US3082426A - Surgical stapling device - Google Patents

Surgical stapling device Download PDF

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US3082426A
US3082426A US36785A US3678560A US3082426A US 3082426 A US3082426 A US 3082426A US 36785 A US36785 A US 36785A US 3678560 A US3678560 A US 3678560A US 3082426 A US3082426 A US 3082426A
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staple
magazine
staples
tissue
arm
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US36785A
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George N Miles
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George Oliver Halsted
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00Metal working
    • Y10T29/53Means to assemble or disassemble
    • Y10T29/53709Overedge assembling means
    • Y10T29/53783Clip applier

Description

2 Sheets-Sheet 1 INVENTOR. George N. Miles March 26, 1963 G. N. MILES SURGICAL STAPLING DEVICE Filed June 17, 1960 March 26, 1963 e. N. MILES 3,082,426

SURGICAL STAPLING DEVICE Filed June 17, 1960 2 Sheets-Sheet 2 INVENTOR. George N. Miles BY Gum, .J/orw, W d

ATTORNEYS 3,i32,4-26 SURGICAL STAILIWG DEVIGE George N. Miles, Tenally, Ni, assignor, by mesne assignments, to George Oliver Halsted, Englewood, NJ. Filed Inna 17, Ne l, Ser. No. 36,785 it Claims. or. r sa9 This invention relates to the field of surgical instruments, and particularly to a suturing instrument for the various closure techniques required in surgery, such as approximation of cut edges or surfaces and hemostasis.

As is well known, the time-honored technique that is still most widely used for approximation is by means of needle and suture. The same holds true for hemostasis, which term is used herein to refer to control of bleeding by the constriction of tissue. It is also commonly known that suturing accounts for a major portion of the time spent in surgery; particularly in situations involving difiiculty in access to the work field.

While there have been various attempts to reduce the time spent in this phase of surgery by the use of metal clips and the like, so far as is known none has been sufficiently satisfactory in all respects to come into general use.

It is, accordingly, a general object of the present invention to provide a suturing instrument and suture elements of diverse application that will simplify and speed up the processes of approximation, hemostasis and the like. More particularly, it is among the objects of the present invention to provide an instrument in the nature of a surgical stapling device for the foregoing purposes.

In accordance with the preferred embodiment of the invention, the foregoing and other related objects and advantages are attained by means of a stapling instrument that can be operated entirely with one hand to clamp tissue tightly in a staple. The instrument preferably is adapted to be loaded readily with staples in magazine form and so arranged as to feed the staples sequentially into working position at the tips of a plier or pincer-like pair of arms. Each staple is fed into place between the working tips after the latter are properly located on opposite sides of the tissue to be clamped or cut edges to be held together. When in proper position, the staple is clinched into closed position by bringing the working tips closer together. When the taps are spread again, the staple will remain clinched in place, and the instrument will be ready for placing and applying the next staple. By providing very narrow, pointed working tips, the instrument can be used with ease in locations which are dilficult to reach, and since only one hand is required to operate the instrument, the other can be used to facilitate closing the cut edges, to hold up the tissue to be constricted, or otherwise to advance the suturing or related procedure.

A more complete understanding of the invention and its features and advantages can be had by reference to the following description of an illustrative embodiment thereof, when considered in connection with the accompanying drawing, wherein,

FIGURE 1 is a top plan view of a surgical stapler embodying the present invention, loaded with a magazine clip of staples in position thereon and illustrating the operation of the apparatus;

FIGURE 2 is a side elevation of the stapler of FIG- URE 1, similar to FIGURE 1 but showing the instrument with the ejector moved into its forward position;

FIGURE 3a is a plan view and FIGURE 3b is an end view of a staple for use in the instrument of FIGURES 1 and 2;

FIGURE 4a is a fragmentary plan view on enlarged scale and FIGURE 4b is a section view of the staple States Patent G ice magazine clip portion of the apparatus, taken on the line 4b-4b of FIGURE 4a;

FIGURE 5 is a perspective view of the jaw and clip supporting portion of the working arm of the instrument shown in FIGURES 1 and 2;

FIGURE 6 is a perspective view illustrating the magazine mounting procedure, showing a magazine just prior to location thereof in the stapler;

FIGURE 7 is a perspective view from beneath of the ejector slide portion of the apparatus, shown on enlarged scale;

FIGURE 8 is a side elevation on greatly enlarged scale of the ejector pawl;

FIGURE 9 is an enlarged fragmentary view of FIG- URE 2., showing the ejector pawl and the staple magazine and illustrating the two operative positions of the pawl during ejection and withdrawal of the ejector; and

FIGURE 10 is a fragmentary plan view corresponding with FIGURE 9.

Referring to FIGURES 1 and 2 of the drawings, a surgical stapler embodying the invention is shown to comprise a pincer or plier-like instrument having a pair of crossed arms 10, 12 which are pivotally joined at their crossover point by a suitable bearing pin 14. The arms 10, 12 terminate at one end in integral handle rings 16 to facilitate holding the instrument in one hand. At their opposite ends, beyond the pivot point, the arms 10, 12 terminate in Working jaws 18, 20 having tapered tips 22, 24. As is described in greater detail hereinafter, one arm 10 carries the various components for holding and feeding staples to the working tips, and consequently is referred to herein for convenience as the major or working arm. This major arm 10 also is bifurcated in the area of the pivot pin (see especially FIGURE 5), accommodating the crossover portion of the minor arm 12 between the bifurcations 25 and providing a stable mounting for the pivot pin 14 which extends across between opposite sides of the major arm 10.

The tips 22, 24 are adapted to function as clamping elements for grasping and holding a portion of tissue 26 including a section of blood vessel 28 therebetween. For that purpose, the tips 22, 24 preferably are tapered to the smallest practical cross section consistent with requisite strength to facilitate working in narrow openings. Moreover, these tips are provided with serrated facing working surfaces 30, 32 to insure a firm grip on the tissue 26. The tips also are adapted to serve as guiding and locking means for staples, to block olf permanently the section of blood vessel 28 temporarily held between them, as is described more fully hereinafter.

A preferred form of staple for use with the instrument shown in FIGURES 1 and 2 is illustrated in FIGURES 3a, 3b, 4a, 4b. These staples, generally designated 34, are of modified V-shape, having a pair of legs comprising free end portions 38 which are approximately parallel to each other up to the mid points 39 of the legs. These parallel end portions 33 are joined by a pair of converging connecting portions 49 which extend inwardly to a meet at the apex of the V at an acute angle. The staples 34 advantageously include at the apex of the V a short projection 42 which extends out of the principal plane of the staple at right angles thereto, for a purpose which will be explained presently.

It has been found that this modified V-shape has the advantage, when the legs are forced toward each other, of bringing the free ends of the legs into engagement while the midpoints 39 are still spaced appreciably from each other, thereby insuring that the staple will stay in place when closed.

The staples necessarily are made of material suitable for prolonged contact with human tissue Without deleterious effect, such as stainless steel. A type 302 or 304 stainless steel wire is suitable for this purpose, preferably with considerable work hardening to give stiifness and good clamping characteristics.

In a typical case, the staples may be formed of 0.0l6 inch diam. wire, and have an overall length of 0.110 inch and a leg spacing between the free end portions 3'8 of 0.085 inch, with a projection 0.025 inch long extending above the plane of the legs of the staple.

To facilitate rapid handling of the staples in conjunction with the stapling instrument, the staples preferably are loaded in readily replaceable magazines, such as the magazine 44. This staple magazine has an approximately rectangular cross section, as shown in EEG- URE 4!), being suitably formed from a rectangular piece of stainless steel sheet to provide a bottom wall 46, side walls 48, and a slotted top wall comprising spaced top portions 50, 52. The spaced top wall portions 59, 52 define a narrow longitudinal slot 54 for accommodating and guiding the projections 42 on the staples 34; the staples lying flat in the magazine 44 in partially nested relation to each other (see FIGURES 1 and 4a). The magazine 44 may hold 15 or more such staples, which preferably are made to have uniform size and characteristics with accurate dimensions so that each staple will be held in its factory-loaded position within the magizine by light frictional engagement with the inside wall surfaces thereof until an ejecting force of several grams is exerted against them one at a time. Straight line motion of the staples without jamming is assured by the guiding action of the several points of support for each staple; namely, the longitudinal sliding contact made by the free end portions 38 of the staple legs with bottom, side and top walls 46-52 of the magazine, in combination with the contact between the projection 42 and the facing edges of the top wall portions 53' and 52 which define the longitudinal slot 54;

The major arm 1d of the stapling instrument is provided with mounting and holding means for a magazine of staples 44. As illustrated most clearly in FIGURES 2 and 5, the arm 10 thins gradually toward the tip 22 from a lateral line 56 just forward of the pivot pin 14, providing a fiat, gently sloping magazine support surface 5'3 which extends along the forward part of one of the bifurcated portions 25 of the arm and an adjacent side surface of the jaw 18. At its forward end, this support surface 58 terminates at an abrupt shoulder 6Q which constitutes the near or inner end of the tip 22, the tip 22 at this point being substantially thicker than the immediately adjacent portion of the jaw 18 and again being tapered from the shoulder 60 forwardly to its outer rounded end 61.

The magazine is adapted to be seated on the flat surface 58, in butting engagement at one end with the shoulder 60.

An elongated magazine retaining member 62 projects from the seating surface 58 near the outer edge thereof and is grooved longitudinally to provide an overlying lip 64 for holding the magazine securely in position in proper alignment with the tip 22. At its opposite end, the magazine is adapted to fit onto a rectangular stud 66 (see FIG- URE 6) which projects forwardly from a support element 68 that extends upwardly from the working arm 10 at a position somewhat rearwardly of the pivot pin 14.

Thus, it will be seen that the magazine 44 is adapted to be held in place against longitudinal movement at its forward end by the jaw shoulder 60 and at its rear end by the stud 66 and support 68. Thus, the shoulder 6t) and the stud 66 and element 68 provide longitudinally spaced opposed supports for holding the magazine. The magazine 44 further is held securely (but readily removably) against lateral movement by the retaining member 62 and by a movable resilient retaining lever 74 which is attached to the major operating arm 19 adjacent to the base of the support element 63 by a pair of rivets 72 or the like. The resilient retainer 7 extends forward- 1v beyond the support element 63 by a distance of about half of the length of the magazine 44, and has a lateral portion 74 with a U-shaped free end '76 forming a saddle which is adapted to fit snugly around the outer edge of the magazine. The retainer "in also is provided with an upwardly bent free tab 78 that is adapted to be caught readily beneath the fingernail of a surgeon to raise the retainer 70' away from the arm 10 for quickly releasing the magazine for replacement by a loaded magazine. For added stability, there is a guide toe '79 extending down along the opposite side of the jaw 18 in sliding engage ment therewith.

Thus, to remove and replace a magazine of staples, the retainer lever 70 is conveniently raised slightly to allow the forward end of the magazine 44 to be raised from behind the lip 62 and then moved away from the shoulder 65), whereupon the magazine can be moved forwardly out of engagement with the stud 66. A new magazine is quickly inserted by reversing this procedure. This insertion of a magazine is illustrated in FIGURE 6, with the magazine being shown in position just prior to engagemerit with the stud 66.

As best seen in FIGURES 2 and 5, the working surface 30 of the tip 22 is provided with a longitudinal groove 30 which extends forwardly from the shoulder 60 and terminates in a stop shoulder 82 just short of the forward end 61 of the tip. It will be noted that this groove 80 is aligned with the axis of the longitudinal staple-holding channel of the magazine 44, and thus the groove 80 is at a slight angle with the length of the major arm 10, this angle being the same as the slope of the magazine seating surface 58. The shoulder 82 serves as a stop for each forwardly moving staple, so that a surgeon will know that the staple is properly positioned and ready for closure. The groove 80 is laterally offset slightly from the magazine seating surface 58, by a distance equal to the thickness of the magazine bottom wall 46 so that the groove is directly aligned with the longitudinal centerline or axis of the staple-holding channel of the magazine.

The jaw of the minor arm 12 has a shape corresponding generally to that of the major arm jaw 18, having a shoulder 85' and a tapering recess 86 (FIGURE 2) which is spaced rearwardly from the tip 24 at a position to allow this shoulder 85 just slightly to clear the forward end of the magazine. The tissue-gripping surface 32 similarly is provided with a longitudinal groove 87 having an end stop 89 and the same configniration as the groove 80 and offset laterally from the plane of the recess 86 of the cutaway recess in the jaw by an amount equal to the thickness of the magazine. bottom wall 46.

In FIGURES l and 2 the jaws are illustrated in open position; however, when the jaws are brought near together into substantially closed position, as indicated at 24' in FIGURE 1, then, the grooves 80 and 87 are in directly opposed aligned and substantially parallel relationship. These tip grooves 80 and 87 are adapted to cooperate in receiving and guiding a staple as the latter is ejected forwardly from the magazine, by means which will now be described.

The staple ejecting means is mounted on the major operating arm 10 on a slide-way 88 which extends along an arcuate path between the support element 68 and a rearward anchor '90 which extends laterally and upwardly from the arm 10 adjacent to the handle ring 16. It will be seen that a plane tangent to the forward end of the slide-way 88 forms a rearward continuation of the plane of the staple magazine, effectively merging therewith at the support element 68. I

It will also be noted that the slide-way 88 is positioned slightly above the operating plane defined by the two.

crossed arms 10 and 12, so as to facilitate access to an ejector slide button 92 which is mounted for longitudinal movement along the slide-way 88. This ejector slide button 92 has a shallow dished contact face 94 to conform to the surgeons finger tip, and the face 94 preferably is knurled to reduce slippage.

The underbody of the slide button 92 is provided with opposed guide channels 96 (FIGURE 7) appropriately spaced and dimensioned to fit upon the slide-way 88 snugly, so as to insure that this button will slide smoothly along the slide-Way without racking or twisting.

Extending forwardly from the button )2, and overlying the magazine locus, is a push rod 98 formed of spring strip material, which is attached by rivets as or the like to the bottom of a longitudinally inclined channel 1% formed between the guideways 96 in the button underbody. Consequently, the push rod '98 is spaced away from the slide-way 88, providing a spacing 181 (FEGURE 2) between the slide-way 38 and the button end of the push rod $3, for a purpose that will be brought out presently.

At its opposite free end, the push rod 8 is provided with a pair of depending ears M2, which provide a mounting for a pivot pin 1% for a double-ended pawl 166 (FIGURE 8). There is a forward pawl tip 108 which is adapted to engage each successive staple behind its projection 42 for moving the staple forwardly, while the other rear pawl tip 110 is adapted to engage in front of the respective projection 42 of staples positioned further toward the back end of the magazine, both to insure that one and only one staple will be ejected on each movement of the ejector and to cooperate in signalling that a magazine has been emptied, as will be described more fully hereinafter.

The forward leg portion 112 of the pawl 1% is relatively short, tapering rapidly from a relatively thick medial pivot portion of the pawl body. The rearward leg portion 114 is considerably longer than the forward portion 112, extending from the pivot portion at an angle of slightly more than 90 to the forward leg portion, and tapering very gradually toward a sharply sloped rear end wall tile which meets the concave face 113 of the pawl body to form the rearwardly directed tip lid. The spacing between the two opposite tips 1%, 110 of the pawl is slightly less than the overall spacing between the respective spaced projections 42 of three nested staples.

A secondary holding spring 118' is mounted on the underside of the push rod 98 and bears against a notch 122 in the convex surface of the pawl 1% adjacent to the pivot point and on the opposite side from the pawl tips. This secondary spring 113 maintains the pawl relatively stable in either of two operative positions. In a first position of the pawl (the staple-ejecting position), as shown in dotted lines in FIGURE 9, the forward pawl tip 188 extends into the magazine slot 5 in engagement behind t e projection 42, on a staple 34 being ejected, while the rearward leg lidis substantially parallel to the magazine and extends over the projections on the two staples which are immediately behind the one that is to be ejected.

lust prior to this staple-ejecting movement, the pawl is in its second position (shown in full lines in FIGURE 9) with its rearward leg portion 114 resting upon the projection 42 of the staple immediately behind the one to be ejected and with its rear tip 11% positioned in front of the next succeeding pro'ection 4-2. When the operator moves the push rod )8 forwardly by means of the button 92', the forward tip 18% will push a staple ahead of it out of the magazine. This results in the pawl rotating slightly (clockwise, as viewed in FIGURE 9), raising the rear leg 11 i away from the projections 42 into the dotted line position as first described above.

The sharp slope of the rearward face ii of the forward tip 168 provides a camming surface which, upon retraction movement of the push rod and pawl, will cause the pawl to pivot by carnming against the projection 4-2 on the first staple in line, thereby to swing the rearward pawl tip 110 into the magazine slot 54 where it can engage the projection 42 on the second staple behind the one against which the forward tip has been cammed However, by virtue of the fact that the spacing between the pawl tips is slightly less than the spacing in between the projections on three nested staples, this engagement of the rearward pawl tip 116 will not occur until after the forward tip has ridden over and has dropped behind the projection on the forwardmost staple The pawl tip 108 is allowed to ride up over a projection in this fashion by the resilience of the push rod spring strip 98. To insure that the pawl will not pivot in the reverse direction before the rear pawl tip has been retracted over the projections 42 of the first two staples in line, the secondary spring 118 engages in the notch 122 on the pawl body so as to hold the pawl in its first position as described above. This first position of the pawl is shown in dotted lines in FIG- URE 9.

Thus, it will be seen that by sliding the ejector button 2 forward and back, the surgeon can sequentially engage one staple at a time, moving each forwardly into the cooperating retaining and guiding grooves 3t) and 87 in the working jaw surfaces 343 and 32, then sequentially (upon rearward motion of the ejector) dropping the ejector tip 108 into position behind the next staple in line in readiness to be ejected. At the same time, rearward motion of the slide will always be stopped at the right point by the rear pawl tip 11%) engaging the projection of the third staple.

It will be observed that the forward slide-way support element 68 projects lateraily slightly beyond the surface of the slide way proper, providing a forwardly sloping surface 124 which, with a magazine in position on the stud 66, merges at its forward end with the magazine surface. The rear face 126 of this projecting portion of the support element 68 meets the slide-way S8 at right angles thereto. The purpose of the sloping forward face 124 is to insure that the rear pawl tip 119 will glide easily past the support 63 and onto the slide-way surface 128 as the operator retracts the forward pawl tip iii?) toward the last two staples in the magazine. The rear face 126 provides a stop for the ejector tip 1%, to prevent forward movement of the pawl when the magazine has become empty, for signaling that the staple magazine has been emptied.

Projecting from the slide-way surface 128 and spaced rearwardly from the stop face 126 a distance equal to the spacing between the projections on two nested staples is a first stop element 13f) presenting avertical forward face 132 and a sloping rear face 134. A second similar stop 136 projects from the slide-way surface 128 a corresponding distance rearwardly from the first stop 130. The first stop 13% simulates the action of a staple projection in positioning the pawl for ejection of the last staple by cooperating with the rear pawl tip 110.

After the last staple has been ejected, retraction movement of the ejector will ride the forward pawl tip 108 up over the sloping surface 124 at the outer end of the support 68 and down behind the vertical surface 126, while the rearward tip is approaching the second stop 1%. Immediately thereafter, the rear tip will engage this second stop 136. Thereafter, upon attempting to eject another staple, the surgeon will be signalled that the magazine is empty by the resistance which the surface 126 offers to forward movement of the ejector, and a new magazine can be inserted. It will be understood, of course, that with a new magazine in place, the pawl can be raised readily from behind the stop surface 126 and held up while being moved into initial position with the forward pawl tip behind the projection 42 of the first staple in the new magazine. The spacing 101 between the flexible push rod 93 and the slide-way 88 provides convenient access for grasping the push rod so as to lift the pawl clear of the staples while moving it forward into its initial position for the new magazine.

Means also are provided for aiding the surgeon in judging the optimum initial closure of the tips 22, 24 with tissue and blood vessel clamped therebetween, thus automatically providing proper initial spacing between the jaws so that subsequent further closure will lock the staple in place. Such means comprise a roller 138 which is aosaaae journalled at the free end of a forwardly-sloping, resilient sensing finger 149 projecting laterally from the working arm 10 toward the minor arm 12. The minor arm 12 has a cooperating partial stop 142 formed on the inner side surface thereof facing the major arm 10. The stop 142 comprises a first flat surface portion 144, the plane of which is spaced from and is substantially parallel to the plane of the adjacent surface of the arm 12. This flat surface portion terminates in an arcuate surface portion 146 which is shaped to conform to the roller surface and has an arcuate length corresponding to about one fourth of the circumferential length of the roller 138. Accordingly, as the arms 10 and 12 are brought toward each other, the sensing roller 138 first will come into contact with the fiat portion 144, moving forwardly therealong until it reaches the arcuate portion 146 of the partial stop as shown in dotted lines in FIGURE 1. At this juncture, the working faces 30, 32 of the jaw tips will lie substantially parallel to each other, in the dotted line position 12' and 24 of FIGURE 1. Moreover, the bottoms of the guide grooves 89 and 87 are now aligned and spaced apart approximately the distance between the free ends 36 of a staple, in proper position to receive a staple therebetween.

Assuming that the surgeon previously has located a blood vessel to be clamped oif preparatory to cutting through the same, as in surgery for example, and has gripped a suitable section of tissue including such blood vessel between the working jaw surfaces, he will noW use his index finger to slide the ejector forwardly as previously described, ejecting a staple from the magazine into the working jaw grooves 80 and 87 until the legs of the staple strike the groove ends 82 and 89.

Now by applying further closing pressure to the operating handles, the roller 13% can be made to ride up over the top of the partial stop member 142 onto the reverse slope 148 thereof, permitting the working jaws to be brought closer together whereby to close and lock the staple in a clamped position around and tightly sealing the section of blood vessel to stop bleeding. The jaws can now be opened and the instrument withdrawn in complete readiness for the next cycle of use.

It will be observed that by spacing the roller lead-in surface 144 inwardly away from the inside surface 150 of arm 12, the reverse slope 148 is elongated somewhat so that after the roller moves beyond the arcuate face 146- it has an appreciable distance to move before meeting the arm surface. This reduces the resistance to arm (and staple) closure that which would otherwise be ofiiered by a relatively short travel on the reverse slope surface, such as would occur if the plane of the lead-in portion 144 were coincident with the inside surface 156.

It will accordingly be seen that the present invention provides a unique and highly functional surgical stapler that can be used by an operator with one hand during all parts of the staple-applying operation thereof, thereby leaving the operator with one hand completely free for such other manipulations as may be required in conjunction with the surgical procedure.

What is claimed is:

l. A surgical stapling device for gripping a section of human tissue or the like and applying a clamping staple thereto, comprising a pair of actuating arms terminating in opposed tissue grasping jaw portions that are movable toward and away from each other and have working surfaces for grasping and holding a section of tissue therebetween, means carried by one of said arms for holding an elongated magazine of staples on said one arm adjacent to the jaw portion of said one arm, manually operable staple ejector means carried by said one arm and operable independently of the closure of said actuating arms, said ejector means being reciprocable longitudinally of said magazine of staples for moving staples one at a tiine from said magazine into position between the working surfaces of said jaw portions while said working surfaces are grasping and holding a section of tissue there between for clinching of the staple upon said section of tissue by said jaw portions.

2. A surgical stapling device for gripping a section of human tissue or the like and applying a clamping staple thereto comprising a pair of arms having opposed jaw portions that are movable toward and away from each other for gripping tissue between said jaw portions, closure control means projecting from one of said arms and cooperable with the other arm for providing yieldablc resistance to further closure of said jaw portions after said jaw portions are moved toward each other and have reached a predetermined close spacing from each other for grasping and holding a portion of tissue therebetween, and means carried by one of said arms for holding and feeding staples one at a time into a position partially encircling the gap between said closely spaced jaw portions, whereby the staple partially encircles the portion of tissue held between said jaw portions, said projecting means being displaceable to effect further closure of said jaw portions whereby to clinch the staple held in said position.

3. A surgical stapling device for gripping a section of human tissue or the like and applying a clamping staple to the gripped tissue comprising a pair of handles, opposed jaw means for gripping tissue therebetween, one of said jaw means operated by said handles providing a support for a magazine of staples, a reciprocable staple ejector connected to said one jaw means and cooperable with a magazine of staples mounted on said one jaw means for ejecting staples therefrom, manual actuating means for operating said staple ejector, and guide means for guiding the staple into a supported position between said jaw means while said jaw means are gripping the tissue to be clamped by the staple.

4. A surgical stapling device for grapping a section of human tissue or the like and applying a clamping staple thereto including a pair of pivotally connected arms, opposed jaw portions at one end of said arms, handle means at the opposite ends of said arms, said jaw portions terminating at their free ends in tapered tips having serrated facing surfaces for gripping and holding tissue therebetween, one of said arms rearwardly of its tip providing a support surface for a magazine of staples, means carried by said one arm for releasably but securely holding said magazine of staples on said support surface, and a manually operable reciprocable member mounted on said on arm and movable longitudinally therealong independently of the movement of said handle means for ejecting staples from said magazine forwardly toward said tips and into position between said jaw means.

5. A surgical stapling device as defined in claim 4, wherein said tips have complementary grooves formed therein and extending longitudinally thereof for guiding and holding staples fed thereinto from said magazine.

6. A surgical stapling device as claimed in claim 4 and wherein said tips have opposed grooves therein, said grooves being in substantially parallel relationship when said tips are closely adjacent to each other, and said grooves having end stops for limiting the movement of a staple along said grooves.

7. A surgical stapling device as defined in claim 4, including means carried by said one arm and cooperable with said staple ejecting means for limiting reciprocating movement of said staple ejecting means to engagement with only one staple on each reciprocation of said ejecting means.

8. A surgical stapling device as defined in claim 4, including partial stop means comprising an element projecting from one of said arms toward the other arm and providing resilient resistance to further closure of said arms when said tips are spaced a predetermined close distance apart whereby to provide an indication that said close spacing has been reached during closing movement of said arms.

aosaaee 9. A surgical stapling device for stapling a portion of living tissue including a pair of opposed jaws having facin? working surfaces for grasping the portion of tissue therebetween, manually operable handle means connected to said opposed jaws for moving said jaws toward each other, retaining means in said device for holding a magezine having a plurality of staples therein, an ejector mechanism for said staples mounted on said device for movement in a direction parallel with the working surface of one of said jaws for feeding the staples one at a time from said magazine to the space between said jaws, said staples being fed with the free ends of their legs projecting forwardly parallel with said working surface of said one jaw and projecting toward the tip of said one jaw with said legs positioned between the working surfaces of said jaws, each of said jaws having a groove therein in its respective working surface extending toward the tip thereof, said grooves being substantially parallel when said working surfaces are grasping a portion of tissue for reeiving and guiding the free ends of the legs of a staple fed thereto, whereby the free ends of the staple lie in said grooves with the staple partially encircling the tissue grasped between said working surfaces and adapted to be clinched thereto upon further closure of said jaws.

ll). A surgical stapling device as claimed in claim 9 and wherein said grooves have dead ends forming stops for abutting against the ends of the legs of the staples for limiting the movement of the staples by the ejector mechanism.

11. A surgical stapling device as claimed in claim 9 including partial stop means providing resistance to further closure of said jaws when said grooves in said jaws are substantially parallel, said partial stop means permitting further closure of said jaws for clinching of a staple upon the actuation of said handle means with increased force for overcoming said resistance.

References Cited in the file of this patent UNITED STATES PATENTS 715,612 Van Schott Dec. 9, 1902 20 2,123,890 Gossrau July 19, 1938 2,256,382 Dole Sept. 16, 1941 2,594,102 Vollmer Apr. 22, 1952 2,635,238 Garland Apr. 2]., 1958 2,874,384 Krone Feb. 24, 1959

Claims (1)

1. A SURGICAL STAPLING DEVICE FOR GRIPPING A SECTION OF HUMAN TISSUE OR THE LIKE AND APPLYING A CLAMPING STAPLE THERETO, COMPRISING A PAIR OF ACTUATING ARMS TERMINATING IN OPPOSED TISSUE GRASPING JAW PORTIONS THAT ARE MOVABLE TOWARD AND AWAY FROM EACH OTHER AND HAVE WORKING SURFACES FOR GRASPING AND HOLDING A SECTION OF TISSUE THEREBETWEEN, MEANS CARRIED BY ONE OF SAID ARMS FOR HOLDING AN ELONGATED MAGAZINE OF STAPLES ON SAID ONE ARM ADJACENT TO THE JAW PORTION OF SAID ONE ARM, MANUALLY OPERABLE STAPLE EJECTOR MEANS CARRIED BY SAID ONE ARM AND OPERABLE INDEPENDENTLY OF THE CLOSURE OF SAID ACTUATING ARMS, SAID EJECTOR MEANS BEING RECIPROCABLE LONGITUDINALLY OF SAID MAGAZINE OF STAPLES FOR MOVING STAPLES ONE AT A TIME FROM SAID MAGAZINE INTO POSITION BETWEEN THE WORKING SURFACES OF SAID JAW PORTIONS WHILE SAID WORKING SURFACES ARE GRASPING AND HOLDING A SECTION OF TISSUE THEREBETWEEN FOR CLINCHING OF THE STAPLE UPON SAID SECTION OF TISSUE BY SAID JAW PORTIONS.
US36785A 1960-06-17 1960-06-17 Surgical stapling device Expired - Lifetime US3082426A (en)

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US4351466A (en) * 1980-10-16 1982-09-28 United States Surgical Corporation Disposable instrument for surgical fastening
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US4412539A (en) * 1976-10-08 1983-11-01 United States Surgical Corporation Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
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US4452376A (en) * 1977-08-05 1984-06-05 Charles H. Klieman Hemostatic clip applicator
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JPS61293446A (en) * 1982-10-06 1986-12-24 Eichi Kuraiman Chiyaaruzu Apparatus for mounting hemostatic clip
US5351871A (en) * 1992-03-26 1994-10-04 William Bauer Intranasal septal stapling device
US5361782A (en) * 1992-03-26 1994-11-08 William Bauer Intranasal septal stapling method
US5366134A (en) * 1991-10-18 1994-11-22 United States Surgical Corporation Surgical fastening apparatus
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US5879371A (en) * 1997-01-09 1999-03-09 Elective Vascular Interventions, Inc. Ferruled loop surgical fasteners, instruments, and methods for minimally invasive vascular and endoscopic surgery
US5915615A (en) * 1992-03-26 1999-06-29 Bauer; William Tissue fastening device
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US20010018592A1 (en) * 1999-03-01 2001-08-30 Laurent Schaller Bridge clip tissue connector apparatus and methods
US20030191481A1 (en) * 2000-03-31 2003-10-09 John Nguyen Multiple bias surgical fastener
US20030195531A1 (en) * 1998-06-03 2003-10-16 Barry Gardiner Tissue connector apparatus and methods
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US20040059378A1 (en) * 2002-06-25 2004-03-25 Incisive Surgical, Inc.. Dynamic bioabsorbable fastener for use in wound closure
US20040068276A1 (en) * 2002-10-04 2004-04-08 Steve Golden Anastomosis apparatus and methods
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US20050043749A1 (en) * 2003-08-22 2005-02-24 Coalescent Surgical, Inc. Eversion apparatus and methods
US20050065601A1 (en) * 2002-04-18 2005-03-24 Coalescent Surgical, Inc. Annuloplasty apparatus and methods
US20050070924A1 (en) * 2003-09-26 2005-03-31 Coalescent Surgical, Inc. Surgical connection apparatus and methods
US20050075667A1 (en) * 1999-03-01 2005-04-07 Laurent Schaller Tissue connector apparatus and methods
US20050075659A1 (en) * 2003-03-30 2005-04-07 Fidel Realyvasquez Apparatus and methods for minimally invasive valve surgery
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USD752219S1 (en) 2015-01-02 2016-03-22 Incisive Surgical, Inc. Tissue fastening instrument
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Cited By (122)

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US3234636A (en) * 1962-03-19 1966-02-15 Ernest C Wood Clip applicator
DE1271891B (en) * 1963-07-24 1968-07-04 C V Heljestrand Ab Device for application of staples suture
US3439523A (en) * 1964-03-30 1969-04-22 Peter B Samuels Hemostatic clip constructions
US3439522A (en) * 1967-05-17 1969-04-22 Peter B Samuels Hemostatic clip and applicator
US3581551A (en) * 1968-07-22 1971-06-01 Jack E Wilkinson Surgical clamp apparatus
US3576288A (en) * 1968-10-10 1971-04-27 United States Surgical Corp Medical instrument
US3899914A (en) * 1973-01-20 1975-08-19 Taichiro Akiyama Apparatus for closing a cut end of a blood vessel
FR2366825A1 (en) * 1976-10-08 1978-05-05 Jarvik Robert Cartridge hemostats and insertion instrument of these clamps
US4412539A (en) * 1976-10-08 1983-11-01 United States Surgical Corporation Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
US4166466A (en) * 1976-10-08 1979-09-04 Jarvik Robert K Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
US4603693A (en) * 1977-05-26 1986-08-05 United States Surgical Corporation Instrument for circular surgical stapling of hollow body organs and disposable cartridge therefor
EP0000756A1 (en) 1977-08-05 1979-02-21 Charles H. Klieman Surgical stapler
US4325376A (en) * 1977-08-05 1982-04-20 Charles H. Klieman Hemostatic clip applicator
EP0000875A1 (en) 1977-08-05 1979-03-07 Charles H. Klieman Hemostatic clip applicator
US4316468A (en) * 1977-08-05 1982-02-23 Charles H. Klieman Surgical stapler
US4452376A (en) * 1977-08-05 1984-06-05 Charles H. Klieman Hemostatic clip applicator
FR2443238A1 (en) * 1978-12-08 1980-07-04 Ispytatelny Inst Med A surgical apparatus for suturing cutaneous tissues
FR2480593A1 (en) * 1980-04-22 1981-10-23 Senco Products Instrument to ligature
DE3115960A1 (en) * 1980-04-22 1982-01-14 Senco Products Ligaturgeraet
US4351466A (en) * 1980-10-16 1982-09-28 United States Surgical Corporation Disposable instrument for surgical fastening
US4379457A (en) * 1981-02-17 1983-04-12 United States Surgical Corporation Indicator for surgical stapler
US4450839A (en) * 1982-02-26 1984-05-29 Ethicon, Inc. Surgical clip applier with serpentine spring clip feeder
US4478218A (en) * 1982-02-26 1984-10-23 Ethicon, Inc. Ligating clip and applier instrument therefor with clip engaging escapement
JPS61293446A (en) * 1982-10-06 1986-12-24 Eichi Kuraiman Chiyaaruzu Apparatus for mounting hemostatic clip
JPH0463696B2 (en) * 1982-10-06 1992-10-12 Eichi Kuraiman Chaaruzu
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US4586503A (en) * 1983-12-01 1986-05-06 University Of New Mexico Surgical microclip
US4887756A (en) * 1984-05-07 1989-12-19 Puchy David P Surgical stapler providing variable degree of staple closure
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US5366134A (en) * 1991-10-18 1994-11-22 United States Surgical Corporation Surgical fastening apparatus
US5351871A (en) * 1992-03-26 1994-10-04 William Bauer Intranasal septal stapling device
US5361782A (en) * 1992-03-26 1994-11-08 William Bauer Intranasal septal stapling method
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US5540240A (en) * 1992-03-26 1996-07-30 Bauer; William Intranasal septal fastener driving method
US5915615A (en) * 1992-03-26 1999-06-29 Bauer; William Tissue fastening device
US5820009A (en) * 1996-02-20 1998-10-13 Richard-Allan Medical Industries, Inc. Articulated surgical instrument with improved jaw closure mechanism
US5879371A (en) * 1997-01-09 1999-03-09 Elective Vascular Interventions, Inc. Ferruled loop surgical fasteners, instruments, and methods for minimally invasive vascular and endoscopic surgery
US6149658A (en) * 1997-01-09 2000-11-21 Coalescent Surgical, Inc. Sutured staple surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery
US7763040B2 (en) 1998-06-03 2010-07-27 Medtronic, Inc. Tissue connector apparatus and methods
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