim 100 is from loadingUnit 300 fires, and allows load units 300 to be connected to Handleset 210/ and be detached from from Handleset 210.
Locking mechanism 290 includes rack gear 292 and rotatable axis 294.The rack gear 292 of locking mechanism 290 has substantial lineProperty configuration and translatable be arranged in handle casing 212.The rack gear 292 of locking mechanism 290 is relative to handle casing 212Longitudinal axis " L " is substantially vertically disposed.When trigger 214 is in non-actuation configuration the rack gear 292 of locking mechanism 290 and cone toothThe notch 232 limited in wheel 230 is coaxially aligned with each other, as shown in Figure 3.In this way, when trigger 214 is in non-actuation configuration,Rack gear 292 can be translated into and leave the notch 232 limited in bevel gear 230.
The axis 294 of locking mechanism 290 is parallel with rotatable drive shaft 270 relative to the longitudinal axis " L " of handle casing 212Ground extends.Axis 294 has the second gear 296b of first gear 296a and support on its distal end of support on its proximal end.Axis294 first gear 296a is connect with 292 gear of rack gear of locking mechanism 290 so that the rotation of the axis 294 of locking mechanism 290 is drivenTranslation of the rack gear 292 of dynamic locking mechanism 290 on the direction of " L " substantially perpendicular to longitudinal axis.The second gear 296b of axis 294It is rotatably connected with inside, the arc gear wheel surface 288 of cuff 280 so that the rotation of cuff 280 leads to the axis of locking mechanism 290294 accompanying rotation.
In use, in order to selectively lock staplers 200, when trigger 214 is in non-actuation configuration completely, byCuff 280 is rotated on the direction of arrow " G " instruction in Fig. 5, this is via the inside of cuff 280, arc gear wheel surface 288 and lockThat determines the second gear 296b of the axis 294 of mechanism 290 is engaged the accompanying rotation for leading to the axis 294 of locking mechanism 290.LockingThe rotation of the axis 294 of mechanism 290 leads to the adjoint translation of rack gear 292.As described above, matching when trigger 214 is in not activate completelyThe rack gear 292 of locking mechanism 290 and 232 coaxial alignment of notch limited in bevel gear 230 when setting.Thus, at trigger 214The notch 232 of bevel gear 230 only can be translated into and leave in completely non-actuation configuration hour rack 292.In latched position,The rack gear 292 of locking mechanism 290 is captured or is arranged in the rotation for preventing and/or preventing bevel gear 230 in notch 232, andTherefore 100 percussions from load units 300 of nail.Moreover, load units 300 may be coupled to Handleset in latched position210/ disconnects from Handleset 210.In unlocked position, the rack gear 292 of locking mechanism 290 is arranged in the notch of bevel gear 230232 outside rotates freely the bevel gear 230 when the actuating by trigger 214 leads to its actuating.
Referring now to Fig. 6-8, as shown therein, load units 300 include outer tube 310, are rotatably disposed within outer tube 310Interior inner tube 320, the guidance coil or spring 330 being arranged between outer tube 310 and inner tube 320, and be loaded in inner tube 310Multiple surgical fasteners or nail 100.
The outer tube 310 of load units 300 includes proximal part 310a and distal portions 310b, and limits perforative inner cavity310c.Load units 300 further include the guidance coil or spring being fixedly placed in at least distal portions 310b of outer tube 310330。
Inner tube 320 is rotatably disposed in coil 330.Inner tube 320 includes proximal part 320a and distal portions 320b,And it limits and passes through inner cavity 320c therein.Proximal part 320a non-rotatably couples with the drive shaft 270 of Handleset 210So that causing the rotation of inner tube 320 via the rotation of drive shaft 270 caused by the actuating of trigger 214 as described above.
The distal portions 320b of inner tube 320 slots, the opposite tine 320b being defined as couple1With pairs of opposing channel or slotMouth 320b2.The distal portions 320b of inner tube 320 can receive multiple nails 100 wherein.Particularly, it is single to be loaded into loading for nail 100Pairs of opposite thread section 112a, 112b of nail 100 (Fig. 9-11) is made to extend through the distal portion of inner tube 320 in member 300Divide the corresponding notch 320b of 320b2And it is slidably disposed in the groove of coil 330, and the distal portion of inner tube 320Divide the pairs of tine 320b of 320b1It is arranged in pairs of fluting section 116a, 116b of nail (Fig. 9-11).
In use, when inner tube 320 via the actuating of the trigger 214 of Handleset 210 and around its longitudinal axis relative toWhen coil 330 rotates, the pairs of tine 320b of inner tube 3201The rotation is transmitted to nail 100 and due to following closely 100 (Fig. 9-11) spiral shape head threads 114a, 114b is engaged with coil 330 and towards distal side or is proximally promoted nail 100.
With reference to Fig. 9-11, as described in above briefly, for applying the surgery that instrument 200 is used together with surgical fastenerFastener is shown and is generally designated as nail 100.Nail 100 includes head part 110, and net keeps section 120 and screw-typeTissue captures section 130.Head part 110 includes having corresponding radial, external, spiral shape head threads 114a, 114bPairs of opposite thread section 112a, 112b, and pairs of section 116a, 116b of opening wide or slot relatively.Head part 110Distal surface is formed in net and keeps on the proximal end of section 120 or be integral with.
The net of nail 100 keeps section 120 to extend and from the distal end of head part 110 or surface in head part 110Extend between distal end or surface and the proximal end of tissue capture section 130.Tissue capture is reached more than when nail 100 is screwed into net 140Net holding section 120 is used for 100 locking of nail, anchors or keep outer in another manner when the depth of the recent side section of section 130Scientific network 140.The reason of this is implemented is the screw thread due to being not in net holding section 120, is located at net and keeps in section 120Screw thread will allow to follow closely and 100 unscrew or exit from net 140.
Net keeps section 120 to have cylindrical or conical lateral cross-sectional profile.Net keep section 120 include relative toThe transverse radial size of the central longitudinal axis of nail 100 is less than the transverse radial size of head part 110, and is less than tissueCapture the transverse radial size of the recent side section of section 130.
It includes the helical thread being formed in truncated-cone shaped body section 134 that the screw-type tissue of nail 100, which captures section 130,132.Distalis or tip 136 limit the terminal that farthest side tissue captures section 130.
The body section 134 that tissue captures section 130 is taper, i.e., becomes towards the distal end that rib stitch captures section 130It is small, and distal side point of cut-off is terminated or is truncated to before the vertex or tip for reaching nail 100.Body section 134 includes concave coneShape the minimum diameter of body section 134 to be limited when its truncation, generally less than 0.01 inch for designated length.
Nail 100 includes capturing the lateral dimension of the farthest side screw thread in section 130 in screw-type tissue, with design constraintIt is big or approximately greater than 0.040 inch as allowing.According to the present invention, the big value of small truncation main diameter and lateral dimensionMinimize tissue indentation.Tissue captures screw thread 132 and terminates at distal tip 136, in the point of cut-off of body section 134Distal side.
By providing the distal tip 136 extended in the distal side that tissue captures the point of cut-off of section 130, it is easy to by nail 100Penetrate net 140；And compared to have with tapered thread the anchoring piece that main body is not truncated, by nail 100 by net 140 be pressed into compared withDegree in soft tissue is minimized.
Due to being applied to the given force of Surgical indication 140 by surgeon, distal force is applied to surgical fastener applicatorTool or nail applicator 200 on, as shown in figs.1-8, follow closely 100 lateral dimension it is bigger, in order to lead to following tissue and surgeryThe distal force that the indentation of net 140 needs to apply is smaller.
Nail 100 is non-hollow and is constructed by suitable bioabsorbable material (for example, polylactic acid, polyglycolide).Nail 100 can by proprietary bio-compatible copolymer (Lactomer USS L1, Boehringer Ingelheim LR 704S, orBoehringer Ingelheim LG-857) it is formed.Nail 100 can also be by suitable not-bio-absorbable material or permanent materialExpect (for example, stainless steel, titanium etc.) construction.
According to the present invention, the component of surgical stapler 200 and nail 100 are sized such that the single complete of trigger 214And complete actuating leads to individually to follow closely 100 from the percussion of load units 300.
According to the present invention it is possible to expect that multiple and different load units 300 can be provided, wherein being mounted with by different materialsThe load units of the surgical fastener of (for example, biological absorbable, permanent etc.) manufacture can be available, or have different lengthThe load units of degree (for example, short, medium and long etc.) can be available, and wherein specific length load units are mounted with respective numbersSurgical fastener.Therefore, particular surgical program (for example, hernia program) is depended on, surgeon, which can choose, to be desired or needed forLoad units any one or combination, and surgeon can during surgical procedure as needed or expectation exchange orReplace load units.
In embodiment, it is contemplated that all load units can have equal length, but be mounted with difference whereinThe surgical fastener of quantity.In this way, the type selective loading that surgeon can depend on pending surgical procedure has lessOr more surgical fastener load units.
It will be understood that can be carry out various modifications to embodiment disclosed herein.So above description should not be explainedFor limitation, but as just the illustration of various embodiments.Those skilled in the art will predict and want in appended rightOther modifications in the scope and spirit asked.