WO2024182139A2

WO2024182139A2 - Articulation mechanism for surgical instruments

Info

Publication number: WO2024182139A2
Application number: PCT/US2024/016128
Authority: WO
Inventors: Thomas G. WENCHELL, Jr.; Wayne Young; Dawson HETTRICK; C. Robert SATTI, III
Original assignee: RevMedica, Inc.
Priority date: 2023-03-01
Filing date: 2024-02-16
Publication date: 2024-09-06
Also published as: WO2024182139A3

Abstract

A surgical fastener applier having a housing, an elongated member extending distally of the housing and having a longitudinal axis, and first and second jaws at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws. An articulation mechanism articulates the jaws from a first position in line with the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis, the articulation mechanism including a first articulation rod, a second articulation rod, and at least one gear operatively engageable with the first articulation rod, wherein rotation of the gear moves the second articulation rod.

Description

ARTICULATION MECHANISM FOR SURGICAL INSTRUMENTS

BACKGROUND OF THE INVENTION

This application claims priority to provisional application 63/449,071, filed March 1, 2023, the entire contents of which are incorporated herein by reference.

1. Field of the Invention

The present invention relates to articulation mechanisms for articulation of jaws of surgical instruments, and particularly, to articulation mechanisms for surgical staplers.

2. Background

Surgical staplers are used in various medical applications where a device is needed to join and dissect anatomical tissue. For endoscopic or laparoscopic use, these staplers are inserted through trocars to access the surgical site. With such remote access, oftentimes the jaws of these surgical staplers need to be articulated to change the angle of the jaws with respect to the elongated shaft. With high forces required to fire the staples through tissue into contact with the anvil for formation, in current staplers, this can cause movement of the jaws with respect to the elongated shaft, thus undesirably changing the articulation angle. Also, in some instances, contact of the jaws with the tissue can undesirably change the articulated position of the jaws.

The need exists for an articulation mechanism that will better stabilize the position of the articulated jaws. This could be beneficial in instruments that have manual firing of staplers as well as instruments that are powered, i.e., have motor driven mechanisms, to effect firing. This could also be beneficial to stabilize jaws in articulated positions in instruments other than surgical staplers.

SUMMARY

The present invention provides an articulation mechanism for use with surgical instruments such as surgical fastener appliers. e.g., surgical staplers, that articulate the jaws of the instrument to various angles with respect to the longitudinal axis of the instrument and maintains the jaws in the angled position during use. The articulation mechanism of the present invention advantageously improves stabilization of the jaws in the articulation position during positioning and firing.

In accordance with one aspect of the present invention, a surgical fastener applier is provided comprising a housing, an elongated member extending distally of the housing and having a longitudinal axis, and a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws. An articulation mechanism articulates the jaws from a first position substantially in line with the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis. The articulation mechanism includes a first articulation rod, a second articulation rod and at least one gear operatively engageable with the first articulation rod, wherein rotation of the gear effects movement of the second articulation rod.

In some embodiments, the first articulation rod has a first length and the second articulation rod has a second length less than the first length.

In some embodiments, when the first articulation rod is moved in a first direction, the second articulation rod is moved in a second direction.

In some embodiments, the at least one gear is positioned between the first and second articulation rods. In some embodiments, teeth of the at least one gear intermesh with teeth on the first and second articulation rods. In some embodiments, a first set of teeth on the first articulation rod are on an inner portion of the first articulation rod and a second set of teeth on the second articulation rod are on an inner portion of the second articulation rod such that the first and second set of teeth face each other. In alternate embodiments, multiple gears are utilized.

In some embodiments, only the first articulation rod is connected to an articulation control of the articulation mechanism such that the second articulation rod is not connected to the articulation control and moves only due to movement of the first articulation rod.

In some embodiments, the at least one gear is rotatable about a transverse post, the transverse post having a slot formed therein. In some embodiments, a plurality of knife laminates extend through the slot. In some embodiments, a pair of jaw clamping laminates extend through the slot.

In some embodiments, the first articulation rod has a first slot at a distal end and the second articulation rod has a second slot at a distal end, wherein a first pin slides within the first slot and a second pin slides within the second slot when the first and second articulation rods are moved axially to articulate the first and second jaws. In some embodiments, the first slot is transverse to a longitudinal axis of the first articulation rod and the second slot is transverse to a longitudinal axis of the second articulation rod.

In some embodiments, the first articulation rod has a proximal end terminating within a proximal housing of the surgical fastener applier and operatively connected to an articulation actuation mechanism, and the second articulation rod has a proximal end terminating distal of the proximal housing.

In accordance with another aspect of the present invention, a surgical fastener applier is provided comprising a housing, an elongated member extending distally of the housing and having a longitudinal axis, and a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws. An articulation mechanism articulates the jaws from a first position substantially in line with the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis. The articulation mechanism includes a first articulation rod having a first slot and a second articulation having a second slot, wherein a first pin slides within the first slot and a second pin slides within the second slot when the first and second articulation rods are moved axially to articulate the first and second jaws.

In some embodiments, the first slot is transverse to a longitudinal axis of the first articulation rod and the second slot is transverse to a longitudinal axis of the second articulation rod.

In some embodiments, the first articulation rod has a proximal end terminating within a proximal housing of the surgical fastener applier and operatively connected to an actuation mechanism, and the second articulation rod has a proximal end terminating distal of the proximal housing.

In some embodiments, the first articulation rod is attached to an actuation mechanism at a proximal portion of the housing, and movement of the first articulation rod effects movement of the second articulation rod. In accordance with another aspect of the present invention, a surgical fastener applier is provided comprising a housing, an elongated member extending distally of the housing and having a longitudinal axis, and a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws. An articulation mechanism articulates the jaws from a first position substantially in line with the longitudinal axis of the elongated member to a second position at ari acute angle to the longitudinal axis. The articulation mechanism includes a first articulation rod and a second articulation rod, wherein to articulate the first and second jaws in a first direction, the first articulation rod is moved axially in a distal direction which moves the second articulation rod axially in a proximal direction, and to articulate the first and second jaws in a second direction, the first articulation rod is moved axially in a proximal direction which moves the second articulation rod axially in a distal direction.

In some embodiments, the surgical fastener applier includes at least one gear operatively engageable with one or both of the first and second articulation rods.

BRIEF DESCRIPTION OF THE DRAWINGS

So that those having ordinary skill in the art to which the subject invention pertains will more readily understand how to make and use the surgical apparatus disclosed herein, preferred embodiments thereof will be described in detail hereinbelow with reference to the drawings, wherein:

Figure 1A is a top perspective view of an embodiment of the articulation mechanism of the present invention;

Figure IB is a close up view of the articulation mechanism of Figure 1 A;

Figure 1C is a top perspective view showing the knife and clamp laminates and the articulation mechanism of Figure 1A;

Figure ID is a bottom perspective view of the articulation mechanism of Figure 1 A;

Figure IE is a top perspective view of the articulation mechanism showing the pivot and adapter;

Figure 2A is a top view of the articulation mechanism of Figure 1A, the position corresponding to the non-articulated position of the jaws (0 degrees);

Figure 2B is a close up top view of the gear mechanism of Figure 2A; Figure 2C is a top view of the knife and clamp laminates which extend through the post of the gear mechanism of Figure 1A:

Figure 3 is a top view similar to Figure 2A showing the articulation rods pinned to the articulation joint (the pivot adapter removed for clarity);

Figure 4 is a top view with the pivot adapter shown;

Figure 5 is a top view similar to Figure 2A showing one of the articulation rods moved distally to articulate the jaws to a 25 degree angle with respect to the elongated shaft (articulated right);

Figure 6 is a top view similar to Figure 5 showing the articulation rod of Figure 5 moved further distally to articulate the jaws to a 45 degree angle with respect to the elongated shaft;

Figure 7 is a top view similar to Figure 2A showing the articulation rod moved proximally to articulate the jaws to a 25 degree angle with respect to the elongated shaft in an opposite direction than that of Figure 5 (articulated left instead of right);

Figure 8 is a top view similar to Figure 7 showing the articulation rod of Figure 7 moved further proximally to articulate the jaws to a 45 degree angle with respect to the elongated shaft;

Figure 9 is a side perspective view of a surgical stapler having the articulation mechanism of Figure 1A wherein articulation is manually controlled/actuated;

Figure 10 is a side view of another surgical stapler having the articulation mechanism of Figure 1A wherein articulation is powered (motor controlled/actuated);

Figure 11 is a cross-sectional view of the housing of the surgical stapler of Figure 10 showing engagement of the drive mechanism of the power pack with the articulation rod of Figure 1A; and

Figure 12 is a side view of another surgical stapler having the articulation mechanism of Figure 1 A having manual firing and manual articulation.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The present disclosure is directed to an articulation mechanism for articulating end effectors, e.g., jaws, of surgical instruments. The articulation mechanisms of the present invention can be used to articulate jaws of surgical fastener appliers, e.g., surgical staplers, as well as end effectors of other surgical instruments. The articulation mechanism can used with endoscopic or laparoscopic surgical staplers to articulate/pivot the jaws between a first 0 degree position aligned (or substantially aligned) with the longitudinal axis of the elongated shaft from which they extend to angled positions at acute (or in some instruments even obtuse) angles with respect to the elongated shaft. The articulation mechanisms of the present invention also maintain the stability of the end effector in the articulated position so it is not subject to movement when external or internal forces are provided, such as by contact with body tissue, firing of fasteners into tissues, etc.

The articulation mechanism can be used with powered endoscopic linear staplers such as shown in Figures 9 and 10 discussed below and disclosed in commonly assigned U.S. Patent Nos. 10,966,720, 10,874,393, 11,331,099 and 11,564,685, the entire contents of each of these patents are incorporated herein by reference. The articulation mechanism of the present invention can also be used with other powered staples as well as with manually actuated staplers, i.e., staplers that are fired via manual pivoting of a trigger/handle. The articulation mechanism can also be used with robotic controlled staplers. Thus, powered, non-powered, and robotic instruments can utilize the articulation mechanism disclosed herein.

The term “proximal” as used herein denotes the region closer to the user and the term “distal” as used herein denotes the region further from the user. The terms “top” or “upper” and “bottom” or “lower” refer to the orientation of the instruments as shown in the orientation of the instrument in Figure 9, with the cover being on the top and the handle extending at the bottom.

Referring now to the drawings and particular embodiments of the present disclosure, wherein like reference numerals identify similar structural features of the devices and systems disclosed herein, and with reference to Figures 1A-8, the articulation mechanism of the present invention is illustrated, designated generally by reference numeral 10. With initial reference to Figures 1A-1D, the articulation mechanism includes an articulation rod 12, an articulation rod 14, and a gear 20. Note the articulation rod 14 is referred to as the “first” articulation rod and the articulation rod 12 is referred to as the “second” articulation rod for convenience, however, the articulation rod 14 could alternatively be considered the “second” articulation rod and articulation rod 12 considered the “first” articulation rod. The first articulation rod 14 is operatively connected (operatively attached) at a proximal end 15 (Figure IE) to an actuation mechanism at the proximal end of the instrument. That is, actuation of the actuation mechanism, whether powered or manual, effects axial movement of the operatively connected articulation rod 14. The actuation mechanism can include an actuator such as a handle, lever, trigger, etc. The second articulation rod 12 is not attached to the actuation mechanism so that its movement is caused by movement of the first articulation rod 14 due to its operative connection thereto via the gear 20. In the illustrated embodiment, the articulation rod 12 has a proximal end 17 (Figure 1A) that terminates distal of the proximal end 15 of the articulation rod 14. Thus, articulation rod 12 as shown has a length shorter than a length of the articulation rod 14. In the illustrated embodiment, both articulation rods 12, 14 terminate at their respective distal ends 12b, 14b (Figure 1C) of distal portions 17, 19, along the same axial line L (Figure 2A).

First articulation rod 14 has a slot 44 to receive pin 46. Preferably, slot 44 is substantially transverse to the longitudinal axis of the articulation rod 14, e.g., at a 90 degree angle in the illustrated embodiment. Second articulation rod 12 has a slot 40 to receive pin 42. Preferably, slot 40 is substantially transverse to the longitudinal axis of the articulation rod 12, e.g., at a 90 degree angle in the illustrated embodiment. The position of pins 42, 46 in respective slots 40, 44 changes as the articulation rods 12, 14 are moved axially as described below. This pin/slot arrangement enables pushing of the articulation rods 12, 14 without pivoting which limits bending of the rods 12, 14. In the absence of the slots, for articulation, one articulation rod would bend inwardly and the other articulation rod would bend outwardly. The articulation rods 12, 14 provide dual rigidity as both sides are locked about the pivot joint as described below.

Articulation rod 12 has a rack forming a plurality of teeth 16 on an inner surface 12a (Figure IB). Similarly, articulation rod 14 has a rack forming a plurality of teeth 18 on an inner surface 14a. Teeth 16, 18 intermesh with teeth 22 of pinion gear 20 which rotates about pin (post) 30. In the view of Figure IB, if articulation rod 14 is moved axially (longitudinally/ linearly) distally, gear 20 rotates clockwise to move articulation rod 12 axially (longitudinally/ linearly) proximally; if articulation rod 14 is moved axially (longitudinally/linearly) proximally, gear 20 rotates counterclockwise to move articulation rod 12 axially (longitudinally/linearly) distally. Thus, the articulation rods move in harmony. Note in the illustrated embodiment, one gear is utilized to effect this motion, however, it is also contemplated that in alternate embodiments, more than one gear can be utilized to effect this motion, e.g., intermeshed gears to effect movement of articulation rod 12 when articulation rod 14 is moved axially. Thus, for example, articulation rod 14 would intermesh with a first gear, articulation rod 12 would intermesh with a second gear, and the first and second gears would interact e.g., intermesh, to cause movement of rod 12 in response to movement of rod 14. A third gear could in some embodiments be interposed between the first and second gears. Other mechanisms to move articulation rod 12 in response to movement of articulation rod 14 are also contemplated. Note it is also contemplated that the function of rods 12 and 14 can be switched so that rod 12 is attached to the actuation mechanism and rod 14 is unattached such that movement of rod 12 effects movement of rod 14. It is also envisioned in alternate embodiments that both rods 12 and 14 can be operatively connected to the actuation mechanism.

In embodiments utilizing powered actuation, a single motor can be used to effect movement of the articulation rod 14 distal and then reverse to move the rod 14 proximally. In alternate embodiments, two separate motors can be used, one for forward and the other for backward movement. A lever, trigger, switch, etc. can be used to activate the motor.

Post 30 has a slot 32 extending therethrough dimensioned to receive clamp laminates and knife laminates therethrough. The flexibility of the laminates allows for articulation of the jaws. More specifically, the pair of inner knife laminates 34 and the pair of outer knife laminates 36 extend through the slot 32 and through the laminate guides 38 which are retained via the positioning of angled ends 38a within slot 39. The knife laminates 34, 36 as shown in Figure 1C engage I-beam 50 which is advanced to sequentially fire the fasteners and dissect tissue between the rows of fasteners. Clamp laminates 52 also extend through slot 32 of post 30 and are positioned within the gap between the upper and lower regions of the knife laminates 34, 36. The clamp rod 60 for clamping the jaws and deployment (firing) tube 62 for fastener firing are shown in Figure IE.

With reference to Figures 1A and ID, articulation rods 12 and 14 are attached to articulation joint/pivot 56. The jaws of the instrument are also attached to pivot joint 56. The anvil jaw 70 which contains a series of anvil pockets 72 for formation of fasteners is shown in Figure 1C. (The jaw containing the staples, positioned in apposition to the anvil jaw 70, is removed for clarity but would pivot/articulate along with the anvil jaw as the pivot join is moved/pivoted). Pivot 56 forks into left region 56a and right region 56b. Left region 56a has an opening 57a to receive left pin 46; right region 56b has an opening similar to opening 57a to receive right pin 42. (Left and right referring to the orientation of Figures 1A and 1C wherein the jaws are to the left and the handle is to the right). Articulation joint 56 pivots about pins 42 and 46 to angle the jaws with respect to the longitudinal axis A (shown in Figure 5) which corresponds to the longitudinal axis of the elongated shaft in which the articulation mechanism 10 and laminates 34, 36 and 50 are contained. Thus, articulation joint 56 moves the jaws in a left and right direction. The articulation can be at various acute angles with respect to longitudinal axis A. Adapter 54 adjacent the pivot 56 is formed from an upper section 54a (Figure 4) and a lower section 54b (Figured ID). Adapter 54 includes adapter channel 55 extending along a length within the elongated shaft. The adapter 54 is removed from Figure 3 for clarity.

Use of the articulation mechanism can be understood with reference to Figures 2A and 5- 8. As noted above, the articulation mechanism 10 can be actuated via one or more motors which operates to move the articulation rod 14 in axial directions. In such embodiments, the motor assembly drives a drive mechanism which operatively engages the articulation rod such as disclosed for example in U.S. Patent No, 11,331,099 showing for example driving assembly 95 with flag 94 engaging end 78 of articulation rod 79. Alternatively, the articulation mechanism can be manually actuated by a handle, lever, etc. operatively connected to the articulation rod 14 to move it in axial directions. In such embodiments, the handle (or lever, etc.), via a linkage, is connected to the articulation rod such that movement of the handle (or lever, etc.) effects axial movement of the operatively connected rod. In either case (powered or manual), articulation rod 14 is moved axially (linearly) in proximal and distal directions.

In Figure 2 A, the articulation mechanism is shown in the initial or neutral position wherein the instrument jaws are aligned (or substantially aligned) with the longitudinal axis, i.e., in a non-articulated or 0 degree position. In this position, pin 46 is in the outermost region of slot 44 and pin 42 is in the outermost region of slot 40.

To articulate the jaws toward the right (as viewed in the orientation of Figure 5), articulation rod 14 is advanced distally. Note how pin 46 is now slightly toward the center of the slot 44. Distal movement of articulation rod 14 causes gear 20 to rotate clockwise about post 30 which moves articulation rod 12 proximally. Note how pin 42 is now slightly toward the center of slot 40. Such movement of rods 14 and 12 causes articulation joint (pivot) 56 to rotate about pins 42 and 46. In Figure 5, the articulation joint is shown pivoted to a 25 degree angle to articulate the jaws to a 25 degree angle (to the right in the orientation of Figure 5) with respect to the longitudinal axis. Note the jaw shown in the drawing is the anvil 70; the cartridge/staple jaw removed for clarity.

Figure 6 shows the jaws pivoted to a 45 degree angle (to the right in the orientation of Figure 5). In this position, articulation rod 14 has been advanced further distally than in Figure 5, causing further clockwise rotation of gear 20 which moves articulation rod 12 proximally a further distance than in Figure 5. Note in this position, pins 46 and 42 are in a center region of slots 44 and 40. Note in some embodiments, the jaws can articulate to angles greater than 45 degrees, effected by further distal movement of the articulation rod 14 which effects further proximal movement of the articulation rod 12. Note that due to the series of teeth of the racks, the jaws can be articulated and retained in multiple articulated positions; the 25 degree and 45 degree articulation are shown in the drawings by way of example.

Figures 7 and 8 show articulation of the jaws (as viewed in the orientation of Figure 8) to the left instead of the right as in Figures 5 and 6. Figure 7 shows the jaws pivoted to a 25 degree angle. In this position, articulation rod 14 has been retracted (moved proximally), causing counterclockwise rotation of gear 20 which moves articulation rod 12 distally. Note in this position, pins 46 and 42 are slightly toward the center region of slots 44 and 40.

Figure 8 shows the jaws pivoted to a 45 degree angle (to the left in the Figure 8 orientation). In this position, articulation rod 14 has been retracted further than in Figure 7, causing further counterclockwise rotation of gear 20 which moves articulation rod 12 distally a further distance than in Figure 7. Note in this position, pins 46 and 42 are in a center region of slots 44 and 40. Note in some embodiments, the jaws can articulate to angles greater than 45 degrees, effected by further distal movement of the articulation rod 14 which effects further proximal movement of the articulation rod 12. Note that due to the series of teeth of the racks, the jaws can be articulated to the left (as well as to the right) and retained in multiple articulated positions as the 25 degree and 45 degree articulation are shown in the drawings by way of example.

Figures 9-11 show examples of a powered surgical stapler in which the articulation mechanism of the present invention is utilized, it being understood that the articulation mechanism of the present invention can be used in other staplers.

The instrument of Figure 10 has reloadable power pack loaded into a compartment of the stapler as described in detail in commonly assigned U.S. Patent Nos. 10,966,720 and 11,331,099, incorporated herein by reference in their entirety. The power pack drive mechanism is engageable with a firing mechanism and with the proximal end of the articulation mechanism, e.g., engageable with proximal end 15 of articulation rod 14. Rod 14 can have a flange 14c engageable by an articulation control, e.g., drive mechanism 95 as in Patent No. 11,331,099, as shown herein in the cross-sectional view of Figure 11. Actuation of the motor in the powered articulation embodiments effects linear (axial) movement of the articulation rod 14 to effect articulation as described above as a drive mechanism powered by the motor engages and axially moves the articulation rod itself or moves a component operatively connected to the articulation rod. The power pack, contains a battery, motor, drive mechanism and stapler engagement structure, which effects firing of the surgical fasteners (staples).

Figure 9 shows another example of a surgical stapler in which the articulation mechanism of the present invention is utilized. The stapler of Figure 9 has powered firing and manual articulation.

With reference to Figure 9, the surgical stapler, also referred to herein as the surgical fastener applying instrument or surgical fastener applier, is designated generally by reference numeral 100 and includes an elongated or endoscopic portion 112 (also referred to as an elongated tubular portion or shaft) extending between the proximal portion and distal portion and has a longitudinal axis A. A handle assembly 102 with a housing 104 (also referred to herein as a handle housing) is positioned at the proximal portion and is configured to house and protect internal mechanisms of the stapler including the removable power pack when loaded (mounted) therein. At the distal portion are opposing members, i.e., jaws 108a, 108b, configured to clamp and constrain tissue during operation of the surgical stapler. At least one of the jaws is movable with respect to the other jaw from an open position to receive tissue between the jaws and a closed position to clamp tissue between the jaws. Thus, one of the jaws can be stationary and the other jaw movable with respect to the stationary jaw or alternatively both jaws can move, e.g., pivot, toward each other. In the embodiment of Figure 9, jaw 108b, which contains at least one row of surgical fasteners (staples) is movable with respect to non-pivoting (stationary) jaw 108a which contains an anvil, e.g., anvil 70 with staple forming pockets 72 as described above. In alternate embodiments, the jaw containing the anvil pivots and the jaw containing the fasteners is stationary. The fasteners are fired (advanced) from jaw 108b by linear movement of a firing mechanism which engages staple drivers within the jaw 108b which move transverse to the longitudinal axis, i.e., transverse to the direction of movement of the firing mechanism, to sequentially advance (from proximal to distal) the staples in the linear rows of staples from the jaw 108b and through tissue to engage the anvil pockets on jaw 108a for formation of the staples. The elongated tubular member 112 extends distally from the housing 104 and is configured to fit through a surgical port (trocar) used for laparoscopic surgery. The endoscopic portion 112 can be of varying dimensions and in some embodiments is configured to fit through a 10mm trocar, although other dimensions for fitting through other size trocars are also contemplated such as trocars ranging from 5mm to 15mm.

The surgical stapler 100 includes a joint 106 that provides for the articulation of the opposing members 108, i.e., pivoting of the jaw assembly to angular positions with respect to the longitudinal axis of elongated member 112. Articulation is achieved by linear motion of articulation rod 14 extending through the endoscopic portion 112. Manual manipulation of a lever 105 (or other manual articulation control) adjacent the handle 2 moves the articulation rod 14 in the proximal and distal directions dependent on the direction of movement of the lever 105 to effect articulation in this non-motor powered embodiment. A rotational member or knob 117 is configured to rotate, with respect to the handle assembly and about a longitudinal axis of the elongated member, which effects rotation of the elongated member 112 and connected jaws 108 about the longitudinal axis of the elongated member 112 to change the rotational position of the jaws 108. A handle lever 114 or other manual control, linked to an axially movable clamping bar, is pivotable from a first position to a second position closer to stationary handle 118 to effect movement of the jaw 108b toward the jaw 108a from an open (unclamped) position to a clamping (closed) position. Release of handle lever 114 returns the jaw 108b to its open position. In summary, the surgical stapler operates by manual pivoting of the lever 114 toward stationary handle 118 to clamp the tissue between jaws 108, followed by powered firing of the staples from jaw 108b, through the clamped tissue and into contact with the staple forming pockets of the anvil jaw 108b. Prior to firing, the jaws 108 can be rotated to a desired orientation by rotation of endoscopic portion 112 via knob 117 and/or articulated about joint 106, via movement of the elongated articulation members (rod) 14, 12, to a desired angled position with respect to the longitudinal axis of endoscopic portion 112 by lever 105. In the embodiment of Figure 9, articulation is performed by manual manipulation of lever 105 which is operatively connected (either via direct attachment or interposed components) to internal articulation rod 14 within tubular member 112 which extends to joint 106 similar to joint/pivot 56 described above. The power pack 18 includes a powering assembly engageable with the firing rod within the housing 104. The engagement and movement of the firing mechanism is described in detail in commonly assigned U.S. Patent No. 11,331,099, so for brevity is not repeated herein.

Figures 10 and 11 illustrate an embodiment wherein the power pack in addition to a drive mechanism to fire the staples includes a drive mechanism for effecting articulation. This motor powered articulation can be in addition to the motor powered staple firing, or alternatively, the power pack can be used solely for powered articulation.

Surgical stapler 120 is identical to surgical stapler 100 except for the power pack mounted in the stapler 120 and the articulation mechanism is engaged by the power pack. Thus, like stapler 100, stapler 120 has a handle assembly 122, an endoscopic portion 124 extending distally therefrom and a pair of jaws 126a, 126b, (collectively “jaws 126”) with at least one of the jaws movable relative to the other jaw, e.g., jaw 126b containing the staples (fasteners) movable toward stationary jaw 126a containing the anvil pockets (or alternatively jaw 126a is movable and jaw 126b is stationary or both jaws are movable). Jaw 126a can also be the same as anvil 70 described above. Handle 128, linked to an axially movable member, is pivotable toward stationary handle 136 to approximate jaws 126 to clamp tissue between the closed jaws. Handle assembly 122 includes a housing 130 and cover 132 which is identical to the cover of stapler 100, i.e., pivotably mounted to the housing 130 to move from a closed to an open position for loading the power pack into the compartment within the housing 130. The compartment sealingly retains the power pack. Stapler 120 also includes a rotation knob 134 which functions in the same manner as rotation knob 112 of stapler 100 to rotate tubular portion (shaft) 124. The jaw assembly articulates about joint 136 (which can correspond to pivot 56 described above) to move the jaws 126a, 126b to angular positions with respect to the longitudinal axis B of stapler 120.

The power pack has a motor assembly and drive mechanism for firing staples and a motor assembly and drive mechanism for articulating the jaws. As shown in Figure 11, the articulation drive mechanism of the power pack engages the articulation rod 14 to effect powered movement of rod 14 to effect articulation as described above. The articulation rod 14 can include a flange 14c at the proximal end which is engaged by a yoke 95 of the drive mechanism within the housing 130. The engagement and movement of the articulation mechanism is described in detail in commonly assigned U.S. Patent No. 11,331,099, so for brevity is not repeated herein. The clamping mechanism is also described in Patent No. 11,331,099.

It should be appreciated that Figure 11 illustrates one type of engagement to effect powered articulation as other engagements/structures are also contemplated. Additionally, Figures 10 and 11 provide an example of powered articulation utilizing the power pack of the 11,331,099 patent; however, it is also contemplated that the articulation mechanism 10 can be utilized with other powered instruments which utilize the power pack of Patent 11,331,099 or other reloadable power packs or utilized with built in non-removable motors and engagement mechanisms.

Figure 12 shows another example of a surgical stapler in which the articulation mechanism of the present invention is utilized. The surgical stapler 140 is a manually operated stapler and has a housing 142 with an articulation control 149 manually actuable, an elongated shaft 144 and a pair of jaws 146a, 146b extending at a distal end of the elongated shaft 144. The manual actuator 149 is operatively connected (either via a direct connection or via interposed components) to the proximal end 15 of the articulation rod 14 to move the articulation rod 14 axially as described in the embodiments above. Handle 148 is moved toward stationary handle 148a to close the jaws and fire the staples. Elongated shaft 144 can extend from the handle 148 to the jaws 146 or alternatively can extend to adapter 145 which is connected at region 147 to elongated shaft 144 for removability (and replacement) of jaws 146a, 146b. In other embodiments, actuator 141 can be moved distally within slot 141a to manually fire the fasteners.

The articulation mechanism of the present invention described herein can be used with endoscopic linear staplers, open surgery linear staplers, circular staplers, as well as firing single clips or tacks, as well as other surgical instruments such as endoscopic scissors and graspers such as disclosed in the 11 ,331 ,099 patent.

It is also contemplated that the articulation mechanism of the present invention described herein can be used with robotic driven surgical staplers wherein clamping, motor actuation and any other functions of the instrument are performed robotically, including remote robotic control. Thus, it can be used for example in robotics systems as described in the commonly assigned PCT application PCT/US2022/016892, filed February 18, 2022, the entire contents of which are incorporated herein by reference. For example, it can be used with a robotically assisted system including a robot arm connected via a connection, e.g., cable, to a surgeon interface console. The surgeon console includes an input device, also referred to as master device, that allows the surgeon to manipulate the robot arm to various positions from the surgeon’s remote location.

The term “surgical fasteners” as used herein encompasses staples having legs which are deformed by an anvil, two part fasteners wherein a fastener or staple component with legs is received and retained in a second component (retainer), and other types of fasteners which are advanced through tissue of a patient in performing surgical procedures.

Although the apparatus and methods of the subject disclosure have been described with respect to preferred embodiments, those skilled in the art will readily appreciate that changes and modifications may be made thereto without departing from the spirit and scope of the present disclosure as defined by the appended claims.

Additionally, persons skilled in the art will understand that the elements and features shown or described in connection with one embodiment may be combined with those of another embodiment without departing from the scope of the present invention and will appreciate further features and advantages of the presently disclosed subject matter based on the description provided.

Throughout the present invention, terms such as “approximately,” “generally,” “substantially,” and the like should be understood to allow for variations in any numerical range or concept with which they are associated. For example, it is intended that the use of terms such as “approximately” and “generally” should be understood to encompass variations on the order of 25%, or to allow for manufacturing tolerances and/or deviations in design.

Although terms such as “first,” “second,” “third,” etc., may be used herein to describe various operations, elements, components, regions, and/or sections, these operations, elements, components, regions, and/or sections should not be limited by the use of these terms in that these terms are used to distinguish one operation, element, component, region, or section from another. Thus, unless expressly stated otherwise, a first operation, element, component, region, or section could be termed a second operation, element, component, region, or section without departing from the scope of the present disclosure.

Each and every claim is incorporated as further disclosure into the specification and represents embodiments of the present disclosure. Also, the phrases “at least one of A, B, and C” and “A and/or B and/or C” should each be interpreted to include only A, only B, only C, or any combination of A, B, and C.

Claims

WHAT IS CLAIMED IS:

1. A surgical fastener applier comprising: a housing; an elongated member extending distally of the housing and having a longitudinal axis; a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws; and an articulation mechanism for articulating the jaws from a first position with respect to the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis, the articulation mechanism including a first articulation rod, a second articulation rod and at least one gear operatively engageable with the first articulation rod, wherein rotation of the gear moves the second articulation rod.

2. The surgical fastener applier of claim 1 , wherein when the first articulation rod is moved in a first direction, the second articulation rod is moved in a second direction.

3. The surgical fastener applier of claim 2, wherein the at least one gear is positioned between the first and second articulation rods.

4. The surgical fastener applier of claim 3, wherein teeth of the at least one gear intermesh with teeth on the first and second articulation rods.

5. The surgical fastener applier of claim 3, wherein the first articulation rod has a first length and the second articulation rod has a second length.

6. The surgical fastener applier of claim 3, wherein a first set of teeth on the first articulation rod are on an inner portion of the first articulation rod and a second set of teeth on the second articulation rod are on an inner portion of the second articulation rod such that the first and second set of teeth face each other.

7. The surgical fastener applier of claim 1, wherein only the first rod is connected to an articulation control of the articulation mechanism such that the second rod is not connected to the articulation control and moves only due to movement of the first rod.

8. The surgical fastener applier of claim 1, wherein the at least one gear is rotatable about a transverse post, the transverse post having a slot formed therein.

9. The surgical fastener applier of claim 8, wherein a plurality of knife laminates extend through the slot.

10. The surgical fastener applier of claim 8, wherein a pair of jaw clamping laminates extend through the slot.

11. The surgical fastener of claim 1, wherein the first articulation rod has a first slot at a distal end and the second articulation rod has a second slot at a distal end, wherein a first pin slides within the first slot and a second pin slides within the second slot when the first and second articulation rods are moved axially to articulate the first and second jaws.

12. The surgical fastener applier of claim 8, wherein the first slot is transverse to a longitudinal axis of the first articulation rod and the second slot is transverse to a longitudinal axis of the second articulation rod.

13. The surgical fastener applier of claim 1, wherein the first articulation rod has a proximal end terminating within the housing of the surgical fastener applier and operatively connected to an articulation control of the articulation mechanism, and the second articulation rod has a proximal end terminating distal of the housing.

14. A surgical fastener applier comprising: a housing; an elongated member extending distally of the housing and having a longitudinal axis; a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws; and an articulation mechanism for articulating the jaws from a first position with respect to the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis, the articulation mechanism including a first articulation rod having a first slot and a second articulation having a second slot, wherein a first pin slides within the first slot and a second pin slides within the second slot when the first and second articulation rods are moved axially to articulate the first and second jaws.

15. The surgical fastener applier of claim 14, wherein the first slot is transverse to a longitudinal axis of the first articulation rod and the second slot is transverse to a longitudinal axis of the second articulation rod.

16. The surgical fastener applier of claim 14, wherein the first articulation rod has a proximal end terminating within the housing of the surgical fastener applier and operatively connected to an articulation mechanism, and the second articulation rod has a proximal end terminating distal of the housing.

17. The surgical fastener applier of claim 14, wherein when the first articulation rod is moved in a first direction, the second articulation rod is moved in a second direction.

18. The surgical fastener applier of claim 14, wherein the first articulation rod is attached to an articulation control of the articulation mechanism at a proximal portion of the housing, and movement of the first articulation rod effects movement of the second articulation rod.

19. A surgical fastener applier comprising: a housing; an elongated member extending distally of the housing and having a longitudinal axis; a first jaw and a second jaw at a distal portion of the elongated member, at least the first jaw movable with respect to the second jaw to clamp tissue between the first and second jaws; an articulation mechanism for articulating the jaws from a first position with respect to the longitudinal axis of the elongated member to a second position at an acute angle to the longitudinal axis, the articulation mechanism including a first articulation rod and a second articulation rod, wherein to articulate the first and second jaws in a first direction, the first articulation rod is moved axially in a distal direction which moves the second articulation rod axially in a proximal direction, and to articulate the first and second jaws in a second direction, the first articulation rod is moved axially in a proximal direction which moves the second articulation rod axially in a distal direction.

20. The surgical fastener applier of claim 19, further comprising at least one gear operatively engageable with the first and second articulation rod.