巴西专利BR112015008201B1 surgical cutting instrument and surgical staple cartridge structure

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专利摘要:
SURGICAL CUTTING INSTRUMENT. The present invention relates to a surgical cutting instrument (100) which includes a first claw element (108), a second claw element (110) movably supported relative to the first claw element for selective movement between an open position and a closed position for clamping the fabric therebetween by applying a closing motion thereof, and a cutting member (122) comprising a fabric cutting edge (13) for cutting the fabric clamped between the first claw element and second claw element by applying a retracting motion to the cutting member.
公开号:BR112015008201B1
申请号:R112015008201-7
申请日:2013-10-10
公开日:2021-07-06
发明作者:Robert L. Koch Jr.；Andrew T. Beckman；Eric W. Thompson；Rachel M. Clair
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

BACKGROUND
[0001] The present description relates, in general, to surgery, and, in particular, to a surgical transaction or cutting tool that can be used to cut tissue by itself or as a part of the surgical tissue cutting instrument and fixation instrument.
[0002] During many surgical procedures, it is common to use a tissue fixation and cutting device, such as a linear cutter, for tissue fixation and cross-cutting, in order to make tissue resection and obtain hemostasis by placement of a plurality of laterally spaced rows of staples on opposite sides of a cross-line fabric or fabric cut. Surgical cutting and fixation instruments are generally used to make a longitudinal incision in tissue and apply rows of staples on opposite sides of the incision. Such instruments commonly include an end actuator having a pair of collaborating grip elements which, if the instrument is intended for endoscopic or laparoscopic applications, is capable of passing through the passage of a cannula. One of the grip elements receives a staple cartridge that has at least two laterally spaced rows of staples. The other gripper element defines an anvil with staple forming pockets aligned with the rows of staples within the cartridge. The instrument includes a plurality of reciprocating wedges which, when actuated distally, pass through openings in the staple cartridge and engage triggers that support the staples to effect discharge of the staples toward the anvil. A cutting instrument is pulled distally along the grip element so that the clamped tissue is cut and secured (eg, stapled).
[0003] An example of a surgical fixation and cutting instrument suitable for endoscopic applications is described in US patent No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, granted on February 21, 2006, whose description which is incorporated herein by reference. In use, a physician is able to close the instrument's claw elements over tissue to position them prior to firing. When the clinician determines that the grip elements are properly securing the tissue, the clinician can then fire the surgical instrument, thereby severing and clamping the tissue. An example of a motor-driven surgical fixation and cutting instrument is described in US Patent No. 7,416,101 entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH LOADING FORCE FEEDBACK", granted on August 26, 2008, which full description which is incorporated herein by reference. BRIEF DESCRIPTION OF THE DRAWINGS
[0004] The innovative features of the various embodiments of the invention are presented in detail in the appended claims. The various modalities of the invention, however, in terms of organization and methods of operation, together with its additional objectives and advantages, can be better understood by consulting the description presented below, taken together with the attached drawings, as exposed.
[0005] Figure 1 is a prospective view of a surgical cutting instrument including a handle, a shaft and an end actuator;
[0006] Figure 2 is a prospective view of a lower gripper of the end actuator of the surgical cutting instrument of Figure 1;
[0007] Figure 3 is a partial exploded view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 1;
[0008] Figure 4 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 1;
[0009] Figure 5 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 1;
[00010] Figure 6 is a partial cross-sectional view of the lower grip of the end actuator of the surgical cutting instrument of Figure 1;
[00011] Figure 7 is a partial cross-sectional view of the lower grip of the end actuator of the surgical cutting instrument of Figure 1;
[00012] Figure 8 is a prospective view of the end actuator of the surgical cutting instrument of Figure 1 near the tissue;
[00013] Figure 9 is a prospective view of the end actuator of the surgical cutting instrument of Figure 1 clamping the tissue;
[00014] Figure 10 is a prospective view of the end actuator of the surgical cutting instrument of Figure 1 clamping tissue, and a cutting member cutting tissue;
[00015] Figure 11 is a prospective view of the tissue cut made by the surgical cutting instrument of Figure 1;
[00016] Figure 12 is a prospective view of a surgical cutting instrument including a handle, a shaft and an end actuator;
[00017] Figure 13 is a prospective view of a lower gripper of the end actuator of the surgical cutting instrument of Figure 12;
[00018] Figure 14 is a partial exploded view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 12;
[00019] Figure 15 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 12;
[00020] Figure 16 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 12;
[00021] Figure 17 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 12;
[00022] Figure 18 is a partial cross-sectional view of the lower jaw of the end actuator of the surgical cutting instrument of Figure 12;
[00023] Figure 19 is a prospective view of a surgical cutting instrument including a handle, a shaft and an end actuator;
[00024] Figure 20 is a prospective view of a lower gripper of the end actuator of the surgical cutting instrument of Figure 19 showing a cutting member in place;
[00025] Figure 21 includes two partial prospective views of a lead member of the surgical cutting instrument of Figure 19, in which the solid line view illustrates an unpositioned cutting member, and the dashed line view illustrates a member of positioned cut;
[00026] Figure 22 is a partial cross-sectional view of a lead member of the surgical cutting instrument of Figure 19;
[00027] Figure 23 is a partial cross-sectional view of a lead member of the surgical cutting instrument of Figure 19;
[00028] Figure 24 is a partial cross-sectional view of a lead member of the surgical cutting instrument of Figure 19;
[00029] Figure 25 is a prospective view of a surgical instrument for cutting and clamping that includes a handle, a shaft and an end actuator;
[00030] Figure 26 is a partial exploded prospective view of a staple cartridge of the end actuator of the surgical instrument of Figure 25;
[00031] Figure 27 is a partial cross-sectional view of the staple cartridge of Figure 26, and a conducting member of the surgical instrument of Figure 25;
[00032] Figure 28 is a partial cross-sectional view of the staple cartridge of Figure 26 illustrating an unpositioned cutting member;
[00033] Figure 29 is a partial cross-sectional view of the staple cartridge of Figure 26 illustrating an unpositioned cutting member;
[00034] Figure 30 is a partial cross-sectional view of the staple cartridge of Figure 26 illustrating a severing member in place;
[00035] Figure 31 is a partial cross-sectional view of the staple cartridge of Figure 26 illustrating a severing member in place;
[00036] Figure 32 is a partial exploded prospective view of a staple cartridge of the end actuator of the surgical instrument of Figure 25;
[00037] Figure 33 is a partial cross-sectional view of the staple cartridge of Figure 32 illustrating an unpositioned cutting member;
[00038] Figure 34 is a partial cross-sectional view of the staple cartridge of Figure 32 illustrating a severing member in place;
[00039] Figure 35 is a partial cross-sectional view of the staple cartridge of Figure 32 illustrating a severing member in place;
[00040] Figure 36 is a partial cross-sectional view of the staple cartridge of Figure 32 illustrating a severing member in place. SUMMARY
[00041] The present invention relates to a surgical cutting instrument that may comprise a first claw element, a second claw element movably supported relative to the first claw element for selective movement between an open position and a closed position for clamping the fabric therebetween by applying a closing motion thereof, and a cutting member comprising a fabric cutting edge for cutting the fabric clamped between the first claw element and the second claw element by the application of a retraction motion to the cutting member.
[00042] A surgical staple cartridge structure for use with a surgical stapler may include a staple cartridge compartment configured to be operably supported on the surgical stapler, wherein the staple cartridge compartment may include a top surface , a slit, and at least one clip cavity. The surgical cartridge structure may also include a cutting member positioned within the staple cartridge compartment, the cutting member comprising a tissue cutting edge configured to cut tissue, the cutting member being retractable from proximally by applying a retracting motion thereof, with the tissue cutting edge being presented proximally as the cutting member is retracted proximally through the tissue.
[00043] A surgical instrument for cutting and securing may include an elongated rod, an elongated channel operatively coupled to the elongated rod and configured to operatively support a staple cartridge therein, and an anvil movably supported relative to the elongated channel for movement selective between an open position and a closed position, wherein the fabric is clamped between the anvil and a staple cartridge held within the elongated channel in response to opening and closing motions applied thereto from the elongated shaft. The surgical instrument may also include a cutting member comprising a tissue cutting edge, wherein the cutting member is retractable relative to the elongated channel, and wherein the tissue cutting edge is configured to cut tissue clamped between. the anvil and staple cartridge during a retraction of the cutting member.
[00044] A surgical instrument for cutting and fixing comprises a first claw having a compartment, the compartment including a top surface, a second claw movably supported relative to the first claw by applying opening and closing movements of the same, and a cutting member including a tissue cutting edge, the cutting member being movable from a starting position proximal to a distal end position by applying a firing motion thereof, and the from the distal end position to the proximal start position by applying a retraction movement thereof, the cutting member being further movably supported within the compartment of the first claw, so that when the cutting member is moving from the proximal start position to the distal end position, the tissue cutting edge is positioned below the top surface of the compartment. of the first jaw, and when the cutting member is moving from the distal end position to the proximal start position, the tissue cutting edge extends above the top surface of the first jaw housing.
[00045] A surgical staple cartridge comprises a cartridge compartment including a top surface, the cartridge compartment operably supporting a plurality of surgical staples therein, and a cutting member movably supported within the cartridge compartment and including a tissue cutting edge, wherein the cutting member is movable from a proximal start position to a distal end position, and from the distal end position to the proximal start position, the cutting member still is movably supported inside the cartridge compartment, so that when the cutting member is moving from the proximal start position to the distal end position, the tissue cutting edge is positioned below the top surface, and when the cutting member is moving from the distal end position to the proximal start position, the tissue cutting edge extends above from the top surface. DESCRIPTION
[00046] When used throughout the present invention, the terms "proximal" and "distal" generally refer to a physician manipulating an end of an instrument used to treat a patient. The term "proximal" generally refers to the portion of the instrument closest to the physician. The term "distal" generally refers to the portion farthest from the physician. It should further be appreciated that, for accuracy and clarity, spatial terms such as "vertical", "horizontal", "upward" and "downward" may be used in the present invention with respect to the illustrated embodiments. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
[00047] Referring to Figure 1, a surgical instrument, generally speaking 100, may comprise a handle 102, a shaft 104, and an end actuator 106. In at least one embodiment, as shown in Figure 1, the actuator of end 106 may comprise a first claw element 108 and a second claw element 110. Surgical end actuator 106 may be configured to perform surgical activities in response to actuation motions applied thereto. The first claw element 108 is movable relative to the second claw element 110 between a first position and a second position. The first position can be an open position, and the second position can be a closed position. In at least one embodiment, referring to Figure 1, first claw element 108 may be pivotally coupled to second claw element 110. Other arrangements suitable for coupling first claw element 108 to second claw element 110 are contemplated. within the scope of this revelation.
[00048] Again referring to Figure 1, the cable 102 may comprise a closure system actuator 112, a trigger actuator 113, and a rotation actuator 114. The closure system actuator 112 may be pivotally coupled to the cable 102. Actuation of the closure system actuator 112 can cause the first claw element 108 to move relative to the second claw element 110. Rotating the rotation actuator 114 can result in the end actuator 106 rotating about of a longitudinal axis LL.
[00049] Referring to Figures 2 to 7, the second claw element 110 may comprise a housing 116 including a top surface 118 having a slit 120 extending along the longitudinal axis L-L. As illustrated in Figure 2, housing 116 may include a cutting member 122 that is movable through slot 120 along longitudinal axis L-L. As illustrated in the exploded view in Figure 3, housing 116 may include a first rail 124, and a second rail 126. Rails 124 and 126 may extend along the longitudinal axis LL so that they are parallel to one another. . In addition, rails 124 and 126 may extend in a plane that is substantially perpendicular to top surface 118, wherein, in at least one embodiment, second rail 126 is closer to top surface 118 than first rail. 124. A distal portion 128 of first rail 124 may converge to intersect with second rail 126 at a junction point 130. Rails 124 and 126 may further extend distally beyond junction point 130, forming a portion. of common rail 132.
[00050] Referring again to Figures 2 to 7, the cutting member 122 may include a fabric cutting edge 134, a first pin 136, a second pin 138 and an engaging portion 140. The cutting member 122 is movable between a proximal start position 142 as shown in Figure 4 and a distal end position 144 as shown in Figure 6. At the proximal start position 142, the first pin 136 is movable in the first rail 124, and the second pin 138 is movable in second rail 126 which causes cutting member 122 to remain in an "unpositioned" orientation. In the positioned orientation, as illustrated in Figure 4, fabric cutting edge 134 is not exposed above top surface 118.
[00051] As illustrated in the exploded view in Figure 3, the surgical instrument 100 may further comprise the lead member 146, which may include a retraction hook 148 and an insertion tip 150. The lead member 146 may be operably coupled, in a proximal portion thereof to trigger actuator 113 so that an operator of surgical instrument 100 can advance lead member 146 distally by advancing trigger actuator 113 distally, and can retract lead member 146 proximally. by retracting trigger actuator 113 proximally.
[00052] Referring to Figures 4 and 5, advancing the lead member 146 in a distal position can bring the insertion tip 150 into the engagement fitting with the engagement portion 140 of the cutting member 122. With the first pin 136 moving on first track 124, and second pin 138 moving on second track 126, further advancing lead member 146 may allow cutting member 122 to move distally from proximal start position 142 through slot 120, as illustrated in Figure 5.
[00053] Referring to Figures 5 and 6, the cutting member 122 can be advanced distally in an unpositioned orientation along the rails 124 and 126 until the first pin 136 enters the distal portion 128 of the first rail 124. The portion The distal 128 may comprise a cam surface 152 which may cause the first pin 136 to be lifted towards the junction point 130 as the cutting member 122 continues to be advanced distally. As a result, the cutting member 122 is gradually transitioned from an unpositioned orientation, as illustrated in Figure 5, wherein the fabric cutting edge 134 is not exposed above the top surface 118 to a positioned orientation, as illustrated in the Figure 6, in which the fabric cutting edge 134 is exposed above the top surface 118. In other words, advancing the first pin 136 against the cam surface 152 can cause the cutting member 122 to move about an axis transverse to the longitudinal axis LL, resulting in the positioning of the fabric cutting edge 134.
[00054] Referring again to Figures 5 and 6, as the cutting member 122 transitions from an unpositioned orientation to a positioned orientation, as described above, the first pin 136 may enter the common portion of the rail 132. , engagement portion 140 of cutting member 122 is releaseable from engagement engagement with insertion tip 150 and may enter engagement engagement with retraction hook 148, as illustrated in Figure 6.
[00055] Now with reference to Figures 6 and 7, the positioned cutting member 122 can then move proximally from the distal end position 144 towards the proximal start position 142 in response to the retraction movements by leading member 146. As illustrated in Figure 6, tissue cutting edge 134 is shown proximally at distal end position 144. Retracting lead member 146 may cause cutting member 122 to move proximally to along the longitudinal axis LL. As cutting member 122 begins to move proximally, first pin 136 moves on a common portion of rail 132, and second pin 138 moves on second rail 126. Upon reaching junction point 130, the first pin 136 is prevented from re-entering distal portion 128 of first rail 124 by lead member 146. Instead, first pin 136 enters second rail 126. As illustrated in Figure 7, both pins 136 and 138 can move in the second rail 126 for balancing movement of the proximally positioned cutting member 122. In certain embodiments, the first claw element 108 may comprise a slit (not shown) corresponding to the slit 120 in the second claw element 110. first grip element 108 may also extend along the longitudinal axis LL, and may receive an upper portion of the cutting member section positioned 122 exposed above the top surface 118 during retraction of the member d. and cut 122 through slot 120.
[00056] Now with reference to Figures 8 through 11, the surgical instrument 100 can be used in performing a surgical procedure of cross-cutting tissue. An operator can actuate the actuator of the closure system 112 of the handle 102 to grip and clamp the tissue between the first grip element 108 and the second grip element 110, as illustrated in Figure 9. The operator can then position the member. stop 122 by advancing trigger actuator 113 as described above. After positioning, the cutting member 122 can be retracted by retracting the firing actuator 113. The tissue cutting edge shown so far 134 can cut through the tissue clamped between the grip elements 108 and 110 as the cutting member 122 is proximally retracted. The transected tissue can then be released from the end actuator 106 by actuating the closure system actuator 112 to open the grip elements 108 and 110.
[00057] Referring to Figure 12, a surgical instrument, generally 200, may comprise a handle 202, a rod 204, and an end actuator 206. In at least one embodiment, as shown in Figure 12, the end actuator 206 may comprise a first claw element 208 and a second claw element 210. End actuator 206 may be configured to perform surgical activities in response to actuation movements applied thereto. First claw element 208 is movable relative to second claw element 210 between a first position and a second position. The first position can be an open position, and the second position can be a closed position. In at least one embodiment, referring to Figure 12, first claw element 208 may be pivotally coupled to second claw element 210. Other arrangements suitable for coupling first claw element 208 to second claw element 210 are contemplated. within the scope of this revelation.
[00058] Again with reference to Figure 12, the cable 202 may comprise a closure system actuator 212, a trigger actuator 213, and a rotation actuator 214. The closure system actuator 212 may be pivotally coupled to the cable 202. Actuation of the closure system actuator 212 may cause the first claw element 208 to move relative to the second claw element 210. Rotating the rotation actuator 214 may result in the end actuator 206 rotating about of a longitudinal axis LL.
[00059] Referring to Figures 13 to 18, the second claw element 210 may comprise a housing 216 that includes a top surface 218 that has a slit 220 that extends along the longitudinal axis L-L. As illustrated in Figure 13, housing 216 may include a cutting member 222 which is movable through slot 220 along longitudinal axis L-L. As illustrated in the exploded view of Figure 14, housing 216 may include a first rail 224 and a second rail 226. Rails 224 and 226 may extend along longitudinal axis LL so that they are substantially parallel to one another. . In addition, rails 224 and 226 may extend in a plane that is substantially perpendicular to top surface 218, with second rail 226 being closer to top surface 218 than first rail 224. As illustrated in Figure 15 , first rail 224 may begin at a starting point 225 positioned at a distal portion of housing 216; and second rail 226 may begin at a starting point 227 positioned in a proximal portion of housing 216. Such an arrangement shortens the distance that cutting member 222 must travel distally before being moved to the positioned orientation.
[00060] Referring again to Figures 13 to 18, a distal portion 228 of the first rail 224 may converge until it intersects with the second rail 226 at the junction point 230. The rails 224 and 226 may further extend distally beyond the point of junction 230 forming a portion of the common rail 232. The cutting member 222 may include a fabric cutting edge 234, a first pin 236, a second pin 238, and an engaging portion 240. The cutting member 222 is movable between a proximal start position 242, which can be defined by starting point 225 of first rail 224, as illustrated in Figure 15, and a distal end position 244 at a distal end of common rail 232, as illustrated in Figure 17 At the proximal start position 242, the first pin 236 can move on the first track 224, and the second pin 238 can move on the second track 226, causing the cutting member 222 to remain in a positioned orientation. In the unpositioned orientation, as illustrated in Figure 15, fabric cutting edge 234 of cutting member 222 is not exposed above top surface 218.
[00061] As illustrated in the exploded view of Figure 14, the surgical instrument 200 may additionally comprise the lead member 246, which may include a retraction hook 248 and an insertion tip 250. The lead member 246 may be operatively coupled, in a portion thereof, to the triggering actuator 213, such that an operator of the surgical instrument 200 can advance the lead member 246 distally by advancing the triggering member 213 distally, and can retract the lead member 246 proximally by retracting the actuator. shot 213 proximally.
[00062] Referring to Figures 15 and 16, advancing the lead member 246 distally can bring the insertion tip 250 into the engagement socket with the engagement portion 240 of the cutting member 222. With the first pin 236 moving on the first track 224, and second pin 238 moving on second track 226, further advancement of lead member 246 may allow cutting member 222 to move a short distance distally from proximal start position 242 through slot 218, as illustrated in Figure 16.
[00063] Referring to Figures 16 and 17, the cutting member 222 can be advanced distally in an unpositioned orientation a short distance along the rails 224 and 226, until the first pin 236 enters the distal portion 228 of the first rail 224. Distal portion 228 may comprise a cam surface 252 which may cause first pin 236 to be lifted toward junction point 230 as cutting member 222 continues to be advanced distally. As a result, the cutting member 222 is transitioned gradually from an unpositioned orientation, as illustrated in Figure 16, with the fabric cutting edge 234 not exposed above the top surface 218, to a positioned orientation, as illustrated. in Figure 17, the fabric cutting edge 234 being exposed above the top surface 218. In other words, advancing the first pin 236 against the cam surface 252 can cause the cutting member 222 to move around. of an axis transverse to the longitudinal axis LL, resulting in the positioning of the tissue cutting edge 234.
[00064] Referring again to Figures 16 and 17, as the cutting member 222 transitions from an unpositioned orientation to a positioned orientation, as described above, the first pin 236 may enter the common rail portion 232. , engagement portion 240 of cutting member 222 is releaseable from engagement engagement with insertion tip 250 and may enter engagement engagement with retraction hook 248, as illustrated in Figure 17.
[00065] Now with reference to Figures 17 and 18, positioned cutting member 222 may then move proximally from distal end position 244 in response to retraction of movements by lead member 246. As illustrated in Figure 17, tissue cutting edge 234 is shown proximally at distal end position 244. Retraction of lead member 246 may cause cutting member 222 to move proximally along longitudinal axis LL. As cutting member 222 begins to move proximally, first pin 236 moves on portion of common rail 232, and second pin 238 moves on second rail 226. Upon reaching junction point 230, the first pin 236 is prevented from re-entering distal portion 228 of first rail 224 by lead member 246. Instead, first pin 236 enters second rail 226. As illustrated in Figure 18, both pins 236 and 238 are movable in the second. rail 226 for balancing movement in proximal position of cutting member 222.
[00066] In certain embodiments, the first claw element 208 may comprise a slit (not shown) that corresponds to the slit 220 in the second claw element 210. The slit of the first claw element 208 may also extend along the longitudinal axis LL e can receive an upper portion of the positioned cutting member section 222 exposed above the top surface 218 during retraction of the cutting member 222 through the slot 220.
[00067] Referring to Figure 19, a surgical instrument, generally 300, may comprise a handle 302, a rod 304 and an end actuator 306. In at least one embodiment, as shown in Figure 19, the end actuator 306 may comprise a first claw element 308 and a second claw element 310. End actuator 306 may be configured to perform surgical activities in response to firing motions applied thereto. First claw element 308 is movable relative to second claw element 310 between a first position and a second position. The first position can be an open position, and the second position can be a closed position. In at least one embodiment, referring to Figure 19, first claw element 308 may be pivotally coupled to second claw element 310. Other suitable means for coupling first claw element 308 to second claw element 310 are contemplated. within the scope of this revelation.
[00068] Again with reference to Figure 19, the cable 302 may comprise a closure system actuator 312, a trigger actuator 313, and a rotation actuator 314. The closure system actuator 312 may be pivotally coupled to the cable 302. Actuation of the actuator of the closure system 312 may cause the first claw element 308 to move relative to the second claw element 310. Rotating the rotation actuator 314 may result in the end actuator 106 rotating about of a longitudinal axis LL.
[00069] Referring to Figures 20 to 24, the second claw element 310 may comprise a housing 316, including a top surface 318 that has a slot 320 that extends along the longitudinal axis L-L. As illustrated in Figure 20, housing 316 may include a cutting member 322 that is movable through slot 320 along longitudinal axis L-L. Cutting member 322 may comprise a tissue cutting edge 334, and a piercing tip 335 on a distal portion of the cutting member, as illustrated in Figure 21
[00070] Referring again to Figures 20 to 24, surgical instrument 300 may further comprise lead member 346, which may include a stop member 348 oriented on a distal portion thereof as illustrated in Figure 21. Lead member 346 in distal direction can be operatively coupled, in a proximal portion thereof, to trigger actuator 313 so that an operator of surgical instrument 300 can advance lead member 346 distally by advancing trigger actuator 313 distally, and can proximally retract lead member 346 by proximally retracting trigger actuator 313.
[00071] Referring to Figures 21 to 24, the cutting member 322 may be pivotally coupled to a distal portion of the lead member 346 proximally to the stop element 348. For example, a pivot pin 350 may be used to couple cutting member 322 to lead member 346. Other means of coupling cutting member 322 to lead member 346 are contemplated within the scope of this disclosure. As illustrated in Figures 21 to 24, cutting member 322 is pivotable relative to lead member 346 about an axis through pivot pin 350 and transverse to longitudinal axis L-L. Pivoting the cutting member 322, in a clockwise direction, around the pivot pin 350 can cause the cutting member 322 to transition from an unpositioned orientation to a positioned orientation. In the unplaced orientation, the fabric cutting edge 334 and piercing tip 335 of the cutting member 346 remain below the top surface 318 of the housing 316, as illustrated by the solid line embodiment in Figure 21. In the fully positioned orientation, however, fabric cutting edge 334 and piercing tip 335 of cutting member 346 are exposed above top surface 318 of housing 316 and cutting member 346 abuts against stop element 348, as illustrated by the dashed line embodiment in Figure 21.
[00072] Now with reference to Figures 22 to 24, housing 316 may comprise a positioned member 356. As illustrated in Figure 22, cutting member 322 may be advanced distally in an unpositioned orientation by advancing the lead member 346, until cutting member 322 engages positioned member 356. Further advancement of lead member 346 may cause cutting member 322 to rotate clockwise around pivot pin 350 transitioning to a positioned orientation, as illustrated. in Figure 23. Other positioning arrangements for positioning the cutting member 322 are contemplated within the scope of the present description.
[00073] The surgical instrument 300 can be used in performing a surgical tissue cross-cutting procedure. An operator can activate the actuator of the closure system 312 to grip and pinch tissue to be transected between the first grip element 308 and the second grip element 310. The operator can then advance the cutting member 322 distally. in an unpositioned orientation, as described above, by advancing trigger actuator 313. Upon engagement of positioned member 356, cutting member 322 can be rotated in a clockwise direction causing piercing tip 335 to penetrate through of tissue clamped between grip element 308 and 310. As the operator continues to advance lead member 346, cutting member 322 continues to rotate until cutting member 322 is stopped upon reaching stop element 348. , then retract the fully positioned cutting member 322 by retracting the trigger actuator 313. The proximally presented tissue cutting edge 334 can cut through the tissue clamped between the members. Jaw elements 308 and 310 as the cutting member is proximally retracted. The transected tissue can then be released from the end actuator 306 by actuating the closure system actuator 312 to open the grip elements 308 and 310.
[00074] Referring to Figure 25, a surgical fixation and cutting instrument, generally 400, may comprise a handle 402, a shaft 404 and an end actuator 406. In at least one embodiment, as shown in Figure 25, end actuator 406 may include a staple cartridge channel 410 for receiving a staple cartridge 411. Staple cartridge 411 may be configured to operatively support surgical staples therein. End actuator 406 may additionally include an anvil 408 that is pivotally connected to staple cartridge channel 410 and is pivotable between open and closed positions by an end actuator closure system.
[00075] To position the staples of staple cartridge 411, surgical instrument 400 may additionally include a staple driver configured to traverse staple cartridge 411 and a trigger trigger configured to advance the staple trigger within the staple cartridge. Bobby pins. In various embodiments, anvil 408 can be configured to deform at least a portion of the staples as they are positioned from the staple cartridge. Various modalities of end actuator closing system and a trigger trigger are disclosed in US Patent No. 6,905,057 entitled SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING A LINKED RACK TRANSMISSION, issued June 14, 2005, and in US Patent No. 7,044,352, entitled SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING, issued May 16, 2006, the full descriptions of which are incorporated herein by reference.
[00076] In various embodiments, a surgical instrument in accordance with the present invention may include a system for moving, or articulating, an end actuator with respect to an elongated rod assembly of the surgical instrument. For example, surgical instrument 400 may include a hinged joint (not shown) that can movably connect end actuator 406 and rod 404. In various embodiments, the swivel joint may allow the end actuator 406 to move relative to the rod assembly 404 in a single plane or, alternatively, in multiple planes. In any event, the swivel joint can include one or more pivot axes around which the end actuator 406 can be swiveled.
[00077] The surgical instrument 400 may include, further (not shown), the locking mechanism that can secure, or lock the relative relationship between the end actuator 406 and the elongated rod assembly 404. Other mechanisms, in accordance with present description, are described in US patent application No. 7,784,662, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH SINGLE PIVOT CLOSURE AND DOUBLE PIVOT FRAME GROUND, granted on August 31, 2010, in US patent No. 7,455,208, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH RIGID FIRING BAR SUPPORTS, granted on November 25, 2008, and publication of US patent application No. 2007/0027469 A1, entitled SURGICAL STAPLING AND CUTTING DEVICE AND METHOD FOR USING THE DEVICE, filed on 24 on July 2006, the full descriptions which are each incorporated herein by reference in the present invention.
[00078] Referring to Figure 25, the cable 402 may comprise a rotation actuator 414. The actuation of the rotation actuator 414 may result in the rotation of the end actuator 406 about a longitudinal axis L-L. Cable 402 may additionally comprise closure system actuator 412. closure system actuator 412 may be pivotally coupled to cable 402. Actuation of closure system actuator 412 can cause anvil 408 to move in with respect to the cartridge runner 410. The handles and drive mechanisms in accordance with the present disclosure are disclosed in US Patent No. 5,465,895, entitled SURGICAL STAPLER INSTRUMENT, issued November 19, 1995, and US Patent Application No. Serial 12/830,013, entitled SURGICAL STAPLING INSTRUMENTS, filed July 2, 2010, the entire descriptions of which are each incorporated by reference in the present invention. In an illustrative example, the closure system actuator 412 can be operably coupled to a closure tube 417. Actuation of the closure system actuator 412 can cause the closure tube 417 to move distally. Distal movement of closure tube 417 can pivotal movement of anvil 408 toward cartridge runner 410, which can effect tissue clamping.
[00079] Referring to Figures 25 to 27, the handle 402 of the surgical instrument for cutting and clamping 400 may further comprise the trigger actuator 415 for positioning the staples from the staple cartridge 411. The staple cartridge 411 may be divided by a central elongated slot 420, as illustrated in Figure 26. A plurality of staple receiving pockets 419 may be formed within the staple cartridge 411 and disposed in laterally spaced longitudinal rows. Clamps 423 can be operably supported on corresponding actuators 425 which are movably positioned within pockets 419, as illustrated in Figure 27. Actuators 425 may be disposed in laterally spaced longitudinal rows. Drivers 425 can be slidably received within pockets 419. Each driver 425 can support a single clip or more clips 423 so that movement of driver 425 through pocket 419 can position clip or clips 423 as illustrated in Figure 27.
[00080] The cartridge 411 may also include longitudinal slots (not shown) arranged to receive wedges 421 that are provided at a distal end of a trigger arrangement (not shown) which, in turn, can be operatively coupled to trigger actuator 415 on cable 402. Driving trigger actuator 415 can cause wedges 421 to move distally by moving trigger trigger distally through stem 404. Wedges 421 can be moved distally through slots are longitudinal into the cartridge 411. Each wedge 421 may comprise an elongated portion 421a and a cam portion 421b. A cam portion 421b may include an individualized angle cam top surface 421c. Under distal movement of wedges 421, cam surfaces 421c can engage and push upwardly triggers 425 on staple cartridge 411 to trigger staples 423 toward anvil 408. triggers in accordance with the present disclosure are disclosed in US Patent No. 5,465,895, entitled SURGICAL STAPLER INSTRUMENT, issued November 19, 1995, and US Patent No. 7,669,746, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, issued March 2, 2010, the full descriptions are each incorporated herein by reference in the present invention.
[00081] Referring again to Figures 25 and 26, the surgical instrument for cutting and holding 400 may also include a cutting member actuator 413, a driving member 446, and a cutting member 422. The cutting member 422 can move through slit 420, along longitudinal axis LL. As illustrated in the exploded view in Figure 26, cartridge 411 may include a first rail 424 and a second rail 426. Rails 424 and 426 may extend along longitudinal axis LL so that they are substantially parallel to one another. . In addition, rails 424 and 426 may extend in a plane that is substantially perpendicular to top surface 418, with second rail 426 being closer to top surface 418 than first rail 424. A distal portion 428 of first rail 424 may converge to intersect with second rail 426 at a junction point 430. Rails 424 and 426 may further extend distally beyond junction point 430, forming a portion of common rail 432.
[00082] Referring to Figures 26 and 28 to 31, the cutting member 422 may include a fabric cutting edge 434, a first pin 436, a second pin 438 and an engaging portion 440. The cutting member 422 may be move between a proximal start position 442 as illustrated in Figure 28 and a distal end position 444 as illustrated in Figure 30. At the proximal start position 442, the first pin 436 can move on the first rail 424 and the second pin 438 is movable on the second rail 426, which causes the cutting member 422 to remain in an unpositioned orientation. In the unpositioned orientation, as illustrated in Figure 28, the fabric cutting edge 434 of the cutting member 422 is not exposed above the top surface 418.
[00083] As illustrated in the exploded view of Figure 26, the lead member 446 may include a retraction hook 448 and an insertion tip 450. The lead member 446 may be operatively coupled, on a proximal portion thereof, to the member actuator. cutter 413 so that an operator of surgical instrument 400 can advance lead member 446 distally by cutting member actuator 413 distally, and can retract cutting member actuator 446 proximally by retracting the actuator. of cutting member 413 proximally.
[00084] Referring to Figures 28 and 29, advancing the lead member 446 in a distal position can bring the insertion tip 450 into the engaging socket with the engaging portion 440 of the cutting member 422. With the first pin 436 if moving on first rail 424 and second pin 438 moving on second rail 426, further advancement of lead member 446 may allow cutting member 422 to move distally from proximal start position 442 through slot 420, as illustrated in Figure 29.
[00085] Referring to Figures 29 and 30, cutting member 422 may be advanced distally in an unpositioned orientation along rails 424 and 426 until first pin 436 enters distal portion 428 of first rail 424. The distal 428 may comprise a cam surface 452 which may cause the first pin 436 to be lifted towards the junction point 430 as the cutting member 422 continues to be advanced distally. As a result, the cutting member 422 is gradually transitioned from an unpositioned orientation, as illustrated in Figure 29, in which the fabric cutting edge 434 is not exposed above the top surface 418, to a positioned orientation, as illustrated. in Figure 30, where the fabric cutting edge 434 is exposed above the top surface 418. In other words, advancing the first pin 436 against the cam surface 452 can cause the cutting member 422 to move around. from a transverse axis to the longitudinal axis LL, resulting in the positioning of the fabric cutting edge 422.
[00086] Referring again to Figures 29 and 30, as the cutting member 422 transitions from an unpositioned orientation to a positioned orientation, as described above, the first pin 436 may enter the common portion of the rail 432. , engagement portion 440 of cutting member 422 is releaseable from engagement engagement with insertion tip 450 and may enter engagement engagement with retraction hook 448, as illustrated in Figure 30.
[00087] Now with reference to Figures 30 and 31, the positioned cutting member 422 can then move proximally from the distal end position 444 towards the proximal start position 442 in response to the retraction movements by leading member 446. As illustrated in Figure 30, tissue cutting edge 434 is shown proximally at distal end position 444. Retracting lead member 446 may cause cutting member 422 to move proximally to along the longitudinal axis LL. As the cutting member begins to move proximally, the first pin 436 moves on a common portion of the rail 432 and the second pin 438 moves on the second rail 426. Upon reaching the junction point 430, the first pin 436 is prevented from re-entering distal portion 428 of first rail 424 by lead member 446. Instead, first pin 436 enters second rail 426. As illustrated in Figure 31, both pins 436 and 438 are movable in second rail 426 for an equilibrium movement of the proximally positioned cutting member 422.
[00088] In certain embodiments, the anvil 408 may comprise a slit (not shown) corresponding to the slit 420 in the cartridge 411. The anvil slit 408 may also extend along the longitudinal axis LL and may receive an upper portion of the section of positioned cutting member 422 exposed above top surface 418 during retraction of cutting member 422 through slot 420.
[00089] In certain embodiments, wedges 421 can be operatively coupled to move simultaneously with the driving member 446, so that a common actuator element (not shown) can simultaneously move the wedges 421 and the driving member 446. For example, during a first stroke of the common actuator element, wedges 421 may be advanced distally simultaneously with conductive member 446 so that wedges 421 contact actuators 425 as insertion tip 450 of conductive member 446 enters the seat of the engages with engaging portion 440 of cutting member 422. During first stroke balancing, unpositioned cutting member 422 can be advanced simultaneously with wedges 421 through staple cartridge 411, as staples 423 are positioned by wedges 421. At the end of the first stroke, the cutting member 422 can reach a fully positioned orientation with a fabric cutting edge presented in a manner. Will proximal 434 at distal end position 444, as previously discussed and as illustrated in Figure 30. During a second stroke of the common actuator element, cutting member 422 can be retracted to cut through tissue now stapled with staples 423. 421 can be simultaneously retracted with the cutting member 422.
[00090] The surgical instrument 400 can be used in performing a surgical tissue cutting and fixation procedure. An operator can activate the actuator of the closure system 412 of the cable 402 to hold and pinch the fabric between the anvil 408 and the staple cartridge 411. The operator can then activate the trigger actuator 415 to position the staples 423, as per described in detail above. When clips 423 are fired into tissue, the operator can then advance cutting member 422 distally in an unpositioned orientation by advancing cutting member actuator 413. Upon reaching distal end position 444, the cutting member 422 achieves a fully positioned orientation. The operator may then retract the fully positioned cutting member 422 by retracting the cutting member actuator 413. The proximally presented tissue cutting edge 434 may cut through the tissue clamped between the anvil 408 and the cartridge 411, to measure that the cutting member 422 is proximally retracted. The transected tissue can then be released from the end actuator 406 by actuating the closure system actuator 412 to open the anvil 408.
[00091] Referring to Figures 32 to 36, in an alternative embodiment a first rail 424' may replace the first rail 424 of the staple cartridge 411. As illustrated in Figure 33, the first rail 424' may start at a portion distal to the along the length of staple cartridge 411. Cutting member 422 is movable from a proximal start position 442' as illustrated in Figure 33 to a distal end position 444 as illustrated in Figure 35. starting proximally 442', the first pin 436 is movable in the first rail 424', and the second pin 438 is movable in the second rail 426, causing the cutting member 422 to remain in an unpositioned orientation. As illustrated in Figure 33, in an unpositioned orientation, the fabric cutting edge 434 of the cutting member 422 is not exposed above the top surface 418.
[00092] Referring to Figures 33 and 34, advancing the lead member 446 in a distal position can bring the insertion point 450 into the engagement socket with the engagement portion 440 of the cutting member 422. With the first pin 436 if moving on the first rail 424', and the second pin 438 moving on the second rail 426, further advancement of the lead member 446 may allow the cutting member 422 to travel a short distance distally from the proximal start position 242' through slot 420, as illustrated in Figure 34.
[00093] Referring to Figures 34 and 35, the cutting member 422 can be advanced distally in an unpositioned orientation a short distance along the rails 424' and 426, until the first pin 436 enters the distal portion 428' of the first rail 424'. Distal portion 428' may comprise a cam surface 452' which may cause first pin 436 to be lifted towards juncture point 430 as cutting member 422 continues to be advanced distally. As a result, the cutting member 422 is gradually transitioned from an unpositioned orientation, as illustrated in Figure 33, with the fabric cutting edge 434 not exposed above the top surface 418, to a positioned orientation, as illustrated. in Figure 35, with the fabric cutting edge 434 being exposed above the top surface 418. In other words, advancing the first pin 436 against the cam surface 452' may cause the cutting member 422 to move in around an axis transverse to the longitudinal axis LL, resulting in the positioning of the fabric cutting edge 434.
[00094] Referring again to Figure 35, as the cutting member 422 transitions from an unpositioned orientation to a positioned orientation, as described above, the first pin 436 may enter the common portion of the rail 432. engaging portion 440 of cutting member 422 may be released from engagement engagement with insertion tip 450 and may enter engagement engagement with retraction hook 448, as illustrated in Figure 35.
[00095] Now referring to Figures 35 and 36, the positioned cutting member 422 may then move proximally from the distal end position 444 in response to retraction of movements by the lead member 446. As illustrated in Figure 35, tissue cutting edge 434 is presented proximally at distal end position 444. Retraction of lead member 446 may cause cutting member 422 to move proximally along longitudinal axis LL. As the cutting member 422 begins to move proximally, the first pin 436 moves on a common portion of the rail 432, and the second pin 438 moves on the second rail 426. Upon reaching the junction point 430, the first pin 436 is prevented from re-entering the distal portion 428' of the first rail 424' by the lead member 446. Instead, the first pin 436 enters the second rail 426. As illustrated in Figure 36, both pins 436 and 438 can to move on the second rail 426 to balance the movement of the proximal cutting member 422.
[00096] Various modalities are described and illustrated in this descriptive report to prepare for a general understanding of the elements, steps, and use of the featured device and methods. It is understood that the various modalities described and illustrated in this descriptive report are non-limiting and incomplete. Thus, the invention is not limited by the description of the various non-limiting and incomplete embodiments presented in this descriptive report. Under appropriate circumstances, components and features described in conjunction with various embodiments may be combined, modified, or rearranged with the steps, components, elements, features, features, limitations, and the like of other embodiments. These modifications and variations are intended to comprise the scope of this descriptive report. As such, claims may be amended to report any elements, steps, limitations, components, and/or characteristics expressly or inherently described in, or even expressly or inherently supported by, this descriptive report. Furthermore, applicants reserve the right to modify the claims to affirmatively disclaim the elements, steps, limitations, components, and/or features that are present in the prior art, regardless of whether such components are explicitly described herein. Therefore, any such amendments comply with the requirements of 35 U.S.C § 112, first paragraph, and 35 U.S.C § 132(a). The various modalities presented and described in this specification may comprise, consist of, or consist essentially of the steps, limitations, components, and/or characteristics as described herein in various ways.
[00097] Any patent, publication, or other descriptive material identified in the present invention is incorporated into the present invention in its entirety, unless otherwise indicated, but only to the extent that the incorporated material does not conflict with definitions, statements or other descriptive material expressly set out in this description. Accordingly, and to the extent necessary, the express description as presented in this specification supersedes any conflict of material incorporated by reference in the present invention. Any material or portion thereof, incorporated by reference into this specification but which conflicts with definitions, statements or other description of materials described herein will be incorporated herein only to the extent that no conflict arises between the incorporated material. and the material from the existing description. Applicants reserve the right to modify this descriptive report to expressly address any subject matter, or portion thereof, incorporated by reference in the present invention.
[00098] The devices described here may be designed to be discarded after single use, or they may be designed to be used multiple times. In either case, however, the device can be refurbished for reuse after at least one use. Refurbishment may include a combination of the steps of disassembling the device, followed by cleaning or replacing specific parts, and subsequent reassembly. In particular, the device can be disassembled and any number of particular parts or parts of the device can be selectively replaced or removed in any combination. After cleaning and/or changing specific parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will note that reconditioning a device can use a variety of different techniques for disassembly, cleaning/replacement and reassembly. The use of such techniques and the resulting refurbished device are all within the scope of this order.
[00099] Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK® bag. The container and instrument are then placed in a radiation field that can penetrate the container, such as ethylene oxide, undergo water vapor, be autoclaved, be submerged in a sterilizing liquid, be exposed to gamma radiation, X-rays, or higher energy electrons. Radiation kills bacteria in the instrument and in the container. The sterilized instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened at the medical facility.

权利要求:
Claims (15)
[0001]
1. Surgical cutting instrument (100, 200, 300, 400), characterized in that it comprises: a first claw element (108, 208, 308, 408); a second gripper element (110, 210, 310, 410); wherein the first claw element is movably supported relative to the second claw element for selective movement between an open position and a closed position to clamp tissue therebetween after applying a closing motion; and a cutting member (122, 222, 322, 422) comprising a fabric cutting edge (134, 234, 334, 434) for cutting fabric trapped between the first grip element (108, 208, 308, 408) and the second claw element (110, 210, 310, 410) by applying a retracting movement proximal to the cutting member (122, 222, 322, 422), wherein the cutting member (122, 222, 322, 422) ) is configured to be advanced distally in a retracted configuration from a first position to a second position along a length of the second grip element (110, 210, 310, 410), and wherein the cutting member (122, 222 , 322, 422) is configured to leave the retracted configuration and adopt a cutting configuration in which the cutting edge (134, 234, 334, 434) is adapted to cut the fabric between the second position and the first position after application of the retract movement proximal to the cutting member (122, 222, 322 422).
[0002]
2. Surgical instrument (100, 200, 300, 400) according to claim 1, characterized in that the cutting member (122, 222, 322, 422) is movable from an uninstalled position to a installed position.
[0003]
3. Surgical instrument (100, 200, 300, 400) according to claim 2, characterized in that the cutting member (122, 222, 322, 422) is movable from the uninstalled position to the position installed by moving the cutting member (122, 222, 322, 422) around a positioning axis.
[0004]
4. Surgical instrument (100, 200, 300, 400) according to claim 3, characterized in that the second claw element (110, 210, 310, 410) defines a longitudinal axis, and in which the axis position transverse the longitudinal axis.
[0005]
5. Surgical instrument (100, 200, 300, 400) according to claim 3, characterized in that the cutting member (122, 222, 322, 422) comprises a piercing tip (335) configured to pierce through of tissue clamped between the first claw element (108, 208, 308, 408) and the second claw element (110, 210, 310, 410) by moving the cutting member (322) around the positioning axis .
[0006]
6. Surgical instrument (100, 200, 300, 400) according to claim 1, characterized in that the cutting member comprises an engagement portion configured to releasably engage with an actuating element (356) of the surgical instrument (100, 200, 300, 400).
[0007]
7. Surgical staple cartridge structure (411) for use with a surgical stapler (400), the staple cartridge structure (411) characterized in that it comprises: a staple cartridge compartment configured to be so-supported operable in the surgical stapler (400), wherein the staple cartridge compartment comprises: an upper surface (418); a slit (420); and at least one clip cavity (419); and a cutting member (422) positioned within the staple cartridge compartment, the cutting member (422) comprising a tissue cutting edge (434) configured to cut tissue, wherein the cutting member (422) is proximally retractable through the slit (420) by applying a retracting motion thereof, and wherein the tissue cutting edge (434) is proximally presented along a range of motion of the cutting member. (422) when the cutting member (422) is proximally retracted through the tissue, wherein the cutting member (422) is adapted to be advanced distally along the same range of motion without exposing the cutting edge of tissue (434) of the cutting member (422) above the upper surface (418) of the surgical staple cartridge compartment.
[0008]
8. Surgical staple cartridge structure (411) according to claim 7, characterized in that the cutting member (422) is movable from an uninstalled position to an installed position.
[0009]
9. Surgical staple cartridge structure (411) according to claim 8, characterized in that the cutting member (422) is movable from the uninstalled position to the installed position by moving the cutting member around of a positioning axis.
[0010]
10. A surgical staple cartridge structure (411) according to claim 8, characterized in that the cutting member (422) comprises a piercing tip configured to pierce through tissue by moving the cutting member (422) to the around the axis of positioning.
[0011]
11. A surgical staple cartridge structure (411) according to claim 7, characterized in that the cutting member (422) comprises an engagement portion configured to releasably engage with an actuator element of the surgical stapler ( 400).
[0012]
A surgical instrument (100, 200, 300, 400) according to any one of claims 1 to 3, being a surgical cutting and clamping instrument comprising an elongated rod (104, 204, 304, 404), characterized in that which comprises: the second claw element (110, 210, 310, 410) comprises an elongate channel operatively coupled to the elongate rod (104, 204, 304, 40) and configured to operatively support a staple cartridge (411) in the same; the first claw element (108, 208, 308, 408) comprises a supported anvil movable relative to the elongated channel for selective movement between an open position and a closed position, wherein tissue is held between the anvil and a staple cartridge. (411) supported within the elongated channel in response to opening and closing motions applied thereto from the elongated rod (104, 204, 304, 404).
[0013]
13. Surgical instrument (100, 200, 300, 400) according to claim 12, characterized in that the cutting member (122, 222, 322, 422) comprises a piercing tip (335) configured to pierce through of tissue clamped between the anvil and staple cartridge by moving the cutting member (122, 222, 322, 422) around the positioning axis.
[0014]
14. Surgical instrument (100, 200, 300, 400) according to claim 12, characterized in that the cutting member (122, 222, 322, 422) comprises an engagement portion configured to releasably engage with an actuating element (356) of the stapler.
[0015]
15. Surgical instrument (100, 200, 300, 400), according to claim 12, characterized in that the cutting member (122, 222, 322, 422) is advanced distally without exposing the cutting edge of the tissue ( 134, 234, 334, 434) of the cutting member (122, 222, 322, 422) above the top surface (418) of the staple cartridge housing (411) supported in the elongated channel.

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US20140103093A1|2014-04-17|

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