TWI430774B - Surgical stapler having a plastic closure plate - Google Patents

Description

Surgical stapler with plastic closure

This application is a continuation of the U.S. Patent Application Serial No. 11/014,910, filed on December 20, 2004, and the U.S. Provisional Patent Application No. 60/532,912 filed on Dec. 30, 2003. The priority of the number is hereby incorporated by reference.

The invention relates to a surgical stapler and a cutting device, and is suitable for pathological diagnosis and treatment by a stapled resection. More particularly, the present invention relates to surgical staplers and cutting devices having a curvature that is particularly adapted to fit the anatomy of a human male pelvis.

Surgical staplers and cutting devices are commonly used for pathological diagnosis and treatment by elbowectomy. The surgical stapling device provides a mechanism for extending the mechanical suture device (via anal canal, mouth, stomach introduction) and service access. While surgical staplers and cutting devices are most commonly used for rectal pathology, surgical staplers and cutting devices may be used in many environments.

Surgical staplers and cutting equipment have been developed for a long time. The device typically includes a support frame, an anvil attached to the support frame, and a cassette module with a plurality of staples or fasteners. The device also includes a drive in the cassette that simultaneously pushes all of the staples or fasteners into the anvil to form the staples into a B-shape or to join a multi-part polymeric fastener to suture the tissue together. Moreover, the devices include a proximity mechanism for moving the cassette module from a position opposite the anvil (to receive tissue therebetween) to a closed position where the tissue is clamped to the anvil and the cassette mold Between groups. Finally, the fixture includes a firing device to move the staple driver forward to form a staple against the anvil.

In accordance with the present invention, a surgical instrument is provided for dispensing a plurality of surgical fasteners to body tissue. The surgical device includes a stent having a proximal end and a distal end, a proximally located handle, and a distally located support structure. The support structure is adapted to support a cassette containing a plurality of surgical fasteners. The device further includes a closure member to support at least a portion of the cassette for movement from a proximal end of the support structure to a distal end of the support structure, wherein at least a portion of the closure member is made of plastic.

Detailed embodiments of the invention are disclosed herein. However, it is to be understood that the disclosed embodiments are merely illustrative of the invention, which may be implemented in various ways. Therefore, the details disclosed herein are not to be construed as a limitation

Referring to Figure 1 in conjunction with Figures 2 through 5, a surgical stapler and cutting device, particularly a continuous surgical stapler 20, for suturing and cutting tissue is shown. The straight surgical stapler 20 has a handle 21 at the first proximal end and an end effector 80 at the opposite distal end. In accordance with a preferred embodiment of the present invention, end effector 80 is curved. The right and left structural panels (commonly referred to as "branch panels") 34, 35 respectively connect the handle 21 to the end effector 80 of the fixture (the left bracket is not shown in Figure 1). The handle 21 has a right side cover 22 that is coupled to the left side cover (the left side cover is not shown in Figure 1). The handle 21 also has a body 23 for grasping and operating the straight surgical stapler 20 (see Figures 2 to 5).

The straight surgical stapler 20 in accordance with the present invention is particularly suitable for insertion into a human male pelvis. In particular, the human male pelvis includes a portion that is relatively small and therefore difficult to access during low anterior resection (LAR) requiring the device to reach near the dentate line within the pelvis. The surgical stapler 20 is specifically shaped and sized to enter and exit the male pelvis during a low anterior resection. In particular, the end effector 80 of the straight surgical stapler 20 is adapted to fit within a 3.62 inch multiplied by 3.00 inch elliptical envelope and function.

With this in mind, in accordance with a preferred embodiment of the present invention, the straight surgical stapler 20 has a distal end with a tissue end effector 80 having a curvature of 7.8 inches (or less) diameter, and more preferably It has a curvature of 4 inches (or less) in diameter to fit into the smallest capsule of the male pelvis. More specifically, end effector 80 has a curvature of between about 1 inch and 4 inches in diameter, and more preferably has a curvature between about 2 inches and 4 inches. In accordance with a preferred embodiment of the invention, end effector 80 has a curvature of about 3 inches in diameter.

Although the end effector 80 is disclosed below as being suitable for use with a replaceable cartridge module 120 having a plurality of components, the inventive concept can be applied to a variety of end effectors and cassette modules without The spirit of the invention is removed.

The end effector 80 is a surgical fixation assembly including a cassette module 120 (see FIGS. 6-9) and a C-shaped support structure 81. The term C-shape is used throughout to describe the concave nature of the support structure 81 and the cassette module 120. The C-shaped structure is advantageous for enhancing the function of surgical suturing and cutting equipment. The distal end 30 of the closure member 28 is configured to receive the cassette module 120. End effector 80 also includes a safety latching mechanism 180 (preferably in Fig. 31) to prevent firing of the previously fired cassette module 120. The cassette module 120 includes a cassette housing 121 coupled to the anvil 122. The cassette module 120 also includes a positioning pin 125, a blade 126, a movable locator 160, and a tissue contacting surface 127 that presents a plurality of slots 128 containing staples, the slots 128 being in one or more columns (ie, The columns of staples are staggered on either side of the blade 126. An elbow (not shown) is fired from the cassette housing 121 against the staple forming surface 129 of the anvil 122, which faces the tissue contacting surface 127 of the cassette housing 121.

As will be apparent from the following disclosure, the present straight surgical stapler 20 is designed to be used with a compound firing device that can replace the cassette module 120. It is to be understood that the inventive concept can be applied to a single firing device without departing from the spirit of the invention.

The support structure 81 of the end effector 80 is attached to the right and left support plates 34, 35 by shoulder rivets 82 and posts 83, respectively. The posts 83 extend from the support structure 81 into the support plates 34, 35. hole. According to a preferred embodiment of the invention, the support structure 81 is formed via a one-piece construction. More specifically, the support structure 81 is extruded, such as in aluminum, and subsequently machined to produce a support structure 81 as disclosed herein. Constructing the support structure 81 in this manner eliminates the need for multiple parts and the associated manufacturing and assembly costs are significantly reduced. Moreover, the unitary structure of the support structure 81 enhances the overall stability of the present surgical stapler 20. Again, the unitary extruded structure of the support structure 81 provides for reduced weight, ease of sterilization (effectively penetrating extruded aluminum due to cobalt radiation), and less tissue trauma (smooth outer surface due to extrusion).

The handle 21 of the straight surgical stapler 20 includes a grip 24 that the surgeon grasps with his or her hand (see Figures 2 to 5). The handle 24 is composed of a right cover handle 25 (see Fig. 1) and a left cover handle (not shown). The closing trigger 26 and the firing trigger 27 are pivotally extendable from below the handle 21. The straight surgical stapler 20 of Figure 1 shows the closure trigger 26 and the firing trigger 27 in an unactuated position, and the cassette module 120 has been inserted and the positioner 160 has been removed. Thus, the cassette housing 121 is spaced from the anvil 122 to place tissue between the cassette housing 121 and the anvil 122.

The handle 21 of the straight surgical stapler 20 includes a tissue locating pin actuation mechanism 100. The tissue locating pin actuation mechanism 100 includes a saddle slider 101 located on the top surface of the handle 21. Moving the slider 101 by hand causes the distal end of the push rod 102 to move. The push rod 102 is coupled to the positioning pin 125 of the cassette module 120. The distal or proximal retraction of the pusher 102 causes a corresponding movement of the locating pin 125. The tissue locating pin actuation mechanism 100 is also releasably coupled within the handle 21 to the closure trigger 26 such that actuation of the closure trigger 26 causes automatic distal movement of the locating pin 125 (if it has not been manually moved to its nearest position) ).

2 to 5 schematically illustrate what happens when the cassette module 120 is installed, and the closure and firing triggers 26, 27 are sequentially pressed toward the grip 24 to actuate the straight surgical stapler 20 End effector 80. As shown in FIG. 2, the straight surgical stapler 20 is loaded with the cassette module 120 and the positioner 160 is removed. As shown in Figure 1, the straight surgical stapler 20 is now ready to receive tissue.

When the closing trigger 26 is partially compressed and parked in its first sway position (as shown in Figure 3), the cassette housing 121 is from its fully open position to an intermediate position between opening and closing (described in more detail below). )mobile. At the same time, the tissue locating pin actuation mechanism 100 moves the locating pin 125 forward from the cassette housing 121 through an opening in an anvil 122. In this position, the tissue placed between the cassette housing 121 and the anvil 122 can be properly positioned and ensures that the tissue between the cassette housing 121 and the anvil 122 is retained. Thus, when the closure trigger 26 has been actuated to an intermediate position, the cassette housing 121 and the anvil 122 are correspondingly positioned in their tissue positioning positions.

When the closing trigger 26 is partially compressed so that it is near the front end of the grip 24 (as shown in Figure 4), the tissue contacting surface 127 of the cassette housing 121 and the staple forming surface 129 of the anvil 122 are positioned close to each other and properly positioned. And the retained organization was then fully clamped. In addition, the firing trigger 27 has been rotated counterclockwise toward the grip 24 to allow the surgeon to grasp the firing trigger 27 to fire the staple. Thus, the firing trigger 27 is now positioned to allow the surgeon to grasp it to fire the staple and cut tissue. When the firing trigger 27 is fully pressed to fire the staples, as shown in FIG. 5, the firing trigger 27 is parked in the vicinity of the closing trigger 26.

Referring now to Figures 6 through 9, a more detailed illustration of the cassette module 120 is presented. The cassette module 120 provides a cutting and sealing mechanism for use in the straight surgical stapler 20, wherein the suturing and cutting functions operate in the same direction during actuation of the device. Although the present cassette module 120 is particularly suitable for use with a straight surgical suturing device, the concept of the present cassette module 120 can be applied to other surgical devices without departing from the spirit of the present invention. In particular, the present cassette module 120 provides for use of the blade 126 with a corresponding washer 123 during the cutting process. The cassette module 120 ensures that multiple firings of the straight surgical stapler 20 do not compromise cutting performance. This is accomplished by the combined anvil 122 (particularly the washer 123) and the cassette module 120. By using the cassette module 120 in combination with the washer 123 and the blade 126, a new gasket 123 and blade 126 are provided each time the cassette module 120 is replaced, resulting in improved cutting performance.

Further parallel positioning of the anvil 122 and the cassette housing 121 provides improved performance such that they move relative to each other while the opposing surfaces of the anvil 122 and the cassette housing 121 are maintained in a parallel orientation. This provides a pressure that is evenly distributed across the tissue, preventing the tissue from being squeezed in the following manner: creping the tissue and forcing the local tissue to escape the space (defined between the anvil 122 and the cassette housing 121).

More specifically, the cassette module 120 includes a plurality of jaws (not shown) of the cassette housing 121, the staples being positioned in the slots 128 containing the staples. A pusher 131 is disposed immediately behind the staples and is configured to push the staples out of the staple slots 128. The blade holder 130 includes a slot 172 and a frame 173 for interacting with the blade retracting hook 45 (Fig. 37), the function of which will be described in more detail below. The blade holder 130 is attached to a blade 126 that extends distally from the blade holder 130, past the slot 200 of the pusher 131 and through the slot 199 of the cassette housing 121. Although the blade in accordance with the preferred embodiment of the present invention is disclosed as being within the outer casing, other configurations may be employed without departing from the spirit of the present invention; for example, it is contemplated that the cassette module 120 may be constructed without a blade, as desired for a particular application.

The blade holder 130 has a dowel pin 138 that extends through a slot 137 in the cassette housing 121. During the longitudinal movement of the blade 126 and the blade holder 130, the blade seat pin 138 is disposed to contact the swaying projection 139 of the cassette slot 137. Similarly, the pusher 131 has a dowel 140 that is configured to individually contact the proximal and distal spur projections 141, 142 of the cassette slot 137.

The blade 126 and the slots 199, 200 are positioned such that at least one row of staples are on either side of the blade 126. In accordance with a preferred embodiment of the present invention, two rows of staple slots 128 (and two rows of staples) are provided on each side of the slot 199 of the cassette housing 121.

The cassette housing 121 includes two generally circular openings 143, 144 at either end of the blade slot 199. A generally circular opening 143 at the bottom of the cassette housing 121 is shaped and dimensioned such that the guide pin 124 can pass through the cassette housing 121. A generally circular opening 144 at the top of the cassette housing 121 is shaped and dimensioned such that the locating pin 125 can pass through the cassette housing 121. The staple slot 128 is configured to extend the staples laterally through the generally circular openings 143, 144. In accordance with a preferred embodiment of the present invention, the anvil 122 includes a plastic gasket 123 and a metal staple forming surface 129. The anvil 122 is positioned to maintain the staple forming surface 129 in conformity with the configuration of the staple. The locating pin 125 is coupled to the coupler 133 by a circumferential groove 135 in the locating pin 125 and a groove 134 in the coupler 133 (preferably as Figure 14).

The coupler 133 is disposed within the arm 145 of the cassette housing 121 and is secured in the arm 145 by the end cap 146.

The guide pin 124 and the locating pin 125 each include slots 147a and 147b (best seen in Figures 8, 9, 36, 39 and 40) with the ends 126a, 126b of the blade 126 disposed therein. The proximal end 148 of the guide pin 124 connects the proximal end 149 of the anvil 122. The distal end 150 of the guide pin 124 extends from the cassette housing 121 and extends through the slot 151 of the anvil 122. The cutting washer 123 slides onto the anvil 122 by a groove 152 on the anvil 122 that fits under the tongue 153 on the washer 123. The opposite end 154 of the cutting washer 123 slides under the anvil arm 155 and is secured to the anvil arm 155 with a pin 156. In this position, the cutting surface 157 of the washer 123 extends upward through the slot 151 of the anvil 122. The combination of the washer 123 to the anvil 122 induces the guide pin 124 to enter the opening formed by the anvil slot 151 and the cutting surface 157, thereby effectively connecting the anvil 122 to the cassette housing 121. The locator 160 is attached to the cassette module 120, as shown in Figure 7, to hold the components of the cassette module 120 in the desired orientation until inserted into the end effector 80.

Turning to Figures 6 through 12, in conjunction with Figures 25 through 29, the locator 160 will be detailed. The positioner 160 has a groove 161 that is disposed around the projection 159 of the cassette housing 121. The positioner 160 includes a flexible inner spring arm 162 that is configured to reciprocate within the positioner 160. The positioner 160 includes a receiving slot 163 that extends partially around the guide pin 124. The spring arm 162 includes a receiving slot 164 that extends partially around the guide pin 124 but is configured to face the opposite direction of the receiving slot 163. The positioner 160 is positioned onto the cassette module 120 such that the receiving slots 163, 164 surround the guide pins 124 and the locators 160 are attracted to the cassette module 120. The spring arm 162 includes a split strip 165 that extends downwardly from the locator 160 below the anvil arm 155. As such, until the cassette module 120 is properly positioned within the end effector 80, the positioner 160 is less susceptible to removal from the cassette module 120. When the cassette module 120 is properly positioned within the end effector 80, the separation strip 165 engages the end effector 80 to release the positioner 160.

Referring again to Figure 1, in conjunction with Figures 2 through 13, a more detailed description of the components of the straight surgical stapler 20 is provided. The straight surgical stapler 20 includes an elongate closure member 28 having a generally U-shaped cross-section that extends from the handle 21 into the surgical fixation assembly of the end effector 80. In accordance with a preferred embodiment of the present invention, closure member 28 is a molded plastic member that is shaped to function and function in accordance with the present invention. By manufacturing the closure member 28 from plastic, manufacturing costs can be reduced and the weight of the straight surgical stapler 20 can be reduced. Moreover, the straight surgical stapler 20 is easy to sterilize with cobalt radiation because the plastic is easily penetrated than stainless steel. Suitable types of plastics include plastics called thermoplastics, including but not limited to polyamines, polyphenylene sulfides, polyethylene terephthalates, polyacetal resins, polyesters, polybenzazoles, polyether oximes, Polyether quinone imine, liquid crystal polymer, acrylonitrile-butadiene-styrene copolymer (ABS), polycarbonate, nylon, polyurethane, polyphthalamide, polyether ketone, It may or may not be added with additives such as glass, wholly aromatic polyamine or carbon fibers or beads to mold to increase strength.

The molded component can be made into a controlled shape with very small tolerances. This will result in a curved shape and a compact shape of the member 28. Furthermore, there is no need to attach multiple boards together. The one-piece mold eliminates the need for fixtures (such as rivets) that hold the closed subsystem. When they are simultaneously molded in the same mold, the other locking pin holes and the guiding rivet holes can be precisely aligned. Moreover, the weight of the plastic is much lighter than that of stainless steel, thus reducing the total weight of the device. During sterilization, plastic components are much easier to pass through by cobalt rays than several steel laminates. Recently, the use of a single-piece molded closure member has reduced the number of tie parts, stainless steel closure plates, and plastic spacers, making assembly much easier.

The distal end of the closure member 28 traverses the wall 84 of the support structure 81. The distal end is configured to receive and retain the cassette housing 121 of the cassette module 120. The central portions of the closure members 28 are each positioned between the right and left side supports 34,35. The right and left closed links 36, 37 are each pivotally attached to the right and left proximal ends of the closure member 28 by a first integrated closure link pin 38. At opposite ends of the closure links 36, 37, the closure links 36, 37 are each pivotally attached to a second integrated closure link pin 39. A second integrated closed link pin 39 connects the closed links 36, 37 to the slotted closed arm link 40. The slotted closed arm link 40 is pivotally mounted to the closure trigger pin 41 on the support plates 34, 35 of the straight surgical stapler 20. The closure trigger 26 pivots downwardly from the slotted closed arm link 40 about the closure trigger pin 41 toward and away from the grip 24. A closure spring 42 encased in the handle 24 of the handle 21 is secured to the slotted closed arm link 40 to provide the desired resistance as the surgeon presses the closure 26 toward the handle 24 and is biased toward the open position The closing plate machine 26 is pressed.

Referring to Figures 13 and 14, the components of the locating pin actuation mechanism 100 will now be described. The handle 21 includes a saddle slider 101 mounted on the top of the handle 21 for linear movement. The slider 101 is attached to a post 103 that extends outwardly from the pusher pusher 104 through a slot 105 of the handle 21 (see Figure 2). The pusher pusher 104 is constrained by the slot 105 to move longitudinally along the long axis of the straight surgical stapler 20. The pusher pusher 104 is coupled to the pusher 102 by a circumferential groove 107 in the pusher 102 that is snapped into the slot 108 of the pusher pusher 104. The distal end of the push rod 102 includes a circumferential groove 109 that interconnects the groove 132 in the proximal end of the connector 133 of the cassette module 120 (best in Figure 2). The distal end of the connector 133 includes a groove 134 to interconnect with the circumferential groove 135 on the locating pin 125.

The closure member 28 includes a post 29 that extends laterally within the handle 21 on either side of the closure member 28. The post 29 is slidably coupled to the L-shaped groove 110 of a yoke portion 111. The yoke 111 is pivotally mounted to the handle 21 by a turn pin 112 on the yoke portion 111. The yoke 111 includes a cam pin 113 that is positioned to urge the cam surface 114 on the push rod pusher 104.

Referring to Figures 13 and 37, the firing transmission assembly will be described. The firing drive assembly includes an elongated firing bar 43 that extends from the handle 21 into the surgical tying assembly of the end effector 80. The firing bar 43 is positioned within the U-shaped cross section of the closure member 28. The distal end of the firing rod 43 extends into the cassette housing 121 and is positioned just adjacent the blade holder 130 and the pusher 131. The distal end of the firing rod 43 is attached with a blade retractor 44 having a blade retraction hook 45.

The firing rod 43 has a rectangular receiving groove 46 (refer to Fig. 13) at a portion where it is sealed in the handle 21. The integrated closed link pin 38 extends through the receiving slot 46. The firing bar 43 also has a proximal section 47. The lower edge of the proximal section 47 of the firing bar 43 also has a sliding surface 48. The proximal section 47 also has an end edge engagement surface 49 that extends from the sliding surface 48. The firing trigger 27 is pivotally mounted to the support plates 34, 35 (which are spaced apart from the closure trigger pins 41) by the firing trigger screw 50 to pivot each of the rollers about mutually independent axes. The firing trigger 27 includes an arcuate firing trigger linkage 51 that extends from the firing trigger screw 50 of the firing trigger 27 to the top 52, the top 52 resting against the sliding of the proximal section 47 of the firing rod 43 On face 48. Within the handle 21, the firing triggers 27 are each attached to first and second firing trigger spring arms 53, 54. The firing trigger spring arms 53, 54 support a torsion spring (not shown) on the right half of the firing trigger 27. Finally, the firing rod return spring 55 is secured to the portion of the firing rod 43 below the handle 21 at the lower edge of the firing rod 43 to bias the firing rod 43 toward its unactuated position.

When the closing trigger 26 is pressed against the grip 24, the slotted closed arm link 40 and the closed links 36 and 37 are moved distally within the receiving groove 46 of the firing rod 43. This distal movement causes the closure member 28 to move correspondingly distally. Likewise, because the first integrated closed link pin 38 (with the closed links 36 and 37 attached thereto) extends through the receiving slot 46 in the firing bar 43, the firing bar 43 simultaneously moves distally with the closure member 28.

The mechanism for defining the intermediate closed turbulence position and releasing the closure trigger 26 from the coincident position to its initial unactuated position is now illustrated in Figure 1 along with Figures 13-20. The top edge of the slotted closed arm link 40 has a clamping slide surface 56 which shows the intermediate detent 57 and the closed detent 58. The release cover 59 slides over the clamping slide surface 56 and engages the intermediate detent 57 and the closure detent 58. The distal end of the release cover 59 has a laterally extending cover projection 60 (see Figure 1 preferably). The release cover 59 is located within the handle 21 and is integrally attached to a release button 61 (located outside the handle 21). The release button 61 has a thumb rest 62, and the release button 61 is pivotally attached to the handle 21 by a release trunnion 63. The release button 61 is biased outwardly from the handle 21, and thus the release cover 59 is biased downwardly by the release spring 64 towards the clamping slide surface 56, the release spring 64 being mounted on the handle 21 by the spring positioning pin 65 and by means of a spring column 66 is mounted on the release button 61. The slotted closed arm link 40 has an arcuate recess 67 between the intermediate detent 57 and the closed detent 58. Rotating in the arcuate recess 67 is a left plug 68 that is integrally connected to the right plug (not shown). Each plug 68 has a latch arm 69 that engages the cover projection 60. The shroud projection 60 has a concave proximal face 70 to provide a gap between the latch arm 69 and the shroud projection 60.

Referring to Figure 31 (cutting view of the cassette and support structure), the components of the firing device latching mechanism 180 will now be described.

As will be apparent from the following disclosure, once the firing device is fired, the latching mechanism 180 prevents the cassette housing 121 from moving into its second closed position, but permits the associated re-approaching movement of the cassette housing 121 and the anvil 122, thereby Proximity provides an indicator that the equipment is not faulty. The permitted re-adjacent motion, when in the first separated position, is about 1//4 to 2/3 of the total distance between the cassette housing 121 and the anvil 122, and when in the first separated position, preferably The total distance between the cassette housing 121 and the anvil 122 is about 1/4, 1/3 or 1/2.

The latching mechanism 180 includes a latching lever 181 that is pivotally mounted to the distal end 30 of the closure member 28 by a pin 182. The latching lever 181 is biased downwardly toward the bottom of the support structure 81 by a spring (not shown). The latching lever 181 includes a proximal end 184 and a distal end 185. The proximal end 184 has a cam surface 186 and a latching groove 187. The support structure 81 of the end effector 80 includes a frame 85 that is configured to interact with the locking groove 187 when the latching mechanism 180 is engaged. Support structure 81 includes a bottom surface 86 between walls 84. The bottom surface 86 is configured to interact with the cam surface 186 when the locking bar 181 is not engaged.

The operation of the cassette module 120, the closure mechanism, the locating pin mechanism, the firing transmission assembly, the intermediate detent 57 and the closure detent 58, the release mechanism, and the latching mechanism 180 will now be described. Referring to Figures 7 through 12 and Figures 21 through 28, loading cassette module 120 to tissue end effector 80 is illustrated. The cassette module 120 is shaped and sized to be selectively inserted and removed from the tissue end effector 80 of the straight surgical stapler 20.

Before inserting the cassette module 120 into the tissue end effector 80 of the straight surgical stapler 20 (as shown in Figure 7), when the groove 161 is configured to surround the protrusion 159 on the top end of the positioner 160 to prevent separation The positioner 160 cannot be easily removed from the cassette module 120. The accommodating slots 163, 164 of the positioner are arranged to surround the guide pins 124 on the bottom of the locator 160 to prevent separation (as shown in Figure 25). The attached locator 160 provides support for the structure of the cassette module 120 and provides an extended surface area for gripping, both of which are characterized by ease of loading. The positioner 160 also prevents the staples from being unloaded from the cassette housing 121 during daily use and prevents accidental exposure of the blade 126 during daily use.

The movement of the blade 126 and the movement of the staples are further limited by a row of tweezers before loading and during loading. Referring to Figure 9, the swaying projection 139 on the cassette housing slot 137 prevents proximal and distal movement of the pin 138 on the blade holder 130. By virtue of the interaction of the pin 140 and the swaying protrusion 141 on the cassette housing 137, the pusher 131 can prevent the far-reaching period caused by the daily use and loading of the cassette module 120 into the straight surgical stapler 20. Move at the end.

The cassette module 120 is loaded into the tissue end effector 80 to slide the cassette housing 121 into the distal end 30 of the closure member 28, as shown in Figures 21-24. During loading, the walls 31a and 31b on the closure member 28 slide into the slots 170a and 170b of the cassette housing 121. At the same time, the short strip 174 (see Fig. 8) slides into the groove 88 of the C-support structure 81. When the jaw 171 is snapped into the swaying groove 32 of the distal end 30 of the closure member 28, the cassette module 120 is loaded, as shown in Figures 21-24.

In the position shown in Figure 24, the cassette module 120 is fully loaded and the distal groove 132 of the coupler 133 has engaged the distal circumferential groove 109 of the push rod 102, causing the locating pin 125 in the cassette module 120. It has been connected to the positioning pin advancement mechanism 100. During loading, the slot 172 of the blade holder 130 engages the blade retraction hook 45 such that when the cassette module 120 is loaded, the hook 45 has engaged the retraction frame 173 on the blade holder 130.

Upon completion of loading of the cassette module 120, the post 188 positioned on the pusher 131 contacts the distal end 185 of the latching lever 181 (see Figure 31). This contact pivots the latching lever 181 about the latching lever pin 182 to a position such that the camming surface 186 is horizontally aligned with the bottom surface 86 of the U-shaped support structure 81.

The positioner 160 is now moved away from the end effector 80. In particular, the loading of the cassette module 120 causes the separation strip 165 to contact the support structure 81 (see FIG. 23), resulting in the spring arm 162 being up when the cassette module 120 is fully loaded (as shown in FIG. 24). motion. This upward movement causes the receiving groove 164 to move so that the guide pin 124 is no longer received (see Figs. 25 and 26). Referring now to Figures 27 through 29, a removal force is applied to the thumb pad 166, causing the positioner 160 to pivot about the projection 159 until the groove 161 can slide away from the projection 159. Removal of the locator 160 allows the loaded straight surgical stapler 20 to be used.

In Figure 15, the closing trigger 26 has been partially compressed from its open, unactuated position of Figures 1 and 13. When the closing trigger 26 is partially compressed, it pivots counterclockwise about the closing trigger screw 41 toward the grip 24. When it pivots, the slotted closed arm link 40 and the closure plate closing links 36, 37 move forward, thereby moving the closure member 28 and the firing rod 43 distally. When the slotted closed arm link 40 moves forward, the cover protrusion 60 of the release cover 59 slides on the clamping sliding surface 56. The cover projection 60 engages the distal end of the latch arm 69 of the plug 68, thereby pivoting the latch 68 in a clockwise direction. When the slotted closed arm link 40 continues to move forward toward the handle 24 in response to the pivoting action of the closing trigger 26, the cover projection 60 of the release cover 59 will eventually be inserted into the intermediate latch 57. Once positioned in the middle detent 57, the closure spring 42 does not return the closure trigger 26 to its original, unactuated position. The closure trigger 26 is now in its intermediate, partially closed position to properly position and retain tissue between the cassette housing 121 and the iron anvil 122, as shown in FIG. Also, as the closure member 28 and the firing bar 43 move distally, the top 52 of the firing trigger link 51 slides over the sliding surface 48 of the proximal section 47 of the firing bar 43.

The locating pin advancement mechanism 100 is actuated during the closed stroke from the open to the intermediate position. The forward movement of the closure member 28 causes the integral post 29 to move distally. The post 29 contacts the L-shaped groove 110 of the yoke portion 111. Thus the distal end of the post 29 moves against the L-shaped slot 110, causing the yoke to pivot about the pin 112. This pivoting brings the post 113 on the yoke 111 into contact with the cam surface 114 on the pusher pusher 104. Further pivotal movement of the yoke 111 causes the post 113 to move the push rod pusher 104 distally (by cam contact on the cam surface 114). The pusher pusher 104 contacts the pusher 102 to move the pusher 102 distally. The push rod 102 sequentially moves the coupler 133 and the positioning pin 125 to the distal end. The closing stroke to the position of the middle middle jaw 57 causes the positioning pin 125 to move distally through the aperture 144 of the cassette housing 121, through the aperture 159 through the washer 123 and the anvil 122, and into the aperture in the support structure 81 (Fig. Not shown). The tissue placed between the contact surface 127 of the cassette housing 121 and the anvil 122 is now trapped between the positioning pin 125 and the guide pin 124.

The same result can be obtained by manually moving the saddle slider 101 distally before closing. The sliding motion will cause the pusher 102, the coupler 133, and the locating pin 125 to move forward until the locating pin 125 is fully disposed through the anvil 122, washer 123, and aperture 89 (in the support structure 81). The closing stroke (after the positioning pin 125 has been manually moved forward) still causes rotation of the yoke 111 described above, but there is no additional movement of the locating pin actuating mechanism 100.

The closed stroke from the position open to the intermediate detent 57 causes the lock lever 181 to move distally (when its borrow pin 182 is attached to the closure member 28, as shown in Fig. 31 (open) and Fig. 32 (intermediate position)). The distal movement of the latching lever 181 causes the camming surface 186 to contact the latching frame 85 of the support structure 81, causing the latching lever 181 to rotate clockwise and to the bottom surface 86 of the sliding contact support structure 81. In this position, the distal end 185 of the support structure 81 has been turned away from the post 188 of the pusher 131.

Referring now specifically to Figure 16, when the closure trigger 26 is squeezed from the intermediate latch 57 toward the grip 24, the latch arm 69 of the plug 68 is separated from the cover projection 60. Therefore, when the plug 68 continues to rotate clockwise, the release cover projection 60 sits on the plug arm 69 and falls into the closed latch 58 by the continuous movement of the closing trigger 26, when the release cover 59 is seated. When the arm 69 is engaged, it causes the release button 61 to rotate clockwise about the pivot 63. When the release cover 60 falls into the closure forceps 58, it emits an audible click to alert the surgeon that it has reached the closed position.

In addition, as the firing bar 43 continues to move forward, the top 52 of the arcuate trigger linkage 51 travels to contact the side engagement surface 49 of the proximal section 47 of the firing bar 43. Thus, the firing trigger 27 is moved into a position where it can continue to move the firing rod 43 distally to fire the staple after the tissue is fully clamped. When the top 52 of the arcuate trigger linkage 51 is moved to engage the side engagement surface 49 of the proximal section 47, the firing trigger 27 begins to pivot counterclockwise toward the grip 24 in response to the right side of the firing trigger 27. The action of the torsion spring (not shown). The firing trigger 27 pivots independently of the pivotal movement of the closing trigger 26, but its pivoting is blocked until the firing rod 43 has moved distally to engage the arcuate firing machine link 51 with the end of the firing rod 43. Face engagement.

Turning now specifically to Figure 17, when the closure trigger 26 is fully squeezed and adjacent the handle 24, the cover projection 60 at the distal end of the release cover 59 enters the closure jaw 58. At the closed detent 58 position, the tissue has been completely sandwiched between the cassette housing 121 and the anvil 122, and the closure spring 42 is unable to return the closure trigger 26 to its original position. The closing trigger 26 is thus held in the position shown in FIG.

While the closing trigger 26 is moving counterclockwise, the firing trigger 27 continues to rotate counterclockwise by the action of the torsion firing lever return spring 55 until the firing trigger 27 is in a relative position relative to the handle 21 of the straight surgical stapler 20. In the vertical direction. In the fully clamped position, the top 52 of the arcuate trigger linkage 51 has fully engaged the engagement surface of the proximal section 47 of the firing rod 43. Thus, the firing trigger 27 is in a position to further move the firing rod 43 distally to inject the staple into the tissue.

In the fully closed position, the staple pocket 128 of the cassette housing 121 is aligned with the staple forming surface 129 of the anvil 122, as shown in FIG. The locating pin 125 has been aligned with the anvil 122 and the top of the cassette housing 121, and the guide pin 124 has been aligned with the bottom of the cassette housing 121 and the bottom of the anvil 122.

As shown in Figures 18 and 34, the firing trigger 27 can be squeezed toward the grip 24 until positioned adjacent to the closure trigger 26. During pivoting of the firing trigger 27, the firing rod 43 moves distally into contact with the blade holder 130. The resulting distal movement of the blade holder 130 results in contact with the blade 126 and the pusher 131. The distal movement of the pusher 131 causes the staple (not shown) to advance distally into the staple forming surface 129 of the anvil 122, resulting in the staple forming a generally B-shape. In conjunction with the formation of the staples, the blade 126 advances distally in the slot 147 of the guide pin 124 and the locating pin 125. The slot 147 guides the blade 126 onto the cutting face 157 of the cutting washer 123, resulting in a cross-cut of any captured tissue.

The hand pressure on the firing trigger 27 is released, causing the firing rod return spring 55 to retract the firing rod 43 and return the firing trigger 27 to the position shown in FIG. This movement causes the return hook 45 to be returned to the blade holder 130 and the retracting frame 173 of the blade 126. The resulting proximal motion retracts the blade 126 into the cassette housing 121, as shown in FIG. The pin 138 on the blade holder 130 is retracted into engagement with the catch 139 on the cassette housing 121 to maintain the blade holder 130 and blade 126 in this retracted position. The pusher 131 is held in its furthest (fired) position by the engagement of the mast 140 on the pusher 131 (engaged by the catch 142 of the cassette slot 137).

If the blade 126 has an interface (e.g., from the user erroneously cutting into other surgical equipment), the force from the firing rod return spring 55 is insufficient to return the firing rod 43 and the blade 126 is returned to the cassette housing 121 for the user to borrow. Pull the triggering machine 27 clockwise to manually retract the cutting system. The manual clockwise movement causes the arcuate firing machine link 51 to rotate clockwise until it strikes the firing bar on the proximal end 47 of the firing bar 43 back to the short strip 71. The contact between the arcuate firing trigger link 51 and the firing rod retracting stub 71 in a clockwise rotation causes the firing rod 43 to retract proximally to the position shown in FIG. This causes the hook 45 to be returned so that the retracting frame 173 and the blade 126 of the blade holder 130 are retracted. Thus, this safety feature allows the user to return the cutting mechanism to a safe position and return the firing system to the position to be opened of the straight surgical stapler 20, as will be described below.

Referring to Figure 19, when the surgeon presses the release button 61, the release cover 59 pivots about the release trunnion 63 in a clockwise direction to move the cover projection 60 away from the closed detent 58 position. When it is removed, the cover projection 60 sits on the latch arm 69 to bypass the intermediate latch position 57 of the clamp link 40. In this manner, the closure and firing triggers 26, 27 can be returned to their original, unactuated position in response to the bias from the closure spring 42 and the firing rod return spring 55. When the cover projection 60 is seated on the latch arm of the plug 68, the latch arm 69 rotates counterclockwise while the closure and firing triggers 26, 27 rotate clockwise back to their original unactuated position. Thus, the surgeon can release the firing triggers 26, 27 to return them to the position shown in Figure 20 without necessarily returning to the intermediate detent 57 position.

The straight surgical stapler 20 is released to the open position shown in Figure 20, causing the closure member 28 and the additional latching lever 181 to retract to the fully open position shown in Figure 36. In this position, the post 188 of the pusher 131 is no longer configured to hold the latching rod distal end 185 downward. The pusher 131 has been snapped to the forward position by the post 140 and the cassette 142 as described above. Thus, when the latching lever 181 (with its proximal end 184 sliding along the support arm surface 86) is fully retracted, it now freely rotates counterclockwise and causes the latching groove 187 to fall below the frame 85 of the Form C support structure 81. When the cassette module 120 is removed as shown in Figure 37, the locking lever 181 will remain in this position.

Any further attempt to close the fired straight surgical stapler 20 will result in the latching groove 187 being hooked into the frame 85 as shown in Figure 38 to provide a previously fired device for retrieval to the user. If the positioner 160 has been removed prior to loading and the cassette module 120 has been misloaded and the cassette module 120 is not in the correct position, this same characteristic will be reproduced. In this case, as described above, the post 188 will not be in the correct position in which the latching lever 181 can be moved into position to be placed against the surface 86. Likewise, the cassette module 120 that has been fired will also not release the latching mechanism 180. It is important to note that there is a closed stroke operation that is permitted in the latching mechanism 180 before the latching groove 187 is engaged with the latch 85. This operation shows the user that the device is not stuck due to some malfunction (e.g., if the latch mechanism 180 is not operating). Therefore, when the latching mechanism 180 is engaged, the user knows that the device is not stuck, but is not loaded properly.

After the release device returns to the open position shown in Figures 1 and 2, the saddle slider is pulled proximally to cause the locating pin 100 to be manually retracted. This retracting action causes the positioning pin 125 to retreat into the cassette housing 121. Upon completion of the manual retraction action, the fired cassette module 120 can be unloaded and replaced with the new cassette module 120.

The above described device is not only suitable for bending staplers. The invention is also applicable to non-bending staplers, such as those disclosed in U.S. Patent No. 5,605,272 issued to Witt et al. This is included in the reference.

While the preferred embodiment of the invention has been shown and described, the embodiments A person skilled in the art can make various changes, modifications and substitutions without departing from the invention. For example, as is apparent to those skilled in the art, the disclosure herein is equally applicable to robotic arm assisted surgery. Again, it is to be understood that each of the above structures has a function and that the structure can be a device that performs the function. Accordingly, the Applicant intends to limit the invention only by the spirit and scope of the appended claims.

20. . . Straight surgical stapler

twenty one. . . handle

twenty two. . . Right side cover

twenty three. . . Body

twenty four. . . Grip

25. . . Right cover handle

26. . . Closed plate machine

27. . . Firing machine

28. . . Closure member

29. . . column

30. . . remote

31a, 31b. . . wall

32. . . Swinging ditch

34, 35. . . Support plate

36, 37. . . Closed connecting rod

38. . . First integrated closed link pin

39. . . Second integrated closed link pin

40. . . Closed arm link

41. . . Closed plate machine screw

42. . . Closed spring

43. . . Firing rod

44. . . Blade return

45. . . Blade return hook

46. . . Storage slot

47. . . Proximal section

48. . . Sliding surface

49. . . End edge mating surface

50. . . Scoring machine

51. . . Firing machine linkage

52. . . top

53. . . First firing machine spring arm

54. . . Second firing machine spring arm

55. . . Killing rod return spring

56. . . Clamping sliding surface

57. . . Middle scorpion

58. . . Closed scorpion

59. . . Release cover

60. . . Cover protrusion

61. . . Release button

62. . . Thumb dock

63. . . Release trunnion

64. . . Release spring

65. . . Spring positioning pin

66. . . Button spring column

67. . . Bow recess

68. . . Left plug

69. . . Plug arm

70. . . Concave near

71. . . Return short

80. . . End effector

81. . . supporting structure

82. . . Shoulder rivet

83. . . column

84. . . wall

85. . . frame

86. . . Bottom

88. . . ditch

89. . . hole

100. . . Locating pin actuating mechanism

101. . . Saddle slider

102. . . Putt

103. . . column

104. . . Pusher pusher

105. . . groove

107. . . Circumferential groove

108. . . groove

109. . . Circumferential groove

110. . . L-shaped groove

111. . . Yoke

112. . . Spinning

113. . . Cam pin, bearing column

114. . . Cam surface

120. . .模组 box module

121. . .外壳 box shell

122. . . anvil

123. . . washer

124. . . Guide pin

125. . . Locating pin

126. . . blade

126a, 126b. . . Ends

127. . . Tissue contact surface

128. . . Slot, elbow bag

129. . . Elbow forming surface

130. . . Blade holder

131. . . Pusher

132. . . ditch

133. . . Coupler

134. . . ditch

135. . . Circumferential groove

137. . .外壳 box housing slot

138. . . Credit sale

139. . . Inciting protrusions, scorpions

140. . . Salesmanship

141. . . Proximal swaying protrusion

142. . . Distal swaying protrusion, box scorpion

143, 144. . . Opening

145. . . arm

146. . . End cap

147, 147a, 147b. . . groove

148. . . Guide pin proximal end

149. . . Anvil proximal

150. . . Guide pin distal

151. . . groove

152. . . ditch

153. . . Tongue

154. . . Opposite end

155. . . Anvil arm

156. . . pin

157. . . Cutting surface

159. . . Projection

160. . . Locator

161. . . ditch

162. . . Spring arm

163. . . Storage slot

164. . . Storage slot

165. . . Separate short strip

166. . . Thumb pad

170a, 170b. . . groove

171. . . Software

172. . . groove

173. . . frame

174. . . Short strip

180. . . Locking mechanism

181. . . Locking lever

182. . . pin

184. . . Proximal

185. . . remote

186. . . Cam surface

187. . . Locking groove

188. . . column

199. . . groove

200. . . groove

1 is a perspective view of a straight surgical stapler in accordance with the present invention; FIG. 2 is a perspective view of the straight surgical stapler removal cartridge module; and FIG. 3 is a view of moving the cartridge housing of the straight surgical stapler to Figure 4 is a perspective view of the cartridge housing of the straight surgical stapler moved to the closed position; Figure 5 is a perspective view of the trigger of the straight surgical stapler to the firing position; Figure 6 is a perspective view of the triggering trigger of the straight surgical stapler; Figure 7 is a perspective view of the cassette (the positioner is fixed on it); Figure 8 is a perspective view of the cassette (the positioner is removed); Figure 9 is a rear perspective view of the cassette module, showing the cassette housing Figure 10, 11 and 12 show a combination of positioners; Figure 13 is a partial cross-sectional view of the straight surgical stapler in an unactuated orientation; Figure 14 is an exploded view of the pin actuation mechanism; Figure 15 is an enclosed view A partial cross-sectional view of the straight surgical stapler with a slightly retracted plate machine; Figure 16 is a partial cross-sectional view of the straight surgical stapler with the closed plate machine fully retracted; Figure 17 is a straight surgical staple with the closed plate machine fully retracted. Partial cross-sectional view of the combiner; Figure 18 shows the straight return of the firing machine and the closing machine Partial cross-sectional view of the surgical stapler; Figure 19 is a partial cross-sectional view of the straight surgical stapler after the surgeon has pressed the release button; Figure 20 is the release closure and firing trigger (not returned to the central cassette position) Portion cross-sectional view of the straight surgical stapler; Figures 21-29 show the insertion of the cassette module and removal of the positioner; Figures 30-38 show various steps involved in actuating the straight surgical stapler; and Figure 39 And 40 is a detailed front view of the cassette case.

20. . . Straight surgical stapler

twenty one. . . handle

twenty two. . . Right side cover

25. . . Right cover handle

26. . . Closed plate machine

27. . . Firing machine

28. . . Closure member

30. . . remote

34. . . Support plate

36, 37. . . Closed connecting rod

38. . . First integrated closed link pin

39. . . Second integrated closed link pin

40. . . Closed arm link

41. . . Closed plate machine screw

59. . . Release cover

60. . . Cover protrusion

61. . . Release button

80. . . End effector

81. . . supporting structure

82. . . Shoulder rivet

83. . . column

100. . . Locating pin actuating mechanism

101. . . Saddle slider

102. . . Putt

120. . .模组 box module

121. . .外壳 box shell

127. . . Tissue contact surface

128. . . Slot, elbow bag

Claims (10)

A surgical apparatus for dispensing a plurality of surgical fasteners to body tissue, the apparatus having an open position and a closed position for dispensing the fasteners, the surgical apparatus comprising: a. a bracket at a proximal end thereof Having a handle and having a support structure at its distal end and a longitudinal axis extending between the handle and the support structure, the support structure being adapted to support a plurality of surgical fasteners; b. a generally C-shaped a closure member for supporting at least a portion of the plurality of surgical fasteners extending radially and outwardly from the longitudinal axis, the closure member comprising a cassette module, the cassette module including a removable positioner and a The locator is coupled to the casing of the anvil, the locator is disposed between the casing and the anvil, the casing and the anvil have parallel surfaces facing each other, wherein when the locator is moved In addition, the cassette housing is moved from the open position to the closed position in a parallel direction maintained by the anvil and the facing surface of the cassette housing, wherein at least a portion of the closure member comprises plastic, and .one strike a mechanism for simultaneously affixing the surgical fasteners; wherein the support structure has a radius of curvature adapted to a male pelvis having a curvature adapted to fit an ellipse of 3.62 inches by 3.00 inches Inside the envelope. For example, the surgical equipment of claim 1 of the patent scope, wherein the surgical equipment is suitable At least one column of surgical fasteners is dispensed. The surgical device of claim 1 further comprises a blade for cutting tissue. The surgical instrument of claim 1, wherein the closure member is at least partially formed of a thermoplastic plastic polymer selected from the group consisting of polyamines, polyphenylene sulfides, and polyethylenes. Terephthalate, acetal resin, polyester, polyfluorene, polyether oxime, polyether oximine, liquid crystal polymer, acrylonitrile-butadiene-styrene copolymer, polycarbonate, nylon, poly Aminoformates, polyphthalamides, polyetherketones. The surgical device of claim 1, wherein the surgical fastener comprises a staple. A surgical device for dispensing a plurality of surgical fixtures, the device having an open position and a closed position for dispensing the fasteners, the surgical kit comprising: a. a bracket having a handle at a proximal end thereof, and Having a support structure at a distal end thereof and a longitudinal axis extending between the handle and the support structure, the support structure being adapted to support a plurality of surgical fasteners; b. a substantially C-shaped closure member for supporting At least a portion of the plurality of surgical fasteners extending radially outwardly and outwardly, the closure member includes a cassette module including a removable locator and a coupling to an anvil a casing, the locator is disposed on the casing and the anvil Between the cassette housing and the anvil having mutually facing parallel surfaces, wherein the cassette housing is maintained by the anvil and the facing surface of the cassette housing when the retainer is removed Moving in a parallel direction from the open position to the closed position, wherein the closure member is substantially entirely made of plastic, and c. a firing mechanism for simultaneously dispensing the surgical fasteners; wherein the support structure has A radius of curvature suitable for a male pelvis having a curvature adapted to fit within an oval capsule of 3.62 inches by 3.00 inches. The surgical device of claim 6, wherein the closure member is at least partially formed of a thermoplastic plastic polymer selected from the group consisting of polyamine, polyphenylene sulfide, and polyethylene. Terephthalate, acetal resin, polyester, polyfluorene, polyether oxime, polyether oximine, liquid crystal polymer, acrylonitrile-butadiene-styrene copolymer, polycarbonate, nylon, poly Aminoformates, polyphthalamides, polyetherketones. The surgical device of claim 6, wherein the surgical fastener comprises a staple. A surgical device for dispensing a plurality of surgical fixtures, the device having an open position and a closed position for dispensing the fasteners, the surgical kit comprising: a. a bracket having a handle at a proximal end thereof, and Having a support structure at its distal end and a longitudinal axis at the handle and the support knot An inter-frame extension, the support structure being adapted to support a plurality of surgical fasteners; b. a substantially C-shaped closure member for supporting at least a portion of the plurality of surgical fasteners extending radially and outwardly from the longitudinal axis, The closure member includes a cassette module including a removable positioner and a cassette housing coupled to an anvil, the positioner being disposed between the cassette housing and the anvil The cassette housing and the anvil have parallel surfaces facing each other, wherein when the positioner is removed, the cassette housing is parallel to the surface maintained by the anvil and the facing surface of the cassette housing Moving from the open position to the closed position, wherein the closure member is formed entirely of a single piece of molded plastic, and c. a firing mechanism for simultaneously dispensing the surgical fasteners; wherein the support structure has a Suitable for the radius of curvature of a male pelvis having a curvature adapted to fit within an oval capsule of 3.62 inches by 3.00 inches. The surgical instrument of claim 9, wherein the closure member is at least partially formed of a thermoplastic plastic polymer selected from the group consisting of polyamine, polyphenylene sulfide, and polyethylene. Terephthalate, acetal resin, polyester, polyfluorene, polyether oxime, polyether oximine, liquid crystal polymer, acrylonitrile-butadiene-styrene copolymer, polycarbonate, nylon, poly Aminoformates, polyphthalamides, polyetherketones.