DEVICE WITH SURGICAL CLAP ACTUATOR ACTUATOR

专利摘要:
"surgical stapler with a plurality of cutting elements. The present invention relates to an apparatus comprising a body, a drive shaft assembly, an end actuator, a cartridge and a staple driver actuator. end is operable to manipulate tissue. the end actuator comprises a lower jaw, a pivoting anvil and a translating cutter. the translating cutter is operable to translate with respect to the lower jaw and the anvil when the anvil is pivoted toward the lower jaw, to manipulate the tissue. the cartridge is insertable into the lower jaw and includes a plurality of staples. the staple driver actuator is arranged inside the cartridge. the staple driver actuator comprises a secondary cutting element. end is operable to drive the staple driver actuator distally to staple and cut tissue substantially simultaneously.
公开号:BR112017005356B1
申请号:R112017005356-0
申请日:2015-09-08
公开日:2022-01-18
发明作者:Chester O. Baxter Iii；Jerome R. Morgan；Frederick E. Shelton Iv；Charles J. Scheib；Michael J. Vendely
申请人:Ethicon, Llc；
IPC主号:

专利说明:

BACKGROUND
[0001] In some cases, endoscopic surgical instruments may be preferred over devices for traditional open surgery, as a smaller incision can reduce recovery time and complications in the postoperative period. Consequently, some endoscopic surgical instruments may be suitable for placing a distal-end actuator at a desired surgical site via a trocar cannula. These distal end actuators can engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (e.g., endocutter, gripper, cutter, stapler, clip applier, access device, drug/gene therapy delivery device, and device for application of energy through the use of ultrasonic vibration, RF, laser, etc.). Endoscopic surgical instruments may comprise a rod between the end actuator and a handle portion, which is manipulated by the physician. This stem can allow insertion to a desired depth and rotation around the longitudinal axis of the stem itself, thus facilitating the positioning of the end actuator on the patient. Positioning of an end actuator may be further facilitated by the inclusion of one or more joints or articulation elements, allowing the end actuator to be selectively pivoted or otherwise deflected with respect to the longitudinal axis of the stem.
[0002] Examples of endoscopic surgical instruments include surgical staplers. Some of these staplers function to secure layers of fabric, cut through the attached layers of fabric, and cause staples to pass through layers of fabric to substantially seal the cut layers of fabric together near their cut ends. Merely exemplary surgical staplers are disclosed in US Patent No. 4,805,823 entitled "Pocket Configuration for Internal Organ Staplers", issued February 21, 1989; US Patent No. 5,415,334 entitled "Surgical Stapler and Staple Cartridge", issued May 16, 1995; US Patent No. 5,465,895 entitled "Surgical Stapler Instrument", issued November 14, 1995; US Patent No. 5,597,107 entitled "Surgical Stapler Instrument", issued Tuesday, 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 Tuesday, 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; US Patent No. 7,000,818 entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued February 21, 2006; US 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" issued June 3, 2008; US Patent No. 7,380,696 entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism" issued June 3, 2008; US Patent No. 7,404,508 entitled "Surgical Stapling and Cutting Device" issued July 29, 2008; US Patent No. 7,434,715 entitled "Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout", issued October 14, 2008; US Patent No. 7,721,930 entitled "Disposable Cartridge with Adhesive for Use with a Stapling Device", issued May 25, 2010; US Patent No. 8,408,439 entitled "Surgical Stapling Instrument with An Articulatable End Effector", issued April 2, 2013; and US Patent No. 8,453,914 entitled "Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly", issued June 4, 2013. The disclosure of each of the aforementioned US patents is incorporated herein by way of reference.
[0003] Although the aforementioned surgical staplers are described as 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. By way of example only, a surgical stapler may be inserted through a thoracotomy and thus between the patient's ribs to reach one or more organs in a thoracic surgical procedure that does not utilize a trocar as a conduit for the stapler. Such procedures may include using a stapler to cut and close a blood vessel leading to a lung. For example, the vessels leading to an organ can be cut and closed with a stapler before removing the organ from the chest cavity. Of course, surgical staplers can be used in many other scenarios and procedures.
[0004] Examples of surgical staplers that may be particularly suitable or used via a thoracotomy are disclosed in US Patent Publication No. 2014/0243801 entitled "Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks", published Aug. from 2014; US Patent Publication No. 2014/0239041 entitled "Lockout Feature for Movable Cutting Member of Surgical Instrument", published Aug 28, 2014; US Patent Publication No. 2014/0239042, entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", published Aug. 28, 2014; US Patent Publication No. 2014/0239036 entitled "Jaw Closure Feature for End Effector of Surgical Instrument", published Aug 28, 2014; US Patent Publication No. 2014/0239040 entitled "Surgical Instrument with Articulation Lock having a Detenting Binary Spring", published August 28, 2014; US Patent Publication No. 2014/0239043 entitled "Distal Tip Features for End Effector of Surgical Instrument", published August 28, 2014; US Patent Publication No. 2014/0239037 entitled "Staple Forming Features for Surgical Stapling Instrument", published August 28, 2014; US Patent Publication No. 2014/0239038 entitled "Surgical Instrument with Multi-Diameter Shaft", published August 28, 2014; and/or US Patent Publication No. 2014/0239044 entitled "Installation Features for Surgical Instrument End Effector Cartridge" published August 28, 2014. The disclosure of each of the aforementioned US Patent Applications is incorporated into the present invention. by way of reference.
[0005] Although various types of surgical stapling instruments and associated components have been produced and used, no one prior to the inventor(s) is believed to have produced or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS
[0006] The attached drawings, which are incorporated into and form part of this descriptive report, illustrate embodiments of the invention and, together with the general description provided above, and the detailed description of the embodiments provided below, serve to explain the principles of present invention.
[0007] Figure 1 shows a perspective view of an exemplary surgical stapling instrument;
[0008] Figure 2 represents a side elevation view of the instrument of Figure 1;
[0009] Figure 3 represents a perspective view of the end actuator of the instrument of Figure 1, with the end actuator in a closed configuration;
[0010] Figure 4 represents a perspective view of the end actuator of Figure 3, with the end actuator in an open configuration;
[0011] Figure 5 represents an exploded perspective view of the end actuator of Figure 3;
[0012] Figure 6 represents a cross-sectional view of the end actuator of Figure 3, taken along line 6-6 of Figure 4;
[0013] Figure 7A represents a cross-sectional side view of the end actuator of Figure 3, taken along line 7-7 of Figure 4, with a trigger bar in a proximal position;
[0014] Figure 7B represents a cross-sectional side view of the end actuator of Figure 3, taken along line 7-7 of Figure 4, with the trigger bar in a distal position;
[0015] Figure 8 represents a perspective view of the end actuator of Figure 3, positioned in the fabric and after being actuated once in the fabric;
[0016] Figure 9 depicts a schematic view of an exemplary control circuit for use in the instrument of Figure 1;
[0017] Figure 10 depicts a perspective view of the instrument cable assembly of Figure 1, with a housing removed in half and some internal components removed;
[0018] Figure 11 describes a perspective view of the components of the drive assembly of the cable assembly of Figure 10;
[0019] Figure 12 represents a perspective view of an elongated member of the actuation assembly of Figure 11, coupled to the firing bar;
[0020] Figure 13 is a partial perspective view of an example staple cartridge of the end actuator of Figure 3 with an example holder disposed above and on an outer top surface of the staple cartridge;
[0021] Figure 14 is an elevation view of the end actuator of Figure 3 and the bracket of Figure 13 disposed on and between an underside of the anvil and the outer top surface of the staple cartridge;
[0022] Figure 15 represents a perspective view of an end actuator with the support of Figure 13, the end actuator having fired and released clamps and the support of Figure 13 in and on the fabric;
[0023] Figure 16 is a partial perspective view of an exemplary variation of the end actuator of Figure 3, with a portion of the end actuator cut away to reveal a wedge slider equipped with a secondary rotating cutting blade;
[0024] Figure 17 represents a side elevation view of the wedge slider of Figure 16 with the secondary cutting blade in an extended position;
[0025] Figure 18 is a partial perspective view of another exemplary variation of the end actuator of Figure 3, with a portion of the end actuator cut away to reveal a wedge slider equipped with a secondary fixed cutting blade;
[0026] Figure 19 represents a side cross-sectional view of the wedge slider of Figure 18, taken along line 19-19 of Figure 18, with the wedge slider in a proximal position;
[0027] Figure 20 represents a side cross-sectional view of the wedge slider of Figure 18, taken along line 19-19 of Figure 18, with the wedge slider in a distal position;
[0028] Figure 21 represents a side view in cross section of an exemplary variation of the wedge slider of Figure 18;
[0029] Figure 22 is a perspective view of another exemplary wedge slider for use with the end actuator of Figure 3, the wedge slider having an upwardly translatable secondary cutting blade;
[0030] Figure 23 represents a side cross-sectional view of the end actuator of Figure 22, taken along line 23-23 of Figure 22, with the secondary cutting blade in a retracted position;
[0031] Figure 24 represents a side cross-sectional view of the wedge slider of Figure 22, taken along line 23-23 of Figure 22, with the secondary cutting blade in an extended position;
[0032] Figure 25 is a perspective view of another exemplary wedge slider for use with the end actuator of Figure 3, the wedge slider having a secondary cutting blade attached with a stabilizing nose; and
[0033] Figure 26 is a side cross-sectional view of the wedge slider of Figure 25, taken along line 26-26 of Figure 25, with the secondary cutting blade advancing distally;
[0034] In some ways, the drawings are intended to be limiting and it is contemplated that various embodiments of the invention may be performed in a variety of other ways, including those not necessarily represented in the drawings. The accompanying drawings incorporated and forming a part of the specification illustrate various aspects of the present invention and, together with the description, serve to explain the principles of the invention; it being understood, however, that this invention is not specifically limited to the provisions shown. DETAILED DESCRIPTION
[0035] The following description of specific examples of the invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments and advantages of the invention will become apparent to those skilled in the art from the following description, which is, by way of illustration, one of the best contemplated modes of carrying out the invention. As will be understood, the invention may have other different and obvious aspects, all without departing from the invention. Accordingly, the drawings and descriptions are to be regarded as illustrative and not restrictive in nature. 1. Exemplifying Surgical Stapler
[0036] Figure 1 depicts an exemplary surgical stapling instrument 10 that includes a handle assembly 20, a stem assembly 30, and an end actuator 40. The end actuator 40 and the distal portion of the shaft assembly 30 are sized for insertion, in a non-articulated state as depicted in Figure 1, through a trocar cannula to a surgical site in a patient to perform a surgical procedure. By way of example only, such a trocar may be inserted into the patient's abdomen, between two of the patient's ribs, or elsewhere. In some cases, the instrument 10 is used without a trocar. For example, the end actuator 40 and the distal portion of the shaft assembly 30 can be inserted directly through a thoracotomy or other type of incision. It should be understood that terms such as "proximal" and "distal" are used in the present invention with reference to a physician holding the handle assembly 20 of the instrument 10. Thus, the end actuator 40 is distal to the handle assembly. 20 more proximal. It will be further understood that, for convenience and clarity, spatial terms such as "vertical" and "horizontal" are used in the present invention in connection with the drawings. However, surgical instruments are used in many orientations and positions, and such terms are not intended to be limiting and absolute.A. Example cable set and shaft set
[0037] As shown in Figures 1-2, the cable assembly 20 of the present example comprises a pistol grip 22, a closing trigger 24 and a firing trigger 26. Each trigger 24, 26 can be selectively pivoted towards and towards away from the 22 pistol grip as will be described in more detail below. The cable assembly 20 further includes an anvil release button 25, a trigger bar reverse switch 27, and a removable battery pack 28. These components will also be described in more detail below. Of course, the cable assembly 20 may have a variety of other components, features and functionality in addition to, or instead of, any of the elements mentioned above. Other suitable configurations for the cable assembly 20 will become apparent to those skilled in the art considering the teachings of the present invention.
[0038] As shown in Figures 1-3, the axle assembly 30 of the present example comprises an outer closing tube 32, a hinge section 34, and a closing ring 36, which is further coupled to an end actuator 40. Closure tube 32 extends along the length of shaft assembly 30. Closure ring 36 is positioned distal to hinge section 34. Closure tube 32 and closure ring 36 are configured to translate longitudinally with respect to each other. to the cable assembly 20. The longitudinal translation of the closure tube 32 is communicated to the closure ring 36 through the hinge section 34. Exemplary resources that can be used to provide the longitudinal translation of the closure tube 32 and the closure ring 36 will be described in more detail below.
[0039] The pivot section 34 is operable to laterally deflect the lock ring 36 and end actuator 40 laterally away from the longitudinal axis LA of the shaft assembly 30 at a desired angle α. Thus, end actuator 40 may reach the back of an organ, or approach tissue from a desired angle or for other reasons. In some versions, pivot section 34 allows deflection of end actuator 40 along a single plane. In some other versions, the pivot section 34 allows deflection of the end actuator along more than one plane. In the present example, the articulation is controlled via a articulation control knob 35 which is located at the proximal end of the axle assembly 30. The knob 35 is rotatable about an axis that is perpendicular to the longitudinal axis LA of the axle assembly. 30. Closing ring 36 and end actuator 40 pivot about an axis that is perpendicular to the longitudinal axis LA of shaft assembly 30 in response to rotation of knob 35. By way of example only, rotation of the clockwise knob 35 can cause corresponding clockwise rotation of closure ring 36 and end actuator 40 on pivot section 34. Pivot section 34 is configured to communicate longitudinal translation of closure tube 32 to ring closure 36, irrespective of whether the hinge section 34 is in a straight configuration or in a hinged configuration.
[0040] In some versions, the hinge section 34 and/or the hinge control 35 is/are constructed and operable in accordance with at least some of the teachings of US Patent Application No. 13/780,067, titled "Surgical Instrument with Sensor and Powered Control", filed February 28, 2013, the disclosure of which is incorporated herein by reference. Articulation section 34 may also be constructed and operable in accordance with at least some of the teachings of US Patent Application No. 14/314,125 entitled "Articulation Drive Features for Surgical Stapler", filed June 25, 2014, the disclosure of which is incorporated herein by reference. and/or in accordance with the various teachings below. Other suitable shapes that hinge section 34 and hinge button 35 may take will be apparent to those skilled in the art, in view of the teachings of the present invention.
[0041] As shown in Figures 1 to 2, the shaft assembly 30 of the present example further includes a rotation knob 31. The rotation knob 31 is operable to rotate the entire shaft assembly 30 and end actuator 40, with respect to cable assembly 20 about longitudinal axis LA defined by axle assembly 30. In some versions, rotation knob 31 is operable to selectively lock the angular position of axle assembly 30 and end actuator 40, in with respect to the cable assembly 20 about the longitudinal axis LA of the axle assembly 30. For example, the rotation knob 31 may be translatable between a first longitudinal position, in which the axle assembly 30 and the end actuator 40 are rotatable with respect to to the cable assembly 20 about the longitudinal axis LA of the axle assembly 30; and a second longitudinal position, wherein the shaft assembly 30 and the end actuator 40 are not rotatable with respect to the cable assembly 20 about the longitudinal axis LA of the shaft assembly 30. Of course, the shaft assembly 30 can have a variety other components, features and functionality in addition to, or instead of, any of the elements mentioned above. By way of example only, at least part of the shaft assembly 30 is constructed in accordance with at least some of the teachings of U.S. Patent Application No. 13/780,402 entitled "Surgical Instrument with Multi-Diameter Shaft", published Dec. February 2013, the disclosure of which is incorporated herein by reference. Other suitable configurations for the axle assembly 30 will be apparent to those skilled in the art in view of the teachings presented herein. B. Exemplifying End Actuator
[0042] As also shown in Figures 1 to 3, the end actuator 40 of the present example includes a lower jaw 50 and a hinged anvil 60. The anvil 60 includes a pair of integral, outwardly extending pins 66 that are disposed in slots. corresponding curves 54 of lower jaw 50. Pins 66 and slots 54 are shown in Figure 5. Anvil 60 is pivotable toward and away from lower jaw 50 between an open position (shown in Figures 2 and 4) and a closed position ( shown in Figures 1, 3 and 7A to 7B). The use of the term "pivoting" (and similar terms with "pivot" as the base) should not be read as necessarily necessitating pivoting motion about a fixed axis. For example, in the present example, anvil 60 rotates about an axis that is defined by pins 66, which slide along curved slots 54 of lower jaw 50 as anvil 60 moves to lower jaw 50. In In such versions, the pivot axis translates along the path defined by the slots 54 while the anvil 60 simultaneously rotates around this axis. Additionally or alternatively, the pivot axis may slide along the slots 54, with the anvil 60 then pivoting about the pivot axis after the pivot axis has slid a certain distance along the slots 54. it is understood that such sliding/translating pivoting movement is encompassed within terms such as "pivot", "pivots", "pivoting". "swivel", "hinged" and the like. Of course, some versions may provide pivoting movement of the anvil 60 about an axis that remains fixed and does not translate within a slot or channel, etc.
[0043] As best seen in Figure 5, the lower jaw 50 of the present example defines a channel 52 which is configured to receive a staple cartridge 70. The staple cartridge 70 can be inserted into the channel 52, the end actuator 40 can be actuated and then the staple cartridge 70 can be removed and replaced with another staple cartridge 70. The lower jaw 50 thus releasably retains the staple cartridge 70 in alignment with the anvil 60 for actuator actuation. 40. In some versions, the lower jaw 50 is constructed in accordance with at least some of the teachings of US Patent Application No. 13/780,417 entitled "Installation Features for Surgical Instrument End Effector Cartridge", filed Feb. 2013, the disclosure of which is incorporated herein by reference. Other suitable shapes that the lower jaw 50 may take will be apparent to those skilled in the art based on the teachings of the present invention.
[0044] As best seen in Figures 4 to 6, staple cartridge 70 of the present example comprises a cartridge body 71 and a tray 76 attached to the underside of the cartridge body 71. The upper side of the cartridge body 71 features a platform 73, against which the tissue can be compressed when the anvil 60 is in a closed position. Cartridge body 71 further defines a longitudinally extending channel 72 and a plurality of staple pockets 74. A staple 77 is positioned in each staple pocket 74. A staple driver 75 is also positioned in each staple pocket. 74, under a corresponding clip 77, and above the tray 76. As will be described in more detail below, the clip drivers 75 are operable to translate upwards into staple pockets 74 to thereby drive staples 77 upward through the pockets. of staples 74 and for engagement with the anvil 60. The staple drivers 75 are moved upwards by a wedge slider 78, which is captured between the cartridge body 71 and the tray 76, and which translates longitudinally through the cartridge body. cartridge 71. Wedge slider 78 includes a pair of obliquely angled cam surfaces 79 which are configured to engage staple drivers 75 and thereby drive staple drivers 75 upward as that the wedge slider 78 translates longitudinally through the cartridge 70. For example, when the wedge slider 78 is in a proximal position, as shown in Figure 7A, the clamp drivers 75 are in descending positions and the clamps 77 are located in staple pockets 74. As wedge slider 78 is driven to the distal position shown in Figure 7B through a translation of knife member 80, wedge slider 78 drives staple drivers 75 upward, thereby driving the staples 77 out of the staple pockets 74 and into the staple forming pockets 64. In this way, the staple drivers 75 translate along a vertical dimension as the wedge slider 78 translates along a horizontal dimension.
[0045] It should be understood that the configuration of the staple cartridge 70 can be varied in a number of ways. For example, the staple cartridge 70 of the present example includes two longitudinally extending lines of staple pockets 74 on one side of the channel 72; and another set of two longitudinally extending rows of staple pockets 74 on the other side of the groove 72. However, in some other versions, the staple cartridge 70 includes three, one, or some other number of staple pockets. 74 on each side of the groove 72. In some versions, the staple cartridge 70 is constructed and operable in accordance with at least some of the teachings of US Patent Application No. 13/780,106 entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", filed February 28, 2013, the disclosure of which is incorporated herein by reference; In addition or alternatively, the staple cartridge 70 may be constructed and operable in accordance with at least some of the teachings of US Patent Application No. 13/780,417 entitled "Installation Features for Surgical Instrument End Effector Cartridge", filed 28 February 2013, the disclosure of which is incorporated herein by reference. Other suitable forms that the staple cartridge 70 may take will be apparent to those skilled in the art, in view of the teachings of the present invention.
[0046] As best seen in Figure 4, the anvil 60 of the present example comprises a longitudinally extending groove 62 and a plurality of staple forming pockets 64. The groove 62 is configured to align with the groove 72 of the staple cartridge. 70 when anvil 60 is in a closed position. Each staple forming pocket 64 is positioned to lie over a corresponding staple pocket 74 of staple cartridge 70 when the anvil 60 is in a closed position. The staple forming pockets 64 are configured to deform the staple legs 77 when the staples 77 are driven through the fabric and into the anvil 60. In particular, the staple forming pockets 64 are configured to flex the staple legs. 77 to secure the staples 77 formed in the fabric. Anvil 60 may be constructed in accordance with at least some of the teachings of US Patent Application No. 13/780,106 entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", filed February 28, 2013; at least some of the teachings of US Patent Application No. 13/780,120 entitled "Jaw Closure Feature for End Effector of Surgical Instrument", filed February 28, 2013; and/or at least some of the teachings of US Patent Application No. 13/780,379 entitled "Staple Forming Features for Surgical Stapling Instrument", filed February 28, 2013, the disclosure of which is incorporated herein by reference. Other suitable shapes that the anvil 60 may take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0047] In the present example, a knife member 80 is configured to translate through the end actuator 40. As best seen in Figures 5 and 7A-7B, a knife member 80 is attached to the distal end of a trigger bar 82, which extends through a portion of shaft assembly 30. As best seen in Figures 4 and 6, a knife member 80 is positioned in grooves 62, 72 of the anvil 60 and staple cartridge 70. The knife member 80 includes a distally presented cutting edge 84 that is configured to cut tissue that is compressed between the anvil 60 and the platform 73 of the staple cartridge 70 as the knife member 80 translates distally through the end actuator 40. As noted above and As shown in Figures 7A-7B, knife member 80 also drives wedge slider 78 distally as knife member 80 translates distally through end actuator 40, thus driving clamps 77 through tissue. and against anvil 60 for formation. Various features that can be used to drive knife member 80 distally through end actuator 40 will be described in more detail below.
[0048] In some versions, the end actuator 40 includes locking features that are configured to prevent the knife member 80 from advancing distally through the end actuator 40 when a staple cartridge 70 is not inserted into the lower jaw 50. In addition In addition or alternatively, the end actuator 40 may include locking features that are configured to prevent the knife member 80 from advancing distally through the end actuator 40, when the staple cartridge 70 has already been actuated once, for example, with all clamps 77 implanted therefrom are inserted into the lower jaw 50. By way of example only, such locking features may be configured in accordance with at least some of the teachings of US Patent Application No. 13/780,082 entitled " Lockout Feature for Movable Cutting Member of Surgical Instrument", filed February 28, 2013, the disclosure of which is incorporated herein by reference; and/or at least some of the teachings of US Patent Application No. 14/314,108 entitled "Method of Using Lockout Features for Surgical Stapler Cartridge", filed June 25, 2014, the disclosure of which is incorporated herein by reference. Other suitable forms that locking features may take will be apparent to those skilled in the art in view of the teachings of the present invention. Alternatively, end actuator 40 may simply omit such latching features. C. Action of an exemplary anvil
[0049] In the present example, the anvil 60 is driven to the lower jaw 50 by advancing the closing ring 36 distally with respect to the end actuator 40. The closing ring 36 cooperates with the anvil 60 through a cam action 60 toward lower jaw 50 in response to distal translation of closure ring 36 relative to end actuator 40. Likewise, closure ring 36 may cooperate with anvil 60 to open anvil 60 away from lower jaw 50. in response to proximal translation of closure ring 36 relative to end actuator 40. By way of example only, closure ring 36 and anvil 60 may interact in accordance with at least some of the teachings of US Patent Application No. 13/780,120, titled "Jaw Closure Feature for End Effector of Surgical Instrument," filed February 28, 2013, the disclosure of which is incorporated herein by reference; and/or may be configured in accordance with at least some of the teachings of US Patent Application No. 14/314,108 entitled "Jaw Opening Feature for Surgical Stapler", filed June 25, 2014, the disclosure of which is incorporated herein by title. of reference. Exemplary features that can be used to provide longitudinal translation of the closure ring 36 with respect to the end actuator 40 will be described in more detail below.
[0050] As noted above, handle assembly 20 includes a pistol grip 22 and a closing trigger 24. As also noted above, the anvil 60 is closed towards the lower jaw 50 in response to the distal advance of the closing ring 36. In the present example, the closing trigger 24 is pivotable towards the pistol grip 22 to drive the closing tube 32 and the closing ring 36 distally. Various suitable components that can be used to convert the pivoting movement of the closing trigger 24 towards the pistol grip 22 to the distal translation of the closing tube 32 and the closing ring 36 with respect to the handle assembly 20 will be evident to those skilled in the art in view of the teachings contained herein. When the closing trigger 24 reaches a fully pivoted state, so that the anvil 60 is in a fully closed position with respect to the lower jaw 50, the locking features on the handle assembly 20 lock the position of the trigger 24 and the closing tube. 32, thereby locking the anvil 60 in a fully closed position with respect to the lower jaw 50. These locking features are released by actuation of the anvil release button 25. The anvil release button 25 is configured and positioned to be actuated by the thumb of the operator's hand holding the pistol grip 22. In other words, the operator can hold the pistol grip 22 with one hand, actuate the closing trigger 24 with one or more fingers of the same hand, and then , actuate the anvil release button 25 with the thumb of the same hand, without having to release the grip of the pistol grip 22 with the same hand. Other suitable features that can be used to actuate the anvil 60 will be apparent to those skilled in the art in view of the teachings of the present invention.D. Actuation of the example trigger bar
[0051] In the present example, instrument 10 provides motorized control of trigger bar 82. Figures 9 to 12 show example components that can be used to provide motorized control of trigger bar 82. In particular, Figure 9 shows a circuit control module 100 that can be used to power an electric motor 102 via electrical energy from a battery 28 (also shown in Figures 1 and 2). The electric motor 102 is operated to translate the firing bar 82 longitudinally as will be described in more detail below. It should be understood that the entire control circuit 100, including the motor 102 and battery pack 28, can be housed in the cable assembly 20. Figure 9 shows the trigger 26 as an open switch, although it should be understand that this switch is closed when the trigger 26 is activated. The circuit 100 of this example also includes a security key 106 which must be closed in order to complete the circuit 100, although it should be understood that the security key 106 is merely optional. Safety switch 106 may be closed by actuation of a button, slider, or other separate feature on handle assembly 20. Safety switch 106 may also provide mechanical latching of firing trigger 26, such that the trigger of trigger 26 is mechanically prevented from actuation until safety switch 106 is actuated.
[0052] Circuit 100 of the present example also includes a latch switch 108, which is configured to be closed by default, but is automatically opened in response to a latch condition. By way of example only, a stall condition may include one or more of the following: the absence of a cartridge 70 in the lower jaw 50, the presence of a spent cartridge 70 (for example, previously fired) in the lower jaw 50, a anvil 60 insufficiently closed, a determination that instrument 10 has been fired too many times, and/or any other suitable conditions. Various sensors, algorithms, and other features that can be used to detect crash conditions will be apparent to those skilled in the art, in view of the teachings of the present invention. Similarly, other suitable types of lockout conditions will be apparent to those skilled in the art, in view of the teachings of the present invention. It should be understood that circuit 100 is open and thus motor 102 is inoperable when lock switch 108 is open. A lock indicator 110 (e.g., an LED, etc.) is operated to provide a visual indication of the status of the lock switch 108. By way of example only, the lock switch 108, the lock indicator 110, and components / functionality may be configured in accordance with at least some of the teachings of US Patent No. 7,644,848 entitled "Electronic Lockouts and Surgical Instrument Including Same", filed January 12, 2010, the disclosure thereof being incorporated herein by reference title.
[0053] Once the trigger bar 82 reaches a more distal position (e.g. at the end of a cutting pass), an end of pass switch 112 is automatically switched to a closed position, reversing the polarity of the applied voltage to motor 102. This reverses the direction of rotation of motor 102, it being understood that the operator will have released trigger trigger 26 at this stage of operation. In this operational state, a current flows through a reverse direction of the indicator 114 (e.g., an LED, etc.) to provide a visual indication to the operator that the rotation of the motor 102 has been reversed. In the present example, and as best seen in Figure 12, a key actuation arm 134 extends laterally from rack member 130, and is positioned to engage end-of-pass key 112 when firing bar 82 reaches a most distal position (e.g. after fabric 90 has been cut and staples 77 have passed through fabric 90). Various other suitable ways in which stride end switch 112 can be automatically switched to a closed position when trigger bar 82 reaches a more distal position will be apparent to those skilled in the art in view of the teachings of the present invention. Similarly, various suitable forms that the reverse direction indicator 114 may take will be apparent to those skilled in the art, in view of the teachings of the present invention.
[0054] The cable assembly 20 of the present example also includes a manual return switch 116, which is also shown in the circuit 100. In the present example, the return switch is activated by actuating the reverse switch 27, which is shown in the assembly 20 in Figure 1. The manual return switch 116 can provide functionality similar to the end of pass switch 112, reversing the polarity of the voltage applied to the motor 102 to thus reverse the direction of rotation of the motor 102. Again, this Reversal can be visually indicated via the reverse direction indicator 114. In some versions, the cable assembly 20 also includes a mechanical return feature that allows the operator to manually reverse the trigger bar 82 and thereby retract the 82 firing bar mechanically. In the present example, this manual return feature comprises a lever that is covered by a removable panel 21, as shown in Figure 1. The manual return switch 116 and the mechanical return feature are each configured to act as a manual return feature. of "rescue", allowing the operator to quickly begin retracting the firing bar 82 proximally during a firing stroke. In other words, the manual return switch 116 or the mechanical return feature can be manually actuated when the trigger bar 82 has only been partially advanced distally.
[0055] In some versions, one or more keys 26, 106, 108,112, 116 are presented in the form of microkeys. Other suitable forms will be apparent to those skilled in the art, in view of the teachings of the present invention. In addition to or in place of the foregoing, at least part of the circuit 100 may be configured in accordance with at least some of the teachings of US Patent No. 8,210,411 entitled "Motor-Driven Surgical Instrument", filed at 3 July 2012, the description thereof being incorporated herein by reference.
[0056] In particular, Figure 10 shows a motor 102 positioned within the pistol grip 22 of the cable assembly 20. Alternatively, the motor 102 may be positioned elsewhere within the cable assembly 20. The motor 102 has a drive shaft 120 which is coupled to a gear assembly 122. In this way, when motor 102 is activated, drive shaft 120 actuates gear assembly 122. As shown in Figure 11, gear assembly 122 is in communication with a drive gear 124 which meshes with an intermediate pinion 126. The pinion 126 is disposed on an axle 128 which is supported within the cable assembly 20 and which is oriented parallel to the drive axle 120 of the motor 102. The pinion 126 it is further engaged with a rack member 130. In particular, the pinion 126 meshes with teeth 132 at the proximal end of the rack member 130. The rack member 130 is slidably supported on the assembly. cable assembly 20. It should be understood from the above that when the motor 102 is activated, the corresponding rotation of the drive shaft 120 is communicated to the pinion 126 through the gear set 122, and the corresponding rotation of the pinion 126 is converted to translation of rack member 130 by teeth 132. As shown in Figures 10 to 12, an elongate member 136 extends distally from rack member 130. As shown in Figure 12, a coupling member 138 joins the bar trigger 82 with elongate member 136. Rack member 130, elongate member 136, coupling member 138, trigger bar 82 and knife member 80 all translate together with respect to cable assembly 20 in response to the activation of the motor 102. In other words, the activation of the motor 102 finally causes the trigger bar 82 to translate longitudinally, in the direction of such translation, depending on the direction of rotation of the drive shaft. ment 120.
[0057] It should be understood that a distal portion of the elongate member 136, the coupling member 138 and the trigger bar 82 extend through the shaft assembly 30. A portion of the trigger bar 82 also extends through the pivot section 34. In some versions, rack member 130, elongate member 136, and coupling member 138 are all substantially linear and rigid; while the firing bar 82 has sufficient flexibility to flex the hinge section 34 and translate longitudinally through the hinge section 34 when the hinge section 34 is in a flexed or hinged state.
[0058] In addition to, or in lieu of, the above, operable features to drive the trigger bar 82 may be configured in accordance with at least some of the teachings of US Patent No. 8,453,914, the disclosure of which is incorporated herein by way of reference. reference. Other components, features, and configurations suitable for providing firing bar 82 motorization will be apparent to those skilled in the art, in view of the teachings of the present invention. It is also to be understood that some other versions may provide manual actuation of the trigger bar 82 so that a motor may be omitted. By way of example only, the trigger bar 82 may be actuated in accordance with at least some of the teachings of any other reference cited herein.
[0059] Figure 8 shows the end actuator 40 after being driven through a single pass through fabric 90. As shown, cutting edge 84 (omitted in Figure 8) cuts through fabric 90, while staple drivers 75 drive two alternating rows of staples 77 through fabric 90 on either side of the cut line produced by cutting edge 84. The staples 77 are all oriented substantially parallel to the cut line in this example, although it should be understood that the staples 77 may be positioned in any suitable orientations. In the present example, the end actuator 40 is removed from the trocar after the first stroke is completed, the spent staple cartridge 70 is replaced with a new staple cartridge 70, and the end actuator 40 is then reinserted through. of the trocar to reach the stapling location for additional cutting and stapling. This process can be repeated until the desired amount of cuts and staples 77 have been provided. It may be necessary to close the fixed jaw 60 to facilitate insertion and removal through the trocar; and it may be necessary to open the fixed jaw 60 to facilitate replacement of the staple cartridge 70.
[0060] It should be understood that the cutting edge 84 can cut the fabric substantially contemporaneously with the driving of the staples 77 through the fabric during each drive stroke. In the present example, the cutting edge 84 has a slight delay with respect to the driving of staples 77, so that a staple 47 is driven through the fabric just before the cutting edge 84 passes through the same region of the fabric, although it should be understood that that order may be reversed or that the cutting edge 84 may be directly synchronized with adjacent clamps 77. While Figure 8 shows the end actuator 40 being actuated across two layers 92 and 94 of fabric 90, it should be understood that the end actuator 40 may be actuated through a single layer of fabric 90 or more than two layers 92 and 94 of fabric. It is also to be understood that the formation and positioning of the staples 77 adjacent to the cut line produced by the cutting edge 84 can substantially seal the tissue at the cut line, thereby reducing or preventing bleeding and/or leakage of other bodily fluids into the line. cutting. Furthermore, although Figure 8 shows the end actuator 40 being actuated on two flat, juxtaposed substantially horizontal layers 92, 94 of fabric, it should be understood that the end actuator 40 can also be actuated along a tubular structure as a blood vessel, a section of the gastrointestinal tract, etc. Figure 8 should therefore not be viewed as a demonstration of any limitation of the contemplated uses for the end actuator 40. Various scenarios and suitable procedures in which the instrument 10 may be used will be apparent to those skilled in the art based on the teachings of present invention.
[0061] It is also to be understood that other components or features of the instrument 10 may be configured and operated in accordance with the various references cited in the present invention. Additional exemplary modifications that may be provided for the instrument 10 will be described in more detail below. Various suitable ways in which the teachings below may be incorporated into instrument 10 will be apparent to those skilled in the art. Similarly, various suitable ways in which the teachings below may be combined with the various teachings of the references cited in the present invention will be apparent to those skilled in the art. It is also to be understood that the teachings below are not limited to the instrument 10 or devices taught in the references cited in the present invention. The teachings below can readily be applied to many other types of instruments, including instruments that would not be classified as surgical staplers. Various other suitable devices and scenarios to which the teachings below can be applied will be apparent to those skilled in the art based on the teachings of the present invention. II. Alternative sample staple cartridge
[0062] Figures 13 and 14 show an alternate exemplary staple cartridge 270 that can be inserted into the lower jaw 50 of the end actuator 40. In addition to what is described below, the staple cartridge 270 of this example is substantially similar to the staple cartridge 70, as described above. For example, cartridge 270, like cartridge 70, comprises a cartridge body 271 and tray (not shown) attached to the underside of cartridge body 271. Similarly, the upper side of cartridge body 271 features a platform 273, against which the tissue can be compressed when the anvil 60 is in a closed position.
[0063] Unlike the cartridge 70, the cartridge 270 is equipped with a support 280 disposed on a platform 273 of the cartridge body 271. In the present example, the support 280 comprises a strong yet flexible material configured to structurally support a line of Bobby pins. Additionally or alternatively, support 280 may be comprised of a material that includes, for example, a hemostatic agent such as fibrin to aid in blood clotting and reduce bleeding at the surgical site cut and/or stapled along tissue 90.
[0064] In other examples, the support 280 may comprise materials other than those discussed above. For example, other auxiliary compounds or hemostatic agents, such as thrombin, can be used so that the strut 280 can help to clot the blood and reduce the amount of bleeding at the surgical site. The hemostatic capabilities of these auxiliary compounds may also contribute to the use of these auxiliary compounds as adhesives and sealants. The agents can help to clot blood at the surgical site, which allows tissue surrounding the blood to stay together and prevent leakage along the stapled tissue site, for example. Other auxiliary compounds or reagents that may be incorporated into support 280 may further include, but are not limited to, medical fluid or matrix components. By way of example only, support 280 may include natural or genetically modified absorbable polymers or synthetic absorbable polymers or mixtures thereof. Purely illustrative examples of natural or genetically modified polymers are proteins, polysaccharides and combinations thereof. Purely illustrative examples of proteins that can be used include prothrombin, thrombin, fibrinogen, fibrin, fibronectin, heparinase, factor X/Xa, factor VII/VIla, factor IX/IXa, factor XI/XIa, factor XII/XIIa, tissue factor, batroxobin, ancrod, ecarin, von Willebrand factor, collagen, elastin, albumin, gelatin, platelet surface glycoproteins, vasopressin and vasopressin analogues, epinephrine, selectin, procoagulant venom, plasminogen activator inhibitor, platelet activating agents, peptides that have hemostatic activity, and/or combinations thereof. Polysaccharides include, but are not limited to, cellulose, alkyl cellulose, for example, methyl cellulose, alkyl hydroxy alkyl cellulose, hydroxy alkyl cellulose, cellulose sulfate, carboxy methyl cellulose salts, carboxy methyl cellulose, carboxy ethyl cellulose, chitin, carboxy methyl chitin, hyaluronic acid, hyaluronic acid salts, alginate, alginic acid, propylene glycol alginate, glycogen, dextran, dextran sulfate, curdlan, pectin, pullulan, xanthan, chondroitin, chondroitin sulfates, carboxy methyl dextran, carboxy methyl chitosan, chitosan, heparin, heparin sulfate, heparan, heparan sulfate, dermatan sulfate, keratan sulfate, carrageenans, chitosan, starch, amylose, amylopectin, poly-N-glucosamine, polymanuronic acid, polyglucuronic acid, polyguluronic acid, and derivatives of any of these. Examples of synthetic absorbable polymers are aliphatic polyester polymers, copolymers, and/or combinations thereof. Aliphatic polyesters are typically synthesized in a ring-opening polymerization of monomers that include, but are not limited to, lactic acid, lactide (L-, D-, meso and mixtures of D and L), glycolic acid, glycolide, ε -caprolactone, p-dioxanone (1,4-dioxan-2-one) and trimethylene carbonate (1,3-dioxan-2-one). Other components, materials, substances, etc. suitable for use in a medicinal fluid or matrix will be apparent to those skilled in the art in view of the teachings contained herein.
[0065] The holder 280 includes a cartridge portion 282, an anvil portion 284, and an intermediate portion 286 disposed between the proximal ends of the cartridge portion 282 and the anvil portion 284. The anvil portion 284 includes a flap 288 that encircles the distal end of the anvil 60, as shown in the Figure. 14. Flap 288, for example, defines a pocket (not shown) sized to receive the distal end of anvil 60, thereby securing anvil portion 284 of holder 280 to anvil 60. Intermediate portion 286 of holder 280 may comprise a preformed curve to facilitate loading of cartridge 270 into the lower jaw and insertion of anvil 60 into the pocket defined by flap 288.
[0066] Cartridge 270 additionally includes fasteners, such as hooks 290, which hold bracket 280. Hooks 290 and bracket 280 may provide a fastening relationship, such as a hook and loop fastening relationship in which the hooks 290 connect to the loops formed within the support material 280. While the present example is shown to have hooks 290, it should be understood that any other suitable means may be used to secure a cartridge portion 282 of the support 280 to the platform 273 of the cartridge 270.
[0067] In use, cartridge 270 with holder 280 is detachably received in lower jaw 50 of end actuator 40, as shown in Figure 13. When end actuator 40, including cartridge 270 and holder 280, is used, as shown in Figure 15, the staples 277 are driven into the fabric 90, simultaneously with or just before the firing bar 82 cuts the fabric 90, while also cutting the support 280. In addition, the staples 277 can capture portions of the support 280 and crimping those portions into the fabric 90 or at least securing the support 280 to the fabric 90. The firing bar 82 cuts through the support 280 while cutting the fabric 90 in use, applying material from the support 280 to the cut fabric .
[0068] While the 280 bracket is shown to have a certain configuration, it should be understood that the exact configuration of the 280 bracket can be varied. For example, in some versions, a medicinal fluid can be suspended in a biocompatible vehicle. Suitable carriers can include, for example, a physiological buffer solution, a high-flow gel solution, saline, and water. In the case of gel solutions, the tissue repair composition may be in a high-flow gel form prior to delivery to the target site, or it may form a gel and remain in place after delivery to the target site. High-flow gel solutions may comprise one or more gelling materials with or without the addition of water, saline, or physiological buffer solution. Gelling materials include proteins, polysaccharides, polynucleotides and other materials such as alginate, cross-linked alginate, poly(N-isopropyl acrylamide), poly(oxyalkylene), poly(ethylene oxide)-poly(propylene oxide), poly( vinyl alcohol), polyacrylate, or monostearoyl glycerol cosuccinate/polyethylene glycol (MGSA/PEG) copolymers and combinations of any of the foregoing.
[0069] Support 280 may alternatively comprise a fibrous block, foam, mesh, or other structure capable of containing an adhesive or other type of medical fluid. By way of example only, cartridge 270 and/or holder 280 may be constructed in accordance with the teachings of US Patent Publication No. 20013/0068816 entitled "Surgical Instrument and Buttress Material", published March 21, 2013 ; US Patent Publication No. 2013/0062391 entitled "Surgical Instrument with Fluid Fillable Buttress", published March 14, 2013; US Patent Publication No. 2013/0068820 entitled "Fibrin Pad Matrix with Suspended Heat Activated Beads of Adhesive", published March 21, 2013; US Patent Publication No. 2013/0082086 entitled "Attachment of Surgical Staple Buttress to Cartridge", published April 4, 2013; US Patent Publication No. 2013/0037596, entitled "Device for Applying Adjunct in Endoscopic Procedure", published February 14, 2013; US Patent Publication No. 2013/0062393 entitled "Resistive Heated Surgical Staple Cartridge with Phase Change Sealant", published March 14, 2013; US Patent Publication No. 2013/0075446 entitled "Surgical Staple Assembly with Hemostatic Feature", published March 28, 2013; US Patent Publication No. 2013/0062394 entitled "Surgical Staple Cartridge with Self-Dispensing Staple Buttress", filed March 14, 2013; US Patent Publication No. 2013/0075445 entitled "Anvil Cartridge for Surgical Fastening Device", published March 28, 2013; and/or US Patent Publication No. 2013/0075447 entitled "Adjunct Therapy for Applying Hemostatic Agent" published March 28, 2013, the disclosure of which is incorporated herein by reference. III. Exemplary alternative wedge sliders
[0070] In some cases, it may be desirable to provide alternative and/or additional and tissue cutting structures and supports 280. For example, in some examples, the instrument 10 itself may be reusable while the cartridge 70, 270 may be disposable. Because of this, repeated use of the instrument 10 can cause the cutting edge 84 of the firing bar 82 to become dull. This slowness can be intensified by the use of a 270 cartridge that includes a 280 holder similar to those discussed above. Additionally or alternatively, cutting edge 84 and/or other portions of firing bar 82 may encounter a buildup of material forming support 280 as the same firing bar 82 is fired through a plurality of supports 280. Such material buildup can adversely affect the ability of the firing bar 82 to cut the fabric and/or additional supports 280. In addition or alternatively, this buildup of material can provide greater friction or interference that requires additional force to drive the firing bar 82 distally. Various examples of additional and/or alternative structures that can be used to provide at least some disposable cutting feature will be described in more detail below, while additional examples will become apparent to those skilled in the art in view of the teachings of the present invention. . Wedge slider with exemplary rotating blade
[0071] Figure 16 shows a perspective cutout view of the lower jaw 50 and an alternative staple cartridge 370. The staple cartridge 370 can be used as a replacement for the staple cartridge 70. Additionally or alternatively, the staple cartridge 370 may include a cartridge-type holder 280 of staples 270 or any other type of holder, including, but not limited to, the various holders described in the various references cited in the present invention. The staple cartridge 370 is substantially similar to the staple cartridge 70, 270 described above with the main difference being that the staple cartridge 370 is equipped with an exemplary alternative wedge slider 378. Wedge slider 378 is similar to wedge slider 78 described above. In the present example, the wedge slider 378 has been modified from the wedge slider 78 to accommodate a secondary cutting blade 380 that is rotatable in the wedge slider 378. In particular, as shown in Figures 16 and 17, the wedge slider 378 includes a body 377 and a plurality of cam surfaces 379. The body 377 defines a blade slot 382. The body and cam surfaces 379 are shorter relative to the cam surface 79 of the wedge slider 78, yet the body 377 and the cam surfaces 379 are oriented at an angle that is steeper than the angle of the cam surface 79 of the wedge slider 78. Consequently, the wedge slider 378 occupies the same amount of longitudinal space within the cartridge. 370 than the wedge slider 78 in the cartridge 70, 270, making the wedge slider 378 substantially interchangeable with the wedge slider 78. The angle of the cam surfaces 379 allows the wedge slider to 378 triggers multiple clamp drivers 75 up simultaneously and/or in a certain predetermined sequence.
[0072] Blade slit 382 is configured to accommodate rotation of blade 380 within wedge slider 378. As can best be seen in Figure 17, blade slit 382 has a shape approximately corresponding to the shape defined by blade 380 which rotates between a stowed position (shown in dashed line) and an extended position. Additionally, blade slot 382 defines a locking feature 383 which, as will be described in more detail below, prevents the blade from rotating proximally beyond the extended position. The shape of the blade slot 382 further defines a proximal opening 384 in the wedge slider 378. As will be described in more detail below, the proximal opening provides access to the blade 380 so that the blade can be actuated by the trigger bar 82, from a stowed position to an extended position. In other examples, blade slot 382 may be of any other suitable shape, as will be apparent to those skilled in the art in view of the teachings herein.
[0073] As can be seen in Figure 17, the wedge slider 378 additionally comprises a pin or shaft 385, which extends through the slot of the blade 382. A through hole 386 in the blade 380 allows the blade 380 to be pivotally coupled. to the wedge slider 378 so that the blade 380 can rotate distally to the retracted position. Although not shown in Figure 17, it is to be understood that the axis of rotation 385 may be equipped with pads, bearings, or other components or features suitable for assisting the rotation of the blade 380. Additionally, the axis of rotation 385 may be equipped with components or elements such as springs suitable for resiliently tilting the blade 380 to the retracted or extended position.
[0074] The 380 blade has a cross-sectional shape similar to a knife. In particular, with reference to blade 380 in the extended position, blade 380 has an upper cutting portion 388 and a lower clamping portion 394. The upper cutting portion 388 comprises a distally facing angled cutting edge 390 and a proximally facing flat portion. 392. Cutting edge 390 extends at an upward angle from attachment portion 394. Although cutting edge 390 comprises a straight edge extending at an angle, it should be understood that cutting edge 390 can be of any other shape. adequate. For example, cutting edge 390 may be curved, serrated, serrated, and/or otherwise configured. The cutting edge 390 may further be angled differently from the angle shown.
[0075] Flat portion 392 extends upward from attachment portion 394. As with cutting edge 390, flat portion 392 need not be limited to the shape described herein. As will be described in more detail below, the flat portion 392 provides a surface that can engage the locking feature 383 of the wedge slider 378.
[0076] The upper cutting portion 388 of the blade 380 extends upward to a certain height above the wedge slider 378. In the present example, the height of the upper cutting portion 388 is configured to cut through a support 280 and the fabric. 90. In other examples, the upper cutting portion 388 may have a height that is less than the height shown so that the upper cutting portion 388 cuts only a support 280 immediately adjacent to the cartridge 370, without necessarily cutting the fabric 90 that is positioned above support 280. It should be understood that upper cutting portion 388, or other elements of cutting portion 388 described above, may be of any other suitable shape, height, or configuration, as will be apparent to those skilled in the art. in view of the teachings of the present invention.
[0077] In an exemplary mode of operation, the blade 380 is in the retracted position, prior to insertion of the cartridge 370 into the lower jaw 50. In the retracted position, the blade 380 is lowered entirely into the cartridge 370 and the wedge slider 378. Consequently , an operator is protected from inadvertent contact with blade 380 while inserting cartridge 70, 270 into lower jaw 50.
[0078] After an operator inserts the 370 cartridge into the lower jaw 50, the 380 blade remains retracted until the operator initiates the firing sequence. After the firing sequence is initiated, the firing bar 82 is actuated distally so that the knife member 80 contacts the wedge slider 378. The knife member 80 may include one or more projecting elements ( not shown) configured to engage blade 380 so that blade can be actuated in the extended position, with locking element 383 stopping further rotation. Alternatively, wedge slider 378 may be equipped with elements suitable for driving blade 380 over knife member 80 in contact with wedge slider 378. In the extended position, blade 380 extends across a platform 373 of cartridge 370 .
[0079] With the blade 380 in the extended position, the firing bar 82 continues to advance distally, driving the cutting edge 390 of the blade 380 through a holder 280 (if provided) and the fabric 90. The cutting edge 84 of the knife member 80 may follow immediately behind blade 380, so that cutting edge 84 cuts any fabric 90 or support 280 of material not cut by blade 380. It should be understood that cutting edge 84 of knife member 80 and cutting edge 390 blade 380 follow a trajectory that is substantially identical. Such a path may, in general, be defined by a longitudinally extending groove 372 of the cartridge 370. By making the first cut pass through the support 280 (and, in some versions, the fabric as well 90), the blade 380 may reduce the wear and/or buildup on knife member 80, thereby extending the life of knife member 80. Additionally, it should be understood that both blade 380 and knife member 80 may follow cam surfaces 379, in so that the wedge slider 378 drives the staples 77 through a given region of tissue before that specific region of tissue is cut by a blade 380 or knife element 80. The stapling and cutting action may further be considered, in a manner substantially simultaneous in the fabric region because the wedge slider 378 is configured so that the time difference between stapling and cutting is substantially short.
[0080] After the instrument 10 is fired, the cartridge 370 can be removed together with the blade 380, so that a new cartridge 370 and/or blade 380 can be inserted into the lower jaw 50. It should be understood that the cartridge 370 may be replaced with an identical cartridge 370 or a different cartridge 70, 270, 370. For example, some cartridges 370 may be equipped with blades 380 configured for different procedures. By way of example only, the cartridge 370 may include a sharper blade 380 for use on lung tissue. Alternatively, cartridge 370 may include a more robust blade 380 for use with stomach tissue. Obviously, cartridge 370 may include a blade 380 for cutting any tissue, as will be apparent to those skilled in the art in view of the teachings of the present invention.B. Wedge slider with exemplary fixed blade
[0081] Figure 18 shows a perspective cutaway view of another alternate exemplary staple cartridge 470 which is equipped with an alternate exemplary wedge slider 478. In the present example, cartridge 470 is substantially the same as cartridge 70, 270 described above, except cartridge 470 includes an upwardly projecting shield 469 that is unitarily coupled to a platform 473 of cartridge 470. Like cartridge 70 , 270, cartridge 470 includes a longitudinally extending channel 472 in platform 473, which also extends through shield 469. As will be discussed in more detail below, shield 469 is configured to cover a blade 480, which is secured by attachment to wedge slider 478.
[0082] The wedge slider 478 is similar to the wedge slider 78, 378 described above. In the present example, like the wedge slider 378, the wedge slider 478 has been modified from the wedge slider 78 to accommodate a secondary cutting blade 480 which is secured by attachment to the wedge slider 478. In particular, as may be best As seen in Figure 19, the wedge slider 478 includes a body 477 defining an opening for blades 482. The body 477 may also include a plurality of cam surfaces not shown suitable for driving the clamps 77 via clamp drivers, into the fabric. Body 477 is shorter relative to cam surface 79 of wedge slider 78, yet body 477 and cam surfaces are oriented at a steeper angle than the angle of cam surface 79 of wedge slider 78 Consequently, the wedge slider 478 occupies the same amount of space longitudinally within the cartridge 470 as the wedge slider 78 making the wedge slider 478 substantially interchangeable with the wedge slider 78. wedge slider 478 drives multiple wedge slides (not shown) upward simultaneously and/or in a predetermined sequence.
[0083] Blade slit 482 is configured to accommodate blade 480 on wedge slider 478. As can best be seen in Figure 19, blade slit 482 has a shape that roughly corresponds to a shape defined by a lower region of the blade. 480. Unlike the blade 380 of the wedge slider 378, the blade 480 of the wedge slider 478 is fixed relative to the wedge slider 478. Thus, the slot of the blade 482 does not need to be configured to accommodate rotation or articulation of the blade. 480. In other examples, blade slit 482 may be of any other suitable shape, as will be apparent to those skilled in the art in view of the teachings herein.
[0084] As can be seen in Figure 19, the wedge slider 478 additionally comprises a pin or rod 485, which extends through the slot of the blade 482. A through hole 486 in the blade 480 allows the blade 480 to be secured by clamping. to the wedge slider 478 so that the blade 480 is substantially fixed with respect to the wedge slider 478.
[0085] Blade 480 has a similar cross-sectional shape to blade 380. In particular, blade 480 has an upper cutting portion 488 and a lower clamping portion 494. The upper cutting portion 488 comprises a distally facing angled cutting edge. 490 and a proximally facing flat portion 492. Cutting edge 490 extends at an upward angle from attachment portion 494. As with cutting edge 390 and flat portion 394 described above, cutting edge 490 and flat portion 494 may comprise any suitable alternative configuration, as will be apparent to those skilled in the art in view of the teachings of the present invention.
[0086] The upper cutting portion 488 of the blade 480 extends upward to a certain height above the wedge slider 478. In the present example, the height of the upper cutting portion 488 is configured to cut through a support 280 and the fabric. 90. However, as with the upper cutting portion 388 described above, the height of the upper cutting portion 488 can be varied to cut through any desired combination of support 280 and/or fabric 90, as will be apparent to those skilled in the art. technique in view of the teachings of the present invention.
[0087] In an exemplary mode of operation, and as shown in Figure 19, the blade 480 is retracted to the shield 469 before inserting the cartridge 470 into the lower jaw 50. When the blade 480 is retracted to the shield 469, the blade 480 is entirely within the cartridge 470. Consequently, an operator is protected from inadvertent contact with the blade 480 while the operator manipulates the cartridge 470 and inserts the cartridge 470 into the lower jaw 50. Additionally, the shield 469 can prevent premature contact between tissue and blade 480 during closing of anvil 60 toward platform 473, until a firing sequence is initiated (e.g., until knife member 80 is displaced distally). For example, in the absence of shield 469, the closing action of anvil 60 may tend to direct tissue proximally toward blade 480 as anvil 60 compresses tissue against platform 473. If such a proximal "milking" action of tissue occurs, the shield 469 blocks the driven tissue proximally from the blade engagement 480.
[0088] After an operator inserts the 470 cartridge into the lower jaw 50, the 480 blade remains retracted until the operator initiates the firing sequence. After the firing sequence is initiated, the firing bar 82 is actuated distally to contact the wedge slider 478. As shown in Figure 20, the firing bar 82 continues to advance distally, driving the wedge slider 478. distally and thereby driving the blade 480 out of the shield 469 so that the cutting edge 490 of the blade 480 can cut a support 280 if equipped and the tissue 90. The cutting edge 84 of the knife member 80 can follow immediately behind the blade 480, such that cutting edge 84 cuts any fabric 90 or support 280 of material not cut by blade 480. It should be understood that cutting edge 84 of knife member 80 and cutting edge 490 of blade 480 follow a path which is substantially identical. Such a path may, in general, be defined by a longitudinally extending groove 470 of the cartridge 770. By making the first cut pass through the holder 280 (and, in some versions, the fabric as well 90), the blade 480 may reduce the wear and/or buildup on knife member 80, thereby extending the life of knife member 80. Additionally, it should be understood that both blade 480 and knife member 80 may follow cam surfaces 479, in so that the wedge slider 478 drives the staples 77 through a given region of tissue before that specific region of tissue is cut by a blade 480 or knife element 80. The stapling and cutting action may further be considered, in a manner substantially simultaneous in the fabric region because the wedge slider 478 is configured so that the time difference between stapling and cutting is substantially short.
[0089] After the instrument 10 is fired, the cartridge 470 can be removed together with the blade 480, so that a new cartridge 70, 370, 470 and/or blade 480 can be inserted into the lower jaw 50. It should be understood that cartridge 470 may be replaced with an identical cartridge 470 or a different cartridge 70, 270, 370. For example, as with the cartridge 370 discussed above, some cartridges 470 may be equipped with blades 480 configured for different procedures such as those described above.
[0090] Figure 21 shows an alternative wedge slider 578 that can be used with the cartridge 70, 270, 470. The wedge slider 578 is functionally and structurally the same as the wedge slider 478 discussed above, except where otherwise noted. Unlike wedge slider 478, wedge slider 578 comprises a different secondary cutting blade 580. In particular, blade 580 is shorter relative to blade 480, so blade 580 is configured to cut only material. support 280, without also reaching the fabric 90 positioned above support 280.
[0091] In some circumstances, the support material 280 may be of a different thickness than the specific depicted thickness. Accordingly, it should be understood that the cutting blade 580 is not limited to cutting just the support 280 or cutting through the entire support 280. In fact, in some circumstances, the blade 580 may consequently cut a portion of the fabric 90. In other cases, blade 580 may cut only a portion of support 280, leaving support material 280 remaining to be cut by cutting edge 84 of knife member 80.C. Wedge slider with exemplifying polarized secondary blade
[0092] Figure 22 shows a perspective view of another exemplary alternative wedge slider 678 that can be used with the cartridge 670, which is a modified version of the cartridge 70, 270. In many respects, the wedge slider 678 of this example is similar to the wedge slider 78, 378, 478, 578 described above. In the present example, like the wedge slider 378, 478, 578, the wedge slider 678 has been modified from the wedge slider 78 to accommodate a secondary cutting blade 680. In particular, as best seen in Figure 23, wedge slider 678 includes a body 677 and a plurality of cam surfaces 679. Body 677 comprises a blade slot 682 which is configured to accommodate a blade 680 as will be described in more detail below. The body 677 and cam surfaces 679 are shorter relative to the cam surface 79 of the wedge slider 78, but the cam surfaces 679 are oriented at an angle that is steeper than the angle of the cam surface 79 of the slider. Wedge slider 78. Consequently, wedge slider 678 occupies the same amount of space longitudinally within the cartridge 70, 270 as wedge slider 78, making wedge slider 678 substantially interchangeable with wedge slider 78. cam surfaces 679 allow wedge slider 678 to drive multiple clamp drivers (not shown) upward simultaneously and/or in a certain predetermined sequence.
[0093] Blade slot 682 is configured to accommodate blade 680 within wedge slider 678. As best seen in Figure 23, blade slot 682 comprises a translation slot 683 and an actuation cavity 684. The translation slot 683 corresponds to a translation slider 692 of the blade 680. As will be described in more detail below, the translation slider 692 is configured to cooperate with a knife member 80 to translate the blade 680 from a retracted position to a extended position via translation slot 683.
[0094] Actuation cavity 684 defines a space for certain components of blade 680 (described below) and a resilient member 686 of wedge slider 678. Resilient member 686 comprises a spring bundle that extends proximally from a spring member. distal attachment 688 which is of unitary construction with wedge slider 678. As will be described in more detail below, resilient member 686 is operable to be flexed up and down within actuation cavity 684 to resiliently force blade 680 into towards the stowed position. Accordingly, actuation cavity 684 is at least partially defined by the range of bending motion of resilient member 686. Although actuation cavity 684 is shown to have a specific shape, it should be understood that the shape of actuation cavity 684 can be varied according to the shape and range of motion of the resilient member 686. Additionally or alternatively, as will be understood from the description below, the shape of the actuation cavity 684 may also be varied according to the shape or translational path blade 680.
[0095] Blade 680 comprises an upper cutting portion 690, translational slider 692, and retaining member 694. Cutting portion 690 comprises a distally oriented sharp cutting edge 691 that is configured to cut through holder 280 and/or or fabric 90. As with the cutting edge 390, 490 described above, the cutting edge 691 can have a variety of alternative configurations that can be configured to cut through a variety of materials.
[0096] The translation slider 692 is of unitary construction with the blade 680 and extends outward from the blade 680. In another example, the translation slider 692 may be detached from and secured by attachment to the blade 680. Translational slider 692 is generally integral with blade 680, and extends distally and outward from the front, right, and left sides of blade 680. As can best be seen in Figure 22, translational slider 692 is , in general, rectangular in shape with rounded distal and proximal ends. The rectangular-shaped longitudinal portion of the translation slider 692 generally defines a plane that is oriented at an oblique angle to the longitudinal axis of the cartridge 670. As will be described in more detail below, the translation slider 692 is arranged slidingly into the translation slot 683 which is formed in the body of the wedge slider 680. The translation slot 683 provides a cam surface for the translation slider 692, so that the translation slot 693 and the translation slider 692 provide an upward movement of blade 680 with respect to wedge slider 678 when blade 680 is driven distally with respect to wedge slider 678. Although translational slider 692 is shown to be oriented at a specific angle with respect to blade 680 , it should be understood that the translation slider 692 may be oriented at any suitable angle, as will be apparent to those skilled in the art. ica in view of the teachings of the present invention.
[0097] Retaining member 694 extends distally from blade 680. In particular, retaining member 694 initially extends substantially perpendicular to a longitudinal axis of blade 680. As retaining member 694 extends distally, retaining member 694 retainer 694 curves down at an angle. As will be understood, the shape of the retaining member 694 is configured to engage the resilient member 686 to resiliently force the blade 680 toward the retracted position. Thus, retaining member 694 can assume a variety of alternative shapes, depending on the specific relationship between wedge slider 678 and blade 680 and other subcomponents thereof.
[0098] Unlike the blade 380, 480, 580 of the wedge slider 378, 478, 578, the blade 680 of the wedge slider 678 is configured to translate obliquely with respect to the wedge slider 478. In particular, the translation slot 683 of the wedge slider 678 is configured to mate with the wedge slider 692 of the blade 680. The translation slot 683 and the translation slide 692 are both oriented at an angle such that the translation slot 683 and the translation slot 692 are operable to cooperatively translate translation blade 680 upward as blade 680 is advanced distally. In this way, the translation slot 683 and the translation slot 692 are operable to transition the blade 680 from the retracted position to the extended position when the blade 680 is advanced distally.
[0099] As can best be seen in Figure 23, the resilient member 686 of the wedge slider 678 and the retaining member 694 of the blade 680 are configured to engage each other so that the resilient member 686 exerts a force that has a component downward and a proximal component over the retaining member 694. This force causes the wedge slider 692 of the blade 680 to be forced to the proximal end of the translation slot 683 of the wedge slider 678, thereby resiliently forcing the blade 680 towards the stowed position. In some versions, the distal edge of the distal projection 83 is oriented at an angle between 75 degrees and 90 degrees to a horizontal plane. Such an angle can provide a cam action that helps overcome the bias of resilient member 686 to retract blade 680 proximally.
[0100] In an exemplary mode of operation, the blade 680 is initially retracted into the retracted position for insertion of the cartridge 670 into the lower jaw 50. When the blade 680 is in the retracted position, the blade 680 is fully within the cartridge 670. Consequently, a operator is protected from inadvertent contact with blade 680 while inserting cartridge 670 into lower jaw 50.
[0101] After an operator inserts the 670 cartridge into the lower jaw 50, the 680 blade remains retracted until the operator initiates the firing sequence. After the firing sequence is initiated, the firing bar 82 is distally driven so that the knife member 80 contacts the blade 680 to first drive the blade 680 to the extended position and then to drive the blade. 680 and wedge slider 678 proximally. As shown in Figures 23 and 24, knife member 80 comprises a distal projection 83 that is configured to contact blade 680. In this way, as firing bar 82 is distally driven, blade 680 is correspondingly driven distally of the wedge slider 678 by the distal projection 83 of the knife member 80. As the blade 680 is driven distally, the translation slot 683 of the wedge slider 678 and the translational slider 692 of the blade 680 actuate simultaneously and cooperatively the blade 680 in the extended position, as can be seen in the transition from the state shown in Figure 23 to the state shown in Figure 24. It should be understood that as the blade 680 is resiliently forced toward the retracted position, the blade 680 is extended only when activated by knife member 80. Continuous advancement of firing bar 82 advances wedge slider 678 distally and drives cutting edge 691 of blade 6 80 through support 280 and/or fabric 90. Cutting edge 84 of knife member 80 may follow immediately behind blade 680, so cutting edge 84 cuts any fabric 90 or support 280 of material not cut by blade 680.
[0102] It should be understood that the cutting edge 84 of the knife member 80 and the cutting edge 690 of the blade 680 follow a path that is substantially identical. Such a path may generally be defined by a channel extending longitudinally (not shown) of the cartridge 670. In making the first cut pass through the holder 280 (and, in some versions, the fabric as well 90), the blade 680 can reduce wear and/or buildup on knife member 80, thereby prolonging the life of knife member 80. Additionally, it should be understood that both blade 680 and knife member 80 can follow cam surfaces. 379, so that the wedge slider 678 drives the staples 77 through a given region of fabric before that specific region of fabric is cut by a blade 680 or knife element 80. The stapling and cutting action may still be considered , substantially simultaneously in the fabric region because the wedge slider 678 is configured so that the time difference between stapling and cutting is substantially short.
[0103] After the instrument 10 is fired, the knife member 80 can be proximally retracted. Proximal retraction of knife member 80 allows resilient member 686 to drive blade 680 back to the retracted position. The blade 680 is thus retracted into a spent cartridge 670 protecting the operator from unwanted contact with the cutting edge 691 when the operator removes the spent cartridge 670 to replace the spent cartridge 670 or otherwise to discard the spent cartridge 670 The cartridge 670 can be removed together with the blade 680 so that a new cartridge 70, 270, 370, 470, 570 equipped with blade 380, 480, 580, 680 can be inserted into the lower jaw 50. It will be understood that cartridge 670 can be replaced with an identical cartridge 670 or a different cartridge 70, 270, 370, 470, 570. For example, as with the wedge slider 378, 478, 578 discussed above, some cartridges 70, 270, 370, 470, 570 can be equipped with 680 blades configured for different procedures like those described above.D. Wedge slider with exemplifying translatable blade
[0104] Figures 25 and 26 show another exemplary alternative wedge slider 778 for use with cartridge 770, which is a modified version of cartridge 70, 270. In many respects, the wedge slider 778 of this example is similar to the wedge slider 778. wedge 78, 378, 478, 578, 678 described above. Like the wedge slider 378, 478, 578, 678, the wedge slider 778 has been modified from the wedge slider 78 to include an integral secondary cutting blade 780. In particular, as best seen in Figure 25, the slider Wedge 778 includes a body 777 and a cam surface 779. The body 777 and cam surface 779 are shorter relative to the cam surface 79 of the wedge slider 78, yet the cam surface 779 is oriented in a angle that is steeper than the cam surface angle 79 of the wedge slider 78. Consequently, the wedge slider 778 occupies the same amount of space longitudinally within the cartridge 70, 270 as the wedge slider 78, making the wedge slider 78 wedge slider 778 substantially interchangeable with wedge slider 78. The angle of cam surfaces 779 allows wedge slider 778 to drive multiple clamp drivers 75 upward simultaneously and/or in a certain sequence. predetermined ance.
[0105] The blade 780 comprises an upper cutting portion 790, a body portion 792 and a stabilizing member 794. The cutting portion 790 comprises a distally oriented cutting edge 791 which is configured to cut through the holder 280 and/or fabric 90. As with the cutting edge 390, 490, 590, 691 described above, the cutting edge 791 can have a variety of alternative configurations that can be configured to cut through a variety of materials.
[0106] Unitary body portion 792 couples blade 780 with wedge slider 778. In other words, wedge slider 778 and blade 780 comprise a single unitary component in this example. In another example, blade 780 may be detached from and secured by attachment to wedge slider 778. Body portion 792 is sized to raise cutting portion 790 to a height suitable for cutting support 280. body portion 792 is shown to have a specific height, it should be understood that the height of body portion 792 can be varied according to numerous factors such as height of platform 773, support 280, thickness, etc.
[0107] Stabilizing element 794 is positioned above cutting edge 791 and extends distally from blade 780. As can best be seen in Figure 26, stabilizing element 794 is positioned to align with the top surface of support 280 Accordingly, the stabilizing element 794 is operable to drive the holder 280 to the cutting edge 791 and can further assist in preventing the holder 280 from detaching from the platform 773 in the region adjacent the blade 780, as will be described in more detail below. Additionally, stabilizing element 794 acts as a shield to prevent inadvertent operator contact with cutting edge 791. Although stabilizing element 794 is shown to have a generally rectangular shape that extends a specific distance, it should be understood that the stabilizing element 794 can be of any suitable size or shape. For example, in other examples the stabilizing element 794 may extend distally beyond that shown. In still other examples, stabilizing element 794 may taper outward or inward to a width that is greater or lesser than blade 780, respectively. Of course, stabilizing member 794 may comprise any other suitable configuration, size and/or shape as will be apparent to those skilled in the art in view of the teachings herein.
[0108] In an exemplary mode of operation, the blade 780 initially projects out of the cartridge 70, 270 at the proximal end of the cartridge 70, 270. The stabilizing element 794 is configured to protect an operator from unwanted contact with the cutting edge 791 while cartridge 70, 270 is inserted into lower jaw 50. Accordingly, an operator is protected from inadvertent contact with blade 780 even if blade 780 protrudes out of cartridge 70, 270.
[0109] After a user inserts the 70, 270 cartridge into the 50 lower jaw, the firing sequence can be started. After the firing sequence is initiated, the firing bar 82 is actuated distally so that the knife member 80 makes contact with the wedge slider 778. As shown in Figure 26, the knife element 80 makes contact with the wedge slider 778. the wedge slider 778 and begins to drive 778 the wedge slider 780 and the blade distally. As the blade 780 is driven distally, the stabilizing element 794 of the wedge slider 778 moves over the upper surface of the holder 280 to stabilize the cutting process. It should be understood that as the stabilizing element 794 travels on top of the support 280, the blade 780 cuts only the support 280. In other examples, the cutting edge 791 of the blade 780 may be configured to be vertically taller. In some of these examples, the stabilizing element 794 can travel over tissue 90 or a support 280 that is adjacent to the anvil 60. Thus, in another example, the blade 780 can be configured to cut materials other than the support 280, such as fabric 90 or other additional supports 280. Cutting edge 84 of knife member 80 may follow immediately behind blade 780, so cutting edge 84 cuts any fabric 90 or support 280 of material not cut by blade 780.
[0110] It should be understood that the cutting edge 84 of the knife member 80 and the cutting edge 790 of the blade 780 follow a path that is substantially identical. Such a path may generally be defined by a channel extending longitudinally (not shown) of the cartridge 770. In making the first cut pass through the holder 280 (and, in some versions, the fabric as well 90), the blade 780 can reduce wear and/or buildup on knife member 80, thus prolonging the life of knife member 80. Additionally, it should be understood that both blade 780 and knife member 80 can follow cam surfaces. 779, so that the wedge slider 778 drives the staples 77 through a given region of tissue before that specific region of tissue is cut by a blade 480 or knife element 80. The stapling and cutting action can still be substantially simultaneously in the fabric region because the wedge slider 778 is configured so that the time difference between stapling and cutting is substantially short.
[0111] After the instrument 10 is fired, the cartridge 70,270 can be removed together with the blade 780, so that a new cartridge 70, 270, 470, 570 can be inserted into the lower jaw 50. It should be understood that the cartridge 70, 270 may be replaced with an identical cartridge 70, 270 or a different cartridge 70, 270, 470, 570. For example, as with the wedge slider 378, 478, 578, 678 discussed above, some cartridges 570 may be equipped with 780 blades configured for different procedures like those described above. IV. Several
[0112] It should be understood that in the various examples described above, a pivot joint is configured to allow an end actuator to pivot along a foreground and therefore be deflected away from the longitudinal axis of a rod assembly. . A locking assembly is operable to selectively lock the pivot joint. The locking assembly includes a locking member which is movable along a second plane to selectively engage the first locking member and thereby lock the hinge joint. The background is offset from the foreground. The background is also non-parallel to the foreground. In some cases, the second locking member is movable along a second axis that is perpendicular to the longitudinal axis of the rod assembly. An unlocking member can selectively unlock the locking member. The unlocking member may move along a third plane, which may be offset from and/or in a non-parallel relationship with the first and/or background planes. The unlocking member may move along a third axis, which may be perpendicular to the longitudinal axis of the rod assembly and/or the second axis.
[0113] 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, embodiments, examples, etc. which are described in the present invention. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen in isolation from one another. Various suitable ways in which the teachings of the present invention may be combined will become 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. It is to be understood that the various teachings of the present invention can be readily combined with the teachings of the various references which are cited in the present invention.
[0114] It is to be understood that any patent, publication, or other disclosure material deemed to be incorporated by reference herein, in whole or in part, is incorporated into the present invention only to the extent that the incorporated material does not conflict with the definitions, statements or other disclosed material set forth in this disclosure. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein supersedes any conflicting material incorporated into the present invention by reference. Any material, or portions thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other existing disclosure material presented herein, is incorporated herein only to the extent that there is no conflict between the material embedded and existing developing material.
[0115] 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 various teachings herein can be readily combined with various teachings of any of the following: US Patent No. 5,792,135 entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity" , issued August 11, 1998, the disclosure of which is incorporated herein by reference; US Patent No. 5,817,084 entitled "Remote Center Positioning Device with Flexible Drive", issued October 6, 1998, the disclosure of which is incorporated herein by reference; U.S. Patent No. 5,878,193, entitled "Automated Endoscope System for Optimal Positioning," issued March 2, 1999, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,231,565 entitled "Robotic Arm DLUS for Performing Surgical Tasks," issued May 15, 2001, the disclosure of which is incorporated herein by reference; US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument", issued August 31, 2004, the disclosure of which is incorporated herein by reference; US Patent No. 6,364,888 entitled "Alignment of Master and Slave in a Minimally Invasive Surgical Apparatus", issued April 2, 2002, the disclosure of which is incorporated herein by reference; US Patent No. 7,524,320 entitled "Mechanical Actuator Interface System for Robotic Surgical Tools", issued April 28, 2009, the disclosure of which is incorporated herein by reference; US Patent No. 7,691,098 entitled "Platform Link Wrist Mechanism", issued April 6, 2010, the disclosure of which is incorporated herein by reference; US Patent No. 7,806,891 entitled "Repositioning and Reorientation of Master/Slave Relationship in Minimally Invasive Telesurgery," issued October 5, 2010, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2013/0012957 entitled "Automated End Effector Component Reloading System for Use with a Robotic System", published January 10, 2013, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0199630 entitled "Robotically-Controlled Surgical Instrument with Force-Feedback Capabilities", published August 9, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0132450 entitled "Shiftable Drive Interface for Robotically-Controlled Surgical Tool", published May 31, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0199633 entitled "Surgical Stapling Instruments with Cam-Driven Staple Deployment Arrangements", published August 9, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0199631 entitled "Robotically-Controlled Motorized Surgical End Effector System with Rotary Actuated Closure Systems Having Variable Actuation Speeds", published August 9, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0199632 entitled "Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector", published August 9, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0203247, entitled "Robotically-Controlled Surgical End Effector System", published August 9, 2012, the disclosure of which is incorporated herein by reference; US Patent Publication No. 2012/0211546 entitled "Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot", published August 23, 2012; US Patent Publication No. 2012/0138660 entitled "Robotically-Controlled Cable-Based Surgical End Effectors", published June 7, 2012, the disclosure of which is incorporated herein by reference; and/or US Publication No. 2012/0205421 entitled "Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems", published August 16, 2012, the disclosure of which is incorporated herein by reference.
[0116] Versions of the device described above can be designed to be discarded after a single use, or they can be designed to be used multiple times. Versions can, in either or both cases, be reconditioned for reuse after at least one use. Overhaul can include any combination of the steps of disassembling the device, followed by cleaning or replacing specific parts, and subsequent reassembly. Specifically, some versions of the device may be disassembled into any number of particular parts, or parts of the device may be selectively replaced or removed in any combination. By cleaning and/or replacing particular parts, some versions of the device can be reassembled for subsequent use in a refurbishment facility or by a user immediately prior to a surgical procedure. Those skilled in the art will understand that refurbishing a device can use a variety of disassembly, cleaning/replacement and reassembly techniques. The use of such techniques and the resulting refurbished device are within the scope of this application.
[0117] By way of example only, 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 field of radiation, 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 sterile 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.
[0118] Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described in the present invention may be carried out by means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and others will become apparent 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 mandatory. Accordingly, the scope of the present invention is to be considered in accordance with the terms of the following embodiments and it is understood that the same is not limited to the details of structure and operation shown and described in the specification and drawings.

权利要求:
Claims (17)
[0001]
1. Apparatus comprising: (a) a body; (b) a shaft assembly (30) extending distally from the body, wherein the shaft assembly defines a longitudinal axis, wherein the shaft assembly has a distal end ;(c) an end actuator (40) positioned at the distal end of the shaft assembly, wherein the end actuator comprises a lower jaw, a pivoting anvil and a translating cutter, wherein the translating cutter is operable to translate relative to the lower jaw and anvil; (d) a cartridge (370), wherein the cartridge is insertable into the lower jaw, wherein the cartridge includes a plurality of clips; and (e) a staple driver actuator (378) disposed in the cartridge, wherein the staple driver actuator comprises a secondary cutting element, the end actuator translating cutter being operable to cut the tissue and direct the staple driver actuator distally for inserting staples into tissue; characterized in that the staple driver actuator (378) further comprises a secondary cutting element (380) that moves distally with the staple driver actuator while driving the staples. fabric staples.
[0002]
2. Apparatus according to claim 1, characterized in that the secondary cutting element (380) comprises a straight cutting edge oriented at an oblique angle to the cartridge.
[0003]
3. Apparatus according to claim 1, characterized in that the secondary cutting element (380) comprises a curved cutting edge.
[0004]
Apparatus according to claim 1, characterized in that the secondary cutting element (380) comprises a cutting edge configured to cut soft tissue.
[0005]
An apparatus according to claim 1, characterized in that the secondary cutting element (380) comprises a cutting edge configured to cut dense tissue.
[0006]
6. Apparatus according to claim 1, characterized in that the secondary cutting element (380) is configured to move selectively between a retracted position and an extended position, the secondary cutting element being disposed in the cartridge when the secondary cutting element is in the retracted position, wherein at least a portion of the secondary cutting element extends through a longitudinally extending groove in the cartridge when the secondary cutting element is in the extended position.
[0007]
7. Apparatus according to claim 6, characterized in that the secondary cutting element (380) is resiliently forced towards the retracted position.
[0008]
8. Apparatus according to claim 7, characterized in that the secondary cutting element (380) is operable to rotate between the retracted position and the extended position.
[0009]
9. Apparatus according to claim 7, characterized in that the secondary cutting element (380) is operable to translate at an oblique angle to the cartridge to transition between the retracted position and the extended position.
[0010]
10. Apparatus according to claim 9, characterized in that the secondary cutting element (380) includes a translation slider, wherein the clamp driver actuator comprises a translation slot, wherein the translation slider and the translation slot are configured to mate to transition the secondary cutting element between the retracted position and the extended position.
[0011]
11. Apparatus according to claim 10, characterized in that the clamp driver actuator comprises a resilient member (686), wherein the secondary cutting element (380) further comprises a distally extending member, in that the distally extending member is configured to engage the staple driver actuator resilient member to resiliently force the secondary cutting element toward the retracted position.
[0012]
12. Apparatus, according to claim 1, characterized in that the secondary cutting element (380) is fixed in relation to the staple driver actuator.
[0013]
13. Apparatus according to claim 12, characterized in that the cartridge includes a guard (469) protruding from the cartridge, wherein the guard is positioned proximally on the cartridge, wherein the secondary cutting element is operable to selectively move in and out of the guard.
[0014]
An apparatus according to claim 12, characterized in that the secondary cutting element (380) includes a distal projection and a distally oriented cutting edge, wherein the distal projection is oriented above the cutting edge.
[0015]
Apparatus according to any one of claims 1 to 14, characterized in that it further comprises a support, at least a portion of the support being oriented adjacent to the cartridge, the secondary cutting element (380) ) is configured to cut through at least a portion of the support.
[0016]
16. Apparatus according to claim 1, characterized in that the cartridge is a removable cartridge and comprises: (i) a housing, (ii) a plurality of clips arranged in the housing, (iii) a platform disposed on the plurality of clips, the platform defining openings, each opening being disposed over a respective clip, (iv) a support (280) at least partially disposed on the platform, and the secondary cutting element having a sharp edge configured to separate at least a portion of the Support.
[0017]
An apparatus according to claim 1, characterized in that the cartridge is one of a plurality of staple cartridges, wherein each cartridge of the plurality of staple cartridges is configured to be interchangeably insertable into the end actuator, in that each staple cartridge of the plurality of staple cartridges is configured for a different surgical procedure.

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引用文献:

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法律状态:
2020-04-28| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-08-03| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2021-08-17| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2021-09-08| B06A| Patent application procedure suspended [chapter 6.1 patent gazette]|

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2021-11-16| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2022-01-18| 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 08/09/2015, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US14/489,746|2014-09-18|

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US14/489,746|US10105142B2|2014-09-18|2014-09-18|Surgical stapler with plurality of cutting elements|

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PCT/US2015/048852|WO2016043999A1|2014-09-18|2015-09-08|Surgical stapler with plurality of cutting elements|

---