STAPLE FEEDING AND FORMING APPARATUS
Disclosed is a surgical stapling apparatus and method of use that includes a cartridge assembly which is capable of being reloaded during a surgical procedure without being removed from the surgical site. This allows a surgeon to continue a surgical operation without withdrawing or removing the surgical stapler for reloading and thus reduces the length of the surgery while allowing the physician to concentrate solely on the surgical procedure rather than dividing attention between the surgical procedure and reloading of the surgical stapler. The surgical stapling apparatus includes an elongate member having a plurality of fasteners arranged in a plurality of longitudinally extending rows which is longitudinally translatable through the cartridge to position the plurality of fasteners relative to a plurality of retention slots extending through an upper surface of the cartridge.
1. Technical Field
The present disclosure relates to surgical staplers. More particularly, the present disclosure relates to a surgical stapling apparatus capable of being reloaded during a surgical procedure without being removed from the surgical site.
2. Background of the Related Art
Surgical devices for first grasping or clamping tissue between opposing jaw structure and then stapling the tissue with surgical fasteners are well known in the art. In some instruments a knife is provided to cut the tissue which has been stapled by the fasteners. Instruments for this purpose typically include two elongated members, one of which carries a staple cartridge and the other of which includes an anvil. The staple cartridge houses a plurality of staples arranged in at least two lateral rows. The anvil defines a surface for forming the staple legs as the staples are driven from the staple cartridge. In certain devices, the stapling operation is effected by cam bars that travel longitudinally through the staple cartridge. A knife may travel between the staple rows to longitudinally cut and/or open the stapled tissue between the rows of staples.
Often all or part of the stapling assembly of the surgical device is located on a loading unit that is operably connected to a handle assembly. While the handle assembly is configured for multiple uses, the loading unit can be configured for a single use. After the single use is exhausted, the loading unit is removed from the handle assembly and properly disposed.
SUMMARYDisclosed is a surgical stapling apparatus that includes a loading unit which is capable of being reloaded during a surgical procedure without being removed from the surgical site. This allows a surgeon to continue a surgical operation without withdrawing or removing the surgical stapler for reloading and thus reduces the length of the surgery while allowing the surgeon to concentrate solely on the surgical procedure rather than dividing attention between the surgical procedure and either reloading or replacing the surgical stapler.
An end effector for a surgical stapling apparatus is disclosed including a housing defining a plurality of passageways and a lumen extending longitudinally therethrough. The end effector includes a cartridge which extends from the housing having a channel extending longitudinally therethrough. An upper surface of the channel includes a plurality of retention slots extending therethrough for the reception of surgical fasteners. The end effector also includes an elongate member having a plurality of fasteners arranged in a plurality of longitudinally extending rows where the elongate member is longitudinally translatable through the housing and the cartridge. The elongate member may be made from a flexible material. A plurality of pushers is disposed within the cartridge and are operatively associated with the plurality of retention slots and adapted to support the plurality of fasteners. The end effector also includes a drive member which is movable through the cartridge and adapted to engage the plurality of pushers to urge the plurality of fasteners through the plurality of retention slots. The drive member may include an actuating member extending proximally therefrom which is adapted to move the drive member through the cartridge.
Each of the plurality of pushers may include a post and the drive member may include a slot where the post of each of the plurality of pushers is adapted to engage the slot of the drive member upon actuation of the drive member. Each of the plurality of pushers may include a guide groove and each of the plurality of fasteners may include a corresponding guide portion where the guide portion is adapted to engage the guide groove to guide the fastener when the pusher urges the fastener through one of the plurality of retention slots.
The housing includes an upper housing and a lower housing with the lumen being defined between the upper and lower housings. The passageways of the housing extend from the lumen and are adapted to guide the fasteners through the housing.
The cartridge includes a plurality of grooved channels formed on an underside of the upper surface and aligned with the passageways of the housing. The plurality of grooved channels is laterally aligned with the plurality of retention slots of the upper surface. The plurality of retention slots may include guide surfaces which are adapted for guiding the plurality of surgical fasteners into the plurality of retention slots.
The elongate member defines a plurality of openings arranged in a plurality of longitudinally extending rows where each opening is adapted to receive a fastener and each opening may include perforations where the openings are adapted to tear along the perforations. Each opening may include a pair of holes and a slit and each fastener may include a backspan and a pair of legs extending from the backspan. The backspan of each fastener may be disposed on a first side of the elongate member and the pair of legs of each fastener may extend through the elongate member to a second side of the elongate member.
A surgical stapling apparatus is disclosed including an actuator assembly,a handle supported by the actuator assembly and including an actuation mechanism, an elongated body extending from the actuator assembly and an end effector at the distal end of the elongated body. The end effector includes a housing defining a plurality of passageways and a lumen extending longitudinally therethrough. A cartridge extends from the housing and includes a channel extending longitudinally therethrough. The cartridge includes an upper surface with a plurality of retention slots extending therethrough for the reception of surgical fasteners. An elongate member including a plurality of fasteners arranged in a plurality of longitudinally extending rows is longitudinally translatable through the housing and the cartridge. A plurality of pushers is disposed within the cartridge and is operatively associated with the plurality of retention slots where the plurality of pushers is adapted to support the plurality of fasteners. A drive member is movable through the cartridge and is adapted to engage the plurality of pushers to urge the plurality of fasteners through the plurality of retention slots. The elongate member may be made from a flexible material.
Each fastener may include a backspan and a pair of legs extending from the backspan. The backspan of each fastener may be disposed on a first side of the elongate member and the pair of legs of each fastener may extend through the elongate member to a second side of the elongate member.
The surgical stapling apparatus may further include an anvil assembly including an anvil plate for receiving and forming a fastener. The anvil assembly is in juxtaposed relation to the cartridge and at least one of the anvil assembly and the cartridge is movable in relation to the other of the anvil assembly and the cartridge.
The drive member includes an actuating member extending proximally therefrom which is adapted to move the drive member through the plurality of openings of the cartridge upon actuation of the actuation mechanism.
The elongate member may be adapted to translate through at least a portion of the elongated body.
A method of using a reloadable surgical stapling apparatus during a surgical procedure is disclosed including inserting the surgical stapling apparatus into a surgical site, grasping a first portion of tissue between an anvil assembly and a cartridge assembly of the surgical stapling apparatus, actuating an actuator assembly of the surgical stapling apparatus to drive a first group of fasteners through retention slots of the cartridge assembly and into the first portion of tissue to secure the first group of fasteners to the first portion of tissue, actuating the actuator assembly to release the first portion of tissue and to position a second group of fasteners within the cartridge assembly in substantial alignment with the retention slots, grasping a second portion of tissue between the anvil assembly and cartridge assembly, and actuating the actuator assembly to drive the second group of fasteners through the retention slots and into the second portion of tissue to secure the second group of fasteners to the second portion of tissue.
The method may further include releasing the second portion of tissue and removing the surgical stapling apparatus from the surgical site where the surgical stapling apparatus is removed from the surgical site after at least the first and second groups of fasteners have been secured to the first and second portions of tissue respectively.
Driving one of the first and second groups of fasteners through the retention slots may include translating a drive member at least partially through the cartridge assembly to engage a plurality of pushers disposed in the cartridge assembly and substantially aligned with the retention slots to drive the plurality of pushers towards the retention slots. Driving the plurality of pushers towards the retention slots may include engaging guide surfaces of the plurality of pushers with one of the first and second groups of fasteners to urge the fasteners through the retention slots.
The cartridge assembly may include an elongate member extending therethrough and having the first and second groups of fasteners extending therethrough and arranged in a plurality of longitudinally extending rows. Actuating the actuator assembly to position the second group of fasteners within the cartridge may include translating the elongate member through the cartridge assembly. Urging one of the first and second groups of fasteners through the retention slots may include urging backspans of the fasteners through the elongate member. Translating the elongate member through the cartridge assembly may include translating an empty portion of the elongate member out of the cartridge assembly.
Various embodiments of the present disclosure are described hereinbelow with references to the drawings, wherein:
In the drawings and in the description which follows, in which like references numerals identify similar or identical elements, the term “proximal” will refer to the end of the apparatus which is closest to the clinician during use, while the term “distal” will refer to the end which is furthest from the clinician, as is traditional and known in the art.
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Cartridge 304 also includes a plurality of grooved channels 312 extending longitudinally along an underside 314 of the upper surface 310 of cartridge 304. Plurality of grooved channels 312 are each laterally aligned with one of the rows of retention slots 308. As seen in
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Drive member 500 is operatively associated with plurality of pushers 350 such that as drive member 500 translates through cartridge assembly 300, drive member 500 engages each of pushers 350 with ramps 504 (
Drive member 500 may include slots 506 for receiving posts 362 of pushers 350 and posts 362 may be substantially cylindrical or curved to facilitate entry into slots 506. Alternatively posts 362 maybe any shape suitable for entry into slots 506 to provide a camming action with slots 506 including, for example, linear shapes, squares, triangles, oblong shapes, or other polygonal or curved shapes. Slots 506 each define an inlet opening 508 at a leading or proximal portion 510 of drive member 500, a channel 512 extending substantially parallel to ramp 504 for translation of posts 362 therethrough, and an outlet opening 514 at a trailing or distal portion 516 of drive member 500, as seen in
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Actuator assembly 12 may be adapted to independently translate elongate member 400 through housing 200 and cartridge assembly 300 through the use of an actuator (not shown) such as, for example, a spool, a gear system or another suitable mechanism for advancing elongate member 400 through housing 200 and cartridge assembly 300. The actuator may directly contact elongate member 400 or may instead drive a pulley system to translate elongate member 400 through housing 200 and cartridge assembly 300. Elongate member 400 may be wound around a pulley or other suitable mechanism at the distal end of end effector 100 and may return to housing 200 via cartridge 300. For example, elongate member 400 may return through channels 306 of cartridge 300 to lumen 206 of housing 200. Alternatively a separate pathway 322 (
Elongate member 400 may, for example, include a feed mechanism 412 (
Housing 200 may include a pre-determined number of fasteners 600 for feeding into cartridge assembly 300 where, for example, a number of reloads or groups of fasteners 600 may be provided to allow a surgeon to reload and fire surgical stapling apparatus 10 multiple times without removing cartridge assembly 300 from the operating site. Each group of fasteners 600 may correspond to the number of retention slots 308 or may correspond to only a part or portion of the number of retention slots 308 where for example multiple groups of fasteners 600 may be required to fully reload cartridge assembly 300.
Housing 200 may optionally receive elongate member 400 and fasteners 600 from an exterior source where, for example, multiple elongate members 400 may be attached or secured together during a procedure to provide additional fasteners 600 to cartridge assembly 300. For example, elongate body 30 may be adapted to provide elongate member 400 and fasteners 600 to housing 200 and may be adapted to allow a surgeon to feed additional elongate members 400 and fasteners into housing 200. In this way the number of fasteners 600 to be used may be tailored to a specific procedure or need of the surgeon.
During use, surgical stapling apparatus 10 is inserted into the surgical site and maneuvered such that tissue “T” is positioned between anvil assembly 110 and cartridge assembly 300. Handle assembly 20 is then actuated to close or approximate anvil assembly 110 and cartridge assembly 300 to grasp tissue “T” therebetween. After tissue “T” is grasped between anvil assembly 110 and cartridge assembly 300 actuator assembly 12 is actuated to translate drive member 500 proximally through cartridge assembly 300 from the initial position (
As drive member 500 translates proximally toward the fully fired position each fastener 600 is urged through a respective retention slot 308. After drive member 500 moves proximally past each of pushers 350 the fired pushers 350 remain in the fired position (
Once firing is complete, actuator assembly 12 is actuated to translate drive member 500 back to its initial position. During translation of drive member 500 back to its initial position drive member 500 engages pushers 350 to return pushers 350 to the unfired position. For example, as seen in
Elongate member 400 is then translated through housing 200 and cartridge assembly 300 by actuator assembly 12 to provide a second group of fasteners 600 to pushers 350 and retention slots 308. During this process, the empty openings 404 of elongate member 400 are translated distally past drive member 500 before returning to housing 200 via channels 306 or passageway 322 of cartridge assembly 300. For example, some or all of a second group of fasteners 600 may be translated into cartridge assembly 300 to partially or fully reload cartridge assembly 300. When elongate member 400 is positioned within cartridge assembly 300 such that a new set of fasteners 600 are aligned with retention slots 308 and the new set of fasteners 600 are supported on pushers 314, surgical stapling apparatus 10 is ready to be fired. It is contemplated that elongate member 400 may be translated through housing 200 and cartridge 300 to reload cartridge 300 before, during or after the translation of drive member 500 distally to the initial position.
The surgeon may then open or un-approximate anvil assembly 110 and cartridge assembly 300 to release the fastened tissue “T”. Alternatively, the surgeon may reload cartridge assembly 300 during the release of tissue “T” or after releasing tissue “T”. The surgeon may now maneuver surgical stapling apparatus 10 within the surgical site to position another portion of tissue “T” or another body tissue between anvil assembly 110 and cartridge assembly 300 as desired for further use of surgical stapling apparatus 10 without withdrawing surgical stapling apparatus 10 from the surgical site. For example, the surgeon may grasp a new portion of tissue between anvil assembly 110 and cartridge assembly 300, fire surgical stapling apparatus 10, and reload cartridge assembly 300 as describe above as many times as desired or necessary for the surgical procedure without removing surgical stapling apparatus 10 from the surgical site. This reduces the length of the surgical procedure, reducing the risk involved, and allows the surgeon to concentrate on the surgical procedure without dividing his attention between performing the procedure and reloading or replacing the surgical stapling apparatus 10 for further fastening of tissue.
Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.
Claims
1. An end effector for a surgical stapling apparatus comprising:
- a housing defining a plurality of passageways and a lumen extending longitudinally therethrough;
- a cartridge extending from the housing and including a channel extending longitudinally therethrough, the cartridge having an upper surface with a plurality of retention slots extending therethrough for the reception of surgical fasteners;
- an elongate member including a plurality of fasteners arranged in a plurality of longitudinally extending rows, the elongate member longitudinally translatable through the housing and the cartridge to move the fasteners from a position proximal of the slots to a position in line with the slots;
- a plurality of pushers disposed within the cartridge and operatively associated with the plurality of retention slots, the plurality of pushers adapted to support the plurality of fasteners; and
- a drive member movable through the cartridge and adapted to engage the plurality of pushers to urge the plurality of fasteners through the plurality of retention slots.
2. An end effector according to claim 1, wherein the elongate member is made from a flexible material.
3. An end effector according to claim 1, wherein each of the plurality of pushers includes a post and the drive member includes a slot, the post of each of the plurality of pushers being adapted to engage the slot upon actuation of the drive member.
4. An end effector according to claim 1, wherein the drive member includes an actuating member extending proximally therefrom, the actuating member adapted to move the drive member through the cartridge.
5. An end effector according to claim 1, wherein each of the plurality of pushers includes a guide groove and each of the plurality of fasteners includes a corresponding guide portion, the guide portion being adapted to engage the guide groove to guide the fastener when the pusher urges the fastener through one of the retention slots.
6. An end effector according to claim 1, wherein the housing includes an upper housing and a lower housing, the lumen being defined between the upper and lower housings.
7. An end effector according to claim 1, wherein the passageways of the housing extend from the lumen and are adapted to guide the fasteners through the housing.
8. An end effector according to claim 1, wherein the cartridge includes a plurality of grooved channels formed on an underside of the upper surface.
9. An end effector according to claim 8, wherein the plurality of grooved channels are aligned with the passageways of the housing.
10. An end effector according to claim 8, wherein the plurality of grooved channels is laterally aligned with the plurality of retention slots of the upper surface.
11. An end effector according to claim 1, wherein the elongate member defines a plurality of openings arranged in a plurality of longitudinally extending rows, each opening adapted to receive a fastener.
12. An end effector according to claim 11, wherein each opening includes perforations, the openings adapted to tear along the perforations.
13. An end effector according to claim 11, wherein each opening includes a pair of holes and a slit.
14. An end effector according to claim 11, wherein the elongate member is adapted to allow the fasteners to break through the elongate member.
15. An end effector according to claim 1, wherein the plurality of retention slots include guide surfaces adapted for guiding the plurality of surgical fasteners into the plurality of retention slots.
16. An end effector according to claim 1, wherein each fastener includes a backspan and a pair of legs extending from the backspan.
17. An end effector according to claim 16, wherein the backspan of each fastener is disposed on a first side of the elongate member and the pair of legs of each fastener extends through the elongate member to a second side of the elongate member.
18. A surgical stapling apparatus comprising:
- an actuator assembly;
- a handle supported by the actuator assembly and including an actuation mechanism;
- an elongated body extending from the actuator assembly;
- an end effector at the distal end of the elongated body, the end effector including: a housing defining a plurality of passageways and a lumen extending longitudinally therethrough; a cartridge extending from the housing and including a channel extending longitudinally therethrough, the cartridge having an upper surface with a plurality of retention slots extending therethrough for the reception of surgical fasteners; an elongate member including a plurality of fasteners arranged in a plurality of longitudinally extending rows, the elongate member longitudinally translatable through the housing and the cartridge to move the fasteners from a position proximal of the slots to a position in line with the slots; a plurality of pushers disposed within the cartridge and operatively associated with the plurality of retention slots, the plurality of pushers adapted to support the plurality of fasteners; and a drive member movable through the cartridge and adapted to engage the plurality of pushers to urge the plurality of fasteners through the plurality of retention slots.
19. A surgical stapling apparatus according to claim 18, wherein the elongate member is made from a flexible material.
20. A surgical stapling apparatus according to claim 18, wherein each fastener includes a backspan and a pair of legs extending from the backspan.
21. A surgical stapling apparatus according to claim 20, wherein the backspan of each fastener is disposed on a first side of the elongate member and the pair of legs of each fastener extends through the elongate member to a second side of the elongate member.
22. A surgical stapling apparatus according to claim 18, further including an anvil assembly including an anvil plate for receiving and forming a fastener, the anvil assembly being in juxtaposed relation to the cartridge, at least one of the anvil assembly and the cartridge being movable in relation to the other of the anvil assembly and the cartridge.
23. A surgical stapling apparatus according to claim 18, wherein the drive member includes an actuating member extending proximally therefrom, the actuating member adapted to move the drive member through the cartridge upon actuation of the actuation mechanism.
24. A surgical stapling apparatus according to claim 18, wherein the elongate member is adapted to translate through at least a portion of the elongated body.
25. An end effector according to claim 18, wherein the elongate member is adapted to allow the fasteners to break through the elongate member.
26. A method of using a reloadable surgical stapling apparatus during a surgical procedure, the method comprising:
- inserting the surgical stapling apparatus into a surgical site;
- grasping a first portion of tissue between an anvil assembly and a cartridge assembly of the surgical stapling apparatus;
- actuating an actuator assembly of the surgical stapling apparatus to drive a first group of fasteners through retention slots of the cartridge assembly and into the first portion of tissue to secure the first group of fasteners to the first portion of tissue;
- actuating the actuator assembly to release the first portion of tissue and to position a second group of fasteners within the cartridge assembly in substantial alignment with the retention slots;
- grasping a second portion of tissue between the anvil assembly and cartridge assembly; and
- actuating the actuator assembly to drive the second group of fasteners through the retention slots and into the second portion of tissue to secure the second group of fasteners to the second portion of tissue.
27. A method according to claim 26, further including releasing the second portion of tissue and removing the surgical stapling apparatus from the surgical site, the surgical stapling apparatus being removed from the surgical site after at least the first and second groups of fasteners have been secured to the first and second portions of tissue respectively.
28. A method according to claim 26, wherein driving one of the first and second groups of fasteners through the retention slots includes translating a drive member at least partially through the cartridge assembly to engage a plurality of pushers disposed in the cartridge assembly and substantially aligned with the retention slots to drive the plurality of pushers towards the retention slots.
29. A method according to claim 28, wherein driving the plurality of pushers towards the retention slots includes engaging guide surfaces of the plurality of pushers with one of the first and second groups of fasteners to urge the fasteners through the retention slots.
30. A method according to claim 26, wherein the cartridge assembly includes an elongate member extending therethrough, the elongate member having the first and second groups of fasteners extending therethrough and arranged in a plurality of longitudinally extending rows, wherein actuating the actuator assembly to position the second group of fasteners within the cartridge including translating the elongate member through the cartridge assembly.
31. A method according to claim 30, wherein urging one of the first and second groups of fasteners through the retention slots includes urging backspans of the fasteners through the elongate member.
32. A method according to claim 30, wherein translating the elongate member through the cartridge assembly includes translating an empty portion of the elongate member out of the cartridge assembly.
Type: Application
Filed: Oct 26, 2011
Publication Date: May 2, 2013
Inventor: John W. Beardsley (Wallingford, CT)
Application Number: 13/281,888