US20230071383A1 - Continuous stapler strip for use with a surgical stapling device - Google Patents
Continuous stapler strip for use with a surgical stapling device Download PDFInfo
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- US20230071383A1 US20230071383A1 US17/987,630 US202217987630A US2023071383A1 US 20230071383 A1 US20230071383 A1 US 20230071383A1 US 202217987630 A US202217987630 A US 202217987630A US 2023071383 A1 US2023071383 A1 US 2023071383A1
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- staples
- stapling device
- deformation element
- surgical stapling
- assembly
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- 238000000926 separation method Methods 0.000 claims description 14
- 238000010304 firing Methods 0.000 description 7
- 238000001356 surgical procedure Methods 0.000 description 4
- 239000003292 glue Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 150000001875 compounds Chemical class 0.000 description 2
- 230000014759 maintenance of location Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 230000002035 prolonged effect Effects 0.000 description 2
- 238000010276 construction Methods 0.000 description 1
- 230000007704 transition 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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0686—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
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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
- A61B2017/00526—Methods of manufacturing
- A61B2017/0053—Loading magazines or sutures into applying tools
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07228—Arrangement of the staples
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Definitions
- the disclosure is directed to surgical stapling devices and, more particularly, to endoscopic surgical stapling devices with continuously-fed staples.
- Surgical stapling devices for performing surgical procedures endoscopically are well known. Such devices are available in a variety of different configurations, e.g., linear, curved, circular, etc., and are suitable for use in a variety of different procedures.
- Linear surgical stapling devices include a tool assembly having an anvil and a staple cartridge that are pivotably coupled to each other at their proximal ends between open and clamped positions.
- a staple cartridge is loaded onto the distal end of the stapling device and includes a plurality of linearly aligned staples that are deformed into tissue upon actuation (e.g., firing) of the stapling device.
- a continuous strip of staples for use with a surgical stapling device which includes an elongated stock of corrugated paper defining a plurality of channels therein.
- An inner facing side of each channel is configured to support a row of staples thereon and extending therealong.
- the plurality of inner facing sides of the plurality of channels is configured to be slidingly received within a corresponding plurality of slots defined within a cartridge assembly of a stapling device for loading the staples therein.
- a plurality of indexing apertures is defined in the elongated stock and extends therealong.
- the plurality of indexing apertures is adapted to engage a staple deformation element of the cartridge assembly during retraction thereof to automatically move the elongated stock proximally to reload a new row of staples after actuation of the stapling device.
- the rows of staples are arranged in an offset manner relative to each other along the elongated stock.
- a leading edge of the elongated stock is adapted to engage an aperture defined within a distal end of an elongated shaft of the stapling device such that, upon reloading, a used portion of the elongated stock is expelled through the aperture.
- the plurality of indexing apertures is configured to engage a pawl disposed on the staple deformation element such that, during retraction, a trailing edge of the pawl operably engages one of the plurality of indexing apertures and pulls the elongated stock proximally as the staple deformation element retracts thereby reloading the cartridge assembly of the stapling device with new staples.
- the elongated stock supports rows of staples on either side of an axis defined therealong.
- the plurality of indexing apertures is disposed along the axis.
- an equal number of rows of staples is disposed on either side of the axis.
- the plurality of indexing apertures facilitates separation of the elongated stock along the length thereof after deformation of the staples.
- the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock and separation thereof after deformation of the staples.
- the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock via engagement with the pawl and separation thereof after deformation of the staples.
- the plurality of indexing apertures cooperates with a knife operably engaged to the staple deformation element to facilitate separation of the elongated stock along the length thereof after deformation of the staples.
- a stapling device which includes a body having a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position.
- the cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof.
- a drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof.
- An elongated stock of corrugated paper is included that defines a plurality of channels therein. An inner facing side of each channel is configured to support the plurality of staples thereon and extending therealong.
- the plurality of inner facing sides of the plurality of channels is configured to be slidingly received in a corresponding plurality of slots defined within the cartridge assembly for loading the staples therein.
- a plurality of indexing apertures is defined in the elongated stock and extends therealong, the plurality of indexing apertures is adapted to engage a staple deformation element of the cartridge assembly during retraction thereof to automatically move the elongated stock proximally to reload a new row of staples after actuation of the stapling device.
- the cartridge assembly further includes a plurality of pusher members disposed therein and extending therealong.
- the plurality of pusher members includes a series of abutting members disposed thereon and disposed in alignment with a corresponding series of staples of the plurality of staples.
- Each of the plurality of pusher members is configured to sequentially engage the staple deformation element during distal actuation thereof and, in turn, engage the corresponding series of staples to force the corresponding series of staples against the anvil assembly for deformation thereof.
- each abutting member of the series of abutting members of each pusher member includes a recess defined therein for supporting one of the series of staples.
- the anvil assembly includes an anvil surface having a corresponding plurality of staple pockets, each staple pocket of the plurality of staple pockets is configured to deform a staple of the plurality of staples thereagainst during actuation of the staple deformation element.
- the staples are arranged in an offset manner relative to each other along the elongated stock.
- a leading edge of the elongated stock is adapted to engage an aperture defined within a distal end of an elongated shaft of the stapling device such that, upon reloading, a used portion of the elongated stock is expelled through the aperture.
- the plurality of indexing apertures is configured to engage a pawl disposed on the staple deformation element such that, during retraction, a trailing edge of the pawl operably engages one of the plurality of indexing apertures and pulls the elongated stock proximally as the staple deformation element retracts thereby reloading the cartridge assembly of the stapling device with new staples.
- the elongated stock supports rows of staples on either side of an axis defined therealong.
- the plurality of indexing apertures is disposed along the axis.
- an equal number of rows of staples is disposed on either side of the axis.
- the plurality of indexing apertures facilitates separation of the elongated stock along the length thereof after deformation of the staples.
- the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock and separation thereof after deformation of the staples.
- the plurality of indexing apertures cooperates with a knife operably engaged to the staple deformation element to facilitate separation of the elongated stock along the length thereof after deformation of the staples.
- a stapling device which includes a body having a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position.
- the cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof.
- a drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof.
- An elongated stock of corrugated paper is configured to slidingly engage the cartridge assembly for loading the staples therein, the elongated stock supporting a plurality of staples thereon and extending therealong.
- a plurality of pusher members is disposed within the cartridge assembly and extends therealong, the plurality of pusher members including a series of abutting members disposed thereon and disposed in alignment with a corresponding series of staples of the plurality of staples.
- Each of the plurality of pusher members is configured to sequentially engage the staple deformation element during distal actuation thereof and, in turn, engage the corresponding series of staples to force the corresponding series of staples against the anvil assembly for deformation thereof.
- each pusher member of the plurality of pusher members includes a pusher tab extending therefrom, each pusher tab sequentially moveable upon actuation of the staple deformation element between a first position relative to the staple deformation element wherein each pusher tab rides within a respective slot defined within the cartridge assembly to guide the respective pusher member into engagement with the series of staples and a second position relative to the staple deformation element wherein the pusher tab is positioned for resetting the pusher member upon retraction of the staple deformation element.
- an exposed surface of the staple deformation element cams the pusher tab to the first position upon initial engagement with the staple deformation element.
- a recess defined within the staple deformation element seats the pusher tab to the second position after deformation of the series of staples.
- a rear camming surface disposed on the staple deformation element sequentially engages each pusher tab upon retraction of the staple deformation element to reset each respective pusher member within the cartridge assembly.
- each abutting member of the series of abutting members of each pusher member includes a recess defined therein for supporting one of the series of staples.
- a stapling device which includes a surgical stapling device having a body including a tool assembly disposed at a distal end thereof.
- the tool assembly includes a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position.
- the cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof.
- a drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof.
- the drive assembly includes an elongated drive bar having a clamping member at a distal end thereof.
- the clamping member includes a retraction member disposed thereon, wherein, upon actuation, the retraction member is configured to both force the staple deformation element distally upon actuation of the drive assembly and pull the staple deformation element proximally upon retraction of the drive assembly.
- the retraction member includes a button-like mechanical interface that is configured to mate within a corresponding aperture defined within the staple deformation element.
- the button-like mechanical interface aligns for engagement within the corresponding aperture when the tool assembly is moved to the closed position.
- the button-like mechanical interface is impeded from engaging the corresponding aperture when the tool assembly is in the open position.
- the button-like mechanical interface disengages from the corresponding aperture upon moving the tool assembly to the open position.
- FIG. 1 is a side perspective view of the disclosed surgical stapling device including a tool assembly in an open position having a dissecting tip according to exemplary aspects of the disclosure;
- FIG. 2 is an enlarged perspective view of the tool assembly with a continuous strip of staples engaged therein;
- FIG. 3 is an enlarged view of the area of detail of FIG. 2 ;
- FIG. 4 is a greatly-enlarged, distal end perspective view of the continuous strip of staples aligned in engagement within corresponding slots defined within a lower jaw cartridge assembly of the tool assembly;
- FIG. 5 is an exploded perspective view of the tool assembly with the continuous strip of staples poised for engagement therewith;
- FIG. 6 is a front, enlarged perspective view of a sled for use with the tool assembly showing a pawl aligned for engagement therewith;
- FIG. 7 is a rear, enlarged perspective view of the sled of FIG. 6 with the pawl engaged therein;
- FIG. 8 is a front, enlarged perspective view of a one of a plurality of pushers for use with the tool assembly;
- FIG. 9 is a rear, enlarged perspective view of a one of the plurality of pushers for use with the tool assembly
- FIG. 10 is a front, perspective view of the lower jaw cartridge assembly for use with the tool assembly
- FIG. 11 is a greatly-enlarged, front, perspective view of the lower jaw cartridge assembly for use with the tool assembly showing the slots defined within a lower jaw cartridge assembly;
- FIG. 12 is cross-sectional view taken along section line 12 - 12 of FIG. 2 ;
- FIG. 13 is cross-sectional view taken along section line 13 - 13 of FIG. 12 ;
- FIG. 14 is cross-sectional view taken along section line 14 - 14 of FIG. 13 ;
- FIG. 15 is cross-sectional view of the lower jaw cartridge assembly and an anvil assembly approximated prior to actuation
- FIG. 16 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly and anvil assembly after actuation highlighting a pawl configured to index the continuous strip of staples;
- FIG. 17 is cross-sectional view of the area of detail of FIG. 16 highlighting the pawl engaging a distal-most hole of the continuous strip of staples;
- FIG. 18 is a greatly enlarged cross-sectional view of a retraction feature of the sled
- FIG. 19 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly and anvil assembly after actuation highlighting a slot defined in the lower jaw cartridge assembly for receiving a pusher tab of the pusher member;
- FIG. 20 is cross-sectional view taken along section line 20 - 20 of FIG. 19 ;
- FIGS. 21 and 22 are top views of the sled engaging the pusher and pusher tab during actuation
- FIGS. 23 and 24 are cross-sectional views of the sled engaging the pusher and pusher tab during retraction
- FIG. 25 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly highlighting the pawl engaging the continuous strip of staples during retraction of the sled for reloading;
- FIG. 26 is a cross-sectional view of the lower jaw cartridge assembly highlighting the pawl engaging the continuous strip of staples during retraction of the sled for reloading.
- proximal is used generally to refer to that portion of the device that is closer to a clinician
- distal is used generally to refer to that portion of the device that is farther from the clinician
- endoscopic is used generally to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through a small diameter incision or cannula.
- clinician is used generally to refer to medical personnel including doctors, nurses, and support personnel.
- FIG. 1 illustrates the disclosed surgical stapling device which is shown generally as stapling device 10 and includes a handle assembly 12 , an elongated body 14 , and a tool assembly 100 .
- the handle assembly 12 includes a hand grip 18 and a plurality of actuator buttons 20 and supports a rotation knob 22 .
- the rotation knob 22 supports the elongated body 14 and is rotatable in relation to the handle assembly 14 to facilitate rotation of the elongated body 14 and the tool assembly 100 in relation to the handle assembly 12 .
- the actuator buttons 20 control operation of the various functions of the stapling device 10 including approximation, firing and cutting.
- the tool assembly 100 can be secured directly to a distal portion of the elongated body 14 .
- the tool assembly 100 can form part of a reload assembly that is releasably coupled to the elongated body 14 and can be replaced to facilitate reuse of the surgical stapling device.
- the stapling device 10 is illustrated as an electrically powered stapling device, it is envisioned that the disclosed tool assembly 100 is suitable for use with a manually powered surgical stapling device.
- U.S. Pat. No. 9,055,943 discloses a stapling device including a powered handle assembly
- U.S. Pat. No. 6,241,139 discloses a manually actuated handle assembly.
- FIGS. 1 - 2 illustrate the tool assembly 100 which includes a lower jaw cartridge assembly 112 (cartridge assembly 112 ), an anvil assembly 114 , and a dissector tip 120 that is supported on the anvil assembly 114 .
- the cartridge assembly 112 is secured to the anvil assembly 114 for pivotal movement about pivot 129 between an open position and a clamped position.
- the dissector tip 120 is described with reference to U.S. patent application Ser. No. 16/842,016 filed on Apr. 7, 2020, the entire contents of which being incorporated by reference herein.
- FIGS. 2 - 3 illustrate the cartridge assembly 112 and anvil assembly 114 of the tool assembly 100 disposed in the open position with a continuous strip of staples 200 (strip 200 ) operably engaged therebetween.
- Strip 200 includes an elongated stock of continuous paper 204 (or other type of support material) having a plurality of corrugations extending therefrom defining a plurality of channels 205 therein and extending therealong.
- a central-most channel 205 is defined along either side of an axis A-A defined through strip 200 and is configured to receive a staple deformation element or sled 400 during reciprocation thereof.
- Each inner facing side 206 of each channel 205 towards axis A-A is configured to hold a row of staples 210 in series along the continuous strip 200 .
- Three rows of staples 210 are disposed on each side of axis A-A defined through strip 200 .
- Each inner facing side 206 of each channel 205 supports a respective series of staples 210 .
- each series of staples 210 is spaced along the strip 200 to align with a corresponding pusher 300 , disposed within the cartridge assembly 112 .
- a series of indexing apertures 215 are defined within the continuous paper 204 and extend at fixed distances relative to one another along the continuous paper 204 .
- the indexing apertures 215 are configured to operably engage with the staple deformation element or firing sled 400 (sled 400 ) to automatically reload a new strip 200 of staples 210 when the sled 400 is retracted.
- the sled 400 may form part of the overall drive assembly 500 once engaged with the clamping member 505 .
- the used portion of the strip 200 is expelled through a proximal end 112 a of cartridge assembly 112 as best shown in FIG. 2 .
- the indexing apertures 215 may also facilitate separation of the strip 200 after deformation of the staples 210 .
- the indexing apertures 215 may be arranged to act like perforations along the strip 200 to facilitate separation thereof.
- the indexing apertures 215 may cooperate with a knife 507 disposed on a leading edge of the clamping member 505 (See FIG. 5 ) to separate the strip 200 after deformation of the staples 210 as explained in more detail below.
- Strip 200 includes a glue 227 or other retainment feature ( FIG. 20 ) for securing each series of staples 210 within each corresponding channel 205 against an inner facing side 206 thereof.
- the glue 227 is of sufficient strength to allow handling of the strip 200 and initial loading of the strip 200 within the cartridge assembly 112 while also allowing easy and consistent separation from the strip 200 upon firing of the stapler 10 .
- FIG. 4 shows a distal end view of the strip 200 being loaded within the cartridge assembly 112 . More particularly, each inner facing side 206 of each respective channel 205 is configured to be received within a corresponding slot 113 defined within the cartridge assembly 112 for loading and alignment purposes. In other words, each inner facing side 206 is configured for sliding receipt within a corresponding slot 113 defined within the cartridge assembly 112 which facilitates transition of the strip 400 through the cartridge assembly 112 for loading and reloading purposes.
- FIG. 5 illustrates an exploded view of the cartridge assembly 112 and anvil assembly 114 along with strip 400 .
- Cartridge assembly 112 defines an axis B-B therethrough. More particularly, cartridge assembly 112 includes an outer channel member 115 which defines a cavity 115 ′ for receiving a staple cartridge 117 therein.
- One or more mechanical interfaces e.g., interfaces 118 on channel member 115 and interfaces 122 on cartridge 117 , may be utilized to secure the cartridge 117 to the channel member 115 .
- a plurality of staple pushers 300 (pushers 300 ) are aligned and positioned within a corresponding plurality of pockets 121 defined within and along the cartridge 117 when the cartridge assembly 112 is assembled. Pockets 121 align with the staples 210 when the strip 200 is loaded into the cartridge assembly 112 as explained in more detail below (See FIGS. 10 and 11 ).
- Anvil assembly 114 includes anvil surface 114 ′ having a plurality of staple pockets 119 defined therein ( FIG. 4 ). Staple pockets 119 deform the staples 210 in a prescribed fashion when forced against each pocket, e.g., each staple leg deforms inwardly relative to the other staple leg. Other envisioned staple 210 deformation patterns are also contemplated and may vary according to the length of the staple 210 , depth of the staple pocket 119 , geometric shape of the staple pocket 119 , etc.
- Drive assembly 500 is utilized to actuate or fire the staples 210 into tissue. More particularly, the drive assembly 500 includes an elongated drive bar 502 including clamping member 505 disposed at a distal end thereof which is configured to operably engage the sled 400 . Upon actuation of the drive assembly 500 , the clamping member 505 drives the sled 400 distally forcibly camming the pushers 300 upwardly (perpendicularly relative to the axis B-B) and into the staples 210 disposed within strip 200 .
- Clamping member 505 also includes the knife 507 on a leading edge thereof for severing tissue after the sled 400 and pushers 300 form the staples 210 against the anvil surface 114 ′.
- FIGS. 6 , 7 and 8 , 9 show views of the sled 400 and one of the pushers 300 , respectively, which, as mentioned above, cooperate to deform the staples 210 against the anvil assembly 114 .
- Sled 400 includes a series of ramping surfaces 405 extending transversally across the surface thereof, ramping from distal-to-proximal ends in a shoe-like manner.
- Sled 400 also includes a pawl 450 for indexing the strip 200 which is explained in more detail below.
- Ramping surfaces 405 are configured to align with and operably engage a corresponding series of abutments 310 disposed on a bottom of each pusher 300 .
- a plurality of staple abutting members 315 oppose the abutments 310 and are each configured to engage a respective staple 210 therein.
- Each abutting member 315 includes a recess 315 ′ defined therein configured to seat each staple 210 during deformation.
- ramping surfaces 405 force the abutments 310 towards tissue which, in turn, force the staples 210 towards anvil assembly 114 as explained below with reference to FIGS. 8 and 9 .
- Ramping surfaces 405 may be compound surfaces and include two or more angled portions to vary the force against the abutments 310 as the sled 400 moves distally. Configuring the sled 400 with compound ramping surfaces 405 may improve deformation of the staples 210 against the anvil assembly 114 .
- Sled 400 also includes a central ramp 415 that includes an exposed surface 420 having a chamfered edge 420 ′ configured to operably engage a pusher tab 325 of the pusher 300 .
- Central ramp 415 includes a stepped area 421 along opposing sides thereof relative to exposed surface 420 , the purposes of which being explained below with respect to actuation of the sled 400 (See FIGS. 13 and 14 compared to FIGS. 20 - 22 ).
- the exposed surface 420 forces the pusher tab 325 transversally (see arrow “F”— FIGS. 20 and 21 )) relative to axis B-B from the stepped area 421 , along exposed surface 420 allowing each pusher tab 325 and pusher 300 to slide within a respective slot 123 defined within the cartridge 117 (See FIGS. 20 - 24 ) toward the tissue.
- Slots 123 ensure the pushers 300 stay in alignment with the staples 210 during actuation of the sled 400 .
- the ramping surfaces 405 engage the abutments 310 and force the abutting members 315 of the pushers 300 into the staples 210 for deformation.
- the resultant deformation force crumbles the continuous stock of paper 204 releasing the staples 210 therefrom (e.g., and breaking any bond or glue 227 retaining the staples to the continuous stock of paper 204 ).
- each pusher 300 engages the leading chamfered edge 420 ′ of exposed surface 420 of central ramp 415 compressing the pusher tab 325 inwardly (See FIGS. 20 and 21 ) and forcing the pusher tab 325 in the direction “F” to ride proximally therealong until a point when the pusher tab 325 bottoms out within recess 423 (See FIG. 22 ).
- the pusher tab 325 is configured to bottom out within recess 423 after complete deformation of the staples 210 —See arrow “S” ( FIG. 22 ).
- the previous or already fired pushers 300 remain in engagement with the deformed staples 210 until the sled 400 is retracted as explained in more detail below.
- the strip 200 is initially loaded onto cartridge 117 and fed through slots 113 defined therein to facilitate alignment of the staples 210 with the pushers 300 .
- the leading most indexing aperture 215 operably engages a trailing edge 454 of the pawl 450 extending from the sled 400 (See FIGS. 16 and 17 ) and the indexing aperture 215 seats in retention between the trailing edge 454 and the leading edge 452 of the pawl 450 .
- the trailing edge 454 of the pawl 450 only allows the strip 200 to move proximally when engaged within an indexing aperture 215 .
- the trailing edge 454 of the pawl 450 also retains the staples 210 of the strip 200 in alignment with the pushers 300 ( FIG. 17 ).
- FIG. 12 shows the strip 200 loaded atop the cartridge 117 with the sled 400 in a proximal-most position and a leading edge 209 of the strip 200 partially expelled from the proximal end of the cartridge 117 .
- the cartridge assembly 112 is disposed in an open position relative to the anvil assembly 114 to facilitate loading.
- the clamping member 505 of the drive assembly 500 is recessed to a proximal position to facilitate loading the strip 200 atop the cartridge 117 and through an aperture 14 ′ defined within distal end of the elongated body 14 .
- the user When the stapler 10 is closed (e.g., when tissue is clamped between the cartridge assembly 112 and anvil assembly 114 ), the user initiates actuation of the drive assembly 500 via actuator buttons 20 (or handle, robotic controller or other mechanism for actuating the drive assembly 500 ) which forces the clamping member 505 into abutting engagement with the sled 400 (See FIG. 15 ).
- actuator buttons 20 or handle, robotic controller or other mechanism for actuating the drive assembly 500
- a retraction member 510 disposed on a leading surface of the clamping member 505 interfaces with a corresponding aperture 425 defined within the sled 400 .
- the retraction member 510 may be a button-like mechanical interface that is configured to mate within corresponding aperture 425 .
- the aperture 425 may be made from a semi-pliable material to allow disengagement of the clamping member 505 and sled 400 when the clamping member 505 is returned to a proximal-most position for opening or repositioning the cartridge assembly 112 and anvil assembly 114 relative to one another.
- the retraction member 510 and aperture 425 engagement may be configured to maintain a first retractive force with relative axial movement between the sled 400 and clamping member 505 , e.g., for retracting the sled 400 after firing, and a may be configured to disengage more easily upon non-axial movement between the sled 400 and the clamping member 505 , e.g., when opening the cartridge assembly 122 relative to the anvil assembly 114 .
- Various designs are envisioned that will accomplish this purpose.
- each pushing tab 325 from each pusher 300 rides along the exposed surface 420 of the sled 400 and within respective slots 123 of cartridge 117 (See FIGS. 23 and 24 ). Further, the trailing edge 454 of the pawl 450 ratchets along the strip 200 as the sled 400 moves distally in the direction “R” ( FIG. 16 ).
- the pusher tabs 325 settle within or bottom out within recess 423 of sled 400 (see direction of arrow “S”— FIG. 22 ). Disposing the pusher tabs 325 within the recess 423 in sled 400 orients or positions each the pusher tab 325 for reset (See FIGS. 19 - 22 ).
- FIGS. 23 and 24 show one particular feature associated with the retraction of the sled 400 involving resetting of the pusher members 300 to a pre-firing position.
- a rear camming surface 410 disposed on the proximal-facing side of exposed surface 420 operably engages each pusher tab 325 as the sled 400 retracts proximally forcing each pusher member 300 back towards its respective pre-firing position (see arrow “P P ”).
- P P pre-firing position
- the trailing edge 454 of the pawl 450 engages a distal-most indexing aperture 215 (i.e., the distal-most indexing aperture 215 of the strip 200 currently disposed between the cartridge assembly 112 and anvil assembly 114 ) and pulls the strip 200 proximally as the sled 400 retracts.
- pulling the strip 200 proximally reloads a new plurality of staples 210 within cartridge 117 (See FIGS. 25 and 26 ).
- the used and empty strip 200 ′ is expelled through aperture 14 ′ in the distal end of elongated member 14 .
- the cartridge assembly 112 may be opened with respect to the anvil assembly 114 by overcoming the engagement of the retention member 510 of the clamping member 505 with aperture 425 of sled 400 .
- the stapler 10 is now reset for continued use.
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Abstract
A continuous strip of staples for use with a surgical stapling device includes an elongated stock of corrugated paper defining a plurality of channels therein. An inner facing side of each channel is configured to support a row of staples thereon and extending therealong and is configured to be slidingly received in a corresponding plurality of slots defined within a cartridge assembly of a stapling device for loading the staples therein. A plurality of indexing apertures is defined in the elongated stock and extends therealong. The plurality of indexing apertures is adapted to engage a staple deformation element of the cartridge assembly during retraction thereof to automatically reload one or more new rows of staples after actuation of the stapling device.
Description
- This application is a continuation of U.S. patent application Ser. No. 17/219,006 filed Mar. 31, 2021, entitled “CONTINUOUS STAPLER STRIP FOR USE WITH A SURGICAL STAPLING DEVICE”, now U.S. Pat. No. 11,497,495 issued Nov. 15, 2022, the entire contents of which being incorporated by reference herein.
- The disclosure is directed to surgical stapling devices and, more particularly, to endoscopic surgical stapling devices with continuously-fed staples.
- Surgical stapling devices for performing surgical procedures endoscopically are well known. Such devices are available in a variety of different configurations, e.g., linear, curved, circular, etc., and are suitable for use in a variety of different procedures. Linear surgical stapling devices include a tool assembly having an anvil and a staple cartridge that are pivotably coupled to each other at their proximal ends between open and clamped positions. Typically, a staple cartridge is loaded onto the distal end of the stapling device and includes a plurality of linearly aligned staples that are deformed into tissue upon actuation (e.g., firing) of the stapling device. Various types of stapler cartridges have been developed allowing multiple or repeated actuations of the stapling device before reloading the staple cartridge onto the distal end. However, during a prolonged surgery, a surgeon may still need to reload the distal end to replenish the supply of staples.
- In order to better utilize a stapling device over a prolonged surgery requiring multiple stapler actuations, a need exists in the art for a surgical stapling device that has a continuous supply of staples for use during surgery.
- Provided in accordance with one aspect of the present disclosure is a continuous strip of staples for use with a surgical stapling device which includes an elongated stock of corrugated paper defining a plurality of channels therein. An inner facing side of each channel is configured to support a row of staples thereon and extending therealong. The plurality of inner facing sides of the plurality of channels is configured to be slidingly received within a corresponding plurality of slots defined within a cartridge assembly of a stapling device for loading the staples therein. A plurality of indexing apertures is defined in the elongated stock and extends therealong. The plurality of indexing apertures is adapted to engage a staple deformation element of the cartridge assembly during retraction thereof to automatically move the elongated stock proximally to reload a new row of staples after actuation of the stapling device.
- In aspects according to the present disclosure, the rows of staples are arranged in an offset manner relative to each other along the elongated stock. In other aspects according to the present disclosure, a leading edge of the elongated stock is adapted to engage an aperture defined within a distal end of an elongated shaft of the stapling device such that, upon reloading, a used portion of the elongated stock is expelled through the aperture.
- In aspects according to the present disclosure, the plurality of indexing apertures is configured to engage a pawl disposed on the staple deformation element such that, during retraction, a trailing edge of the pawl operably engages one of the plurality of indexing apertures and pulls the elongated stock proximally as the staple deformation element retracts thereby reloading the cartridge assembly of the stapling device with new staples.
- In aspects according to the present disclosure, the elongated stock supports rows of staples on either side of an axis defined therealong. In other aspects according to the present disclosure, the plurality of indexing apertures is disposed along the axis. In yet other aspects according to the present disclosure, an equal number of rows of staples is disposed on either side of the axis.
- In aspects according to the present disclosure, the plurality of indexing apertures facilitates separation of the elongated stock along the length thereof after deformation of the staples. In other aspects according to the present disclosure, the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock and separation thereof after deformation of the staples. In still other aspects according to the present disclosure, the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock via engagement with the pawl and separation thereof after deformation of the staples.
- In aspects according to the present disclosure, the plurality of indexing apertures cooperates with a knife operably engaged to the staple deformation element to facilitate separation of the elongated stock along the length thereof after deformation of the staples.
- Provided in accordance with one aspect of the present disclosure is a stapling device which includes a body having a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position. The cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof. A drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof. An elongated stock of corrugated paper is included that defines a plurality of channels therein. An inner facing side of each channel is configured to support the plurality of staples thereon and extending therealong. The plurality of inner facing sides of the plurality of channels is configured to be slidingly received in a corresponding plurality of slots defined within the cartridge assembly for loading the staples therein. A plurality of indexing apertures is defined in the elongated stock and extends therealong, the plurality of indexing apertures is adapted to engage a staple deformation element of the cartridge assembly during retraction thereof to automatically move the elongated stock proximally to reload a new row of staples after actuation of the stapling device.
- In aspects according to the present disclosure, the cartridge assembly further includes a plurality of pusher members disposed therein and extending therealong. The plurality of pusher members includes a series of abutting members disposed thereon and disposed in alignment with a corresponding series of staples of the plurality of staples. Each of the plurality of pusher members is configured to sequentially engage the staple deformation element during distal actuation thereof and, in turn, engage the corresponding series of staples to force the corresponding series of staples against the anvil assembly for deformation thereof.
- In aspects according to the present disclosure, each abutting member of the series of abutting members of each pusher member includes a recess defined therein for supporting one of the series of staples. In other aspects according to the present disclosure, the anvil assembly includes an anvil surface having a corresponding plurality of staple pockets, each staple pocket of the plurality of staple pockets is configured to deform a staple of the plurality of staples thereagainst during actuation of the staple deformation element. In aspects according to the present disclosure, the staples are arranged in an offset manner relative to each other along the elongated stock.
- In aspects according to the present disclosure, a leading edge of the elongated stock is adapted to engage an aperture defined within a distal end of an elongated shaft of the stapling device such that, upon reloading, a used portion of the elongated stock is expelled through the aperture.
- In aspects according to the present disclosure, the plurality of indexing apertures is configured to engage a pawl disposed on the staple deformation element such that, during retraction, a trailing edge of the pawl operably engages one of the plurality of indexing apertures and pulls the elongated stock proximally as the staple deformation element retracts thereby reloading the cartridge assembly of the stapling device with new staples.
- In aspects according to the present disclosure, the elongated stock supports rows of staples on either side of an axis defined therealong. In other aspects according to the present disclosure, the plurality of indexing apertures is disposed along the axis. In still other aspects according to the present disclosure, an equal number of rows of staples is disposed on either side of the axis.
- In aspects according to the present disclosure, the plurality of indexing apertures facilitates separation of the elongated stock along the length thereof after deformation of the staples. In other aspects according to the present disclosure, the plurality of indexing apertures is arranged on the elongated stock to both facilitate reloading of the elongated stock and separation thereof after deformation of the staples. In still other aspects according to the present disclosure, the plurality of indexing apertures cooperates with a knife operably engaged to the staple deformation element to facilitate separation of the elongated stock along the length thereof after deformation of the staples.
- Provided in accordance with one aspect of the present disclosure is a stapling device which includes a body having a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position. The cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof. A drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof. An elongated stock of corrugated paper is configured to slidingly engage the cartridge assembly for loading the staples therein, the elongated stock supporting a plurality of staples thereon and extending therealong. A plurality of pusher members is disposed within the cartridge assembly and extends therealong, the plurality of pusher members including a series of abutting members disposed thereon and disposed in alignment with a corresponding series of staples of the plurality of staples. Each of the plurality of pusher members is configured to sequentially engage the staple deformation element during distal actuation thereof and, in turn, engage the corresponding series of staples to force the corresponding series of staples against the anvil assembly for deformation thereof.
- In aspects according to the present disclosure, each pusher member of the plurality of pusher members includes a pusher tab extending therefrom, each pusher tab sequentially moveable upon actuation of the staple deformation element between a first position relative to the staple deformation element wherein each pusher tab rides within a respective slot defined within the cartridge assembly to guide the respective pusher member into engagement with the series of staples and a second position relative to the staple deformation element wherein the pusher tab is positioned for resetting the pusher member upon retraction of the staple deformation element.
- In aspects according to the present disclosure, an exposed surface of the staple deformation element cams the pusher tab to the first position upon initial engagement with the staple deformation element. In other aspects according to the present disclosure, a recess defined within the staple deformation element seats the pusher tab to the second position after deformation of the series of staples.
- In aspects according to the present disclosure, a rear camming surface disposed on the staple deformation element sequentially engages each pusher tab upon retraction of the staple deformation element to reset each respective pusher member within the cartridge assembly.
- In aspects according to the present disclosure, each abutting member of the series of abutting members of each pusher member includes a recess defined therein for supporting one of the series of staples.
- Provided in accordance with one aspect of the present disclosure is a stapling device which includes a surgical stapling device having a body including a tool assembly disposed at a distal end thereof. The tool assembly includes a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position. The cartridge assembly includes a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof. A drive assembly is disposed within the body and is configured to operably engage the staple deformation element upon actuation thereof. The drive assembly includes an elongated drive bar having a clamping member at a distal end thereof. The clamping member includes a retraction member disposed thereon, wherein, upon actuation, the retraction member is configured to both force the staple deformation element distally upon actuation of the drive assembly and pull the staple deformation element proximally upon retraction of the drive assembly.
- In aspects according to the present disclosure, the retraction member includes a button-like mechanical interface that is configured to mate within a corresponding aperture defined within the staple deformation element. In other aspects according to the present disclosure, the button-like mechanical interface aligns for engagement within the corresponding aperture when the tool assembly is moved to the closed position.
- In aspects according to the present disclosure, the button-like mechanical interface is impeded from engaging the corresponding aperture when the tool assembly is in the open position.
- In aspects according to the present disclosure, after actuation and retraction of the staple deformation element, the button-like mechanical interface disengages from the corresponding aperture upon moving the tool assembly to the open position.
- Other features of the disclosure will be appreciated from the following description.
- Various aspects of the disclosed surgical stapling device are described herein below with reference to the drawings, wherein:
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FIG. 1 is a side perspective view of the disclosed surgical stapling device including a tool assembly in an open position having a dissecting tip according to exemplary aspects of the disclosure; -
FIG. 2 is an enlarged perspective view of the tool assembly with a continuous strip of staples engaged therein; -
FIG. 3 is an enlarged view of the area of detail ofFIG. 2 ; -
FIG. 4 is a greatly-enlarged, distal end perspective view of the continuous strip of staples aligned in engagement within corresponding slots defined within a lower jaw cartridge assembly of the tool assembly; -
FIG. 5 is an exploded perspective view of the tool assembly with the continuous strip of staples poised for engagement therewith; -
FIG. 6 is a front, enlarged perspective view of a sled for use with the tool assembly showing a pawl aligned for engagement therewith; -
FIG. 7 is a rear, enlarged perspective view of the sled ofFIG. 6 with the pawl engaged therein; -
FIG. 8 is a front, enlarged perspective view of a one of a plurality of pushers for use with the tool assembly; -
FIG. 9 is a rear, enlarged perspective view of a one of the plurality of pushers for use with the tool assembly; -
FIG. 10 is a front, perspective view of the lower jaw cartridge assembly for use with the tool assembly; -
FIG. 11 is a greatly-enlarged, front, perspective view of the lower jaw cartridge assembly for use with the tool assembly showing the slots defined within a lower jaw cartridge assembly; -
FIG. 12 is cross-sectional view taken along section line 12-12 ofFIG. 2 ; -
FIG. 13 is cross-sectional view taken along section line 13-13 ofFIG. 12 ; -
FIG. 14 is cross-sectional view taken along section line 14-14 ofFIG. 13 ; -
FIG. 15 is cross-sectional view of the lower jaw cartridge assembly and an anvil assembly approximated prior to actuation; -
FIG. 16 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly and anvil assembly after actuation highlighting a pawl configured to index the continuous strip of staples; -
FIG. 17 is cross-sectional view of the area of detail ofFIG. 16 highlighting the pawl engaging a distal-most hole of the continuous strip of staples; -
FIG. 18 is a greatly enlarged cross-sectional view of a retraction feature of the sled; -
FIG. 19 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly and anvil assembly after actuation highlighting a slot defined in the lower jaw cartridge assembly for receiving a pusher tab of the pusher member; -
FIG. 20 is cross-sectional view taken along section line 20-20 ofFIG. 19 ; -
FIGS. 21 and 22 are top views of the sled engaging the pusher and pusher tab during actuation; -
FIGS. 23 and 24 are cross-sectional views of the sled engaging the pusher and pusher tab during retraction; -
FIG. 25 is an enlarged, cross-sectional view of the distal end of the lower jaw cartridge assembly highlighting the pawl engaging the continuous strip of staples during retraction of the sled for reloading; and -
FIG. 26 is a cross-sectional view of the lower jaw cartridge assembly highlighting the pawl engaging the continuous strip of staples during retraction of the sled for reloading. - The disclosed surgical stapling device will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. However, it is to be understood that the aspects of the disclosure described herein are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure.
- In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “endoscopic” is used generally to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through a small diameter incision or cannula. Further, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel. As used herein, the terms “parallel” and “aligned” are understood to include relative configurations that are substantially parallel, and substantially aligned, i.e., up to about + or −10 degrees from true parallel or true alignment.
-
FIG. 1 illustrates the disclosed surgical stapling device which is shown generally as staplingdevice 10 and includes ahandle assembly 12, anelongated body 14, and atool assembly 100. Thehandle assembly 12 includes ahand grip 18 and a plurality ofactuator buttons 20 and supports arotation knob 22. Therotation knob 22 supports theelongated body 14 and is rotatable in relation to thehandle assembly 14 to facilitate rotation of theelongated body 14 and thetool assembly 100 in relation to thehandle assembly 12. Theactuator buttons 20 control operation of the various functions of the staplingdevice 10 including approximation, firing and cutting. Thetool assembly 100 can be secured directly to a distal portion of theelongated body 14. Alternately, thetool assembly 100 can form part of a reload assembly that is releasably coupled to theelongated body 14 and can be replaced to facilitate reuse of the surgical stapling device. Although thestapling device 10 is illustrated as an electrically powered stapling device, it is envisioned that the disclosedtool assembly 100 is suitable for use with a manually powered surgical stapling device. U.S. Pat. No. 9,055,943 (the '943 Patent) discloses a stapling device including a powered handle assembly and U.S. Pat. No. 6,241,139 (the '139 Patent) discloses a manually actuated handle assembly. -
FIGS. 1-2 illustrate thetool assembly 100 which includes a lower jaw cartridge assembly 112 (cartridge assembly 112), ananvil assembly 114, and adissector tip 120 that is supported on theanvil assembly 114. Thecartridge assembly 112 is secured to theanvil assembly 114 for pivotal movement aboutpivot 129 between an open position and a clamped position. For a more detailed description of thecartridge assembly 112 of thetool assembly 100, see, e.g., the '943 and '139 Patents referenced above. Details relating to thedissector tip 120 are described with reference to U.S. patent application Ser. No. 16/842,016 filed on Apr. 7, 2020, the entire contents of which being incorporated by reference herein. -
FIGS. 2-3 illustrate thecartridge assembly 112 andanvil assembly 114 of thetool assembly 100 disposed in the open position with a continuous strip of staples 200 (strip 200) operably engaged therebetween.Strip 200 includes an elongated stock of continuous paper 204 (or other type of support material) having a plurality of corrugations extending therefrom defining a plurality ofchannels 205 therein and extending therealong. Acentral-most channel 205 is defined along either side of an axis A-A defined throughstrip 200 and is configured to receive a staple deformation element orsled 400 during reciprocation thereof. - Each inner facing
side 206 of eachchannel 205 towards axis A-A is configured to hold a row ofstaples 210 in series along thecontinuous strip 200. Three rows ofstaples 210 are disposed on each side of axis A-A defined throughstrip 200. Each inner facingside 206 of eachchannel 205 supports a respective series ofstaples 210. As described in more detail below, each series ofstaples 210 is spaced along thestrip 200 to align with acorresponding pusher 300, disposed within thecartridge assembly 112. - A series of
indexing apertures 215 are defined within thecontinuous paper 204 and extend at fixed distances relative to one another along thecontinuous paper 204. As explained in more detail below, theindexing apertures 215 are configured to operably engage with the staple deformation element or firing sled 400 (sled 400) to automatically reload anew strip 200 ofstaples 210 when thesled 400 is retracted. As explained in more detail below, thesled 400 may form part of theoverall drive assembly 500 once engaged with the clampingmember 505. The used portion of thestrip 200 is expelled through aproximal end 112 a ofcartridge assembly 112 as best shown inFIG. 2 . Theindexing apertures 215 may also facilitate separation of thestrip 200 after deformation of thestaples 210. In other words, theindexing apertures 215 may be arranged to act like perforations along thestrip 200 to facilitate separation thereof. Moreover, theindexing apertures 215 may cooperate with aknife 507 disposed on a leading edge of the clamping member 505 (SeeFIG. 5 ) to separate thestrip 200 after deformation of thestaples 210 as explained in more detail below. -
Strip 200 includes aglue 227 or other retainment feature (FIG. 20 ) for securing each series ofstaples 210 within each correspondingchannel 205 against aninner facing side 206 thereof. Theglue 227 is of sufficient strength to allow handling of thestrip 200 and initial loading of thestrip 200 within thecartridge assembly 112 while also allowing easy and consistent separation from thestrip 200 upon firing of thestapler 10.FIG. 4 shows a distal end view of thestrip 200 being loaded within thecartridge assembly 112. More particularly, each inner facingside 206 of eachrespective channel 205 is configured to be received within acorresponding slot 113 defined within thecartridge assembly 112 for loading and alignment purposes. In other words, each inner facingside 206 is configured for sliding receipt within acorresponding slot 113 defined within thecartridge assembly 112 which facilitates transition of thestrip 400 through thecartridge assembly 112 for loading and reloading purposes. -
FIG. 5 illustrates an exploded view of thecartridge assembly 112 andanvil assembly 114 along withstrip 400.Cartridge assembly 112 defines an axis B-B therethrough. More particularly,cartridge assembly 112 includes anouter channel member 115 which defines acavity 115′ for receiving astaple cartridge 117 therein. One or more mechanical interfaces, e.g., interfaces 118 onchannel member 115 andinterfaces 122 oncartridge 117, may be utilized to secure thecartridge 117 to thechannel member 115. A plurality of staple pushers 300 (pushers 300) are aligned and positioned within a corresponding plurality ofpockets 121 defined within and along thecartridge 117 when thecartridge assembly 112 is assembled.Pockets 121 align with thestaples 210 when thestrip 200 is loaded into thecartridge assembly 112 as explained in more detail below (SeeFIGS. 10 and 11 ). -
Anvil assembly 114 includesanvil surface 114′ having a plurality ofstaple pockets 119 defined therein (FIG. 4 ). Staple pockets 119 deform thestaples 210 in a prescribed fashion when forced against each pocket, e.g., each staple leg deforms inwardly relative to the other staple leg. Other envisionedstaple 210 deformation patterns are also contemplated and may vary according to the length of thestaple 210, depth of thestaple pocket 119, geometric shape of thestaple pocket 119, etc. -
Drive assembly 500 is utilized to actuate or fire thestaples 210 into tissue. More particularly, thedrive assembly 500 includes anelongated drive bar 502 including clampingmember 505 disposed at a distal end thereof which is configured to operably engage thesled 400. Upon actuation of thedrive assembly 500, the clampingmember 505 drives thesled 400 distally forcibly camming thepushers 300 upwardly (perpendicularly relative to the axis B-B) and into thestaples 210 disposed withinstrip 200. The pushers, in turn, force thestaples 210 through tissue disposed between thecartridge assembly 112 andanvil assembly 114 and into theanvil surface 114′ to form thestaples 210 thereagainst in alternating row-like fashion alongcartridge 117. Clampingmember 505 also includes theknife 507 on a leading edge thereof for severing tissue after thesled 400 andpushers 300 form thestaples 210 against theanvil surface 114′. -
FIGS. 6, 7 and 8, 9 show views of thesled 400 and one of thepushers 300, respectively, which, as mentioned above, cooperate to deform thestaples 210 against theanvil assembly 114.Sled 400 includes a series of rampingsurfaces 405 extending transversally across the surface thereof, ramping from distal-to-proximal ends in a shoe-like manner.Sled 400 also includes apawl 450 for indexing thestrip 200 which is explained in more detail below. Rampingsurfaces 405 are configured to align with and operably engage a corresponding series ofabutments 310 disposed on a bottom of eachpusher 300. A plurality ofstaple abutting members 315 oppose theabutments 310 and are each configured to engage arespective staple 210 therein. Each abuttingmember 315 includes arecess 315′ defined therein configured to seat each staple 210 during deformation. - As the
sled 400 moves distally, rampingsurfaces 405 force theabutments 310 towards tissue which, in turn, force thestaples 210 towardsanvil assembly 114 as explained below with reference toFIGS. 8 and 9 . Rampingsurfaces 405 may be compound surfaces and include two or more angled portions to vary the force against theabutments 310 as thesled 400 moves distally. Configuring thesled 400 withcompound ramping surfaces 405 may improve deformation of thestaples 210 against theanvil assembly 114.Sled 400 also includes acentral ramp 415 that includes an exposedsurface 420 having a chamferededge 420′ configured to operably engage apusher tab 325 of thepusher 300. -
Central ramp 415 includes a steppedarea 421 along opposing sides thereof relative to exposedsurface 420, the purposes of which being explained below with respect to actuation of the sled 400 (SeeFIGS. 13 and 14 compared toFIGS. 20-22 ). During distal movement of thesled 400 and in conjunction with the rampingsurfaces 405 operably engaging theabutments 310 of eachpusher 300, the exposedsurface 420 forces thepusher tab 325 transversally (see arrow “F”—FIGS. 20 and 21 )) relative to axis B-B from the steppedarea 421, along exposedsurface 420 allowing eachpusher tab 325 andpusher 300 to slide within arespective slot 123 defined within the cartridge 117 (SeeFIGS. 20-24 ) toward the tissue.Slots 123 ensure thepushers 300 stay in alignment with thestaples 210 during actuation of thesled 400. - As the
sled 400 moves forward, the rampingsurfaces 405 engage theabutments 310 and force the abuttingmembers 315 of thepushers 300 into thestaples 210 for deformation. The resultant deformation force crumbles the continuous stock ofpaper 204 releasing thestaples 210 therefrom (e.g., and breaking any bond orglue 227 retaining the staples to the continuous stock of paper 204). - As best shown in the comparison of
FIGS. 13-14 compared toFIGS. 20-22 , as thesled 400 advances distally to deform thestaples 210, thepusher tab 325 of eachpusher 300 engages the leading chamferededge 420′ of exposedsurface 420 ofcentral ramp 415 compressing thepusher tab 325 inwardly (SeeFIGS. 20 and 21 ) and forcing thepusher tab 325 in the direction “F” to ride proximally therealong until a point when thepusher tab 325 bottoms out within recess 423 (SeeFIG. 22 ). Thepusher tab 325 is configured to bottom out withinrecess 423 after complete deformation of thestaples 210—See arrow “S” (FIG. 22 ). As thesled 400 continues to move distally to engagesubsequent pushers 300 of thecartridge 117, the previous or already firedpushers 300 remain in engagement with thedeformed staples 210 until thesled 400 is retracted as explained in more detail below. - As mentioned above, the
strip 200 is initially loaded ontocartridge 117 and fed throughslots 113 defined therein to facilitate alignment of thestaples 210 with thepushers 300. Upon initial loading, the leadingmost indexing aperture 215 operably engages a trailingedge 454 of thepawl 450 extending from the sled 400 (SeeFIGS. 16 and 17 ) and theindexing aperture 215 seats in retention between the trailingedge 454 and theleading edge 452 of thepawl 450. The trailingedge 454 of thepawl 450 only allows thestrip 200 to move proximally when engaged within anindexing aperture 215. The trailingedge 454 of thepawl 450 also retains thestaples 210 of thestrip 200 in alignment with the pushers 300 (FIG. 17 ). -
FIG. 12 shows thestrip 200 loaded atop thecartridge 117 with thesled 400 in a proximal-most position and aleading edge 209 of thestrip 200 partially expelled from the proximal end of thecartridge 117. When loading thestrip 200, thecartridge assembly 112 is disposed in an open position relative to theanvil assembly 114 to facilitate loading. The clampingmember 505 of thedrive assembly 500 is recessed to a proximal position to facilitate loading thestrip 200 atop thecartridge 117 and through anaperture 14′ defined within distal end of theelongated body 14. Once thestrip 200 is loaded, thestapler 10 is ready for clamping of tissue and actuation. - When the
stapler 10 is closed (e.g., when tissue is clamped between thecartridge assembly 112 and anvil assembly 114), the user initiates actuation of thedrive assembly 500 via actuator buttons 20 (or handle, robotic controller or other mechanism for actuating the drive assembly 500) which forces the clampingmember 505 into abutting engagement with the sled 400 (SeeFIG. 15 ). Upon engagement, aretraction member 510 disposed on a leading surface of the clampingmember 505 interfaces with acorresponding aperture 425 defined within thesled 400. - The
retraction member 510 may be a button-like mechanical interface that is configured to mate withincorresponding aperture 425. Theaperture 425 may be made from a semi-pliable material to allow disengagement of the clampingmember 505 andsled 400 when the clampingmember 505 is returned to a proximal-most position for opening or repositioning thecartridge assembly 112 andanvil assembly 114 relative to one another. In embodiments, theretraction member 510 andaperture 425 engagement may be configured to maintain a first retractive force with relative axial movement between thesled 400 and clampingmember 505, e.g., for retracting thesled 400 after firing, and a may be configured to disengage more easily upon non-axial movement between thesled 400 and the clampingmember 505, e.g., when opening thecartridge assembly 122 relative to theanvil assembly 114. Various designs are envisioned that will accomplish this purpose. - Once the clamping member 5050 and the
sled 400 are engaged, further actuation of thedrive assembly 500 urges thesled 400 distally to sequentially impact thepushers 300. More particularly, the rampingsurfaces 405 of thesled 400 engage the correspondingabutments 310 of eachpusher 300 to force the abuttingmembers 315 into each staple 210 (SeeFIG. 19 ).Staples 210, in turn, are forced into and againstanvil surface 114′ of theanvil assembly 114. As mentioned above a plurality ofstaple pockets 119 are defined within theanvil surface 114′ and force thestaples 210 to deform thereagainst according to a prescribed geometry. As shown, three rows ofstaples 210 are formed on each side of thesled 400, two of the rows in general alignment relative to one another with a trailing center row therebetween (SeeFIG. 20 ). Other staple 210 patterns are also contemplated. - As the
sled 400 moves distally and deforms thestaples 210, theknife 507 disposed on the distal end of the clampingmember 505 severs tissue between the rows ofdeformed staples 210. At the same time each pushingtab 325 from eachpusher 300 rides along the exposedsurface 420 of thesled 400 and withinrespective slots 123 of cartridge 117 (SeeFIGS. 23 and 24 ). Further, the trailingedge 454 of thepawl 450 ratchets along thestrip 200 as thesled 400 moves distally in the direction “R” (FIG. 16 ). As thesled 400 moves distally and after sequential deformation of each of the plurality ofstaples 210 via thepusher members 300, as mentioned above, thepusher tabs 325 settle within or bottom out withinrecess 423 of sled 400 (see direction of arrow “S”—FIG. 22 ). Disposing thepusher tabs 325 within therecess 423 insled 400 orients or positions each thepusher tab 325 for reset (SeeFIGS. 19-22 ). - More particularly, after the
sled 400 has been fully actuated and is disposed in a distal-most orientation, retraction of the sled 400 (viaactuator button 18 or other mechanisms used for retraction (not shown)) performs multiple functions.FIGS. 23 and 24 show one particular feature associated with the retraction of thesled 400 involving resetting of thepusher members 300 to a pre-firing position. As the user begins to retract thesled 400 by retracting the clampingmember 505 of the drivingassembly 500 as explained above, arear camming surface 410 disposed on the proximal-facing side of exposedsurface 420 operably engages eachpusher tab 325 as thesled 400 retracts proximally forcing eachpusher member 300 back towards its respective pre-firing position (see arrow “PP”). As thesled 400 moves proximally, all of thepusher members 300 are sequentially reset in this fashion. - In addition and upon retraction of the
sled 400, the trailingedge 454 of thepawl 450 engages a distal-most indexing aperture 215 (i.e., thedistal-most indexing aperture 215 of thestrip 200 currently disposed between thecartridge assembly 112 and anvil assembly 114) and pulls thestrip 200 proximally as thesled 400 retracts. As a result, pulling thestrip 200 proximally reloads a new plurality ofstaples 210 within cartridge 117 (SeeFIGS. 25 and 26 ). The used andempty strip 200′ is expelled throughaperture 14′ in the distal end ofelongated member 14. - Once the
sled 400 is fully retracted and as mentioned above, thecartridge assembly 112 may be opened with respect to theanvil assembly 114 by overcoming the engagement of theretention member 510 of the clampingmember 505 withaperture 425 ofsled 400. Thestapler 10 is now reset for continued use. - Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary aspects of the disclosure. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described aspects of the disclosure. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
Claims (22)
1-20. (canceled)
21. A continuous strip of staples for use with a surgical stapling device, comprising:
an elongated stock of paper defining a plurality of channels therein, a side of each channel configured to support a plurality of staples thereon and extending therealong, the sides of the plurality of channels each configured to be slidingly received within a corresponding plurality of slots defined within a cartridge assembly of a stapling device for loading the plurality of staples therein; and
a plurality of indexing apertures defined in the elongated stock and extending therealong, the plurality of indexing apertures adapted to engage a staple deformation element of the cartridge assembly at least during retraction thereof to move the elongated stock to reload a new plurality of staples after actuation of the stapling device.
22. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein the plurality of staples is arranged in an offset manner relative to each other along the elongated stock.
23. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein a leading edge of the elongated stock is adapted to engage an aperture defined within a distal end of an elongated shaft of the stapling device such that, upon reloading, a used portion of the elongated stock is expelled through the aperture.
24. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein the plurality of indexing apertures is configured to engage a pawl disposed on the staple deformation element such that, during retraction, a trailing edge of the pawl operably engages one of the plurality of indexing apertures and pulls the elongated stock proximally as the staple deformation element retracts thereby reloading the cartridge assembly of the stapling device with a new plurality of staples.
25. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein the elongated stock supports the plurality of staples on either side of an axis defined therealong.
26. The continuous strip of staples for use with a surgical stapling device according to claim 25 , wherein the plurality of indexing apertures is disposed along the axis.
27. The continuous strip of staples for use with a surgical stapling device according to claim 25 , wherein an equal number of the plurality of staples is disposed on either side of the axis.
28. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein the plurality of indexing apertures facilitates separation of the elongated stock along the length thereof after deformation of the plurality of staples.
29. The continuous strip of staples for use with a surgical stapling device according to claim 28 , wherein the plurality of indexing apertures is arranged on the elongated stock to facilitate both reloading of the elongated stock and separation thereof after deformation of the plurality of staples.
30. The continuous strip of staples for use with a surgical stapling device according to claim 24 , wherein the plurality of indexing apertures is arranged on the elongated stock to facilitate both reloading of the elongated stock via engagement with the pawl and separation thereof after deformation of the plurality of staples.
31. The continuous strip of staples for use with a surgical stapling device according to claim 21 , wherein the plurality of indexing apertures cooperates with a knife operably engaged to the staple deformation element to facilitate separation of the elongated stock along the length thereof after deformation of the plurality of staples.
32. A surgical stapling device, comprising:
a body including a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position, the cartridge assembly including a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof;
a drive assembly disposed within the body and configured to operably engage the staple deformation element upon actuation thereof;
an elongated stock of corrugated paper configured to slidingly engage the cartridge assembly for loading the plurality of staples therein, the elongated stock supporting the plurality of staples thereon and extending therealong; and
a plurality of pusher members disposed within the cartridge assembly and extending therealong, the plurality of pusher members including a series of abutting members disposed thereon and disposed in alignment with a corresponding series of staples of the plurality of staples, each of the plurality of pusher members configured to sequentially engage the staple deformation element during distal actuation thereof and, in turn, engage the corresponding series of staples to force the corresponding series of staples against the anvil assembly for deformation thereof.
33. The surgical stapling device according to claim 32 , wherein each pusher member of the plurality of pusher members includes a pusher tab extending therefrom, each pusher tab sequentially moveable upon actuation of the staple deformation element between a first position relative to the staple deformation element wherein each pusher tab rides within a respective slot defined within the cartridge assembly to guide the respective pusher member into engagement with the series of staples and a second position relative to the staple deformation element wherein the pusher tab is positioned for resetting the pusher member upon retraction of the staple deformation element.
34. The surgical stapling device according to claim 33 , wherein an exposed surface of the staple deformation element cams the pusher tab to the first position upon initial engagement with the staple deformation element.
35. The surgical stapling device according to claim 33 , wherein a recess defined within the staple deformation element seats the pusher tab to the second position after deformation of the series of staples.
36. The surgical stapling device according to claim 33 , wherein a rear camming surface disposed on the staple deformation element sequentially engages each pusher tab upon retraction of the staple deformation element to reset each respective pusher member within the cartridge assembly.
37. The surgical stapling device according to claim 32 , wherein each abutting member of the series of abutting members of each pusher member includes a recess defined therein for supporting one of the series of staples.
38. A surgical stapling device, comprising:
a body including a tool assembly disposed at a distal end thereof, the tool assembly including a cartridge assembly and an anvil assembly pivotably coupled thereto such that the tool assembly is moveable from an open position to a clamped position, the cartridge assembly including a staple deformation element disposed therein configured to operably engage and deform a plurality of staples upon distal movement thereof; and
a drive assembly disposed within the body and configured to operably engage the staple deformation element upon actuation thereof, the drive assembly including an elongated drive bar having a clamping member at a distal end thereof, the clamping member including a retraction member disposed thereon,
wherein, upon actuation, the retraction member is configured to both force the staple deformation element distally upon actuation of the drive assembly and pull the staple deformation element proximally upon retraction of the drive assembly.
39. The surgical stapling device according to claim 38 , wherein the retraction member includes a button-like mechanical interface that is configured to mate within a corresponding aperture defined within the staple deformation element, the button-like mechanical interface aligning for engagement within the corresponding aperture when the tool assembly is moved to the closed position.
40. The surgical stapling device according to claim 39 , wherein the button-like mechanical interface is impeded from engaging the corresponding aperture when the tool assembly is in the open position.
41. The surgical stapling device according to claim 39 , wherein, after actuation and retraction of the staple deformation element, the button-like mechanical interface disengages from the corresponding aperture upon moving the tool assembly to the open position.
Priority Applications (1)
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US17/987,630 US20230071383A1 (en) | 2021-03-31 | 2022-11-15 | Continuous stapler strip for use with a surgical stapling device |
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US17/219,006 US11497495B2 (en) | 2021-03-31 | 2021-03-31 | Continuous stapler strip for use with a surgical stapling device |
US17/987,630 US20230071383A1 (en) | 2021-03-31 | 2022-11-15 | Continuous stapler strip for use with a surgical stapling device |
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US17/219,006 Continuation US11497495B2 (en) | 2021-03-31 | 2021-03-31 | Continuous stapler strip for use with a surgical stapling device |
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US20230071383A1 true US20230071383A1 (en) | 2023-03-09 |
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US17/987,630 Pending US20230071383A1 (en) | 2021-03-31 | 2022-11-15 | Continuous stapler strip for use with a surgical stapling device |
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US17/219,006 Active US11497495B2 (en) | 2021-03-31 | 2021-03-31 | Continuous stapler strip for use with a surgical stapling device |
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2021
- 2021-03-31 US US17/219,006 patent/US11497495B2/en active Active
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- 2022-03-14 EP EP22711645.6A patent/EP4312813A1/en active Pending
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US11497495B2 (en) | 2022-11-15 |
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