WO2023221028A1 - Dispositif d'agrafage chirurgical avec cliquet à gâchette de déclenchement - Google Patents

Dispositif d'agrafage chirurgical avec cliquet à gâchette de déclenchement Download PDF

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Publication number
WO2023221028A1
WO2023221028A1 PCT/CN2022/093781 CN2022093781W WO2023221028A1 WO 2023221028 A1 WO2023221028 A1 WO 2023221028A1 CN 2022093781 W CN2022093781 W CN 2022093781W WO 2023221028 A1 WO2023221028 A1 WO 2023221028A1
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WIPO (PCT)
Prior art keywords
pawl
trigger
cam surface
firing
handle assembly
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PCT/CN2022/093781
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English (en)
Inventor
Zhaokai Wang
Original Assignee
Covidien Lp
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Publication date
Application filed by Covidien Lp filed Critical Covidien Lp
Priority to PCT/CN2022/093781 priority Critical patent/WO2023221028A1/fr
Publication of WO2023221028A1 publication Critical patent/WO2023221028A1/fr

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    • 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

Definitions

  • the disclosure is generally related to surgical stapling devices and, more particularly, to surgical stapling devices that include structure to prevent retraction of a trigger of a firing mechanism until the trigger has moved through a complete firing stroke.
  • Surgical stapling devices for applying rows of staples through compressed living tissue are known in the art and are commonly used for closure of tissue or organs prior to transection or resection of the tissue and for occlusion of the organs during thoracic or abdominal procedures.
  • These stapling devices often include a tool assembly that has a cartridge assembly and an anvil that are movable in relation to each other between unclamped and clamped positions.
  • the cartridge assembly may be replaceable to facilitate reuse of the stapling device.
  • the stapling device includes the tool assembly, an approximation assembly for supporting the cartridge assembly and moving the cartridge assembly in relation to the anvil between the unclamped and clamped positions, and a drive member or thrust bar that is movable through a firing stroke to eject staples from the cartridge assembly.
  • the stapling device may also include a retraction mechanism that can be actuated to return the thrust bar during the actuation stroke and move the tool assembly from the clamped position back to the unclamped position.
  • a clinician may actuate the retraction mechanism before the firing stroke has been completed. This may result in the staples not being fully formed in tissue when a staple line is applied to tissue. When the staples are not fully formed in the tissue, leaks in a staple line may occur increasing risks of infection.
  • This disclosure generally relates to a surgical stapling device including a handle assembly that includes a pawl that prevents movement of a trigger of the handle assembly from a partially actuated position to an unactuated position during a firing stroke of the stapling device.
  • a handle assembly for a surgical stapling device including a housing, a trigger, an approximation assembly, a clamp member, a firing member, and a pawl member.
  • the housing defines a cavity.
  • the trigger is supported on the housing and includes a pivot member, an abutment member, and a post.
  • the trigger is movable from an unactuated position to an actuated position through a clamp stroke and movable from the unactuated position to the actuated position through a firing stroke.
  • the approximation assembly includes a proximal link and a distal link.
  • the proximal link has a proximal portion pivotably coupled to the housing and a distal portion.
  • the distal link has a proximal portion pivotably coupled to the distal portion of the proximal link and a distal portion.
  • the clamp member has a proximal portion pivotably coupled to the distal portion of the distal link of the approximation assembly and is movable between retracted and advanced positions.
  • the firing member is movable between firing retracted and firing advanced positions through a firing intermediate position.
  • the pawl member is pivotably supported within the cavity of the housing of the handle assembly and has a first cam surface and a second cam surface.
  • the post of the trigger is positioned to move along the first cam surface of the pawl during the clamp stroke of the trigger and movable along the second cam surface of the pawl during the firing stroke of the trigger.
  • the second cam surface of the pawl is configured to prevent movement of the trigger from an intermediate position located between the unactuated position and the actuated position back towards the unactuated position.
  • a handle assembly including a handle assembly, an elongate body, an end effector, a cartridge assembly, an anvil, a clamp member, a firing member, and a handle assembly.
  • the elongate body has a proximal portion coupled to the handle assembly and a distal portion.
  • the end effector is supported on the distal portion of the elongate body.
  • the clamp member extends from the handle assembly through the elongate body and has a proximal portion and a distal portion.
  • the distal portion defines a pocket that receives the cartridge assembly.
  • the clamp member is movable between retracted and advanced positions to move the cartridge assembly in relation to the anvil between unclamped and clamped positions.
  • the firing member extends from the handle assembly through the elongate body to the cartridge assembly and is movable between retracted and advanced positions through an intermediate position to eject staples from the cartridge assembly.
  • the handle assembly includes a housing defining a cavity, a trigger, an approximation assembly, and a pawl member.
  • the trigger is supported on the housing and includes a pivot member, an abutment member, and a post.
  • the trigger is movable from an unactuated position to an actuated position through a clamp stroke and movable from the unactuated position to the actuated position through a firing stroke.
  • the approximation assembly includes a proximal link and a distal link.
  • the proximal link has a proximal portion that is pivotably coupled to the housing and a distal portion.
  • the distal articulation link has a proximal portion that is pivotably coupled to the distal portion of the proximal link and a distal portion pivotably coupled to the clamp member.
  • the pawl member is pivotably supported within the cavity of the housing of the handle assembly and has a first cam surface and a second cam surface.
  • the post of the trigger is positioned to move along the first cam surface of the pawl during the clamp stroke of the trigger and movable along the second cam surface of the pawl during the firing stroke of the trigger.
  • the second cam surface of the pawl is configured to prevent movement of the trigger from a trigger intermediate position located between the unactuated position and the actuated position back towards the unactuated position.
  • the second cam surface of the pawl defines recesses that receive the post and are configured to prevent movement of the trigger from the firing intermediate position back towards the unactuated position.
  • the pawl is pivotably supported within the housing between a first pawl position in which the first cam surface is aligned with the post and a second pawl position in which the second cam surface is aligned with the post.
  • the pawl includes an engagement member, and the approximation assembly is movable during the clamp stroke from a first assembly position in which the proximal and distal links define axes that are misaligned with each other to a second assembly position in which the longitudinal axes of the proximal and distal links are substantially aligned.
  • the approximation assembly is movable into engagement with the engagement member of the pawl during the clamp stroke to move the pawl from the first pawl position towards the second pawl position.
  • a biasing member is engaged with the pawl to urge the pawl towards the first pawl position.
  • the pawl includes a third cam surface that is positioned between the first and second cam surfaces and is positioned to engage the post as the trigger moves from the actuated position towards the unactuated position during the clamp stroke.
  • the third cam surface of the pawl is positioned on an inwardly facing surface of the pawl and includes an angled surface, and the post is positioned to move over the third cam surface to bias the pawl outwardly to allow the post to pass over the pawl into alignment with the second cam surface of the pawl.
  • the pawl includes a stop member that engages the handle assembly and prevents rotation of the pawl to the first position.
  • the handle assembly includes a biasing member to urge the trigger to the unactuated position.
  • the handle assembly includes a firing link that is pivotably coupled to the trigger and is positioned to engage the proximal portion of the firing member as the trigger moves through the firing stroke to move the firing member from the firing intermediate position to the firing advanced position.
  • FIG. 1 is a side perspective view of a stapling device according to the aspects of the disclosure in an unclamped, pre-fired position;
  • FIG. 2 is a side perspective exploded view of a handle assembly and elongate body of the stapling device shown in FIG. 1;
  • FIG. 3 is a side perspective view of the handle assembly of the stapling device shown in FIG. 1 with a housing of the handle assembly shown in phantom and the stapling device in a pre-fired unclamped position;
  • FIG. 4 is a perspective view from one side of a pawl of the handle assembly of the stapling device shown in FIG. 2;
  • FIG. 5 is a perspective view from the other side of the pawl of the handle assembly of the stapling device shown in FIG. 4;
  • FIG. 6 is a cross-sectional view taken along section line 6-6 of FIG. 3;
  • FIG. 7 is a side perspective view of the handle assembly of the stapling device shown in FIG. 1 with a half-section of the housing of the handle assembly removed, the stapling device in the pre-fired unclamped position, and a trigger of the handle assembly in an unactuated position;
  • FIG. 8 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 1 with the housing of the handle assembly removed, the stapling device in a clamped position, and the trigger of the handle assembly in an actuated position;
  • FIG. 9 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 8 with the housing of the handle assembly removed and the stapling device in the clamped position as the trigger of the handle assembly returns to the unactuated position;
  • FIG. 10 is a perspective view from the proximal end of the handle assembly of the stapling device shown in FIG. 1 with the housing of the handle assembly shown in phantom, and the stapling device in the clamped position as the trigger returns to the unactuated position;
  • FIG. 11 is an enlarged view of the indicated area of detail shown in FIG. 10 as the trigger moves back to the unactuated position;
  • FIG. 12 is an enlarged view of the indicated area of detail shown in FIG. 10 as the trigger continues to return to the unactuated position;
  • FIG. 13 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 8 with the housing of the handle assembly removed and the stapling device in the clamped position as the trigger of the handle assembly is moved towards the actuated position to fire the stapling device;
  • FIG. 14 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 13 with the housing of the handle assembly removed as the trigger of the handle assembly continues to move towards the actuated position to fire the stapling device;
  • FIG. 15 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 13 with the housing of the handle assembly removed as the trigger of the handle assembly continues to move towards the actuated position to fire the stapling device;
  • FIG. 16 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 13 with the housing of the handle assembly removed as the trigger of the handle assembly continues to move towards the actuated position to fire the stapling device;
  • FIG. 17 is a side cross-sectional view of the handle assembly of the stapling device shown in FIG. 13 with the housing of the handle assembly removed after the stapling device is fired with the trigger of the handle assembly in the actuated position.
  • proximal is used generally to refer to that portion of the device that is closer to a clinician during use of the device in its customary fashion
  • distal is used generally to refer to that portion of the device that is farther from the clinician during use of the device in its customary fashion
  • clinical is used generally to refer to medical personnel including doctors, nurses, and support personnel.
  • directional terms such as front, rear, upper, lower, top, bottom, and similar terms are used to assist in understanding the description and are not intended to limit the disclosure.
  • the disclosed surgical stapling device includes a handle assembly that includes a pawl that prevents movement of a trigger of the handle assembly from a partially actuated position to an unactuated position during a firing stroke of the stapling device.
  • the pawl ensures that a clinician completes the firing stroke during actuation of the stapling device to fully form staples.
  • FIG. 1 illustrates the disclosed surgical stapling device shown generally as stapling device 10.
  • the stapling device 10 includes a handle assembly 12, an elongate body 14 that defines a longitudinal axis “X” , and an end effector 16.
  • the handle assembly 12 includes a stationary handle 18 and a pivotable trigger 20 that is movable in relation to the stationary handle 18 through one or more actuation strokes to clamp and fire the stapling device 10.
  • the handle assembly 18 includes a housing 22 that defines a cavity 22a (FIG. 7) and forms the stationary handle 18, a release button 24, and alignment pin advancement knobs 26 supported within the housing 22 of the handle assembly 12.
  • the release button 24 is supported on the housing 22 and is depressible to return the stapling device 10 to an unclamped position.
  • the alignment pin advancement knobs 26 are slidably supported on opposite sides of the housing 18 of the handle assembly 12 and facilitate manual advancement of an alignment pin pusher 28.
  • the alignment pin pusher 28 is engaged with an alignment pin (not shown) of the end effector as known in the art.
  • the end effector 16 includes an end effector frame 32 and a cartridge assembly 34.
  • the end effector frame 32 is secured to a distal portion of the elongate body 14 and includes a distal transverse portion 32a, a proximal transverse portion 32b, and a longitudinal portion 32c that is coupled to the distal and proximal transverse portions 32a, 32b, respectively, to form a U-shape that defines a gap 36 between the distal and proximal transverse portions 32a, 32b.
  • the cartridge assembly 34 is supported within the gap 36 defined by the end effector frame 32 and is movable between unclamped and clamped positions as described in further detail below.
  • the distal transverse portion 32a of the end effector frame 32 supports an anvil 38 that is positioned in juxtaposed opposition to the cartridge assembly 34 in the clamped position.
  • an exemplary stapling device including components identified above, see, e.g., U.S. Patent No. 8,371,494 (hereinafter “the ’494 Patent” ) .
  • FIGS. 2 and 3 illustrate the handle assembly 12 and the elongate body 14 of the stapling device 10.
  • the stapling device 10 includes a frame including first and second spaced frame members 40 and 42 that are secured together in spaced relation to each other with rivets or pins 44.
  • Each of the frame members 40, 42 includes a proximal portion 46 that is secured to the housing 22 of the handle assembly 12 and a distal portion 48 that is secured to the end effector 16.
  • the frame members 40, 42 are spaced from each other to define a channel 46 between the frame members 40, 42.
  • the stapling device 10 includes an approximation assembly 50 that includes a proximal link 52, a distal link 54, and a clamp member 56.
  • the proximal link 52 has a proximal portion that is pivotably coupled between the proximal portions of the frame members 40, 42 by a pivot pin 58.
  • the pivot pin 58 extends between openings 60 in the proximal portions of the frame members 40, 42 and through an opening 62 in the proximal portion of the proximal link 52 such that the proximal link 52 of the approximation assembly 50 is pivotably supported between the frame members 40, 42.
  • the distal link 54 of the approximation assembly 50 is pivotably coupled the distal portion of the proximal link 52 by a pivot pin 66 such that the proximal and distal links 52, 54 are pivotably coupled together.
  • the distal portion of the distal link 54 is pivotably coupled to a proximal portion of the clamp member 56 by a pivot member 68.
  • the pivot member 68 extends through an opening 70 in the distal portion of the distal link 54, through an opening 72 in the proximal portion of the clamp member 56, and through elongate slots 74 in the frame members 40, 42.
  • the clamp member 56 is positioned between the frame members 40, 42 within the channel 46 and defines three longitudinally extending slots 76 that are spaced along the length of the clamp member 56.
  • the three slots 76 receive the pins 44 that secure the frame members 40, 42 together. Receipt of the pins 44 within the slots 76 and receipt of the pivot pin 68 in the slot 74 of the frame members 40, 42 restrict the clamp member 56 to longitudinal and linear movement within the channel 46 defined between the frame members 40, 42.
  • the clamp member 56 includes a distal portion 78 that defines a pocket that releasably receives the cartridge assembly 34 (FIG. 1) .
  • the distal portion 78 of the clamp member 56 supports the cartridge assembly 34 within the gap 36.
  • the clamp member 56 is movable between a retracted position and an advanced position to move the stapling device 10 in relation to the anvil 38 (FIG. 1) between unclamped and clamped positions.
  • the clamp member 56 defines a channel 80 that has an open proximal end and an open distal end and receives a firing member 82.
  • the firing member 82 has a distal portion 82a that is received within the cartridge assembly 34 and a proximal portion 82b that is engaged with the clamp member 56 such that distal movement of the clamp member 56 causes corresponding distal movement of the firing member 82.
  • the proximal portion 82b of the firing member 82 defines a notch 83 and includes a flange 84 that defines an opening 84a.
  • a biasing member 86 (FIG.
  • the firing member 82 defines three longitudinally extending slots 88 that are spaced along the length of the firing member 82.
  • the three slots 88 receive the pins 44 that secure the frame members 40, 42 together. Receipt of the pins 44 within the slots 88 restrict the firing member 82 to longitudinal and linear movement within the channel 80 of the clamp member 56.
  • the slots 88 in the firing member 82 are aligned with the slots 76 in the clamp member 56.
  • the distal ends of the slots 76 are aligned with the distal ends of the slots 88, but the proximal ends of the slots 88 of the firing member 82 are positioned proximally of the proximal ends of the slots 76 of the clamp member 56.
  • the increased length of the slots 88 in the firing member 82 allows the firing member 82 to be moved distally independently of the clamp member 56 from a firing member intermediate position to a firing member advanced position after the stapling device 10 (FIG. 1) is in the clamped position to facilitate firing of the stapling device 10.
  • the trigger 20 includes a pivot member 90 that is supported on the housing 12 such that the trigger 20 is pivotable between a non-actuated position (FIG. 1) spaced from the stationary handle 18 to an actuated position located adjacent the stationary handle 18.
  • the trigger 20 includes a body 92 including a grip portion 94 that extends outwardly of the housing 22 of the handle assembly 12 and an inner portion 96 positioned within the housing 22 of the handle assembly 12.
  • the inner portion 96 of the trigger 20 supports the pivot member 90 and includes a clevis portion 98 and a proximal extension 100.
  • the clevis 98 is positioned distally of the pivot member 90 and the proximal extension 100 is positioned proximally of the pivot member 90.
  • a firing link 102 is secured to the clevis 98 by a bolt 106 that extends across the clevis 98 through an opening 102a in a proximal portion of the firing link 102.
  • the firing link 102 extends distally from the clevis 98 along a lower surface of the firing member 82 and is rotatable about the bolt 106.
  • a biasing member 108 is positioned within the housing 22 and is engaged with the firing link 102 to urge the firing link 102 into engagement with the lower surface of the firing member 82.
  • the firing link 102 includes a tab 102b that engages the clamp member 56 (FIG. 6) to limit rotation of the firing link 102.
  • the biasing member 108 includes a torsion spring that is supported about the pivot member 90 of the trigger 20.
  • the firing member 82 When the firing member 82 is in the retracted position, the distal end of the firing link 102 is engaged with the firing member 82 at a position distally of the notch 83 in the firing member 82.
  • the biasing member 108 urges the distal end of the firing link 102 into the notch 83 of the firing member 82 as known in the art.
  • the proximal extension 100 of the trigger 20 includes an abutment member 110, a post 111 (FIG. 7) , and a hook 112.
  • the hook 112 is positioned on the proximal end of the proximal extension 100 of the trigger 20 and is coupled to one end of a biasing member 114.
  • the other end of the biasing member 114 is coupled to the housing 22 of the handle assembly 12 to urge the trigger towards the unactuated position.
  • the biasing member 114 is a coil spring although other biasing member configurations are envisioned.
  • the abutment member 110 of the trigger 20 is positioned beneath the approximation assembly 50 of the stapling device 10.
  • the firing member 82 is urged towards a retracted position by the biasing member 86 (FIG. 3) .
  • the firing member 82 is engaged with the clamp member 56 such that the biasing member 86 urges the clamp member 56 to the retracted position.
  • the proximal and distal links 52 and 54 of the approximation assembly 50 define longitudinal axes that are misaligned with each other to define a V-shape.
  • the abutment member 110 engages the proximal and/or distal links 52, 54 of the approximation assembly 50 and moves the proximal and distal links 52, 54 to positions in which the longitudinal axes of the proximal and distal links 52, 54 are substantially aligned with each other to advance the clamp member 56 from the retracted position to the advanced position and move the cartridge assembly 34 (FIG. 1) from the unclamped position to the clamped position.
  • the proximal and distal links 52, 54 are moved upwardly to an over-center position such that when the trigger 20 is released, the biasing member 86 urges the proximal and distal links 52, 54 upwardly to prevent retraction of the clamp member 56.
  • the upward movement of the proximal and distal links 52, 54 is restricted beyond the over-center position by a pawl 120 described below.
  • the release button 24 forms part of a release assembly 118 (FIG. 2) that can be depressed to move the proximal and distal links 52, 54 to an under-center position to allow the biasing member 86 to return the clamp member 56 to the retracted position.
  • a release assembly see the ‘494 Patent.
  • FIGS. 4-7 illustrate the pawl 120 which includes a body 122 having a pivot member 124, a stop member 126, an engagement member 128, a connector 130, a first cam surface 132, a second cam surface 134 (FIG. 4) , and a third cam surface 135.
  • the pivot member 124 is received within an opening 136 in the frame member 40 (FIG. 2) to rotatably support the pawl 120 on the frame member 42.
  • the connector 130 is positioned on a distal side of the pawl 120 and is coupled to a proximal end of a biasing member or spring 140. A distal end of the spring 140 is secured to a tab 142 (FIG.
  • the stop member 126 is positioned to extend above the frame member 40 and prevents rotation of the pawl 120 by the spring 140 beyond a predetermined position (FIG. 7) .
  • the spring 140 is in tension to urge the pawl 120 in a counterclockwise direction as viewed in FIG. 2.
  • the first cam surface 132 is positioned on a proximal side of the pawl 120 and defines a curved surface.
  • the first cam surface 132 is positioned to be engaged by the post 111 of the trigger 120 when the trigger 20 is moved through a first actuation stroke (hereinafter “the clamp stroke” ) to move the stapling device 10 (FIG. 1) from the unclamped position to the clamped position.
  • the second cam surface 134 is positioned to be engaged by the post 111 of the trigger 20 when the trigger 20 is moved through a second actuation stroke (hereinafter “the firing stroke” ) to advance the firing member 82 to eject staples from the cartridge assembly 34.
  • the second cam surface 134 defines a plurality of recesses 134a that are dimensioned to receive the post 111 of the trigger 20 as the trigger 20 is moved through the firing stroke.
  • the recesses 134a are configured to allow the post 111 of the trigger 20 to move in a first direction (e.g., upwardly) along the second cam surface 134 but prevent movement of the post 111 in a second opposite direction (e.g., downwardly) along the second cam surface 134 to prevent movement of the trigger 20 from a partially actuated position back towards the unactuated position during the firing stroke as described in further detail below.
  • the third cam surface 135 is positioned on an inwardly facing surface on a lower end of the pawl 120 between the first and second cam surfaces 132, 134.
  • the third cam surface 135 includes an angled surface (FIG. 11) that slopes downwardly and inwardly as viewed in FIG. 11 from the inner surface of the pawl 120.
  • the engagement member 128 is supported or formed on an upper end of the body 122 of the pawl 120 and extends inwardly to a position above the approximation assembly 50.
  • the proximal link 152 engages the engagement member 128 to rotate the pawl 120 slightly in a clockwise direction as viewed in FIG. 8.
  • the second cam surface 134 of the pawl 120 moves to a position to engage the post 111 of the trigger 20 when the trigger 20 is returned to the unactuated position.
  • FIGS. 6 and 7 illustrate the handle assembly 12 of the stapling device 10 (FIG. 1) with the stapling device 10 in a pre-fired unclamped position.
  • the proximal and distal links 52, 54 of the approximation assembly 50 are in misaligned positions and the clamp member 56 and firing member 82 are in retracted positions.
  • the trigger 20 is in the unactuated position spaced from the stationary handle 18 of the housing 22 of the handle assembly 12 and the post 111 of the trigger 20 is positioned proximally of the first cam surface 132 of the pawl 120.
  • the tab 102b of the firing link 102 is engaged with a bottom surface of the clamp member 56 to prevent over rotation of the firing link 102.
  • FIG. 8 illustrates the handle assembly 12 of the stapling device 10 when the trigger 20 is moved to the actuated position during the clamp stroke.
  • the abutment member 110 of the trigger 20 engages the proximal link 52 of the approximation assembly 50 to move the proximal and distal links 52, 54 upwardly to substantially aligned positions. Since the proximal end of the proximal link 52 is secured to the frame members 40, 42 (FIG. 2) , the distal link 54 is advanced to move the clamp member 56 from the retracted position to the advanced position. As described above, this movement advances the cartridge assembly 34 within the gap 36 (FIG. 1) of the end effector frame 32 and advances the firing member 82 (FIG. 3) to an intermediate position. In the intermediate position of the firing member, the distal portion of the firing link 102 moves into the notch 83 of the firing member 102.
  • the post 111 moves along the first cam surface 132 of the pawl 120.
  • the proximal link 52 moves upwardly in the direction of arrow “B” towards the position aligned with the distal link 54, the proximal link 52 engages the engagement member 128 of the pawl 120 to rotate the pawl 120 in a clockwise direction as indicated by arrow “C” .
  • FIGS. 9-12 illustrate the handle assembly 12 of the stapling device 10 as the trigger 20 is moved from the actuated position back towards the unactuated position in the direction of arrow “D” during the clamp stroke.
  • the spring 114 returns the trigger 20 to the unactuated position.
  • the post 111 of the trigger moves downwardly along the pawl 120 in the direction of arrow “E” in FIG. 9. Because the pawl 120 has been rotated in the clockwise direction by the proximal link 52 of the approximation assembly 50, the post 111 is aligned with the third cam surface 135 of the pawl 120.
  • the pawl 120 As the post 111 passes over the third cam surface 135 of the pawl 120 (FIG. 11) , the pawl 120 is deflected outwardly in the direction of arrow “F” in FIG. 11 by the post 111. When the post 111 of the trigger 20 passes over the third cam surface 135, the pawl returns to its undeformed configuration to position the post 111 into alignment with the second cam surface 134 of the pawl 120.
  • FIGS. 13-16 illustrate the handle assembly 12 of the stapling device 10 as the trigger 20 is moved in the direction of arrow “H” from the unactuated position towards the actuated position during the firing stroke.
  • the post 111 of the trigger 20 moves along the second cam surface 54 and initially rotates the pawl 120 in the direction of arrow “I” in FIG. 13 to move the engagement member 128 of the pawl 120 out of engagement with the proximal link 52 of the approximation assembly 50.
  • the post 111 moves along the second cam surface 134 in the direction of arrow “J” and moves into and out of the recesses 134a formed along the second cam surface 134 moving the pawl 120 back and forth in the directions of “K” and “K1” in FIGS 14 and 15.
  • the pawl 120 is urged by the spring 140 in the direction of arrow “K” to retain the post 111 within the recesses 134a.
  • the recesses 134a are configured to capture the post 111 such that if the trigger 20 is released by a clinician prior to reaching the actuated position during the firing stroke, the trigger 20 is prevented from being returned to the unactuated position by the biasing member 114. Thus, the trigger 20 must be moved to the actuated position to complete the firing stroke before the trigger 20 will return to the unactuated position.
  • FIG. 17 illustrates the handle assembly 12 of the stapling device 10 as the trigger 20 is moved in the direction of arrow “L” from the actuated position towards the unactuated position during the firing stroke.
  • the trigger 20 reaches the actuated position, the post 111 moves off the upper end of the second cam surface 134 of the pawl 120 and the biasing member 140 pivots the pawl 120 in the counterclockwise direction indicated by the arrow “M” to position the post 111 above an upper end 150 of the first cam surface 132 of the pawl 120.
  • the biasing member 114 urges the trigger 20 back to the unactuated position in the direction of arrow “L” causing the post 111 of the trigger 20 to move unimpeded in the direction of arrow “N” downwardly along the first cam surface 132 of the pawl 120.
  • the pawl 120 of the handle assembly 12 ensures that the clinician moves the trigger 20 from the unactuated position to the actuated position during the firing stroke to fully form staples before the trigger 20 can return to the unactuated position.
  • the release button 24 can be depressed to return the proximal and distal links 52, 54 to their misaligned positions to return the stapling device 10 (FIG. 1) to the unclamped position. More specifically, when the release button 24 is depressed, the proximal and distal links 52, 54 of the approximation assembly 50 are moved downwardly past their aligned positions. When this occurs, the biasing member 86 returns the clamp member 56 and the firing member 82 to their retracted positions.

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  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract

Un dispositif d'agrafage chirurgical (10) comprend un ensemble poignée (12). L'ensemble poignée (12) comprend un boîtier (22), une gâchette (20), un ensemble d'approximation (50), un élément de serrage (56), un élément de déclenchement (82) et un élément cliquet (120). L'élément cliquet (120) peut empêcher le mouvement d'une gâchette (20) de l'ensemble poignée (12) d'une position partiellement actionnée à une position non actionnée pendant une course de déclenchement du dispositif d'agrafage (10).
PCT/CN2022/093781 2022-05-19 2022-05-19 Dispositif d'agrafage chirurgical avec cliquet à gâchette de déclenchement WO2023221028A1 (fr)

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US20070095877A1 (en) * 2000-10-13 2007-05-03 Racenet David C Surgical stapling device
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AU2012200594A1 (en) * 2003-06-17 2012-02-23 Covidien Lp Surgical stapling device
CN104039242A (zh) * 2012-01-05 2014-09-10 伊西康内外科公司 组织缝合触发器上用于防止钳口过早打开的棘轮特征结构
WO2014139327A1 (fr) * 2013-03-15 2014-09-18 Covidien Lp Appareil d'agrafage chirurgical
US20180235633A1 (en) * 2017-02-23 2018-08-23 Covidien Lp Endoscopic surgical clip applier

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US20040164123A1 (en) * 2000-10-13 2004-08-26 Racenet David C. Surgical stapling device
US20070095877A1 (en) * 2000-10-13 2007-05-03 Racenet David C Surgical stapling device
AU2012200594A1 (en) * 2003-06-17 2012-02-23 Covidien Lp Surgical stapling device
US20080083806A1 (en) * 2006-10-06 2008-04-10 Tyco Healthcare Group Lp Grasping jaw mechanism
CN104039242A (zh) * 2012-01-05 2014-09-10 伊西康内外科公司 组织缝合触发器上用于防止钳口过早打开的棘轮特征结构
WO2014139327A1 (fr) * 2013-03-15 2014-09-18 Covidien Lp Appareil d'agrafage chirurgical
US20180235633A1 (en) * 2017-02-23 2018-08-23 Covidien Lp Endoscopic surgical clip applier
CN108542464A (zh) * 2017-02-23 2018-09-18 柯惠Lp公司 内窥镜手术施夹器

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