CA1266596A - Surgical instrument - Google Patents

Abstract

SURGICAL INSTRUMENT
Abstract of The Disclosure A surgical instrument for placing linear staple sutures comprises a body having a closed rectangular frame, each of the lateral sides of said frame being provided with a slot which is located on the inner surface of said laterial side close to the adjacent side of said frame, the axis of said slot being parallel to each of said lateral sides; a die provided with a plurality of recesses and secured on the adjacent side of the frame, the extreme recesses of said die being arranged inside the slots on the frame lateral sides; a staple head accom-modated in the body, a detachable staple magazine having a plurality of staple slots and adapted to be so positi-oned that its portions provided with extreme staple slots should engage the slots in the lateral sides of the frame; a staple ejector, and actuators of the staple head and of the staple ejector, respectively.

Description

Title of the Invention SIJE'GICA~ I17STRIJr,lEMT
?ield o~ the ~nvention Tne present inventio~ relDtes -GO medical equi~ment and has ~articll]ar reIerence to surgical instru,nents.
nhe invention can find a~lication for placing li-near sta~le sutures when stitching up various organs, in ~articular, for stitchinG up the intestlnes in sur-gery of new;~orn infants and babies, for surgery in hard-10 of-access places, e.g~, for stitching up the organs lyinG dee?ly in the small ~elvis, and also for suturing blood vessels in vascular surgery.
3aclc~,round of t~.e Invention Xnorm in the present state of the art are surgi-1'~ cal suturing instruments (otherwise called staplirmachines) for placing linear sutures, comprising a body naving a nook which carries a die with a number of recesses, a sta~le head with a staple maga~ine and a staple ejector, a tissue restrictor and actuators 20 of the staple head and the ejector[(cf. 9 e. G~ ~ US Pa tent ~o. 3,494,533 Int.Cl. ~ 31b 1/00 issued in 1970 to David To Green et al.~.
The free end of the hook to which the die is held, i~ arranged in a cantilevered manner; hence the const-25 ruction of the stitching portion of the instrument isinadequately riGid in three mutually square directions, i~e.~ in the direction of suturing and in a plane square theretoc Since the stitching mechanism of the instrument susta-ins heavy loads dllrin~ the suturing process, re-sulting from compression of the ~alls of organs being sutured and once-through deforri1ation (bending) of a great number of sta~le~, a auality suture cannot be ob-tained unless a staole mutual arran,~ement of the die ecesses and the magazine 3-ta~le slots is provided.
The required ri~idity of he construction to meet this imoortant prereauisite is attained in said instruments due to considerably enlarged cross-sectional dimensions 10 of -the elements of the hook~ the body frame, and some other components of the stitchins mechanism. C'omparati-vely large dimensions of the stitching ?ortion affect adversely the maneuvrability of the instrument and ren-der it inapplicable in narrow body cavities.
loreover, a relatively large width of the die and staple magazine requires respectively more s~ace for the instrument to set in the suturing position and leads to a comparatively great distance from the sta~le suture to the line of cut on the tissues carried out along the 20 magazlne and die edge and hence to a rude suture obtained.
~nd conversely~ vhen the cross-sectional slze of the hook and other components of the stitching mechanism is re-duced, this might result in considerable deformation of the mechanism components during the suturing process9 25 an inadmissible increase in the suturing gap, or dis-tortion of the true shape of stitches applied.
The aforementloned disadvan-tages are eliminated in surgical instruments for placing linear sutures, i.ncor~ora-ting a ~od-r having a closed fra~e~
3ne more prior-art surgic:al lnstrur.lent for pla-cin r linear SlltUreS i3 kno~,n t;o comprise a body with a closed rectangular frame, a die ?rovided with a ?lurality of recesses and secuTed on one side of the frame, and a staple head ~et in th~ frame 03po5ite to the die and mounted movably with res~ect thereto. ~
detachable staple magazirle is fi~ed s-tationary in the staple head~ as ~ell as a staple ejector is set t;nere-in, which i3 .90 arranged as to corres~ond to the ma--.,azine sta~le slots. ~'he staple head has an actuator accommodated in the instrurnent body, and the staple e~ector actuator is located in the staple head body ~(cf~, e.g., US 'atent NQ.4~378~9O1 Int~ Cl. B 25C 5~00 issued in 1983 to Ernest ~Akopov and July G.Shaposhni-kov)~
High-rigidity construction of the body ~ith a closed rectangular frarne makes it possible~ with the load upon the stitching mechanism remaining unaffected in the course of rnultistaple suture application, to considerabl~r reduce deformation of the instr~nent com~
ponents and provide for a stable mutual arrangement of the magazine staple slots and the die recesses, a fea--ture that dralws distinction between the instrument under discussion and its analogues. ~he instrwnent is able to ensure higher-quality formation of suture stitches rmd attain better tightness of the suture and hence i-ts better hermetlcity and hemostatic cha-.$~

racter~ ~iGher ri iditr Q; ~he construction ~akes itossible to redllce the cro~s-sectional dimensions of the instrumenl s-titchin~, mec~anism and thereb~ to ren-der it more rnaneuvrable in ~he ODera~i~e ~rrollnd, to decrease the distance fro~ t~e suture to the line of cu-t of tlae -tissues lnvol~ed and to o~tain a more de-licate sutureO
Iowever~ the e-~-treme s-taple slots of the magazine and the respecti~e e~treme die recesses are s~aced somewhat apart from the frame lateral side. Besides7 since the instruments of -the character considered here-in are designed for placing double-row sutures with one of the rows offset relative to the other (the so-called staggered-stitch sutures), the distance bet-ween -the extreme ~aired magazine slots and die recesses of one row and the respective slots and recesses of o-th2r row ls as a rule adoDted -to be half the pitch of stitches in each row. Hence the suture placed on a considerable e~tension from the frame lateral side is in fact a single-row one, mhe aIorementioned construction Darticulars of the instrurnen-t under dlscussion result in that when -the instrwnent is used for 3uturing an organ whose semiDerimeter at the ~lace of suture applica-tion equals the distance between the frame lateral sides, the mar-ginal portions of the organ fail to be stitched Wit'l staples, or are stitched with a single-row suture over sDme lengtî, ,Ience neither hermetic tightness nor hemos-tasis of -the sutl1re ~lacéd on the e~treme portions of the stitched-u3 organ is attained after the !naOazi.ne and die have been ~rought apart and the instrument haS been rithdrawn Irom the o~erative woun.d.
_n pr?-c-r cal surgery the semi~erimeter o.f a com~-ressed ort~an .rn ~y I`re~uently oe in excess of the dista~c~
between tne la-teral sides of the frarne of an instrument applied, since it is hard to estimate by e~le the size and serniperimeter o:E a hollovr organ when compressed~
lO and to compare its size with the distance between the lateral frame sides, especially when manipulating deep-ly in the wound and observability of the o~erative field is hampered. In such a situation the aforesaid disadvan-tage is still more demonstrable, inasmuch as the mar-15 ginal tissues of the organ operated upon are compressed lengthwise the line of the suture being placed and are free to spread out as soon as the instrument is with-drawn from the operative wound, ~rrhereby the length of the non-sutured section is still increased.
`.1henever good observation of the operative ~ield is provided and an adequately convenient access to the suture is.obtained, imperfections of a mechanical su-ture are quite evident, and the surgeon is in a position of placing au~iliary manual sutures on the extreme sec-25 tions of the operative wound to provide hermetic tight-ness and good hemostasis of the suture. EIowever, the instrument proves to be inapplicable in case of surgery nder hard-of-access conditions deeply in a narrow 03e-l~ative fie~Ld rhere visual control oE the sutllre is dif-ficul-t~ or ~r Qn it is ?ractically impossiblQ to place addition 1 sutures on the e~treme ~round sections due to di-Fficul-~-.iQs in ?assing a -thread~fit~ted needle and perlo-rmirlJ manlal-sllture apnlication manipul~tions.
. ~he irls-tru.~ent is ~s~ ina~nlicable in cases wnere a snort stum~ of the stitched-up organ slips off after a mechanica] suture has been applied and gets obscured oy the surrollnding tiSSUQS and organs, or when any fur-ther effects with a needle and thread upon delicateeasily vulnerable tissues~ e,g, 5 -those of infants~
Nonsutured extreme sections of the stitched-up organs might develop profuse postoperative bleeding, distur-bed aseptics, or some other com lications that might 15 happen fa-tal to a patient.
Swnmary of the Invention It is an object of the present invention to ~ro~
vide a surgical lnstrument which would be capable of stitching up organs deeply in a narrow operative wound 0 and seated in hard-of-access places.
t is another object of the present invention to provide a possibility of ?lacin~ a high-quality and stability staple suture.
It is one more object of the ?resent invention to 25 ~rovide for positive application of stitches of a sta?le suture to the marginal portions of the organs being stitched up.
~n object of the invention is also to ?rovide a ~etac~able s-ta?le m2gazine It)r -the surgical ins-trument of the character set for-th hereinabove, ~hich renders use of the lnstrument reliable and extends its func-ti.onal car~abil.ities~
aid and other objec-ts are accomDlished due to the fact -that~ accordin~ to the invention~ a .surgical instrument for placing linear staple sutures comprises a bod~ ith a closed rec-tangular frame, each of the ~o lateral opposite sides of said frame having a 910-t 10 on the inner sllrface of said lat eral side close to a third frarne side adjacent to the lateral ones, the axis of said slot being parallel to the respective frame lateral side, a die having a pluralit~ of re-cesses and secured on the third frame side in such 15 a manner.that the die extreme portions incorporating extreme recesses are accommoclated inside the slots in the frame lateral sides~ a sta?le head mounted in the body opposite to the die and traversably with res?ect thereto, a detachable staple magazine adapted to be 20 fixed in the sta~le head stationary with respect thereto and provided with a plurality o~ staple slots~- said sta?le maga~.ine, l~hen in the suturinL position, being set with its portions incorporating extreme staple slots, into the slo-ts on the frame lateral sides opposite to the 25 respective extreme die recesses9 a staple ejector mo-vabl.y mounted in the sta?le held and so arranged as to corres?ond to -the mag~azine staple slots, an actuator of the s-ta~le head and an actuator of the sta?le ejector~

'aoth actuators being acco~.modated in the body.
-t l~ e~?edient that those ?ortions of the detachable sta?le magazine ~nich are accommodated inside the slots on the frame la-teral sides be of the same wi.dth as said slot~
'ïhen the detachable magazine has guide projec-tions for its se-tting in the staple head, i-t is expedient that said guide ?rojec-tions be ~rovided on a section de.fined '~y the distance between the rojections on-the frame 10 lateral sides, when in the suturing position.
It is also expedient that those portions of the detachable magazine which correspond to the side. grooves defined by the guide projections, and the ma~azine por-tions installed inside the slots on the frame ]ateral 15 sides, be of the same width.
The detachable staple magazine may have a stop shaped as a projection for the magazine to preliminarily fi~ with res?ect to the sta~le head and to the slots on the frame lateral sides.
Each of the frame lateral sides has an o~ening communicating with the slot and located on the section adjacent to the die.
It is likewise expedient that a projection adjacent to the die be p,ovided on par-t of each frame laterial sides on th~ i~ner surface thereof, and that a slot be ~rovided in said ~rojection and be open on the side ~?Si~e to the die.
'~he aforesaid oojects are accomplished also due to t~e fact -'hat a surgical instrumen-t for placing linear sta~le sutures, according to the invention, com-~rises a bod~ .lith a closed rectangular frame, wherein each of its late~al sides has a ?:rojection ~nose axis is ?arallel to -the res~ec~ive f'rame laterai sidel a die -provided.~ith a ~lurality of recesses and secured on a frame third side between the lateral sides-thereof in ;,uch a manner -that -the die e~treme portions incor'pora-tin~
ex-treme recesses, encompass the respective ~rojec-tion 10 on the frame lateral side, a sta~le head mounted in the frame o~posite to the die and traversably with respect thereto, a detachable staple magazine ada~ted to be set in the staple head stationary with respect ~thereto and having a ?lurality of s~taple slots and a slot in 15 each of its end faces, said. slot corresp-onding to the ~rojection on -the frame lateral side~ said ~rojections being for said magazlne'to set, throu~h the slots in its end faces, in the suturing position, the e~treme staple slots of said magazine being located on-the 20 portions forming the slots in the end faces and have their res~ective e~treme recesses of the die~ hich are situated on the die portions encompassing the pro`
jections on the frame lateral sides, a staple ejector mounted movably in the staple head and so arranged as 25 to correspond to the magazine staple slots7 an actuator ol the staple head and an actuator of the staple ejector, ~oth actuators being accommodated in the body.
~-oTri.sion of -the frame lateral (with respect to the -.'ie) sides ~v-in, lon,~itudin~l slots on their inner sur-lace in t`~e i.;.mediate vicinit,~ of the die, and fittinO
the die ?or-tions incorDoratin,~ e~treme recesses and the magazine Dortions incorpora-ti~g e-ftreme st~?le slots, 5 into these longitudinal slots~ ma~s it possiole to ensure ~ r- ~,idity of the constructio~ of t;~e closed frame and comparative',y small cross-sectional dimensions of the stitching meci~anism construction el,ements, as well as to as~ure a?Dlication ol the suture stit-cnes to 10 -the marginal ?ortions of the organs pressed in between -the maga2ine and the die and reliably restricted by the frame lateral sides. The length of the organ being stitched up, which is inter?osed ,bet~,veen the frame la-teral sides and pressed between the magazine and the 15 die9 is shorter than the length of.the suture being placed even though the len~th of the cross-sectional semiperi~eter of the organ9 whèn in a free state,' e~ceeds much the distance between the frame laterial sides. ~his makes the use of the instrument much more reliable, e~-2G tends its fvnctional capabilities due to good maneuvrabi-lity of the instrument in the o?erative wound and assures hermetic tightness and hemostasis of the mechanical suture applied. It is due to the aforestated construc-tion features that the instrument is applicable for 25 surgery in hard-of-access and confined places9 as well as for s-titching up organs having delicate and thin-walled tissues, e.g.~ in surgery of babies or in vascular surgery invol~ring im~roved quality of sutures appli.ed.

- .rovi~ion of a through opening in each of the frame lateral sides on it3 ~ection adjacent to the die - makes forma-tion of ~titches on the suture extrerne ~ections reliable and ~table in the cour~e o~ prolonl~^ed appli-cation of the ins-trument in sur~ical practice, this bein.~ clue -to -the fact that said opening reduces to a ~reat e~tent a possitility of soiling the die e~treme reces~es and the portions of the longitudinal slots in the frame lateral sides which are adjacent to the 13 di.e, improves visual control and simplifies w~shi.n~
and cleaning of this portion-of the instrument from blood after surgery. This feature is of great impor~
tance, since when polluted the e~treme die recesses and the ~ections of the longitudinal slots adjacent thereto will fail to provide a required quality and ~tability of the stitch formation process, especially in case of a comparatively small staple size, e.~., .
~ith a staple wire diameter less than 002 mm, which is the case with stitching up small-size organs 7 for instance, in surgery of infant3.
Thus, the aforestated construction features o-f the instruments enable ~ts e~panded functional capaciliti-es, improve the quality, stability and reliability of me-chanical suture application within prolonged service life of the instrument~ To 3um up, all this makes it po~sible to reduce the number of postoperative compli-cations and simplify surgeon's work.

65~6 3rief Description of the DrawinOs ,'urther object.~ and advanta~es of the pre3ent in--~ention will become apparent frorn a consideration of some specific embodiments thereof, reference bein,, made to the accompanying d-~a~.;ings,wherein~
'IG. 1 i~ a ~;ener~l view of the 3ur,ic21 i~lstru-ment 9 according to the invention;
' ~IG..2 is a sectional view of the ~me. in~trwnent 7 ~ taken along the line -II-II in ~I. l;
~IGo 3 is a sectional view of the 3ame instrument, taken along the line III-III in ~IG. 2;
FIG. 4 is a sectional view of the same instrument, taken along the line IV-IV in ~IG.. 3;;
FIG. 5 i~ a sectional view of the same instrument, taken along the line V-V in FIG. 3;
FIG, 6 is a sectional view of the same inq-trument~
taken along the line VI-VI in FIG. 2;
FIG~ 7 is a frag~entary, partly sectional view of the same instrument having a solid body frame, accor-ding to the invention;-FIG~ 8 is a fragmentary, partly sectional view of .the same instrument showing its staple head in warkingposition;
FIG. 9 i9 a 9ectional view of the same lnstrument, 25 -taken alon~ the line IX I~ in ~IG. 3;
~ IG. 10 is a sectional view of the same instru-ment, taken along the line X-X in ~IG, 8;
~IG~ 11 is a 3ectional view of the same instru-ment, taken alon~ the line XI-XI in FIGo 3;
~ IG~ 12 shows a linear staple suture applied to an organ interposed betvleen the frame lateral 3ides;
~ IG L3 illustrates another embodiment of the sur-~ical ins-trumen-t, accordln~, to the in-~ention, showin~
a sectional view of the frame and staple head thereof, taken alon the instrumen-t axie;
~ IG~ 14 is a sectional view of the same instru-ment, taken along the line XIV-XIV in ~IG. 13;
~IG, 15 is a sectional view of the same inst~u-ment, taken along the line XV-~ in ~IG. 14;
~ IG. 16 is a sectional vie~ of the same in~trument, taken along the line XVI-~VI în ~IG. 14;
FIG~ 17 is a sectional view of the same instrument, taken along the line XVII-XVII in FIG. 14;
~ IG. 18 shows a linear staple suture applied to an organ interposed bet~een the frame lateral sides:
~ IG. 19 illustrates ~ne more embodiment of the surgical instrument, according to the invention, show-2U ing a sectional view-of the frame and staple head there-of, taken alon~ the frame axial plane;
'IG. 20 is a sectional view of the same instr~nent, taken along the line X~-~X in FIG. 19;
~IG. 21 is a sectional view of the ~ame instrument, taken along the line XXI-~XI in ~IG. 19; and IG~ 22 illustrates still one more embodiment of the surgical instrument, accordirlg to the in~ention, showing a sectional view of the frame and staple head thereof, taken along the frame axial plane.

Detailed Description of the Invention The ~urgical instrlIment for placin~ linear staple sutures of the constructlon considered hereln can find most utility when applied for placing staple sutures in hard-of-access places or deeply in a narro~J opera-tive ~lround~ ~he ins-trument comprises a body 1 (FIGS 1,

2) ha~in~, a closed rectangular ~rame 2, which carries a die 4 secured on a side 3 of said frame. A staple head 5 i~ associated with ~he ~rame 2 which is situa-ted opposite to the die 4 and mounted traver~ably to-wards and away therefrom.
The staple head 5 has a rod 6 (~IGS 1, 3) accommo-dated in a slot 7 of the body 1, and a body 8 ~IG. 4).
The body 8 acçommodates a detachable staple ma~azine 9 fi~ed stationary therein and having a housing 9' shaped a~ a rectangular parallelepiped and a number of ~taple slots 10 (~IG. 3), a tr2versable staple ejector 11 arranged 90 that it~ prongs 12 corre~pond to the staple slots 10 of the magazine 9.
The housing 9' of the magazine 9 has two side grooves 13 (~IG. 4) which are adapted to engage, when the ma~azine 9 is fitted in the staple head 5, with projections 14 provided on the inner surfaces o~ the body ~ o~ the s-taple head 5. To lock the magazine 9 in place in ~h~3taple head 5, said magazine h~s a 3top 15 (~IG. 5) shaped as a proJection and resting against a face 16 of an opening 17 in the staple head 5.
rhe staple ejec~50r 11 (~IG. 2) has a rod 1~ (~IG. 6) accom~odated in ~he 910t 7 (FIG. 2) o~ the body 1 under the rod 6 of the ~taple head. An opening 19 (T~lIG. 3) i9 provided in -the ~taple head for the ~taple ejector 11 to pass therein7 The rod 6 (~IG~ 2) of the ~taple head is provided Nith a hollow tailpiece 20 havin~ an external thread 21 and an internal thread 22. ~ nut 23 is engaged with the external thread 21, said nut being in fact an actuator of the staple head 5. The-nut 23 i~ locked in the ~ody 1 with the aid of an annular groove 24 adapted to interact with a lug 25 on the bod~r 1.
A screw 26 is en~aged with the internal thread 22 of the tailpiece 20j said ~crew being in fact an actu-ator o~ the staple e~ector 11. The screw 26 ha`s a cannelure 27 with which the rod 18 of the staple ejector is adaDted to interact through a lug 28 (~'IG. 6~ pro-vided at the end of the rod 18~ The screw 26 is provided with a removable handle 29 ~IG. 1).
Sides 30 and 31 of the frame 2~ lateral with res-pect to the die 4, associate the ~ide 3 and an opposite~ide 32 of the frame 2, thus imparting high rigidity to the latter. '~he frame 2 may be either solid (~IGo 7) or one of its lateral ~ides, e.g., the side 30, nay be made as a stem 33 (~iG. 1) and mounted detachably.
The latter being the case, the frame 2 is made as a U-shaped member 34 (~IGS 3, 83 and vacant ends 35, 36 of the fr2me sides 3 and 32 are encompassed by stops 37, 38 (~IG, 3) of the detachable stem 33. ~or the ?urpose ~he stem 33 has an o~enin,, 39 into which the vacant end 35 of the fra~e side 3 is fitted, and i3 ?rovided wi-th two side slots 4G, 41 situated at the ~lace where the vaca~t end 36 is engaged with the opposite side 3? oi the frs~e 2, said slots 40, 41 being embraces wi-th a fork 42 at the vacant end 36 of the frame side 32. Retainers 43, 44 are provided at the frame v1acan~t ends 35, 36 (I~IGS 3, 8) for the stem 33 to lock in ~o~ition~ The stem 33 can be detached due to the fact that the U-shaped member of the frame 2 is made springy by virtue of elastic strain of the lateral side 31 rigidly linked with the sides 3 and 32 of the frame 2.
','~hen pressing on the vacant end 35 of the side 3 and on the stem 33 from below upwards against the end 36 of the side 32, the stop 38 (~IDS 8, 9) OI the stem 33 is thrown out of engagement with the retainer 44, thus releasing the stem 33 for its disengagement from the sides 3 and 32. The lateral sides 30, 31 (FIG. 10) of the frame 2 are encompassed by the body 8 of the staple head 5, when in working posi-tion, and serve as the guides for the staple ~lead to traverse from the initial'to the workin~ position.
It is due to high constructional rigidity of the closed rectangular frame 2 of the body 1 (~IG. 3) that a stable mutual arrangement of the recesses 4' in -the die 4 and the staple slots 10 in the magazine 9 is attained when substantial loads are imposed upon the stitcnin-.rnecha~ism, resulting fro~ compression of -the organ.s operated upon and a single-stage bending deformation of a great number of staples in the course O~r sutllring. ~linimized cross-sectional dimen-sions of -the side 3 Wit.l the c~.ie 4, tne lateral sides 30, 31 of the frame 2 and the entire stitcnin,, mechanism are attained, accordingl~T. Thi.s in turr.
provides for good maneuvrability of the instrument in the operative wound and a possibility of ~lacing de-lica-~e elastic sutures featuring a small tissue torus.
The lateral sid.es 30, 31 of the-frame 2 have res pective longitudinal slots on the inner surface thereof 5 situated in the immediate vicinity of the die 4. The a~is of each of the slots 45, 46 is oarallel to the respective lateral side of the frame 2 (~IG. 4). Por-tions 479 48 (FIG. 11) of the die 4 incorporating e~treme recesses 49, 50 are accommodated.inside the longitudinal slots 45, 46. Portions 51, 52 (FIG. 10) of the magazine 9 incorporating extreme s-ta~le slots 53, 54 are also accommodated in the longitudinal slots 459 46 on the lateral sidès of the frame 2 (~IGS 79 8) when the staple head 5 is in working position corres~onding to a re~uired suturing gap.
Such a constructional arrangement of the closed 25. rectangul&r frame 2 of the body 1 and of the staple head 5 witn the magazine 9 makes it possible to stitch up organs deeply in a n~rrow operPtive wound or in hard-of-access ?laces, assures application of staple sutures 55 (FIG. 12) to -the marginal portions of the walls of organs 56 pressed between the magazine and the die even in the cases rihere the length of the semi-perimeter of the cros~-sectional dimensions of the organ 569 l~a~len in a free state~ e~ceeds tne ~istance betY~een the lateral sides 3~i, 31 of the fr2me 2O T-lis renders instrument a?plica~tion under hard-of-access conditions more reliable.
The portions 51, 52 of the detachable ma~azine 9 (FIG. 10), incorporating the e~treme stanle slots 53, 54 accommodated inside the slots 45, 46 on the lateral sides 3G, 31 of the frame 2, have a riidth appro~imately equal to the width of said slots 45, 46, while the portions of the magazine 9 ~hich corres~ond to the side grooves 13 and -to the e~treme portions 51, 52 thereof~are equal in width. The lateral walls of the magazine 9 on said sections thereof are conlanar (~IGS 8 lG).
The side grooves 13 (FIG~ 4~ 5) in the magazine 9 are defined by guide projections 57, 58 which are provided on a section confined by the distance from the lateral sides 30, 31 ~FIG. 8) of the fr~e when is -the suturing position. Tne stop 15 (FIG. 5) of the magazine 9 is located on said ~I'Oj ection 57 so as to contact the face 16 of the body 8 of the staple head 5 and provide for preliminar~ fi~ing of thc magazine 9 with respect -to the ~ta~le head 5 and -to the slots 45, 46 (~'Iu. 3) on the lateral sides of the frame 2. Such a co~structional arranrrement of the magazine e~ables convenient reDlacemen-t of a~ em?ty magazire witn a staDle-loadedone9 which may be the case wner! a number of mechanical sta?le sutures are to be placed deeply in the o~e~a-tive wound without ~i-thdrawal of the frame ?
of the body 1 tnerefrom, e.g., when two linear sutures have to be placed under nard-of-access condi-tions and the tissues of the organ being stitched up snould be se-~ered between the sutures ap~lied. Such being the case, the ap~lication of tne first suture is followed by replacemen-t of the enpty magazine in the staple head 5 detached from thé frame 2 of the bod~ 1 and wit~drawn from the operative wound, whereas the frame 2 of -the body 1 embraces the organ stitched up with the first suture and remains deeply in the ope-rative wound. Once the staple-loaded magazine 9 has been fitted into the staple head 5, the stop 15 locks reliably the magazine g with respect to the staple head 2 and to the slots 45 9 46 on the lateral sides of the frame 2 the instant at which the staple head i9 instroduced into the operative wound and enga~ed with t~le frame 2 of the body 1.
The lateral sides 30, 31 (FIG. 3) of the frame 2 have respective openings 59-, 60 in its portions ad-jacent to the die 4, said openings facing the longi-tudinal slots 45, 46. The openings 59, 60 provides for convenient access to the e~treme recesses 49, 5G
(~IG. 11) of tne die 4 situated in the longitudinal slots 45, 46 on tne frame lateral sidss, a featurethat practically rules out any danger of ~olluting the extreme portions 47~ 4~, of the die 4 located in tne longitudinal slo-ts 45, 46 on the lateral sides 30, 31 of tn frame 2 ard the slots 45, 46 themselves and im~roves the ~iashing and cleaning conditions of the latter. This also facilitate.s visual control over tne condi~ion of the surfaces of said instrument components within the zone most critical to its functionin~. ~1ence trouble-free instrument operation is provid.ed within a prolonged period of its clinical use.
h respective projection 61, 62 adjacent to the die 4 is provided on part of each lateral side 30, 31 ( IG. 1) of the frame 2 on the inner surface thereof, and the res~ective longitudinal slot 45, 46 (~IG~ 3) is made in each of the projections 61, 62. With the staple head 5 (FIGI 3) in the initial position ~he portions 51, 52 of the magazine 9, incorporating the - extreme staDle slots 53, 54, are situated outside the longitudinal slots 45, 46. ~or the extreme ~ortions 51, 52 of the magazine 9 to engage in the longitudinal slots 45 9 46 of the projections 61, 62 on the lateral sid.es 30, 31 of the-close~ frame 2 when the staple head 5 travels from the ini-tial to the working position, said slots 45, 46 are made o~en on the side opposite .
to the die 4~
LU~S 63 are provided on tne rod 6 (~IG. 1) of tne sta?le head 5, engageable -~ith slots on t.~e la-teral ~aces of the slot 7 in the boày 1 .~or t;ne rod 6 to a oin incepar~bly wi-th t;he body 1~
In one of the embodiments of the instrument each of lateral sides 65, 66 (FIGS 13, 14) of the closed rectangular frame 2 has a respective projection 67, 68 is located on part of the respective lateral side 6~, 66 adJacent to a die 69. The side 3 mounting the die 69 and the sid.e 32 of the U-sha~ed member of -tne frame 2 h~re at its vacan-t end a f ork 70 (FIG, 15) anc a fc~rl~ 71, 10 respective],~. The detachable side of the fran,e 2 has lat'eral slots 72, 73 encompassed by the fork 70, and slots 74, 75 encompassed by the fork 71. ~he die 69 (~IG. 16) is so arranged that its extreme portions 769 ' 77 incorporating e~treme recesses 78, 79 encompass tne 15 res~ective projections on the res~ective lateral side 65, 66 of the frame 2.
' A detachable staple magazine 80 (FIG. 17) has a respective slot 81, 82 in each of its end faces7 cor-- responding to the respective projection 67, 68 on the 20 r~éspect.ive lateral side 65, 66 of the frame 2. Extreme sta~le slots 83, 84 are located on portions 85, 86 of the magazine 80 which establish the end slots 81S 82 and correspond to the extreme recesses 78, 79 (FIG. 16) . of the die 69.
,25 It is due to such a constructional arrangement, like~lse -the embodiment illustrated in FI~S 1, 2, 10, 11 tha-t the length of ~ staple suture 87 ~FIG. 18) ~laced on an organ 8~, exc~eds the distance bet~een the la-teral sides 65, 66 of the frame 2~ q'his ensures appli-cation of sta~le sutures to the marginal sections of the organ tis~ues pressed between the magazine and tne die during the suturing process, enables quality suturing of o~gans under hard-of-access conditions, and renders instru~ent applicati~n more reliable.
There have been considered hereinbefore the embodimellts of the surgical instrument featuring the slot 7 (~IG. 1) of the body 1 073ening to~qards a direc-- - tion square with the plane of the frame 2. However, the distinguishing fèatures of the instrument of the ?resent invention enable one to obtain the aforediscussed substantial advantages also in the c~se where a slot 89 (~IG. 19) of the body 1 opens towards a direction coin-cident with the plane of the frame 2. In such a case the vacant end 36 of the side 32 of the frame 2 has an opening 90 whose faces 91, 92 (li'IG. 20) coincide with latéral faces 93, 94 of the slot 89 in the body 1.
?o provlde rnore rigidity of the mutual arran~ement of the faces 91, 92 of the oblong opening 90, the detachable stem 33 (-ii'IG. 21) incorporates restric-tors 959 96 to prevent the thin faces 91, 92 from dis-placemen-t in a direction square with the plane of the frame 2. The longitudinal slots 45~ 46 on the lateral sides 30, 31 of the frame 2, which accommodate the extrem.e portions of both the die-4 and the magazine 9, are made in the projections 61~ 62 of -the lateral sides 30, 31 as in the embodiment of the instr~ment illustrated in ~IGo 3.
k.n instrument :naving the body l with -the slot 89 ( IG. l9) openin~ tov~ards Q direction coincident with the ?lane of the frame 2 may a'Lso be made (not shown in the drawing) as illustrated in FIG. 14. In such a ca~e the sides 6~, 66 of the frame 2 have the respec ti~e Drojections 67, 68 ~hich are e~com~assed by the extreme portions 76~ 77 (FIG. 16) of the die 69 in-corporating the e~treme recesses 78, 79 and by the extreme portions 85, 86 (l~'IG. 17) of the magazine 80 incorporating the extreme sta~le slots 83, 84, with the magazine 80 in its-working position.
All the hereinbeforè çonsidered embodiments of the instrument lllustrated in FIGS l through 21~ are far from exhausting completely the potentialities of further embodying the instr~nent according to the in-vention. Thus, for instance~ FIG. 22 illustrates an embodimen~t of the instrument, wherein lateral sides 97, 98 of the frame 2 of the body l has longitudinal slots 99j lO0 running througnout the len~th of the lateral sides 97, 98. hn alternative embodiment of the instru-ment to the preceding one ma~ be provided (not sho~m in the draYIin~), wherein the proJections 67; 68 (FIG. 14j on the lateral sides of the frame 2 of -the body l encompassed b~y the extreme portions of the die 69 ~ 24 -(L~ 16) incor~ora-tin.-, the e~treme recesses 7~, 79 and by the ex-treme ?ortions of the magazine 80 (hI~. 17) incorl?orati.ng the extreme sta~le slots, are ~rovided throu~iho~t the e.~tire length of the l.ater21 sid.es of the frame 2.
The de~acnable sta?le magazine in all tne embodi-ments of the constructional arrangement of the instru-ment may be either disposable (made of plastics) or reusable (from metal or other suitable materials).
~ne instrument of the invention o~erates as-foll~ws, - Before instrument ap~lication the staple head 5 a.nd the ejec-tor 11 are set to the initial ~osition (~IGS 1~ 2), and the detachable stem 33 is disengaged from the U-shaped member of th.e frame 2, Then the ma-ga~ine 9 is fitted into the sta~le head 5, the slots 10 of said magazine having been loaded wi-th staples (omitted in the drawing) beforehand. Once a routine resection pre-paration procedure of the organ-56 to be sutured, e.g.~
. 20 an intestine seated deeply in the small pelvis has been carried out, the.side 3 of the frame 2 is brought under the organ to be sutured, and the organ is encom~assed by the die 4 and the magazine 9. I~ext the detachable stem 33 is fitted onto tne vacant ends 35, 36 of the sid.es 3 and 32 of the ~-sha~ed member 34 of the frame 2, thus closing the latter and confining the organ 56 between the lateral sides 30~ 31 of the frame 2. ComparatiYely small size of the sid.e 3 carrying the die 4~ of the ~IL~iS~i lateral sides 30, 31 of tne frame 2 and of the CrosQ--section of the entire stitching mecaanism enables the instru.ment to be conveniently brought to the place of suture al~lication. Then the nut 23 is rotated to brin_ the magaz:ine 9 closer to the die 4 until the amount of the suturing gap ~IGo 9) is obt~ined, correspondinr to the ~all thickness of the organ 56 being slt~lred, ~he marginal ~ortions of the wal l s of ' he organ 56 which are being com~ressed, are confined Y~ithin the 1~ latera.l sid.es 30, 31 (-i?I5. 12) of the frame 2 even in ca~es Y.~here the length of the semi erimeter of the organ 56, when in a free state, e~ceeds the distance between the lateral sid.es 30, 31 of tne frame 2.
Tnereu.pon the handle 29 (~IGS 1? 2) of the actuator of the ejector 11 is rotated to drive the s-taples (omitted in the drawing) out of the magazine 9, wn.ich on meeting the die 4~ are bent to suture the Yvalls of the organ 55. This done, the resected portion of the stitched-up organ 56 is severed along the lateral surface of.the die 4 and magazine 9, the magazine 9 is brought a~art from the die 4 by rotating the nut 23, and the instrum.ent is withdrarm from the o~erative wound, Thanks to the fact that, YJith the staple head 5 in working positicn, the extreme recesses 49, 50 (~IG, 11) Of the die 4 and the e~treme staple slots 53, 54 (~IG. 10) of the magazine 9 are accommodated in the longitudinal.
- slots 45 9 45 of the lateral sides 30, 31 of the closed . - 26 ~

frame 29 the mecll~nical staple suture 55 (~IG. 12) close,c completel~T the lumen of the stitched-u~ organ 56.
~ rnenever -tne surgical pI'OC edure involves applica-tion of` tYro linear ~taple sutures 55 followed by severir, the tissue between tle sutuIes ap?lied, which is tile case when sti-tching up, e.g., two intestine ends, ap~lication of the first suture is-foLlowed by retracting the staple head 5 along with the magazine 9 to the initial posi-tion by rotating the nut 23, Then the sta~le head 5 to-10 gether with the magazine 9, the ejector 11 and theactuators of the staple nead 5 and the eaector 11 is e~tracted from the framé 2 of the body 1 and withdra~n~
from the operatlve wound. The frame 2 of the body 1 is left d,eeply in the o?erative wound so that the organ 5t 15 stitched up with the first suture is enclosed by the frame 2, ~hen the empty magazine is replaced with a loaded one outside the operative wound, wnereupon the loaded masazine 9 (FIG. 5) is fitted into the body 8 of the staple head 5 released from -the frame 2 and its 20 lateral side 309 until the stop 15 rests against the face 16 of the opening 17 in the staple head 5. Ne~t the staple head 5 is introduced into tne operative wound and sunk in the interior space of the frame 2 of the body 1, whereupon the frame 2 is displaced with 25 respect to the first staple suture so that the die 4 secured on the side 3 of the frame 3 should be positioned under the organ 56 being sutured three to five mm away from the line of the previously applied suture. ~fter that the magazine 9 is brought toge-ther ~;ith the die 4 as close as the amount of the suturing gap, and a se-cond linear staple su-ture is applied p~rallel to tne first one as it has been described in -the ~recedin--case. Tnen the walls of the organ 56 are severed usin~
a scal?el by moving i-t-along the lateral surface of the magazine 9 and die 4; w;~ereupon the nut 23 is rotated to bring -the magazine 9 apart from the d.ie 4-, 10 and the instrumen1 is withdrawn from -the operative wound.
~ ixa-tion of the detachable magazine 9 in the staple head 5 by means of the stop 15 of the magazine 9 makes possib]e a reliable a.nd fail-safe introduction of the 15 staple head 5 along with the magazine 9 into the inte-rior s~ace of the closed frame 2 when manipulating deeply in the operative wound and under hard-of-access conditions~ This construction feature of the instrument enables one to place two parallel sutures under the 20 aforesaid hard-of-access conditions without withdrawing the sid.e 3 of the frame 2 with the die 4 from under the organ 55 stitched u~ with the first suture for replacing the empty maga~ine 9 with a staple-loaded one, and ~Jithout repeated introduction of the side 3 with 25 the die 4 under the stitched-up organ 5$ for placing a second suture. Thereby the risk of inflicting trau-matic lesion u~on the organ being sutured and the - 2~ -.

surroundirlg tissues is reduced~ while the r~nge of application techniques of the instrument of the charac-ter under consideration is e~tended, which is of im-portance for prac~ical surgery~
Whenever use is made o:f an instrument ha~ing the non-separable closed rectangular frame 2 (FIG. 7), the organ being sutured? e.gc, the auricular appendage of the h.eart~ is introduced into the space confined bet-~een the die 4, the magazine 9 and the lateral sides 30, 31 of t~le frame 2 in a direction square with the plane of the frame 2. When the excised portion of the organ being sutured is in fact a solid conglomerate which cannot be interposed between the die 4 and the nagazine 9, such being the case with the suturing of the pharyn~ for laryngocarcinoma, the body 1 should be disengaged from the rest of the instrument before its application. As a result the interior opening of the closed frame 2 of the body 1 is released from the staple head 5 along with the maga3ine 9 and the staple ejector 11. While passing the conglomerate of the tumor being excised through the wide interior opening of the frame 29 one brings the side 3 of the frame 2 to the place of suture application located between the chin rising thereabove and the thorax, whereupon the staple head 5 in assembly with the rest of the instrument com-ponents is engaged with the bod~ l~ All other steps of the instrument application procedure with an instru-~ 29 ~

ment having the non-separable closed frame 2 of the body 1 are quite the same as in the case o~ an instru-ment comprising the frame 2 with a detachable lateral side. l'he narrower lateral sides 30, 31 of the frame 2 its side 3 and the magazine 9 provide for convenient setting of the instrument to the suturing position with-out any danger of inflicting traumatic lesion upon the organs 56 being sutured or the surrounding tissues, as well as ~pplication ~f ~ delicate suture with a low 10 tissue torus, while the distinguishing features of the stitching mechanlsm construction preclude any possibi-lity of incompetence or failure of the suture applied to the marginal portions of the stitched-up organ and enQure good hemostatic effect.
There may also be applied, using the aforedescribed, technique~ also an instrument having a closed rectangu-lar frame 2 (FIGS 3, 8) but without a removable lateral side 30 in the form of the detachable stem 33. The con-struction of the instrument enables one to replace the 20 magazines in the staple head 5 with the frame 2 closed and remaining engaged with the ætaple head 5 and with $he all other instrument components. With this purpose in viewy one should re-tract the staple head 5 to the initial position, raise it a lit-tle above the frame 2 ~5 by pressing the head 5 in a direction square with the plane of the fr~me, and bring it out of the interior opening of the frame 2 as far as to at*ain that the .. .

lateral side 30 of the frame 2 should not interfere with the re~ovnl of the ma~azine 9 from or its fi-tting into the staple head 5. The rod 18 (~IGo 2) of the ejector 11 and the rod 6 of the staple head 5 remain accommodated in the slot 7 of the body 1.~ Once the staple-loaded magazine 9 has been fitted into the body 8 of the ~taple head 5, one should let the la-tter down into the interior opening of the frame ~ along with the magazine 9; this done, the instrument is ready for operation.
Operation of the instrwnent embodiment as shown in FIGS 13 to 17 differ6 practically in nothing from its embodiment illustrated in FIGS 1, 2, 10, 119 the only difference lying in the mutual arrangement of the e~treme portions of the magazine incorporati~ the eætreme staple slots, and the die incorporating the extreme recesses and hence in the mutual arrangement of the e~treme staples of the mechanical suture being placed (FI&. 12 and 18) with respect to the frame la-teral sides..
Operation of the instrument embodiments as illust-rated in FIG~ 19 to 22, featuring the slot 89 (FIG. 19 in the body 1 which opens towards a direction coinci-dent ~ith the plane of the frame, practically does not differ from the originally disclosed embodiment thereof~ It must solely be noted that replacement of the m~gazines in these embodiments of the instru-

- 3~ -~ a ment may be made not until the stem 33 is removed from the U-qhaped member 4 of the ~rame 2.
~ hus, the constructional features of the instru-ment as disclosed in the claims of the invention in contemplation, provide for combination of high rigidi-ty of the instr~ment stitching mechanism, small cross--sectional dimensions of the frame supporting side and the lateral sides thereof, and of the entire stitching mechanism with a possibility of placing staple sutures whose length exceeds the length of the ~emiperimeter of organs compres~ed for suturing. It is due to the aforesa:Ld fact that a surgical ~uture applied by the instrument i~ featured by high reliability and stabili-ty, as well as by hermetic tightness and good hemostatic properties whenever the length o~ the semiperimeter of the organ being sutured is sho~ter than the distance bet-ween the frame lateral sides, and that application of a high-quality suture is assured in cases ~here the length o~ the semiperimeter of the organ being sutured in the released state is either equal to or exceeds th~
distance between the frame lateral sides. The marginal portions of the organ being sutured prove to be sti~ched up at all times9 which has been corroborated by e~peri-mental studies during which trial suturing procedures have been applied to purposely selected portions of the various organs, such as the lungs, inte~tines, the cardiac auricular appendage, etc.~ wherein the length of a whole semiperi~eter e~ceeds the distance between the frame lateral sides. These advantages of the instru-ment disclosed herein render it app]icable in a narrow and deep operative wound; in hard-of-access places, where there is too little space for manipulation with the instrument or with other surgical instruments for placing additional manual sutures after stitching-up the org~n with a mechanical ~suture; whenever applic~-tion of additional manual sutures is quite undersirable, 10 e.g., in case of suturing fine delicate tissues easily penetrable by needle and thread, or when suturing or-gans that have previously been e~posed to beam therapy;
in cases where the stump of the stitched-up organ "es-capes" or slips off just after application of a mecha-15 nical suture, severing the resected portion of -the organ and bringing the magazine and the die apart so that the stump is difficult to identify among the sur-rounding tissues for--revision, or when failure of a mechanical suture might result in profuse bleeding.
Construction of the instrument according to the claims of the present invention improves the quality of applied sutures, e~tends the functional capabilities of the instruments for suturing organs, and makes their application in the various fields of surgery in infants 25 and adults more reliable.

Claims (11)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A surgical instrument for placing linear staple sutures, comprising:
a body;
a closed rectangular frame making part of said body and established by a first and a second lateral side and a third and a fourth side arranged therebet-ween;
a first and a second slot, similar to each other and provided in said respective first and second frame lateral sides, each of said slots having its geometrical axis parallel to said respective first and second late-ral sides of said frame;
a die fixed on said third side of said frame; said die having a plurality of recesses facing inwards said frame, and portions with said extreme recesses situated within said first and second slots;
a staple head mounted in said frame opposite to said die and traversably with respect to the latter;
a detachable staple magazine adapted to be installed stationary in said staple head; said detachable magazine having a number of staple slots and portions with extreme staple slots and adapted to be set in the suturing po-sition with respect to said frame so that said magazine portions with the extreme staple slots be arranged in-side said first and second lateral sides of said frame opposite to said respective portions of said die with the extreme recesses;
a staple ejector movably fitted in said staple head and so arranged as to correspond to said staple slots of said magazine;
an actuator of said staple head, accommodated in said body;
an actuator of said staple ejector, accommodated in said body.

2. A surgical instrument as claimed in Claim 1, wherein said portions of said detachable magazine pro-vided with the extreme staple slots have the same width as said first and second slots in said first and se-cond lateral sides of said frame.

3. A surgical instrument as claimed in Claim 1, wherein said detachable magazine has portions confined within said first and second lateral sides in the sutu-ring position, and guides on said confined portions.

4. A surgical instrument as claimed in Claim 1, wherein said detachable magazine has a stop shaped as a projection and adapted for said magazine to preliminari-ly fix with respect to said staple head and to said first and second slots in said first and second lateral s sides of said frame.

5. A surgical instrument as claimed in Claim 1, wherein a first and a second opening is provided in said first and second lateral side of said frame; said first opening communicating with said second slot.

6. A surgical instrument as claimed in Claim 2, where-in said detachable magazine has a stop shaped as a projection and adapted for said magazine to preliminari-ly fix with respect to said staple head and to said first and second slots in said first and second lateral sides of said frame.

7. A surgical instrument as claimed in Claim 3, wherein said detachable magazine has a Atop shaped as a projection and situated on any of said guides; said stop adapted for said detachable magazine to prelimina-rily fix with respect to said staple head and to said first and second slots in said first and second laterial sides of said frame.

8. A surgical instrument for placing linear staple sutures, comprising:
a body;
a closed rectangular frame making part of said body and formed by a first and a second lateral side and a third and a fourth side arranged therebetween, a first and a second projection situated respectively on said opposite first and second lateral sides of said frame thereinside and close to said third side adjacent to said first and second lateral sides;

a first and a second slot, similar to each other and provided in said respective first and second pro-jections, each of said slots having its geometrical axis parallel to said respective first and second late-ral sides of said frame; said first and second slots opening on the side facing the fourth side of said frame;
a die fixed on said third side of said frame; said die having a plurality of recesses facing inwards said frame, and portions with said extreme recesses situa-ted within said first and second slots;
a staple head mounted in said frame opposite to said die and traversably with respect to the latter;
a detachable staple magazine adapted to be instal-led stationary in said staple head; said detachable maga-zine having a number of staple slots and portions with extreme staple slots and adapted to be set in the suturing position with respect to said frame so that said magazine portions with the extreme staple slots be arranged inside said first and second slots on said first and second lateral sides of said frame opposite to said respective portions of said die with the extreme recesses;
a staple ejector movably mounted in said staple head and so arranged as to correspond to said slots of said magazine;
an actuator of said staple head, accommodated in said body;
an actuator of Aid staple ejector accommodated in said body.

9 A surgical instrument as claimed in Claim 8, wherein said first and second projections are located on part of said first and second lateral sides.

10. A surgical instrument for placing linear staple sutures, comprising:
a body;
a closed rectangular frame making part of said body and formed by a first and a second lateral side and a third and a fourth side arranged therebetween;
a first and a second projection situated respec-tively on said opposite first and second lateral sides of said frame thereinside and close to said third side first and second lateral sides;
a die fixed on said third side of said frame;
said die having a plurality of recesses facing inwards said frame, and portions with said extreme recesses, said portions encompassing said first and second pro-jections situated on said first and second lateral sides of said frame;
a staple head mounted in said frame opposite to said die and traversably with respect to the latter;
a detachable staple magazine adapted to be installed stationary in said staple head; said detachable maga-zine having a number of staple slots and a first and a second slots in each of the end faces thereof, said slots corresponding to said first and second projec-tions on said first and second lateral sides of said frame, said magazine having also portions with said extreme staple slots, said portions encompassing said first and second slots in the end faces of said maga-zine; said detachable magazine adapted to be set in the suturing position with respect to said frame so that said portions with the extreme staple slots are arranged opposite to said respective portions of said die with the extreme recesses;
a staple ejector movably mounted in said staple head and so arranged as to correspond to said staple slots of said magazine;
an actuator of said staple head, accommodated in said body;
an actuator of said staple ejector, accommodated in said body.

11. In a surgical instrument for placing linear staple sutures, comprising;
a body;
a closed rectangular frame making part of said body and formed by a first and a second lateral side and a third and a fourth side arranged therebetween;
a first and a second projection situated res-pectively on said opposite first and second lateral sides of said frame thereinside and close to said third side adjacent to said first and second lateral sides;
a die fixed on said third side of said frame; said die having a plurality of recesses facing inwards said frame, and portions with said extreme recesses, said portions encompassing said first and second projections situated on said first and second lateral sides of said frame;
a staple head mounted in said frame opposite to said die and traversably with respect to the latter;
a detachable staple magazine adapted to be fixed stationary in said staple head and having a body and a number of staple slots in said body;
a staple ejector movably mounted in said staple head and so arranged as to correspond to said staple slots of said magazine;
an actuator of said staple head, accommodated in said body;
an actuator of said staple ejector, accommodated in said body, CHARACTERIZED in that said body of said detachable staple magazine has a first and a second slot on the end faces thereof, said slots corresponding to said first and second projections on said first and second lateral sides of said frame and that said deta-chable magazine has portions with said extreme staple slots, said portions forming said first and second slots in the end faces of said magazine; said detachable staple magazine adapted to be set to the suturing posi-tion with respect to said frame so that said portions with the extreme staple slots are arranged opposite to said respective portions of said die with the extreme recesses.