CN104042288A

CN104042288A - Operation anastomosis device

Info

Publication number: CN104042288A
Application number: CN201310084096.XA
Authority: CN
Inventors: 陈琳
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2013-03-15
Filing date: 2013-03-15
Publication date: 2014-09-17
Also published as: WO2014139440A1

Abstract

The invention discloses an operation anastomosis device, which comprises a handle part, a thin and long main body part and a far side head part, wherein the thin and long main body part extends from the handle part to the far side, the far side head part comprises an anvil assembly and a replaceable anastomosis assembly, the replaceable anastomosis assembly comprises a pusher and a plurality of anastomosis nails, an ejection assembly extends between the handle part and the replaceable anastomosis assembly, and comprises a pusher connecting piece, the pusher connecting piece is releasably engaged with the pusher, and can movably drive the pusher to move, an approaching assembly extends between the handle part and the far side head part, and comprises an anvil retainer, the anvil retainer releasably supports the anvil assembly, a first engaging sleeve ring can be rotationally supported around the far end of the thin and long main body, and is releasably engaged with the replaceable anastomosis assembly, a casing of the handle part releasably supports one or a plurality of modular assemblies to assist a clinical doctor in using the device, and each modular assembly comprises an indicator assembly or a locking assembly.

Description

Surgical stapling apparatus

Technical field

The disclosure relates generally to a kind of for surgical stapling nail is applied to systemic surgical stapling apparatus, and relates more particularly to a kind of for implementing the identical surgical stapling apparatus of annular of hollow tissue structure.

Background technology

The operation link of the hollow tissue part that refers to separation of coincideing.Typically, identical operation is to carry out after the operation of ill or defective part that removes hollow tissue structure, thereby needs the link of the remaining terminal part of organizational structure.Depend on performed specific operation and/or other factors, can coincide by annular (for example end to end anastomosis, end to side-to-side anastomosis or side to side-to-side anastomosis) links the end portion of described tissue.

Coincide in operation in annular, link two end portion of pipe with stapling apparatus, the annular array that described stapling apparatus drives anastomosis staple by each end portion so that end portion is connected to each other and take out any tissue in the new hollow tissue structure linking to clear up the passage by described hollow tissue structure qualification with end-to-end relation simultaneously.Typical annular stapling apparatus comprises slender axles, and it has in the handle portion of proximal end with at the anastomosis staple holding member of far-end.Comprise that the anvil assembly of anvil stem and attached anvil head is arranged on the far-end of described slender axles, next-door neighbour's anastomosis staple holding member.In use, end portion to be linked is sandwiched between anvil head and anastomosis staple holding member.The end portion of having clamped is then by driving from one or more anastomosis staples of described anastomosis staple holding member by organizing and entering anvil head so that anastomosis staple is shaped connected to each other around at tissue.Authorizing the 7th of Milliman, 857, No. 187 United States Patent (USP)s (" 187 patent ") and authorize the 6th, 945 of the people such as Gresham, the example of having described this type of annular stapling apparatus in No. 444 United States Patent (USP)s (" 444 patent "), its full content is incorporated herein by reference.

Typically, after once using, be discardable for the surgical stapling apparatus of implementing the identical operation of annular.Because the cost of health care rises, for comprise can reusable parts and be constructed to be beneficial to sterilization that can reusable parts surgical stapling apparatus there are needs.

Summary of the invention

The invention discloses a kind of surgical stapling apparatus, the elongated body portions that it comprises handle portion, distad extend from described handle portion and comprise anvil assembly and the distally head of interchangeable anastomotic component.Described interchangeable anastomotic component comprises pusher and multiple anastomosis staple.Described pusher is movable, to penetrate anastomosis staple from described interchangeable anastomotic component.Emitting module extends and comprises that pusher connector, described pusher connector are pieceable and be movable to cause the motion of described pusher releasedly with described pusher between described handle portion and described interchangeable anastomotic component.Approach assembly extends between described handle portion and distally head.Approach assembly and comprise anvil block keeper, it is constructed to support releasedly described anvil assembly.Described approach assembly be can activate to make described anvil assembly with respect to described interchangeable anastomotic component motion.The first engagement collar supports rotationally around the far-end of described elongated body portions, and is constructed to engage releasedly described interchangeable anastomotic component.

In an embodiment, described interchangeable anastomotic component comprises the shell that holds described pusher.Described shell has and comprises that externally threaded near-end, described external screw thread are constructed to engage releasedly the female thread being formed in described the first engagement collar.

Described elongated body portions can comprise outer tube, and described the first engagement collar is supported rotationally around the far-end of described outer tube.

In an embodiment, wherein said outer tube comprises annular flange flange, and described annular flange flange is oriented to prevent that described the first engagement collar from sliding and departing from the far-end of described outer tube.

In an embodiment, the second engagement collar supports rotationally around the near-end of described outer tube, and described handle portion comprises housing.Described the second engagement collar is constructed to engage releasedly described housing, to contribute to the separation of described outer tube from described housing.Described the second engagement collar can comprise that female thread and described housing can comprise external screw thread, and described external screw thread is constructed to engage releasedly the female thread of described engagement collar, releasedly described outer tube is fixed to described housing.

In an embodiment, described handle portion comprises housing, the proximal portion that it supports the proximal portion of described emitting module and approaches assembly.Modular indicator assemblies can be fixed to described housing releasedly.Described modular indicator assemblies can be constructed to be fixed to described housing for clinicist provides instruction and can be used as a unit by least one screw in the time that described device is in ready-to-go-round position.

In an embodiment, described housings support modular safety interlocking assembly, modular safety interlocking assembly is constructed to block the pivoting action of latch members, for stoping the action of described emitting module.Described locking assembly comprises installing plate, and described installing plate is fixed to described housing releasedly by screw, to contribute to safety interlocking assembly to be easily attached to described housing or to remove from described housing in unit as a whole.

In an embodiment, the described assembly that approaches comprises: drive screw, it defines helical channel; The sleeve assembly that can rotate, it comprises the brake that is positioned at described helical channel; And rotating knob, it is fixed to the described sleeve assembly that can rotate.Described rotating sleeve assembly is rotatably fixed to described housing and can relatively described driving screw turns, to realize the longitudinal translation of described driving screw in described housing.

Described rotating sleeve assembly can comprise the sleeve with annular flange flange.Described device can also comprise: first collar, and it is fixed to the near-end of described housing; And second collar, it is fixed to described first collar, and wherein said first collar and second collar define annular recess, and annular recess is constructed to receive rotationally the annular flange flange on described sleeve.

In an embodiment, described first collar is fixed to the near-end of described housing releasedly, for example, be threadedly engaged with described housing.

In an embodiment, described pusher connector comprises that L-type slit and described pusher comprise finger, and described finger can rotate to engage with described L-type slit, thereby described pusher is fixed to described pusher connector releasedly.

In an embodiment, multiple anastomosis staples of described interchangeable anastomotic component are supported in annular anastomosis staple guiding cap.

The invention also discloses surgical stapling apparatus, described surgical stapling apparatus comprises: handle portion; Elongated body portions, it distad extends from described handle portion; Distally head, the interchangeable anastomotic component that it comprises anvil assembly and holds multiple anastomosis staples; Emitting module, it extends between described handle portion and described interchangeable anastomotic component; And approaching assembly, it extends between described handle portion and described distally head.Described approach assembly be can activate to make described anvil assembly with respect to described interchangeable anastomotic component motion.In one embodiment, at least one modular assembly be fixed to described housing and can remove from described housing as single unit to contribute to the sterilization of described device.

Described modular assembly can be, indicator assemblies be used to clinicist to identify that anvil assembly has approached and described device in ready-to-go-round position.Alternately, described modular assembly can be safety interlocking assembly.

Brief description of the drawings

At this, various embodiment of surgical stapling apparatus of the present disclosure are described with reference to accompanying drawing, wherein:

Fig. 1 is the side isometric view of the far-end of the embodiment of surgical stapling apparatus of the present disclosure, and anvil assembly is attached to this device;

Fig. 2 is the side view of the surgical stapling apparatus that removes anvil assembly that shows in Fig. 1;

Fig. 3 is the top perspective view that the near-end of the surgical stapling apparatus that shows in Fig. 2 is seen;

Fig. 4 is the axonometric chart of the amplification of the handle portion of the surgical stapling apparatus that shows in Fig. 3;

Fig. 5 is the side isometric view of the amplification of the handle portion that removes of the housing that shows in Fig. 4;

Fig. 6 is the cutaway view along the hatching 6-6 of Fig. 5;

Fig. 7 is the cutaway view along the hatching 7-7 of Fig. 5;

Fig. 8 is the exploded perspective view of the surgical stapling apparatus that shows in Fig. 1;

Fig. 9 is the exploded perspective view of the interchangeable anastomotic component of the surgical stapling apparatus that shows in Fig. 1;

Figure 10 is the side isometric view of the far-end of the surgical stapling apparatus that shows in Fig. 2, and interchangeable anastomotic component separates with the outer tube of surgical stapling apparatus;

Figure 11 is the side isometric view of the pusher of the interchangeable anastomotic component that shows in Figure 10;

Figure 12 is the side isometric view of the far-end of the surgical stapling apparatus that shows in Fig. 2, and its interchangeable anastomotic component separates with outer tube and outer tube is partly clipped to expose the far-end of pusher connector;

Figure 13 is the side isometric view of the far-end of the surgical stapling apparatus that shows in Figure 12, and when interchangeable anastomotic component is connected to the pusher connector of surgical stapling apparatus, outer tube is partly clipped to expose pusher connector;

Figure 14 has rotated and after engaging with the pusher connector of surgical stapling apparatus at the pusher of interchangeable anastomotic component, the side isometric view of the far-end of the surgical stapling apparatus showing in Figure 13;

Figure 15 is while interchangeable anastomotic component being fixed to outer tube in engagement collar rotation, the side isometric view of the far-end of the surgical stapling apparatus showing in Figure 14;

Figure 16 is the side isometric view of the emitting module of the surgical stapling apparatus that shows in Fig. 1;

Figure 17 is the side isometric view of the decomposition of the emitting module that shows in Figure 16;

Figure 18 is the side view of the pusher connector of the emitting module that shows in Figure 17;

Figure 19 is the cutaway view of the longitudinal axis of the pusher connector that shows in Figure 18;

Figure 20 is the cutaway view of the longitudinal axis along the pusher connector that in Figure 19 show of pusher connector when being out of shape and being received within outer tube;

Figure 21 is the side isometric view that approaches assembly of the surgical stapling apparatus that shows in Fig. 1;

Figure 22 is the axonometric chart of the amplification of the details area of the instruction that shows in Figure 21;

Figure 23 is the side isometric view of the amplification of the described near-end that approaches assembly;

Figure 24 is the side isometric view of the decomposition that approaches assembly that shows in Fig. 1;

Figure 25 is the view of the amplification of the details area of the instruction that shows in Figure 24;

Figure 26 is the cutaway view of obtaining along the hatching 26-26 of Figure 25;

Figure 27 is the side isometric view of the safety interlocking assembly of the handle portion of the surgical stapling apparatus that shows in Fig. 1;

Figure 28 is the side isometric view of the decomposition of the safety interlocking assembly that shows in Figure 27;

Figure 29 is the top perspective view of the indicator assemblies of the handle portion of the surgical stapling apparatus that shows in Fig. 1;

Figure 30 is the face upwarding stereogram of the indicator assemblies that shows in Figure 29;

Figure 31 is the top perspective view of the decomposition of the indicator assemblies that shows in Figure 29;

Figure 32 is the side isometric view of the decomposition of the housing parts of the handle portion of the surgical stapling apparatus that shows in Fig. 1;

Figure 33 is the side view cutaway drawing of the surgical stapling apparatus that has removed anvil assembly that shows in Fig. 1;

Figure 34 is the view of the amplification of the details area of the instruction that shows in Figure 33;

Figure 35 is the view of the amplification of the details area of the instruction that shows in Figure 33;

Figure 36 is the view of the amplification of the details area of the instruction that shows in Figure 35;

Figure 37 is the side view cutaway drawing of obtaining along the hatching 37-37 of Figure 35;

Figure 38 is the side view cutaway drawing of the handle portion of the surgical stapling apparatus that shows in Fig. 1, and its position is corresponding to the approximated position of anvil assembly;

Figure 39 is the view of the amplification of the details area of the instruction that shows in Figure 38;

Figure 40 is the cutaway view of the far-end of the anvil assembly that shows in Fig. 1 surgical stapling apparatus while being positioned at approximated position;

Figure 41 is the cutaway view of the handle portion of the surgical stapling apparatus that shows in Fig. 1, and its position is corresponding to the transmitting site of surgical stapling apparatus; And

Figure 42 is the cutaway view of the far-end of the surgical stapling apparatus that is positioned at transmitting site that shows in Fig. 1.

Detailed description of the invention

Describe the embodiment of surgical stapling apparatus of the present disclosure in detail now with reference to these accompanying drawings, in these accompanying drawings, identical Reference numeral represents identical or corresponding element in each view.In whole description, term " nearside " by refer to the part that approaches user most of device and term " distally " by refer to device away from the part of user.

Fig. 1 to Figure 42 has shown the embodiment of the surgical stapling apparatus conventionally showing with Reference numeral 10 of the present disclosure.Specifically referring to figs. 1 through Fig. 7, surgical stapling apparatus 10 comprises proximal handle portion 20, elongated central body portion 30 and distally head 40.Proximal handle portion 20 comprises housing 22, transmitting trigger 24, safety interlocking assembly 25, rotating knob 26 and the indicator assemblies 27 of approaching.Housing 22 supports indicator assemblies 27 and comprises the first housing 22a and the second housing 22b, and these housings will further discuss in detail below.

Referring to figs. 1 through Fig. 3 and Fig. 8, the elongated central body portion 30 of surgical stapling apparatus 10 comprises bending elongated outer tube 32, and elongated outer tube 32 has the engagement collar 36a of the far-end that is arranged in outer tube 32 and is arranged in the engagement collar 36b of the proximal end of outer tube 32.Alternately, elongated outer tube 32 can be linear for example, to be applicable to specific operation technique, hemorrhoidectomy.Outer tube 32 is constructed to receive slidably and approaches assembly 200(Fig. 8) and the parts of emitting module 300, just as will be described in detail below.In an embodiment, engagement collar 36a is supported on the far-end of outer tube 32 rotationally, to contribute to and being connected of interchangeable anastomotic component 100.Similarly, engagement collar 36b can be supported on the near-end of outer tube 32 rotationally, to contribute to outer tube 32 and the screw thread of the housing 22 of handle portion 20 to fix, as will be discussed in further detail below.

Especially with reference to Fig. 1 and Fig. 8 to Figure 15, distally head 40(Fig. 1 of surgical stapling apparatus 10) comprising: anvil assembly 400, its can with approach assembly 200(Fig. 8) far-end engage releasedly; And interchangeable anastomotic component 100, its can with engagement collar 36a and emitting module 300(Fig. 8 of elongated central body portion 30) the far-end of elongated pusher connector 330 engage releasedly.Interchangeable anastomotic component 100 (or its part) can be constructed to the disposable unit of replacing with new interchangeable anastomotic component 100 (or its part) after each transmitting.The remaining part of surgical stapling apparatus 10 is constructed to can parts reusable, that can separate and that can sterilize, but one or more in these parts can alternately be constructed to disposable unit.Distally head 40 will be discussed in more detail below.

The various parts of surgical stapling apparatus 10 described below are constructed to contribute to the assembling of surgical stapling apparatus 10 and remove stage makeup and costume, thereby contribute to the disposal of those disposable units and the sterilization of replacement and the reusable parts of those energy and assemble.Forming material that the various parts of surgical stapling apparatus 10 use will depend on the instructions for use of requirement of strength and specific features of specific features, and for example, whether parts are can be reusable or disposable.For example, the reusable and/or heavily stressed parts of energy that comprise anvil assembly 400 and approach the part of mechanism of device can be formed by high-strength material that can repeated disinfection, for example, comprise the material of rustless steel and aluminum.Disposable and/or the low stress parts of device can be formed by the thermoplastic that comprises Merlon as the part of anastomotic component 100.

With reference to Fig. 8 and Figure 21 to Figure 26, surgical stapling apparatus 10 approach assembly 200 comprise approach knob 26(Figure 21), drive screw 220, rotating sleeve assembly 230, corresponding the first extension 240 and second screw extension 250(Figure 24) and anvil block keeper 260.Rotating sleeve assembly 230 comprises 231(Figure 24 of hollow body portion of cylindricality), inner sleeve 231a, first collar 280 and second collar 281.The main part 231 of hollow defines bore hole 294(Figure 26) and comprise proximal flange 282 and distally housing 283(Figure 25), distally housing 283 defines the recess 283a for receiving ball brake assembly 284, will be discussed in more detail below.Inner sleeve 231a be secured to hollow main part 231 inner surface and comprise that cut portion 231b is to contribute to the passing through of ball 284a of ball brake assembly 284.Second collar 281 defines bore hole 281a, and bore hole 281a is dimensioned to receive slidably sleeve assembly 230.Through hole 281a comprises cut portion 281b, and cut portion 281b is dimensioned to contribute to the passing through of distally housing 283 of main part 231.The nearside of second collar 281 is constructed to engage releasedly the distally of first collar 280, as passed through coupling screw thread (not shown).In the time that first collar 280 engages with second collar 281, the collar 280 and 281 defines ring chamber 285(Figure 38), described ring chamber is sized to the flange 282 of receiving rotationally main part 231.

With reference to Figure 25, ball brake assembly 284 comprises brake component, for example ball 284a, connector 284b and pin 284c.Ball 284a is positioned in the recess 283a of distally housing 283 to be received within the helical channel 222(Figure 24 that drives screw 220) in.Connector 284b defines bulb-shaped recess, and this bulb-shaped recess is for receiving a side relative with the screw 220 of ball 284a, ball 284a is remained on to the recess 283a of distally housing 283.Connector 284b defines the bore hole 286 for acceptance pin 284c.Pin 284c extends through opening 287 in housing 283 and the bore hole 286 of connector 284b, so that connector 284b and ball 284a are fixed in the recess 283a of housing 283.Recess 283a comprises the cut portion 288 of the rib-shaped piece 289 for receiving connector 284b, suitably the bore hole of connector 284b 286 is aimed at the opening 287 in housing 283.

Approach the main part 26b that knob 26 comprises flat grip part 26a and cylindricality.Use the modes such as bonding, welding that grip part 26a is fixed in the slit 290 in main part 26b and be fixed in the slit 298 in the near-end of main part 231.By grip part 26a being positioned in slit 290 and 298, grip part 26a is rotatably fixed to the main part 231 of main part 26b and rotating sleeve assembly 230.Main part 26b defines bore hole 291(Figure 38), main aperture 291 is dimensioned to receive the near-end of hollow body portion 231.Retaining screw 292 is set to the main part 26b of knob 26 to be fixed to the hollow body portion 231 of sleeve assembly 230, makes the rotation of knob 26 cause the rotation of sleeve assembly 230.Alternately, other fastening methods can, for knob 26 is rotatably fixed to sleeve assembly 230, comprise adhesion, welding, interlocking structure, stationary fit and snap fit adapter.

In use, by the hollow body portion 231 of sleeve assembly 230 is located to the bore hole 281a by second collar 281 and enter in the bore hole 294 that near-end that housing 22 makes to drive screw 220 is received within hollow body portion 231 and ball 284a be positioned in drive screw 220(Figure 26) helical channel 222 in, rotating sleeve assembly 230 is fixed to the near-end of housing 22.As discussed above, the flange 282 of hollow body portion 231 is positioned in the ring chamber 285 between the collar 280 and the collar 281, and but housing 22 that hollow body portion 231 can rotate relative to housing 22 relative is axially fixed.The far-end of second collar 281 is by screw thread (not shown) or use other known fastening methods (for example, friction, snap fit (Snap-fit) etc.) to be attached to releasedly the near-end of housing 22.In the time approaching knob 26 and rotate, the ball 284a of ball brake assembly 284 is around driving screw 220 in the interior rotation of helical channel 222.Because hollow body portion 231 and the therefore relative housing 22 of ball brake assembly 284 are axially fixed, ball 284a forces and drives screw 220 in the interior translation of housing 22.

The far-end of screw 220 comprises transverse slot 226(Figure 24).Although also can conceive other structures, the first screw extension 240 and the second screw extension 250 comprise flexible-belt portion 242 and 252 separately.Allow that with the flexibility of portion 242 and 252 screw extension 240 and 250 translations of screw extension are by the bending elongated outer tube 32 of elongated body portions 30.Each near-end with portion 242 and 252 comprises that corresponding 244He254 hole, hole 244 and 254 is sized to the near-end of acceptance pin 246 for the interior hold-down screw extension 240 respectively of the transverse slot 226 at screw 220 and screw extension 250.Screw extension 240 and screw extension 250 separately with portion 242 and be sized in the transverse slot 262 in the near-end that is formed at anvil block keeper 260 and be accepted with portion 252, anvil block keeper 260 is fastened to the far-end of screw extension 240 and screw extension 250.More particularly, pair of pin 264 extends through near-end and band portion 240 and the band portion 250 of anvil block keeper 260, so that screw extension 240 and screw extension 250 are fixed to anvil block keeper 260.

With reference to figure 8, Figure 21 and Figure 24, anvil block keeper 260 comprises the 265a(Figure 24 of trocar portion), main part 265b and attachment 265c.Although also can conceive other more not blunt or more not sharp-pointed pointed tip configuration, the 265a of trocar portion comprises blunt trocar tip 267.Main part 265b is the diameter that diameter cylindricality and that have is greater than the 265a of trocar portion substantially.The circular protrusion 268 that defines nearside shoulder part is arranged to around the main part 265b of anvil block keeper 260 and is constructed to engage in known manner anvil assembly 400(Fig. 1), so that anvil assembly 400 is fixed to anvil block keeper 260 releasedly.

With reference to Fig. 8 and Figure 21 to Figure 26, in use, in the time approaching knob 26 and manually rotate, the main part 231 of hollow also rotates around the near-end that drives screw 220.Because sleeve 230 is axially fixing with respect to housing 22, and the ball 284a of ball brake assembly 284 is arranged in helical channel 222 and with respect to hollow body portion 231 and rotatably fixes, hollow body portion 231 causes ball 284a to move along the passage 222 of screw 220 around the axial rotation of screw 220, thereby promotes screw 220 in the 231 axially translations of the interior relative hollow body of housing 22 portion.One in the time of screw 220 axial translation, and the anvil block keeper 260 that is fastened to the first screw extension 240 and the second screw extension 250 of the far-end that drives screw 220 and is fastened to the far-end of screw extension 240 and 250 axially moves through the outer tube 32 of elongated body portions 30.Therefore, at anvil assembly 400(Fig. 1) engage releasedly around the far-end of anvil block keeper 260, knob 26 can be rotated, to cause anvil assembly 400(Fig. 1) relative anastomotic component 100(Fig. 1) motion between spaced position and approximated position, that is: anvil assembly 400 moves and is more close or further from anastomotic component 100, depends on the rotation direction of knob 26.

With reference to Fig. 1, Fig. 6 to Fig. 8 and Figure 21 to Figure 24, approach assembly 200 and also comprise screw stop part 270, it is fastened to the effect that drives screw 220 and be constructed to play proximal stop, receives space for the minimum tissue limiting between anvil assembly 400 and anastomotic component 100.More specifically, driving screw 220 to be retracted to its recent side position to limit anvil assembly 400 and anastomotic component 100(Fig. 1) between approximated position or when minimum interstice, screw stop part 270 is positioned at the surrounding of driving screw 220 and the far-end of the hollow body portion 231 of sleeve assembly 230 that butt can be rotated.Screw stop part 270 comprises cam adjustment member 272, and it allows to be optionally adjusted at the minimum interstice limiting between anastomotic component 100 and anvil assembly 400.In ' 187 patents of Milliman and ' 444 patents of Gresham, describe cam in detail and adjust member 272, the full content of this patent is incorporated herein by reference.

Screw stop part 270 also comprises a pair of guiding elements 274(Fig. 7), guiding elements 274 radially stretches out from screw stop part 270.Guiding elements 274 is sized to along its inwall along housing 22 of guiding piece 29(and forms) (Fig. 7) slide, approach assembly 200 translations by fixed handle 22 to maintain suitable aligning and guiding.Screw stop part 270 also defines the retaining part 270a of inclination, and the retaining part of inclination is oriented to engage the pivot member of emitting module 300 after screw stop part 270 has been resit an exam lower its recent side position retraction, as describing in detail below.

With reference to Fig. 6 to Fig. 8 and Figure 16 to Figure 17, emitting module 300 comprises transmitting trigger 24, transmitting connector 310, elongated pusher connector 330 and coupling member 350.The far-end of transmitting trigger 24 is pivotally connected to coupling member 350 by pivot member 352.Pivot member 352 comprises far-end 352a, and it can be threaded connection with the opening 24a in the far-end of trigger 24.Referring to Figure 17.Coupling member 350 uses any known fastening method be fixed to the near-end of elongated pusher connector 330 and can form with pusher connector 330 entirety conversely.Wing member 358 radially stretches out and is sized to the passage 31(Fig. 6 forming along inwall along housing 22 from the pusher connector 330 of next-door neighbour's coupling member 350) slide, to maintain suitable aligning and guiding coupling member 350 and 330 translations of pusher connector by the housing 22 of handle portion 20.It is contemplated that, wing member 358 can form with coupling member 350 entirety.

Also, with reference to Figure 18 to Figure 20, elongated pusher connector 330 defines the structure of the generally tubular with hollow inside and comprises cut portion 332, and described cut portion is extended along a part for the length of elongated pusher connector 330.Like this, elongated pusher connector 330 defines the halfpipe section 334 of next-door neighbour's cut portion 332.Elongated pusher connector 330 also comprises multiple relative lateral recess 336 that replace, and in the position separating, the outer surface around the far-end of pusher connector 330 extends along its length described recess.Thereby recess 336 contributes to the elastic bending of elongated pusher connector 330 in outer tube 32 to reduce during launching causes that 330 translations of pusher connector are by the desired power of outer tube 32.

The hollow inside of elongated pusher connector 330 is constructed to receive slidably the far-end that drives screw 220 and the first screw extension 240 and the second screw extension 250 that approaches assembly 200.In the time remaining static, elongated pusher connector 330 can limit slight curving structure, as shown in Figure 18 and 19, and when translation is by bending outer tube 32(Fig. 8) time, elongated pusher connector 330 can be constructed to flexibly be bent to more bending structure from resting position (Figure 19), as shown in figure 20.After described device has been launched, the curved configuration of elastic pusher connector 330 can be such as promoting elongated pusher connector 330 to the position of retracting, not launching.In addition, or instead, between the far-end of wing member 358 and the near-end of outer tube 32, provide biasing member 359(Fig. 8) so that pusher connector 330 and/or make coupling member 350 towards the biasing of transmitting site (Figure 35) proximad not.

As mentioned above, the near-end of elongated pusher connector 330 is fixed to coupling member 350.As shown in Fig. 8 and Figure 16 to Figure 20, the far-end of elongated pusher connector 330 comprises that the tubular neck portions 338 of hollow, hollow tubular cervical region define L-type recess 340(Fig. 8 of similar bayonet socket).As described in detail later, the far-end of elongated pusher connector 330 is constructed to engage releasedly the pusher 112 of anastomotic component 100.

With reference to Fig. 8 and Figure 16 to Figure 17, transmitting connector 310 has: far-end, and it is fixed to transmitting trigger 24 pivotally by pivot member 312; And near-end, it is attached to dismountable cover piece 22b of housing 22.More specifically, the near-end of transmitting connector 310 defines the bifurcated configurations with the first flange 313 and the second flange 315, and the first flange and the second flange comprise the opening that is constructed to receive pivot member 316.Pivot member 316 between the first flange and the second flange 313,315 and outwards extends, and each end of pivot member 316 is positioned as and is received in detachable cover piece 22b(Figure 38) opposite side in triangle slit 28(Fig. 4 of forming) in.Detachable cover piece 22b uses and comprises that any known fastening method of screw, interlock feature, snap fit etc. is detachably fixed to the housing 22 of handle portion 20.Triangle slit 28 is by by vertical proximal wall 28a, horizontal bottom wall 28b and make vertical proximal wall 28a and the angled wall 28c of horizontal bottom wall 28b interconnection limits.Like this, between the period of energization of transmitting trigger 24, allow that pivot member 316 slightly longitudinally and/or vertically moves in triangle slit 28, thereby to provide larger mechanical dominance distad to advance elongated pusher connector 330.Pivot member 316 is subject to the inhibition with respect to the substantial motion of housing 22, and the actuating that makes like this to launch trigger 24 has caused the distally translation of elongated pusher connector 330 relative housings 22.As shown in Figure 35, can provide biasing member 381 to be positioned in the position of the bottom of next-door neighbour's proximal wall 28a to promote transmitting connector 310 to pivot member 316.It can be the inner surface that can be fixed to by securing member, screw, rivet 381a or other known clamp device or technology transmitting trigger 24 with the biasing member 381 of the form of leaf spring.

Before the actuating of transmitting trigger 24, with approaching assembly 200, the relative anastomotic component 100 of anvil assembly 400 is approached, as described above.When this happens, retaining part 270a(Figure 39 of the inclination of screw stop part 270) move to the position of pivot member 316 nearsides.When making to launch trigger 24 and activate transmitting trigger 24 to housing 22 pivotables, transmitting connector 310 is around pivot member 316 to housing 22 pivotables, distad promote transmitting trigger 24 and pivot member 352 with relative housing 22, pivot member 316 is supported by the retaining part 270a of screw stop part 270.Because pivot member 352 is pivotally fixed to coupling member 350, the distal movement of pivot member 352 causes the distal movement of coupling member 350, distad to promote pusher connector 330.The far-end of pusher connector 330 is attached to the pusher 112 of anastomotic component 100, as will be described below, the distally translation of pusher connector 330 can be caused so that pusher 112 distad translation by nail bin groupware 110, thereby penetrate surgical stapling nail 600(Fig. 9 from anastomotic component 100).

Anvil assembly 400 can be any known anvil assembly that comprises the anvil assembly with fixing head or tiltable head, as disclosed in ' 444 patents of ' 187 and Gresham that are combined in by reference in full Milliman with it.As comprised anvil head assembly 410 at anvil assembly 400 known in the art, it comprises anvil head 414 and anvil block center rod assembly 420.Anvil block center rod 420 is constructed to engage releasedly anvil block keeper 260.In addition, anvil block keeper 260 can be formed single or alternately, can be formed multi-part formula assembly and comprise contractile trocar, as disclosed in 187 patents that are combined in by reference in full this with it.

Turn to Fig. 1 and Fig. 9 to Figure 14, interchangeable anastomotic component 100 comprises nail bin groupware 110 and conjugative component 140(Fig. 9).Nail bin groupware 110 is constructed to hold multiple surgical stapling nails 600, and in the time that emitting module 300 activates (Fig. 8) contribute to surgical stapling nail 600 penetrate, by organizing and entering anvil head assembly 410(Figure 42) anvil head 414(Fig. 1), the shaping for surgical stapling nail 600 around tissue.Conjugative component 140 is constructed to contribute to anastomotic component 100 to engage the operating of far-end of the outer tube 32 of elongated central body portion 30 with engagement collar 36a.Anastomotic component 100(or its parts) can be formed as disposable assembly, it is constructed to substitute with new anastomotic component after each transmitting.

Conjugative component 140 comprises shell 142, and described shell can be formed (for example polyethylene) and is constructed to disposable unit by any applicable material.Shell 142 defines the structure of general hollow and comprises distally cylindricality branch 147, central taper branch 148 and nearside cylindricality branch 149, and described nearside cylindricality branch 149 defines the diameter slightly more small than distally cylindricality branch 147.Multiple openings 150 are formed in taper branch 148 to allow that in the operating period of surgical stapling apparatus 10 fluid and tissue pass through.The nearside cylindricality branch 149 of shell 142 is configured to the engagement collar 36a(Fig. 8 with the elongated center main part 30 around pusher connector 330) engage releasedly.More specifically, the nearside cylindricality branch 149 of shell 142 comprises the screw thread 149a arranging around its outer annular surface.Screw thread 149a is constructed to engage the lip-deep screw thread 37(of the inner annular Figure 34 that is arranged in engagement collar 36a).Engagement collar 36a is supported rotationally around the far-end of outer tube 32, makes like this it opposite shell 142 to rotate that shell 142 is fixed to outer tube 132.Collar flange 41(Figure 10) form to prevent to remove collar 36a from outer tube 32 around the far-end of outer tube 32.Although the shown bead that is formed in outer tube 32 separation around of flange 41, flange 41 can integrally form with outer tube 32.Collar 36a is shown as having female thread and shell 142 is shown as having external screw thread.But, can conceive, these surfaces can be reverse.Be threaded onto shell 142 although collar 36a is shown as, can conceive, other connected structures can be for shell 142 being fixed to collar 36a or being fixed to the far-end of outer tube, as snap fit adapter, bayonet type adapter, frictional connection device etc.

Specifically with reference to figure 9 to Figure 15, nail bin groupware 110 is accommodated in the shell 142 of conjugative component 140, and comprises pusher 112(Figure 11), cylindricality cutter 114 and anastomosis staple guiding cap 116.Shell 142 defines central tubular bore hole 142a, and it is sized to and receives slidably anvil block keeper 260.Tubular liner 142b is fixed in the near-end of tubular bore 142a, so that bore hole 142a(Fig. 9 to be provided) rigidity.Central tubular bore hole 142a is by horizontal flange 142c(Figure 34) be fixed to shell 142.As mentioned above, nail bin groupware 110 and shell 142 are constructed to disposable unit.

The pusher 112 of nail bin groupware 110 defines central bore hole 118 and is constructed and is received in shell 142.More particularly, pusher 112 comprises: distally cylindricality branch 119, and it is positioned in the distally cylindricality branch 147 of shell 142 slidably; Taper branch 121 of central authorities, it is slidably located in the center subsections 148 of shell 142; And nearside cylindricality branch 123, it has the diameter less than distally cylindricality branch 119 and is positioned slidably in the nearside branch 149 of shell 142.Pusher 112 comprises slit 113, and it receives the flange 142c of shell 142 slidably, to fix and axially to guide rotationally the motion of pusher 112 in shell 142.

The nearside branch 123 of pusher 112 is constructed to engage releasedly pusher connector 330.More specifically, pusher 112 comprises nearside adjutage 123a, and it has angled finger 123b.In the time that shell 142 is located around the far-end of pusher connector 330, as subsequently in Figure 12 to 14 demonstration, shell 142 can be rotated, thereby pusher 112 is rotated and finger 123b is positioned in the slit 340 of pusher connector 330 that pusher 112 is fixed to pusher connector 330 releasedly.As discussed above, after pusher 112 has been fixed to pusher connector 330, engagement collar 36a can be pushed into around outer tube 32, as shown in Figure 15, to make to be formed on the screw thread 37(Figure 34 on the inner surface of collar 36a) motion and engaging with the screw thread 149a forming around shell 142.After this, engagement collar 36a can be rotated, optionally interchangeable anastomotic component 100 is fixed on outer tube 32.

With reference to Fig. 9 and Figure 11, the far-end of pusher 112 comprises the pusher fingers 129 of multiple distal extensions especially, and it is sized to and is received within slidably in the slit 131 forming in anastomosis staple guiding cap 116.Anastomosis staple guiding cap 116 for example, is engaged with around the far-end of shell 142 via the joint of projection 133 and recess 135 (, via snap fit, welding, adhesion, etc.).Each slit 131 in the 116 interior formation of anastomosis staple guiding cap is constructed to keep surgical stapling nail 600.At pusher 112, in response to the actuating of transmitting trigger 24, while advancing, surgical stapling nail 600 is penetrated, is formed on anvil assembly 400(Fig. 1 by organizing and entering from the slit 131 of anastomosis staple guiding cap 116) anvil head 414 recess (not shown).Cylindricality cutter 114(Fig. 9) connected with the fastening cutter 114 of relative pusher fingers 129 by pin the bore hole 118 of pusher 112 is interior, before making like this advancing of pusher 112 cause cutter 114 and then by tissue simultaneously.The far-end of cutter 114 comprises annular cut edge 115, cuts and organizes contributing to.

With reference to Fig. 4, Figure 27, Figure 28 and Figure 32, safety interlocking assembly 25 is supported on detachable housing 22b(Figure 32) bottom on.Safety interlocking assembly 25 comprises the substrate 700 that defines passage 702, and described passage is sized to and receives slidably lockplate 704.Substrate 700 comprises the integral installation piece 706 that defines bore hole 708.Lockplate 704 is slidably mounted in passage 702 and comprises that nearside extends finger 710, and nearside extends finger 710 and extends through bore hole 708.Biasing member (for example disc spring 712) is positioned in mounting blocks 706 and is supported on around the finger 710 between the bearing 714 of near-end of lockplate 704, distad to advance lockplate 704.

Lockplate 704 comprises a pair of distally projection 716, driving screw 220 to move so that anvil assembly 400 and interchangeable anastomotic component 100(Fig. 1) while approaching, distally projection is positioned with the protruding 275(Figure 22 on joint screw stop part 270).Barrier structure 720 is formed on the far-end of lockplate 704.

Transmitting trigger latch members 722 is supported on dismountable housing 22b(Figure 32 pivotally) go up and operate explicitly with safety interlocking assembly 25.More particularly, the opening 726 that cover piece 22b defines a pair of separation is for receiving pivotally pivot member 718.Pivot member 718 is positioned by the bore hole 730 in pivot member 728, so that latch members 722 is fixed to cover piece 22b pivotally.

Latch members 722 is positioned between housing 22 and transmitting trigger 24 pivotally, to stop the actuating of launching trigger 724, until anvil assembly 400 approaches with interchangeable anastomotic component 100.More specifically, support 732 is formed in latch members 722 and is positioned during in its farthest side position (Figure 27) and engages to prevent the pivoting action of latch members 722 towards housing 22 with barrier structure 720 at lockplate 704.Along with anvil assembly 400 and interchangeable anastomotic component 100 approach, protruding 275(Figure 23 of screw stop part 270) engage the distally projection 716 on lockplate 704, pull lockplate 704 and barrier structure 720 is separated with support 732 with proximad.In the time that this situation occurs, latch members 722 can be switched to Figure 41 with substrate 700(towards housing 22) position aimed at, to contribute to launch the actuating of trigger 24.

Substrate 700 comprises installs bore hole 740, and described installation bore hole is received screw 794(Fig. 8).Screw is also received within and is formed on housing 22b(Figure 32) in opening 790 in, so that safety interlocking assembly 25 and cover piece 22b are fixed to housing 22 releasedly.The removing of screw 794 contributes to separating of safety interlocking assembly 722 and housing 22b and housing 22, to allow the more effective sterilization of the reusable parts of energy of stapling apparatus 10, just as will be described in detail below.By removing screw 794, safety interlocking assembly 25 can be used as module or single unit removes from housing 22.

See figures.1.and.2 9 to Figure 32, indicator assemblies 27 comprises gripper shoe 802, and described gripper shoe is removably supported on housing 22 by screw 803.Gripper shoe 802 supports spherical indicator 824, lens cover piece 824a and slide assemblies 830.Indicator 824 is supported on pivot member 832 around pivotally, and pivot member extends through the opening 834 in gripper shoe 802.Lens cover piece 824a is positioned in indicator 824 tops, and in an embodiment, lens cover piece 824a is formed by amplified material, to contribute to the easily visual of indicator 824.Slide assemblies 830 comprises distally plate 836, and distally plate 836 has distally abutment member or upwarps lip shape portion 840.The near-end of nearside plate 839 butt distally plates 836 and comprising to downward-extension projection 841.Nearside plate 839 comprises extension 842, and extension for example supports biasing member 844(, disc spring).Biasing member 844 is positioned at while compression around nearside extension 842 and is being formed between supporting construction 816 in gripper shoe 802 and the nearside plate 839 of slide assemblies 830, distad to promote slide assemblies 830 in longitudinal recess 850, described longitudinal recess is defined along the inwall of gripper shoe 802.Indicator 824 comprises a pair of protruding 852a to downward-extension and 852b(Figure 39).The lip shape portion 840 that upwarps of distally plate 836 is positioned between protruding 852a and protruding 852b.

In the not transmitting site of device 10, biasing member 844 distad promotes slide assemblies 830, thereby engage with protruding 852a and make indicator 824 be switched to primary importance so that lip shape portion 840 is moved, this for surgeon provide install 10 not yet approach and not in being ready to the instruction of emission state.Also, with reference to Figure 39, screw stop part 270 is fixedly attached to and drives screw 220(Figure 22).Screw stop part 270 comprises the first bearing or engagement member 862, its be positioned at slide assemblies walk and engage for 830 times be supported on nearside plate 839 to downward-extension projection 841, to make nearside plate 839 proximal motion.The motion of nearside plate 839 causes the corresponding proximal movement of distally plate 836, and the lip shape portion 840 that upwarps that makes distally plate 836 is bump bonding 852b during the approaching of device 10.In the time that the lip shape portion 840 that upwarps of distally plate 836 engages the protruding 852b of indicator 824, upwarp lip shape portion 840 and cause that indicator 824 is switched to the second position around pivot member 832.In this second position, indicator 824 is installed the 10 approaching and instructions in ready-to-go-round position now for surgeon provides.See Figure 41.

By support indicator assemblies 27 in gripper shoe 802, can be by removing screw 803 using indicator assemblies 27 as a single unit or module easily and rapidly removes from installing 10 handle portion 20.This modular designs has allowed the easy separation of the parts of handle portion 20, to contribute to the sterilization of surgical stapling apparatus 10 and to reuse.Alternately, the other types of indicator can be used together with those surgical stapling apparatus 10 of describing in being included in ' 187 patents of Millian and ' 444 patents of Gresham.

Figure 33 to Figure 38 has shown Fig. 1 at anvil assembly 400() be attached to anvil block keeper 260(Figure 34) before at anvil block keeper 260 in surgical stapling apparatus 10 that advance completely or non-approximated position.As shown in Figure 34, anastomotic component 100 is fixed to engagement collar 36a anastomotic component 100 is fixed to elongated central body portion 30.In addition, screw stop part 270 is positioned in the far-end of fixed handle 22, makes lockplate 704 be positioned to prevent latch members 722(Figure 36) pivoting action and be switched to its counter clockwise direction position as the indicator 834 as shown in Figure 36.

Now by describe in detail surgical stapling apparatus 10 for the follow-up use re-using, remove stage makeup and costume and assemble.Referring to Figure 38 to Figure 40, in use, distally head 40(Fig. 1 of surgical stapling apparatus 10) be inserted into inner operative site, make like this anvil assembly 400 and anastomotic component 100 be positioned and be close to tissue to be coincide.Once by desired location, anvil assembly 400 relatively anastomotic component 100 approaches, and approaches assembly 200(Fig. 8 by manipulation) tissue is clamped between the two.More particularly, anvil assembly 400 moves to approaching or closed position, to capture the tissue between anvil assembly 400 and anastomotic component 100 by rotating in a first direction rotary knob 26.Knob 26 rotation in a first direction causes that sleeve assembly 230, around driving screw 220 to rotate, so that ball 284a moves along the helical channel 222 of screw 220, makes distad translation in the indicated direction of screw 220 arrow " A " in Figure 39 like this.The far-end of screw 220 is connected to screw extension 240 and screw extension 250, screw extension 240 and screw extension 250 are then secured to anvil block keeper 260 at their far-end, make so similarly proximad translation of anvil block keeper 260, so that anvil assembly 400 approaches with respect to anastomotic component 100.Can turning knob 26 make anvil assembly 400 approach to the position of a hope with respect to anastomotic component 100, to clamp tissue between the two.

As shown in Figure 39, in the time driving screw 220 to move to its recent side position, the projection 275 of screw stop part 270 engages safety interlocking assembly 25(Figure 27) lockplate 704 on projection and proximad retraction plate 704, so that barrier structure 720 is separated with the support 732 in latch members 722.In the time that this situation occurs, latch members 722 can be switched to Figure 39 with safety interlocking assembly 25() the position aimed at of substrate 700, to contribute to launch the actuating of trigger 24.

In addition, in the time that screw 220 moves to its recent side position, engagement member 862(Figure 22 of screw stop part 270) engage the projection 841 of nearside plate 839, so that plate 839 and distally plate 836 proximads are retracted.Along with distally plate 836 proximal motion, the projection 852b of lip shape portion in indicator 824 makes indicator 824 be switched to its second position, wherein for surgeon provides stapling apparatus to approach and the instruction in ready-to-go-round position now.

With reference to Figure 40 to Figure 42, anvil assembly 400 is arranged in the approximated position of clamping the tissue between the anastomosis staple guiding cap 116 of anvil head 414 and anastomotic component 100, and emitting module 300 can activated to coincide and be held tissue and organize coring to being held.More specifically, for surgical stapling apparatus 10 is launched, trigger 24(Figure 41) compressed towards housing 22.As described above, the far-end of transmitting trigger 24 is connected to the near-end of pusher connector 330 by coupling member 350.Therefore, in the time that transmitting trigger 24 activated, the retaining part 270a of pivot member 316 joint screw stop parts 270, makes like this at trigger 24 in the time that housing 22 is compressed, and trigger 24 distad advances.In the time that this situation occurs, pusher connector 330 is the motion of ground, distally also, with distally promote pusher 112(Figure 40 of nail bin groupware 110).The anastomosis staple guiding cap 116 that relatively holds surgical stapling nail 60 at pusher 112 is distad when translation, and the finger 129 of pusher 112 engages anastomosis staple 600 and penetrates anastomosis staple 600 from anastomosis staple guiding cap 116.Leave guiding cap 116 and when organizing, anastomosis staple 600 is received within the recess in the anvil head 414 that is formed on anvil assembly 400 and in tissue shaping around at anastomosis staple 600.Cylindricality cutter 114 side by side moves with pusher 112, makes like this cutter 114 distad be advanced equally with to organizing coring.

Surgical stapling apparatus 10(Fig. 1) coincide for carrying out annular.Typically, for example, need annular to coincide in the operating period of the part of removing ill vascular (colon or intestinal).In this type of operating period, the ill part of vascular removes from ill vascular, and the end of remaining the first and second vessel segment is used surgical stapling apparatus 10 to link together.Annular is coincide, and also in many other operation techniques, (for example, in gastric bypass surgery operation) need to.

Before removing ill vascular part from ill vascular, be attached with anvil assembly 400(Fig. 1 of removable trocar (not shown)) be positioned in the first vessel segment in the first side of ill part.In Gresham ' 444 patents that are combined in by reference in full as mentioned above this with it, the removable trocar that is suitable for use together with anvil assembly 400 is disclosed.Remove ill vascular part and sewed up the first vessel segment and the opening of the second vessel segment after, device 10 far-end is positioned in the second vessel segment on the opposite side of the ill part having removed.At this moment, removable trocar is pushed through the stitching thread in the end of the first vessel segment and removes from anvil assembly.Next, most advanced and sophisticated 267(Fig. 2 of the trocar of anvil block keeper 260) be pushed through the stitching thread in the second vessel segment and connect with the center rod of anvil assembly 400.Surgical stapling apparatus 10 can approach and transmitting in mode discussed above now, to link the end of the first vessel segment and the second vessel segment and any tissue that hinders vascular lumen is carried out to coring.(referring to for example Figure 42).Referring to being for example combined in by reference this ' 444 patents of Gresham.

After identical operation, surgical stapling apparatus 10 can remove from internal surgical site.Although do not show, anvil assembly 400 can be constructed to be switched to low profile structure (low-profile configuration), to contribute to surgical stapling apparatus 10 removing from internal surgical site.Alternately, anvil assembly 400 does not need to have pivoting head and can be advanced the orientation that described operative site is identical with it and removes from operative site.

After surgical stapling apparatus 10 has been launched, can be by with respect to anastomotic component 100 rotational engagement collar 36a and from the far-end of outer tube 32 so that the screw thread 37 of collar 36a and shell 142(Figure 15) screw thread 149a separate and by with respect to pusher 117 rotation cases 142 so that the angled finger 123b of pusher 112 and pusher connector 330(Figure 14) slit 340 separate, remove used anastomotic component 100.In the time that anastomotic component 100 separates with outer tube 32, new anastomotic component 100 can be fixed to outer tube 32 by mode discussed above, so that same patient is carried out to extra operation.The anastomotic component 100 using can be disposed by surgeon.If this patient does not need further to coincide operation, stapling apparatus 10 can further be dismantled to contribute to the sterilization of device 10 to reuse.

To carry out disinfection, by nearside engagement collar 36b and outer tube 32 are separated, the near-end of outer tube 32 is separated for provision for disengagement 10 with housing 22.As shown in Figure 37, collar 36b is supported on the near-end of outer tube 32 rotationally.Flange 43 is formed on around the near-end of outer tube 32, leaves outer tube 32 to prevent the collar 36b from sliding.Although do not show, the outer surface of the inner surface of collar 36b and housing 33 can comprise screw thread, and screw thread is used for making collar 36b to be fixed to releasedly housing 22.Alternately, imagination, can make the near-end of outer tube 32 be fixed to the far-end of housing 22 with other known releasable connected structures.

Once outer tube 32 separates with housing 200 with anastomotic component 100, can dismantle housing 22 so that the path of the internal part that enters described device to be provided.More specifically, by housing 22b and housing 22 being separated and by removing pivot member 352 from transmitting trigger opening 24a and coupling member 350, transmitting trigger 24 can remove from housing 22.By being formed on the opening 23(Fig. 2 in cover piece 22a) can approach pivot member 352, and remove screw 794(Fig. 4 by the substrate 700 from safety interlocking assembly 25 and cover piece 22b), safety interlocking assembly 25 can remove from housing 22.By from housing 822(Fig. 1) remove screw 832, indicator assemblies 27 also can be removed from housing 22.Indicator assemblies 27 and safety interlocking assembly 25 are modular forms and can be used as individual cell and separate with housing 22.Next,, by unscrewing retaining screw 292, rotary knob 26 can separate with the near-end of assembly 230.Finally, by unscrewing the collar 281 from housing 22, the collar 281 can separate with housing 22.After this, for example, for sterilize (autoclaving), can by outer tube 32 and housing 22 proximads extract emitting module 200 and approach assembly 300.After sterilization, by reversing, above-described demounting procedure can be re-assemblied device 10.The step that it should be pointed out that assembly and disassembly need to not carried out with any specific order.

It should be appreciated by those skilled in the art that, be unrestricted exemplary embodiment in apparatus and method this specific description and that show in the accompanying drawings.It is contemplated that, element and the feature of showing an exemplary embodiment or describe can combine with another element and feature, and do not deviate from the scope of the present disclosure.Equally, it will be appreciated by those of skill in the art that the of the present disclosure further Characteristics and advantages based on above-described embodiment.Therefore, the disclosure do not shown especially and describe limit, the claim of enclosing indicated except.

Claims

1. a surgical stapling apparatus, comprising:

Handle portion;

Elongated body portions, it distad extends from described handle portion;

Distally head, it comprises anvil assembly and interchangeable anastomotic component, described interchangeable anastomotic component comprises pusher and multiple anastomosis staple, described pusher can move to penetrate anastomosis staple from described interchangeable anastomotic component;

Emitting module, it extends between described handle portion and described interchangeable anastomotic component, described emitting module comprises pusher connector, and described pusher connector can engage and can move to cause with described pusher the motion of described pusher releasedly;

Approach assembly, it extends between described handle portion and described distally head, the described assembly that approaches comprises anvil block keeper, described anvil block keeper be constructed to support releasedly described anvil assembly and be can activate to make described anvil assembly with respect to described interchangeable anastomotic component motion; And

The first engagement collar, its far-end around described elongated body portions supports rotationally, and described engagement collar is constructed to engage releasedly described interchangeable anastomotic component.

2. surgical stapling apparatus according to claim 1, wherein said interchangeable anastomotic component comprises the shell that holds described pusher, described shell has near-end, described near-end comprises external screw thread, and described external screw thread is constructed to engage releasedly the female thread being formed in described the first engagement collar.

3. surgical stapling apparatus according to claim 1, wherein said elongated body portions comprises that outer tube and described the first engagement collar support rotationally around the far-end of described outer tube.

4. surgical stapling apparatus according to claim 3, wherein said outer tube comprises collar flange, described collar flange is positioned to prevent that described the first engagement collar from sliding and leaving the described far-end of described outer tube.

5. surgical stapling apparatus according to claim 3, also comprise the second engagement collar, described the second engagement collar supports rotationally around the near-end of described outer tube, wherein said handle portion comprises housing, and described the second engagement collar is constructed to engage releasedly described housing to contribute to separating of described outer tube and described housing.

6. surgical stapling apparatus according to claim 5, wherein said the second engagement collar comprises that female thread and described housing comprise external screw thread, described external screw thread is constructed to engage releasedly the described female thread of described engagement collar.

7. surgical stapling apparatus according to claim 1, wherein said handle portion comprises housing, proximal portion and the described proximal portion that approaches assembly of emitting module described in described housings support.

8. surgical stapling apparatus according to claim 7, also comprise modular indicator assemblies, described indicator assemblies is fixed to described housing releasedly, described indicator assemblies be constructed to described device during in ready-to-go-round position for clinicist provides instruction.

9. surgical stapling apparatus according to claim 8, wherein said modular indicator assemblies is fixed to described housing by least one securing member.

10. surgical stapling apparatus according to claim 7, wherein said housings support modular safety interlocking assembly, described modular safety interlocking assembly is constructed to stop the pivoting action of latch members, and described locking assembly comprises the installing plate that is fixed to releasedly described housing.

11. surgical stapling apparatus according to claim 10, wherein said modular safety interlocking assembly is fixed to described housing by least one securing member that extends through described installing plate.

12. surgical stapling apparatus according to claim 7, the wherein said assembly that approaches comprises: drive screw, it defines helical channel; Rotating sleeve assembly, it comprises the brake being positioned in described helical channel; And rotating knob, it is fixed to described rotating sleeve assembly, and described rotating sleeve assembly is rotatably fixed to described housing and can relatively described driving screw turns, to cause the longitudinal translation of described driving screw in described housing.

13. surgical stapling apparatus according to claim 12, wherein said rotating sleeve assembly comprises the sleeve with collar flange, and described device also comprises: first collar, it is fixed to the near-end of described housing; And second collar, it is fixed to described first collar, and wherein said first collar and second collar define the annular recessed portion that is constructed to the described collar flange of receiving rotationally described sleeve.

14. surgical stapling apparatus according to claim 13, wherein said first collar is fixed to the described near-end of described housing releasedly.

15. surgical stapling apparatus according to claim 14, wherein said first collar and described housing are threadedly engaged with.

16. surgical stapling apparatus according to claim 1, wherein said pusher connector comprises that L-type slit and described pusher comprise finger, described finger can rotate to engage with described L-type slit, thereby described pusher is fixed to described pusher connector releasedly.

17. surgical stapling apparatus according to claim 1, described multiple anastomosis staples of wherein said interchangeable anastomotic component support with annular array.

18. 1 kinds of surgical stapling apparatus, comprising:

Elongated body portions, it has near-end and far-end;

Distally head, it is positioned as the described far-end of contiguous described elongated body portions, and described distally head comprises anvil assembly and holds the interchangeable anastomotic component of multiple anastomosis staples;

Emitting module, it extends between described handle portion and described interchangeable anastomotic component;

Approach assembly, it extends between described handle portion and described distally head, described approach assembly be can activate to make described anvil assembly with respect to described interchangeable anastomotic component motion; And

At least one in modular locking assembly and safety interlocking assembly, it is fixed to described housing removedly.

19. surgical stapling apparatus according to claim 18, also comprise the engagement collar of the far-end that is attached to removedly described elongated body portions.

20. surgical stapling apparatus according to claim 18, wherein said interchangeable anastomotic component is fixed to described engagement collar releasedly.