RU2508913C2 - Block structure for surgical stapling apparatus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine. A surgical stapling apparatus comprises a fixing device for fastening first and second clamping members together. A cutter can be advanced and/or backed out in relation to the first and second clamping elements. A lock can block or at least prevent the cutter from the movement and at least advancement in relation to the first and second clamping members until the fixing device closes.

EFFECT: fixing device is designed to gear with the lock when the fixing device is moved from an completely open position into a completely close, and to detach from the cutter for the lock operation.

17 cl, 37 dwg

Description

BACKGROUND

i. Technical field

The present invention relates to stapling staple instruments and, in various embodiments, to surgical stapling staple instruments for applying at least one row of staples.

ii. State of the art

In recent years, surgeons have become increasingly inclined to use stapling instruments for suturing body tissues such as the lungs, esophagus, stomach, duodenum and / or other organs in the intestine. The use of a suitable stapling tool in many cases allows you to do a better job and in a shorter time and simplify previously complex surgical operations, such as the imposition of gastrointestinal anastomoses. The preceding linear two- and four-row detachable and stapling apparatuses contained cassette-free instruments, in which the brackets were manually inserted separately. Other preceding devices contained a pre-sterilized disposable staple loading module and a cutting element that could be used to simultaneously cut tissue and form rows of staples. An example of such a surgical stapling apparatus is proposed in US Pat. No. 3,499,591, INSTRUMENT FOR PLACING LATERAL GASTROINTESTINAL ANASTOMOSES, issued March 10, 1970, the entire contents of which are hereby incorporated by reference.

The stapling tool may comprise a pair of interacting elongated clamping elements, with each clamping element being able to be inserted into the inner tubular organ of the body to be anastomosed. In various embodiments, one of the clamping elements can serve as a support under the bracket cassette with at least two transversely spaced rows of brackets, and the other clamping element can serve as a support under the anvil with bracketing recesses aligned with the rows of brackets in the bracket cassette. Typically, the stapling tool may further comprise a pushing rod and a knife blade that can be moved relative to the clamping elements to sequentially push the brackets out of the bracket cassette by cam surfaces on the pushing rod. In at least one embodiment, the cam surfaces can be configured to drive a plurality of leashes of brackets placed on a cassette and corresponding to individual brackets, to push the brackets into focus with the anvil and form transversely spaced rows of deformed brackets in the fabric trapped between the clamping elements. However, in typical staple-stapling tools, the anvil is fixed relative to the staple cartridge after the clamping elements are assembled together and the height of the staples formed cannot be adjusted. In at least one embodiment, the knife blade can move behind the ejector rod and cut the fabric along the line between the rows of brackets. Examples of these stapling tools are described in US Pat. No. 4,429,695, SURGICAL INSTRUMENTS, issued February 7, 1984, the entire contents of which are incorporated herein by reference.

In various embodiments, a typical staple-stapling tool may include first and second clamping elements that can be secured with a latch, while the latch can be moved between an open position, a partially closed position, and a closed position. However, in the open and partially closed positions of the latch, the first and second clamping elements of a typical stapling tool may unintentionally disconnect from each other, which will require additional time to reassemble the clamping elements. In some circumstances, the separation of the first and second clamping elements may expose the knife blade. In some cases, in addition to the aforementioned, the staple-stapling tool may include a control handle extending from the ejection bar, which can be held under the surgeon and for feeding in the distal direction, to forward the ejection bar and the knife blade in the cassette for brackets. However, it is sometimes possible to forward the control handle relative to the clamping elements, even if the first and second clamping elements are not yet assembled. After assembly, in at least one case, since the control handle may extend outward from the surgical instrument, it may inadvertently come into contact with tissue surrounding the surgical field and, as a result, the tissue may interfere with the movement of the control handle. In these circumstances, the surgeon may make an effort to move the control handle past the tissue and / or change the position of the stapling instrument, which may increase the time required to complete the surgery. In connection with the above problem, there is a need to make a corresponding improvement.

SUMMARY OF THE INVENTION

In at least one embodiment of the present invention, the surgical stapling instrument may comprise first and second clamping elements that can be rotatably connected to each other and locked in position by a latch. In various embodiments, the first and second clamping elements may include first and second locking elements, which may allow the first and second clamping elements to rotate relative to one another, but not to allow or at least restrain the separation of the first and second clamping elements. These embodiments may be particularly useful in circumstances where the latch is in a partially closed position and the first and second clamping elements are manipulated to position the fabric between them. In at least one of the aforementioned embodiments, the first and second clamping elements can be connected to one another enough to prevent or at least reduce the likelihood of the first and second clamping elements being disconnected from one another and exposing the cutting element. In at least one embodiment of the present invention, the surgical stapling tool may include a sleeve that can extend at least partially from above and / or around the cutting element. In various embodiments, the housing may at least partially close the cutting element when the first and second clamping elements are disconnected from one another, but allows the cutting element to move relative to the first and second clamping elements during use.

In various embodiments, the implementation of the surgical stapling tool may optionally contain a cutting element and / or a sliding block for the extrusion of brackets, which can be fed forward and / or retract relative to the first and second clamping elements. In some embodiments, the sliding bracket extrusion unit may be fed forward and / or together with the cutting element to force the brackets out of the bracket cassette in one of the first and second clamping elements. In at least one embodiment of the present invention, the surgical stapling tool may include a lock that can block or at least hold the clamping element and / or the sliding block for displacing the brackets from moving or at least feeding forward with respect to the first and second clamping elements before the lock is closed. In at least one embodiment, the latch may be adapted to engage the lock when the latch is moved from a fully open position to a fully closed position, and to disengage the lock from the cutting element and / or the sliding bracket extrusion unit during operation. In at least one embodiment, one of the first and second clamping elements may comprise an anvil having at least one shaping surface that can be configured to deform the brackets when the brackets are ejected from the bracket cassette. In at least one embodiment of the present invention, the anvil can be adjusted by movement relative to the bracket cassette to adjust the degree to which the brackets are deformed. In various embodiments, the anvil can be adjusted by means of a sliding adjustment bar and / or a rotary cam.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other features and advantages of the present invention and the method for their preparation, and the invention itself become more apparent and understandable when referring to the following description of embodiments of the invention with reference to the accompanying drawings, in which:

FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment of the present invention;

FIG. 2 is a perspective view with a spatial separation of the components of the surgical stapling instrument of FIG. one;

FIG. 3 is a vertical projection with a spatial separation of the components of the surgical stapling instrument of FIG. one;

FIG. 4 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1, showing the first and second sections assembled with one another;

FIG. 5 is a partial sectional view of the surgical stapling instrument of FIG. 1, where the proximal end of the first portion shown in FIG. 4 is shown fixed to the proximal end of the second portion of FIG. 4, and the second portion is shown in the process of turning toward the first portion;

FIG. 6 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1, where the latch is shown pivotally mounted in the first portion, the latch engaged with the second portion, the latch rotated to a partially closed position;

FIG. 7 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1, where the latch depicted in FIG. 6 is shown in the closed position;

FIG. 8 is a perspective view of the cartridge assembly for the brackets of the surgical stapling instrument of FIG. one;

FIG. 9 is an exploded view of the components of the cassette bracket assembly shown in FIG. 8;

FIG. 10 is a view of the bracket assembly shown in FIG. 8, in a section taken along line 10-10 of FIG. 9;

FIG. 11 is a spatial exploded view of the components of the sliding bracket displacement unit and the cutting element of the bracket assembly shown in FIG. 8;

FIG. 12 is a perspective view of the assembly of the sliding block for displacing the brackets and the cutting element shown in FIG. eleven;

FIG. 13 is a perspective view of the surgical stapling instrument of FIG. 1, wherein the firmware / cutting drive device is shown distally shifted along a first side of a surgical stapling instrument;

FIG. 14 is a perspective view of the surgical stapling instrument of FIG. 1, wherein the firmware / cutting drive device shown in FIG. 13 is shown distally shifted along a second side of a surgical stapling instrument;

FIG. 15 is a cross-sectional view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention, showing a latch in a partially closed position and a locking mechanism engaged with a drive firmware / cutting device;

FIG. 16 is a sectional view of the surgical stapling tool of FIG. 15, in which the latch is in the closed position and unhooks the locking mechanism from the initiating drive device;

FIG. 17 is a perspective view of the anvil assembly of the surgical stapling instrument of FIG. one;

FIG. 18 is an exploded perspective view of the components of the anvil assembly of FIG. 17;

FIG. 19 is another perspective view with a spatial separation of the components of the anvil assembly of FIG. 17;

FIG. 20 is a vertical cross-sectional view of the components of the anvil assembly of FIG. 17;

FIG. 21 is a sectional view of an assembly of the anvil assembly of FIG. 17, where the anvil adjustment member is shown in a first position;

FIG. 22 is a sectional view of an assembly of the anvil assembly of FIG. 17, where the anvil adjustment member shown in FIG. 21 is shown in a second position;

FIG. 23 is a sectional view of an assembly of the anvil assembly of FIG. 17, where the anvil adjustment member shown in FIG. 21 is shown in a third position;

FIG. 24 is a perspective view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention;

FIG. 25 is a view of the surgical stapling instrument of FIG. 24, in a section taken along line 25-25 of FIG. 24;

FIG. 26 is an exploded perspective view of the proximal end of the surgical stapling instrument of FIG. 24, comprising a locking mechanism for releasably securing the rotary anvil adjustment member in a desired position;

FIG. 27 is a perspective view of the surgical stapling instrument of FIG. 24, with some components removed and other components shown in section;

FIG. 28 is a spatially separated view of the components of the sections of the surgical stapling instrument of FIG. 24, where the rotary anvil adjustment member is shown in a first orientation;

FIG. 29 is a perspective view of a rotatable anvil adjustment member shown in FIG. 28;

FIG. 30 is an end view of the surgical stapling instrument of FIG. 24, with some components removed and other components shown by dashed lines depicting the rotary anvil adjustment member, is shown in a first orientation shown in FIG. 28;

FIG. 31 is an end view of the surgical stapling instrument of FIG. 24, in a section taken along line 31-31 of FIG. 24;

FIG. 32 is an end view of the surgical stapling instrument of FIG. 24, where the rotary anvil adjustment member shown in FIG. 28 is shown rotated in a first direction to a second orientation;

FIG. 33 is an end view, in section, of the surgical stapling instrument of FIG. 24, where the anvil adjustment member is shown in the second orientation shown in FIG. 32;

FIG. 34 is an end view of the surgical stapling instrument of FIG. 24, where the rotary anvil adjustment member shown in FIG. 28 is shown rotated in a second direction in a third orientation;

FIG. 35 is a sectional end view of the surgical stapling tool of FIG. 24, where the anvil adjustment member is shown in the third orientation shown in FIG. 34;

FIG. 36 is a perspective view of a drive device for rotating the anvil adjustment member shown in FIG. 28 and

FIG. 37 is a partially cutaway view of a surgical stapling instrument containing a spring configured to push the distal end of the first portion of the handle away from the distal end of the second portion of the handle when the stapling tool is in a partially closed configuration.

Corresponding entries indicate corresponding parts in several views. The illustrations given in this application illustrate preferred embodiments of the invention in one embodiment, and these illustrations cannot be interpreted in the sense of any limitation of the scope of the invention.

DETAILED DESCRIPTION

The following is a description of some exemplary embodiments of the invention to provide a general idea of the principles of construction, operation, manufacture and use of devices and methods proposed in this application. At least one example of these embodiments is shown in the accompanying drawings. Those of ordinary skill in the art should understand that the specific devices and methods described herein and presented in the accompanying drawings are non-limiting exemplary embodiments, and that the scope of the various embodiments of this limitation is determined solely by the claims. Features that are explained or described in connection with one exemplary embodiment may be combined with features of other embodiments. It is intended that such modifications and changes be within the scope of the present invention.

Simultaneously with this application, three applications for US patents belonging to this applicant have been filed. At the time of filing, three of these applications were designated as follows:

SURGICAL STAPLING INSTRUMENT WITH CUTTING MEMBER ARRANGEMENT, Atty. Docket No. END6414USNP / 080203, inventors: Chester Baxter and James Bedi;

SURGICAL STAPLER HAVING AN INTERMEDIATE CLOSING POSITION, Atty. Docket No. END6411USNP / 080200, inventors: Chester Baxter and James Bedi; and

SURGICAL STAPLER WITH APPARATUS FOR ADJUSTING STAPLE HEIGHT, Atty. Docket No. END6406USNP / 080195, inventors: Chester Baxter and James Bedi, the descriptions of which are fully incorporated into this description by reference.

As shown in FIG. 1, a surgical stapling instrument, indicated at 100, may comprise a first handle portion 102 and a second handle portion 104. In various embodiments, the first handle portion 102 and the second handle portion 104 may be gripped, for example, by a surgeon, and may include a handle portion 106. In at least one embodiment, the first handle portion 102, as shown in FIG. 2 and 3 may comprise a first pad 108 attached to the first frame 110 and, likewise, a second handle portion 104 may comprise a second pad 112 attached to the second frame 114. The pad 108 and 112 may have ergonomic profiles or other suitable contours to help to the surgeon while manipulating the stapling tool 100 in the surgical field. In various embodiments, the implementation of the pads 108 and 112 of the handle, for example, may contain extended protrusions 109 and 113, respectively, which can facilitate the introduction of stapling staple instrument 100 into the surgical field. In various embodiments, the handle pads 108 and 112 may be made, for example, of lightweight plastic materials and / or any other suitable material, and the handle frames 110 and 114 may be made of, for example, stainless steel, titanium and / or any other suitable material.

In various embodiments, as also shown in FIG. 1-3, the distal ends of the handle portions 102 and 104 may comprise an end effector 120, which may be configured, for example, to handle tissue in the surgical field. In at least one such embodiment, the end effector 120 may include a chute 122 for the bracket cassette configured to receive and / or hold the bracket cassette, as described in more detail below. In some embodiments, the implementation of the chute 122 under the cassette for brackets may contain a one-piece elongated grooved frame, continuing from the frame 110 of the first section of the handle. In at least one embodiment of the present invention, the bracket chute 122 may comprise a pair of opposed elongated side walls 124 connected by a bottom wall 126. A pair of spaced vertical side flanges 128 may extend upward from the opposed side walls 124 along the rear or proximal section of the groove 122 under the cassette for brackets. In various embodiments, the width of the bracket chute 122 between the side flanges 128 may be greater than the width of the upper clamping element or anvil 130 extending from the second portion 104 of the handle. In at least one embodiment, the distance between the flanges 128 can be configured to allow at least a portion of the anvil 130 to fit between the side flanges 128 when the stapling tool is assembled for operation. As shown in FIG. 2, each side flange 128 may comprise, for example, a cutout or recess 127, which may be adapted to receive at least one locking protrusion 131, for example, extending from the anvil 130 and / or any other suitable portion of the second handle portion 104 as described in more detail below.

As indicated above and also shown in FIG. 1-3, the chute 122 for the bracket cassette may be configured to secure and / or hold the bracket cassette, for example the bracket cassette 150, inside the end effector 120, wherein the bracket cassette may include at least one bracket ( not shown), retrievable fit in this cassette. In the various embodiments shown in FIG. 8-10, the bracket bracket 150 may include at least one bracket bracket 151, which may be configured to receive brackets in any suitable arrangement, for example, in at least two transversely spaced longitudinal rows. In at least one embodiment shown in FIG. 9 and 10, the cassette 150 for the brackets may comprise a housing 152 and a tray 154 of the cassette for the brackets, while the casing 152 and / or the tray 154 of the cassette for the brackets may be configured to form a groove or passage to fit into it with a possibility to shift the sliding block brackets and / or cutting element. In at least one embodiment, the tray 154 may comprise, for example, flexible brackets 155 that can be adapted to engage the bracket cassette 152 for snap fit and / or press fit fittings. As shown in FIG. 10-12, the cassette 150 for the brackets may further comprise a unit 160 of the sliding bracket extrusion unit, which may comprise a portion 162 of the sliding bracket extrusion unit, and furthermore a cutting element 164. In various embodiments, the cutting element 164 may include a cutting edge 165 and, for example, a fixing bracket 166, while the fixing bracket 166 can be configured to press fit and / or snap fit into the cutout 163 in the sliding bracket extrusion block 162 when the cutting member 164 is assembled m with the displacement portion 162 sliding block brackets. In various other embodiments, the portion 162 of the sliding bracket extrusion unit may be molded as an integral part with a cutting member 164.

In addition to the foregoing, as shown in FIG. 8-10, the bracket cassette body 152 may comprise a slot, for example a slot 156, which may be adapted to receive at least a portion of a cutting member 164 and / or any other portion of a node 160 of the sliding block for displacing the brackets and the node 200 an ejection rod (described below), wherein a slot 156 can be made to allow the movement of the cutting element 164 between the first and second positions within the cassette 150 for brackets. In various embodiments, a slot 156 may be provided to allow the cutting element 164 to be moved between the proximal position (FIG. 10) and the distal position to dissect tissue located, for example, between the bracket cassette 150 and the anvil 130. As also shown in FIG. 10-12, a portion 162 of the sliding bracket extrusion unit may comprise cam, inclined, or drive surfaces 167 that may be configured to come into contact with the leads of the brackets located within the bracket cassette 150. In various embodiments, as shown in FIG. 9, the cassette 150 for the brackets may include braces leads 168 that can be lifted or slid up inside the brackets 151 by the sliding block portion 162 so that the upward movement of the braces leads 168 can eject or release brackets at least partially located inside the brackets 151 for brackets. Although leashes 168 brackets can, in fact, be lifted vertically up, the term up, etc. may mean, for example, that the brace leashes 168 are moved to the top surface or the protective pad 158 of the brace cartridge and / or, for example, to the anvil 130. In some embodiments, as shown in FIG. 9, each brace leash 168 may include at least one beveled surface 169 oriented at the same angle as the cam surface 167 and / or any other suitable angle that can provide a relatively flat or at least substantially , a flat sliding contact surface between the sliding block 162 displacement brackets and leads 168 brackets. In various embodiments, the implementation of the leash of brackets can be made with the possibility of crowding out only one bracket, and in some embodiments, the implementation of the leash of brackets can be made with the possibility of simultaneously crowding out at least two brackets located, for example, in adjacent rows. Other devices are described in U.S. Patent Application No. 12 / 030,424, SURGICAL STAPLING INSTRUMENT WITH IMPROVED FIRING TRIGGER ARRANGEMENT, filed February 13, 2008, and the entire contents of which are incorporated herein by reference.

In various embodiments, implementation, as explained above, the surgical stapling tool may include a node of the cutting element / sliding block extrusion of brackets, configured to dissect tissue and staples from the cassette for brackets. However, in some embodiments, the surgical stapling tool may not need or need to contain a cutting element. In at least one such embodiment, the cassette for the brackets may comprise a sliding brace displacement unit located therein, and / or the surgical instrument may be configured to move the sliding brace displacement unit to the brace cassette so that the fabric can be stapled, otherwise case, for example, without its dissection. In some other embodiments, the cassette for brackets may include a sliding block for displacing the brackets located therein, while the surgical instrument may include a cutting element that allows it to be moved inward or relative to the cassette for brackets. In at least one such embodiment, the cutting element can be fed forward into contact with the sliding bracket extrusion unit such that the cutting element and the sliding bracket extrusion unit can be fed forward together. After that, the cutting element can be pulled back enough so that the cassette for the brackets can be separated from the surgical instrument and replaced with a new cassette for the brackets containing a new sliding block for the extrusion of the brackets. These embodiments may be beneficial when the sliding bracket extrusion unit may engage or warp during use. Other embodiments are possible in which the cassette for the brackets may comprise a cutting element located therein, and the surgical instrument may comprise a sliding block for displacing the brackets to be moved inward or relative to the cassette for the brackets. In at least one such embodiment, similarly to the options described above, the sliding bracket extrusion block can be brought into contact with the cutting element so that the cutting element and the sliding bracket extrusion block can be fed forward together. After that, the sliding block for displacing the brackets can be pulled back enough so that the cassette for brackets can be separated from the surgical instrument and replaced with a new cassette for brackets, with a new cutting element. These embodiments may be useful when the cutting element may be deformed or deformed during use. In various embodiments, as explained in more detail below, the cassette for brackets may include a protective casing or pad made / nu with the possibility of preventing or at least reducing the likelihood of the surgeon or other doctor touching the cutting element located inside the cassette for brackets, for example, when handling the cassette for brackets.

In various embodiments, in addition to the foregoing, for example, the chute 122 for the bracket cassette and / or the bracket cassette 150 may include, for example, at least one / one interacting protrusion and / or recess that can be made to hold with the possibility of removing the cartridge 150 for the brackets inside the groove 122 under the cartridge for the brackets. After the cassette 150 for the brackets is inserted into the chute 122 under the cassette for the brackets, in various embodiments, the first portion 102 of the handle can be assembled with the second portion 104 of the handle. In various other embodiments, the implementation of the cartridge for brackets can be inserted into the groove under the cartridge for brackets after the first and second sections of the handle are assembled one with the other. In each case, as shown in FIG. 1-7, the first handle portion 102 and the second handle portion 104 may comprise proximal ends 103 and 105, respectively, which can be assembled one with another so that the first and second handle sections can be connected to one another with the possibility of rotation or swing around axis. In various embodiments, as shown in FIG. 2 and 3, the first handle portion 102 may comprise at least one finger or protrusion 111 extending from it, which may be adapted to slide into at least one notch, groove, or slot 115 in the second portion 104 handles. In some embodiments, slots 115 may be formed in the second handle frame 114, and protrusions 111 may extend from the proximal end post 107, extending, for example, from the first handle frame 110. To assemble the first handle portion 102 with the second handle portion 104, as shown in FIG. 4, the open ends of the slots 115 can be aligned with the protrusions 111 so that, for example, the second portion 104 of the handle can be moved relative to the first portion 102 of the handle and the protrusions 111 can be moved inside the slots 115. In at least one embodiment as shown in FIG. 2 and 3, the open ends of the slots 115 may be proximal to their closed ends. In at least one such embodiment, the proximal end 105 of the second handle section 104 can be distal from the proximal end 103 of the first handle section 102 so that the second handle section 104 can be moved proximal to fit the protrusions 111 inside the slots 115. In various in other circumstances, the first handle portion 102 may be positioned proximally relative to the second handle portion 104 and be distally shifted to accommodate protrusions 111 within the slot th 115.

In various embodiments, as shown in FIG. 5, the second handle section 104 can be rotated toward the first handle section 102 so that the anvil 130 can be moved to the desired position relative to the bracket bracket 150 and / or the chute 122 for the bracket bracket. In some embodiments, the first handle portion 102 can be rotated to the second handle portion 104 and / or the first and second handle portions can be rotated one to the other. In both cases, the protrusions 111 and the slots 115, when engaged with each other, may contain an axis around which one of the first and second sections of the handle or both of these sections can be moved relative to each other. In various embodiments, the second grip portion 104 can be moved relative to the first grip portion 102 so that the anvil 130 can be moved to a position that is opposite to the bracket 150. In some embodiments, as shown in FIG. 6, the second handle section 104 can be moved relative to the first handle section 102 so that the locking protrusions 131 extending from the second handle section 104 can be aligned with the recesses 127 in the first handle section 102 and / or inserted into said recesses. In various embodiments, as shown mainly in FIG. 2 and 3, the first handle portion 102 may further comprise a locking mechanism 180 that is pivotally mounted in a given portion and which can be used to engage the locking protrusions 131 extending from the second handle portion 104 and to fasten the first and second handle sections of one with another. Although not shown, other embodiments can be imagined in which the locking mechanism is rotatably mounted in the second portion of the handle, and the locking protrusions may extend from the first portion of the handle. In any case, in at least one embodiment, the locking mechanism 180 can be mounted on the first frame 110 on at least one pivot pin 182, which can be configured to define an axis around which the latch 180 can rotate.

In some embodiments, as shown in FIG. 4 and 5, the locking mechanism 180 may comprise a latch frame 184 and, in addition, a latch plate 186 mounted on the latch frame 184. In various other embodiments, the implementation of the latch latch and the frame of the latch may form an integral unit, or, in some embodiments, the implementation of the locking mechanism may not even contain a lining. In some embodiments, the retainer frame 184 may be grooved and may comprise a pair of opposed elongated side walls 185 that are spaced apart enough to span the first frame portion 110. In at least one embodiment, the retainer pad 186 may be formed, for example , from plastic lightweight materials and / or any other suitable material, and the retainer frame 184 may be made, for example, of stainless steel and / or any other suitable material. In some embodiments, when the locking mechanism 180 is closed, as shown in FIG. 7, the retainer pad 186 may align with the first handle pad 108. The retainer pad 186 may comprise a profiled portion 187, which may be configured so that it is more convenient for the surgeon to manipulate the stapling staples with the tool 100, while in at least one embodiment, the profiled portion 187 may be aligned with or at least substantially aligned with a protrusion 109 extending from the first handle pad 108. The locking mechanism 180 may further comprise at least one locking lever 188 extending from the locking mechanism, which may be adapted to engage with at least one locking protrusion 131 extending from the second portion 104 of the handle, and attracting and / or securing protrusions 131 inside recesses 127, as shown in FIG. 7. In at least one embodiment, at least one of the locking levers 188 may be integral with the latch frame 184. In some embodiments, as shown in FIG. 6, at least one of the locking levers 188 may comprise a distal bracket 189, which may be configured to enclose at least a portion of the protrusions 131 to enclose or surround, or at least partially enclose or surround, the protrusions 131. In at least one embodiment, the locking levers 188 may function as a supracentral latch to hold the locking mechanism 180 in its locked or closed position.

In use, in various circumstances, one of the first portion 102 of the handle and the second portion 104 of the handle may be located on the first side of the tissue in the surgical field, and the other portion of the handle can be rotated to the desired position on the opposite side of the fabric. In these embodiments, the cassette 150 for brackets can be placed on one side of the fabric, and the anvil 130 can be placed on the other side of the fabric. After this, as also described above, the locking mechanism 180 can be actuated so that it can be moved from the open position to the closed position to fix the second section 104 of the handle to the first section 102 of the handle and applying a fixing force to the tissue located between the cartridge 150 for brackets and anvil 130. In some circumstances, the locking mechanism 180 may be translated between an open position (FIG. 5), a partially closed or intermediate position (FIG. 6), and a closed position (FIG. 7). In at least one such embodiment, as shown in FIG. 5 and 6, the locking mechanism 180 can be translated between an open position in which the locking levers 188 are not engaged with the protrusions 131 and a partially closed position in which the locking levers 188 are engaged with the protrusions 131, so that although the anvil 130 is brought into a position that is at least partially opposite with respect to the cassette 150 for the brackets, between the anvil 130 and the cassette 150 for the brackets there may be sufficient clearance, which may allow, for example, the reinstallation of the end effector 120 relative to the fabric. Once the anvil 130 and the cassette 150 for the brackets are satisfactorily positioned relative to the fabric, the locking mechanism 180 can be moved from its partially closed position to the closed position, as shown in FIG. 7.

In various embodiments, in addition to the foregoing, the surgical stapling tool may further comprise a clamping member, which may be configured to wring the first portion of the handle of the stapling tool from the second portion of the handle. In at least one embodiment, as will be explained in more detail below, a spring and / or any suitable resilient material can be inserted between the first and second portions of the handle so that the anvil and the cassette for the brackets of the stapling tool can be unclenched. In some embodiments, the spring may be configured to at least partially part the first and second portions of the handle so that there is a gap between the anvil and the cassette for the brackets, and the gap may be sufficient to allow the fabric to be placed between the anvil and the cassette for the brackets . In use, the surgeon may position the surgical stapling instrument without necessarily diluting the first and second portions of the handle and holding them in a diluted position. This tool can, in particular, be useful when the surgical stapling tool is in a partially closed position and the surgeon manipulates the tool in the surgical field. After the surgeon concludes that the stapling tool is in a satisfactory location, the surgeon can compress and / or unhook the spring and bring the stapling tool into a closed configuration.

In various circumstances, as explained above, the distal end of the first handle portion 102 can be moved relative to the distal end of the second handle portion 104, in particular when the locking mechanism 180 is not engaged or only partially engaged with the protrusions 131 of the second handle portion 104. In these circumstances, the protrusions 111 and the slots 115 at the proximal ends of the first and second parts of the handle can be configured to hold at least the proximal ends of the first and second parts of the handle one with the other when the distal ends of the first and second parts of the handle are moved, for example one relative to the other. In other words, the protrusions 111 and the slots 115 may cooperate to prevent or at least restrain the complete separation of the first portion 102 of the handle with the second portion 104 of the handle. In some embodiments, the first handle portion may comprise a first locking portion, and the second handle portion may comprise a second locking portion, wherein the first and second locking portions may be coupled to one another and prevent the first handle portion from completely disconnecting from the second handle portion . In at least one embodiment, the protrusions 111 may comprise a first locking portion, and the slots 115 may comprise a second locking portion. In previously known staple-stapling tools, such closing sections were absent, and instead relied on a single locking mechanism to hold the first and second sections of the handle one with the other. In circumstances in which the locking mechanisms of the previously known stapling instruments did not fully engage with both the first and second parts of the handle, the first and second parts of the handle could be completely disconnected from one another, as a result of which, for example, the surgeon needed to be reinstalled and again to collect areas of the handle. In some circumstances, the complete separation of the first and second parts of the handle of the previously mentioned staple-stapling tools may expose at least a portion of the cutting element.

In various embodiments, as explained above, the locking mechanism 180 may be configured to move between an open position, a partially closed position, and a closed position. When the locking mechanism 180 is in its open position, as also explained above, the protrusions 111 can be inserted into and / or removed from the slots 115. The locking levers 188 may be configured such that when the locking mechanism 180 is in its partially closed position shown in FIG. 6, engage the locking protrusions 131 in such a way that the protrusions 111 cannot be pulled out of the slots 115. In at least one such embodiment, the locking levers 188 and the locking protrusions 131 can be configured to prevent or at least restrain a distally directed moving the second handle portion 104 relative to the first handle portion 102 and, as a result, preventing or at least restraining the protrusions 111 from slots 115 to be released. Accordingly, the locking levers 188 and the locking you stupas 131 may be configured to prevent proximally directed movement of the first handle portion 102 relative to the second handle portion 104. Similar to the options described above, in various embodiments, the locking levers 188 and the locking protrusions 131 can also be configured to prevent or at least hold the protrusions 111 out of the slots 115 when the locking mechanism 180 is in its closed position (FIG. 7) . In some embodiments, in addition to the foregoing, the locking protrusions 131 can extend from the second portion 104 of the handle in a position that is intermediate between its proximal and distal ends. In at least one such embodiment, the protrusions 111 and the slots 115 may be configured to hold the first and second portions of the handle one with the other at their proximal ends while the locking mechanism 180 can be used to hold the first and second portions of the handle of one with another in their intermediate place. In any case, in some embodiments, the first and second portions of the handle cannot be detached from one another until the locking mechanism 180 is moved to its fully open position. In at least one such embodiment, the protrusions 111 and the slots 115 cannot detach from each other when the locking mechanism 180 is in a closed and / or partially closed position.

After the anvil 130 and the cassette 150 for brackets are set to a satisfactory position, the fabric located between the anvil 130 and the cassette 150 for brackets can be stapled and / or dissected. In various embodiments, as shown in FIG. 3, the surgical stapling instrument 100 may further comprise an ejector rod assembly 200, which may be configured to feed forward and / or retract the assembly 160 of the sliding bracket extrusion unit, for example, inside the bracket bracket 150. In at least one embodiment, the ejector rod assembly 200 may comprise an ejector rod 202 and a firmware / cutting drive device 204 (control device), wherein the firmware / cutting drive device 204 may be configured to move the ejection rod 202 and the assembly 160 a sliding block for displacing the brackets in the distal direction for displacing the brackets from the cassette 150 for brackets and deforming the brackets on the anvil 130, as explained above. In at least one embodiment, as shown in FIG. 11 and 12, the sliding bracket extrusion unit 162 may include a cutout, groove, or slot 161 that can be adapted to receive the distal end 201 (FIG. 3) of the ejector rod 202 and can be operatively connected to said rod. In some embodiments, the implementation of the node 160 of the sliding block extrusion brackets may come into operational engagement with the ejector rod 202, when the cartridge 150 for brackets is inserted into the groove 122 under the cartridge for brackets. In at least one embodiment, the distal end 201 and the slot 161 may include interacting structural elements that can allow the distal end 201 and the slot 161 to be assembled in the transverse direction, but to prevent or at least restrain the distal end 201 from being disconnected from the slot 161 in the proximal direction and / or distal direction. In other embodiments, the ejector rod 202 can be fed in the distal direction until it comes into contact and engages with the node 160 of the sliding block extrusion brackets. In at least one such embodiment of the present invention, the node 160 of the sliding block extrusion brackets can remain stationary until contact with the ejector rod 202. In any case, as explained above, the drive device 204 may have such a working connection with the ejector rod 202, that a pushing and / or pulling force can be applied to the drive device 204 and transmitted to the ejector rod 202. In some embodiments, as described in more detail below, the drive device 204 can t be rotatably coupled to the proximal end 203 of the ejector rod 202 so that the drive device 204 can selectively rotate between at least the first and second positions.

In addition to the foregoing, as shown in FIG. 1, 13, and 14, the drive device 204 may allow movement between a first position on the first side 116 of the surgical stapling instrument 100 (FIG. 13), a second position on the second side 117 (FIG. 14) and an intermediate position (FIG. 1), located at the proximal ends 103 and 105 of the first and second sections 102 and 104 of the handle. After the drive device 204 is rotated to a position on one of the first and second sides 116, 117, the drive device 204 can be fed in a distal direction. As a result, in various circumstances, the surgeon can choose whether to move the drive device 204 distally along the first side 116 or along the second side 117. These circumstances may occur when it is likely that the drive device 204 may, for example, come across tissue surrounding the operative field, when the drive device 204 is moved distally along one side of the surgical instrument, has a higher value compared to the other side. In various embodiments, as shown in FIG. 2 and 3, the actuator 204 may comprise a lever 206 extending from it, and the lever 206 may be rotatably secured to the proximal end 203 of the ejector rod 202. In some embodiments, as also shown in FIG. 1, 13 and 14, the surgical instrument 100 may comprise a first groove (not shown) extending along the first side 116, and a second groove 118 extending along the second side 117, wherein the first and second grooves may be slidably accommodated, at least a portion of the drive device 204. In at least one embodiment, the side walls of the first and second grooves can define movement, or at least help limit the movement of the drive device 204 so that it can not move along a predefined path. As shown in FIG. 14, for example, a second groove 118 may be formed between the first handle portion 102 and the second handle portion 104 so that when the actuator 204 is moved distally along the second side 117, the lever 206 of the actuator 204 can be moved between the first and second portions of the handle . Similar to the above, the first groove can also be formed between the first and second portions of the handle. In various embodiments, as also shown in FIG. 13 and 14, the surgical instrument 100 may further comprise a transition groove 119, which may also be configured to allow the lever 206 and / or any other suitable portion of the actuator device 204 to slide therein. In at least one such embodiment, the transition groove 119 can connect the first and second grooves so that when the drive device 204 is installed in its intermediate position, the drive device 204 can be moved to any of its first and second positions. In some embodiments, the first groove, the second groove 118, and the transition groove 119 may be parallel or at least substantially parallel to each other and / or in the same plane, although other embodiments may be contemplated in which at least , one of the grooves is not parallel to the other and / or is in another plane. In addition, although the first and second sides in the illustrated embodiment are on opposite sides of the surgical instrument 100, other embodiments may be contemplated in which, for example, the first and second grooves are on adjacent sides and / or on sides that are not directly opposite one another. In addition, other embodiments may be suggested in which the sides of the stapling tool are not easily distinguishable, for example, in tools having round and / or arc-curved portions.

In various embodiments, in addition to the above, the surgical stapling tool 100 may further comprise a locking mechanism that can block or at least restrain the drive device 204 and, accordingly, the node 160 of the sliding block for displacing the brackets from premature forward feed. In at least one embodiment, the locking mechanism may be configured to block or at least hold the drive device 204 from feeding in the distal direction until the locking mechanism 180 is brought into a closed or at least partially closed position. In some embodiments, implementation, as generally shown in FIG. 5, the surgical stapling tool 100 may further comprise a locking mechanism 220 that may engage with the drive device 204 and may remain engaged with the drive device 204 when the locking mechanism 180 is in the fully open position (FIG. 5) and / or at least a substantially open position. In various embodiments, the locking mechanism 220 may include a lock 222 that can be engaged in engagement with the actuator 204 by the compressive force exerted on the lock, for example by a locking spring 224. In at least one such embodiment, the actuator 204 may comprise at least one notch, groove, or slot (not shown), which may be configured to fit at least a portion of the lock 222. In use, the locking mechanism 220 may hold the drive stroystvo 204 in position until latching mechanism 180 is not displaced in its fully closed position (FIG. 7) and / or at least a substantially closed position. In these circumstances, in at least one embodiment, the locking mechanism 180 may be adapted to engage with the locking mechanism 220 and to release the lock 222 from the drive device 204. In at least one such embodiment, as shown in FIG. . 5-7, the locking mechanism 180 may further comprise a cam 183, which may be adapted to engage with the cam surface 223 on the lock 222 when the locking mechanism 180 is moved to its closed position, and, as a result, the sliding and / or other moving the lock 222 from the drive device 204. In various embodiments, the cam 183 may include a wall, rib, and / or ridge extending from the retainer pad 186 and / or the retainer frame 184. In any case, after the lock 222 has sufficiently disengaged from the drive device 204, in at least one embodiment, the drive device 204 can be moved from its transitional position shown in FIG. 1 to one of its first and second positions, as shown in FIG. 13 and 14.

As explained above, the locking mechanism 220 may be configured to lock or at least hold the push rod 202 away from the distal feed until the locking mechanism 180 is moved to a predetermined position, for example, a closed position and / or a partially closed position. In a preferred embodiment, the locking mechanism 220 may also block or at least partially constrain the assembly 160 of the sliding block for displacing the brackets from the feed to the assembly of the first handle portion 102 and the second handle portion 104 with one another. In fact, the locking mechanism 220 can prevent cutting and / or stapling of the fabric located between the anvil 130 and the cassette 150 for the brackets to properly install the anvil 130 and the cassette 150 for the brackets relative to the fabric. In addition, in fact, the locking mechanism 220 can prevent staples from being inserted into the fabric until proper compressive force is applied to the fabric. In any case, when the locking mechanism 180 returns to its fully open position and / or partially open position, the cam 183 can be displaced from the lock 222 so that the locking spring 224 can press the lock 222 into engagement with the drive device 204. In various other embodiments implementation as shown in FIG. 15 and 16, the locking mechanism 220 ′ may comprise a lock 222 ′ comprising a cam surface 223 ′ and, optionally, a stopper 226 ′ that can limit the relative movement of the lock 222 ′. In at least one embodiment, for example, cam 183 may be configured to come into contact with cam surface 223 ', and, due to profiling, beveling and / or angular inclination of the surface of cam surface 223', cam 183 can be made with the possibility of sliding the lock 222 'in the distal direction, as shown in FIG. 16. The lock 222 'can be shifted in the distal direction so that the pin 228', which continues from the lock 222 ', can move between the first position (Fig. 15), in which it is located in the hole 229' in the drive device 204 ', and the second position (Fig. 16), in which the pin 228 'is sufficiently withdrawn from the hole 229'. In various embodiments, the stopper 226 ′ may be configured such that when the lock 222 ′ is displaced distally, the stopper 226 ′ may come into contact with the cam 183 as soon as the lock 222 ′ is sufficiently displaced. In these embodiments, the stopper 226 ′ may be configured to define a second or offset position of the lock 222 ′. Similar to the above options, when the locking mechanism 180 is removed from its closed position and the cam 183 is disengaged from the locking mechanism 220 ', the locking spring 224' can again move the stopper 222 'into engagement with the drive device 204'.

In various embodiments, as explained above, the firmware / cutting drive unit can be used to move the ejection bar, the sliding ejection unit of the brackets and / or the cutting element between the first and second positions. As also explained above, for example, the ejector rod assembly 200 can be used to move the assembly of the sliding bracket extrusion block, for example the assembly 160 of the sliding bracket expulsion unit, from the proximal position (FIG. 10) to the distal position. In some embodiments, the bracket cassette, for example the bracket cassette 150, may comprise an assembly 160 of the sliding bracket extrusion unit enclosed therein, while the assembly 160 of the sliding bracket extrusion unit may be located in the proximal position shown in FIG. 10, when the bracket cassette is installed or inserted into the groove 122 under the bracket cassette. In at least one such embodiment, as shown in FIG. 8-10, the cassette 150 for the brackets may include an additional casing 170, which may be configured to close at least a portion of the cutting element 164, for example, when the node 160 of the sliding block extrusion brackets is in its proximal position. In various embodiments, the casing 170 may be configured to protect, for example, a surgeon when handling the staple cartridge, when inserting the staple cartridge into the surgical stapler, and / or, for example, when assembling at least two sections of the surgical stapler one with the other. In at least one such embodiment, at least the upper portion of the cutting edge 165 may extend above the protective pad or upper surface 158 of the cassette 150 for the brackets, and, in the absence of a protective casing, for example casing 170, the upper portion of the cutting edge 165 may be naked.

In various embodiments, as explained above, the cutting element 164 may be at least partially located within the slot or groove 156, and as shown in FIG. 10, at least the top or top portion of the cutting member 164 may extend above the guard 158. In at least one embodiment, as shown in FIG. 8-10, the casing 170 may comprise a first wall or a first portion 172 extending from the first portion 157 of the bracket cassette 152, a second wall or second portion 174 extending from the second portion 159 of the bracket cassette 152, and an upper wall or upper portion 176 extending between the first wall 172 and the second wall 174. In some embodiments, the casing may comprise only one support wall or support portion extending from the bracket cassette body and, in addition, an upper wall or upper portion, continue out of it. In other embodiments, the implementation of the casing may contain at least one side wall or section and not contain any upper wall. In at least one such embodiment, the side walls of the casing may be configured to extend above the top of the cutting element, or at least extend, for example, above the cutting edge of the cutting element. In any case, as shown in FIG. 10, at least a portion of the cutting element 164 may be located below the upper wall 176 and / or between the side walls 172 and 174 when the node 160 of the sliding block extrusion brackets is in its proximal position. In some embodiments, the cutting element 164 may be entirely located below the upper wall 176 and / or entirely located inside the casing 170. In at least one embodiment, the cutting element 164 may be located below the upper wall 176 so that the cutting surface 165 does not extend beyond the distal edge 175 and / or proximal edge 177 of the upper wall 176. In at least one embodiment, the casing 170 may include a rear wall 178, which may be configured to limit the directional movement of the cutting element 164 and / or any other portion of the node 160 of the sliding block extrusion brackets. In various embodiments, for example, at least a portion of the casing 170 may be integral with the cassette bracket body 152. In at least one such embodiment, the first wall 172, the second wall 174, the upper wall 176 and / or the rear wall 178 may be molded when the bracket cassette body 152 is made, for example, by injection molding. In some embodiments, at least a portion of the casing 170 may be assembled on the housing 152 using a self-locking fit design, a press fit design, and / or any other suitable method.

In various embodiments, in addition to the foregoing, the cutting element 164 may be formed by a flat or at least substantially flat body having a sharp edge extending along at least one side of the body of the cutting element. In at least one such embodiment, the first wall 172 and / or the second wall 174 may be formed and arranged so that they may contain flat or at least substantially flat inner surfaces 173 that are parallel or at least substantially parallel to the side surfaces of the cutting element 164. In some embodiments, the cutting element 164 can fit snugly between the inner surfaces 173 of the walls 172 and 174. In at least one such embodiment, the distance between the shanks 172 and 174 may be such or at least substantially the same as the width of the slot 156. In any case, the casing may be configured such that at least, for example, a portion of the casing extends over at least a portion slots 156. In some embodiments, the housing 170 may completely enclose or surround the cutting member 164 and / or the cutting surface 165. In at least one embodiment, although not shown, the housing may comprise a tear-off and / or notched portion that maybe at least partially detached nyatsya, separated and / or otherwise deformed to allow the emergence of the cutting element from the housing. In at least one such embodiment, the cutting fabric surface can be made so that it comes into contact with the casing, for example, to destroy and / or dissect the wall of the casing. In various embodiments, the casing wall may comprise a thin section, a reduced thickness section, a groove, and / or any other configuration to facilitate deformation and / or dissection of the casing wall. In some embodiments, the implementation of the cutting element may contain at least one additional cutting surface and / or, for example, anvil, which can be made for deformation and / or dissection of the casing. In at least one embodiment, the casing may comprise a movable and / or flexible portion, for example, a flip element and / or a flexible flap, which can be configured to move and / or bend sufficiently to allow passage of the cutting element. In any case, embodiments may be contemplated in which the cutting element may have any suitable configuration for dissecting the tissue, and the protective cover may have any suitable configuration for at least partially enclosing or covering the cutting element. In addition, although the cutting element may contain a pointed edge, as explained above, it can be assumed that other suitable cutting elements are applicable, for example, cutting elements with an electric current supply sufficient to dissect the tissue.

As explained above, the casing 170 may be configured to at least partially close, enclose and / or enclose the cutting element when the cutting element is in its proximal position. In various embodiments, the cutting element can be fed in the distal direction, for example, to dissect tissue and then retracted in the proximal direction to place the cutting element again inside the housing 170. In these embodiments, the cutting element can at least partially be closed by the housing 170 when the cassette for brackets is installed in a surgical stapling instrument with brackets or removed from it. In some embodiments, a new or unfinished bracket cassette can be inserted into the groove under the bracket cassette to replace at least a partially spent bracket cassette. In at least one such embodiment, the new cassette for brackets may comprise a new cutting element and / or an assembly of a sliding brace displacement unit located in the cassette for brackets, although embodiments in which previously used cutting element and / or assembly can be assumed the sliding bracket extrusion unit can be sufficiently removed from the spent cassette for the brackets and inserted into the new cassette for the brackets for reuse. In embodiments in which a new cutting element and / or assembly of the sliding bracket extrusion unit is provided with each new bracket cartridge, for example, a sharp cutting edge with each bracket cartridge can be used.

In various embodiments, although not shown, the cassette for brackets may comprise at least two housings configured to at least partially close the cutting element when the cutting element is in at least two positions. In at least one embodiment, the cassette for brackets may include a proximal casing configured to at least partially close the cutting element when the cutting element is, for example, in the proximal position, and, in addition, the distal casing made with the possibility of at least partially closing the cutting element when the cutting element is, for example, in a distal position. In at least one such embodiment, the cutting element may be located inside the proximal casing when the cassette for brackets is inserted into a surgical stapling instrument, and, in some embodiments, the cutting element may slide into the distal casing after, for example, the cutting element cut through the fabric in the end effector. As a result, in these embodiments, the cutting element may be at least partially located within the distal casing when the bracket cassette is removed from the surgical stapler. These embodiments may be particularly useful when, for example, a vessel is located between the proximal casing and the distal casing of the bracket cassette. In various embodiments, although not shown, the cutting element can be moved in the proximal direction from a distal position to a proximal position and / or any other suitable position.

In various embodiments, in addition to the above, the anvil 130 may comprise at least one opening, a slot or recess 179 (FIG. 17), which may be configured to receive at least a portion of the casing 170 when, for example, the anvil 130 is brought directly opposite to the cassette 150 for the brackets. In at least one embodiment, there may be sufficient clearance between the casing 170 and the recess 179 so that the anvil 130 and the cassette 150 can move relative to each other without interference or at least without significant interference between them. In embodiments containing at least two shrouds for the cutting element described above, the opposing anvil may comprise at least two corresponding openings for receiving shrouds. In various embodiments, the anvil may comprise a movable cutting element and at least one casing for at least partially closing, enclosing and / or enclosing the cutting element. In some embodiments, although not shown, both the anvil and the cassette for the brackets may contain at least one movable cutting element and / or at least one casing configured to at least partially close , coverage or conclusion of the cutting elements when they are, for example, in the proximal position.

As explained above, the ejector rod assembly 200 can be fed in the distal direction to move the bracket eraser sliding assembly 160 within the bracket assembly 150. In various embodiments, as also described above, the wedge-shaped cam surfaces 167 of the brace extrusion block 162 can move into contact with the inclined surfaces 169 on the brace leashes 168 for sequentially and / or simultaneously pushing the brackets from the brace cassette 150 against the anvil 130 and for forming brackets to give them any suitable configuration, for example a B-shaped configuration. In at least one such embodiment, as shown in FIG. 17, the anvil 130 may comprise at least one brace-forming surface, for example a brace-forming recess 132, which may be configured to deform the brackets. In some embodiments, the anvil 130 may further comprise a slot, a groove, or a cutout 133 that can be adapted to slide, for example, at least a portion of the sliding brace extrusion unit 162, the cutting element 164, and / or the ejector rod 202. B in at least one embodiment, although not shown, the anvil may comprise an anvil strip that can be rigidly and / or fixedly mounted in the anvil groove formed in the anvil. In various other embodiments, as shown in FIG. 18 and 19 and described in more detail below, the anvil 130 may comprise an anvil plate 134 that is movably mounted in the anvil groove 136. In some embodiments, the anvil groove 136 may include opposing side walls 137 and, in addition, a base 138 extending between the side walls 137. In at least one embodiment, the anvil 130 may further comprise, for example, a distal front portion 139 mounted on the anvil, while the front section 139 can be configured to be installed, for example, by press fit and / or self-locking fit into the anvil groove 136, so that the front section 139 can be held firmly bend in the mentioned trench. In some embodiments, the front portion 139 may consist of a soft and / or malleable material, such as rubber, and may have any suitable shape that can facilitate the insertion of the anvil 130, for example, into the operative field. In some embodiments, as shown in FIG. 28, the front portion, for example the front portion 139 ', can be fixed to the anvil with at least one fastener 139a'. Similarly, as shown in FIG. 1, a gutter for a brace cassette and / or a cassette for brackets, for example a cassette 150 for brackets, may include a front section, for example a front section 153, which can facilitate the insertion of the cassette 150 for brackets, for example, into the surgical field.

As indicated above, the brackets can be pushed out of the bracket cassette and warped on the anvil. In various cases, the distance between the bracket-forming surfaces on the anvil 130 and the sliding bracket block 162 may specify the degree to which the brackets are deformed. For example, if the distance between the bracket-forming recesses 132 on the anvil 130 and the upper surfaces 135 on the sliding bracket extrusion block 162 (Figs. 10-12) is relatively large, then the brackets will be less deformed than when the distance between the recesses 132 is the anvil and the surfaces 135 of the sliding block is relatively small. Accordingly, if the distance between the recesses 132 on the anvil and the surfaces 135 of the sliding block is relatively small, the brackets will be deformed to a greater extent than when the distance between the recesses 132 on the anvil and the surfaces 135 of the sliding block is relatively large. The distance between the recesses 132 on the anvil and the surfaces 135 of the sliding block is often called the height of the formation of the brackets. The height of the formation of the brackets can sometimes be measured between the top surface or the protective pad of the cassette for brackets and bracket-forming surfaces on the anvil. However, for the purposes of this application, any reference to the height of the brackets or something similar may include one or both of the measurement methods, when appropriate, and / or any other suitable measurement method. In any case, as explained in more detail below, a surgical stapling tool, for example a stapling tool 100, may include means for adjusting the height of the staple formation.

In various embodiments, in addition to the foregoing, the anvil may comprise at least one forming surface that can move to and from or away from the cassette for the bracket to adjust the height of the formation of the brackets. In at least one embodiment, as shown in FIG. 17-23, the anvil 130 may include an anvil plate 134 that can be mounted to move and / or slide in the anvil groove 136. In some embodiments, the anvil 130 may further comprise at least one fixing or guide pin 140, wherein the anvil plate 134 may include at least one fixing or guide groove 141 configured to receive at least one shear , a portion of the pins 140. In at least one such embodiment, the pins 140 and / or the grooves 141 may be configured to limit a predetermined path along which the anvil strip 134 can move. As shown in FIG. 18, the pins 140 and the slots 141 may be of such construction and arrangement that the anvil strip 134 can move along a linear or at least substantially linear path, while the linear path can be at least partially defined, for example, axes 142 and 143. Other embodiments are possible in which the anvil strip can move along a non-linear path, such as a rounded and / or curved path. In some embodiments, at least a portion of pins 140 may be held in holes 144 in side walls 137, while in at least one embodiment, pins 140 may press fit into holes 144. In any case, as explained in the present application, the pins 140 may guide the anvil strip 134 as it moves, for example, to and away from the bracket cassette 150.

In various embodiments, in addition to the foregoing, a surgical stapling instrument, such as a stapling instrument 100, may include at least one adjusting element configured to set an anvil portion, such as an anvil strap 134, relative to other parts of the anvil assembly and / or the opposite cassette for brackets. In some embodiments, as shown in FIG. 18 and 19, the stapling tool 100 may comprise an anvil plate adjustment member 230, which may be configured to limit the range of movement of the anvil plate 134. In at least one such embodiment, as shown in FIG. 20 and 21, an adjustment member 230 may be positioned between the anvil strip 134 in a first position in which a first surface or step 231 of the adjustment element 230 is located between the base 138 of the anvil groove 136 and the first mounting surface 145 on the anvil strip 134. In this first position, the first step 231 may specify the extent of the possible or allowable relative movement between the anvil plate 134 and the anvil groove 136. For example, when the anvil 130 is pressed against the fabric, as explained above, the anvil strip 134 may come into contact with the fabric and slide up to the base 138 until the first mounting surface 145 comes into contact with the first step 231. As soon as the surface 145 and step 231 have come into contact, the adjusting element 230 may block or at least restrain the anvil strip 134 from moving further to the base 138. As a result, in at least one such embodiment, the adjusting element 230 may perform the stopper function in such a way that the distance between the base 138 and the tissue contact surface 148 on the anvil strip 134 can be defined as the first distance 234. Although the base 138 serves as a reference level in the present example, for example, other sections of the anvil 130 can be used as reference levels and / or opposite cassette for brackets. When the adjusting element 230 is in its first position, as explained above, the second surface or step 232 of the adjusting element 230 may be between the base 138 and the second mounting surface 146 on the anvil plate 134, and in addition, the third surface or step 233 may be between a base 138 and a third mounting surface 147. As shown in FIG. 20, the adjusting element 230 may comprise at least two sets of steps 231, 232 and / or 233, and the anvil plate 134 may comprise at least two sets of mounting surfaces 145, 146 and / or 147. Although the configuration is described above. for setting the position of the anvil strip 134 by the first step 231 and the first mounting surface 145, the second and third steps (232, 233) of the adjustment element 230 and the second and third mounting surfaces (146, 147) of the anvil plate 134, respectively, can also be made with the possibility job position Lanka anvil 134. However, for brevity, the present example is described below with reference to the first surface or step 231, as a surface that defines the position of the anvil plate 134, although it will be apparent to the reader that steps 232 and 233 can also set the position of the anvil plate 134.

In some embodiments, the first position of the adjustment element 230 may provide a relatively small or short height of formation of the brackets. In other embodiments, although not shown, the first position of the adjustment element may provide an intermediate, relatively large, and / or any other suitable height for forming the brackets. If the height of the formation corresponding to the first position of the adjusting element is suitable, the surgeon can proceed to use a surgical stapling tool for stapling and / or dissecting the tissue, as described above. However, if the height of the formation of the brackets is not suitable, the surgeon or other doctor may shift the adjusting element 230 so that the adjusting element 230 can allow the anvil plate 134 to move upward to a different distance when the anvil plate 134 comes into contact with a tissue located between anvil 130 and cassette 150 for brackets. In at least one such case, the distance over which the anvil strip 134 is able to move upward may be greater, which provides a greater height for the formation of the brackets. Accordingly, in other circumstances, the adjusting element can be moved so that the anvil plate 134 can move up a smaller distance, for example, when the anvil plate 134 comes into contact with the fabric, thereby reducing the height of the formation of the brackets. Although the term “up” and a similar term may imply a vertical direction, the term is not limited to such a meaning; rather, the term “up” can mean any direction that is the direction to the base of the anvil and / or, for example, from the cassette for brackets. In any case, the adjusting element 230 can be moved between its first position shown in FIG. 21 and the second position shown in FIG. 22 to increase the height of the formation of the brackets. As indicated by the arrow “P” in FIG. 22, the adjuster 230 can be shifted in the proximal direction to move the adjuster 230 between its first and second positions, although embodiments can be suggested in which the adjuster can be shifted in the distal direction and / or in any suitable direction to adjust the adjuster 230. After the adjustment member 230 has been moved to its second position shown in FIG. 22, a first surface or step 231 may be installed between the base 138 and the second mounting surface 146 of the anvil plate 134. In this second position, the first step 231 can again set the extent of the allowable relative movement between the anvil plate 134 and the anvil groove 136. In at least one embodiment, similar to the above options, the adjusting element 230 can act as a stopper so that the distance between the base 138 and the tissue contact surface 148 on the anvil strip 134 can be set as the second distance 235.

In addition to the foregoing, the adjusting member 230 can be moved between its second position shown in FIG. 22 and the third position shown in FIG. 23 to again increase the height of the formation of the brackets. As indicated by the arrow “P” in FIG. 23, the adjusting member 230 can be shifted in the proximal direction to move the adjusting member 230 between its second and third positions. After the adjustment member 230 has been moved to its third position shown in FIG. 23, a first surface or step 231 may be installed between the base 138 and the third mounting surface 147. In this third position, the first step 231 may again define the extent of the allowable relative movement between the anvil plate 134 and the anvil groove 136. In at least one embodiment, similar to the above-described embodiments, the adjusting element 230 can act as a stopper so that the distance between the base 138 and the tissue contact surface 148 on the anvil strip 134 can be set as the third distance 236. Although an embodiment is described above. in which the adjusting element 230 can be selectively moved between three positions to provide three different heights of formation of the brackets, other embodiments may be contemplated that comprise an adjusting an element that can be moved between at least four positions to provide at least four different heights of formation of the brackets. For example, the adjusting element can be moved between four positions to provide four different heights of formation of the brackets. Additional embodiments may be provided that comprise an adjusting element that can be moved between two positions to provide two heights for forming brackets. In addition, although the surfaces or steps 231, 232 and 233 of the adjusting member 230 are arranged in a descending order, other arrangements may be suggested in which the surfaces or steps are arranged in an ascending order. You can imagine other layouts in which surfaces or steps are not necessarily placed either in ascending or descending order. Similarly, the mounting surfaces 145, 146 and 147 of the anvil strip 134 may be arranged in an ascending order, a descending order (FIG. 20), and / or any other suitable order. In addition, although the adjusting element 230 can be shifted along the axis, other embodiments may be contemplated in which the adjusting element can be moved along any suitable path, for example, a rounded and / or curved path.

As described above with reference to FIG. 21, the adjusting element 230 may comprise three surfaces or steps 231, 232 and 233, and the anvil strip 134 may contain three corresponding mounting surfaces 145, 146 and 147. When the adjusting element 230 is, for example, in its first position, the first surface 231 may positioned so that it abuts or abuts against the first mounting surface 145, the second surface 232 can be positioned so that it abuts or abuts against the second mounting surface 146, and the third surface 233 can be located so that it abuts or is adjacent to the third mounting surface 147. When adjustment member 230 is slid relative to anvil strips 134 as described above with reference to FIG. 22 and 23, the surfaces 231, 232 and 233 of the adjusting element 230 can be sequentially moved stepwise relative to the surfaces 145, 146 and 147 of the anvil strip 134. In at least one such embodiment of the present invention, the adjusting element may comprise a number of steps equal to the number of mounting surfaces on the anvil strip. Other embodiments may be imagined in which the adjusting element comprises more steps than there are mounting surfaces on the anvil strip. In at least one such embodiment, the anvil strip may comprise one mounting surface, wherein the steps of the adjusting element are selectively used, for example, to limit the upward movement of the anvil strip. Regarding, in general, the adjusting element 230 and the anvil strip 134, in various embodiments, the anvil strip may comprise one mounting surface, for example a mounting surface 145, for example, the steps 231, 232 and 233 of the adjusting element 230 can be selectively installed between the base 138 and the mounting surface 145. In these embodiments, the first step 231 may have a first thickness or height that may block or limit the upward movement of the bar 134 anvils to define the first height of the formation of the brackets, the second step 232 may have a second thickness or height that can block or limit the upward movement of the anvil plate 134 to define the second height of the formation of the brackets, and, in addition, the third step 233 may have a third thickness or a height that can block or limit the upward movement of the anvil strip 134 to define a third height for the formation of the brackets. In at least one embodiment, the thickness or height of the steps 231, 232 and / or 233 can be measured between the rear surface 237 of the adjusting element 230 and the surface on the steps (231, 232, 233), which will be in contact with the anvil plate 134. In various embodiments, the difference in height or thickness between the first step 231 and the second step 232 may be the same or at least substantially the same as the difference in height or thickness between the second step 232 and the third step 233. As a result, in at least one such embodiment, the step heights may increase in a linear manner, or at least substantially linearly. In alternative embodiments, the difference in height or thickness between the first and second steps may differ from the difference in height or thickness between the second and third steps. In at least one such embodiment, the first, second, and third steps may increase or decrease in height or thickness in a non-linear manner; that is, although not shown, steps can increase or decrease in height or thickness non-linearly and / or exponentially.

As explained above, the adjustment element, for example the adjustment element 230, can be moved between at least two positions. In various embodiments, the implementation of a surgical stapling instrument may include a drive device (control device) configured to move the adjusting element. In at least one embodiment, as shown in FIG. 17-20, the surgical stapling tool 100 may include a drive device 250 that may be operatively connected to an adjusting element 230 so that a force can be applied to the drive device 250, with the possibility of transmitting this force to the adjusting element 230. In some embodiments, the drive device 250 may comprise gripping portions or handles 252 that may be gripped by, for example, a surgeon to feed forward or retract the adjustment element 230 in the anvil 130, as cleared up above. In some embodiments, the grip portions 252 may extend from the housing 251 of the drive device, while the housing 251 of the drive device may comprise at least one opening, a slot or cavity 253, which may be configured to receive at least a portion of the adjustment element 230. In at least one such embodiment, as shown in FIG. 19, the adjusting member 230 may comprise a lock 254 extending from it, wherein at least a portion of the lock 254 may fit into the hole 253 to secure the drive device housing 251 to the adjusting member 230. In various embodiments, the lock 254 may comprise at least one elastic or flexible foot 255, which may deviate when it is inserted into the hole 253, but the elasticity returns or at least partially returns the foot to the undeformed position after the legs 256 of the feet 255 chno pushing through the hole 253. In at least one such embodiment, the leg 256 may block or at least restrain the body 251 of the drive device with an adjusting element separation 230.

In various embodiments, in addition to the above, the surgical stapling tool may further comprise a locking mechanism for holding or holding with the possibility of releasing the drive device 250 and / or the adjusting element 230 in the desired position. In at least one embodiment, as shown in FIG. 19, the latch member 260 may be attached to the actuator 250, while in at least some embodiments, the actuator housing 251 may include at least one groove, notch, or recess 257, which can be accommodated and / or holding the retainer body 261 therein of the retainer member 260. In at least one embodiment, the retainer housing 261 may comprise at least one hole 263 and / or any other suitable grooves, slots or cutouts that may be configured to receive at least one fastener for securing the retainer housing 261, for example, to the housing 251 of the drive device. The latch member 260 may further comprise latch tabs 262 that can be engaged with at least one recess, hole or cutout (FIGS. 2-7), for example, in a first frame portion 110. In particular, as shown in FIG. 2 and 3, each side flange 128 may comprise at least one recess 101 formed therein (101a, 101b, and 101c), while the tabs 262 of the lock can be engaged with the upper surfaces of the side flanges 128 so that the tabs 262 of the lock could move into and out of the recesses 101. In the embodiment shown, each side flange may comprise three recesses 101 that can be detachably fixed to the drive device 250 in a first distal position, a second intermediate position and a third proximal position, wherein the first, second and third positions of the drive device 250 may accordingly, relate to the first, second and third positions of the above-described adjusting element 230. For example, when the drive device 250 is in the first distal position , the latch tabs 262 of the latch member 260 may be located in the recess 101a to detachably lock the actuator 250 and the adjuster 230 in their first position. When sufficient force is applied, the actuator 250 can be moved proximal to its second position so that the tabs 262 of the latch are mounted in the recess 101b, and the actuator 250 and the adjusting element 230 are locked in their second positions. Similarly, when sufficient force is applied, the actuator 250 can be moved proximal to its third position so that the tabs 262 of the latch are mounted in the recess 101c, and the actuator 250 and the adjusting element 230 are locked in their third positions. In various embodiments, the latch tabs 262 may be configured such that the actuator 250 can be returned to its first and / or second position.

As described above, the adjusting element 230 can be moved along a predetermined path between at least two positions of the actuating device 250. In various embodiments, the surgical stapling instrument 100 may include, for example, at least one guide for guiding or restricting movement adjustment element 230 and / or drive unit 250. In some embodiments, adjustment element 230 may fit snugly between side walls 137 of the anvil 130, so that the adjusting element 230 can be guided by the side walls 137. In at least one such embodiment, the side walls 137 may be configured to direct or limit lateral or lateral movement of the adjusting element 230. In various embodiments, the latch 262 of the latch member 260 of the latch may comprise resilient elements that can be configured to apply upwardly pressing or pulling forces to the adjusting element 230, in order to fit the adjusting element 230 in a stop or at least against the base 138 and between the side walls 137. In some embodiments, as shown in FIG. 19, the base 138 of the anvil 130 may further comprise a guide slot 149, which may be adapted to receive at least a portion of the adjustment element 230 and / or the drive device 250 so that the guide slot 149 can limit the movement of the adjustment element 230 and a drive device 250. In at least one such embodiment, the lock 254 of the adjusting element 230 can be continued to extend through the guide slot 149 so that when the lock 25 4 are inserted into the opening 253 of the actuator 250, as described above, the base 138 of the anvil 130 would be caught between the adjusting element 230 and the actuator 250. In some embodiments, the guide slot 149 may be configured to limit the movement of the lock 254 so that the adjusting element 230 could be blocked or at least restrained from distally directed movement when the adjusting element 230 is in its first or extreme distal position, and / or, likewise, block or at least restrain from proximal directional movement when the adjusting element 230 is in its third or extreme proximal position.

In various embodiments, in addition to the foregoing, the latch member, for example, similar to the latch member 260, can be used to expand the first handle portion 102 and the second handle portion 104. In at least one embodiment, as shown in FIG. 37, the surgical stapling tool 100 ′ may include a latch member 260 ′ configured to position the first handle portion 102 and the second handle portion 104 such that there is a gap between the anvil 130 and the cassette 150. This design feature, as described above, can allow the surgeon to conveniently manipulate the surgical instrument, without necessarily holding the first and second sections of the handle separately from one another. In some embodiments, the locking member 260 ′, when secured to the second handle portion 104, may provide sufficient opportunity for the locking tabs 262 ′ extending from the locking member 260 ′ to contact flanges 128 and, when compressed, exert a tensile force to the first and second sections of the handle. As shown in FIG. 37, the tabs 262 'can contact surfaces 101d on the flanges 128. To squeeze the tabs 262' of the lock, the locking mechanism 180 can be moved to a partially closed position so that the locking levers 188 can engage and at least partially enclose the locking tabs 131 With this configuration, the surgeon can manipulate the instrument and, if it is sure of the position of the instrument, move the locking mechanism 180 to the closed position and additionally squeeze the tabs 262 '. Similarly to the above, the locking member 260 ′ can be coupled or otherwise engaged into engagement with the drive device 250 so that when the drive device 250 is moved between its first, second and third positions, as described above, the tabs 262 ′ can engage with the recesses 101a 101b and 101c, respectively. As a result, in at least one such embodiment, the actuator 250 may have a preset position in which the actuator 250 is distal from its first position, and furthermore, surfaces 101d may comprise preset surfaces on which the tabs can rest 262 'when the drive unit 250 is in its preset position.

As described above, the adjusting element can be moved or progressively moved between the first and second positions to adjust the height of the formation of the brackets set by the surgical stapling staples instrument. In various embodiments, although not shown, the adjusting element may be configured, for example, to force the anvil strip to be displaced to and away from the opposite bracket cassette. In at least one such embodiment, the surgical stapling tool may comprise at least one clamping member, for example a spring, configured to place the anvil strap in position with the adjusting member in such a way that when the adjusting member move between its first and second positions, the adjusting element could shift the anvil bar between the first and second positions to adjust the first and second heights of formation of brackets. In various embodiments, as a result of the foregoing, the adjusting element may be configured to divert the anvil portion to a desired position. In at least one such embodiment, the adjusting element can be shifted along the axis to forcibly displace the anvil strip. In other embodiments, the rotary adjusting element may be configured to, for example, force the anvil strip to be displaced to and / or from the bracket cassette.

In addition to the foregoing, as explained in more detail below, the adjusting element can be rotated to adjust the height of the formation of the brackets. As shown in FIG. 24-36, the surgical instrument 100 'may comprise, similarly to the embodiments described above, a first handle portion 102', a second handle portion 104 'and a fixing mechanism 180' that can be used to clamp tissue between the anvil 130 'and the cassette 150' for the brackets. As shown in FIG. 25, likewise in the same way as described above, the locking mechanism 180 ′ can be rotatably connected to the first portion 102 ′ by at least one pivot pin 182 ′, while the locking mechanism 180 ′ can comprise at least one locking lever 188 ', which may be adapted to engage the second portion 104' and fix the first and second portions of the handle to one another. Also similar to the above options, as shown in FIG. 25 and 27, the surgical instrument 100 'may further comprise an ejector rod assembly 200', which may be configured to feed forward the cutting element and / or the sliding bracket extrusion unit within the end effector 120 '. In at least one such embodiment, the ejector rod assembly 200 ′ may comprise a proximal end 203 ′ and a drive device 204 ′, while the drive device 204 ′ may be rotatably mounted on the proximal end 203 ′ and selectively mounted on the first and the second sides of the stapling tool 100 '. In various embodiments, the implementation of the surgical stapling tool 100 'may contain structural elements identical or similar to those described in connection with the surgical stapling tool 100, and can be used in the same way or similar to the tool 100, and, as a result, relevant information is not repeated in this application.

In various embodiments, as shown in FIG. 27, the surgical instrument 100 'may include a rotary adjusting element 230', which can be selectively set to at least the first and second positions to provide different heights of formation of the brackets. In some embodiments, the surgical instrument 100 ′ may comprise a drive device 250 ′ that can be operatively connected to the adjuster 230 ′ so that the actuator 250 ′ can move the adjuster 230 ′ between at least its first and second positions. In at least one embodiment, as shown in FIG. 28, the drive device 250 ′ may include a drive device housing 251 ′ and a grip portion or handle 252 ′. The housing 251 ′ of the drive unit may comprise an opening 258 ′ that can be adapted to receive the proximal end 238 ′ of the adjusting element 230 ′ so that rotational movement, torque and / or force can be transmitted from the drive unit 250 ′ to the adjusting element 230 '. In at least one such embodiment, as shown in FIG. 36, the aperture 258 'may have a non-circular profile and / or profile that includes at least one flat drive surface configured to transmit rotary movement from the housing 251' of the drive device to the adjusting element 230 '. In some embodiments, the implementation of the hole 258 'can be made with dimensions and the possibility of tight fit of the proximal end 238' of the adjusting element 230 '. In at least one embodiment, the aperture 258 'may be configured to receive a proximal end 238' over a press and / or self-locking fit. In various embodiments, as also shown in FIG. 28, the grip portion 104 ′ may comprise at least one slot 259 ′, which may be configured to extend through it at least a portion of the housing 251 ′ of the drive device so that the grip portion 252 ′ can be mounted on the housing 251 'of the drive device, when disposed between them at least a portion of the second portion 104' of the handle. In at least one such embodiment, the second handle portion 104 'may further comprise a recess 253', which may be configured so that, if not all, then at least a portion of the grip portion 252 'is located in the recess 253' . In some embodiments, the recess 253 ′ may be configured so that the grip portion 252 ′ does not extend above the upper surface of the second grip portion 104 ′, however, in other embodiments, the upper grip portion 252 ′ can extend above the second grip portion 104 ′, as shown in FIG. 30, so that the access to the capture area 252 'is convenient for the surgeon.

In various embodiments, as explained above, the adjusting element can be rotated between at least the first and second positions to adjust the height of the formation of the brackets set by the surgical stapling brackets apparatus. In some embodiments, as shown in FIG. 28, the surgical stapling instrument may include an adjusting element mounted rotatably in the anvil, the adjusting element may be configured to limit the relative movement of the movable section of the anvil. In at least one such embodiment, the surgical stapling instrument 100 ′ may comprise an anvil strip 134 ′ that can be held in the anvil groove 136 ′ by the fixing or guide pins 140 ′, while the guide pins 140 ′ can be tolerated the upward shift of the anvil strip 134 'when the anvil strip 134' comes into contact with the fabric, as described above. As shown in FIG. 27, 30 and 31, the adjusting element 230 ′ can be installed in the first position or with the first orientation so that the adjusting element can limit the upward movement of the anvil strip 134 ′ inside the anvil groove 136 ′ and set the height of the brackets for the brackets. In at least one such embodiment, as shown in FIG. 30 and 31, the adjusting member 230 ′ may comprise opposing first surfaces 231 ′ that can be positioned between the base 138 ′ of the anvil chute 136 ′ and the mounting surface 145 ′ of the anvil plate 134 ′ so that when the mounting surface 145 ′ comes into contact with of one of the first surfaces 231 ', the contact surface 148' with the fabric of the anvil strip 134 'could be mounted, for example, at a first distance 234' from the base surface 129 'on the anvil 130'. Accordingly, the forming surfaces 132 'can be mounted at a first distance from the bracket cassette so that when the brackets are pushed out of the bracket cassette, the brackets can be deformed to the first height of the brackets. In addition to the foregoing, the first diameter 241 'may be limited between the first surfaces 231', while the first diameter 241 'may define the maximum raised position of the anvil strip 134' inside the anvil chute 136 '.

As indicated above, the adjusting element 230 'can be rotated to adjust the height of the formation of the brackets. In various embodiments, the adjustment element 230 ′ can be rotated between its first position or first orientation (FIGS. 30 and 31) and the second position or second orientation (FIGS. 32 and 33). In at least one embodiment, as shown in FIG. 32 and 33, the handle 252 'can be rotated in the direction indicated by the arrow "A" to move the adjusting element 230' between its first and second positions. Similar to the options described above, when the adjusting element 230 ′ is in its second position or in the second orientation, the adjusting element 230 ′ can limit the upward movement of the anvil strip 134 ′ inside the anvil groove 136 ′ and set the height of the brackets for the brackets. In at least one such embodiment, as shown in FIG. 32 and 33, the adjusting member 230 ′ may comprise opposing second surfaces 232 ′ that can be installed between the base 138 ′ and the mounting surface 145 ′ such that when the mounting surface 145 ′ comes into contact with one of the second surfaces 232 ′, 148 'of contact with the fabric of the anvil strip 134' could be mounted, for example, at a second distance 235 'from the base surface 129'. Accordingly, the forming surfaces 132 'can be mounted at a second distance from the bracket cassette so that when the brackets are pushed out of the bracket cassette, the brackets can be deformed to a second height of the brackets. In various embodiments, similar to the options described above, the second diameter 242 'may be limited between the second surfaces 232', while the second diameter 242 'may define the maximum raised position of the anvil strip 134' inside the anvil groove 136 '. Although the first surfaces 231 'and the second surfaces 232' may be formed by flat or at least substantially flat surfaces, other embodiments may be contemplated in which the first and second surfaces 231 'and 232' may comprise at least partially rounded or curved contours. In any case, as shown in FIG. 27, the adjusting element 230 'may comprise at least one groove 240' for a loose fit, which may be configured to provide a clearance between the adjusting element 230 'and the fixing pins 140'. Slots 240 'for a loose fit can be configured to provide a clearance between the adjusting element 230' and the locking pins 140 'when the adjusting element 230' is in its first position, second position, and / or any other suitable position.

In various embodiments, in addition to the foregoing, the adjusting element 230 ′ can be rotated between its first position or first orientation (FIGS. 30 and 31) and the third position or third orientation (FIGS. 34 and 35). In at least one embodiment, as shown in FIG. 34 and 35, the handle 252 'can be rotated in the direction indicated by the arrow "B" to move the adjusting element 230' between its first and third positions. Similar to the above options, when the adjusting element 230 'is in its third position or in the third orientation, the adjusting element 230' can limit the upward movement of the anvil strip 134 'inside the anvil groove 136' and set the height of the brackets for the brackets. In at least one such embodiment, as shown in FIG. 34 and 35, the adjusting element 230 'may comprise opposing third surfaces 233' that can be installed between the base 138 'and the mounting surface 145' so that when the mounting surface 145 'comes into contact with one of the third surfaces 233', the surface 148 'of contact with the fabric of the anvil strip 134' could be mounted, for example, at a third distance 235 'from the base surface 129'. Accordingly, the forming surfaces 132 ′ can be mounted at a third distance from the bracket cassette so that when the brackets are pushed out of the bracket cassette, the brackets can be deformed to a third height of the brackets. In various embodiments, similar to the options described above, the third diameter 243 'may be limited between the third surfaces 233', while the third diameter 243 'may define the maximum raised position of the anvil strip 134' inside the anvil groove 136 '. As also shown in FIG. 34 and 35, the third surfaces 233 'may be formed by at least partially rounded contours, however, other embodiments may be contemplated in which the third surfaces 233' may comprise planar or at least substantially planar contours. In at least one embodiment, the adjustment element 230 ′ may be configured such that the largest distance or diameter between the rounded third surfaces 233 ′ can be used to define the third height of the brackets.

As explained above with reference to FIG. 30 and 31, the adjusting element 230 ′ can be set to a first position or a first orientation to adjust the first height of formation of the brackets set by the surgical stapling tool 100 ′. As also explained above with reference to FIG. 32 and 33, the drive unit 250 ′ can be used to move the adjusting element 230 ′ to its second position or second orientation to adjust the second height of the formation of the brackets. To this end, in at least one embodiment, a force can be applied to the handle 252 ′ that can cause the handle 252 ′ and the adjustment element 230 ′ attached thereto to rotate in the direction indicated by the arrow “A”. In at least one embodiment, the adjusting element 230 ′ and / or the actuating device 250 ′ can be sufficiently fixed so that while the adjusting element 230 ′ is rotated, the adjusting element 230 ′ can rotate about an axis, for example an axis 245 '(Fig. 27). In at least one embodiment, as shown in FIG. 25, the proximal end 203 ′ of the ejector rod assembly 200 ′ may comprise at least one notch, groove, or recess 205 ′, which may be configured to receive and / or hold at least a portion of an adjustment element 230 ′ therein and / or drive device 250 '. In any case, as shown in FIG. 30-33, the second position or the second orientation of the adjusting element 230 'may allow the anvil strip 134' to be moved a greater distance within the anvil groove 136 'in comparison with the situation when the adjusting element 230' is in its first position. As a result, in at least one embodiment, the second height of the formation of the brackets may be greater than the first height of the formation of the brackets. As also explained above with reference to FIG. 34 and 35, the drive unit 250 'can be used to move the adjusting element 230' to its third position or third orientation to adjust the third height of the formation of the brackets. To this end, in at least one embodiment, a force can be exerted on the handle 252 'that can cause the handle 252' and the adjustment element 230 'attached thereto to rotate in the direction indicated by the arrow “B”. As shown in FIG. 30, 31, 34 and 35, the third position or the third orientation of the adjusting element 230 ′ may allow the anvil strip 134 ′ to be moved a smaller distance inside the anvil groove 136 ′ in comparison with the situation when the adjusting element 230 ′ is in its first position. As a result, in at least one embodiment, the first and second heights of the formation of the brackets may be greater than the third height of the formation of the brackets. In at least one such embodiment, the first position of the adjusting element 230 ′ and the drive unit 250 ′ may be an intermediate position, wherein the adjusting element 230 ′ can be selectively moved to its second and third positions directly from its first position. In fact, the first position of the adjusting element 230 'may mean the intermediate height of the brackets, while the second and third positions of the adjusting element 230' may mean, respectively, greater or less than the height of the brackets. In some embodiments, as shown in FIG. 24, at least one designation may be included on the surgical stapling instrument 100 ′ that can be configured to indicate the heights of the formation of the brackets or at least the relative heights of the formation of the brackets that can be selected. For example, the second handle portion 104 'may comprise a first symbol 245', which may indicate an intermediate or first height of the brackets, a second symbol 246 ', which may indicate a large or second height of the brackets, and, in addition, a third symbol 247', which may indicate smaller or third parentheses.

In various embodiments, in addition to the foregoing, at least some of the first surfaces 231 ′, second surfaces 232 ′, and third surfaces 233 ′ may contain or define or at least partially contain or define a perimeter or circle adjustment element 230 '. As explained above, due to the first, second and third diameters (241 ', 242' and 243 ') defined respectively by the first, second and third surfaces (231', 232 'and 233'), the perimeter or closed loop of the adjusting element 230 'may be non-circular. However, in some embodiments, the perimeter or closed loop of the adjustment element 230 ′ may be symmetrical, substantially symmetrical and / or asymmetrical. In various embodiments, in addition to the foregoing, the adjusting element may comprise a cam rotatably arranged, for example, between the base 138 'of the anvil 130' and the mounting surface 145 'of the anvil strip 134'. In at least one such embodiment, for example, at least one of the first surfaces 231 ′, the second surfaces 232 ′ and the third surfaces 233 ′ may comprise or define a cam profile, which, similarly to the above-described embodiments, can be made with the possibility of forcibly installing the anvil strip 134 'and / or providing a stop on which the anvil strip 134' can be installed. In any case, although not shown, various embodiments can be suggested in which the adjusting element can be shifted and rotated to adjust for the brackets at least two heights of the formation of the brackets set by the surgical stapling tool. In at least one such embodiment, the adjusting element may comprise a cam profile, which may be formed along the length of the adjusting element, while longitudinal and / or rotary can be used to move the cam profile between at least the first and second positions displacement.

In various embodiments, similar to the embodiments described above, the surgical instrument 100 ′ may further comprise a locking mechanism configured to hold or at least detachably hold the actuator 250 ′ in a desired position. In at least one embodiment, as shown in FIG. 25 and 26, the surgical instrument 100 'may further comprise a retainer element 260' comprising a retainer body 261 'and at least one retainer tab 262'. As shown in FIG. 26, the retainer body 261 ′ may comprise at least one notch, recess or groove 263 ′, which may be adapted to receive at least a portion of the proximal end 105 ′ of the second handle portion 104 ′ so that retainer element 260 'could be held in position. In at least one such embodiment, the proximal end 105 'may further comprise at least one notch, groove, or recess 265', which may be adapted to fit the retainer element 260 'tightly. In some embodiments, at least a portion of the retainer body 261 ′, such as a groove 263 ′, may be installed by press fit, self-locking fit, or otherwise suitably held in recess 265 ′. As also shown in FIG. 26, each latch tab 262 ′ of the latch member 260 ′ may comprise at least one protrusion 264 ′ extending from it, which may be adapted to engage the housing 251 ′ of the drive device and releasably lock the drive device 250 ′ in the desired position . In at least one embodiment, as shown in FIG. 36, the housing 251 ′ of the drive device may comprise at least one recess or hole 269 ′, which may be adapted to receive a protrusion 264 ′. When the protrusion 264 'is installed in the recess 269', the protrusion can be arranged to hold the drive device 250 ', for example, in its first position, until sufficient force is applied to the drive device 250' to cause the protrusion 264 'to move from the recess 269' . In particular, the force exerted on the drive unit 250 ′ can be transmitted to the protrusion 264 ′ and, due to the interaction between the surfaces of the protrusion 264 ′ and the recess 269 ′, the latch tab 262 ′ corresponding to the protrusion 264 ′ can bend or move in the proximal direction so that allow movement of the housing 251 'of the drive device relative to it. To provide space for said proximal movement, as shown in FIG. 26, the recess 265 ′ may comprise elongated portions 266 ′, each of which can be adapted to accommodate at least a portion of the tab 262 ′ so that the tabs 262 ′ can move relative to the portion 104 ′ of the handle. When the drive unit 250 ′ is moved to its second or third position, the drive unit housing 251 ′ may come into contact with a protrusion 264 ′ extending from the other tab 262 ′ and deflect the tab 262 ′ in the proximal direction so that as soon as the drive unit 250 'is in its second or third positions, the tab 262' could spring deflect forward or in the distal direction so that the protrusion 264 'could lock in the recess 269'. In at least one embodiment, in addition to the foregoing, the interaction between the protrusions 264 ′ and the side walls of the recess 269 ′ can be such that the drive device 250 ′ can be held securely, for example, in one of its first, second and the third position, but in order to allow movement of the drive device 250 ', with sufficient force. In these embodiments, the latch member 260 ′ may block or at least restrain the drive device 250 ′ and, accordingly, the adjusting element 230 ′ from unintentional displacement.

The devices described in this application may be designed to be disposed of after a single use, or these devices may be designed for repeated use. However, in each case, the device can be restored for reuse after at least one use. Recovery may include any combination of the steps of disassembling the device, then cleaning or replacing specific parts, and then reassembling. In particular, the device can be disassembled, and any number of specific parts or parts of the device can be selectively replaced or disassembled in any combination. After cleaning and / or replacing specific parts, the device can be reassembled for subsequent use either in a repair facility or by a team of surgeons immediately before a surgical operation. It will be apparent to those skilled in the art that device recovery is possible using many different disassembly, cleaning / replacement and reassembly methods. The use of both these methods and the resulting reconditioned device is within the scope of this application.

In a preferred embodiment, the invention described in this application will undergo treatment before surgery. First receive and, if necessary, clean a new or used tool. Then the instrument can be sterilized. According to one sterilization method, the instrument is placed in a closed or hermetically sealed container, for example a bag of plastic or TYVEK® material. Then the container and the instrument are placed in a radiation field that can penetrate through the container, for example, gamma radiation, X-rays or high-energy electrons. Radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. A hermetically sealed container keeps the instrument in a sterile state until the container is opened in a medical facility.

Above, the present invention is described in the form of exemplary constructions thereof, however, the present invention can be further modified within the scope of the disclosed entities. Therefore, it is intended that this application cover any changes, applications, or modifications to the invention using the general principles of the invention. In addition, it is intended that the present application cover such departures from the present description that do not go beyond the known or accepted practice in the field of technology to which the present invention relates.

Claims (17)

1. Surgical stapling brackets apparatus containing:
the first portion of the handle containing a groove under the cassette for brackets, made with the possibility of holding the cassette for brackets;
a second portion of the handle containing the anvil;
first groove of the drive;
a second drive groove, wherein at least one of said first and second drive grooves defines a predetermined path;
drive element;
a drive device that is operatively engaged with the drive element, the drive device being selectively moved to the first groove of the drive and the second groove of the drive, and wherein the drive device is configured to move the drive element along a predetermined path;
a drive device lock selectively engaged with the drive device; and
a latch rotatably coupled to one of said first portion of the handle and a second portion of the handle, wherein the latch is movable between an open position and a closed position, and the latch is adapted to engage the other of the first portion of the handle and the second portion of the handle and move the anvil to the desired position relative to the groove under the cassette for the brackets, and said latch is arranged to engage the lock of the drive device, to When the lock is moved to the closed position to disengage the lock of the drive device from the drive device. 2. The surgical stapling device according to claim 1, in which the drive device is configured to be installed in an intermediate groove of the drive connecting the first groove of the drive and the second groove of the drive. 3. The surgical stapling apparatus according to claim 2, wherein the locking of the drive device is arranged to hold the drive device in the intermediate groove of the drive when the latch is in the open position. 4. The surgical stapling apparatus according to claim 2, in which the drive device is configured to selectively rotate into one of the first drive groove and the second drive groove when the drive device is located inside the intermediate drive groove, and the lock of the drive device is configured to prevent rotation of the drive device in any of the aforementioned first drive groove and second drive groove when the lock of the drive device is engaged with the drive device. 5. The surgical staple-stitching apparatus of claim 1, wherein the lock of the drive device is configured to hold the drive device in position between the first drive groove and the second drive groove when the latch is in the open position. 6. The surgical stapling apparatus according to claim 1, further comprising a fixing spring configured to tighten the lock of the drive device into engagement with the drive device. 7. The surgical stapling device according to claim 1, in which the drive element comprises at least one element from a cutting element and a sliding block for the extrusion of the brackets. 8. A surgical stapling machine containing:
a first portion of the handle comprising:
proximal end;
distal end and
a gutter for a cassette for brackets, configured to accommodate a cassette for brackets;
a second portion of the handle containing:
proximal end;
distal end and
anvil;
drive element;
a drive device in operational engagement with the drive element, wherein the drive device is configured to move the drive element in the distal direction along a predetermined path;
a drive device lock selectively engaged with the drive device; and
a latch rotatably connected to one of said first handle section and a second handle section, the latch being adapted to engage the other of the first handle section and the second handle section and bring the anvil to the desired position relative to the groove under the bracket cassette when the latch moves between the open position and the closed position, and the latch is configured to engage the lock of the drive device when the latch is moved to a closed positioning and disengaging the lock of the drive device from the drive device. 9. The surgical staple-stapling apparatus of claim 8, further comprising a fixing spring configured to tighten the lock of the drive device into engagement with the drive device. 10. The surgical stapling apparatus of claim 8, further comprising a first drive groove and a second drive groove, the drive device being selectively moved into the first drive groove and the second drive groove, at least one of the first groove the drive and the second groove of the drive defines the aforementioned predetermined path, and, thus, the lock of the drive device is configured to prevent movement of the drive device in any of the aforementioned first groove of the drive and the second about the groove of the drive when the lock of the drive device is engaged with the drive device. 11. The surgical staple-stitching apparatus of claim 8, further comprising a first drive groove and a second drive groove, the drive device being configured to selectively move into the first drive groove and second drive groove, at least one of the first groove the drive and the second groove of the drive defines the aforementioned predetermined path, and, the lock of the drive device is configured to hold the drive device in position between the first groove of the drive and the second groove of the drive when it is fixed p is in the open position. 12. The surgical staple-stitching apparatus of claim 8, wherein the drive element comprises at least one element of a cutting element and a sliding block for displacing the brackets. 13. A surgical stapling apparatus comprising:
the first portion of the handle containing a groove under the cassette for brackets, made with the possibility of holding the cassette for brackets;
a second portion of the handle containing the anvil;
drive element;
a drive device in operational engagement with the drive element, wherein the drive device is configured to move the drive element along a predetermined path;
a drive device lock engaged with the drive device, and
a latch rotatably coupled to one of the first handle portion and the second grip portion, the latch being rotatable between the open position and the closed position, the latch being able to engage the other of the first grip portion and the second grip portion and install the anvil relative to the groove under the cassette for brackets, when the latch is moved between the open position and the closed position, and the latch is made with the possibility disengaging the lock of the drive device from the drive device when the latch moves between the open position and the closed position. 14. The surgical staple-stapling apparatus of claim 13, further comprising a fixing spring configured to tighten the lock of the drive device into engagement with the drive device. 15. The surgical stapling apparatus according to claim 13, further comprising a first drive groove and a second drive groove, the drive device being selectively moved into the first drive groove and the second drive groove, at least one of the first groove the drive and the second groove of the drive sets a predefined path, and the lock of the drive device is configured to prevent movement of the drive device in any of the aforementioned first groove of the drive and the second groove of the drive, when the lock of the drive device is engaged with the drive device. 16. The surgical stapling apparatus according to claim 13, further comprising a first drive groove and a second drive groove, wherein the drive device is selectively movable into the first drive groove and the second drive groove, at least one of said first groove the drive and the second groove of the drive sets a predetermined path, and the lock of the drive device is arranged to hold the drive device in position between the first groove of the drive and the second groove of the drive when the latch is in the open position. 17. The surgical stapler-stapling apparatus of claim 13, wherein the drive element comprises at least one element of a cutting element and a sliding block for displacing the brackets.

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