US20220225988A1 - Surgical stapling device with floating staple cartridge - Google Patents
Surgical stapling device with floating staple cartridge Download PDFInfo
- Publication number
- US20220225988A1 US20220225988A1 US17/712,748 US202217712748A US2022225988A1 US 20220225988 A1 US20220225988 A1 US 20220225988A1 US 202217712748 A US202217712748 A US 202217712748A US 2022225988 A1 US2022225988 A1 US 2022225988A1
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- United States
- Prior art keywords
- cartridge
- staple cartridge
- staple
- channel
- compression
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- Abandoned
Links
- 230000006835 compression Effects 0.000 claims abstract description 81
- 238000007906 compression Methods 0.000 claims abstract description 81
- 230000014759 maintenance of location Effects 0.000 claims description 29
- 239000000463 material Substances 0.000 claims description 3
- 238000010304 firing Methods 0.000 description 6
- 230000023597 hemostasis Effects 0.000 description 4
- 239000013013 elastic material Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 239000000853 adhesive Substances 0.000 description 2
- 230000001070 adhesive effect Effects 0.000 description 2
- 230000003872 anastomosis Effects 0.000 description 1
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000003466 welding Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00862—Material properties elastic or resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00951—Material properties adhesive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Definitions
- the present disclosure is directed to a surgical stapling device and, more particularly, to a surgical stapling device including a tool assembly having a staple cartridge that is supported on a compressible base to accommodate tissues of different thicknesses.
- Surgical stapling devices for ejecting staples to join tissue or tissue segments in a fast and efficient manner in a variety of surgical procedures, e.g., anastomoses procedures, are well known.
- Surgical stapling devices include a tool assembly having a cartridge assembly and an anvil assembly.
- the cartridge assembly and the anvil assembly define tissue contact surfaces that define a tissue gap when the tool assembly is in a clamped position.
- the tissue gap is dimensioned to receive tissue of a given thickness range to effect hemostasis. If the tissue positioned between the jaws is outside the defined range, either too thick or too thin, the tissue contact surfaces of the cartridge and anvil assemblies may not be properly positioned during firing of the stapling device to provide effective hemostasis.
- the tissue thickness is misidentified by the clinician or if the tissue thickness falls near the outer edges of the range for a given staple size, the likelihood of ineffective hemostasis is increased.
- a cartridge assembly in one aspect of the disclosure, includes a cartridge channel having a bottom wall and side walls that define a recess. Each of the side walls has a first end secured to the bottom wall and a second end spaced from the bottom wall defining an elongated slot.
- a staple cartridge defines a longitudinal axis and includes an upper wall defining a tissue contact surface and side walls. The upper wall extends radially outward of the side walls of the staple cartridge to define a longitudinally extending shoulder that is positioned adjacent to each of the side walls of the staple cartridge.
- the staple cartridge is dimensioned to be received within the recess of the cartridge channel such that the shoulders of the staple cartridge rest atop the side walls of the cartridge channel.
- a compression strip is supported in each of the elongated slots defined in the second end of the side walls of the cartridge channel. The elongated slots and the compression strips are configured to interlock to secure the compression strips to the cartridge channel.
- a cartridge assembly in another aspect of the disclosure, includes a cartridge channel having a bottom wall and side walls defining a recess, and a staple cartridge defining a longitudinal axis and supporting a plurality of staples and a plurality of pushers.
- the staple cartridge is received within the recess of the cartridge channel.
- the staple cartridge has an upper wall defining a tissue contact surface and a plurality of staple retention slots.
- a compression pad is positioned between the bottom wall of the cartridge channel and the staple cartridge.
- each of the compression strips includes a connecting portion that is received within the longitudinal slot.
- the connecting portion of each of the compression strips and the elongated slot are dove-tail shaped.
- the second end of each of the side walls of the cartridge channel includes cutouts, the cutouts intersecting the elongated slot to divide the elongated slot into a plurality of segments.
- each of the compression strips is formed of a plurality of segments, and each of the plurality of segments of the compression strips has a length that corresponds to a length of one of the plurality of segments of the elongated slots.
- each of the compression strips is formed from an elastic material.
- the cartridge assembly includes a support plate and the staple cartridge includes staples and pushers and defines an open end opposite to the upper wall.
- the support plate is supported on the open end of the staple cartridge to retain the staples and pushers within the staple cartridge.
- the staple cartridge and the support plate define a gap with the bottom wall of the cartridge channel.
- a compression pad is positioned in the gap between the staple cartridge and the bottom wall of the cartridge channel.
- the cartridge channel and the staple cartridge each define a knife slot
- the compression pad includes a first half positioned on one side of the knife slots and a second half positioned on the other side of the knife slots.
- the compression pad is secured to the bottom wall of the cartridge channel using an adhesive.
- the compression pad is formed from an elastic material.
- FIG. 1 is a side perspective view of a surgical stapling device including an exemplary embodiment of the presently disclosed tool assembly in a clamped position;
- FIG. 1A is an enlarged view of the indicated area of detail shown in FIG. 1 ;
- FIG. 2 is a side perspective view of the tool assembly of FIG. 1 in an unclamped position with an anvil assembly of the tool assembly shown in phantom;
- FIG. 3 is a side, perspective, exploded view of a cartridge assembly of the tool assembly shown in FIG. 2 ;
- FIG. 3A is a cross-sectional view taken along section line 3 A- 3 A;
- FIG. 4 is a side perspective view of a channel member of the cartridge assembly shown in FIG. 3 with compression strips attached to side walls of the channel member;
- FIG. 5 is a side perspective view of the channel member of the cartridge assembly shown in FIG. 4 with the compression strips and a compression pad supported on the channel member;
- FIG. 6 is an enlarged view of the indicated area of detail shown in FIG. 2 ;
- FIG. 7 is an enlarged view of the indicated area of detail shown in FIG. 3 ;
- FIG. 8 is an enlarged view of the indicated area of detail shown in FIG. 3 ;
- FIG. 9 is a perspective view of the indicated area of detail shown in FIG. 8 as the compression strip is attached to the side wall of the channel member;
- FIG. 10 is a cross-sectional view taken along section line 10 - 10 of FIG. 1A ;
- FIG. 11 is a cross-sectional view taken along section line 11 - 11 of FIG. 10 ;
- FIG. 12 is a cross-sectional view taken along section line 11 - 11 of FIG. 10 with the tool assembly clamped on relatively thin tissue;
- FIG. 13 is a side view of a staple of the cartridge assembly of FIG. 12 after the staple is deformed in thin tissue;
- FIG. 14 is a cross-sectional view taken along section line 11 - 11 of FIG. 10 with the tool assembly clamped on tissue having a relatively moderate thickness;
- FIG. 15 is a side view of a staple of the cartridge assembly of FIG. 14 after the staple is deformed in the tissue having a relatively moderate thickness;
- FIG. 16 is a cross-sectional view taken along section line 11 - 11 of FIG. 10 with the tool assembly clamped on relatively thick tissue;
- FIG. 17 is a side view of a staple of the cartridge assembly of FIG. 16 after the staple is deformed in the relatively thick tissue.
- proximal is used generally to refer to that portion of the device that is closer to a clinician
- distal is used generally to refer to that portion of the device that is farther from the clinician
- endoscopic is used generally used to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through small diameter incision or cannula
- clinician is used generally to refer to medical personnel including doctors, nurses, and support personnel.
- the tool assembly also includes a compressible pad that is supported on the bottom wall of the channel.
- the staple cartridge is supported on the compressible pad within the cartridge channel such that the staple cartridge can move or float within the cartridge channel.
- FIG. 1 illustrates an exemplary embodiment of the presently disclosed surgical stapling device shown generally as 10 .
- the stapling device 10 includes a handle assembly 12 , a body portion 14 that defines a longitudinal axis “X” and extends from a distal portion of the handle assembly 12 , and a tool assembly 100 supported on a distal portion of the body portion 14 .
- the handle assembly 12 includes a stationary hand grip 16 , a firing trigger 18 , a rotation knob 20 , and an articulation lever 22 .
- the firing trigger 18 is actuatable to move the tool assembly 100 between an unclamped position ( FIG. 2 ) and a clamped position ( FIG. 1A ) and to fire the stapling device 10 .
- the articulation lever 22 is rotatable to pivot the tool assembly 100 in relation to the body portion 14 about an axis transverse to the longitudinal axis “X”.
- the rotation knob 20 pivotally supports the body portion 14 and the tool assembly 100 on the distal portion of the handle assembly 12 . Rotation of the rotation knob 20 in relation to the handle assembly 12 causes corresponding rotation of the body portion 14 and tool assembly 100 in relation to the handle assembly 12 .
- a handle assembly 12 including the firing trigger 18 , rotation knob 20 , and articulation lever 22 , and other components of the stapling device 10 including the body portion 14 see U.S. Pat. No. 8,418,904 (“the '904 Patent”) which is incorporated herein by reference in its entirety.
- the presently disclosed tool assembly 100 is illustrated as part of a manually powered surgical stapling device 10 , it is also envisioned that the tool assembly 100 could be incorporated into a powered surgical stapling device such as disclosed in U.S. Pat. Nos. 9,055,943 and 8,806,973 and U.S. Publication No. 2015/0076206 which are also incorporated herein by reference in their entirety.
- the tool assembly 100 includes an anvil assembly 102 and a cartridge assembly 104 .
- a proximal portion of the anvil assembly 102 is pivotally coupled to a proximal portion of the cartridge assembly 104 by a pair of pivot members 105 such that the anvil assembly 102 is pivotal in relation to the cartridge assembly 104 to move the tool assembly 100 between an unclamped position ( FIG. 2 ) and a clamped position ( FIG. 1A ).
- the cartridge assembly could also be pivotally supported to the anvil assembly 102 .
- the anvil assembly 102 includes a tissue contact surface that includes a plurality of staple deforming depressions. See, e.g., the anvil assembly disclosed in the '904 Patent.
- the cartridge assembly 104 includes a staple cartridge 106 that supports a plurality of staples 108 and a plurality of pushers 110 , a cartridge channel 112 , a staple cartridge support plate 114 , compression strips 116 , compression pads 118 , and an actuation sled 120 . It is envisioned that the cartridge assembly 104 may include only compression strips 116 or compression pads 118 as discussed in further detail below.
- the staple cartridge 106 includes a tissue contact surface 124 ( FIG. 3 ) that defines a central knife slot 106 a , and a plurality of rows of laterally spaced staple retention slots 124 a in the tissue contact surface 124 .
- the tissue contact surface 124 is stepped downwardly from the central knife slot 106 a towards the outer edge of the staple cartridge 106 .
- the tissue contact surface 124 of the staple cartridge 106 can be planar.
- Each staple retention slot 124 a receives one of the staples 108 and a respective pusher 110 .
- the support plate 114 of the cartridge assembly 104 is secured to an open, lower end of the staple cartridge 106 opposite to the tissue contact surface 124 by a snap-fit or other type connection.
- the support plate 114 covers the open lower end of the staple cartridge 106 to retain the staples 108 and pushers 110 within the staple cartridge 106 .
- the staple cartridge 106 also defines a plurality of longitudinal slots 130 ( FIG. 11 ).
- the longitudinal slots 130 communicate with the open, lower end of the staple cartridge 106 and the staple retention slots 124 a to accommodate the staple pushers 110 and facilitate passage of the actuation sled 120 through the staple cartridge 106 .
- the staple cartridge 106 includes opposite sidewalls 132 and an upper wall 134 that defines the tissue contact surface 124 and the staple retention slots 124 a .
- the upper wall 134 extends radially outward of the side walls 132 to define shoulders 136 ( FIG. 3A ).
- the staple cartridge 106 also includes protrusions 140 ( FIG. 3 ) that extend radially outwardly of each of the side walls 132 of the staple cartridge 106 and facilitate securement of the staple cartridge 106 within the cartridge channel 112 .
- the cartridge channel 112 includes a bottom wall 144 and spaced side walls 146 that together define a recess 148 that is dimensioned to receive the staple cartridge 106 and support plate 114 when the staple cartridge 106 and the support plate 114 are assembled.
- the bottom wall 144 defines a central longitudinal knife slot 150 that is aligned with the central knife slot 106 a defined in the staple cartridge 106 as well as a longitudinal knife slot 152 defined by the support plate 114 .
- the knife slots 106 a , 150 and 152 are dimensioned to facilitate passage of a drive member and knife (not shown) through the staple cartridge 106 . See, e.g., the '904 Patent for a detailed description of an exemplary embodiment of a drive member and knife of a surgical stapling device.
- the compression strips 116 are formed of a compressible and/or elastic material.
- Each of the compression strips 116 includes a support portion 156 and a connecting portion 158 .
- the support portion 156 of each of the compression strips 116 defines a flat surface 156 a that is positioned and configured to support the shoulders 136 of the staple cartridge 106 ( FIG. 3A ).
- the spaced side walls 146 of the cartridge channel 112 each define a retention slot 160 ( FIG. 8 ) that is configured to receive a connecting portion 158 of the compression strips 116 .
- the retention slots 160 and the connecting portions 158 of the compression strips 116 have interlocking configurations which mate to securely fasten the compression strips 116 within the retention slots 160 .
- the retention slots 160 and the connecting portion of the compression strips 116 each include have a dove-tail configuration although other interlocking configurations are envisioned, e.g., T-shaped slots, etc.
- the connecting portion 158 of the compression strips 116 are slidably received within the retention slots 160 to secure the compression strips 116 to the upper edges of the side walls 146 of the cartridge channel 112 .
- adhesives, welding, friction fitting, or the like can be used to secure the compression strips from moving axially within the slots 160
- the side walls 146 of the cartridge channel 112 each include a plurality of notches 170 .
- the notches 170 provide access to ends of the retention slots 160 at a plurality of locations along the side walls 146 of the cartridge channel 112 to allow the connecting portions 158 of the compression strips 116 to be inserted into the retention slots 160 at multiple locations along the side walls 146 .
- the compression pads 118 are supported on the bottom wall 144 of the cartridge channel 112 between the bottom wall 144 and the support plate 114 of the cartridge assembly 104 ( FIG. 11 ) on opposite sides of the knife slot 150 .
- the compression pads 118 are formed of an elastic and/or compressible material and support the staple cartridge 106 to facilitate movement of the staple cartridge 106 in relation to the anvil assembly 102 during clamping and firing of the surgical stapling device 10 .
- the compression pads 118 include cut outs 118 a that provide space for expansion of the compression pad 118 during firing. Although shown as being circular, the cut outs 118 a can be of any configuration.
- the surgical stapling device 10 is illustrated to include both compression strips 116 and compression pads 118 , it is envisioned that the surgical stapling device need only include the strips 116 or the pads 118 .
Abstract
A surgical stapling device includes tool assembly having an anvil assembly and a cartridge assembly including a cartridge channel and a staple cartridge supported within the cartridge channel. The cartridge channel has a pair of spaced sidewalls and a bottom wall. The cartridge assembly includes compression strips that are supported on upper edges of the side walls and are positioned to support the staple cartridge. In embodiments, each of the compression strips includes a connecting portion and the upper edge of each of the side walls defines a slot that is configured to receive the connecting portion of a respective compression strip to secure the compression strip to the side wall of the cartridge channel. In some embodiments, the tool assembly also includes a compressible pad that is supported on the bottom wall of the cartridge channel between the bottom of the cartridge channel and the staple cartridge.
Description
- This application is a continuation of U.S. patent application Ser. No. 16/829,379, filed Mar. 25, 2020, which is a continuation of U.S. patent application Ser. No. 15/684,223, filed Aug. 23, 2017, now U.S. Pat. No. 10,624,636, the disclosure of each of which is incorporated by reference herein in its entirety.
- The present disclosure is directed to a surgical stapling device and, more particularly, to a surgical stapling device including a tool assembly having a staple cartridge that is supported on a compressible base to accommodate tissues of different thicknesses.
- Surgical stapling devices for ejecting staples to join tissue or tissue segments in a fast and efficient manner in a variety of surgical procedures, e.g., anastomoses procedures, are well known. Surgical stapling devices include a tool assembly having a cartridge assembly and an anvil assembly. The cartridge assembly and the anvil assembly define tissue contact surfaces that define a tissue gap when the tool assembly is in a clamped position. The tissue gap is dimensioned to receive tissue of a given thickness range to effect hemostasis. If the tissue positioned between the jaws is outside the defined range, either too thick or too thin, the tissue contact surfaces of the cartridge and anvil assemblies may not be properly positioned during firing of the stapling device to provide effective hemostasis. In addition, if the tissue thickness is misidentified by the clinician or if the tissue thickness falls near the outer edges of the range for a given staple size, the likelihood of ineffective hemostasis is increased.
- Accordingly, a continuing need exists in the suturing arts for a surgical stapling device that is capable of providing effective hemo stasis for a greater range of tissue thicknesses.
- In one aspect of the disclosure, a cartridge assembly includes a cartridge channel having a bottom wall and side walls that define a recess. Each of the side walls has a first end secured to the bottom wall and a second end spaced from the bottom wall defining an elongated slot. A staple cartridge defines a longitudinal axis and includes an upper wall defining a tissue contact surface and side walls. The upper wall extends radially outward of the side walls of the staple cartridge to define a longitudinally extending shoulder that is positioned adjacent to each of the side walls of the staple cartridge. The staple cartridge is dimensioned to be received within the recess of the cartridge channel such that the shoulders of the staple cartridge rest atop the side walls of the cartridge channel. A compression strip is supported in each of the elongated slots defined in the second end of the side walls of the cartridge channel. The elongated slots and the compression strips are configured to interlock to secure the compression strips to the cartridge channel.
- In another aspect of the disclosure, a cartridge assembly includes a cartridge channel having a bottom wall and side walls defining a recess, and a staple cartridge defining a longitudinal axis and supporting a plurality of staples and a plurality of pushers. The staple cartridge is received within the recess of the cartridge channel. The staple cartridge has an upper wall defining a tissue contact surface and a plurality of staple retention slots. A compression pad is positioned between the bottom wall of the cartridge channel and the staple cartridge.
- In embodiments, each of the compression strips includes a connecting portion that is received within the longitudinal slot.
- In some embodiments, the connecting portion of each of the compression strips and the elongated slot are dove-tail shaped.
- In certain embodiments, the second end of each of the side walls of the cartridge channel includes cutouts, the cutouts intersecting the elongated slot to divide the elongated slot into a plurality of segments.
- In embodiments, each of the compression strips is formed of a plurality of segments, and each of the plurality of segments of the compression strips has a length that corresponds to a length of one of the plurality of segments of the elongated slots.
- In some embodiments, each of the compression strips is formed from an elastic material.
- In certain embodiments, the cartridge assembly includes a support plate and the staple cartridge includes staples and pushers and defines an open end opposite to the upper wall. The support plate is supported on the open end of the staple cartridge to retain the staples and pushers within the staple cartridge.
- In embodiments, the staple cartridge and the support plate define a gap with the bottom wall of the cartridge channel.
- In some embodiments, a compression pad is positioned in the gap between the staple cartridge and the bottom wall of the cartridge channel.
- In certain embodiments, the cartridge channel and the staple cartridge each define a knife slot, and the compression pad includes a first half positioned on one side of the knife slots and a second half positioned on the other side of the knife slots.
- In some embodiments, the compression pad is secured to the bottom wall of the cartridge channel using an adhesive.
- In embodiments, the compression pad is formed from an elastic material.
- Various embodiments of the presently disclosed tool assembly are described herein below with reference to the drawings, wherein:
-
FIG. 1 is a side perspective view of a surgical stapling device including an exemplary embodiment of the presently disclosed tool assembly in a clamped position; -
FIG. 1A is an enlarged view of the indicated area of detail shown inFIG. 1 ; -
FIG. 2 is a side perspective view of the tool assembly ofFIG. 1 in an unclamped position with an anvil assembly of the tool assembly shown in phantom; -
FIG. 3 is a side, perspective, exploded view of a cartridge assembly of the tool assembly shown inFIG. 2 ; -
FIG. 3A is a cross-sectional view taken alongsection line 3A-3A; -
FIG. 4 is a side perspective view of a channel member of the cartridge assembly shown inFIG. 3 with compression strips attached to side walls of the channel member; -
FIG. 5 is a side perspective view of the channel member of the cartridge assembly shown inFIG. 4 with the compression strips and a compression pad supported on the channel member; -
FIG. 6 is an enlarged view of the indicated area of detail shown inFIG. 2 ; -
FIG. 7 is an enlarged view of the indicated area of detail shown inFIG. 3 ; -
FIG. 8 is an enlarged view of the indicated area of detail shown inFIG. 3 ; -
FIG. 9 is a perspective view of the indicated area of detail shown inFIG. 8 as the compression strip is attached to the side wall of the channel member; -
FIG. 10 is a cross-sectional view taken along section line 10-10 ofFIG. 1A ; -
FIG. 11 is a cross-sectional view taken along section line 11-11 ofFIG. 10 ; -
FIG. 12 is a cross-sectional view taken along section line 11-11 ofFIG. 10 with the tool assembly clamped on relatively thin tissue; -
FIG. 13 is a side view of a staple of the cartridge assembly ofFIG. 12 after the staple is deformed in thin tissue; -
FIG. 14 is a cross-sectional view taken along section line 11-11 ofFIG. 10 with the tool assembly clamped on tissue having a relatively moderate thickness; -
FIG. 15 is a side view of a staple of the cartridge assembly ofFIG. 14 after the staple is deformed in the tissue having a relatively moderate thickness; -
FIG. 16 is a cross-sectional view taken along section line 11-11 ofFIG. 10 with the tool assembly clamped on relatively thick tissue; and -
FIG. 17 is a side view of a staple of the cartridge assembly ofFIG. 16 after the staple is deformed in the relatively thick tissue. - The presently disclosed surgical stapling device including a tool assembly with a floating staple cartridge will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “endoscopic” is used generally used to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through small diameter incision or cannula. In addition, the term clinician is used generally to refer to medical personnel including doctors, nurses, and support personnel.
- The presently disclosed surgical stapling device includes a tool assembly having an anvil assembly and a cartridge assembly including a cartridge channel and a staple cartridge supported within the cartridge channel. The cartridge assembly includes a cartridge channel having a pair of spaced sidewalls and a bottom wall. The cartridge assembly includes compression strips that are supported on upper edges of the side walls of the cartridge channel and are positioned to support the staple cartridge. In embodiments, each of the compression strips includes a connecting portion and the upper edge of each of the side walls defines a slot that is configured to receive the connecting portion of a respective compression strip to secure the compression strips to the side walls of the cartridge channel. The compression strips allow the staple cartridge to move or float in relation to the anvil assembly of the tool assembly to accommodate tissues of different thicknesses.
- In some embodiments, the tool assembly also includes a compressible pad that is supported on the bottom wall of the channel. The staple cartridge is supported on the compressible pad within the cartridge channel such that the staple cartridge can move or float within the cartridge channel.
-
FIG. 1 illustrates an exemplary embodiment of the presently disclosed surgical stapling device shown generally as 10. The staplingdevice 10 includes ahandle assembly 12, abody portion 14 that defines a longitudinal axis “X” and extends from a distal portion of thehandle assembly 12, and atool assembly 100 supported on a distal portion of thebody portion 14. In embodiments, thehandle assembly 12 includes astationary hand grip 16, a firingtrigger 18, arotation knob 20, and anarticulation lever 22. The firingtrigger 18 is actuatable to move thetool assembly 100 between an unclamped position (FIG. 2 ) and a clamped position (FIG. 1A ) and to fire the staplingdevice 10. Thearticulation lever 22 is rotatable to pivot thetool assembly 100 in relation to thebody portion 14 about an axis transverse to the longitudinal axis “X”. Therotation knob 20 pivotally supports thebody portion 14 and thetool assembly 100 on the distal portion of thehandle assembly 12. Rotation of therotation knob 20 in relation to thehandle assembly 12 causes corresponding rotation of thebody portion 14 andtool assembly 100 in relation to thehandle assembly 12. - For a detailed description of a
handle assembly 12 including the firingtrigger 18,rotation knob 20, andarticulation lever 22, and other components of the staplingdevice 10 including thebody portion 14, see U.S. Pat. No. 8,418,904 (“the '904 Patent”) which is incorporated herein by reference in its entirety. Although the presently disclosedtool assembly 100 is illustrated as part of a manually poweredsurgical stapling device 10, it is also envisioned that thetool assembly 100 could be incorporated into a powered surgical stapling device such as disclosed in U.S. Pat. Nos. 9,055,943 and 8,806,973 and U.S. Publication No. 2015/0076206 which are also incorporated herein by reference in their entirety. - Referring to
FIGS. 1A and 2 , thetool assembly 100 includes ananvil assembly 102 and acartridge assembly 104. A proximal portion of theanvil assembly 102 is pivotally coupled to a proximal portion of thecartridge assembly 104 by a pair ofpivot members 105 such that theanvil assembly 102 is pivotal in relation to thecartridge assembly 104 to move thetool assembly 100 between an unclamped position (FIG. 2 ) and a clamped position (FIG. 1A ). It is envisioned that the cartridge assembly could also be pivotally supported to theanvil assembly 102. Although not shown, theanvil assembly 102 includes a tissue contact surface that includes a plurality of staple deforming depressions. See, e.g., the anvil assembly disclosed in the '904 Patent. - Referring to
FIG. 3 , in some embodiments thecartridge assembly 104 includes astaple cartridge 106 that supports a plurality ofstaples 108 and a plurality ofpushers 110, acartridge channel 112, a staplecartridge support plate 114, compression strips 116,compression pads 118, and anactuation sled 120. It is envisioned that thecartridge assembly 104 may includeonly compression strips 116 orcompression pads 118 as discussed in further detail below. Thestaple cartridge 106 includes a tissue contact surface 124 (FIG. 3 ) that defines acentral knife slot 106 a, and a plurality of rows of laterally spacedstaple retention slots 124 a in thetissue contact surface 124. In embodiments, thetissue contact surface 124 is stepped downwardly from thecentral knife slot 106 a towards the outer edge of thestaple cartridge 106. Alternately, thetissue contact surface 124 of thestaple cartridge 106 can be planar. Eachstaple retention slot 124 a receives one of thestaples 108 and arespective pusher 110. - The
support plate 114 of thecartridge assembly 104 is secured to an open, lower end of thestaple cartridge 106 opposite to thetissue contact surface 124 by a snap-fit or other type connection. Thesupport plate 114 covers the open lower end of thestaple cartridge 106 to retain thestaples 108 andpushers 110 within thestaple cartridge 106. Thestaple cartridge 106 also defines a plurality of longitudinal slots 130 (FIG. 11 ). Thelongitudinal slots 130 communicate with the open, lower end of thestaple cartridge 106 and thestaple retention slots 124 a to accommodate thestaple pushers 110 and facilitate passage of theactuation sled 120 through thestaple cartridge 106. As known in the art, advancement of theactuation sled 120 through thestaple cartridge 106 lifts thepushers 110 within theretention slots 124 a to eject thestaples 108 from theretention slots 124 a . See, e.g., the '904 Patent for a detailed description of the operation, and interaction of theactuation sled 120 andpushers 110. - The
staple cartridge 106 includesopposite sidewalls 132 and anupper wall 134 that defines thetissue contact surface 124 and thestaple retention slots 124 a . Theupper wall 134 extends radially outward of theside walls 132 to define shoulders 136 (FIG. 3A ). Thestaple cartridge 106 also includes protrusions 140 (FIG. 3 ) that extend radially outwardly of each of theside walls 132 of thestaple cartridge 106 and facilitate securement of thestaple cartridge 106 within thecartridge channel 112. - Referring also to
FIGS. 4 and 5 , thecartridge channel 112 includes abottom wall 144 and spacedside walls 146 that together define arecess 148 that is dimensioned to receive thestaple cartridge 106 andsupport plate 114 when thestaple cartridge 106 and thesupport plate 114 are assembled. Thebottom wall 144 defines a centrallongitudinal knife slot 150 that is aligned with thecentral knife slot 106 a defined in thestaple cartridge 106 as well as alongitudinal knife slot 152 defined by thesupport plate 114. Theknife slots staple cartridge 106. See, e.g., the '904 Patent for a detailed description of an exemplary embodiment of a drive member and knife of a surgical stapling device. - Referring also to
FIGS. 3 and 6-9 , the compression strips 116 are formed of a compressible and/or elastic material. Each of the compression strips 116 includes asupport portion 156 and a connectingportion 158. In embodiments, thesupport portion 156 of each of the compression strips 116 defines aflat surface 156 a that is positioned and configured to support theshoulders 136 of the staple cartridge 106 (FIG. 3A ). - In embodiments, the spaced
side walls 146 of thecartridge channel 112 each define a retention slot 160 (FIG. 8 ) that is configured to receive a connectingportion 158 of the compression strips 116. In embodiments, theretention slots 160 and the connectingportions 158 of the compression strips 116 have interlocking configurations which mate to securely fasten the compression strips 116 within theretention slots 160. In some embodiments, theretention slots 160 and the connecting portion of the compression strips 116 each include have a dove-tail configuration although other interlocking configurations are envisioned, e.g., T-shaped slots, etc. The connectingportion 158 of the compression strips 116 are slidably received within theretention slots 160 to secure the compression strips 116 to the upper edges of theside walls 146 of thecartridge channel 112. In addition, adhesives, welding, friction fitting, or the like can be used to secure the compression strips from moving axially within theslots 160 - Referring briefly back to
FIGS. 4 and 5 , theside walls 146 of thecartridge channel 112 each include a plurality ofnotches 170. Thenotches 170 provide access to ends of theretention slots 160 at a plurality of locations along theside walls 146 of thecartridge channel 112 to allow the connectingportions 158 of the compression strips 116 to be inserted into theretention slots 160 at multiple locations along theside walls 146. - Referring again to
FIGS. 3 to 5, 10 and 11 , in embodiments, thecompression pads 118 are supported on thebottom wall 144 of thecartridge channel 112 between thebottom wall 144 and thesupport plate 114 of the cartridge assembly 104 (FIG. 11 ) on opposite sides of theknife slot 150. As discussed above regarding the compression strips 116, thecompression pads 118 are formed of an elastic and/or compressible material and support thestaple cartridge 106 to facilitate movement of thestaple cartridge 106 in relation to theanvil assembly 102 during clamping and firing of thesurgical stapling device 10. In embodiments, thecompression pads 118 include cutouts 118 a that provide space for expansion of thecompression pad 118 during firing. Although shown as being circular, thecut outs 118 a can be of any configuration. - Referring to
FIGS. 10-13 , when thin tissue T1 is clamped between thetissue contact surface 124 of thestaple cartridge 106 and thetissue contact surface 102 a of theanvil assembly 102 and thesurgical stapling device 10 is fired, the forces applied to the compression strips 116 and thecompression pads 118 is minimal such that thecompressible strips 116 andpads 118 undergo minimal deformation or compression. As such, very little movement of thestaple cartridge 106 in relation to theanvil assembly 102 occurs. Thus, thestaple cartridge 106 remains in close relation to theanvil assembly 102 and the staple 108 a (FIG. 13 ) undergoes substantial deformation. - Referring to
FIGS. 14 and 15 , when thicker tissue T2 is clamped between thetissue contact surface 124 of thestaple cartridge 106 and thetissue contact surface 102 a of theanvil assembly 102 and thesurgical stapling device 10 is fired, the forces applied to the compression strips 116 and thecompression pads 118 increases such that thecompressible strips 116 andcompression pads 118 undergo more substantial deformation or compression. As such, thestaple cartridge 106 moves further downwardly away from theanvil assembly 102 to compensate for the thicker tissue T2. Thus, thestaple cartridge 106 becomes spaced further from theanvil assembly 102 and the staple 108 b undergoes more substantial deformation. - Referring to
FIGS. 16 and 17 , when even thicker tissue T3 is clamped between thetissue contact surface 124 of thestaple cartridge 106 and thetissue contact surface 102 a of theanvil assembly 102 and thesurgical stapling device 10 is fired, the forces applied to the compression strips 116 and thecompression pads 118 increases even further such that thecompressible strips 116 andpads 118 undergo even more substantial deformation or compression. As such, thestaple cartridge 106 moves further downwardly away from theanvil assembly 102 to compensate for the thicker tissue T3. Thus, thestaple cartridge 106 becomes spaced even further from theanvil assembly 102 and the staple 108 b undergoes even more substantial deformation. - Although the
surgical stapling device 10 is illustrated to include both compression strips 116 andcompression pads 118, it is envisioned that the surgical stapling device need only include thestrips 116 or thepads 118. - Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described embodiments. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
Claims (21)
1. (canceled)
2. A tool assembly comprising:
an anvil assembly having a first tissue contacting surface;
a cartridge assembly coupled to the anvil assembly to facilitate movement of the tool assembly between open and clamped positions, the cartridge assembly including a cartridge channel and a staple cartridge, the staple cartridge including a cartridge body, staples, pushers, and an actuation sled, the cartridge body having a second tissue contacting surface and defining a cartridge knife slot and a plurality of staple slots positioned on opposite sides of the knife slot, the staples received in the staple slots, the cartridge channel having a bottom wall and spaced side walls that define a recess, the bottom wall defining a channel knife slot that is longitudinally aligned with the cartridge knife slot, the staple cartridge received within the recess, the first tissue contacting surface being in juxtaposed spaced relation to the second tissue contacting surface when the tool assembly is in the clamped position; and
compression pads positioned on the bottom wall of the cartridge channel, the compression pads being formed of a compressible material and supporting the staple cartridge within the recess of the cartridge channel to facilitate movement of the staple cartridge within the recess of cartridge channel, one of the compression pads positioned on each side of the channel knife slot.
3. The tool assembly of claim 2 , wherein the staple cartridge includes a staple cartridge support plate secured to a lower end of the cartridge body, the compression pads positioned between the staple cartridge support plate and the bottom wall of the cartridge channel.
4. The tool assembly of claim 2 , wherein the actuation sled is movable through the cartridge body of the staple cartridge into sequential engagement with the pushers to eject the staples from the staple retention slots.
5. The tool assembly of claim 2 , further including compression strips supported on each of the side walls of the cartridge channel, the compression strips positioned to engage and support the staple cartridge.
6. The tool assembly of claim 5 , wherein each of the side walls of the cartridge channel defines a retention slot, each of the retention slots receiving a portion of one of the compression strips.
7. The tool assembly of claim 6 , wherein the retention slots and the compression strips have interlocking configurations to fasten the compression strips within the retention slots.
8. The tool assembly of claim 7 , wherein the interlocking configurations are doe-tail configurations.
9. The tool assembly of claim 2 , wherein each of the compression strips has a supporting portion with a flat surface for supporting the staple cartridge.
10. The tool assembly of claim 7 , wherein the cartridge channel defines notches that provide access to the retention slots, each of the notches communicating with at least one of the retention slots.
11. The tool assembly of claim 9 , wherein the staple cartridge defines shoulders, and the flat surface of the compression strips support the shoulders of the staple cartridge.
12. A surgical stapling device comprising:
a handle assembly;
an elongate body portion having a proximal portion and a distal portion, the proximal portion secured to the handle assembly; and
a tool assembly supported on the distal portion of the elongate body portion, the tool assembly including:
an anvil assembly having a first tissue contacting surface;
a cartridge assembly coupled to the anvil assembly to facilitate movement of the tool assembly between open and clamped positions, the cartridge assembly including a cartridge channel and a staple cartridge, the staple cartridge including a cartridge body, staples, pushers, and an actuation sled, the cartridge body having a second tissue contacting surface and defining a cartridge knife slot and a plurality of staple slots positioned on opposite sides of the knife slot, the staples received in the staple slots, the cartridge channel having a bottom wall and spaced side walls that define a recess, the bottom wall defining a channel knife slot that is longitudinally aligned with the cartridge knife slot, the staple cartridge received within the recess, the first tissue contacting surface being in juxtaposed relation to the second tissue contacting surface when the tool assembly is in the clamped position; and
compression pads positioned on the bottom wall of the cartridge channel, the compression pads being formed of a compressible material and supporting the staple cartridge within the recess of the cartridge channel to facilitate movement of the staple cartridge within the recess of cartridge channel, one of the compression pads positioned on each side of the channel knife slot.
13. The surgical stapling device of claim 12 , wherein the staple cartridge includes a staple cartridge support plate secured to a lower end of the cartridge body, the compression pads positioned between the staple cartridge support plate and the bottom wall of the cartridge channel.
14. The surgical stapling device of claim 12 , wherein the actuation sled is movable through the cartridge body of the staple cartridge into sequential engagement with the pushers to eject the staples from the staple retention slots.
15. The surgical stapling device of claim 12 , further including compression strips supported on each of the side walls of the cartridge channel, the compression strips positioned to engage and support the staple cartridge.
16. The surgical stapling device of claim 15 , wherein each of the side walls of the cartridge channel defines a retention slot, each of the retention slots receiving a portion of one of the compression strips.
17. The surgical stapling device of claim 16 , wherein the retention slots have dove-tail configurations, and the compression strips have dove-tail configurations, the dove-tail configurations of the compression strips received within the retention slots of the cartridge channel to fasten the compression strips within the retention slots.
18. The surgical stapling device of claim 12 , wherein each of the compression strips has a supporting portion with a flat surface that supports the staple cartridge.
19. The surgical stapling device of claim 18 , wherein the cartridge channel defines notches that provide access to the retention slots, each of the notches communicating with at least one of the retention slots.
20. The surgical stapling device of claim 18 , wherein the staple cartridge defines shoulders, and the flat surface of the compression strips support the shoulders of the staple cartridge.
21. The surgical stapling device of claim 12 , wherein the handle assembly is in the form of mechanical handle assembly or a powered handle assembly.
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US17/712,748 US20220225988A1 (en) | 2017-08-23 | 2022-04-04 | Surgical stapling device with floating staple cartridge |
US18/213,391 US20230329712A1 (en) | 2017-08-23 | 2023-06-23 | Surgical stapling device with floating staple cartridge |
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US16/829,379 US20200222048A1 (en) | 2017-08-23 | 2020-03-25 | Surgical stapling device with floating staple cartridge |
US17/712,748 US20220225988A1 (en) | 2017-08-23 | 2022-04-04 | Surgical stapling device with floating staple cartridge |
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US17/712,748 Abandoned US20220225988A1 (en) | 2017-08-23 | 2022-04-04 | Surgical stapling device with floating staple cartridge |
US18/213,391 Pending US20230329712A1 (en) | 2017-08-23 | 2023-06-23 | Surgical stapling device with floating staple cartridge |
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US20190059887A1 (en) | 2019-02-28 |
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