CN102440816B - 用于执行圆形吻合术的手术吻合装置及其所用的手术吻合钉 - Google Patents
用于执行圆形吻合术的手术吻合装置及其所用的手术吻合钉 Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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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
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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
Abstract
本公开涉及一种砧座组件、一种末端执行器和/或一种适合对中空组织器官的内壁执行曲线或圆形吻合术和/或治疗的手术吻合装置，其中，所述砧座组件包括：具有近端和远端的砧座中心杆，所述中心杆限定中心纵轴线；以及固定于所述砧座中心杆的远端的砧座头。所述砧座头包括：限定组织接触面的砧座板；以及形成在所述砧座板的组织接触面中的多个吻合钉成形穴，其中，多个吻合钉穴中的每个限定弓形纵轴线。本发明尤其涉及用于执行圆形吻合术的手术吻合装置及其所用的手术吻合钉。
Description
相关申请的交叉引用
本申请要求于2010年11月8日提交的序列号为61/410,980的美国临时专利申请，以及2010年10月1日提交的序列号为61/388,788的美国临时专利申请中的每个的利益和优先权，各个所述申请的全部内容通过引用合并于此。
技术领域
本公开通常涉及一种对身体组织施加手术吻合钉的手术吻合装置。本公开尤其涉及适合对内部组织和/或中空组织器官的内壁执行曲线或圆形吻合术和/或治疗的手术吻合装置。
背景技术
吻合术是对分离的中空器官部分进行手术接合。通常，在切除中空组织的病态或有缺陷的部分的手术之后执行吻合术操作，并且要接合剩余的端部分。根据所需的吻合术操作，可以通过圆形、端对端或边对边器官重建方法来接合端部分。
在圆形吻合术操作中，通过吻合器械驱动圆形阵列吻合钉穿过每个器官部分的端部分，并且同时对在被驱动的圆形阵列吻合钉内部的任何组织取芯，以疏通管状通道，从而接合器官部分的两端。专利号为6,053,390、5,588,579、5,119,983、5,005,749、4,646,745、4,576,167和4,473,077的美国专利中描述了用于执行中空器官的圆形吻合术的器械的示例，这些专利的全部内容通过引用合并于此。通常，这些器械都包括细长轴，其近端为用于致动器械的手柄部，其远端布置有吻合钉保持部件。砧座组件安装在器械的远端邻近吻合钉保持部件，所述砧座组件包括砧座杆，砧座杆附接有砧座头。待吻合的中空器官的组织的相对两端部夹紧在砧座头和吻合钉保持部件之间。通过从吻合钉保持部件驱动一个或多个吻合钉以使吻合钉的末端穿过组织并且由砧座头变形来吻合夹紧的组织。通过一个或多个推进器从吻合钉保持部件驱动吻合钉。环形刀具同时被推进对中空器官中的组织取芯，从而疏通器官内的管状通道。
除了中空器官的吻合术之外，执行圆形吻合术的手术吻合装置已经被用于治疗直肠中的内痔。通常，在使用圆形吻合装置治疗痔疮的过程中，手术吻合装置的砧座头和吻合钉保持部件通过肛门插入直肠中，使得砧座头和吻合钉保持部件处于开放或非接近的位置。然后，使用荷包缝合器将患有内痔的组织拉向砧座杆。接下来，砧座头和吻合钉保持部件相互接近，以夹紧位于砧座头和吻合钉保持部件之间的痔疮组织。吻合装置开始工作，切除患有痔疮的组织并吻合被切割的组织。由海因里希(Heinrich)所有的专利号为6,959,851的美国专利公开了治疗痔疮的手术吻合装置，其全部内容通过引用合并于此。
在圆形吻合装置中，与径向靠内的环形行相比，对于径向靠外的环形行来说，通常在每个环形行中的相邻吻合钉成形穴以及对应的吻合钉保持穴之间的间隙或间距更大。吻合钉具有直的钉冠(backspan)，吻合钉成形穴和吻合钉保持穴具有直的纵轴线。内环形行吻合钉成形穴和/或吻合钉保持穴决定每个环形行的吻合钉数量。每个环形行具有相同或相等数量的吻合钉成形穴和/或吻合钉保持穴。相应地，与内环形行相比，在外环形行中，每个环形行中的相邻吻合钉成形穴和/或吻合钉保持穴之间的间隙最大。
因此，需要提供一种圆形手术吻合装置，其中从外环形行到内部组织和/或到内环形行，每个环形行中相邻吻合钉成形穴和/或吻合钉保持穴之间的间隙被减小或在其各个环形行中保持不变。
发明内容
本公开涉及一种砧座组件、一种末端执行器和/或一种适合对中空组织器官的内壁执行曲线或圆形吻合术和/或治疗的手术吻合装置。
根据本公开的一方案，提供了一种用于手术吻合装置的砧座组件。所述砧座组件包括：具有近端和远端的砧座中心杆，所述中心杆限定中心纵轴线；固定于所述砧座中心杆的远端的砧座头。所述砧座头包括：限定组织接触面的砧座板；形成在所述砧座板的组织接触面中的多个吻合钉成形穴，其中，多个吻合钉穴中的每个具有曲线长度。
所述砧座组件可以具有吻合钉成形穴，其中，每个吻合钉成形穴具有从所述中心杆的所述中心纵轴线延伸出的曲率半径。
所述砧座头可以是圆形，所述砧座板限定多个环形行的吻合钉成形穴。吻合钉成形穴的每个环形行可包括相等数量的吻合钉成形穴。
对于所有环形行的吻合钉成形穴，每个环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可以基本相等。所述砧座组件可包括吻合钉成形穴，其中，内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度相对短于外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。
所述砧座板可限定至少两个环形行的吻合钉成形穴，或至少三个环形行的吻合钉成形穴。在某些实施例中，所述砧座板限定内环形行的吻合钉成形穴，中间环形行的吻合钉成形穴，以及外环形行的吻合钉成形穴。
所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。所述外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。
在某些实施例中，所述内环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离基本等于所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可基本等于所述外环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。
在某些实施例中，至少两个相邻环形行的所述吻合钉成形穴中的吻合钉成形穴相互嵌套(nest)。这样可以最大化用于保存吻合钉的所述砧座表面的利用率。而且，至少两个相邻环形行的吻合钉成形穴的嵌套有助于保持吻合钉的径向和纵向间距一致，从而使组织上的压力分布均匀。
根据本公开的另一方案，提供了一种用于手术吻合装置的末端执行器。所述末端执行器包括：砧座组件，其包括具有近端和远端的砧座中心杆，所述中心杆限定中心纵轴线；固定于所述砧座中心杆的远端的砧座头。所述砧座头包括：限定组织接触面的砧座板；以及形成在所述砧座板的组织接触面中的多个吻合钉成形穴，其中，多个吻合钉穴中的每个具有曲线长度。所述末端执行器进一步包括吻合钉钉仓组件，用于限定与砧座组件的多个吻合钉成形穴对应的多个吻合钉保持狭槽，所述吻合钉钉仓组件包括支撑在其中的彼此呈间隔关系的多个手术吻合钉。
在某些实施例中，所述吻合钉钉仓组件的多个吻合钉保持狭槽中的每个具有曲线长度。所述砧座组件的每个吻合钉成形穴可以具有从中心杆的中心纵轴线延伸出的曲率半径。所述吻合钉钉仓组件的每个吻合钉保持狭槽可以具有从手术吻合装置的中心纵轴线延伸出的曲率半径。
所述砧座组件可以为圆形并且限定多个环形行的吻合钉成形穴，所述钉仓组件可以为圆形并且限定多个环形行的吻合钉保持狭槽。
所述砧座组件的每个环形行的吻合钉成形穴可包括相等数量的吻合钉成形穴。所述吻合钉钉仓组件的每个环形行的吻合钉保持狭槽可包括相等数量的吻合钉保持狭槽。
对于所有环形行的吻合钉成形穴，所述砧座组件的每个环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可以基本相等。对于所有环形行的吻合钉成形穴，所述吻合钉钉仓组件的每个环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可以基本相等。
所述砧座组件的内环形行吻合钉成形穴中的每个吻合钉成形穴的长度可以相对短于所述砧座组件的外环形行吻合钉成形穴中的每个吻合钉成形穴的长度。所述吻合钉钉仓组件的内环形行吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对短于所述吻合钉钉仓组件的中间环形行吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。
所述砧座组件的所述砧座板可限定至少两个环形行的吻合钉成形穴，或至少三个环形行的吻合钉成形穴。所述吻合钉钉仓组件可限定至少两个环形行的吻合钉保持狭槽，或至少三个环形行的吻合钉保持狭槽。
所述砧座组件的所述砧座板可限定内环形行的吻合钉成形穴、中间环形行的吻合钉成形穴，以及外环形行的吻合钉成形穴。所述吻合钉钉仓组件可限定内环形行的吻合钉保持狭槽、中间环形行的吻合钉保持狭槽，以及外环形行的吻合钉保持狭槽。
所述砧座组件的所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述砧座组件的所述内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。所述砧座组件的所述外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述砧座组件的所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。
所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对长于所述吻合钉钉仓组件的所述内环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对长于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。
所述砧座组件的所述内环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可基本等于所述砧座组件的所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。所述砧座组件的所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可基本等于所述砧座组件的所述外环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。
所述吻合钉钉仓组件的所述内环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可基本等于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离。所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可基本等于所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离。
所述砧座组件的至少两个相邻环形行的吻合钉成形穴中的吻合钉成形穴可以相互嵌套。所述吻合钉钉仓可以包括具有曲线形状钉冠的手术吻合钉。
所述吻合钉钉仓的每个环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽可以装载有——钉冠具有对应于吻合钉保持狭槽的长度的适当长度的手术吻合钉。所述吻合钉钉仓的每个环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽可以装载有——钉冠具有对应于吻合钉保持狭槽的长度的适当长度的手术吻合钉。
所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠长度可以相对长于所述吻合钉钉仓组件的所述内环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠长度。所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠长度可以相对长于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠长度。
每个手术吻合钉可以包括钉冠和从钉冠的每个相对端悬接的钉腿，其中，所述钉腿限定平面，并且其中，所述钉冠呈弓形并且沿由所述手术吻合钉的钉腿限定的平面向外的方向突出。
根据本公开的另一方案，提供了一种手术吻合装置，其包括：手柄组件，其包含固定手柄、接近机构(approximation mechanism)和用于发射多个手术用紧固件的发射扳机；以及末端执行器，其支撑在手柄组件的远端上。所述末端执行器包括：砧座组件，其包括具有近端和远端的砧座中心杆，所述近端构造为用于选择性地连接接近机构，所述中心杆限定中心纵轴线；以及固定于所述砧座中心杆的远端的砧座头。所述砧座头包括：限定组织接触面的砧座板；以及形成在所述砧座板的组织接触面中的多个吻合钉成形穴，其中，多个吻合钉穴中的每个具有曲线长度。所述末端执行器进一步包括吻合钉钉仓组件，用于限定对应于砧座组件的多个吻合钉成形穴的多个吻合钉保持狭槽，所述吻合钉钉仓组件包含支撑在其中的彼此呈间隔的关系的多个手术吻合钉。
所述吻合钉钉仓组件的多个吻合钉保持狭槽中的每个可具有曲线长度。
所述砧座组件的每个吻合钉成形穴可以具有从中心杆的中心纵轴线延伸出的曲率半径。所述吻合钉钉仓组件的每个吻合钉保持狭槽可以具有从手术吻合装置的中心纵轴线延伸出的曲率半径。
所述砧座组件可以为圆形并且可限定多个环形行的吻合钉成形穴，所述钉仓组件可以为圆形并且可限定多个环形行的吻合钉保持狭槽。
所述砧座组件的各个环形行的吻合钉成形穴可包括相等数量的吻合钉成形穴。
所述吻合钉钉仓组件的各个环形行的吻合钉保持狭槽可包括相等数量的吻合钉保持狭槽。
对于所有环形行的吻合钉成形穴，所述砧座组件的每个环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可以基本相等。对于所有环形行的吻合钉成形穴，所述吻合钉钉仓组件的每个环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可以基本相等。
所述砧座组件的内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对短于所述砧座组件的外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。所述吻合钉钉仓组件的内环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对短于所述吻合钉钉仓组件的外环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。
所述砧座组件的所述砧座板可限定至少两个环形行的吻合钉成形穴，或至少三个环形行的吻合钉成形穴。所述吻合钉钉仓组件可限定至少两个环形行的吻合钉保持狭槽，或至少三个环形行的吻合钉保持狭槽。
所述砧座组件的所述砧座板可限定内环形行的吻合钉成形穴、中间环形行的吻合钉成形穴，以及外环形行的吻合钉成形穴。所述吻合钉钉仓组件可限定内环形行的吻合钉保持狭槽、中间环形行的吻合钉保持狭槽，以及外环形行的吻合钉保持狭槽。
所述砧座组件的所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述砧座组件的所述内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。所述砧座组件的所述外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度可以相对长于所述砧座组件的所述中间环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。
所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对长于所述吻合钉钉仓组件的所述内环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度可以相对长于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽的长度。
所述砧座组件的所述内环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可基本等于所述砧座组件的所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。所述砧座组件的所述中间环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离可基本等于所述砧座组件的所述外环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离。
所述吻合钉钉仓组件的所述内环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可基本等于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离。所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离可基本等于所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离。
所述砧座组件的至少两个相邻环形行的吻合钉成形穴中的吻合钉成形穴可以相互嵌套。
所述吻合钉钉仓的每个环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽可以装载——钉冠具有对应于吻合钉保持狭槽的长度的适当长度的手术吻合钉。
所述吻合钉钉仓的每个环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽可以装载——钉冠具有对应于吻合钉保持狭槽的长度的适当长度的手术吻合钉。所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠的长度可以相对长于所述吻合钉钉仓组件的所述内环形行吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠的长度。所述吻合钉钉仓组件的所述外环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠的长度可以相对长于所述吻合钉钉仓组件的所述中间环形行的吻合钉保持狭槽中的每个吻合钉保持狭槽中装载的手术吻合钉的钉冠的长度。
每个吻合钉可以具有曲线形状的钉冠。每个手术吻合钉可以包括钉冠和从钉冠的每个相对端悬接的钉腿，其中，所述钉腿限定平面，并且其中，所述钉冠呈弓形并且沿由所述手术吻合钉的钉腿限定的平面向外的方向突出。
附图说明
下面将参照附图，说明在此公开的圆形手术吻合装置的各个实施例，其中：
图1是根据本公开的一个实施例的圆形手术吻合装置的立体图；
图2是现有技术壳体组件和砧座组件的后视立体图；
图3是图2所示的现有技术砧座组件和壳体组件的前视立体图；
图4是现有技术手术吻合钉的立体图；
图5是图2和图3所示的砧座组件的砧座板的组织接触面的平面图；
图6是图5所示的细节区域的放大图；
图7是根据本公开的一个实施例的用于圆形吻合装置的砧座组件中的砧座板的平面图；
图8是图7所示的细节区域的放大图；
图9是根据本公开的另一个实施例的砧座组件和壳体组件的纵剖示意图；
图10是根据本公开的一个实施例的用于圆形吻合装置中的钉仓组件的组织接触面的平面图；
图11是图10所示的细节区域的放大图；
图12是根据本公开的另一个实施例的用于圆形吻合装置中的钉仓组件的组织接触面的平面图；
图13是图12所示的细节区域的放大图；
图14是根据本公开的一个实施例的用于圆形吻合装置中的手术吻合钉的立体图；
图15是图14所示的手术吻合钉的正视图；以及
图16是图14和图15所示的手术吻合钉的俯视平面图。
具体实施方式
现在，将参照附图详细说明在此公开的用于圆形吻合装置的砧座组件和钉仓组件的各个示例性实施例，其中，使用相似的附图标记标识相似或相同的元件。如图所示和说明书下文所述，按照本技术领域中的传统和惯例，术语“近侧”是指正确操作时砧座组件、钉仓组件、或圆形吻合装置或其部件的最靠近操作者的一端，而术语“远侧”是指最远离操作者的一端。此外，术语“手术用紧固件”应该被理解为包括由适合将相邻组织部分接合到一起的期望用途的生物相容性材料成形的任何基本刚性结构，包括但不限于手术吻合钉、夹子、两件式紧固件和类似物。
图1示出了通常由附图标记10指代的圆形吻合装置。简言之，手术吻合装置10包括：手柄组件12、从手柄组件12延伸出的细长中央主体部14，以及支撑在中央主体部14的远端上或所述远端处的远侧头部16。所述中央主体部14的长度和/或配置可以变更或改变以满足可使用手术紧固件应用装置的特定手术操作的需要。例如，中央主体部14可以为基本平直形状，如用于治疗痔疮的手术操作时，或者可选择地，所述中央主体部可以为弯曲形状。所述中央主体部可以为柔性的。所述中心体部14和/或所述头部16的横向尺寸也可以被改变以适应特定手术操作。
手柄组件12包括固定手柄20、发射扳机22和能够旋转的接近旋钮24。所述头部16包括壳体组件130和砧座组件140。所述壳体组件130被配置、定尺寸且适于容纳多个手术用紧固件150，所述紧固件的示例可参见图1，所述紧固件用于连接患者组织的相邻部分。吻合钉或其他紧固件可以包含在钉仓或装载单元中。头部16的所述壳体组件130和所述砧座组件140包括附加部件并且执行附加功能，在共同转让人为格雷西姆(Gresham)等人的专利号为7,234,624的美国专利“用于执行圆形吻合术的手术吻合装置(SurgicalStapling Device for Performing Circular Anastomoses)”中讨论了各个附加构件，该专利的全部内容通过引用合并于此。
如图2、图3、图5和图6所示，根据现有技术的砧座组件通常被标识为40。砧座组件40包括砧座中心杆组件42和砧座头组件44。如图2和图3中最佳所示，砧座中心杆组件42包括中心杆42a；如图2、图5和图6所示，砧座头组件44包括砧座头44a和砧座板44b，所述砧座板44b限定用于接收和成形吻合钉的相应吻合钉成形穴48的三个同心环形行46a、46b、46c。
如图5和图6所示，每个吻合钉成形穴48限定线性或平直的纵轴线“Y”。再如图5和图6所示，吻合钉成形穴48的第一或内环形行46a沿半径“R1”布置，吻合钉成形穴48的第二或中间环形行46b沿半径“R2”(大于半径“R1”)布置，并且吻合钉成形穴48的第三或外环形行46c沿半径“R3”(大于半径“R2”)布置。相对于每个吻合钉成形穴48的中点测量每个半径“R1”、“R2”和“R3”。
如图5和图6所示，由于每个吻合钉成形穴48限定线性或平直的纵轴线“Y”，因此从砧座头组件44的吻合唇缘部(lip)44c到每个吻合钉成形穴48的径向距离不一致或不是常数。特别是从吻合唇缘部44c到每个吻合钉成形穴48的中点的径向距离“AL1”小于从吻合唇缘部44c到每个吻合钉成形穴48的任一纵向端的径向距离“AL2”。
此外，如图6所示，由于每个吻合钉成形穴48限定线性或平直的纵轴线“Y”，因此吻合钉成形穴48的相邻环形行46a、46b、46c之间的径向距离“AL3”′也不一致或不是常数。特别地，例如，从吻合钉成形穴48的相对径向靠内环形行(如46a、46b)的每个吻合钉成形穴48的任一纵向端到吻合钉成形穴48的相对径向靠外环形行(如46b、46c)的每个吻合钉成形穴48的中点的径向距离“AL3”小于从吻合钉成形穴48的相对径向靠外环形行(如46b、46c)的每个吻合钉成形穴48的中点到吻合钉成形穴48的相对径向靠内环形行(如46a、46b)的每个吻合钉成形穴48的任一纵向端的径向距离。
如图5和图6所示，由于每个环形行46a、46b和46c包括相等数量的吻合钉成形穴48并且由于每个吻合钉成形穴48具有相等的长度“L”，因此，每个环形行46a、46b、46c中相邻吻合钉成形穴48之间的距离会随着环形行46a、46b、46c的半径增加而增加。特别地，吻合钉成形穴48的第一或内环形行46a限定其中相邻吻合钉成形穴48之间的第一距离“Ga”。吻合钉成形穴48的第二或中间环形行46b限定其中相邻吻合钉成形穴48之间的第二距离“Gb”，该第二距离大于第一或内环形行46a的相邻吻合钉成形穴48之间的第一距离“Ga”。吻合钉成形穴48的第三或外环形行46c限定其中相邻吻合钉成形穴48之间的第三距离“Gc”，该第三距离大于第二或内环形行46b的相邻吻合钉成形穴48之间的第二距离“Gb”。
此外，由于每个吻合钉成形穴48具有平直或线性形状，并且由于全部所述吻合钉成形穴48具有一致或相等的长度“L”，必须选择相邻环形行46a、46b、46c的半径(R1、R2、R3)以使一个环形行46a、46b、46c中的吻合钉成形穴48不会干扰相邻环形行46a、46b、46c中的吻合钉成形穴48。
如图3所示，根据现有技术的吻合钉钉仓组件通常被标识为30。吻合钉钉仓组件30包括布置为三个同心环形行36a、36b、36c的多个吻合钉保持狭槽38。每个吻合钉保持狭槽38被配置为在其中保持手术吻合钉。当砧座组件40连接至圆形吻合装置10时，为了与砧座组件40正确配合，钉仓组件30包括的吻合钉保持狭槽38的数量等于或对应于彼此并置轴向对准的砧座组件40的吻合钉成形穴48的数量。
如图4所示，根据现有技术的手术吻合钉通常被标识为50。每个手术吻合钉50包括钉冠52和从钉冠52的相对端悬接的一对钉腿54、56。如图4所示，手术吻合钉50的钉冠52为基本平直和线性形状，其中钉冠52位于由钉腿54和56限定的平面内。可以参考共同所有和转让的专利号分别为7,611,038和7,398,907的美国专利“方向偏置吻合钉和用于成形吻合钉的砧座组件(Directionally Biased Staple and Anvil Assembly for Forming the Staple)”，每个专利的全部内容通过引用合并于此，用于详细讨论手术吻合钉50。
另外，也可以参考共同转让人为格雷西姆(Gresham)等人的专利号为7,234,624的美国专利“用于执行圆形吻合术的手术吻合装置(Surgical StaplingDevice for Performing Circular Anastomoses)”，该专利的全部内容通过引用合并于此，用于详细讨论和阐述圆形吻合装置10的操作和结构。通常，砧座中心杆连接至砧座固定器，砧座固定器连接至螺杆。旋钮的转动可收回螺杆和砧座固定器，以使砧座和钉仓组件彼此接近。可操纵枢转式手柄以前移推进器连杆，从而前移推进器和刀具，抵靠砧座成形吻合钉，并且切割组织。
还可以参考于2004年2月23日提交的公开号为2005/0187576的美国专利申请“手术切割和吻合装置(Surgical Cutting and Stapling Device)”，该专利公开的全部内容通过引用合并于此，用于详细讨论和阐述电动或机电式圆形吻合装置的操作和结构，该专利中所述的圆形吻合装置可以包含本公开的钉仓组件130和砧座组件140或与它们一起使用，如下文所述。
现在参照图1和图5至图16，根据本公开，其中示出了包含末端执行器和/或与末端执行器一起使用的圆形吻合装置，所述末端执行器具有钉仓组件130、砧座组件140和手术吻合钉150，下面将详细说明。所述手柄组件与细长中央主体部基本如上文所述。可选择地，所述末端执行器可以被配置为与配置有电动机或与电动机或其它能量源一起使用的手柄组件和主体部、轴和/或适配器一起使用。
如图7和图8所示，根据本公开的一个实施例，砧座组件通常被标识为140。砧座组件140包括砧座头144a和砧座板144b，所述砧座板限定用于接收和成形吻合钉的相应吻合钉成形穴148a、148b、148c的多个同心环形行146a、146b、146c。
如图7和图8所示，每个吻合钉成形穴148限定环形或弓形的纵轴线“Y1”。所述吻合钉成形穴为曲边矩形形状(curved oblong shape)。每个所述吻合钉成形穴的曲线长度(curved length)遵循所述砧座板的弓形面的形状。所述吻合钉成形穴具有新月形双凹面形状，以接收具有弯曲形状钉冠的吻合钉。再如图7和图8所示，吻合钉成形穴148的第一或内环形行146a沿半径“R4”布置，吻合钉成形穴148的第二或中间环形行146b沿半径“R5”(大于半径“R4”)布置，并且吻合钉成形穴148的第三或外环形行146c沿半径“R6”(大于半径“R5”)布置。相对于每个吻合钉成形穴148的中点测量每个半径“R4”、“R5”和“R6”。
由于每个吻合钉成形穴148限定环形或弓形的纵轴线“Y1”，因此，砧座组件140的相应第一或内环形行146a和第二或中间环形行146b的半径“R4”和“R5”之间的相对径向距离可以小于砧座组件40的相应第一或内环形行46a和第二或中间环形行46b的半径“R1”和“R2”之间的相对径向距离。
此外，砧座组件140的相应第二或中间环形行146b和第三或外环形行146c的半径“R5”和“R6”之间的相对径向距离可以小于砧座组件40的相应第二或中间环形行46b和第三或外环形行46c的半径“R2”和“R3”之间的相对径向距离。这样，吻合钉成形穴148a、148b和148c的环形行146a、146b和146c彼此之间可以更接近地堆置。
继续参照图7和图8，对于相应的环形行146a、146b、146c，每个吻合钉成形穴148限定环形或弓形的纵轴线“Ya、Yb和Yc”，并且每个环形行146a、146b和146c包括相等数量的吻合钉成形穴148。各环形行146a、146b、146c中的各吻合钉成形穴148a、148b、148c的长度“La”、“Lb”和“Lc”可以沿径向向外方向增加。特别地，第二或中间环形行146b中的吻合钉成形穴148b的长度“Lb”可以大于第一或内环形行146a中的吻合钉成形穴148a的长度“La”；并且第三或外环形行146c中的吻合钉成形穴148c的长度“Lc”可以大于第二或中间环形行146b中的吻合钉成形穴148b的长度“Lb”。
按这种方式，如图7和图8所示，由于各吻合钉成形穴148a、148b和148c的长度“La”、“Lb”和“Lc”之间存在差异，因此每个相应环形行146a、146b、146c中的相邻吻合钉成形穴148a、148b、148c之间的距离可以基本相等。特别地，吻合钉成形穴148a的所述第一或内环形行146a限定其中相邻吻合钉成形穴148a之间的第一距离“Ga”。吻合钉成形穴148b的所述第二或中间环形行146b限定其中相邻吻合钉成形穴148b之间的第二距离“Gb”，该第二距离基本等于第一或内环形行146a的相邻吻合钉成形穴148a之间的第一距离“Ga”。吻合钉成形穴148c的所述第三或外环形行146c限定第三距离“Gc”，该第三距离基本等于第一或内环形行146a的相邻吻合钉成形穴148a之间的第一距离“Ga”和第二或中间环形行146b的相邻吻合钉成形穴148b之间的第二距离“Gb”。
此外，每个吻合钉成形穴148a、148b、148c可以包括周边轮廓或覆盖区(footprint)，周边轮廓或覆盖区具有由一对平行的弓形侧壁限定的中央部，一对平行的弓形侧壁将由放大的球状或圆形壁限定的一对端部相连。可以参考共同所有和转让的专利号分别为7,611,038和7,398,907的美国专利“方向偏置吻合钉和用于成形吻合钉的砧座组件(Directionally Biased Staple and AnvilAssembly for Forming the Staple)”，各个专利的全部内容通过引用合并于此，用于详细讨论吻合钉成形穴148a、148b、148c的端部。
按这种方式，如图7和图8所示，各环形行146a、146b和146c中的吻合钉成形穴148a、148b和148c可以相互嵌套。可利用冲压、模压或其他方法来形成所述吻合钉成形穴。可使用平版印刷法和/或微电解法。可使用微电解分离法在砧座板中形成所述吻合钉成形穴，以使所述吻合钉成形穴具有曲线长度。
如图7和图8所示，由于相应环形行146a、146b和146c中的每个吻合钉成形穴148a、148b、148c分别限定弓形的纵轴线“Ya、Yb、Yc”，因此从砧座头组件144的吻合唇缘部144c到相应环形行146a、146b和146c中的每个吻合钉成形穴148a、148b、148c的径向距离基本一致或是常数。特别地，从吻合唇状部144c到相应环形行146a、146b和146c中的每个吻合钉成形穴148a、148b、148c的中点的径向距离“AL1”基本等于从吻合唇缘部144c到相应环形行146a、146b和146c中的每个吻合钉成形穴148a、148b、148c的任一纵向端的径向距离“AL2”。
此外，如图7所示，由于相应环形行146a、146b和146c中的每个吻合钉成形穴148a、148b、148c分别限定弓形的纵轴线“Ya、Yb、Yc”，因此吻合钉成形穴148a、148b、148c的相邻环形行146a、146b、146c之间的径向距离AL3”也基本一致或是常数。特别地，例如，从吻合钉成形穴148的相对径向靠内环形行(如146a、146b)中的每个吻合钉成形穴148a、148b的任一纵向端到吻合钉成形穴148的相对径向靠外环形行(如146b、146c)中的每个吻合钉成形穴148b、148c的中点的径向距离“AL3”小于从吻合钉成形穴148的相对径向靠外环形行(如146b、146c)中的每个吻合钉成形穴148b、148c的中点到吻合钉成形穴148的相对径向靠内环形行(如146a、146b)中的每个吻合钉成形穴148a、148b的任一纵向端的径向距离。
如图10和图11所示，根据本公开的一个实施例，吻合钉钉仓组件通常被标识为130。吻合钉钉仓组件130包括布置为三个同心环形行136a、136b、136c的多个吻合钉保持狭槽138。每个吻合钉保持狭槽138被配置为在其中保持手术吻合钉。当砧座组件140连接至圆形吻合装置10时，为了与砧座组件140正确配合，钉仓组件130包括的吻合钉保持狭槽138的数量等于或对应于彼此并置轴向对准的砧座组件140的吻合钉成形穴148的数量。
如图10和图11所示，对于各环形行136a、136b、136c，每个吻合钉保持狭槽138限定环形或弓形的纵轴线“Ya、Yb和Yc”。所述吻合钉保持狭槽具有曲边矩形形状。每个所述吻合钉保持狭槽的所述曲线长度遵循所述钉仓组件的所述弓形面的形状。所述吻合钉保持狭槽具有新月形双凹面形状，以接收具有弯曲形状钉冠的吻合钉。相应环形行136a、136b、136c中的吻合钉保持狭槽138的弓形纵轴线“Ya、Yb和Yc”与相应环形行146a、146b、146c中的吻合钉成形穴148的弓形纵轴线“Ya、Yb和Yc”大致相似或具有大致相似的曲率半径。再如图10和图11所示，吻合钉保持狭槽138的第一或内环形行136a具有半径“R4”，吻合钉保持狭槽138的第二或中间环形行136b具有半径“R5”(大于半径“R4”)，并且吻合钉保持狭槽138的第三或外环形行136c具有半径“R6”(大于半径“R5”)。相对于每个吻合钉保持狭槽138的中点测量每个半径“R4”、“R5”和“R6”。此外，每个环形行136a、136b、136c中的每个吻合钉保持狭槽138a、138b、138c的半径沿其整个长度为基本常数或一致。
继续参照图10和图11，每个吻合钉保持狭槽138a、138b、138c限定相应的环形或弓形的纵轴线“Ya、Yb和Yc”，环形行136a、136b和136c包括相等数量的吻合钉保持狭槽138。相应环形行136a、136b、136c中的相应吻合钉保持狭槽138a、138b、138c的长度“La”、“Lb”和“Lc”可以沿径向向外方向增加。特别地，第二或中间环形行136b中的吻合钉保持狭槽138b的长度“Lb”可以大于第一或内环形行136a中的吻合钉保持狭槽138a的长度“La”；并且第三或外环形行136c中的吻合钉保持狭槽138c的长度“Lc”可以大于第二或中间环形行136b中的吻合钉保持狭槽138b的长度“Lb”。换言之，每个相应环形行136a、136b、136c中的每个吻合钉保持狭槽138a、138b、138c的长度与每个相应环形行146a、146b、146c中的相应吻合钉成形穴148a、148b、148c的长度“La”、“Lb”和“Lc”基本相对应或相关。
按这种方式，如图10和图11所示，由于相应吻合钉保持狭槽138a、138b和138c的长度“La”、“Lb”和“Lc”之间存在差异，因此每个相应环形行136a、136b、146c中的相邻吻合钉保持狭槽138a、138b和138c之间的距离可以基本相等。特别地，吻合钉保持狭槽138a的所述第一或内环形行136a限定相邻吻合钉保持狭槽138a之间的第一距离“Ga”，吻合钉保持狭槽138b的所述第二或中间环形行136b限定基本等于第一距离“Ga”的第二距离“Gb”，并且吻合钉保持狭槽138c的所述第三或外环形行136c限定基本等于相邻吻合钉保持狭槽138a之间的第一距离“Ga”和相邻吻合钉保持狭槽138b之间的第二距离“Gb”的第三距离“Gc”。
如图10和图11所示，由于相应环形行136a、136b和136c中的每个吻合钉保持狭槽138a、138b、138c分别限定弓形纵轴线“Ya、Yb、Yc”，因此从钉仓组件140的吻合唇缘部130c到相应环形行136a、136b和136c中的每个吻合钉保持狭槽138a、138b、138c的径向距离基本一致或是常数。特别地，从吻合唇状部130c到相应环形行136a、136b和136c中的每个吻合钉保持狭槽138a、138b、138c的中点的径向距离“AL1”基本等于从吻合唇缘部130c到相应环形行136a、136b和136c中的每个吻合钉保持狭槽138a、138b、138c的任一纵向端的径向距离“AL2”。
此外，如图11所示，由于相应环形行136a、136b和136c中的每个吻合钉保持狭槽138a、138b、138c分别限定弓形纵轴线“Ya、Yb、Yc”，因此吻合钉保持狭槽138a、138b、138c的相邻环形行136a、136b、136c之间的径向距离“AL3”也基本一致或是常数。特别地，例如，从吻合钉保持狭槽138的相对径向靠内环形行(如136a、136b)的每个吻合钉保持狭槽138a、138b的任一纵向端到吻合钉保持狭槽138的相对径向靠外环形行(如136b、136c)的每个吻合钉保持狭槽138b、138c的中点的径向距离“AL3”小于从吻合钉保持狭槽138的相对径向靠外环形行(如136b、136c)的每个吻合钉保持狭槽138b、138c的中点到吻合钉保持狭槽138的相对径向靠内环形行(如136a、136b)的每个吻合钉保持狭槽138a、138b的任一纵向端的径向距离。
暂时参照图9，吻合钉钉仓组件130可以具有与专利号为7,398,908的美国专利“包括具有多个吻合钉尺寸的钉仓的手术吻合器械(Surgical StaplingInstruments Including a Cartridge having Multiple Staple Sizes)”中所示和所述的任何组织接触面基本相似的阶梯状组织接触面140a，该专利的全部内容通过引用合并于此。
现在参照图12和图13，根据本公开的另一个实施例，其中示意性地示出了砧座组件140的吻合钉成形穴248，下面将详细说明。如图12和图13所示，每个吻合钉成形穴248限定弯折(bent)或非线性的纵轴线，以便接近弯曲或弓形的纵轴线。特别地，如图13所示，每个吻合钉成形穴248至少包括用于限定第一线性纵轴线“Y1”的第一段248a和用于限定第二线性纵轴线“Y2”的第二段248b，其中第一段248a与第二段248b之间的夹角为“α”。
尽管前面已经参照图12和图13描述了砧座组件140的吻合钉成形穴，在本公开的范围内，上述内容也基本等同地适用于吻合钉钉仓组件的吻合钉保持狭槽。
如图14至图16所示，根据本公开的实施例，手术吻合钉通常被标识为150。每个手术吻合钉150包括钉冠152和从钉冠152的相对端悬接的一对钉腿154和156。如图14和图16所示，手术吻合钉150的钉冠152为弯曲形状并且限定弓形纵轴线“Y3”，其中钉冠152从由钉腿154和156限定的平面向外延伸。手术吻合钉150的钉冠152的弓形纵轴线“Y3”与相应吻合钉成形穴148a、148b、148c的弓形纵轴线“Ya、Yb、Yc”和/或吻合钉保持狭槽138a、138b、138c的弓形纵轴线“Ya、Yb、Yc”基本相似或具有基本相似的曲率半径。
此外，根据本公开，根据手术吻合钉150被装载到吻合钉保持狭槽138a、138b、138c的哪个环形行136a、136b、136c，手术吻合钉150的钉冠152具有的长度“La”、“Lb”或“Lc”将对应于相应吻合钉保持狭槽138a、138b、138c的长度“La”、“Lb”和“Lc”。特别地，装载到吻合钉保持狭槽138a的第一或内环形行136a中的手术吻合钉150将具有长度为“La”的钉冠152，装载到吻合钉保持狭槽138b的第二或中间环形行136b中的手术吻合钉150具有长度为“Lb”的钉冠152，并且装载到吻合钉保持狭槽138c的第三或外环形行136c中的手术吻合钉150具有长度为“Lc”的钉冠152。可构思的是，随着手术吻合钉150的钉冠152的长度“La”、“Lb”和“Lc”增加，手术吻合钉150的钉腿154和156的对应长度会下降，因此，用于形成出吻合钉保持狭槽138a、138b、138c的相应环形行136a、136b、136c中装载的手术吻合钉150的材料的总长度基本保持不变。
此外，根据本公开，可理解的是，装载到吻合钉保持狭槽138a的第一或内环形行136a中的手术吻合钉150将具有曲率半径为“R4”的钉冠152，装载到吻合钉保持狭槽138b的第二或中间环形行136b中的手术吻合钉150具有曲率半径为“R5”的钉冠152，并且装载到吻合钉保持狭槽138c的第三或外环形行136c中的手术吻合钉150具有曲率半径为“R6”的钉冠152。用于驱动吻合钉的一个推进器构件(或多个推进器构件)将具有各自的推板，所述推板弯曲以对应于吻合钉的钉冠的形状。
上面所述的吻合钉成形穴和吻合钉保持狭槽具有内行的穴(或狭槽)，所述内行的穴(或狭槽)与布置在内行的外侧的相邻行的穴(或狭槽)间隔开相同的距离。因为与上文结合图2至图4所述的装置相比靠外布置的行中的穴(或狭槽)的间距已经减小，所以潜在的遗漏路径显著变小。
对于上述手术吻合装置、末端执行器和/或砧座组件，可以使用两个环形行的手术吻合钉、两个环形行的吻合钉保持狭槽和两个环形行的吻合钉成形穴。所述环形行可以为圆形、卵形、半圆形或弧的形状。另外，每个吻合钉保持狭槽和吻合钉成形穴的纵轴线可以成角度或弯折以便接近弧形。在具有线性钳夹或其他形状钳夹的手术吻合装置和末端执行器中，可以使用具有曲线长度的吻合钉保持狭槽行和吻合钉成形穴行。
上述说明包含许多实施例，但是这些实施例不应被理解为对本公开的范围的限制，而只能理解为各种实施例的示例。因此，上述说明不应被理解为对本发明的限制，而只能理解为各种实施例的范例。本领域的技术人员在本公开的范围和精神之内可以设计其他修改方案。
Claims (10)
1.一种手术吻合装置，包括：
手柄组件，其包括固定手柄、接近机构和用于发射多个手术用紧固件的发射扳机；以及
末端执行器，其支撑在所述手柄组件的远端上，所述末端执行器包括：
砧座组件，包括：
具有近端和远端的砧座中心杆，所述近端构造为用于选择性连接至所述接近机构，所述中心杆限定中心纵轴线；以及
固定于所述砧座中心杆的所述远端的砧座头，所述砧座头包括：
限定组织接触面的砧座板；以及
形成在所述砧座板的所述组织接触面中的多个吻合钉成形穴，其中，所述多个吻合钉成形穴中的每个具有曲线长度；以及
吻合钉钉仓组件，其限定了与所述砧座组件的多个吻合钉成形穴对应的多个吻合钉保持狭槽，所述吻合钉钉仓组件包括支撑在其中的彼此呈间隔关系的多个手术吻合钉，
所述砧座组件限定三个环形行的吻合钉成形穴，至少两个相邻环形行的所述吻合钉成形穴中的吻合钉成形穴相互嵌套。
2.根据权利要求1所述的手术吻合装置，其中，所述吻合钉钉仓组件的所述多个吻合钉保持狭槽中的每个具有曲线长度。
3.根据权利要求2所述的手术吻合装置，其中，所述砧座组件的每个吻合钉成形穴具有从所述中心杆的所述中心纵轴线延伸出的曲率半径。
4.根据权利要求3所述的手术吻合装置，其中，所述吻合钉钉仓组件的每个吻合钉保持狭槽具有从所述手术吻合装置的中心纵轴线延伸出的曲率半径。
5.根据权利要求4所述的手术吻合装置，其中，所述砧座组件为圆形，并且所述钉仓组件为圆形并且限定多个环形行的吻合钉保持狭槽。
6.根据权利要求1所述的手术吻合装置，其中，所述砧座组件的各个环形行的吻合钉成形穴包括相等数量的吻合钉成形穴。
7.根据权利要求5所述的手术吻合装置，其中，所述吻合钉钉仓组件的各个环形行的吻合钉保持狭槽包括相等数量的吻合钉保持狭槽。
8.根据权利要求7所述的手术吻合装置，其中，对于所有环形行的吻合钉成形穴，所述砧座组件的每个环形行的吻合钉成形穴中的相邻吻合钉成形穴之间的距离基本相等。
9.根据权利要求8所述的手术吻合装置，其中，对于所有环形行的吻合钉成形穴，所述吻合钉钉仓组件的每个环形行的吻合钉保持狭槽中的相邻吻合钉保持狭槽之间的距离基本相等。
10.根据权利要求9所述的手术吻合装置，其中，所述砧座组件的相对靠内环形行的吻合钉成形穴中的每个吻合钉成形穴的长度相对短于所述砧座组件的相对靠外环形行的吻合钉成形穴中的每个吻合钉成形穴的长度。
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| US13/207,653 US9750502B2 (en) | 2010-10-01 | 2011-08-11 | Surgical stapling device for performing circular anastomosis and surgical staples for use therewith |
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| CN102440816A CN102440816A (zh) | 2012-05-09 |
| CN102440816B true CN102440816B (zh) | 2016-08-31 |
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| EP (1) | EP2436318B1 (zh) |
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- 2011-08-26 AU AU2011218605A patent/AU2011218605B2/en not_active Ceased
- 2011-09-07 JP JP2011195041A patent/JP6247810B2/ja active Active
- 2011-09-09 CN CN201110274263.8A patent/CN102440816B/zh not_active Expired - Fee Related
- 2011-09-09 EP EP11250769.4A patent/EP2436318B1/en active Active
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Also Published As
| Publication number | Publication date |
|---|---|
| CA2749709C (en) | 2018-08-14 |
| US20200054339A1 (en) | 2020-02-20 |
| JP6247810B2 (ja) | 2017-12-13 |
| US9750502B2 (en) | 2017-09-05 |
| US20120080492A1 (en) | 2012-04-05 |
| EP2436318A2 (en) | 2012-04-04 |
| JP2012075872A (ja) | 2012-04-19 |
| CA2749709A1 (en) | 2012-04-01 |
| EP2436318A3 (en) | 2013-08-28 |
| US11357507B2 (en) | 2022-06-14 |
| CN102440816A (zh) | 2012-05-09 |
| AU2011218605A1 (en) | 2012-04-19 |
| AU2011218605B2 (en) | 2014-07-31 |
| EP2436318B1 (en) | 2016-11-02 |
| US10537331B2 (en) | 2020-01-21 |
| US20170360444A1 (en) | 2017-12-21 |
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