• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
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    • 专利摘要:
    motorized rotary entry circular stapler with modular end actuator. the present description relates to a surgical stapling device (200) comprising a handle assembly (210), a shank assembly (230) and a stapling head assembly (240). the rod assembly comprises a rotating drive shaft (232) that translates between two longitudinal positions to switch between a tissue pinching mode and a tissue cutting/stapling mode. the stapling head assembly includes a first set of rotary drive elements (280) that convert the rotary motion of the drive shaft into a tissue pinching action when the drive shaft is in a distal position. the stapling head assembly also includes a second set of rotary drive elements (250) and (260) that convert the rotary motion of the drive shaft into a tissue cutting/stapling action when the drive shaft is in a position proximal. the drive shaft can be driven manually or by motor. the stapling head assembly can be supplied in the form of a cartridge which is removable from the shank assembly.
    公开号:BR112015014025B1
    申请号:R112015014025-4
    申请日:2013-12-16
    公开日:2021-08-31
    发明作者:Jeffrey S. Swayze；Chester O. Baxter, Iii；Frederick E. Shelton, Iv.
    申请人:Ethicon Endo-Surgery, Inc.；
    IPC主号:
    专利说明:

    BACKGROUND
    [001] In some configurations, a surgeon may wish to position a surgical instrument through a patient's orifice and use the instrument to adjust, position, secure and/or otherwise interact with tissues within the patient. For example, in some surgical procedures, portions of the gastrointestinal tract may be cut and removed to eliminate unwanted tissue, or for other reasons. Once the tissue is removed, the remaining portions may need to be re-attached. One of the tools for performing these anastomotic procedures is a circular stapler that is inserted through a patient's orifice.
    [002] Examples of surgical circular staplers are described in US Patent No. 5,205,459 entitled "Surgical Anastomosis Stapling Instrument", issued April 27, 1993; US Patent No. 5,271,544 entitled "Surgical Anastomosis Stapling Instrument", issued December 21, 1993; US Patent No. 5,275,322, entitled "Surgical Anastomosis Stapling Instrument", issued January 4, 1994; US Patent No. 5,285,945 entitled "Surgical Anastomosis Stapling Instrument", issued February 15, 1994; US Patent No. 5,292,053 entitled "Surgical Anastomosis Stapling Instrument", issued March 8, 1994; US Patent No. 5,333,773 entitled "Surgical Anastomosis Stapling Instrument", issued August 2, 1994; US Patent No. 5,350,104 entitled "Surgical Anastomosis Stapling Instrument", issued September 27, 1994; and US Patent No. 5,533,661 entitled "Surgical Anastomosis Stapling Instrument", issued July 9, 1996. The description of each of the above-cited US patents is incorporated by reference into the present invention. Some of these staplers work to secure layers of fabric, cut through the attached layers of fabric and cause the staples to pass through the layers of fabric to substantially join the cut layers of fabric together, close to their cut ends, thus joining two separate ends of an anatomical lumen.
    Merely additional examples of surgical staplers are set forth in US Patent No. 4,805,823 entitled "Pocket Configuration for Internal Organ Staplers", issued January 21, 1989; U.S. Patent No. 5,415,334 entitled "Surgical Stapler and Staple Cartridge", issued May 16, 1995; U.S. Patent No. 5,465,895 entitled "Surgical Stapler Instrument", issued November 14, 1995; US Patent No. 5,597,107 entitled "Surgical Stapler Instrument", issued January 28, 1997; US Patent No. 5,632,432 entitled "Surgical Instrument", issued May 27, 1997; US Patent No. 5,673,840 entitled "Surgical Instrument", issued October 7, 1997; US Patent No. 5,704,534 entitled "Articulation Assembly for Surgical Instruments", issued January 6, 1998; US Patent No. 5,814,055 entitled "Surgical Clamping Mechanism", issued September 29, 1998; US Patent No. 6,978,921 entitled "Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism", issued December 27, 2005; U.S. Patent No. 7,000,818 entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued February 21, 2006; U.S. Patent No. 7,143,923 entitled "Surgical Stapling Instrument Having a Firing Lockout for an Unclosed Anvil", issued December 5, 2006; US Patent No. 7,303,108 entitled "Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack", issued December 4, 2007; US Patent No. 7,367,485 entitled "Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission", issued May 6, 2008; US Patent No. 7,380,695 entitled "Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of Firing", granted June 3, 2008; US Patent No. 7,380,696 entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism", granted June 3, 2008; US Patent No. 7,404,508 entitled "Surgical Stapling and Cutting Device", issued July 29, 2008; U.S. Patent No. 7,434,715 entitled "Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout", issued October 14, 2008; and US Patent No. 7,721,930 entitled "Disposable Cartridge with Adhesive for Use with a Stapling Device", issued May 25, 2010. The description of each of the above-cited US patents is incorporated herein by reference. Although the aforementioned surgical staplers are described as being used in endoscopic procedures, it should be understood that these surgical staplers can also be used in open procedures and/or other non-endoscopic procedures.
    [004] Although various types of surgical stapling instruments and associated components have been manufactured and used, it is believed that no one prior to the inventors has manufactured or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS
    [005] Although the specification concludes with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which the same numbers references identify the same elements and where:
    [006] Figure 1 represents a side elevation view of an example of a surgical instrument for circular stapling,
    [007] Figure 2A represents an enlarged longitudinal cross-sectional view of an exemplary stapling head assembly of the instrument of Figure 1, showing an exemplary anvil in an open position,
    [008] Figure 2B represents an enlarged longitudinal cross-sectional view of the clamping head assembly of Figure 2A, showing the anvil in a closed position,
    [009] Figure 2C represents an enlarged longitudinal cross-sectional view of the stapling head assembly of Figure 2A, showing a staple driver and an exemplary blade in a fired position,
    [0010] Figure 3 represents an enlarged partial cross-sectional view of an exemplary clamp formed against the anvil,
    [0011] Figure 4A is an enlarged side elevation view of an exemplary actuator cable assembly of the surgical instrument of Figure 1, with a portion of the body removed, showing a trigger in an unfired position and a locking feature in a locked position,
    [0012] Figure 4B represents an enlarged side elevation view of the actuator cable assembly of Figure 4A, showing the trigger in a fired position and the locking feature in an unlocked position,
    [0013] Figure 5 represents an enlarged partial perspective view of an exemplary indicator assembly of the surgical instrument of Figure 1, showing an indicator window and an indicator lever,
    [0014] Figure 6 represents a diagrammatic view of the indicator window of Figure 5, showing an exemplary indicator bar and corresponding exemplary clamp representations,
    [0015] Figure 7A is a perspective view of an alternative circular stapling surgical instrument, with an anvil uncoupled from a trocar;
    [0016] Figure 7B represents a perspective view of the surgical instrument of Figure 7A, with the anvil coupled with the trocar;
    [0017] Figure 8 represents a partially exploded view of the surgical instrument of Figure 7A, showing components of the stapling head assembly;
    [0018] Figure 9 is a partial perspective view of the distal end of the rotary drive shaft of the surgical instrument of Figure 7A;
    [0019] Figure 10 represents a perspective view of a first rotary drive element of the clamping head assembly of Figure 8;
    [0020] Figure 11 is a cross-sectional view of the first rotary drive element of Figure 10, taken along line 11-11 of Figure 10;
    [0021] Figure 12 represents a perspective view of a second rotary drive element of the clamping head assembly of Figure 8;
    [0022] Figure 13 is a perspective view of a drive nut of the clamping head assembly of Figure 8;
    [0023] Figure 14 represents a perspective view of a clamping actuator of the clamping head assembly of Figure 8;
    [0024] Figure 15 is a perspective view of the trocar of the stapling head assembly of Figure 8;
    [0025] Figure 16A is a cross-sectional side view of the stapling head assembly of Figure 8, with the anvil in an open position and with the rotary drive shaft in a distal position;
    [0026] Figure 16B represents a cross-sectional side view of the stapling head assembly of Figure 8, with the anvil in a closed position and with the rotary drive shaft in the distal position;
    [0027] Figure 16C represents a cross-sectional side view of the clamping head assembly of Figure 8, with the anvil in the closed position and with the rotary drive shaft displaced to a proximal position;
    [0028] Figure 16D is a cross-sectional side view of the staple head assembly of Figure 8, with the staple driver and blade in a fired position;
    [0029] Figure 17A is a perspective view of the staple head assembly of Figure 8, with the staple head cartridge coupled to the rod assembly;
    [0030] Figure 17B represents a perspective view of the staple head assembly of Figure 8, with the staple head cartridge uncoupled from the rod assembly; and
    [0031] Figure 18 represents a cross-sectional view of the distal end of the stem assembly of the surgical instrument of Figure 7A.
    [0032] The drawings are not intended to be limiting in any way, and it is contemplated that various modalities of the technology may be carried out in a variety of other ways, including those not necessarily represented in the drawings. The drawings incorporated in the annex and forming a part of the descriptive report illustrate various aspects of the present technology, and together with the description they serve to explain the principles of the technology; it is understood, however, that this technology is not limited precisely to the provisions shown. DETAILED DESCRIPTION
    [0033] The following description of some examples of the technology should not be used to limit its scope. Other examples, elements, aspects, modalities and advantages of the technology will become evident to those skilled in the art with the following description, which is through illustrations, one of the best ways contemplated for carrying out the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without departing from the technology. Consequently, the drawings and descriptions are to be regarded as illustrative in nature and not restrictive. I. Overview of the exemplary surgical instrument for circular stapling
    [0034] Figures 1 to 6 represent an example of circular surgical stapling instrument 10, having a stapling head assembly 20, a rod assembly 60 and an actuator cable assembly 70, each of which will be described in detail below. Stem assembly 60 extends distally from actuator cable assembly 70, and clamping head assembly 20 is coupled to a distal end of stem assembly 60. In summary, actuator cable assembly 70 functions in such a way as to activating a staple driver 24 of the staple head assembly 20 to drive a plurality of staples 66 out of the staple head assembly 20. To form finished staples, staples 66 are bent by an anvil 40 that is secured to the distal end. of instrument 10. Consequently, tissue 2 shown in Figures 2A to 2C can be stapled using instrument 10.
    [0035] In the present example, the instrument 10 comprises a closing system and a triggering system. The closure system comprises a trocar 38, a trocar actuator 39 and a rotary knob 98. An anvil 40 can be coupled to a distal end of the trocar 38. The rotary knob 98 is intended to longitudinally translate the trocar 38 with respect to the assembly of clamping head 20, thus translating the anvil 40 when the anvil 40 is coupled to the trocar 38, to clamp tissue between the anvil 40 and the clamping head assembly 20. The firing system comprises a trigger 74, an assembly of trigger drive 84, a trigger actuator 64, and a staple trigger 24. The staple trigger 24 includes a knife 36 configured to cut tissue when the staple trigger 24 is actuated longitudinally. In addition, clips 66 are positioned distally to a plurality of clip drive elements 30 of clip driver 24, so that clip driver 24 also drives clips 66 distally when clip driver 24 is actuated longitudinally. Thus, when trigger 74 is actuated and trigger drive assembly 84 actuates clamp driver 24 via drive actuator 64, knife 36 and elements 30 substantially simultaneously cut tissue 2 and drive the staples 66 distally to the staple head assembly 20 and into tissue. The components and functionalities of the closing system and the triggering system will now be described in more detail. A. Anvil example
    [0036] As shown in Figures 1 to 2C, the anvil 40 is selectively attachable to the instrument 10 to provide a surface against which the clips 66 can be folded to staple the material contained between the clipping head assembly 20 and the anvil 40. The anvil 40 of the present example is selectively attachable to a trocar or sharpened rod 38, which extends distally to the clamping head assembly 20. Referring to Figures 2A through 2C, the anvil 40 is selectively attachable upon attachment from a proximal shaft 42 of the incus 40 to a distal tip of the trocar 38. The incus 40 comprises a generally circular anvil head 48 and a proximal shaft 42 extending proximally from the head of the incus 48. In the example shown, the proximal shaft 42 comprises a tubular member 44 having resiliently slanted retaining tabs 46 to selectively couple the anvil 40 to the trocar 38, although this is It is only optional, and it should be understood that other retention features for attaching the anvil 40 to the trocar 38 may also be used. For example, C-clips, staples, threads, pins, stickers, etc. may be employed to couple the incus 40 to the trocar 38. Furthermore, although the incus 40 is described as selectively attachable to the trocar 38, in some versions the proximal rod 42 may include a one-way coupling feature so that, once fixed, the anvil 40 cannot be removed from the trocar 38. Merely exemplary unidirectional elements include barbs, unidirectional snap buttons, tweezers, collars, flaps, bands, etc. Of course still other configurations for coupling anvil 40 to trocar 38 will be apparent to one of skill in the art in view of the teachings of the present invention. For example, trocar 38 may instead be a hollow shaft, and proximal shaft 42 may comprise a sharpened shaft that can be inserted into the hollow shaft.
    [0037] The anvil head 48 of the present example comprises a plurality of clip-forming pockets 52 formed on a proximal face 50 of the anvil head 48. Consequently, when the anvil 40 is in the closed position and the clips 66 are driven to outside the staple head assembly 20 and into the staple forming pockets 52, as shown in Figure 2C, legs 68 of staples 66 are bent to form finished staples.
    [0038] With the anvil 40 as a separate component, it should be understood that the anvil 40 can be inserted and secured to a portion of tissue 2 before being coupled to the stapling head assembly 20. By way of example only, the anvil 40 can be inserted and secured to a first tubular tissue portion 2, while the instrument 10 is inserted and secured to a second tubular tissue portion 2. For example, the first tubular tissue portion 2 can be sutured to or around a portion of the incus 40, and the second tubular tissue portion 2 may be sutured in or around the trocar 38.
    [0039] As shown in Figure 2A, the incus 40 is then coupled to the trocar 38. The trocar 38 of the present example is shown in a more distal actuated position. This extended position of the trocar 38 can provide a larger area to which tissue 2 can be attached, prior to attachment of the incus 40. In addition, the extended position of the trocar 38 can also provide easier attachment of the incus 40 to the trocar. 38. Trocar 38 additionally includes a tapered distal tip. This tip may be capable of piercing through tissue, and/or assisting in the insertion of incus 40 into trocar 38, although the tapered distal tip is merely optional. For example, in other versions the trocar 38 may have a non-piercing tip. Additionally, or alternatively, the trocar 38 may include a magnetic portion not shown that can attract the incus 40 towards the trocar 38. Of course, other configurations and arrangements for the incus 40 and the trocar 38 will be apparent to those skilled in the art, in view of the teachings contained herein.
    [0040] When the anvil 40 is coupled to the trocar 38, the distance between a proximal face of the anvil 40 and a distal face of the clamping head assembly 20 defines a span distance d. The trocar 38 of the present example is translatable longitudinally with respect to the clamping head assembly 20 by means of an adjustment knob 98 located at a proximal end of the actuator cable assembly 70, as will be described in more detail below. Consequently, when the anvil 40 is coupled to the trocar 38, rotation of the adjustment knob 98 extends or reduces the span distance d by actuating the anvil 40 relative to the clamping head assembly 20. For example, as shown sequentially in Figures 2A to 2B, the anvil 40 is shown acting proximally to the actuator cable assembly 70, from an initial open position to a closed position, thus reducing the gap distance between the two portions of 2 fabric to be joined. When the gap distance is placed within a predetermined range, the stapling head assembly 20 can be heated, as shown in Figure 2C, to staple and cut the fabric 2 between the anvil 40 and the stapling head assembly 20. stapling head assembly 20 is intended to staple and cut fabric 2 by a user turning a trigger 74 of actuator cable assembly 70, as will be described in more detail below.
    [0041] As noted above, the span distance d corresponds to the distance between the anvil 40 and the stapling head assembly 20. When instrument 10 is inserted into a patient, this span distance d may not be easily visible. Accordingly, a movable indicator bar 110, shown in Figures 5 to 6, is arranged to be visible through an indicator window 120 positioned opposite the trigger 74. The indicator bar 110 is intended to move in response to rotation of the knob. setting 98 so that the position of the indicator bar 110 is representative of the span distance d. As shown in Figure 6, the indicator window 120 further comprises a scale 130 indicating that the anvil span is in a desired operating range (e.g., a green colored region or "green zone") and a representation of corresponding staple compression at each end of scale 130. By way of example only, as shown in Figure 6, a first staple image 132 represents a large staple height, while a second staple image 134 represents a small staple height. Consequently, a user can view the position of the coupled anvil 40 relative to the clamping head assembly 20 via the indicator bar 110 and the scale 130. The user can then adjust the positioning of the anvil 40 via the adjustment knob 98 as needed.
    [0042] Referring again to Figures 2A to 2C, a user sutures a portion of the fabric 2 around the tubular element 44 so that the head of the anvil 48 is situated on a portion of the fabric 2 to be stapled. When tissue 2 is secured to anvil 40, retaining tabs 46 and a portion of tubular member 44 protrude from tissue 2 so that the user can attach anvil 40 to trocar 38. With tissue 2 attached to tissue 2 trocar 38 and/or the other portion of the stapling head assembly 20, the user attaches the anvil 40 to the trocar 38 and drives the anvil 40 proximally toward the stapling head assembly 20 to reduce the gap distance d. When the instrument 10 is within the operating range, the user then staples the ends of the fabric 2, thus forming a substantially contiguous tubular portion of the fabric 2.
    The anvil 40 may be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. B. Example Stapling Head Assembly
    [0044] The clamping head assembly 20 of the present example is coupled to a distal end of the rod assembly 60 and comprises a tubular housing 22 housing a sliding clamp driver 24 and a plurality of clamps 66 contained in the clamp pockets 32. Clamps 66 and staple pockets 32 are disposed in a circular array around tubular housing 22. In the present example, staples 66 and staple pockets 32 are arranged in a pair of concentric annular rows of staples 66 and staple pockets 32. clamp driver 24 is intended to actuate longitudinally within tubular housing 22 in response to rotation of trigger 74 of actuator cable assembly 70. As shown in Figures 2A to 2C, clamp driver 24 comprises a flared cylindrical element having a trocar opening 26, a central recess 28 and a plurality of elements 30 circumferentially disposed around the central recess 28 and extending distally. and with respect to rod assembly 60. Each element 30 is configured to contact, and engage with, a corresponding clip 66 of the plurality of clips 66 in clip pockets 32. Consequently, when clip actuator 24 is actuated distal to the actuator cable assembly 70, each element 30 drives a corresponding clip 66 out of its clip pocket 32 through a clip opening 34 formed in a distal end of the tubular housing 22. extends from the staple driver 24, the plurality of staples 66 are driven out of the staple head assembly 20 at substantially the same time. When the anvil 40 is in the closed position, the staples 66 are driven into staple-forming pockets 52 for flexing the legs 68 of the staples 66, thereby staple the material located between the anvil 40 and the staple head assembly 20. Figure 3 depicts a merely exemplary staple 66 carried by an element 30 in a staple-forming pocket 32 of the anvil 40 for flexing the legs 68.
    [0045] The staple driver 24 additionally includes a cylindrical knife 36 that is coaxial to the opening of the trocar 26 and insertion of the staple pockets 32. In the present example, the cylindrical knife 36 is disposed within the central recess 28 to translate distally with the staple driver 24. When the anvil 40 is secured to the trocar 38, as described above, the head of the anvil 48 provides a surface against which the cylindrical knife 36 cuts the material contained between the anvil 40 and the clamping head assembly 20 In some versions, the anvil head 48 may include a not-shown recess for the cylindrical knife 36 to help cut material (eg, by providing a cooperative cutting edge). Additionally, or alternatively, the anvil head 48 may include one or more opposing cylindrical knife knives not shown offsetting the cylindrical knife 36 so that it can provide a scissor-like cutting action. Still other configurations will be evident to those skilled in the art in view of the teachings contained herein. The stapling head assembly 20 thus functions both to staple and to cut the fabric 2 substantially simultaneously in response to actuation by the actuator cable assembly 70.
    [0046] Logically, the clamping head assembly 20 can be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
    [0047] As noted earlier, the staple driver 24 includes a trocar opening 26. The trocar opening 26 is configured to allow the trocar 38 to slide longitudinally with respect to the clamping head assembly 20 and/or stem assembly 60 As shown in Figures 2A to 2C, the trocar 38 is coupled to a trocar actuator 39 so that the trocar 38 can be actuated longitudinally by rotating the rotary knob 98, as will be described in more detail below with reference to the assembly. of actuator cable 70. In the present example, the trocar actuator 39 comprises an elongated, relatively rigid rod coupled to the trocar 38, although this is merely optional. In some versions, actuator 39 can comprise a longitudinally rigid material while allowing lateral flexion so that portions of instrument 10 can be selectively flexed or curved during use; or instrument 10 may include a previously prepared bent rod assembly 60. A merely exemplary material is nitinol. When the anvil 40 is coupled to the trocar 38, the trocar 38 and the anvil 40 are translatable via the actuator 39 to adjust the gap distance d between the anvil 40 and the clamping head assembly 20. Yet other additional configurations for that the actuator 39 longitudinally actuating the trocar 38 will be evident to the person skilled in the art, in view of the teachings contained herein. C. Rod Assembly Example
    [0048] The stapling head assembly 20 and the trocar 38 are positioned at a distal end of the stem assembly 60, as shown in Figures 2A through 2C. The rod assembly 60 of the present example comprises an outer tubular member 62 and a drive actuator 64. The outer tubular member 62 is coupled to the tubular sheath 22 of the clamping head assembly 20 and to a body 72 of the actuator cable assembly 70 , thus offering mechanical support for the actuating components contained therein. The proximal end of the trigger actuator 64 is coupled to a trigger trigger assembly 84 of the actuator cable assembly 70, described below. The distal end of actuating actuator 64 is coupled to clamp actuator 24 so that rotation of trigger 74 longitudinally actuates clamp actuator 24. As shown in Figures 2A to 2C, actuating actuator 64 comprises a tubular member having a longitudinal axis open so that the actuator 39 coupled to the trocar 38 can actuate longitudinally and in relation to the actuating actuator 64. It should be understood, of course, that other components may be disposed within the actuating actuator 64, as will be evident to the person versed in the technique, in view of the teachings contained herein.
    The rod assembly 60 may be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. D. Example of Actuator Cable Assembly
    [0050] Now referring to Figures 4A to 5, the actuator handle assembly 70 comprises a body 72, a trigger 74, a lockout feature 82, a trigger drive assembly 84 and a trocar drive assembly 90. The trigger 74 of the present example is pivotally mounted to the body 72 and is coupled to the trigger drive assembly 84 so that rotation of the trigger drive 74 from an unfired position shown in Figure 4A to a fired position shown in Figure 4B triggers the drive actuator 64 described above. A spring 78 is coupled to the body 72 and the trigger 74 to bias the trigger 74 toward the unfired position. The locking feature 82 is a pivoting element that is coupled to the body 72. In a first, locked position, the locking feature 82 is pivoted up and away from the body 72 so that the locking feature 82 engages the trigger. 74 and mechanically resists triggering of trigger 74 by a user. In a second unlocked position, as shown in Figures 1 and 4B, the locking feature 82 is rotated downward so that the trigger 74 can be actuated by the user. Consequently, with the locking feature 82 in the second position, the trigger 74 can engage a trigger drive assembly 84 to trigger the instrument 10.
    [0051] As shown in Figures 4A and 4B, the trigger drive assembly 84 of the present example comprises a sliding trigger carriage 86 engaged with a proximal end of the trigger actuator 64. The carriage 86 includes a set of tabs 88 on a proximal end of carriage 86 to retain and engage a pair of trigger arms 76 extending from trigger 74. Consequently, when trigger 74 is rotated, carriage 86 is longitudinally actuated and transfers longitudinal movement to the actuating actuator. 64. In the example shown, carriage 86 is fixedly coupled to the proximal end of drive actuator 64, although this is merely optional. Indeed, in a merely alternative example, carriage 86 may simply be in a position abutting drive actuator 64, while a distal spring (not shown) tilts drive actuator 64 proximally with respect to actuator cable assembly 70.
    [0052] Trigger actuation assembly 84 can be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
    [0053] Body 72 also houses a trocar drive assembly 90 configured to drive trocar 38 longitudinally in response to rotation of adjustment knob 98. As best shown in Figures 4A through 5, trocar drive assembly 90 of the present example comprises the adjustment knob 98, a splined stem 94 and a sleeve 92. The splined stem 94 of the present example is situated at a distal end of the trocar actuator 39, although it should be understood that the splined stem 94 and the actuator The trocar 39 may alternatively be separate components that engage to impart longitudinal movement. Adjustment knob 98 is pivotally supported by the proximal end of body 72, and functions to rotate sleeve 92 which is engaged with splined rod 94 by means of an inner tab not shown. The splined rod 94 of the present example comprises a continuous groove 96 formed in the outer surface of the splined rod 94. Consequently, when the adjustment knob 98 is rotated, the inner tab moves within the groove 96 and the splined rod 94 is actuated longitudinally with respect to sleeve 92. As the splined rod 94 is situated at the distal end of the trocar actuator 39, turning the adjustment knob 98 in a first direction advances the trocar actuator 39 distally with respect to the actuator handle assembly 70. Consequently , the gap distance d between the anvil 40 and the clamping head assembly 20 is increased. By turning the adjustment knob 98 in the opposite direction, the trocar actuator 39 is actuated proximally to the actuator cable assembly 70 to reduce the span distance d between the anvil 40 and the clamping head assembly 20. Thus, the trocar driving assembly 90 is intended to drive the trocar 38 in response to the b Rotary Adjustment Knob 98. Of course, other configurations for the Trocar Drive Assembly 90 will be apparent to the person skilled in the art in view of the teachings contained herein.
    The groove 96 of the present example comprises a plurality of different portions 96A, 96B, 96C having a different range or number of grooves per axial distance. The present groove 96 is divided into a distal portion 96A, a middle portion 96B and a proximal portion 96C. As shown in Figure 5, a distal portion 96A comprises a fine pitch or a high number of grooves along a short axial distance from the splined rod 94 so that a large number of rotations of adjustment knob 98 are required to travel the short axial distance. The middle portion 96B comprises a section with comparably thicker gap or with fewer grooves per axial distance so that relatively few rotations are needed to traverse a long axial distance. Consequently, the span distance d can be quickly reduced by relatively few rotations of the adjustment knob 98. The proximal portion 96C of the present example is substantially similar to the distal portion 96A and comprises a thin gap or a high number of grooves for a short axial distance from the splined rod 94 so that a large number of rotations is needed to traverse the short axial distance. The proximal portion 96C of the present example is positioned on the sleeve 92 when the anvil 40 is substantially close to the clamping head assembly 20 so that an indicator bar 110 moves within the indicator window 120 along the scale 130 to indicate the span. the anvil is within a desired operating range as will be described in detail below. Consequently, when the tab is within the proximal portion 96C of the groove 96, each rotation of the adjustment knob 98 can reduce the gap distance d to a small amount to provide fine tuning.
    The trocar actuation assembly 90 can be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
    [0056] In the example shown in Figures 4A through 4B, a U-shaped clip 100 is secured to an intermediate portion of the trocar actuator 39 located distally from the splined stem 94. In the present example, an extension of the trocar actuator 39 engages. a slot in the handle assembly housing 70 to prevent the trocar actuator 39 from rotating around its axis when the adjustment knob 98 is turned. In some other versions, the U-shaped clip 100 engages a portion of the body 72 to substantially prevent the trocar actuator 39 from rotating about its axis when the adjustment knob 98 is rotated. The U-shaped clip 100 of the present example further includes an elongated slot 102 on each of its opposite sides for receiving a connecting element, such as a thread, screw, pin, clip, etc., to selectively adjust a longitudinal slot position. elongated 102 of the U-shaped clip 100 relative to the trocar actuator 39 for purposes of calibrating the gauge bar 110 relative to the scale 130.
    [0057] As shown in Figure 5, the actuator cable assembly 70 further includes an indicator bracket 140 configured to engage and rotate an indicator 104. The indicator bracket 140 of the present example is slidable relative to the body 72 along a pair of slots formed in body 72. Indicator bracket 140 comprises a rectangular plate 144, indicator arm 146, and angled flange 142. Angle flange 142 is formed at the proximal end of rectangular plate 144, and includes an opening not shown for mounting to form sliding over the trocar actuator 39 and/or the splined rod 94. A coil spring 150 is interposed between the flange 142 and a protrusion 152 to bias the flange 142 against the U-shaped cleat 100. Consequently, when the cleat U-shaped 100 acts distally with trocar actuator 39 and/or splined rod 94, coil spring 150 forces indicator bracket 140 to move distally with U-shaped clamp 100. Thus, the U-shaped loop 100 forces the indicator bracket 140 proximally to the protrusion 152 as the trocar actuator 39 and/or the splined rod 94 translate proximally, thus compressing the coil spring 150. you should understand that, in some versions, indicator bracket 140 may be fixedly attached to trocar actuator 39 and/or grooved rod 94.
    [0058] In the present example, a portion of the locking feature 82 abuts a surface 141 of the indicator bracket 140 when said indicator bracket 140 is in a longitudinal position that does not correspond to when the anvil span is within a desired operating range eg a green colored region or "green zone". When the anvil span is within a desired operating range eg a green colored region or "green zone", the indicator bracket 140 thins to provide a pair of spans 145 on either side of an indicator arm 146 that allows allow the locking feature 82 to rotate, thereby releasing the trigger 74. Consequently, the locking feature 82 and the indicator bracket 140 can substantially prevent a user from releasing and operating the trigger 74 until the anvil 40 is in a predetermined operating range. . It should be understood, of course, that lockout feature 82 may be omitted entirely in some versions.
    [0059] This operating range may be visually communicated to the user by means of an indicator bar 110 of an indicator 104 shown against a scale 130, described briefly above. At the distal end of the index bracket 140 is a distally extending index arm 146 that terminates in a laterally extending finger 148 to control movement of the index 104. The index arm 146 and finger 148, best shown in Figure 5, are configured to engage the a tab 106 of indicator 104 so that indicator 104 is rotated when indicator bracket 140 is actuated longitudinally. In the present example, indicator 104 is pivotally coupled to body 72 at a first end of indicator 104, although this is merely optional, and other pivot points of indicator 104 will be apparent to one of ordinary skill in the art in view of the teachings contained herein. . An indicator bar 110 is positioned at the second end of indicator 104 such that indicator bar 110 moves in response to actuation of indicator bracket 140. Consequently, as discussed above, indicator bar 110 is displayed through an indicator window 120 against a scale 130 shown in Figure 6 to show the relative span distance d between the anvil 40 and the clamping head assembly 20.
    [0060] Logically, the bracket of the indicator 140, the indicator 104, and/or the actuator cable assembly 70 can be further constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US Patent No. 5,271,544; US Patent No. 5,275,322; US Patent No. 5,285,945; US Patent No. 5,292,053; US Patent No. 5,333,773; US Patent No. 5,350,104; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. II. Motorized circular stapling surgical instrument with selectable control
    [0061] In some cases, it may be desirable to provide motorized control of instrument 10. It may additionally be desirable to enable a user to select between motorized control or manual control of a motorized version of the circular surgical stapling instrument 10. For example, instrument 10 may include an operational mode selection assembly that allows the user to disengage an automated motorized activation system and provide manual actuation of that system. It may also be desirable to provide a switch set to change the mode of a single rotary drive between a fabric clamping mode and a fabric cutting/stapling mode. In other words, such a switch set can enable a single rotary drive to activate the anvil 40 clamping features or activate the knife 36 and clamp insertion features of instrument 10. The examples below include merely illustrative versions of instrument 10 where a single motor can be used to control both clamping and cutting/stapling of fabric through a single rotary drive; where the operator can select between motorized operation and manual operation; and a staple head cartridge assembly that responds to single rotary drive in motorized and manual operation.
    [0062] Figures 7A to 7B show an exemplary motorized stapling instrument 200 that serves as a variation of instrument 10. The stapling instrument 200 of this example includes a handle assembly 210, a rod assembly 230, and a head assembly. stapling 240. Like the stapling head assembly 20 described above, the stapling head assembly 240 of the present example is intended to engage an anvil 290, clamp the fabric with the anvil 290, cut the clamped tissue with the anvil 290 and propel the staples into tissue that is clamped with the anvil 290. The stapling instrument 200 can be used to create a secure anastomosis (eg, an end-to-end anastomosis) within a patient's gastrointestinal tract or elsewhere . The anvil 290 of this example includes a head 292, a shaft 294 that extends proximally of the head 294, and a proximal face 296 having concentric annular arrays of clips forming pockets not shown. Shaft 294 is configured to removably engage trocar 244 of Stapling Head Assembly 240. Various exemplary features and operabilities of Stapling Head Assembly 240 will be described in more detail below; other suitable features and operabilities will be apparent to those skilled in the art in view of the teachings of the present invention.
    [0063] The rod assembly 230 is intended to communicate a rotary drive force of the cable assembly 210 to the clamping head assembly 240 through a rotary drive shaft 232 as will be described in more detail below. Some versions of rod assembly 230 may include one or more flexible sections. An example of a rod assembly that is configured with flexible sections and that can be incorporated into rod assembly 230 is disclosed in US patent application [attorney document no. END7163USNP.0597933] entitled "Motor Driven Rotary Input Circular Stapler with Lockable Flexible Shaft", filed on the same date as this application, the description of which is incorporated by reference herein. Alternatively, rod assembly 230 may be rigid along the length of rod assembly 230 or have one or more flexible sections configured in some other way.
    [0064] The cable assembly 210 includes an integrated power source 220, a motor 222 and a transmission assembly 224. The integrated power source 220 may comprise a rechargeable battery or a non-rechargeable battery. In some other versions, power source 220 is external to cable assembly 210. By way of example only, power source 220 may be located on rod assembly 230, clamping head assembly 240, or completely external to the instrument. of clip 200. Motor 222 may comprise a conventional DC motor. Transmission assembly 224 is coupled to motor 222 and with a proximal end 233 of rotary drive shaft 223; and is intended to communicate rotary motion of motor 222 to rotary drive shaft 232. Transmission assembly 224 is also operable to communicate this rotary motion regardless of whether rotary drive shaft 232 is longitudinally displaced to a distal position or longitudinally displaced to a proximal position, as will be described in more detail below.
    [0065] The cable assembly 210 also includes a rotary control knob 214 and a control ring 216. The rotary control knob 214 is intended to translate longitudinally to select between motorized operation of the stapling instrument 200 or manual operation of the instrument clamping speed 200. Rotary control knob 214 is also rotary to manually rotate drive shaft 232 when rotary control knob 214 is in the longitudinally manually operated position. Control ring 216 is longitudinally movable to move drive shaft 232 between the distal position and the proximal position. By way of example only, at least a portion of the cable assembly 210 may be configured and operated in accordance with at least some of the teachings of the US patent application [attorney document no. END7159USNP.0597920], entitled "Circular Stapler with Selectable Motorized and Manual Control", filed on the same date as the present application, the description of which is incorporated by reference into the present invention. Other suitable ways in which the cable assembly 270 can be constructed and operated will be apparent to those skilled in the art in view of the teachings of the present invention. It should also be understood that the teachings of the present invention are not limited to clamping instruments that have motors. In fact, the teachings below can be readily applied to many types of instruments that are purely manually operated and that do not even provide a motorized operation option. A. Exemplary Stapling Head Drive Assembly
    [0066] Figures 8 to 15 show various features that are used to activate the stapling head assembly 240 of the present example. In particular, these features include a first swivel drive element 250, a second swivel drive element 260, a drive nut 270, and a collet drive 280. These components 250, 260, 270 and 280 are coaxially aligned with the shaft of drive 232 and are all enclosed within a cartridge housing 300, which will be described in more detail below. Also, as seen in Figure 8, the staple head assembly 240 includes a staple holder 242, a staple driver 243 and a cylindrical knife 245. staples (not shown) through openings, in staple holder 242 and staples forming pockets of proximal face 296 of anvil 290. Knife 245 translates distally with staple driver 243, thus cutting tissue substantially at the same time as adjacent tissue is being stapled.
    [0067] As best seen in Figures 10 to 11, the first rotary drive element 250 defines an orifice 252 and includes a proximal set of internal splines 254. The diameter of the orifice 252 increases distally in the internal splines 254, so that the first swivel drive element 250 includes an annular shoulder-shaped portion facing the distal position 256. The first swivel drive element 250 also includes a threaded aperture 258 extending transversely from the outside of the first swivel drive element 250 to hole 252. As shown in Figure 9, the distal end of the drive shaft 232 includes a set of outer splines 234 that complement the inner splines 254 of the first rotary drive element 250. Thus, when splines 234 and 54 are in a common longitudinal position, rotation of the drive shaft 232 rotates the first rotary drive element 250. In this example, splines 234 and 254 are in a common longitudinal position when drive shaft 232 is in a proximal position. When drive shaft 232 is driven distally (eg by slider ring 216 distally), splines 234 and 235 disengage so that rotation of drive shaft 232 will not rotate first rotary drive element 250. As shown in Figures 9 through 11, splines 234 and 254 have complementary tapered ends to promote the positioning of splines 234 in the interstices between splines 254 when drive shaft 232 is translated back from the distal position to the proximal position.
    [0068] As best seen in Figure 12, the second swivel drive element 260 of the present example defines an internal hole 262, includes an external thread 264 at its distal end and includes a recessed proximal portion 266. A threaded opening 268 extends. transversely from the outside of the second swivel drive element 260 to the hole 262. The proximal portion 266 is configured to slidably fit within the hole 262 of the first swivel drive element 250. In particular, the threaded openings 258 and 268 line up with each other when the proximal portion 266 is disposed in hole 262 and a set screw 251 (shown in Figure 8) is secured in threaded openings 258 and 268 to secure the first and second swivel drive elements 250 and 260 united. The first and second rotary drive elements 250 and 260 will thus rotate together as a single element.
    [0069] As best seen in Figure 13, the drive nut 270 of the present example defines an internal hole 262, includes an internal thread 274 and includes an external key 276. The orifice 262 is configured to receive the distal end of the second rotary drive element 260. In particular, thread 264 meshes with thread 274. Outer key 276 receives a key 306 that extends inwardly from cartridge housing 300 as shown in Figure 8. The relationship between key 276 and key 306 prevent drive nut 270 from turning relative to cartridge housing 300; but allows drive nut 270 to translate relative to cartridge housing 300. Therefore, it should be understood that when drive shaft 232 and rotary drive elements 250 and 260 rotate together, the relationship between threads 264 and 274 will cause drive nut 270 to translate distally or proximally within cartridge housing 300, depending on the direction in which drive shaft 232 and rotary drive elements 250, 260 are rotated. Clamp driver 243 and knife 245 are fixedly attached to drive nut 270 in this example, so that clip driver 243 and knife 245 translate as a single unit with drive nut 270 relative to the drive bracket. clamp 242 and with respect to cartridge housing 300. Therefore, it should be understood that when drive shaft 232 is in a proximal position and is rotated, such rotation will activate clamp driver 243 and knife 245 distally or proximally with respect to staple holder 242 and with respect to cartridge housing 300, depending on the direction of rotation.
    [0070] As best seen in Figure 14, the pinch driver 280 of the present example comprises a shaft 282 with thread 284 at the distal end of the shaft 282. The pinch driver 280 also includes a proximal drive feature 286, a flange annular 288 and a thrust bearing 289 which is positioned around shaft 282 and distal to annular flange 288. As best seen in Figures 16A through 16D, shaft 282 extends longitudinally through holes 252, 262 and 272 to reach the trocar 244. As best seen in Figure 15, the proximal end of the trocar 244 includes a threaded opening 246. The threaded opening 246 is configured to receive a distal end of the shaft 282, thus meshing with thread 284. is intended to translate relative to cartridge housing 300, but does not rotate relative to cartridge housing 300. Thus, trocar 244 will translate relative to cartridge housing 300 in response to rotation of clamping driver 280 relative to cartridge housing 300, due to the interaction between thread 284 and threaded opening 246. Also as seen in Figures 16A to 16D, flange 288 and thrust bearing 289 are captured between the shoulder-shaped portion 256 of the first swivel drive element 250 and the proximal end 266 of the second swivel drive element 260, so that the swivel drive elements 250 and 260 prevent the clamping driver 280 from moving longitudinally .
    [0071] Proximal activation feature 286 has a hexagonal cross section in this example and is therefore configured to complement a hexagonal recess 236 formed at the distal end of drive shaft 232, as shown in Figure 9. Although hexagonal shapes are used in the present example, it should be understood that any other suitable shape may be used, including, but not limited to, rectangular, semicircular, triangular, elliptical, etc. When the drive shaft 232 is in the distal position (for example, when the control ring 216 is in the distal position), the proximal drive feature 286 is received in the hexagonal recess 236 so that the rotation of the drive shaft 232 rotates. the clamping driver 280. When the drive shaft 232 is in the proximal position (for example, when the control ring 216 is in the proximal position), the proximal drive feature 286 is disengaged from the hexagonal recess 236 so that rotation of drive shaft 232 do not rotate pinch drive 280. B. Exemplary operating sequence
    [0072] It should be understood from the foregoing that when the drive shaft 232 is in the distal position, rotation of the drive shaft 232 will rotate the clamping drive 280, but not the rotary drive elements 250, 260. When drive shaft 232 is in the proximal position, rotation of drive shaft 232 will rotate rotary drive elements 250 and 260, but not clamping drive 280. In this way, drive shaft 232 can be rotated and translated in a specific sequence to provide tissue clamping, cutting and stapling. An example of such a sequence is shown in Figures 16A to 16D.
    [0073] In particular, Figure 16A shows the anvil 290 coupled to the trocar 244 and the drive shaft 232 in the distal position. It should be understood that control ring 216 is also in the distal position at this stage. Head 292 of anvil 290 is positioned in a first lumen 400 defined by fabric 402, with axis 294 of anvil 290 protruding from lumen 400. A suture 404 is used to secure fabric 402 around axis 294 as a cord of purse. In some uses, tissue 402 defines an upper section of the gastrointestinal tract, such as an upper portion of the colon or an upper portion of the esophagus. It should be understood that anvil 290 may travel proximally through lumen 400 before being coupled to trocar 244. Stapling head assembly 240 is positioned within a second lumen 410 defined by tissue 412. A suture 414 is used to secure the fabric 412 around the trocar 244 as a purse string. In some uses, tissue 412 defines a lower section of the gastrointestinal tract, such as a lower portion of the colon or a lower portion of the esophagus. It should be understood that the staple head assembly 240 can travel distally through the lumen 410 prior to being coupled to the anvil 290.
    [0074] With the anvil 290 and the clamping head assembly 240 coupled and positioned within the respective lumens 400 and 410, the motor 222 can be activated to rotate the drive shaft 232. If the cable assembly 210 is in the mode of In manual operation, control knob 214 can be manually rotated to rotate drive shaft 232. With drive shaft 232 being in the distal position, drive feature 286 of clamp driver 280 is housed in recess 236 of drive shaft 232, so that rotation of drive shaft 232 rotates clamp driver 280. This rotation retracts trocar 244 and incus 290 proximally with respect to clamping head assembly 240 as shown in Figure 16B. This retraction provides for clamping of tissue 402 and 412 between the proximal face 296 of the anvil head 292 and the clamp holder 242. The drive shaft 232 can be rotated until the gap between the proximal face 296 and the clamp holder 242 is reached. The gap can be indicated to the user in several ways. By way of example only, the stapling instrument 200 may include an equivalent of the indicator window 120 as described above. As another merely illustrative example, an encoder or other feature can track the rotation of the drive shaft 232 and a control module can read such data and thereby activate an LED display or other type of electronic display to indicate the span distance to the user. Other suitable ways in which an operator receives feedback on span distance will be apparent to those of ordinary skill in the art in light of the teachings of the present invention.
    [0075] Once the operator reaches the desired gap between the proximal face 296 and the clamp holder 242, the user can translate the drive shaft 232 proximally as shown in Figure 16C. This can be done by translating the control ring 216 proximally or in any other suitable way. When drive shaft 232 proximally translates 232, recess 236 disengages drive feature 286 and splines 234 engage splines 254. Translation of drive shaft 232 from the distal to the proximal position thereby shifts the stapling head assembly 240 from fabric clamping mode to fabric cutting/stapling mode. In some other versions, the staple head assembly 240 is configured so that translation of the drive shaft from the distal position to the proximal position changes the staple head assembly 240 from a tissue cutting/stapling mode to a mode. of tissue clamping; and vice versa.
    [0076] Once the stapling head assembly 240 is moved from the fabric clamping mode to the fabric cutting/stapling mode, the drive shaft 232 can again be rotated. Again, this can be accomplished by activating motor 222; or by turning control knob 214 manually if cable assembly 210 is in manual operating mode. In some cases, an operator may prefer to use cable assembly 210 in manual mode during fabric clamping (Figures 16A and 6B) and then use cable assembly 210 in motorized mode while cutting/stapling fabric. Figures 16C to 116; or vice versa. In either case, when drive shaft 232 is rotated during fabric cutting/stapling mode, this rotation is communicated through rotary drive elements 250 and 260. Rotation of rotary drive elements 250 and 260 drives the swivel nut. drive 270 in distal position as shown in Figure 16D, due to engagement between threads 264 and 274. This distal advance of drive nut 270 advances staple driver 243 and knife 245 distally, thereby cutting and stapling tissue 402 and 412. An encoder, force sensor, timer, and/or any other suitable feature can be used to determine when to stop motor 222 automatically upon sufficient advance of drive nut 270, clamp driver 243 and knife 245.
    [0077] After fabric 402 and 412 have been stapled and cut, drive shaft 232 can be advanced distally again to engage clamp driver 280, then rotating in the opposite direction to direct anvil 290 slightly away from assembly of the stapling head 240. With the anvil 290 still attached to the stapling head assembly 240, the stapling instrument 200 can then be withdrawn proximally through lumen 410, leaving a secure and fluid-tight anastomosis joining the lumens 400 and 410. Other suitable ways in which the stapling instrument 200 can be used will be apparent to those skilled in the art in view of the teachings of the present invention. C. Exemplary Removable Staple Head Cartridge
    [0078] In some cases, it may be desirable to allow the removal of at least part of the stapling head assembly 240 from the stapling instrument rest 200. Figures 17 and 18 show exemplary features that are incorporated in the stapling head assembly 240 and the rod assembly 230 of the present example to enable removal of the clamping head assembly 240 from the rod assembly 230. In particular, Figures 17 and 18 show the clamping head assembly 240 being provided in a cartridge housing 300 which is removable from the distal end of the rod assembly 230. The cartridge housing 300 includes a pair of outwardly extending tabs 302 which are positioned on the free ends of the respective resilient arms 304. The distal end of the rod assembly 230 has a socket 237 that receives cartridge housing 300. Socket 237 includes a pair of side openings 231 that correspond to tabs 302 of cartridge housing 30 2. In particular, resilient arms 304 are configured to resiliently tilt tabs 302 into openings 231 when cartridge housing 300 is fully accommodated in socket 237, thereby locking cartridge housing 300 in place relative to rod assembly 230 As best shown in Figure 18, a distal end of drive shaft 232 is positioned within socket 237 so that the distal end of drive shaft 232 will enter hole 252 of first rotary drive element 250 when the housing of the cartridge 300 is fully seated in socket 237.
    [0079] To remove cartridge housing 300 from socket 237 and thereby decouple staple head assembly 240 from rod assembly 230, a user may depress both tabs 302 inward to decouple tabs 302 from openings 231. While holding tabs 302 in these depressed positions, the user can then pull cartridge housing 300 distally away from rod assembly 230, as shown in the transition from Figure 17A to Figure 17B. At some point thereafter, another cartridge housing 300 may be inserted into socket 237. In some cases, this may be done during a single surgical procedure. For example, if the operator made an error during an initial attempt to secure an anastomosis and failed to properly position the staples of the stapling head assembly 240, the operator may withdraw the stapling head assembly from the surgical site and reload the shank 230 with another set of stapling head 240 to attempt to complete the anastomosis again with the same stapling instrument 200. The operator would thus avoid the need to discard the entire stapling instrument 200 and use an entirely new stapling instrument 200 .
    [0080] As another merely illustrative example, the stapling instrument 200 can be provided as a partially reusable device. For example, after being used in a surgical procedure, a nurse or other staff member can remove the staple head assembly 240 from the rod assembly 230 and discard the used staple head assembly 240. The stapling instrument rest 200 can then be sent to the sterilization or other recovery process. In cases where the clamping instrument 200 includes a power source 220, motor 222 and/or other electronic components, such components may be removed for separate processing while the remainder of rod assembly 230 and cable assembly 210 are sterilized by any suitable method. After processing, the previously used rod assembly 230 and handle assembly 210 can be combined with a new staple head assembly 240 for use in another surgical procedure. Various other suitable ways in which the components of the stapling instrument 200 can be handled before, during and after surgical procedures will be apparent to those skilled in the art in view of the teachings of the present invention.
    [0081] Of course, the modular configuration of the staple head assembly cartridge 240 in the present example is merely optional. Other suitable forms in which at least part of the stapling head assembly 240 may be provided in a cartridge or modular form will be apparent to those skilled in the art in view of the teachings of the present invention. It should also be understood that some versions of the clamping head assembly 240 may simply be unitary with the stem assembly 230 so that the clamping head assembly 240 cannot be removed from the stem assembly 230. By way of example only , some such versions of the stapling instrument 200 may be configured for single use only, so that the entire stapling instrument 200, including the stapling head assembly 240, is discarded after a single use. Other suitable variations will be apparent to those skilled in the art in view of the teachings of the present invention. 111. Other considerations
    [0082] It should be understood that any one or more of the teachings, expressions, modalities, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, modalities, examples, etc. which are described here. Therefore, the teachings, expressions, modalities, examples, etc. described above should not be viewed in isolation from one another. Various suitable ways in which the teachings of the present invention may be combined will be readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included within the scope of the appended claims.
    At least some of the teachings of the present invention can be readily combined with one or more teachings of US Patent No. 7,794,475 entitled "Surgical Staples Having Compressible or Crushable Members for Securing Tissue Therein and Stapling Instruments for Deploying the Same" , issued September 14, 2010, the description which is incorporated by reference into the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0084] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US patent application No. 13/693,430 entitled "Trans-Oral Circular Anvil Introduction System with Dilation Feature", filed on December 4, 2012, the description which is incorporated by reference into the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0085] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US Patent Application No. 13/688,951 entitled "Surgical Staple with Integral Pledget for Tip Deflection", filed 29 of November 2012, the description of which is incorporated by reference into the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0086] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US Patent Application No. 13/706,827 entitled "Surgical Stapler with Varying Staple Widths Along Different Circumferences", filed at December 6, 2012, the description of which is incorporated by reference into the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0087] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US Patent Application No. 13/688,992 entitled "Pivoting Anvil for Surgical Circular Stapler", filed November 29 of 2012, which description is incorporated by reference in the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0088] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US Patent Application No. 13/693,455 entitled "Circular Anvil Introduction System with Alignment Feature", filed on 4th of December 2012, the description which is incorporated by reference in the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0089] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US patent application no. US patent application [attorney document no. END7159USNP.0597920] entitled "Circular Stapler with Selectable Motorized and Manual Control", filed on the same date as the present application, the description of which is incorporated by reference into the present invention. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0090] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US patent application no. Stapler with Selectable Motorized and Manual Control, Including a Control Ring", filed on the same date as the present application, the description of which is incorporated by reference herein. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0091] Similarly, at least some of the teachings of the present invention may be readily combined with one or more teachings of US patent application no. [attorney document no. END7163USNP.0597933], entitled "Motor Driven Rotary Input Circular Stapler with Lockable Flexible Shaft", filed on the same date as this application, the disclosure of which is incorporated by reference herein. Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.
    [0092] It is understood that any patent, publication, or other descriptive material, in whole or in part, which is said to be incorporated into the present invention by way of reference, is incorporated into the present invention only if the incorporated material does not enter. in conflict with existing definitions, statements, or other descriptive material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, which is hereby incorporated by reference into the present invention, but which conflicts with existing definitions, statements, or other descriptive materials set forth herein will be incorporated herein only to the extent that no conflict. will appear between the embodied material and the existing descriptive material.
    [0093] Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings of the present invention can be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, California, USA. Similarly, those skilled in the art will recognize that the various teachings of the present invention can be easily combined with the various teachings of US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument", issued August 31 of 2004, the description of which is incorporated herein by reference.
    [0094] The versions described above may be designed to be discarded after a single use, or they may be designed to be used multiple times. Versions can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, some versions of the device can be disassembled, in any number of particular parts or parts of the device can be selectively replaced or removed in any combination. With cleaning and/or replacement of particular parts, some versions of the device can be reassembled for subsequent use in a reconditioning facility, or by a user immediately prior to a surgical procedure. Those skilled in the art will understand that reconditioning a device can utilize a variety of 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.
    [0095] Just as an example, the versions described here can be sterilized before and/or after a procedure. In a sterilization technique, the device is placed in a closed, sealed container such as a plastic or TYVEK bag. The container and device can then be placed in a radiation field, such as gamma radiation, X-rays or high energy electrons, which can penetrate the container. Radiation can kill bacteria in the device and container. The sterilized device can then be stored in a sterile container for later use. The device may also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide, or water vapor.
    [0096] Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described in the present invention can be made by suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and not necessary. Accordingly, the scope of the present invention is to be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of structure and operation shown and described in the specification and drawings.
    权利要求:
    Claims (15)
    [0001]
    1. A circular surgical stapler (200) for stapling tissue, wherein the stapler (200) comprises: (a) a body assembly (210); (b) a rotary drive shaft (223), and (c) a clamping assembly (240), the clamping assembly comprising: (i) an anvil (290), (ii) a clamp holder (242 ), (iii) a clamp driver (243) operable to urge the clamps through the clamp holder (242) and towards the anvil (290), characterized in that (d) the drive shaft (223) is translatable between a first longitudinal position and a second longitudinal position with respect to the body assembly (210, 230); and (e) the clamping assembly (240) further comprises: (f)) a first drive member (280) operable to move the anvil (290) toward the clamp holder (242) in response to rotation of the shaft. drive (223) in the first longitudinal position, and (v) a second drive member (250, 260) operable to move the clamp drive (243) toward the anvil (290) in response to rotation of the drive shaft (223) in the second longitudinal position.
    [0002]
    2. Stapler according to claim 1, characterized in that the anvil (290) includes an annular array of staples forming pockets.
    [0003]
    3. Stapler according to claim 1, characterized in that the body assembly includes a drive shaft translation input (216) operable to translate the drive shaft (223) between the first longitudinal position and the second longitudinal position.
    [0004]
    4. Stapler according to claim 1, characterized in that the body assembly includes a motor (222) operable to rotate the drive shaft (223).
    [0005]
    5. Stapler according to claim 1, characterized in that the stapling assembly (240) further includes a blade feature (245) operable to cut the fabric.
    [0006]
    6. Stapler according to claim 5, characterized in that the second drive member (250, 260) is further operable to move the blade feature (245) toward the anvil (290) in response to rotation of the drive shaft (223) in the second longitudinal position.
    [0007]
    7. Stapler according to claim 1, characterized in that the stapling assembly (240) further comprises a trocar coupled to the anvil (290).
    [0008]
    8. Stapler according to claim 7, characterized in that the trocar (244) is threadably coupled to the first drive member (280).
    [0009]
    9. Stapler according to claim 1, characterized in that the drive shaft (223) has a recess (236) distally presented, the first drive member (280) including a proximal drive feature (286 ), wherein the recess (236) of the drive shaft (223) is configured to receive the drive feature (286) of the first drive member (280) in response to the drive shaft (223) being in the first longitudinal position, whereby the drive shaft (223) is configured to decouple the drive feature (286) from the first drive member (280) in response to the drive shaft (223) being in the second longitudinal position.
    [0010]
    10. Stapler according to claim 1, characterized in that the drive shaft (223) has a set of distal splines (234), the second drive member (250) having a set of proximal splines ( 254) wherein the distal splines (234) of the drive shaft (223) are configured to mesh with the proximal splines (254) of the second drive member (250) in response to the drive shaft (223) being in the second position longitudinal; wherein the drive shaft (223) is configured to decouple the distal splines (234) of the drive shaft (223) from the proximal splines (254) of the second drive member (250) in response to the drive shaft (223) being in the first longitudinal position.
    [0011]
    11. Stapler according to claim 1, characterized in that the second drive member (250, 260) comprises a swivel member (260) and a translation member (270) threadably coupled to the swivel member (260 ), whereby the translation member (270) is intended to linearly drive the clamp driver (242).
    [0012]
    12. Stapler according to claim 1, characterized in that it further comprises a rod assembly (230) extending distally from the body assembly (210), the rod assembly (230) defining a distal socket (237), wherein the drive shaft (223) has a distal end located within the distal socket (237).
    [0013]
    13. Stapler according to claim 12, characterized in that the staple assembly (240) further comprises a cartridge body (300), wherein the cartridge body (300) houses the staple holder (242) , the staple driver (243), the first drive member (250, 260) and the second drive member (280), with at least part of the cartridge body (300) being inserted into the distal socket (237) of the rod assembly (230).
    [0014]
    14. Stapler according to claim 13, characterized in that the cartridge body (300) includes at least one tab (302) resiliently tensioned, wherein at least one tab (302) resiliently tensioned is intended to secure from detachably the cartridge body (300) within the distal socket (237) of the stem assembly (230).
    [0015]
    15. Stapler according to claim 14, characterized in that the distal socket (237) includes at least one opening (231) configured to receive the at least one tab (302) resiliently tensioned.
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    同族专利:
    公开号 | 公开日
    EP3263047B1|2020-02-19|
    EP2941199B1|2017-08-02|
    RU2015129085A|2017-01-25|
    JP2016500303A|2016-01-12|
    JP6639910B2|2020-02-05|
    US10512467B2|2019-12-24|
    US20170245859A1|2017-08-31|
    EP3263047A2|2018-01-03|
    CN104853684A|2015-08-19|
    CN104853684B|2017-11-10|
    US11020120B2|2021-06-01|
    US20190105053A1|2019-04-11|
    US20140166728A1|2014-06-19|
    US11013513B2|2021-05-25|
    US20190105052A1|2019-04-11|
    US9597081B2|2017-03-21|
    BR112015014025A2|2017-07-11|
    EP3263047A3|2018-02-28|
    EP2941199A2|2015-11-11|
    WO2014099704A3|2014-08-14|
    WO2014099704A2|2014-06-26|
    MX2015007740A|2015-09-07|
    IN2015DN04208A|2015-10-16|
    RU2673376C2|2018-11-26|
    MX358133B|2018-08-06|
    RU2015129085A3|2018-03-27|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US4207898A|1978-03-27|1980-06-17|Senco Products, Inc.|Intralumenal anastomosis surgical stapling instrument|
    US4606343A|1980-08-18|1986-08-19|United States Surgical Corporation|Self-powered surgical fastening instrument|
    US4805823A|1988-03-18|1989-02-21|Ethicon, Inc.|Pocket configuration for internal organ staplers|
    US5333773A|1991-08-23|1994-08-02|Ethicon, Inc.|Sealing means for endoscopic surgical anastomosis stapling instrument|
    GR920100358A|1991-08-23|1993-06-07|Ethicon Inc|Surgical anastomosis stapling instrument.|
    US5350104A|1991-08-23|1994-09-27|Ethicon, Inc.|Sealing means for endoscopic surgical anastomosis stapling instrument|
    US5433721A|1992-01-17|1995-07-18|Ethicon, Inc.|Endoscopic instrument having a torsionally stiff drive shaft for applying fasteners to tissue|
    US5271543A|1992-02-07|1993-12-21|Ethicon, Inc.|Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism|
    US5415334A|1993-05-05|1995-05-16|Ethicon Endo-Surgery|Surgical stapler and staple cartridge|
    US5465895A|1994-02-03|1995-11-14|Ethicon Endo-Surgery, Inc.|Surgical stapler instrument|
    US5597107A|1994-02-03|1997-01-28|Ethicon Endo-Surgery, Inc.|Surgical stapler instrument|
    EP0699418A1|1994-08-05|1996-03-06|United States Surgical Corporation|Self-contained powered surgical apparatus|
    US5704534A|1994-12-19|1998-01-06|Ethicon Endo-Surgery, Inc.|Articulation assembly for surgical instruments|
    US5632432A|1994-12-19|1997-05-27|Ethicon Endo-Surgery, Inc.|Surgical instrument|
    US5814055A|1995-09-19|1998-09-29|Ethicon Endo-Surgery, Inc.|Surgical clamping mechanism|
    US6119913A|1996-06-14|2000-09-19|Boston Scientific Corporation|Endoscopic stapler|
    EP3158942B1|2001-06-22|2018-08-08|Covidien LP|Electro-mechanical surgical device|
    US7032798B2|1999-06-02|2006-04-25|Power Medical Interventions, Inc.|Electro-mechanical surgical device|
    US6783524B2|2001-04-19|2004-08-31|Intuitive Surgical, Inc.|Robotic surgical tool with ultrasound cauterizing and cutting instrument|
    AU2003279151A1|2002-10-04|2004-05-04|Tyco Healthcare Group, Lp|Pneumatic powered surgical stapling device|
    US6978921B2|2003-05-20|2005-12-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating an E-beam firing mechanism|
    US7380695B2|2003-05-20|2008-06-03|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a single lockout mechanism for prevention of firing|
    US7143923B2|2003-05-20|2006-12-05|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a firing lockout for an unclosed anvil|
    US7380696B2|2003-05-20|2008-06-03|Ethicon Endo-Surgery, Inc.|Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism|
    AU2004249287B2|2003-06-20|2009-12-24|Covidien Lp|Surgical stapling device|
    US7434715B2|2003-09-29|2008-10-14|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having multistroke firing with opening lockout|
    US7303108B2|2003-09-29|2007-12-04|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack|
    US8025199B2|2004-02-23|2011-09-27|Tyco Healthcare Group Lp|Surgical cutting and stapling device|
    US8181840B2|2004-03-19|2012-05-22|Tyco Healthcare Group Lp|Tissue tensioner assembly and approximation mechanism for surgical stapling device|
    US7367485B2|2004-06-30|2008-05-06|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission|
    CN2734146Y|2004-09-03|2005-10-19|马剑文|Degradable anastomosis part of human body digestive tract and anastomat thereof|
    CN100443059C|2005-03-24|2008-12-17|上海创亿医疗器械技术有限公司|Tube type anastomat for alimentary canal|
    US8579176B2|2005-07-26|2013-11-12|Ethicon Endo-Surgery, Inc.|Surgical stapling and cutting device and method for using the device|
    US7575144B2|2006-01-31|2009-08-18|Ethicon Endo-Surgery, Inc.|Surgical fastener and cutter with single cable actuator|
    US7416101B2|2006-01-31|2008-08-26|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting and fastening instrument with loading force feedback|
    US8028885B2|2006-05-19|2011-10-04|Ethicon Endo-Surgery, Inc.|Electric surgical instrument with optimized power supply and drive|
    US8360297B2|2006-09-29|2013-01-29|Ethicon Endo-Surgery, Inc.|Surgical cutting and stapling instrument with self adjusting anvil|
    US7721930B2|2006-11-10|2010-05-25|Thicon Endo-Surgery, Inc.|Disposable cartridge with adhesive for use with a stapling device|
    US7708182B2|2007-04-17|2010-05-04|Tyco Healthcare Group Lp|Flexible endoluminal surgical instrument|
    US8220689B2|2007-05-02|2012-07-17|Endogene Pty Ltd|Device and method for delivering shape-memory staples|
    US7832408B2|2007-06-04|2010-11-16|Ethicon Endo-Surgery, Inc.|Surgical instrument having a directional switching mechanism|
    EP2044888B1|2007-10-05|2016-12-07|Covidien LP|Articulation mechanism for a surgical instrument|
    US7922063B2|2007-10-31|2011-04-12|Tyco Healthcare Group, Lp|Powered surgical instrument|
    US8281974B2|2009-01-14|2012-10-09|Tyco Healthcare, Group LP|Surgical stapler with suture locator|
    US9125654B2|2011-03-14|2015-09-08|Ethicon Endo-Surgery, Inc.|Multiple part anvil assemblies for circular surgical stapling devices|
    US8910847B2|2011-05-19|2014-12-16|Ethicon Endo-Surgery, Inc.|Low cost anvil assembly for a circular stapler|
    US9498222B2|2012-11-29|2016-11-22|Ethicon Endo-Surgery, Llc|Pivoting anvil for surgical circular stapler|
    US9289207B2|2012-11-29|2016-03-22|Ethicon Endo-Surgery, Llc|Surgical staple with integral pledget for tip deflection|
    US9724100B2|2012-12-04|2017-08-08|Ethicon Llc|Circular anvil introduction system with alignment feature|
    US9572573B2|2012-12-04|2017-02-21|Ethicon Endo-Surgery, Llc|Trans-oral circular anvil introduction system with dilation feature|
    US20140158747A1|2012-12-06|2014-06-12|Ethicon Endo-Surgery, Inc.|Surgical stapler with varying staple widths along different circumferences|
    US9463022B2|2012-12-17|2016-10-11|Ethicon Endo-Surgery, Llc|Motor driven rotary input circular stapler with lockable flexible shaft|
    US9597081B2|2012-12-17|2017-03-21|Ethicon Endo-Surgery, Llc|Motor driven rotary input circular stapler with modular end effector|
    US9445816B2|2012-12-17|2016-09-20|Ethicon Endo-Surgery, Llc|Circular stapler with selectable motorized and manual control|US8360296B2|2010-09-09|2013-01-29|Ethicon Endo-Surgery, Inc.|Surgical stapling head assembly with firing lockout for a surgical stapler|
    US9125654B2|2011-03-14|2015-09-08|Ethicon Endo-Surgery, Inc.|Multiple part anvil assemblies for circular surgical stapling devices|
    US9445816B2|2012-12-17|2016-09-20|Ethicon Endo-Surgery, Llc|Circular stapler with selectable motorized and manual control|
    US9597081B2|2012-12-17|2017-03-21|Ethicon Endo-Surgery, Llc|Motor driven rotary input circular stapler with modular end effector|
    US10709452B2|2013-09-23|2020-07-14|Ethicon Llc|Methods and systems for performing circular stapling|
    US20150083772A1|2013-09-23|2015-03-26|Ethicon Endo-Surgery, Inc.|Surgical stapler with rotary cam drive and return|
    US9713469B2|2013-09-23|2017-07-25|Ethicon Llc|Surgical stapler with rotary cam drive|
    WO2016192037A1|2015-06-02|2016-12-08|Covidien Lp|Surgical stapling instrument with self-locking screw|
    US9987001B2|2015-06-12|2018-06-05|Covidien Lp|Surgical anastomosis apparatus|
    US10456134B2|2015-06-26|2019-10-29|Ethicon Llc|Surgical stapler with reversible motor|
    US10517602B2|2015-06-26|2019-12-31|Ethicon Llc|Surgical stapler with reversible polarity|
    US10188386B2|2015-06-26|2019-01-29|Ethicon Llc|Surgical stapler with anvil state indicator|
    US10405855B2|2015-06-26|2019-09-10|Ethicon Llc|Firing circuit for surgical stapler|
    US10307157B2|2015-06-26|2019-06-04|Ethicon Llc|Surgical stapler with anvil seating detection|
    US10905415B2|2015-06-26|2021-02-02|Ethicon Llc|Surgical stapler with electromechanical lockout|
    US10478189B2|2015-06-26|2019-11-19|Ethicon Llc|Method of applying an annular array of staples to tissue|
    US10265066B2|2015-06-26|2019-04-23|Ethicon Llc|Surgical stapler with incomplete firing indicator|
    US10194911B2|2015-06-26|2019-02-05|Ethicon Llc|Surgical stapler with ready state indicator|
    BR102019003934A2|2018-03-07|2019-09-17|Ethicon Llc|SURGICAL STAPLER WITH REVERSIBLE POLARITY|
    US10271841B2|2015-06-26|2019-04-30|Ethicon Llc|Bailout assembly for surgical stapler|
    US10226253B2|2015-06-26|2019-03-12|Ethicon Llc|Firing assembly for circular stapler|
    US10271842B2|2015-06-26|2019-04-30|Ethicon Llc|Anvil stabilization features for surgical stapler|
    US10492790B2|2015-09-24|2019-12-03|Ethicon Llc|Apparatus and method for cinching a straight staple line|
    US10485548B2|2015-09-24|2019-11-26|Ethicon Llc|Apparatus and method for forming a staple line with trocar passageway|
    US9987013B2|2015-09-24|2018-06-05|Ethicon Llc|Surgical staple buttress with magnetic elements|
    US10499909B2|2015-09-24|2019-12-10|Ethicon Llc|Apparatus and method for pleating a bodily lumen|
    US10307165B2|2015-09-24|2019-06-04|Ethicon Llc|Apparatus and method for radially bunching a bodily lumen|
    US10524797B2|2016-01-13|2020-01-07|Covidien Lp|Adapter assembly including a removable trocar assembly|
    BR112018070102A2|2016-04-01|2019-02-12|Ethicon Llc|circular stapling system comprising load control|
    US10271851B2|2016-04-01|2019-04-30|Ethicon Llc|Modular surgical stapling system comprising a display|
    US10376263B2|2016-04-01|2019-08-13|Ethicon Llc|Anvil modification members for surgical staplers|
    GB201611306D0|2016-06-29|2016-08-10|Norwegian Univ Of Science And Tech |Surgical stapler and a method of stapling tissue|
    US20180132849A1|2016-11-14|2018-05-17|Ethicon Endo-Surgery, Llc|Staple forming pocket configurations for circular surgical stapler anvil|
    US10542981B2|2016-11-14|2020-01-28|Ethicon Llc|Atraumatic stapling head features for circular surgical stapler|
    US10980542B2|2016-11-14|2021-04-20|Ethicon Llc|Circular surgical stapler with recessed deck|
    US10603041B2|2016-11-14|2020-03-31|Ethicon Llc|Circular surgical stapler with angularly asymmetric deck features|
    US10695068B2|2017-04-28|2020-06-30|Ethicon Llc|Hysteresis removal feature in surgical stapling instrument|
    US10729444B2|2017-04-28|2020-08-04|Ethicon Llc|Liquid-immune trigger circuit for surgical instrument|
    US10470758B2|2017-08-29|2019-11-12|Ethicon Llc|Suturing device|
    US10881403B2|2017-08-29|2021-01-05|Ethicon Llc|Endocutter control system|
    US10835310B2|2017-08-29|2020-11-17|Ethicon Llc|Electrically-powered surgical systems|
    US10675082B2|2017-08-29|2020-06-09|Ethicon Llc|Control of surgical field irrigation by electrosurgical tool|
    US10905417B2|2017-08-29|2021-02-02|Ethicon Llc|Circular stapler|
    US10912581B2|2017-08-29|2021-02-09|Ethicon Llc|Electrically-powered surgical systems with articulation-compensated ultrasonic energy delivery|
    US11172928B2|2017-08-29|2021-11-16|Cilag Gmbh International|Endocutter control system|
    US10932808B2|2017-08-29|2021-03-02|Ethicon Llc|Methods, systems, and devices for controlling electrosurgical tools|
    US10905421B2|2017-08-29|2021-02-02|Ethicon Llc|Electrically-powered surgical box staplers|
    US10898219B2|2017-08-29|2021-01-26|Ethicon Llc|Electrically-powered surgical systems for cutting and welding solid organs|
    US10912567B2|2017-08-29|2021-02-09|Ethicon Llc|Circular stapler|
    US11160602B2|2017-08-29|2021-11-02|Cilag Gmbh International|Control of surgical field irrigation|
    US10485527B2|2017-08-29|2019-11-26|Ethicon Llc|Control system for clip applier|
    US10925682B2|2017-08-29|2021-02-23|Ethicon Llc|Electrically-powered surgical systems employing variable compression during treatment|
    US10905493B2|2017-08-29|2021-02-02|Ethicon Llc|Methods, systems, and devices for controlling electrosurgical tools|
    US10888370B2|2017-08-29|2021-01-12|Ethicon Llc|Methods, systems, and devices for controlling electrosurgical tools|
    US10856928B2|2017-08-29|2020-12-08|Ethicon Llc|Electrically-powered surgical systems|
    US10548601B2|2017-08-29|2020-02-04|Ethicon Llc|Control system for clip applier|
    US11013528B2|2017-08-29|2021-05-25|Ethicon Llc|Electrically-powered surgical systems providing fine clamping control during energy delivery|
    US10966720B2|2017-09-01|2021-04-06|RevMedica, Inc.|Surgical stapler with removable power pack|
    US10695060B2|2017-09-01|2020-06-30|RevMedica, Inc.|Loadable power pack for surgical instruments|
    US11058428B2|2017-09-27|2021-07-13|Cilag Gmbh International|Circular stapling instrument with asymmetric molded shroud components|
    US10758236B2|2017-09-27|2020-09-01|Ethicon Llc|Circular stapling instrument with torque limiting feature|
    US10751059B2|2017-09-27|2020-08-25|Ethicon Llc|Circular stapling instrument anvil with shank having unitary latches with living hinge|
    US11039839B2|2017-09-27|2021-06-22|Cilag Gmbh International|Circular stapling instrument with unitary closure rod|
    US10835256B2|2017-09-27|2020-11-17|Ethicon Llc|Circular stapling instrument with firing trigger having integral resilient features|
    US11141160B2|2017-10-30|2021-10-12|Cilag Gmbh International|Clip applier comprising a motor controller|
    US11229436B2|2017-10-30|2022-01-25|Cilag Gmbh International|Surgical system comprising a surgical tool and a surgical hub|
    US11103268B2|2017-10-30|2021-08-31|Cilag Gmbh International|Surgical clip applier comprising adaptive firing control|
    US10695081B2|2017-12-28|2020-06-30|Ethicon Llc|Controlling a surgical instrument according to sensed closure parameters|
    US10758310B2|2017-12-28|2020-09-01|Ethicon Llc|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|
    US11202570B2|2017-12-28|2021-12-21|Cilag Gmbh International|Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems|
    US20190205001A1|2017-12-28|2019-07-04|Ethicon Llc|Sterile field interactive control displays|
    US10944728B2|2017-12-28|2021-03-09|Ethicon Llc|Interactive surgical systems with encrypted communication capabilities|
    US11096693B2|2017-12-28|2021-08-24|Cilag Gmbh International|Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing|
    US20190201087A1|2017-12-28|2019-07-04|Ethicon Llc|Smoke evacuation system including a segmented control circuit for interactive surgical platform|
    US10987178B2|2017-12-28|2021-04-27|Ethicon Llc|Surgical hub control arrangements|
    US20190206551A1|2017-12-28|2019-07-04|Ethicon Llc|Spatial awareness of surgical hubs in operating rooms|
    US11056244B2|2017-12-28|2021-07-06|Cilag Gmbh International|Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks|
    US10892995B2|2017-12-28|2021-01-12|Ethicon Llc|Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs|
    US11266468B2|2017-12-28|2022-03-08|Cilag Gmbh International|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|
    US11076921B2|2017-12-28|2021-08-03|Cilag Gmbh International|Adaptive control program updates for surgical hubs|
    US11257589B2|2017-12-28|2022-02-22|Cilag Gmbh International|Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes|
    US20190200997A1|2017-12-28|2019-07-04|Ethicon Llc|Stapling device with both compulsory and discretionary lockouts based on sensed parameters|
    US11132462B2|2017-12-28|2021-09-28|Cilag Gmbh International|Data stripping method to interrogate patient records and create anonymized record|
    US11045591B2|2017-12-28|2021-06-29|Cilag Gmbh International|Dual in-series large and small droplet filters|
    US10943454B2|2017-12-28|2021-03-09|Ethicon Llc|Detection and escalation of security responses of surgical instruments to increasing severity threats|
    US11100631B2|2017-12-28|2021-08-24|Cilag Gmbh International|Use of laser light and red-green-blue coloration to determine properties of back scattered light|
    US11179208B2|2017-12-28|2021-11-23|Cilag Gmbh International|Cloud-based medical analytics for security and authentication trends and reactive measures|
    US11069012B2|2017-12-28|2021-07-20|Cilag Gmbh International|Interactive surgical systems with condition handling of devices and data capabilities|
    US10849697B2|2017-12-28|2020-12-01|Ethicon Llc|Cloud interface for coupled surgical devices|
    US11147607B2|2017-12-28|2021-10-19|Cilag Gmbh International|Bipolar combination device that automatically adjusts pressure based on energy modality|
    US11013563B2|2017-12-28|2021-05-25|Ethicon Llc|Drive arrangements for robot-assisted surgical platforms|
    US11234756B2|2017-12-28|2022-02-01|Cilag Gmbh International|Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter|
    US11166772B2|2017-12-28|2021-11-09|Cilag Gmbh International|Surgical hub coordination of control and communication of operating room devices|
    US10966791B2|2017-12-28|2021-04-06|Ethicon Llc|Cloud-based medical analytics for medical facility segmented individualization of instrument function|
    US10892899B2|2017-12-28|2021-01-12|Ethicon Llc|Self describing data packets generated at an issuing instrument|
    US20190274716A1|2017-12-28|2019-09-12|Ethicon Llc|Determining the state of an ultrasonic end effector|
    US20190201034A1|2017-12-28|2019-07-04|Ethicon Llc|Powered stapling device configured to adjust force, advancement speed, and overall stroke of cutting member based on sensed parameter of firing or clamping|
    US11109866B2|2017-12-28|2021-09-07|Cilag Gmbh International|Method for circular stapler control algorithm adjustment based on situational awareness|
    US11160605B2|2017-12-28|2021-11-02|Cilag Gmbh International|Surgical evacuation sensing and motor control|
    US11051876B2|2017-12-28|2021-07-06|Cilag Gmbh International|Surgical evacuation flow paths|
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    US20190298350A1|2018-03-28|2019-10-03|Ethicon Llc|Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems|
    US11160556B2|2018-04-23|2021-11-02|Covidien Lp|Threaded trocar for adapter assemblies|
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    US11134952B2|2018-10-15|2021-10-05|Cilag Gmbh International|Dual lever to reduce force to fire in circular surgical stapler|
    US11259807B2|2019-02-19|2022-03-01|Cilag Gmbh International|Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device|
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    US11116508B2|2019-03-08|2021-09-14|Cilag Gmbh International|Electrical potential shifting circuit for powered surgical stapler|
    US11224432B2|2019-03-08|2022-01-18|Cilag Gmbh International|Timer circuit to control firing of powered surgical stapler|
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    US20200281593A1|2019-03-08|2020-09-10|Ethicon Llc|Power control circuit for powered surgical stapler|
    WO2020237631A1|2019-05-31|2020-12-03|Covidien Lp|Circular stapling device|
    US11123101B2|2019-07-05|2021-09-21|Covidien Lp|Retaining mechanisms for trocar assemblies|
    US11185331B2|2019-09-18|2021-11-30|Cilag Gmbh International|Method for controlling end effector closure for powered surgical stapler|
    US11185324B2|2019-09-18|2021-11-30|Cilag Gmbh International|Anvil retention and release features for powered circular surgical stapler|
    US11123074B2|2019-09-18|2021-09-21|Cilag Gmbh International|Method for controlling cutting member actuation for powered surgical stapler|
    US20210077111A1|2019-09-18|2021-03-18|Ethicon Llc|Method for calibrating movements of actuated members of powered surgical stapler|
    US20220008075A1|2020-07-10|2022-01-13|Ethicon Llc|Compression and Firing Force Sensor for Circular Surgical Stapler|
    US20220008071A1|2020-07-10|2022-01-13|Ethicon Llc|Load sensor for circular surgical stapler|
    法律状态:
    2018-11-21| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-12-10| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-06-29| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-08-31| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 16/12/2013, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US13/716,318|US9597081B2|2012-12-17|2012-12-17|Motor driven rotary input circular stapler with modular end effector|
    US13/716,318|2012-12-17|
    PCT/US2013/075243|WO2014099704A2|2012-12-17|2013-12-16|Motor driven rotary input circular stapler with modular end effector|
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