Surgical Stapler
A surgical fastener applying apparatus comprising a cartridge section having a cartridge containing a plurality of fasteners, an anvil section having an anvil for receiving the fasteners when advanced from the cartridge, the cartridge and anvil sections clamping tissue therebetween. The first and second cam members are movable within the cartridge section to fire the fasteners. A cam member supporting member fixed within the cartridge section has an upper surface on which the cam members are slidable. The upper surface of the cam member supporting member has a first upper surface portion on a first plane and a second lower surface portion in a different substantially parallel second plane such that the first and second cam members slide in offset planes on the upper surface to fire the fasteners.
This application is a continuation application of U.S. patent application Ser. No. 14/534,283 filed on Nov. 6, 2014, which is a continuation application of U.S. patent application Ser. No. 14/247,524 filed on Apr. 8, 2014, now U.S. Pat. No. 8,905,288, which is a continuation application of U.S. patent application Ser. No. 12/335,732, filed on Dec. 16, 2008, now U.S. Pat. No. 8,727,199, which claims priority from provisional application Ser. No. 61/018,685, filed Jan. 3, 2008, the entire contents of which are incorporated herein by reference.
Technical Field
The present disclosure relates to a surgical stapling device and more particularly to a surgical stapling device having pusher-engaging cam members that are slidable on offset planes.
Background of the Related Art
There are several known types of surgical stapling instruments specifically adapted for use in various procedures. In many such surgical devices, tissue is first grasped or clamped between opposing jaw structures and then joined by surgical fasteners. The fasteners are typically in the form of surgical staples. These staples generally include a pair of legs adapted to penetrate tissue and connected by a backspan from which they extend. In use, the staples are formed to a “B” configuration. Two-part fasteners are also known and include legs that are barbed and connected by a backspan which are engaged and locked into a separate retainer piece that is usually located in the anvil. In some devices, a knife is provided to cut the tissue which has been joined by the fasteners.
In these devices, one of the jaw structures carries a staple cartridge having one or more laterally spaced rows of staples, which are aligned with corresponding rows of anvil depressions on an opposing jaw structure. The tissue is initially gripped or clamped such that individual fasteners can be ejected from the cartridge, through the slots, and forced through the clamped tissue. The staples are ejected by longitudinal movement of a driver and forced through the clamped tissue, forming against the staple forming depressions of the anvil. The staples can be arranged in a linear or non-linear row.
A common issue in transecting tissue and/or in anastomosis procedures employing the surgical stapling instruments is the balance between anastomotic strength and the degree of hemostasis achievable. It is known to include different size staples in a surgical stapling instrument having a constant gap (uniform distance) between an anvil and a staple cartridge.
A common concern in these surgical procedures is hemostasis, or the rate at which bleeding of the target tissue is stopped. It is commonly known that by increasing the amount of pressure applied to a wound, the flow of blood can be limited, thereby decreasing the time necessary to achieve hemostasis. To this end, conventional surgical fastening apparatus generally apply two or more rows of fasteners about the cut-line to compress the surrounding tissue in an effort to stop any bleeding and to join the cut tissue together. Each of the fasteners will generally apply a compressive force to the tissue sufficient to effectuate hemostasis, however, if too much pressure is applied, this can result in a needless reduction in blood flow to the tissue surrounding the cut-line. Accordingly, the joining of tissue together in this manner may result in an elevated level of necrosis, a slower rate of healing, and/or a greater convalescence. On the other hand, if not enough pressure is applied, proper hemostasis may not be achieved.
Consequently, it would be advantageous to provide a surgical fastening apparatus capable of limiting the flow of blood in the tissue immediately adjacent the cut tissue to effectuate hemostasis and wound closure, while maximizing blood flow in the surrounding tissue to facilitate healing.
SUMMARYThe present disclosure relates to forming different sized staples by advancing cam members on different planes. In preferred embodiments, the cam members have common sizes and angles and the pushers have common sizes and angles which among other advantages, can facilitate the manufacturing process.
More specifically, a cartridge section having offset or stepped surfaces for cam members to travel along is disclosed herein. The offset or stepped surfaces allow the cam members to travel in different planes, which enables in preferred embodiments cam members of substantially the same height and pushers of substantially the same height to be used to fire staples of different sizes against an anvil.
In one aspect, the present disclosure provides a surgical fastener applying apparatus comprising a cartridge section having a cartridge containing a plurality of fasteners and an anvil section having an anvil for receiving the fasteners when advanced from the cartridge, the cartridge and anvil sections clamping tissue therebetween. First and second cam members are movable within the cartridge section to fire the fasteners. A cam member supporting member is fixed within the cartridge section and has an upper surface on which the cam members are slidable. The upper surface of the cam member supporting member has a first upper surface portion on a first plane and a second lower surface portion on a different substantially parallel second plane such that the first and second cam members slide in offset planes on the upper surface to fire the fasteners.
In a preferred embodiment, the first and second cam members are of substantially the same height. In a preferred embodiment, the plurality of fasteners include a first set of fasteners having legs of a first length and a second set of fasteners having legs of a second longer length.
In a preferred embodiment, the first upper surface portion is closer to the anvil section than the second lower surface portion, and the second cam member slides along the second lower surface to fire the second set of fasteners.
The cartridge may include third and fourth cam members, the third and fourth cam members being movable on substantially parallel offset planes. The second and fourth cam members are preferably positioned outboard of the first and third cam members and configured to fire fasteners having a length greater than a length of fasteners fired by the first and third cam members.
In one embodiment, the cartridge includes a plurality of fastener pushers configured to engage the fasteners as they are advanced by the cam members, the fastener pushers preferably being of substantially the same height. The pushers are preferably movable by the cam members in a direction substantially transverse to the direction of movement of the cam members.
The present disclosure also provides a surgical fastener applying apparatus comprising a cartridge section having a cartridge containing first and second sets of fasteners and an anvil section having an anvil for receiving the fasteners when advanced from the cartridge, the cartridge and anvil sections clamping tissue therebetween. A first cam member is movable within the cartridge section to advance the first set of fasteners against the anvil to fully form the fasteners, the first cam member movable in a first plane. A second cam member is movable within the cartridge section along with the first cam member to advance the second set of fasteners to fully form the fasteners, the second cam member movable in a second plane offset from the first plane and further from the anvil section than the first plane when the anvil and cartridge sections are positioned to clamp tissue therebetween.
In one embodiment the cam members are of substantially the same height. In one embodiment, the first set of fasteners has legs of a first length and the second set of fasteners has legs of a second longer length.
Preferably, the cartridge includes a plurality of fastener pushers configured to engage the fasteners as they are advanced by the cam members, the fastener pushers preferably being of substantially the same height.
Various embodiments of the present disclosure are described herein below with references to the drawings, wherein:
Embodiments of the presently disclosed stapler will now be described in detail with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. As is common in the art, the term “proximal” refers to that part or component closer to the user or operator, i.e. surgeon or physician, while the term “distal” refers to that part or component further away from the user.
Turning first to
With reference to
More specifically, four cam bars (members) 110a-110d, four pushers 120a-120d and four staples 130a-130d are shown in
As can be appreciated with reference to the Figures, the difference in heights of surface portions 152, 154 of offset plane 151 enables staples 130 of different sizes (leg lengths) to be fired into anvil pockets of anvil assembly 14 (shown schematically in
It should be appreciated that the offset planes of the present disclosure can also be used with other staplers, including, for example, other linear staples and endoscopic linear staplers, such as disclosed for example in
It is also contemplated that as an alternative to two surface heights of the cam member support 150 (or support 240 described below), more than two surface heights can be used. For instance, the offset planes can include surfaces of three different heights to provide advancement of cam members at three different levels. This can be used, for example, for applying three different size staples.
A method of firing staples of different sizes is also provided. The method includes causing first and third cam members (bars) 110b, 110c to travel along a first plane and causing second and fourth cam members (bars) 110a, 110d, outboard of the first and third cam members 110b, 110c, to travel along a second plane, where the first plane and the second plane are offset from each other. The second plane is further from the anvil surface when the cartridge 19 and anvil are in position clamping tissue therebetween. As the cam bars 110a-110d travel along the upper surface of cam member support 150, they contact respective pushers which then drive the respective staples out of the corresponding cartridge slot, through tissue clamped between the anvil and cartridge, and into anvil pockets for formation into B-shaped staples. This method applies staples of different lengths. For example, staples of shorter length would be applied to clamped tissue closer to the center of the jaws and staples of longer length would be applied to clamped tissue further from the center.
In a preferred embodiment, the raised (stepped) surfaces for supporting the cam bars can be formed on a plastic or other material insert in the bottom of channel 18 of the cartridge half section 12. The insert can be one piece formed with surfaces on different planes, e.g. by varying the thickness of the portions, or, alternatively, separate inserts to achieve the differing heights can be utilized.
This cam arrangement can be used with the endoscopic surgical stapler of
In a preferred embodiment, staples of longer leg length are placed in the four outer rows and staples of shorter leg length are placed in the two inner rows. Preferably, the cam members are of substantially the same height, as are the pushers.
Although described for fastener applying apparatus for firing staples formed by an anvil, the offset plane of this disclosure could also be used in fastener applying apparatus for firing two part fasteners.
While the above description contains many specifics, these specifics should not be construed as limitations on the scope of the present disclosure, but merely as illustrations of various embodiments thereof. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the disclosure.
Claims
1. (canceled)
2. A cartridge assembly for use in a surgical fastener applying apparatus, the cartridge assembly comprising:
- a first fastener pusher configured to engage a first fastener having a first length;
- a second fastener pusher configured to engage a second fastener having a second length greater than the first length of the first fastener;
- a cartridge channel including a first surface having a first height and a second surface having a second height, the first height of the first surface being greater than the second height of the second surface, wherein the first surface is configured to be axially aligned with the first fastener and the second surface is configured to be axially aligned with the second fastener; and
- a cam bar movable along the cartridge channel to facilitate displacement of the first fastener pusher and the second fastener pusher to eject the first fastener and the second fastener, respectively.
3. The cartridge assembly according to claim 2, wherein the first fastener pusher is spaced-apart from the first surface of the cartridge channel a first distance and the second fastener pusher is spaced-apart from the second surface of the cartridge channel a second distance greater than the first distance.
4. The cartridge assembly according to claim 2, wherein the cartridge channel includes a longitudinal centerline, the first surface of the cartridge channel extending along the longitudinal centerline and the second surface of the cartridge channel including a first lateral portion extending along one side of the first surface and a second lateral portion extending along an opposite side of the first surface.
5. The cartridge assembly according to claim 2, wherein the cam bar includes a first cam member and a second cam member, the first cam member movable along the first surface of the cartridge channel and the second cam member movable along the second surface of the cartridge channel.
6. The cartridge assembly according to claim 5, wherein the first cam member includes a first trajectory moving along the first surface of the cartridge channel and the second cam member includes a second trajectory moving along the second surface of the cartridge channel, the first trajectory of the first cam member being parallel to the second trajectory of the second cam member.
7. The cartridge assembly according to claim 5, wherein the first cam member includes a first camming surface and the second cam member includes a second camming surface, the first camming surface of the first cam member and the first surface of the cartridge channel defining a first angle and the second camming surface of the second cam member and the second surface of the cartridge channel defining a second angle, wherein the first angle is equal to the second angle.
8. The cartridge assembly according to claim 7, wherein the first cam member and the second cam member each include a distally tapered configuration such that a distance defined between the first camming surface and the first surface of the cartridge channel decreases in a distal direction, and a distance defined between the second camming surface and the second surface of the cartridge channel decreases in the distal direction.
9. The cartridge assembly according to claim 5, wherein the first cam member and the second cam member are positioned and configured such that the first fastener pusher and the second fastener pusher are displaced perpendicularly in relation to the first surface of the cartridge channel and the second surface of the cartridge channel and parallel in relation to one another.
10. The cartridge assembly according to claim 5, wherein the first cam member and the second cam member are positioned and configured such that the first fastener pusher and the second fastener pusher are displaced transversely in relation to a direction of movement of the first cam member and the second cam member, respectively.
11. A cartridge assembly for use in a surgical fastener applying apparatus, the cartridge assembly comprising:
- a first fastener pusher configured to engage a first fastener having a first length;
- a second fastener pusher configured to engage a second fastener having a second length greater than the first length of the first fastener;
- a cartridge channel including a first surface having a first height and a second surface having a second height, the first height of the first surface being greater than the second height of the second surface, wherein a length difference between the first length of the first fastener and the second length of the second fastener is proportional to a height difference between the first height of the first surface and the second height of the second surface; and
- a cam bar movable along the cartridge channel to facilitate displacement of the first fastener pusher and the second fastener pusher to eject the first fastener and the second fastener, respectively.
12. The cartridge assembly according to claim 11, wherein the first fastener pusher is spaced-apart from the first surface of the cartridge channel a first distance and the second fastener pusher is spaced-apart from the second surface of the cartridge channel a second distance greater than the first distance.
13. The cartridge assembly according to claim 11, wherein each of the first fastener pusher and the second fastener pusher includes an equivalent height.
14. The cartridge assembly according to claim 11, further including a longitudinal track extending through the cartridge channel, the cartridge channel having a first lateral side and a second lateral side on opposite sides of the longitudinal track, wherein the longitudinal track is configured to accommodate movement of a cutting member.
15. The cartridge assembly according to claim 14, wherein the cam bar includes a first cam member and a second cam member, the first cam member movable along the first surface of the cartridge channel on the first lateral side and the second cam member movable along the second surface of the cartridge channel on the first lateral side.
16. The cartridge assembly of claim 15, wherein the first cam member is connected to the second cam member such that the first cam member and the second cam member move as a single unit.
17. The cartridge assembly according to claim 15, wherein the first cam member includes a first camming surface and the second cam member includes a second camming surface, the first camming surface of the first cam member and the first surface of the cartridge channel defining a first angle and the second camming surface of the second cam member and the second surface of the cartridge channel defining a second angle, wherein the first angle is equal to the second angle.
18. The cartridge assembly according to claim 17, wherein the first cam member and the second cam member each include a distally tapered configuration such that a distance defined between the first camming surface and the first surface of the cartridge channel decreases in a distal direction, and a distance defined between the second camming surface and the second surface of the cartridge channel decreases in the distal direction.
19. The cartridge assembly according to claim 15, wherein the cam bar further includes a third cam member and a fourth cam member, the third cam member movable along the first surface of the cartridge channel on the second lateral side and the fourth cam member movable along the second surface of the cartridge channel on the second lateral side.
20. The cartridge assembly according to claim 19, wherein the first cam member and the third cam member each includes a first trajectory moving along the first surface of the cartridge channel and the second cam member and the fourth cam member each includes a second trajectory moving along the second surface of the cartridge channel, the first trajectory of the first cam member and the third cam member being parallel to the second trajectory of the second cam member and the fourth cam member.
21. The cartridge assembly according to claim 19, wherein the first fastener includes a plurality of first fasteners arranged into a first row and a second row on opposite sides of the longitudinal track and the second fastener includes a plurality of second fasteners arranged into a first row and a second row on opposite sides of the longitudinal track.
22. The cartridge assembly according to claim 18, wherein the first cam member and the third cam member are configured to eject the first row and the second row of the plurality of first fasteners, respectively, and the second cam member and the fourth cam member are configured to eject the first row and the second row of the plurality of second fasteners, respectively.
Type: Application
Filed: Mar 22, 2017
Publication Date: Jul 13, 2017
Inventor: Thomas Wenchell (Durham, CT)
Application Number: 15/465,645