US3269631A - Surgical stapler - Google Patents

Surgical stapler Download PDF

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US3269631A
US3269631A US376598A US37659864A US3269631A US 3269631 A US3269631 A US 3269631A US 376598 A US376598 A US 376598A US 37659864 A US37659864 A US 37659864A US 3269631 A US3269631 A US 3269631A
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staple
clinching
jaw
driving
stapler
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US376598A
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Takaro Timothy
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Takaro Timothy
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    • 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
    • A61B17/072Surgical 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
    • 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
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • 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
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/0725Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots

Description

Aug. 30, 1966 TIMOTHY TAKARO SURGICAL STAPLER 2 Sheets-Sheet 1 Filed June 19, 1964 INVENTOR- TIMOTHY 'I AKARO avg Q, M

ATToczNav g- W55 TIMOTHY TAKARO SURGICAL STAPLER 2 Sheets-Sheet 2 Filed June 19, 1964 Fla. 2

INVENTOR ATTORNEY United States Patent Wee 3,269,631 SURGICAL STAPLER Timothy Takaro, Asheviile, N.C., assignor to the United States of America as represented by the Secretary of the Army Filed June 19, 1964, Ser. No. 376,598 4 Claims. (Cl. 227-144) The invention described herein may be manufactured and used by or for the Government for governmental purposes without the payment to me of any royalty thereon.

This invention relates to a surgical suturing instrument, particularly to a stapling device for suturing an object to the inside wall of a blood vessel or other body structure. Referring more particularly to the stapling device, this invention relates to a stapler having means to (1) position the object to be sutured, and (2) complete the suturing by driving and clinching a plurality of staples simultaneously.

The classic surgical devices for approximating a wound or incision and for grafting body tissues have been, and for most purposes still are, the needle and suture. It is well known, however, that suturing by needle has its disadvantages; it is inordinately time consuming and, in some cases, exceedingly awkward due to the inaccessibility of the area to be sutured. In more recent times it has been found that metallic staples or staples made from other suitable material can be successfully used for suturing, and that in certain cases stapling is the most efiicient and effective method of suturing.

Although in certain cases stapling has been the most desirable method of suturing, this method has not been without drawbacks. For example, in inaccessible areas it is still difficult to hold the object to be sutured in the proper position. Likewise, the placing of one staple at a time, with attendant shifting of the stapler to the next stapling position, is time consuming and increases the difficulty of maintaining proper alignment of the object to be sutured. Further, care must be taken to insure that the clinching pressure of the stapler does not crush the body tissue.

Accordingly, it is an object of this invention to provide a surgical stapler which will overcome the above disadvantages.

Another object is to provide a surgical stapler with means for positioning and holding the object to be sutured.

Another object is to provide a surgical stapler with means for simultaneously driving and clinching a plurality of staples.

Another object is to provide a surgical stapler which will not crush the body tissue being stapled.

Another object is to provide a surgical stapler suitable for suturing an object to the inside wall of a body structure, specifically for positioning and suturing an artificial valve leaflet or natural cusp in the non-coronary aortic sinus of Valsalva.

The invention comprises a plier-type staple-driving jaw and staple-clinching jaw and anvil, a staple-housing unit and holding insert, a staple-driver, a catch mechanism, an adjusting screw, and an assembling pin. In the preferred embodiment, the stapler is designed to suture an artificial valve leaflet or natural cusp in the non-coronary aortic sinus of Valsalva. This semilunar valve leaflet is located at the beginning of the aorta and serves to prevent regurgitation as the blood is pumped out of the heart into the aorta.

The structural features of the invention are illustrated in the accompanying drawings, in which:

FIG. 1 is a front elevation of a preferred embodiment of the stapler;

3,269,631 Patented August 30, 1966 FIG. 2 is a front elevation view of another embodi men-t showing the stapler head and working mechanism;

FIG. 3 is a plan View of the staple-housing unit and staple-driver, with a section of the driver cut away to show the staple-holding insert;

FIG. 4 is a front elevation view of the embodiment of FIG. 2 showing the clinching operation of the stapler with the stapleaclinching jaw positioned inside the aorta; and

FIG. 5 is a partial elevation and partial sectional view taken along the line 44 of FIG. 3 and showing the interaction of the staple-driver, staple housing unit and insert, and anvil.

Referring to the drawings, reference numeral 1 designates an instrument suitable for inserting and clinching staples. The instrument comprises a staple driving jaw 2 and a staple clinching jaw 3. The handle portions 30 and 40 of the levers of jaws 2 and 3, respectively, may be of any suitable form, but for a secure grasp, scissor-type handle loops 31 and 41 are preferred. laws 2 and 3 are pivotally joined by assembling pin 4 to form a simple lapped joint such as used in ordinary scissors or pliers.

Circular, staple-clinching anvil 5 is fastened to the distal end of jaw 3 by flat headed screws 6. Anvil 5 has a reamed hole 7 in its center to provide for accurate alignment in assembling anvil 5, staple-holding insert 8, and staple-driver 9. A plurality of staple-clinching slots 10 are machined in the face of anvil 5, preferably in a semicircular pattern. Slots 10 are rectangular in section and comprise two adjacent circular arc staple-clinching segments similar to those of an ofiice stapler.

Staple-housing unit 11 is pivotally attached to stapler 1 by assembly pin 4 which passes through the yoke end of housing 11 and jaws 2 and 3. The shank of housing 11 has milled groove 12 for flush pivotal mounting of a catch mechanism that will be described in detail below. The distal end of housing 11 is in the form of a circular ring 14 containing threaded holes 15 for the screws which fasten staple-holding insert 8 Within ring 14.

Staple-holding insert 8, mounted within ring 14, has grooves 16 milled along degrees of its periphery. The number of grooves 16 is equal to the number of stapleclinching slots 10 in anvil 5 and to the number of staples to be driven simultaneously. Insert 8 contains reamed center hole 17 which is the assembly alignment hole for insert 8. When insert 8 is mounted within housing 11, the outer periphery of insert 8 fits flush with the inside face of ring 14 except for the openings formed by grooves 16. The staples to be driven are inserted in these openings.

Staple-driver 9 is circular in plan and fiat on its top surface. Driver 9 is also disk-shaped, with rake-like teeth 18 extending downward along 180 degrees of its periphery. Teeth 18 are designed to fit into the openings formed by grooves 16 of insert 8. These teeth are sufliciently long to drive the staples of housing 11 when staple-driving jaw 2 is depressed. Teeth 18 are frict-ionally seated in the openings formed by grooves 16. Assembly alignment hole 19 is reamed in the center of driver 9.

As shown in FIG. 1, the preferred catch mechanism 32 comprises a tip portion 33 pivotally mounted on jaw 2 by means of screw 34 and a rearwardly extending lever portion 35. The distal end of lever portion 35 is provided with a lateral extension 36 which is so located as to be operable by the users thumb without releasing the clamping pressure exerted on the handles 31 and 41. Tip portion 33 is provided with a notch 37 engageable with pin 38 mounted in milled groove 12 and disengageable from pin 38 upon downwardmotion of the distal end of lever portion 35. In use the notch 37 is engaged with pin 38 while the stapler is being positioned and when the staples are to be driven the catch is released by downward pressure of the users thumb on extension 36.

The embodiment of FIG. 2 has a catch 13 pivotally fastened to housing 11 by screw 13'. Open slot 20 of catch 13 is designed to slip over the pin shank of screw 21. to lock jaw 2 and housing 11 together while the stapler is being positioned. When the staples are to be driven, catch 13 is released by applying finger pressure across the serrated upper edge 22 of the catch.

Adjusting screw 23 is threaded through ja-w 3. This screw adjusts the Width of the opening between housing 11 and anvil so as to prevent crushing of the sutured tissue when the stapler jaws are closed. Lock nut 24 locks thumb screw 25 at the desired position. In the modification shown in FIG. 1 the adjusting screw assembly 23, 24 and 25 is positioned nearer to the anvil 5 than in FIG. 2 to prevent spreading of the distance between the jaws of the instrument during maximal compression of the handles.

In the operation of the specific embodiment, anvil 5 is loaded with the valve .leaflet 26, which may be either a prosthetic leaflet or a homoor auto-graft leaflet, to be sutured as shown in FIG. 2. The shape of anvil 5 is designed so that the leaflet is extended in the proper configuration for stapling and the valve leaflet is held in position by purse string sutures or ties. Grooves 16 are loaded with staples and driver 9 inserted. The anvil is inserted into the non-coronary aortic sinus of Valsalva to the proper depth and position. During this period housing 11 and jaw 2 are locked together by catch 13. When the stapler and valve are properly positioned, the catch is released and the jaws of the stapler are closed. This movement causes driver 9 to drive the staples out of their housing, through the aortic wall and the valve leaflet, and against the clinching slots where they are clinched in the manner of an ordinary stapler. The clinched staples suture the leaflet permanently, rapidly, and with ease, into the aortic sinus where it replaces a leaflet resected because of disease.

It is to be understood that the surgical stapler herein disclosed is illustrative only and that this invention includes all modifications and uses which fall within the scope of the following claims.

I claim:

1. A surgical stapler for driving and clinching a plurality 0f staples simultaneously, comprising a staple-driving lever and a staple-clinching lever, said levers being pivotally connected and having handle portions at one end from said pivot and jaw portions at the opposite end,

a multiple staple-clinching anvil mounted on the jaw portion of said staple-clinching lever, a multiple staplehousing unit independently pivotally mounted to said pivotal connection and extending between said stapledriving and staple-clinching jaws, and a multiple stapledriver independently seated within and movable relative to said housing unit by said driving jaw.

2. A surgical stapler as in claim 1, said stapler further comprising means for releasably locking together the multiple staple-housing unit, multiple staple-driver, and staple-driving jaw.

3. A surgical stapler for driving and clinching a plurality of staples simultaneously, comprising a pivotally connected staple-driving lever and staple-clinching lever, said levers having handle portions at one end from said pivot and jaw portions at the opposite end, a staple-clinching anvil fastened to the jaw portion of said staple-clinching lever and containing a plurality of clinching slots, a staple-housing unit pivotally mounted to said pivotal connection and extending between said jaws, said housing comprising an outer and inner portion, the inner portion having a plurality of spaced projections which extend from the inner portion to said outer portion, the spaces between projections forming a plurality of staple-receiving openings wherein staples may be frictionally retained, a stapledriver having a plurality of teeth frictionally and independently retained above staples in said staple-receiving openings and movable relative to said openings by said driving lever, a catch releasably locking said staple-driver, housing unit, and driving jaw together, and an adjustable stop to regulate the closed interval between said anvil and said housing unit and driver.

4. The surgical stapler as in claim 3 wherein said catch is pivoted on said driving lever and comprises a locking portion cooperating with a pin on said housing unit, and an operating portion, said operating portion extending rearwardly from the locking portion to a point in proximity with said handle portions.

References Cited by the Examiner UNITED STATES PATENTS 220,932 10/1879 McGill 227-144 799,564 9/1905 Henry 227-144 2,940,451 6/1960 Vogelfanger et al. 227'19 XR 3,144,654 8/1964 Mallina et al. 22719 GRANVILLE Y. CUSTER, 111., Primary Examiner.

Claims (1)

1. A SURGICAL STAPLER FOR DRIVING AND CLINCHING A PLURALITY OF STAPLES SIMULTANEOUSLY, COMPRISING A STAPLE-DRIVING LEVER AND A STAPLE-CLINCHING LEVER, SAID LEVERS BEING PIVOTALLY CONNECTED AND HAVING HANDLE PORTIONS AT ONE END FROM SAID PIVOT AND JAW PORTIONS AT THE OPPOSITE END, A MULTIPLE STABLE-CLINCHING ANVIL MOUNTED ON JAW PORTION OF SAID STAPLE-CLINCHING LEVER, A MULTIPLE STAPLEHOUSING UNIT INDEPENDENTLY PIVOTALLY MOUNTED TO SAID PIVOTAL CONNECTION AND EXTENDING BETWEEN SAID STAPLEDRIVING AND STAPLE-CLINCHING JAWS, AND A MULTIPLE STAPLEDRIVER INDEPENDENTLY SEATED WITHIN AND MOVABLE RELATIVE TO SAID HOUSING UNIT BY SAID DRIVING JAW.
US376598A 1964-06-19 1964-06-19 Surgical stapler Expired - Lifetime US3269631A (en)

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Cited By (83)

* Cited by examiner, † Cited by third party
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US3575038A (en) * 1968-10-17 1971-04-13 Herbert Ernest Mallett Surgical instrument
US3576288A (en) * 1968-10-10 1971-04-27 United States Surgical Corp Medical instrument
US4047654A (en) * 1976-06-23 1977-09-13 Alfredo Alvarado Surgical stapler
US4122989A (en) * 1975-12-19 1978-10-31 Kapitanov Nikolai N Instrument for suturing with metal staples
US4241861A (en) * 1977-12-20 1980-12-30 Fleischer Harry N Scissor-type surgical stapler
US4316468A (en) * 1977-08-05 1982-02-23 Charles H. Klieman Surgical stapler
US4325376A (en) * 1977-08-05 1982-04-20 Charles H. Klieman Hemostatic clip applicator
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
US4522327A (en) * 1983-05-18 1985-06-11 United States Surgical Corporation Surgical fastener applying apparatus
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
EP0543149A2 (en) * 1991-10-18 1993-05-26 United States Surgical Corporation Surgical stapling apparatus
US5337937A (en) * 1991-10-18 1994-08-16 United States Surgical Corporation Surgical stapling apparatus
US5697542A (en) * 1995-10-19 1997-12-16 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
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US8453914B2 (en) 2009-12-24 2013-06-04 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
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US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10201349B2 (en) 2013-08-23 2019-02-12 Ethicon Llc End effector detection and firing rate modulation systems for surgical instruments
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US10206605B2 (en) 2015-03-06 2019-02-19 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
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US10206678B2 (en) 2006-10-03 2019-02-19 Ethicon Llc Surgical stapling instrument with lockout features to prevent advancement of a firing assembly unless an unfired surgical staple cartridge is operably mounted in an end effector portion of the instrument
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10213262B2 (en) 2006-03-23 2019-02-26 Ethicon Llc Manipulatable surgical systems with selectively articulatable fastening device
US10226249B2 (en) 2013-03-01 2019-03-12 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US10231794B2 (en) 2011-05-27 2019-03-19 Ethicon Llc Surgical stapling instruments with rotatable staple deployment arrangements
US10238391B2 (en) 2013-03-14 2019-03-26 Ethicon Llc Drive train control arrangements for modular surgical instruments
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10245032B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Staple cartridges for forming staples having differing formed staple heights
US10245035B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Stapling assembly configured to produce different formed staple heights
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US10245027B2 (en) 2014-12-18 2019-04-02 Ethicon Llc Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge
US10258333B2 (en) 2012-06-28 2019-04-16 Ethicon Llc Surgical fastening apparatus with a rotary end effector drive shaft for selective engagement with a motorized drive system
US10258330B2 (en) 2010-09-30 2019-04-16 Ethicon Llc End effector including an implantable arrangement
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US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10265074B2 (en) 2010-09-30 2019-04-23 Ethicon Llc Implantable layers for surgical stapling devices
US10271846B2 (en) 2005-08-31 2019-04-30 Ethicon Llc Staple cartridge for use with a surgical stapler
US10278780B2 (en) 2007-01-10 2019-05-07 Ethicon Llc Surgical instrument for use with robotic system
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10293100B2 (en) 2004-07-28 2019-05-21 Ethicon Llc Surgical stapling instrument having a medical substance dispenser
US10299787B2 (en) 2007-06-04 2019-05-28 Ethicon Llc Stapling system comprising rotary inputs
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
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US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
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Cited By (142)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3576288A (en) * 1968-10-10 1971-04-27 United States Surgical Corp Medical instrument
US3575038A (en) * 1968-10-17 1971-04-13 Herbert Ernest Mallett Surgical instrument
US4122989A (en) * 1975-12-19 1978-10-31 Kapitanov Nikolai N Instrument for suturing with metal staples
US4047654A (en) * 1976-06-23 1977-09-13 Alfredo Alvarado Surgical stapler
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
US4316468A (en) * 1977-08-05 1982-02-23 Charles H. Klieman Surgical stapler
US4325376A (en) * 1977-08-05 1982-04-20 Charles H. Klieman Hemostatic clip applicator
US4241861A (en) * 1977-12-20 1980-12-30 Fleischer Harry N Scissor-type surgical stapler
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
US4522327A (en) * 1983-05-18 1985-06-11 United States Surgical Corporation Surgical fastener applying apparatus
EP0543149A2 (en) * 1991-10-18 1993-05-26 United States Surgical Corporation Surgical stapling apparatus
US6446854B1 (en) * 1991-10-18 2002-09-10 United States Surgical Corporation Surgical stapling apparatus
US5337937A (en) * 1991-10-18 1994-08-16 United States Surgical Corporation Surgical stapling apparatus
EP0543149A3 (en) * 1991-10-18 1993-09-15 United States Surgical Corporation Surgical stapling apparatus
US5769303A (en) * 1995-10-19 1998-06-23 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
US5779131A (en) * 1995-10-19 1998-07-14 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
US5697542A (en) * 1995-10-19 1997-12-16 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
US5779132A (en) * 1995-10-19 1998-07-14 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
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