대표
청구항
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A tool structure or tool insert has a runner system which includes at least one branching runner which branches in at least two directions forming at least a first pair of branch runners for receiving laminar flowing material for the formation of a product. Each branch runner is at a position in the runner system such that it receives material having significantly similar conditions from side-to-side of a bisecting plane of that runner which bisects the cross section of at least a portion of the length of that branch runner. This material also has dissim...
A tool structure or tool insert has a runner system which includes at least one branching runner which branches in at least two directions forming at least a first pair of branch runners for receiving laminar flowing material for the formation of a product. Each branch runner is at a position in the runner system such that it receives material having significantly similar conditions from side-to-side of a bisecting plane of that runner which bisects the cross section of at least a portion of the length of that branch runner. This material also has dissimilar conditions from side-to-side of a perpendicular plane of each branch runner which is perpendicular to the bisecting plane of that runner with the perpendicular plane of each branch runner also bisecting the cross section of the same portion of the length of each branch runner that the bisecting plane bisects. A repositioner in the tool or tool insert repositions the dissimilar conditions of the laminar flowing material to preselected positions in circumferential directions around the center of the flow paths of each runner of each pair of branch runners. Each pair of branch runners is joined at a location on each runner of each pair which causes the flow from each of these runners to form a half of a joint stream of material which has conditions across its flow path that are significantly balanced from side-to-side of two perpendicular planes which bisect the flow path of the joint stream. [FOREIGN-PATENT]117960, CH; 337437, DE; 1111677, FR; 6429266, JP pin is pulled in the direction of withdrawal of said pin from said receiver opening. 3. The surgical fastener of claim 2, wherein said free ends of said plurality of latches are separated by a spacing therebetween, said spacing being diminished when said pin is pulled in the direction of withdrawal causing said ledge to encounter said free ends and further converging said latches toward each other reducing the size of said retainer opening. 4. The surgical fastener of claim 3, wherein said plurality of latches are distributed around the internal periphery of said internal surface with a spacing therebetween proximate the junction of said plurality of latches with said internal surface, said junction spacing constituting a fall back receiver opening for retaining said pin by causing side surfaces of said plurality of latches to encounter and abut said ledge, capturing said head in said junction spacing. 5. The surgical fastener of claim 1, wherein said plurality of first portions are arranged in a predetermined spacial configuration adjacent to one another with a plurality of second portions arranged in homologous fashion with said first tissue constraining surfaces facing said second tissue constraining surfaces. 6. The surgical fastener of claim 5, further including a gasket interposed between said plurality of first portions and said plurality of second portions. 7. The surgical fastener of claim 6, wherein said gasket is divided into a plurality of segments by a plurality of radial slots. 8. The surgical fastener of claim 6, wherein said gasket is composed of a material selected from the group consisting of fluoropolymers, polyurethanes, aliphatic polymers, poly(amino acids), copoly(ether-esters), polyalkylenes oxalates, polyamides, poly(iminocarbonates), polyorthoesters, polyoxaesters, polyamidoesters, polyoxaesters containing amine groups, poly(anhydrides) and polyphosphazines. 9. The surgical fastener of claim 8, wherein said gasket is produced by lyophilization. 10. The surgical fastener of claim 8, wherein said gasket is biodegradeable. 11. The surgical fastener of claim 5, wherein said predetermined spacial configuration approximates a circle and said fastener is an anastomotic fastener. 12. The surgical fasteners of claim 11, wherein said fastener preserves radial flexibility of a resultant anastomosis to which it is applied. 13. The surgical fastener of claim 12, wherein said first portions and said second portions establish a compressive force on the anastomosed tissue in a configuration which approximates two concentric rings. 14. The surgical fastener of claim 1, wherein at least one of said plurality of first portions and said plurality of second portions is biodegradable. 15. The surgical fastener of claim 1, wherein said first portions are composed of a material selected from the group consisting of fluoropolymers, polyurethanes, aliphatic polyesters, poly(amino acids), copoly(ether-esters), polyalkylenes oxalates, polyamides, poly(iminocarbonates), polyorthoesters, polyoxaesters, polyamidoesters, polyoxaeasters containing amine groups, poly(anhydrides), polypophazenes and bipolymers. 16. The surgical fastener of claim 1, wherein said first portions are composed of a biodegradeable material which acts as a therapeutic release matrix for release of at least one of the agents of the following group consisting of antibiotics, antiviral agents, chemetherapeutic agents, anti-rejection agents, analgesics, anti-inflammatory agents, hormones, steroids, growth factors, proteins, polysaccharides, glycoproteins and lipoproteins. 17. A surgical fastening system, comprising: a fastener applicator having an elongated hollow tube with a handle at a first end; an actuator rod extending through a lumen of said tube and extensible from a second end thereof; a hollow actuator tube couplable at one end to said actuator rod and slideably insertable into said second end of said tube; a first fastener carrier couplable to sai d actuator tube proximate a second end of said distal actuator fitting; a casing tube disposed about said positioning tube proximate said second end of said positioning tube and having a free end which is substantially coaxial with said positioning tube and annularly spaced therefrom; a second fastener carrier coupled to said free end of said casing tube; a fastener driver disposed between said tube and said casing tube, said fastener driver having a retracted position and a dispensing position, said dispensing position being displaced a predetermined distance from said retracted position in a direction distal to said first end of said tube; a trigger disposed proximate said handle for moving said fastener driver between said retracted position and said dispensing position; a mechanical linkage extending between said trigger and said fastener driver; an actuator rod adjuster for adjusting the spacing between said first fastener carrier relative to said second fastener carrier when said actuator rod is coupled to said actuator tube by adjusting the position of said actuator rod within said tube; and the surgical fastener of claim 1, wherein said plurality of first portions are insertable into said first carrier, said plurality of second portions are insertable into said second carrier, said first portions positionable proximate the first side of the bodily tissue when positioned within said first carrier, said second portions positionable proximate the second side of the bodily tissue adjacent corresponding ones of said first portions when positioned within said second carrier, said first portions extendable through the bodily tissue to contact said second portions and interlock therewith when said first portions are ejected from said first carrier by said fastener driver. 18. A surgical fastening system, comprising: a plurality of individual fastener pairs each having a first portion with a first tissue constraining surface and a second portion with a second tissue constraining surface; holding means for holding said plurality of individual fastener pairs in a generally circular array; positioning means for positioning said first portions proximate a first side of a bodily tissue and said second portions proximate a second side of said bodily tissue adjacent corresponding ones of said first portions; and ejecting means for ejecting said first portions from said holding means such that said first portions extend through the bodily tissue to contact said second portions and interlock therewith to form interlocking pairs. said first tissue constraining surface of each of said first portions approximating a first pair of concentric circles, said second tissue constraining surface of each of said second portions approximating a second pair of concentric circles, the bodily tissue being clamped between said first pair of concentric circles and said second pair of concentric circles when said first portions and said second portions are interlocked. 19. The surgical fastener system of claim 18, further comprising cutting means for cutting excess tissue proximate said interlocking pairs. 20. A method for anastomosing tissue, comprising the steps of: holding a plurality of individual fastener pairs each having a first portion with a first tissue constraining surface and a second portion with a second tissue constraining surface with said first portions proximate a first fraction of bodily tissue and said second portions proximate a second fraction of bodily tissue to be anastomosed to said first fraction of bodily tissue and adjacent corresponding ones of said first portions; ejecting said first portions through the first and second fractions of bodily tissue; and contacting said first portions with said second portions, said first portions and said second portions interlocking, each of first portions overlapping an adjacent one of said first portions and each of said second portions overlapping an adjacent one of said second portions, said first tissue constraining surface approximating a first set of concentric rings, said second tissue constraining surface approximating a second set of concentric rings. 21. The method of claim 20, wherein said steps of holding and ejecting are performed by a fastener dispenser and further including the steps of removing said second portions from said dispenser after said interlocking and passing said dispenser through said anastomosed junction by stretching said anastomosed junction radially outward. ssembly of claim 17 further including a coil surrounding said surgical fastener and wherein said fastener includes first and second enlarged portions and said fastener first end portion coupling and said second coupling are adapted for receipt of said fastener first and second enlarged portions, respectively, said second coupling including members having portions that have a radially outward bias and extend within said coil when said coil is compressed against said second coupling. 23. The tissue connector assembly of claim 17 wherein said fastener includes a groove and projection and said second coupling includes a member having a groove and projection and a sleeve slidably mounted thereon, said fastener groove and projection being configured to mate with said coupling member groove and projection. 24. The tissue connector assembly of claim 17 further including a flexible member having a portion coupled to said second tissue piercing member and a knotted portion, said second coupling including a tubular member having a bore, said knotted portion being in said bore and said bore having a portion with a diameter less than that of a section of said knotted portion. 25. The tissue connector assembly of claim 17 wherein said second coupling comprises an annular blade coupled to said second piercing member, said annular blade surrounding and being secured to a portion of said surgical fastener. 26. The tissue connector assembly of claim 1 wherein said surgical fastener comprises a surgical clip. 27. The tissue connector assembly of claim 26 wherein said surgical clip comprises a wire. 28. The tissue connector assembly of claim 27 further including a coil surrounding at least a portion of said wire and having confined ends. 29. The tissue connector assembly of claim 28 wherein said wire comprises shape memory material. 30. The tissue connector assembly of claim 29 wherein said surgical clip has an open configuration and a closed configuration. 31. The tissue connector assembly of claim 30 wherein said surgical clip is in said closed configuration when in a relaxed state. 32. The tissue connector assembly of claim 30 wherein said surgical clip is generally U-shaped when in said open configuration. 33. The tissue connector assembly of claim 30 wherein said surgical clip assumes a spiral configuration when in said closed configuration. 34. A tissue connector assembly comprising a surgical fastener having an unbiased loop configuration, a first tissue piercing member and a second tissue piercing member, said surgical fastener having a first end portion and a second end portion, said first tissue piercing member being coupled to said first end portion and said second tissue piercing member being coupled to said second end portion, said assembly further including a coupling, said first tissue piercing member and said first end portion of said surgical fastener being coupled to said coupling, said assembly including a second coupling, said surgical fastener second end portion and second piercing member being coupled to said second coupling, the assembly further including a flexible member and a coil, said flexible member having a portion coupled to said second tissue piercing member and a portion coupled to said second coupling, said coil surrounding said surgical fastener and being compressed against said second coupling, said fastener including an enlarged portion and said fastener first end portion coupling being adapted for receipt of said enlarged portion, said second coupling including a first member fixedly secured to said fastener and a second member slidably coupled to said fastener, and said flexible member being compressed between said second coupling members when said coil is compressed against said slidably coupled member. 35. A tissue connector assembly comprising a surgical fastener having first and second end portions, a first tissue piercing member, a second tissue piercing member, and at least one flexible member having f irst and second end portions, said at least one flexible member first end portion being attached to said first tissue piercing member, said at least one flexible member second end portion being coupled to said first end portion of said surgical fastener, said second end portion of said surgical fastener being coupled to said second tissue piercing member. 36. The tissue connector assembly of claim 35 wherein said at least one flexible member comprises a suture. 37. The tissue connector assembly of claim 35 wherein said at least one flexible member comprises metal. 38. The tissue connector assembly of claim 35 further including a coupling, said flexible member and surgical fastener being secured to said coupling. 39. The tissue connector assembly of claim 38 wherein said coupling and flexible member have outer surfaces, said coupling and flexible member being configured to form a smooth, continuous transition there between along said outer surfaces. 40. The tissue connector assembly of claim 38 wherein said coupling and flexible member form an interface, at least a portion of each of said coupling and flexible member adjacent to said interface having the same cross-sectional shape and dimension. 41. The tissue connector assembly of claim 38 wherein said coupling and flexible member have essentially the same cross-sectional shape and dimension. 42. The tissue connector assembly of claim 38 wherein said surgical fastener is releasably coupled to said coupling. 43. The tissue connector assembly of claim 38 wherein said surgical fastener includes an enlarged portion and said coupling comprises a tubular member having movable portions adapted to receive at least a portion of said enlarged portion. 44. The tissue connector assembly of claim 43 wherein said enlarged portion is spherical. 45. The tissue connector assembly of claim 43 wherein said movable portions comprises a plurality of strands. 46. The tissue connector assembly of claim 45 wherein a plurality of said strands include a notch for receiving a portion of said enlarged portion. 47. The tissue connector assembly of claim 45 wherein said strands comprise wires. 48. The tissue connector assembly of claim 45 wherein said strands comprise cables. 49. The tissue connector assembly of claim 38 including a second coupling, said surgical fastener second end portion and second piercing member being coupled to said second coupling. 50. The tissue connector assembly of claim 49 wherein said surgical fastener includes a first and second enlarged portion and each of said couplings comprise a generally tubular member having movable portions adapted to receive at least a portion of one of said enlarged portion. 51. The tissue connector assembly of claim 50 wherein said movable portions comprise a plurality of strands. 52. The tissue connector assembly of claim 50 wherein a plurality of said strands include a notch for receiving a portion of said enlarged portions. 53. The tissue connector assembly of claim 49 wherein said second coupling releases the coupling between said second piercing member and said surgical fastener in response to releasing said fastener first end portion coupling. 54. The tissue connector assembly of claim 49 further including a coil surrounding said surgical fastener and wherein said fastener includes first and second enlarged portions and said fastener first end portion coupling and said second coupling are adapted for receipt of said fastener first and second enlarged portions, respectively, said second coupling including member that are biased radially outward with portions extending within said coil when said coil is compressed against said second coupling. 55. The tissue connector assembly of claim 49 further including a second flexible member and a coil, said second flexible member having a portion coupled to said second tissue piercing member and a portion coupled to said second coupling, said coil surrounding said surgical fastener and being compressed aga inst said second coupling, said fastener including an enlarged portion and said fastener first end portion coupling being adapted for receipt of said enlarged portion, said second coupling including a first member fixedly secured to said fastener and a second member slidably coupled to said fastener, and said flexible member being compressed between said second coupling members when said coil is compressed against said slidably coupled member. 56. The tissue connector assembly of claim 49 wherein said fastener includes a groove and projection and said second coupling includes a member having a groove and projection and a sleeve slidably mounted thereon, said fastener groove and projection being configured to mate with said coupling member groove and projection. 57. The tissue connector assembly of claim 49 further including a second flexible member having a portion coupled to said second tissue piercing member and a knotted portion, said second coupling including a tubular member having a bore, said knotted portion being in said bore and said bore having a portion with a diameter less than that of a section of said knotted portion. 58. The tissue connector assembly of claim 49 wherein said second coupling comprises an annular blade coupled to said second piercing member, said annular blade surrounding and being secured to a portion of said surgical fastener. 59. The tissue connector assembly of claim 35 wherein said surgical fastener comprises a surgical clip. 60. The tissue connector assembly of claim 59 wherein said surgical clip comprises a wire. 61. The tissue connector assembly of claim 60 further including a coil surrounding at least a portion of said wire and having confined ends. 62. The tissue connector of claim 61 wherein said wire comprises shape memory material. 63. The tissue connector assembly of claim 62 wherein said surgical clip has an open configuration and a closed configuration. 64. The tissue connector assembly of claim 63 wherein said surgical clip is in said closed configuration when in a relaxed state. 65. The tissue connector assembly of claim 63 wherein said surgical clip is generally U-shaped when in said open configuration. 66. The tissue connector assembly of claim 63 wherein said surgical clip assumes a spiral configuration when in said closed configuration. 67. A tissue connector assembly comprising two needles, a surgical clip and a flexible member having a portion releaseably coupled to said surgical clip and a portion coupled to one of said needles, the other one of said needles being coupled to said surgical clip. 68. The tissue connector assembly of claim 67 further comprising a second flexible member having a portion releaseably coupled to said surgical clip and a portion coupled to said other one of said needles. 69. The tissue connector assembly of claim 67, wherein said surgical clip comprises a wire and said assembly further includes a coil surrounding at lest a portion of said wire and having confined ends. 70. The tissue connector assembly of claim 69 wherein said wire comprises shape memory material and has an open configuration and a closed configuration in the form of a loop. 71. A method of setting a tissue connector assembly including a surgical fastener and multiple tissue piercing members coupled thereto comprising manipulating a single portion of the tissue connector assembly to both release the tissue piercing members from the fastener and actuate closure of the fastener. 72. A method of securing portions of material together, at least one of which comprises tissue, the method comprising placing at least a portion of a first piercing member, having a surgical fastener coupled thereto, in a vessel lumen, placing at least a portion of a second piercing member, which also is coupled to the surgical fastener and where at least one of the piercing members is coupled to the surgical fastener with a flexible member, in a tubular graft, passing the first piercing member through the w all of the vessel from an interior surface thereof, passing the second piercing member through the wall of the tubular graft from an interior surface thereof, and positioning the fastener with one portion thereof extending through said vessel wall and another portion extending through said graft wall. 73. The method of claim 72 wherein the flexible member is selected to be a suture. 74. The method of claim 72 wherein all of the at least one flexible member and the piercing members are removed from the fastener. 75. Tissue connector apparatus for connecting at least two structures, said apparatus comprising: a surgical clip adapted to connect the at least two structures together, said clip having first and second end portions and being constructed for movement from an open configuration to a closed configuration; a flexible member having a first end and a second end, said second end coupled to said first end portion of said surgical clip; a first needle secured to said first end of said flexible member; and a second needle having a first end and a second end, said second needle second end being coupled to said surgical clip second portion. 76. The tissue connector apparatus of claim 75 wherein said clip is adapted to connect structures selected from the group consisting of tissue, prostheses, and graft materials. 77. The tissue connector apparatus of claim 75 wherein said clip comprises a wire. 78. The tissue connector apparatus of claim 77 wherein said wire comprises nitinol. 79. The tissue connector apparatus of claim 75 further including a coil surrounding at least a portion of said clip. 80. The tissue connector apparatus of claim 79 further including a coil restraint at one of the end portions of said clip for limiting movement of said coil relative to said clip. 81. The tissue connector apparatus of claim 80 wherein said clip has an enlarged portion which forms said coil restraint. 82. The tissue connector apparatus of claim 80 further including a second coil restraint at said second end portion of said clip for limiting relative movement between said coil and said clip. 83. The tissue connector apparatus of claim 82 wherein said restraints each form an enlarged portion on said clip. 84. The tissue connector apparatus of claim 82 wherein said coil has first and second ends, at least one end of said coil being slidably movable along said clip. 85. The tissue connector apparatus of claim 82 further comprising a coupling that releasably couples said clip first end portion to said flexible member. 86. The tissue connector apparatus of claim 85 further comprising a second coupling that releasably couples said clip second end portion to said second needle. 87. The tissue connector apparatus of claim 82 further including a second flexible member, said second flexible member being secured to said second needle and releasably coupled to said clip. 88. The tissue connector apparatus of claim 87 wherein said first and second flexible members each comprise a suture. 89. The tissue connector apparatus of claim 87, further comprising first and second couplings, said second coupling releasably coupling said clip second end portion to said second flexible member and said first coupling releasably coupling said clip first end portion to the other of said flexible members. 90. The tissue connector apparatus of claim 89 wherein said surgical clip comprises shape memory material and is adapted to assume said closed configuration. 91. Tissue connector apparatus comprising a surgical clip, first and second needles each having first and second end portions, first and second couplings, and first and second flexible members, said surgical clip adapted to connect at least two structures together and constructed for movement from an open configuration to a closed configuration, said surgical clip having first and second end portions, said first coupling being releasably coupled to said first end portion of said surgical clip and said second
