LOADING UNIT FOR SURGICAL INSTRUMENTS WITH LOW PROFILE PUSHERS
A loading unit for engagement with a surgical instrument, and including double pushers and double retention cavities. At least one double pusher includes a first body portion having a first upper surface configured to engage a portion of a first fastener, a second body portion having a second upper surface configured to engage a portion of a second fastener, and a bridge interconnecting the first body portion and the second body portion. Each of the first upper surface and the second upper surface defining an acute angle with respect to a longitudinal axis. At least one double retention cavity includes a first retention guiding surface configured to engage a proximal pusher guiding surface of the first body portion of the double pusher retained therein, and a second retention guiding surface configured to engage a distal pusher guiding surface of the first body portion of the double pusher retained therein.
The present disclosure relates generally to instruments for surgically joining tissue and, more specifically, to a loading unit for surgical instruments with low profile pushers.
Background of Related ArtVarious types of surgical instruments used to surgically join tissue are known in the art, and are commonly used, for example, for closure of tissue or organs in transection, resection, anastomoses, for occlusion of organs in thoracic and abdominal procedures, and for electrosurgically fusing or sealing tissue.
One example of such a surgical instrument is a surgical stapling instrument, which may include an anvil assembly, a cartridge assembly for supporting an array of surgical fasteners, an approximation mechanism for approximating the cartridge and anvil assemblies, and a firing mechanism for ejecting the surgical fasteners from the cartridge assembly.
Using a surgical stapling instrument, it is common for a surgeon to approximate the anvil and cartridge members. Next, the surgeon can fire the surgical stapling instrument to emplace surgical fasteners in tissue. Further, the surgeon may use the same instrument or a separate instrument to cut the tissue adjacent or between the row(s) of surgical fasteners.
Additionally, a loading unit (e.g., a single use loading unit or a disposable loading unit) may be attached to an elongated or endoscopic portion of a surgical stapling instrument. Such loading units allow surgical stapling instruments to have greater versatility. The loading units may be configured for a single use, and/or may be configured for multiple uses.
Further, end effectors and/or loading units are generally limited in size by various components contained therein. That is, while there may be a need for end effectors and/or loading units having diameters that are smaller than those typically available, the diameter of the end effector and/or loading unit is typically limited by the size, geometry and/or orientation of the pushers, I-beam, actuation sled, and fasteners, for example, contained therein.
SUMMARYThe present disclosure relates to a loading unit configured for engagement with a surgical instrument. The loading unit includes a proximal body portion, an end effector, an actuation sled, double pushers and double retention cavities. The proximal body portion defines a longitudinal axis. The end effector is disposed in mechanical cooperation with the proximal body portion, and includes a cartridge assembly and an anvil assembly. One of the cartridge assembly and the anvil assembly is movable with respect to the other of the cartridge assembly and the anvil assembly between an open position and an approximated position. The cartridge assembly is configured to house fasteners therein. The actuation sled is longitudinally translatable within the cartridge assembly. The double pushers are disposed within the cartridge assembly. At least one double pusher includes a first body portion having a first upper surface configured to engage a portion of first fastener, a second body portion having a second upper surface configured to engage a portion of a second fastener, and a bridge interconnecting the first body portion and the second body portion. The first body portion includes a proximal pusher guiding surface and a distal pusher guiding surface. Each of the first upper surface and the second upper surface defines an acute angle with respect to the longitudinal axis. The double retention cavities are disposed within the cartridge assembly, and each double retention cavity is configured to retain one double pusher therein. At least one double retention cavity includes a first retention guiding surface configured to engage the proximal pusher guiding surface of the first body portion of the double pusher retained therein, and a second retention guiding surface configured to engage the distal pusher guiding surface of the first body portion of the double pusher retained therein.
In disclosed embodiments, the at least one double pusher may include a first ramp disposed on a lower surface of the first body portion. The first ramp may be configured to be engaged by a first angled wedge of the actuation sled. It is also disclosed that the at least one double pusher may include a second ramp disposed on a lower surface of the second body portion. The second ramp may be configured to be engaged by a second angled wedge of the actuation sled. Additionally, it is disclosed that the first ramp may be disposed at a parallel angle with respect to the longitudinal axis, and the second ramp may be disposed at a parallel angle with respect to the longitudinal axis. It is further disclosed that the first ramp may be disposed directly beneath a portion of the upper surface of the first body portion, and that the second ramp may be disposed directly beneath a portion of the upper surface of the second body portion.
In embodiments, the acute angle may be between about 30° and about 60°.
It is also disclosed that the at least one double retention cavity may include a third retention guiding surface configured to engage the proximal pusher guiding surface of the second body portion of the double pusher retained therein, and a fourth retention guiding surface configured to engage the distal pusher guiding surface of the second body portion of the double pusher retained therein.
In disclosed embodiments, the bridge may interconnect a proximal portion of the first body portion with a distal portion of the second body portion.
It is further disclosed that an outer-most diameter of the end effector may be about 12 mm with the end effector in the approximated position. Additionally, it is disclosed that the loading unit may include fasteners retained at least partially within the cartridge assembly. At least one fastener may have a height of about 5 mm.
The present disclosure also relates to an end effector configured for use with a surgical instrument. The end effector includes a cartridge assembly, an anvil assembly, an actuation sled, pushers, and a plurality of fasteners. One of the cartridge assembly and the anvil assembly is movable with respect to the other of the cartridge assembly and the anvil assembly between an open position and an approximated position. The actuation sled is translatable along a longitudinal axis within the cartridge assembly. The pushers are disposed at least partially within the cartridge assembly and are configured to be selectively engaged by the actuation sled. At least one pusher has a first upper surface configured to engage a first fastener and a first ramp configured to be engaged by a first wedge of the actuation sled. The first upper surface is disposed at an acute angle with respect to the longitudinal axis. The first ramp is disposed at a parallel angle with respect to the longitudinal axis. The plurality of fasteners is retained at least partially within the cartridge assembly. Each fastener of the plurality of fasteners is disposed in contact with one pusher of the plurality of pushers, and each fastener of the plurality of fasteners includes a height of about 5 mm. An outer-most diameter of the end effector is about 12 mm.
In disclosed embodiments, the at least one pusher may include a second upper surface configured to engage a second fastener, and a second ramp may be configured to be engaged by a second wedge of the actuation sled. It is also disclosed that the first upper surface may be parallel to the second upper surface.
In embodiments, the first ramp may be disposed directly beneath a portion of the first upper surface. It is further disclosed that the second ramp may be disposed directly beneath a portion of the second upper surface.
It also disclosed that the acute angle may be between about 30° and about 60°.
In disclosed embodiments, the first upper surface may be included on a first body portion of the at least one pusher and the second upper surface may be included on a second body portion of the at least one pusher, and that the pusher may also include a bridge interconnecting a proximal portion of the first body portion with a distal portion of the second body portion.
Various embodiments of the present disclosure are illustrated herein with reference to the accompanying drawings, wherein:
Embodiments of the presently disclosed surgical instrument, loading unit for use therewith, and cartridge assembly for use therewith, are described in detail with reference to the drawings, wherein like reference numerals designate 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, e.g., surgeon or physician, while the term “distal” refers to that part or component farther away from the user.
A surgical instrument of the present disclosure is indicated as reference numeral 100 in
Examples of loading units for use with a surgical stapling instrument are disclosed in commonly-owned U.S. Pat. No. 5,752,644 to Bolanos et al., the entire contents of which are hereby incorporated by reference herein. Further details of an endoscopic surgical stapling instrument are described in detail in commonly-owned U.S. Pat. No. 6,953,139 to Milliman et al., the entire contents of which are hereby incorporated by reference herein.
In surgical instrument 100 in accordance with the present disclosure, a firing rod (not shown) is moved distally in response to actuation of handle assembly 110 to deploy fasteners 600 (
With reference to
Various features of loading unit 200 disclosed herein allow loading unit 200 to have a relatively small diameter “d” (e.g., about 12 mm) as compared with more conventional instruments having diameters of about 15 mm. As shown in
Additionally, in the illustrated embodiments, a proximal portion 212 of proximal body portion 210 of loading unit 200 is sized and configured to engage elongated portion 120 of surgical instrument 100 (
More particularly, with reference to
With reference to
With further regard to actuation sled 520, distal translation of actuation sled 520 sequentially engages pushers 800, and causes pushers 800 to move in the general direction of arrow “B” (
With particular reference to
Referring now to
With particular reference to
With reference to
Additionally, first body portion 810 includes an arcuate proximal edge 813 and an arcuate distal edge 814, and second body portion 820 includes an arcuate proximal edge 823 and an arcuate distal edge 824 (
With reference to
Referring now to
In use, distal movement of actuation sled 520 through cartridge assembly 400 causes wedges 524b and 524c of actuation sled 520 to contact first camming members 840 of double pushers 800a, 800b, and causes wedges 524a and 524d to contact second camming members 850 of double pushers 800a, 800b, which consequently causes double pushers 800a, 800b to move in the general direction of arrow “B” (
With reference to
Additionally, with reference to
With reference to
Guidance block 870 includes a width “w1” disposed parallel to the longitudinal axis “A-A,” and guidance block 880 includes a width “w2” disposed parallel to the longitudinal axis “A-A.” Width “w1” is measured between a proximal surface 870a and a distal surface 870b of guidance block 870, and width “w2” is measured between a proximal surface 880a and a distal surface 880b of guidance block 880 (
Accordingly, the height-to-width ratio of guidance block 870 is about 1.5:1, and the height-to-width ratio of guidance block 880 is about 1.1:1. Such large ratios (relative to more traditional pushers) help enable the use of a relatively short pusher 800, which helps enable the use of relatively large fasteners 600 (e.g., 5 mm) in a relatively small diameter “d” end effector 200 (e.g., 12 mm).
Further, in either orientation of double pusher 800 (i.e., first double pusher 800a and second double pusher 800b), the height “h1” of upper channel 815 of first body portion 810 is closer to knife channel 401 than upper channel 825 of second body portion 820. Here, upper channel 815 of first body portion 810 may engage a smaller fastener (e.g., a 4 mm staple), while upper channel 825 of second body portion 820 may engage a larger fastener (e.g., a 5 mm staple).
With reference to
As shown in
The orientation of various parts of pusher 800 enable diameter “d” (
The present disclosure also includes using fasteners 600 having the same height as each other, and/or fasteners 600 having a different height from other fasteners 600. For example, fasteners 600 that are located in an outer row farthest from knife channel 401 of cartridge assembly 400 may have a larger height (e.g., 5 mm) than fasteners 600 (e.g., 4 mm) located in the inner row closest to knife channel 401. The stepped configuration of tissue-contacting surface 410 of cartridge assembly 400 may facilitate the use of fasteners 600 having different heights. Further details of fasteners having different heights, and a stepped tissue-contacting surface are disclosed in commonly-owned U.S. Patent Application Publication No. 2016/0270788 to Czernik, the entire contents of which are hereby incorporated by reference herein.
It is also envisioned that loading unit 200 is configured for use with alternate pushers. With reference to
As shown in
Loading units 200 using alternate pushers 900, 950 include retention cavities 1000 that are shaped to correspond to the shapes of pushers 900, 950.
The present disclosure also includes methods of performing a surgical procedure using surgical instrument 100 and/or loading unit 200 disclosed herein. For example, a method including using loading unit 200 having a diameter of about 12 mm to eject fasteners having a height of about 5 mm is disclosed. Such methods also include inserting loading unit 200 at least partially through a trocar having a diameter of about 12 mm.
In any embodiment disclosed herein, the fasteners or staples can have an angled orientation in the staple cartridge. This orientation affects how the staple pushers are configured. As a result, the stapling instrument can be arranged for stapling greater tissue thicknesses, or to minimize the overall size of the instrument.
Although a manual stapler is shown in
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 claims appended hereto.
Claims
1. A loading unit configured for engagement with a surgical instrument, the loading unit comprising:
- a proximal body portion defining a longitudinal axis;
- an end effector disposed in mechanical cooperation with the proximal body portion, the end effector including a cartridge assembly the cartridge assembly configured to house fasteners therein;
- an actuation sled longitudinally translatable within the cartridge assembly;
- double pushers disposed within the cartridge assembly, at least one double pusher includes a first body portion having a first upper surface configured to engage a portion of a first fastener, a second body portion having a second upper surface configured to engage a portion of a second fastener, and a bridge interconnecting the first body portion and the second body portion, the first body portion including a proximal pusher guiding surface and a distal pusher guiding surface, the second body portion including a proximal pusher guiding surface and a distal pusher guiding surface, each of the first and second upper surfaces defining an acute angle with respect to the longitudinal axis; and
- double retention cavities disposed within the cartridge assembly, each double retention cavity configured to retain one double pusher therein, at least one double retention cavity includes a first retention guiding surface configured to engage the proximal pusher guiding surface of the first body portion of the double pusher retained therein, and a second retention guiding surface configured to engage the distal pusher guiding surface of the first body portion of the double pusher retained therein.
2. The loading unit according to claim 1, wherein the at least one double pusher includes a first ramp disposed on a lower surface of the first body portion, the first ramp is configured to be engaged by a first angled wedge of the actuation sled.
3. The loading unit according to claim 2, wherein the at least one double pusher includes a second ramp disposed on a lower surface of the second body portion, the second ramp is configured to be engaged by a second angled wedge of the actuation sled.
4. The loading unit according to claim 3, wherein the first ramp is disposed at a parallel angle with respect to the longitudinal axis, and wherein the second ramp is disposed at a parallel angle with respect to the longitudinal axis.
5. The loading unit according to claim 2, wherein the first ramp is disposed directly beneath a portion of the upper surface of the first body portion.
6. The loading unit according to claim 3, wherein the second ramp is disposed directly beneath a portion of the upper surface of the second body portion.
7. The loading unit according to claim 1, wherein the acute angle is between about 30° and about 60°.
8. The loading unit according to claim 1, wherein the at least one double retention cavity includes a third retention guiding surface configured to engage the proximal pusher guiding surface of the second body portion of the double pusher retained therein, and a fourth retention guiding surface configured to engage the distal pusher guiding surface of the second body portion of the double pusher retained therein.
9. The loading unit according to claim 1, wherein the bridge interconnects a proximal portion of the first body portion with a distal portion of the second body portion.
10. The loading unit according to claim 1, wherein an outer-most diameter of the end effector is about 12 mm with the end effector in the approximated position.
11. The loading unit according to claim 10, further including fasteners retained at least partially within the cartridge assembly, at least one fastener has a height of about 5 mm.
12. An end effector configured for use with a surgical instrument, the end effector comprising:
- a cartridge assembly;
- an actuation sled translatable along a longitudinal axis within the cartridge assembly;
- pushers disposed at least partially within the cartridge assembly and configured to be selectively engaged by the actuation sled, at least one pusher having a first upper surface configured to engage a first fastener and a first ramp configured to be engaged by a first wedge of the actuation sled, the first upper surface disposed at an acute angle with respect to the longitudinal axis, the first ramp disposed at a parallel angle with respect to the longitudinal axis; and
- a plurality of fasteners retained at least partially within the cartridge assembly, each fastener of the plurality of fasteners disposed in contact with one pusher of the plurality of pushers, and each fastener of the plurality of fasteners includes a height of about 5 mm;
- wherein an outer-most diameter of the end effector is about 12 mm.
13. The end effector according to claim 12, wherein the at least one pusher includes a second upper surface configured to engage a second fastener and a second ramp configured to be engaged by a second wedge of the actuation sled.
14. The end effector according to claim 13, wherein the first upper surface is parallel to the second upper surface.
15. The end effector according to claim 12, wherein the first ramp is disposed directly beneath a portion of the first upper surface.
16. The end effector according to claim 13, wherein the first ramp is disposed directly beneath a portion of the first upper surface and where the second ramp is disposed directly beneath a portion of the second upper surface.
17. The end effector according to claim 12, wherein the acute angle is between about 30° and about 60°.
18. The end effector according to claim 12, wherein the first upper surface is included on a first body portion of the at least one pusher and the second upper surface is included on a second body portion of the at least one pusher, and further including a bridge interconnecting a proximal portion of the first body portion with a distal portion of the second body portion.
Type: Application
Filed: Feb 22, 2017
Publication Date: Aug 23, 2018
Inventor: Stanislaw Kostrzewski (Newtown, CT)
Application Number: 15/439,312