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    • 专利摘要:
    The present invention relates to an apparatus including a body, a drive shaft assembly, a stapling head assembly and an anvil. the staple head assembly includes a platform member, a plurality of staples and a driver. the platform member includes a first platform surface, a second platform surface, an outer annular array of clip openings formed through the platform surfaces, an internal annular array of clip openings formed across the platform surfaces, and a plurality of distancing features extending distally from the second platform surface. the second platform surface is lowered relative to the first platform surface. The actuator is operable to drive the clamps through the clamp openings. The anvil is operable to compress the fabric against the platform surface.
    公开号:BR112019009663A2
    申请号:R112019009663
    申请日:2017-05-31
    公开日:2019-09-10
    发明作者:C Miller Christopher；E Shelton Frederick Iv
    申请人:Ethicon Llc；
    IPC主号:
    专利说明:

    Invention Patent Descriptive Report for CIRCULAR SURGICAL STAPLER WITH ANGULATELY ASYMMETRIC PLATFORM RESOURCES.
    BACKGROUND OF THE INVENTION [001] In some surgical procedures (for example, colorectal, bariatric, thoracic, etc.), portions of a patient's digestive tract (for example, the gastrointestinal and / or esophageal tract, etc.) can be cut and removed to eliminate unwanted tissue or for other reasons. After the tissue is removed, the remaining portions of the digestive tract can be coupled in an end-to-end anastomosis. End-to-end anastomosis can provide a substantially unobstructed flow path from one portion of the digestive tract to the other portion of the digestive tract, without also providing any type of leak at the anastomosis site.
    [002] An example of an instrument that can be used to provide an end-to-end anastomosis is a circular stapler. Some of these staplers work to hold layers of fabric together, cut through the layers of fabric stuck and have the clips go through the fabric layers to substantially seal the fabric layers together near the separate ends of the fabric layers, joining thus, two separate ends of an anatomical lumen together. The circular stapler can be configured to cut the fabric and seal the fabric substantially simultaneously. For example, the circular stapler can separate excess tissue, which is inside an annular matrix of staples in an anastomosis, to provide a substantially smooth transition between the sections of anatomical lumen that are joined in the anastomosis. Circular staplers can be used in open procedures or in
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    2/38 endoscopic procedures. In some cases, a portion of the circular stapler is inserted through the hole that occurs naturally in a patient.
    [003] Examples of circular staplers are described in US Patent No. 5,205,459, entitled Surgical Anastomoseis Stapling Instrument, issued on April 27, 1993; US Patent No. 5,271,544, entitled Surgical Anastomosis Stapling Instrument, issued December 21, 1993; US Patent No. 5,275,322, entitled Surgical Anastomosis Stapling Instrument, issued January 4, 1994; US Patent No. 5,285,945, entitled Surgical Anastomosis Stapling Instrument, issued February 15, 1994; US Patent No. 5,292,053, entitled Surgical Anastomosis Stapling Instrument, issued March 8, 1994; US Patent No. 5,333,773, entitled Surgical Anastomosis Stapling Instrument, issued August 2, 1994; US Patent No. 5,350,104, entitled Surgical Anastomosis Stapling Instrument, issued September 27, 1994; US Patent No. 5,533,661, entitled Surgical Anastomosis Stapling Instrument, issued July 9, 1996; and in US Patent No. 8,910,847, entitled Low Cost Anvil Assembly for Circular Stapler, published on December 16, 2014. The description of each of the aforementioned US patents is incorporated by reference in the present invention.
    [004] Some circular staplers may include a motorized drive mechanism. Examples of circular staplers with motorized drive mechanisms are described in the US patent publication. 2015/0083772, entitled Surgical Stapler with Rotary Cam Drive and Return, published on March 26, 2015; US publication No. 2015/0083773, entitled Surgical Stapling Instrument with Drive Assembly Having Toggle Features, published on March 26, 2015; in US publication No. 2015/0083774, entitled
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    3/38 of Control Features for Motorized Surgical Stapling Instrument, published on March 26, 2015; and in US publication No. 2015/0083775, entitled Surgical Stapler with Rotary Cam Drive, published on March 26, 2015. The disclosure of each of the aforementioned US patent publications is incorporated by reference in the present invention.
    [005] Although various types of surgical stapling instruments and associated components have been produced and used, it is believed that no one before the inventor (s) has produced or used the invention described in the attached claims.
    BRIEF DESCRIPTION OF THE DRAWINGS [006] Although the specification concludes with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples, taken in conjunction with the accompanying drawings , in which like reference numbers identify like elements, and in which:
    [007] Figure 1 represents a perspective view of an exemplary circular stapler;
    [008] Figure 2 represents a perspective view of the circular stapler of Figure 1, with a battery removed from a cable assembly and an anvil removed from a stapling head assembly;
    [009] Figure 3 represents a perspective view of the anvil of the circular stapler of Figure 1;
    [0010] Figure 4 represents a perspective view of the stapling head assembly of the circular stapler of Figure 1;
    [0011] Figure 5 represents an exploded perspective view of the stapling head assembly of Figure 4;
    [0012] Figure 6 represents an exploded perspective view
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    4/38 of the circular stapler of Figure 1, with portions of the drive shaft assembly shown separately from each other;
    [0013] Figure 7A represents a cross-sectional side view of the anvil of Figure 3 positioned within a first section of a digestive tract and the stapling head assembly of Figure 4 positioned in a second section of the digestive tract, with the anvil separated from the stapling head assembly;
    [0014] Figure 7B represents a cross-sectional side view of the anvil of Figure 3 positioned within the first section of the digestive tract and the stapling head set of Figure 4 positioned in the second section of the digestive tract, with the anvil attached to the set the stapling head;
    [0015] Figure 7C represents a side view in cross section of the anvil of Figure 3 positioned within the first section of the digestive tract and the stapling head assembly of Figure 4 positioned in the second section of the digestive tract, with the anvil retracted towards to the stapling head assembly so as to secure the fabric between the anvil and the stapling head assembly;
    [0016] Figure 7D represents a cross-sectional side view of the anvil of Figure 3 positioned within the first section of the digestive tract and the stapling head set of Figure 4 positioned in the second section of the digestive tract, with the head set of stapling actuated to cut and staple the attached fabric;
    [0017] Figure 7E represents a cross-sectional side view of the first and second sections of the digestive tract of Figure 7A joined together in an end-to-end anastomosis;
    [0018] Figure 8 represents a partial perspective view of the
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    5/38 stapling head assembly and drive shaft assembly of the circular stapler in Figure 1 inserted into a patient's colon, with the stapling head assembly positioned close to the patient's sacrum, and with the patient's anatomy shown in transversal section;
    [0019] Figure 9 represents a partial perspective view of the stapling head assembly and the driving shaft assembly of the circular stapler of Figure 1 inserted into a patient's colon, with the stapling head assembly engaging a fold of tissue the colon, and with the patient's anatomy shown in cross section;
    [0020] Figure 10 represents a perspective view of an exemplary alternative stapling head assembly that can be incorporated into the circular stapler of Figure 1;
    [0021] Figure 11 represents a top plan view of a platform member of the staple head assembly of Figure 10; and [0022] Figure 12 is a perspective view in partial cross section of the stapling head assembly of Figure 10 positioned in a section of a digestive tract.
    [0023] The drawings are not intended to be limiting in any way and it is envisaged that various modalities of technology can be performed in a variety of other ways, including those not necessarily represented in the drawings. The drawings incorporated in the annex and forming part of the specification illustrate various aspects of the present technology and, together with the description, serve to explain the principles of the technology; it is understood, however, that this technology is not limited to precisely the provisions shown.
    DETAILED DESCRIPTION
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    6/38 [0024] The following description of certain examples of the technology should not be used to limit its scope. Other examples, resources, aspects, modalities and advantages of the technology will become evident to those versed in the technique from the following description, which is given by way of illustration, one of the best ways contemplated to execute the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without disregarding the technology. Consequently, drawings and descriptions should be considered as illustrative and not restrictive in nature.
    Overview of the exemplary circular stapling surgical instrument [0025] Figures 1 to 2 represent an exemplary surgical circular stapling instrument 10 that can be used to provide an end-to-end anastomosis between two sections of an anatomical lumen, as a portion of the digestive tract of a patient. The instrument 10 in this example comprises a cable assembly 100, a drive shaft assembly 200, a stapling head assembly 300, an anvil 400 and a removable battery 120. Each of these components will be described in more detail below. It should be understood that, in addition to or in place of the aforementioned, instrument 10 can still be constructed and operable in accordance with at least some of the teachings of US patent application No. 14 / 751,612, entitled Method of Applying an Annular Array of Staples to Tissue, deposited on June 26, 2015; US patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US patent No. 5,533,661; and / or US Patent No. 8,910,847, the disclosures of which are hereby incorporated by reference. Still other suitable settings
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    7/38 will be evident to one skilled in the art in view of the teachings described here.
    Exemplary fabric engaging features of the circular stapling instrument [0026] As best seen in Figure 3, the anvil 400 of the present example comprises a head 410 and a stem 420. The head 410 includes a proximal surface 412 that defines a plurality of staple forming pockets 414. The staple forming pockets 414 are arranged in two concentric annular arrays in the present example. The staple forming pockets 414 are configured to deform the staples as the staples are pushed into the staple forming pockets 414 (for example, deforming a staple that has a generic U shape to a B shape, as it is known in technique). The stem 420 defines a hole or lumen 422 and includes a pair of pivoting lock members 430 positioned in the hole 422. Each lock member 430 includes features that allow the anvil 400 to be removably attached to a trocar 330 of the head assembly staple 300, as will be described in more detail below. It should be understood, however, that the anvil 400 can be removably attached to a trocar 330 using any other suitable components, resources or techniques.
    [0027] The stapling head assembly 300 is located at the distal end of the drive shaft assembly 200. As shown in Figures 1 to 2, the anvil 400 is configured to be removably coupled to the drive shaft assembly 200, adjacent to stapling head assembly 300. As will be described in more detail below, anvil 400 and stapling head assembly 300 are configured to cooperate with tissue manipulation in three ways, including the
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    8/38 tightening the fabric, cutting the fabric and stapling the fabric. As can best be seen in Figures 4 to 5, the stapling head assembly 300 comprises a tubular housing 310 which houses a sliding clip driver member 350. A cylindrical inner core member 312 extends distally within the tubular housing 310. O tubular housing 310 is fixedly attached to an outer sheath 210 of the drive shaft assembly 200, so that tubular housing 310 serves as a mechanical support for the staple head assembly 300.
    [0028] The trocar 330 is positioned coaxially within the inner core member 312 of the tube housing 310. The trocar 330 is operable to move distally and proximally to the tube housing 310 in response to the rotation of a button 130 located at the end proximal to the cable assembly 100. The trocar 330 comprises a drive shaft 332 and a head 334. Head 334 includes a pointed tip 336 and a proximal surface extending inward 338. Head 334 and the distal portion of the shaft drive 332 are configured for insertion in hole 422 of anvil 420. The proximal surface 338 is configured to complement the features of the locking members 430 to provide a pressure fit between the anvil 400 and the trocar 330.
    [0029] The clip driver member 350 is operable to act longitudinally within the tubular housing 310 in response to the activation of the motor 160 as will be described in more detail below. Staple trigger member 350 includes two concentric annular arrays presented distally from staple actuators 352. Staple actuators 352 are arranged to match the arrangement of staple forming pockets 414 described above. Thus, each staple driver 352 is configured to drive a corresponding staple into a color staple forming pocket
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    9/38 respondent © 414 when the stapling head assembly 300 is triggered. The clip driver member 350 also defines a bore 354 that is configured to receive coaxially a core member 312 of tubular casing 310.
    [0030] A cylindrical knife member 340 is positioned coaxially within the clip trigger member 350. The knife member 340 includes a sharp circular cutting edge, presented distally 342. The knife member 340 is dimensioned in such a way that the member knife edge 340 defines an outer diameter that is less than the diameter defined by the internal annular matrix of clamp actuators 352. Knife member 340 also defines an aperture that is configured to coaxially receive a core member 312 of tube housing 310.
    [0031] A platform member 320 is fixedly attached to the tubular housing 310. The platform member 320 includes a distally presented platform surface 322 that defines two concentric annular arrays of staple openings 324. The staple openings 324 are arranged to match to the clamp actuators 352 and the clamp-forming pockets 414 described above. In this way, each staple opening 324 is configured to provide a path for a corresponding staple driver 352 to drive a corresponding staple through the platform member 320 and into a corresponding staple forming pocket 414 when the staple head assembly 300 is triggered. It should be understood that the arrangement of the staple openings 322 can be modified exactly like the arrangement of staple forming pockets 414 as described above. It should also be understood that various structures and techniques can be used to contain the staples within the staple head assembly 300 before the staple head assembly
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    10/38 ament 300 to be triggered. The platform member 320 defines an internal diameter that is only slightly larger than the outside diameter defined by the knife member 340. The platform member 320 is thus configured to allow the knife member 340 to move distally to a point where the cutting edge 342 is distal to the platform surface 322.
    [0032] Figure 6 shows various components of the drive shaft assembly 200, which extends distally from the cable assembly 100 and couples the components of the staple head assembly 300 to the components of the cable assembly 100. In particular, and how mentioned above, the drive shaft assembly 200 includes an outer sheath 210 that extends between the cable assembly 100 and the tubular sheath 310. In the present example, the outer sheath 210 is rigid and includes a preformed curved section 212 that it is configured to facilitate the positioning of the stapling head assembly 300 in a patient's colon, as described below. The curved section 212 includes an inner curve 216 and an outer curve 214.
    [0033] The drive shaft assembly 200 additionally includes a trocar actuation rod 220 and a trocar actuation band assembly 230. The proximal end of the trocar actuation band assembly 230 is fixedly attached to the proximal end of the shaft trocar 332. The proximal end of the trocar 230 drive band assembly is fixedly attached to the distal end of the trocar trigger rod 220, so that the trocar 330 will move longitudinally with respect to the outer sheath 210 in response to the translation of the set of the drive band for the trocar 230 and the drive stem of the trocar 220 in relation to the outer sheath 210. The set of the operating band of the trocar 230 is configured to flex from
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    11/38 so that the set of actuating band of the trocar 230 can follow along the preformed curve in the set of drive shaft 200 as the set of band of actuation of the trocar 230 is translated longitudinally in relation to the outer sheath 210. However, the trocar drive band assembly 230 has sufficient column strength and tensile strength to transfer the distal and proximal forces from the trocar actuation rod 220 to the trocar drive 332. The trocar drive 220 it is rigid. A clamp 222 is fixedly attached to the trocar drive rod 220 and is configured to cooperate with complementary features within the cable assembly 100 to prevent the trocar driver 220 from rotating within the cable assembly 100 while still allowing the stem trocar driver 220 translates longitudinally within the cable assembly 100. The trocar driver 220 also includes a thick helical thread 224 and a thin helical thread 226.
    [0034] The drive shaft assembly 200 additionally includes a staple head assembly 240 which is slidably received within the outer sheath 210. The distal end of the staple head assembly 240 is fixedly attached to the proximal end of the staple trigger member 350. The proximal end of the staple head assembly trigger 240 is attached to a drive bracket 250 via a pin 242. It is therefore to be understood that the staple trigger member 350 is longitudinally moved in relation to to the outer sheath 210 in response to translation of the staple head assembly 240 and the drive bracket 250 relative to the outer sheath 210. Staple head assembly 240 is configured to flex so that the stapling head assembly 240 can follow
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    12/38 along the preformed curve in the drive shaft assembly 200 as the staple head assembly 240 is longitudinally translated in relation to the outer sheath 210. However, the staple head assembly 240 has a column strength sufficient to transfer distal forces from the drive bracket 250 to the clip trigger member 350.
    B. Circular Stapling Instrument User Input Exemplifying Features [0035] As shown in Figure 1, the cable assembly 100 includes a pistol grip 112 and various components that are operable to act on the anvil 400 and the head assembly. stapling 300. In particular, the cable assembly 100 includes a button 130, a safety trigger 140, a trigger trigger 150, a motor 160 and a motor drive module 180. Button 130 is coupled to the drive stem of the trocar 220 by means of a nut (not shown), so that the thick helical thread 224 will selectively engage a thread engaging feature within the nut; and in such a way that the fine helical screw 226 will selectively engage a thread engaging feature (not shown) inside the button 130. These complementary structures are configured so that the trocar stem 220 will first translate move proximally at a relatively slow rate, then move proximally at a relatively fast rate in response to the rotation of knob 130.
    [0036] It should be understood that when the anvil 400 is coupled to the trocar 330, the rotation of the button 130 will provide the corresponding translation of the anvil in relation to the staple head assembly 300. It should also be understood that the button 130 can be rotated in a first angular direction (for example, in the
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    13/38 clockwise) to retract the anvil 400 towards the staple head assembly 300; and in a second angled direction (for example, counterclockwise) to advance the anvil 500 in the opposite direction of the staple head assembly 300. The knob 130 can therefore be used to adjust the gap between the opposing surfaces 412 322 of the anvil 400 and the stapling head assembly 300 until a suitable span distance has been obtained.
    [0037] In the present example, the cable assembly 100 comprises a feedback feature for user 114 that is configured to provide the operator with visual feedback indicating the positioning of the anvil 400 in relation to the stapling assembly 300. The operator can then , observe the feedback feature for user 114 while turning the knob 130, to confirm that the proper gap between the anvil 400 and the stapling set 300 has been reached. As an example only, the feedback feature for user 114 can be configured and operable according to at least some of the teachings in US patent application No. 14 / 751,612, entitled Method of Applying an Annular Array of Staples to Tissue, filed on June 26, 2015, the disclosure of which is hereby incorporated by reference. Other suitable ways of providing feedback to the user will be evident to those skilled in the art in view of the teachings in this document.
    [0038] The trigger trigger 150 is operable to drive the motor 160 to thereby trigger the staple head assembly 300. The safety trigger 140 is operable to selectively block the trigger trigger 150 based on the longitudinal position of the anvil 400 in relation to the stapling head assembly 300. The cable assembly 100 also includes components that
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    14/38 are operable to selectively lock both triggers 140, 150 based on the position of the anvil 400 in relation to the staple head assembly 300. When the triggers 140, 150 are blocked, the trigger trigger 150 is prevented from starting the actuation of the staple head assembly 300. In this way, the trigger 150 is operable only to initiate the activation of the staple head assembly 300 when the position of the anvil 400 in relation to the staple head assembly 300 is within a pre range -definite.
    [0039] In the present example, the trigger trigger 150 of the present example includes an integral actuating paddle, such as the paddle shown and described in US patent application No. 14 / 751,231, entitled Ultrasonic Surgical Instrument With Staged Clamping, filed on 26 June 2015, the disclosure of which is hereby incorporated by reference. The paddle is configured to activate a motor activation module switch 180 (Figure 1) when the trigger trigger 150 is turned to a triggered position. The motor drive module 180 is in communication with the battery 120 and the motor 160, so that the motor drive module 180 is configured to supply the motor 160 with electrical power from the battery 120 in response to the blade that drives the motor drive module key 180. In this way, the motor 160 will be activated when the trigger trigger 150 is turned. This drive of the motor 160 will act the stapling head assembly 300, as described in more detail below.
    [0040] The purpose of battery 120 is to supply electrical power to a motor 160, as noted above. The battery 120 can be removably attached to the cable assembly 100 via a snap fit or in any other suitable manner. It should be understood that battery 120 and cable assembly 100 may have an
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    15/38 electrical devices, pins and complementary sockets and / or other resources that provide paths for electrical communication of the battery 120 with components electrically powered in the cable assembly 100 when the battery 120 is coupled to the cable assembly 100. It should also be understood that , in some versions, the battery 120 is incorporated unitarily within the cable assembly 100, so that it (the battery 120) cannot be removed from the cable assembly 100.
    C. Exemplary anastomosis procedure with circular stapling instrument [0041] Figures 7A to 7E show instrument 10 being used to form an anastomosis 70 between two tubular anatomical structures 20, 40. Just as an example, the tubular anatomical structures 20 , 40 may comprise sections of a patient's esophagus, sections of a patient's colon, other sections of the patient's digestive system, or any other anatomical tubular structures. In some versions, one or more diseased portions of a patient's colon are removed, with the anatomical tubular structures 20, 40 of Figures 7A to 7E representing the remaining separate portions of the colon.
    [0042] As shown in Figure 7A, the anvil 400 is positioned on a anatomical tubular structure 20 and the clamping head assembly 300 is positioned on another anatomical tubular structure 40. In versions where the anatomical tubular structures 20, 40 comprise the colon sections of a patient, the stapling head assembly 300 can be inserted through the patient's rectum. It should also be understood that the procedure depicted in Figures 7A to 7E is an open surgical procedure, although the procedure can instead be performed by laparoscopy. Just as an example, such a surgical procedure can be provided according to at least some of the teachings
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    16/38 of US Publication No. 2016/0100837, entitled Staple Cartridge, published on April 14, 2016, the disclosure of which is incorporated herein by reference; and / or US patent application No. 14 / 864,310, entitled Apparatus and Method for Reprocessing a Medical Device, filed on September 24, 2015, the disclosure of which is hereby incorporated by reference. The various suitable ways in which the instrument 10 can be used to form an anastomosis 70 in a laparoscopic procedure will be evident to those skilled in the art in view of the teachings presented here.
    [0043] As shown in Figure 7A, the anvil 400 is positioned on the anatomical tubular structure 20 so that the stem 420 protrudes from the open cut end 22 of the anatomical tubular structure 20. A pouch suture 30 is provided over a region medium of the stem 420 to generally hold the anvil position 400 on the anatomical tubular structure 20. Likewise, the stapling head assembly 300 is positioned on the anatomical tubular structure 40 so that the trocar 330 protrudes from the open cut end 42 of the anatomical tubular structure 20. A pouch suture 50 is provided over a mid-region of the drive shaft 332 to generally secure the position of the stapling head assembly 300 to the anatomical tubular structure 40.
    [0044] Then, the anvil 400 is attached to the trocar 330 by inserting the trocar 330 into hole 422, as shown in Figure 7B. Locking members 430 engage the trocar 334 head 330, thereby providing a secure fit between the anvil 400 and the trocar 330. The operator then turns the knob 130 while holding the cable assembly 100 stationary through the pistol grip 112. This rotation of knob 130 causes trocar 330 and anvil 400 to retract proximally, as described
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    17/38 above. As shown in Figure 7C, this proximal retraction of the trocar 330 and the anvil 400 compresses the tissue of the anatomical tubular structures 20, 40 between the surfaces 412, 322 of the anvil 400 and the staple head assembly 300. The operator observes the feedback to user 114 to determine whether the gap distance d between the opposing surfaces 412, 322 of the anvil 400 and the stapling head assembly 300 is adequate; and make any necessary adjustments using button 130.
    [0045] Once the operator has properly adjusted the span distance d using button 130, the operator pulls the safety trigger 140 to allow the trigger trigger 150 to be triggered. The operator then pulls the trigger trigger 150. This actuation of the trigger trigger 150 in turn activates a motor activation module key 180, which in turn activates the motor 160 to actuate the stapling head assembly 300 by activating the knife member 340 and the clip trigger member 350 distally as shown in Figure 7D. As knife member 340 travels distally, cutting edge 342 of knife member 340 cooperates with inner edge 416 of anvil 400, thus shearing excess tissue that is positioned within annular recess 418 of anvil 400 and inside knife member 340.
    [0046] As shown in Figure 4, the anvil 400 of the present example includes a breakable washer 417 within the annular cavity 418. This washer 417 is broken by knife member 340 when knife member 340 completes a full range of distal movement from the position shown in Figure 7C to the position shown in Figure 7D. The drive mechanism for knife member 340 can provide an increased mechanical advantage when knife member 340 reaches the end of its distal movement,
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    18/38 thus providing a greater force through which the washer breaks 417. Of course, the breakable washer 417 can be omitted entirely in some versions. In versions where washer 417 is included, it should be understood that washer 417 can also serve as a cutting edge for knife member 340 to assist in cutting the fabric. Such a cutting technique can be used in addition to, or in place of, the aforementioned shearing action between the inner edge 416 and the cut edge 342.
    [0047] As the staple trigger member 350 moves distally from the position shown in Figure 7C to the position shown in Figure 7D, the staple trigger member 350 drives the staples 90 through the tissue of tubular anatomical structures 20, 40 and into the staple forming pockets 414 of the anvil 400. The staple forming pockets 414 deform the driven staples 90 in a B shape, as is known in the art. The clips formed 90 in this way hold the ends of the tissue together, thus coupling the anatomical tubular structure 20 with the anatomical tubular structure 40.
    [0048] After the operator has activated the staple head assembly 300 as shown in Figure 7D, the operator turns the knob 130 to actuate the anvil 400 distally away from the staple head assembly 300, increasing the gap span d to facilitate the release of tissue between surfaces 412, 322. The operator then removes the instrument 10 from the patient, with the anvil 400 still attached to the trocar 330. Referring again to the example in which the tubular anatomical structures 20, 40 comprise sections of a patient's colon, the instrument 10 can be removed through the patient's rectum. With the instrument 10 removed, the anatomical tubular structures 20, 40 are left attached together by two annular arrays of clamps 90 to an anastomosis
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    19/38 if 70, as shown in Figure 7E. The internal diameter of anastomosis 70 is defined by the cut edge 60 left by knife member 340.
    Exemplary alternative stapling head set [0049] As noted above, in some cases, anatomical structures 20, 40 may comprise sections of a patient's colon. Figure 8 shows the staple head assembly 300 and a distal portion of the drive shaft assembly 200 arranged in a patient's colon C. As shown, the staple head assembly 300 and the drive shaft assembly 200 are inserted through the patient's rectum R. As also shown, the curvature of the curved section 212 is configured to generally complement the curvature of the patient's colon C. However, as also shown in Figure 8, there may be cases where the platform member 320 tends to compress the patient's colon C T tissue against the patient's sacrum S and / or some other substantially rigid anatomical structure. Depending on the angle at which the operator has inserted the staple head assembly 300 and the drive shaft assembly 200, and / or depending on the force that the operator is applying to the staple head assembly 300 and the drive shaft assembly 200 during insertion, the T tissue of the patient's colon C may be damaged (e.g., torn) when the T tissue is compressed between the stapling head assembly 300 and the patient's sacrum S. In versions where the platform member 320 has tissue tightening and / or other protruding features (eg, staple guidance features, etc.), these features may increase the risk of damage to the T tissue of the patient's colon C as per the stapling head assembly 300 and the drive shaft assembly 200 are being inserted into the patient's colon C.
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    20/38 [0050] Similarly, as shown in Figure 9, people of ordinary skill in the art will recognize that the T tissue of colon C defines a plurality of folds F, and that the staple head assembly 300 can bump into such folds F according to the stapling head assembly 300 and the drive shaft assembly 200 are inserted into the patient's colon C. This bump can also create a risk of damaging the T tissue of the patient's colon C. Again, in versions where the platform member 320 has tissue tightening and / or other protruding features (for example, staple guidance features, etc.), these features can increase the risk of damage to the T tissue of the patient's colon C when the stapling head assembly 300 hits the folds F.
    [0051] Therefore, it may be desirable to provide a version of the stapling head assembly 300 that minimizes the risk of damaging the patient's C colon T tissue during insertion of the stapling head assembly 300 and the drive shaft assembly 200 into the patient's colon C. In addition, it may be desirable to provide a version of the stapling head set 300 that includes features that improve the tightening of the fabric during the performance of the stapling head set 300, thereby promoting better cutting of the fabric and positioning of the staple, without increasing the risk of damage to the patient's colon C tissue during insertion of the stapling head assembly 300 and the drive shaft assembly 200 into the patient's colon C.
    [0052] Figure 10 shows an example exemplary stapling head assembly 500 that can be readily incorporated into the stapling instrument instead of the stapling head assembly 300. Except as described below, the stapling head assembly 500 of this example is configured and
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    21/38 operable just like the stapling head assembly 300 described above. The staple head assembly 500 of this example includes a platform member 502 that has a platform surface 522 that defines two concentric annular arrays of staple openings 524. Staple openings 524 are arranged to match the arrangement of staple actuators 352 and the staple forming pockets 414 described above. In this way, each clamp opening 524 is configured to provide a path for a corresponding clamp driver 352 to drive a corresponding clamp through the platform member 500 and into a corresponding clamp forming pocket 414 when the staple head assembly 500 is triggered. The platform member 502 defines an internal diameter that is only slightly larger than the outside diameter defined by the knife member 540. The platform member 502 is thus configured to allow the knife member 540 to move distally to a point where the cutting edge 542 is distal to the platform surface 522.
    [0053] Unlike the platform member 320 described above, the platform member 502 of the present example includes a first zone 510 and a second zone 550. The first zone 510 is characterized by the fact that the platform surface 522 is substantially flat within of the first zone 510. The first zone 510 includes an outer edge 520 that has a curved configuration. The outer edge 520 is thus configured to reduce the risk of the outer edge 520 colliding with tissue T as the staple head assembly 500 is inserted into the patient's colon C.
    [0054] The second zone 550 is characterized by the fact that it has a lowered platform surface 552 with a plurality of spacer features 560 that project upwards from the lowered platform surface 552. A stepped transition 530 is
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    22/38 formed at the boundaries between zones 510, 550, thus providing a drawdown from the platform surface 522 to the lowered platform surface 552. In some versions, the transition 530 is oriented perpendicularly to the surfaces 522, 552, so that transition 530 provides an abrupt drop from the platform surface 522 to the lowered platform surface 552. In some other versions, transition 530 is oriented obliquely to surfaces 522, 552, so that transition 530 provides an sloping transition between the platform surface 522 and the lowered platform surface 552. Alternatively, the transition 530 can have a curved configuration or any other suitable configuration.
    [0055] Spacing features 560 each include an outward facing surface 562, an outer wall portion 564, and an inner wall portion 566. Outward facing surfaces 562 are curved to complement the curved edge configuration external 520. The outward facing surfaces 562 are thus configured to reduce the risk of spacing resources 560 hitting tissue T when the staple head assembly 500 is inserted into the patient's C colon. The outer wall portions 564 are configured to partially wrap around the outer matrix of clamp openings 524. The outer wall portions 564 are thus configured and positioned to provide guidance for the clamps 90 exiting the outer matrix of clamp openings 524 The inner wall portions 564 are configured to partially wrap around the inner matrix of clamp openings 524. The inner wall portions 564 are thus configured and positioned to provide guidance for the clamps 90 exiting the inner matrix of clamp openings. 524.
    [0056] Since each portion of inner wall 566 is contiguous
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    23/38 with a corresponding outer wall portion 564, and since the internal matrix of clamp openings 524 is angularly displaced with respect to the internal matrix of clamp openings 524, each spacer feature 560 generally has a configuration in zigzag. In the present example, the upper edges 568 of the spacer features 560 are located on the same plane as the platform surface 522, so that the upper edges 568 and the platform surface 522 come into contact with the fabric along the same plane. In other words, although the lowered platform surface 552 is lowered in relation to the upper edges 568, the platform surface 522 is not lowered in relation to the upper edges 568. In some other versions, at least a portion of the upper edges 568 extends above or below the plane of the 522 platform surface.
    [0057] It should also be understood that the 560 spacing features are distinctly formed in the present example, so that gaps are located between each 560 spacing feature and the adjacent 560 spacing features. In some other versions, the spacing features 560 are contiguous with each other.
    [0058] The second zone 550 also includes an annular wall projecting upwards 592. The annular wall 592 is flush with the platform surface 522. The annular wall 592 is configured to compress a partially annular region of tissue against the anvil 400 thus providing assistance for the edge 542 of knife member 540 to shear the fabric. The annular wall 592 is contiguous and coplanar with the inner region of the platform surface 522, so that the annular wall 592 and the platform surface cooperate to compress a completely annular region of tissue against the anvil 400, thus providing uniform compression along a circumference
    Petition 870190051999, of 6/3/2019, p. 27/68
    24/38 complete of a tissue region. An annular recess 590 is formed between annular wall 590 and spacer features 560. In some other versions, inner wall portions 566 extend completely to annular wall 590, so that annular wall 590 is directly connected to the features distance 560 through internal wall portions 566.
    [0059] It should be understood that the projected configuration of the spacer features 560 in relation to the lowered platform surface 552 will provide fabric engagement effects in the second zone 550 that are not provided in the first zone 510. In particular, when the fabric is compressed between the platform member 502 and the anvil 400, as described above, portions of the compressed tissue enter the recessed areas adjacent to the 560 spacing features. Having part of the tissue within these recessed areas can help to reduce the overall pressure than otherwise way it would be applied to the fabric if the fabric was being compressed against a consistently flat platform surface like the 322 platform surface. By reducing the total pressure on the fabric, the platform member 502 can reduce the risk of the fabric becoming fractured by excess compression. In addition to reducing total pressure on the fabric, the entry of portions of fabric into recessed areas adjacent to the 560 spacing features can provide a squeeze on the compressed fabric that is greater than the squeeze that could otherwise be obtained using a surface with a consistently flat platform like the 322 platform surface. The increased tightening of the fabric can promote a more accurate cut by the knife member 540 and also promote the more satisfactory positioning of the staples 90 in the fabric. In this way, the presence of the 560 spacing features can reduce the risk of tissue overcompression and also promote more effective tissue cutting and stapling.
    Petition 870190051999, of 6/3/2019, p. 28/68
    25/38 [0060] As best seen in Figure 11, the first zone 510 extends along an angular band Θ of approximately 90 ° from the circumference of the platform member 502 in the present example. As an additional example only, the first zone 510 can extend along an angular band Θ less than approximately 90 ° from the circumference of the platform member 502. For example, the first zone 510 can extend along an angular band Θ between approximately 30 ° to approximately 90 °° the circumference of the platform member 502; or between approximately 45 ° and approximately 90 ° of the circumference of the floor member 502.
    [0061] As noted above, the entry of tissue into recessed areas adjacent to the 560 spacing features can reduce the risk of tissue overcompression and promote more effective tissue cutting and stapling when the anvil 400 and the head assembly are actuated stapling 500. However, this same tissue entry in recessed areas adjacent to the spacing features 560 may present some risks when inserting the stapling head assembly 500 and the drive shaft assembly 200 into the fabric. In other words, in the variations of the platform member 502 where the spacer features 560 are positioned along the complete circumference of the platform member 502, the T fabric may have a tendency to enter the recessed areas adjacent to the spacer features 560 during insertion of the drive shaft assembly 200 and a staple head assembly 500 into the patient's colon C. Any resulting T-tissue collision in the 560 spacing resources can increase the risk of damage to T-tissue in the event that T-tissue is being compressed against the sacrum S as described above with reference to Figure 8.
    [0062] To avoid the aforementioned risks that could potentially
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    26/38 otherwise be associated with tissue bumping in the spacing resources 560 during insertion of the drive shaft assembly 200 and the staple head assembly 500 into the patient's colon C, the first zone 510 is positioned to correspond with the outer curve 214 of the curved section 212 of the drive shaft assembly 200. As shown in Figure 8, the region of the staple head assembly 300 that corresponds to the external curve 214 is the region of the staple head assembly 300 that would tend to compress the T fabric against the sacrum S. Thus, by having a first zone 510 in that region, the staple head assembly 500 avoids the risks that could otherwise be associated with the spacing resources 560 during the insertion of the axis assembly drive 200 and stapling head assembly 500 in the patient's C colon; while still providing the advantages of spacing features 560 in the second zone when anvil 400 and staple head assembly 500 are actuated.
    [0063] In addition to the risk of damage to the T tissue that could otherwise occur due to the compression of the T tissue against the sacrum S, the configuration of the platform member 502 can also provide a reduced risk of damage to the T tissue when the set of stapling head 500 has arrived in a position where trocar 300 can be attached to anvil 400. Figure 12 shows an example of stapling head assembly 500 in such a position. In particular, Figure 12 shows the stapling head assembly 500 positioned within a tubular anatomical structure, with a pouch suture 50 being provided over a middle region of the drive shaft 332 to generally hold the position of the stapling head assembly 500 in the anatomical tubular structure 40. It should be understood that the annular wall 592 is intentionally omitted from view
    Petition 870190051999, of 6/3/2019, p. 30/68
    27/38 shown in Figure 12, to demonstrate how the upper edges 568 are flush with the platform surface 522 in the present example. It should also be understood that the annular wall 592 would also be flush with the upper edges 568 in the present example, so that the annular wall 592 would obscure the view of the spacer features 560 in Figure 12 if the upper annular wall 592 was not omitted of Figure 12.
    [0064] As can be seen, with the staple head assembly 500 in the position shown in Figure 12, the outermost region of the distal end of the staple head assembly 500 is supporting the grouped region of the tissue of anatomical structure 40. In alternative versions where this outermost region of the distal end of the stapling head assembly 500 has a relatively sharp corner, such a corner may tend to damage or even tear that adjacent tissue region. However, in the present example, since both the outer edge 520 and the outward facing surfaces 562 provide a curved profile, there is a reduced risk of rupture of the annular region of tissue in contact with the outer edge 520 and the facing surfaces. out 562. Thus, even if the operator presses the staple head assembly 500 distally while the staple head assembly 500 is situated in the position shown in Figure 12, the curved configuration of the outermost region of the distal end of the head assembly staple 500 can substantially prevent the outermost region of the distal end of the staple head assembly 500 from tearing adjacent tissue. Although this region of the staple head assembly 500 (that is, the region collectively defined by the outer edge 520 and outward facing surfaces 562) has a curved profile in this example, in some other versions this region of the staple assembly 500 may have a beveled profile or any or
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    28/38 suitable type of atraumatic profile.
    Exemplary combinations [0065] The following examples refer to several non-exhaustive ways in which the teachings of the present invention can be combined or applied. It should be understood that the following examples are not intended to restrict coverage of any claims that may be made at any time in this application or in deposits subsequent to this application. No rights waiver is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of the present invention can be arranged and applied in several other ways. It is also contemplated that some variations may omit certain features referred to in the examples below. Therefore, none of the aspects or resources referred to below should be considered critical, unless explicitly stated otherwise at a later date by the inventors or by a successor of interest to the inventors. If any claims are made in this application or in subsequent filings related to this application that include additional features in addition to those listed below, it is not assumed that these additional features have been added for any reason related to patentability. Example 1 [0066] Apparatus characterized by the fact that it comprises: (a) a body; (b) a drive shaft assembly that extends distally from the body assembly, the drive shaft assembly having a distal end; (c) a stapling head assembly located at the distal end of the drive shaft assembly, the stapling head assembly comprising: (c) a platform member, the platform member comprising: (A) a first platform surface,
    Petition 870190051999, of 6/3/2019, p. 32/68
    29/38 (B) a second platform surface, the second platform surface being recessed in relation to the first platform surface, (C) an external annular matrix of staple openings formed through the first and second platform surfaces, (D) an internal annular matrix of openings for staples formed through the first and second platform surfaces, and (E) a plurality of spacing features extending distally from the second platform surface, (ii) a plurality of staples, and (iii) an operable driver to drive the clamps through the clamp openings; and (d) an anvil, the anvil being operable to compress the tissue against the first platform surface. Example 2 [0067] Apparatus according to claim 1, characterized in that each spacer partly comprises an end of a corresponding staple opening of the external annular matrix of staple openings.
    Example 3 [0068] Apparatus according to claim 1, characterized in that each spacer partly comprises an end of a corresponding clamp opening of the internal annular matrix of clamp openings.
    Example 4 [0069] Apparatus according to claim 1, characterized in that each spacing feature comprises an outer wall portion and an inner wall portion, the outer wall portion partially covering one end of an opening corresponding staple of the external annular matrix of the staple openings, the portion of the inner wall partially covering one end of a staple opening of the internal annular matrix of the staple openings.
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    30/38
    Example 5 [0070] Apparatus according to claim 4, characterized in that the outer wall portion and the inner wall portion of each spacer feature forms a respective zigzag configuration.
    Example 6 [0071] Apparatus according to claim 1, characterized in that each spacing feature has a rounded outer edge that has a curvature.
    Example 7 [0072] Apparatus according to claim 6, characterized by the fact that the first platform surface has a rounded outer edge, the rounded outer edge of the first platform surface having the same curvature as the curvature of the outer edges rounded off distance resources. Example 8 [0073] Apparatus according to claim 1, characterized by the fact that each distance feature has an upper edge located along a plane, the first platform surface being coplanar as the plane along which the upper edges of the spacing features are located.
    Example 9 [0074] Apparatus according to claim 1, characterized in that the platform member additionally includes a gradual transition from the first platform surface to the second step surface.
    Example 10 [0075] Apparatus according to claim 1, characterized by the fact that the platform member defines a first angular region and a second angular region, the first surface being
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    31/38 platform extends along only the first angular region, the second platform surface extending along only the second angular region.
    Example 11 [0076] Apparatus according to claim 10, characterized in that the first angular region extends over an angular range between approximately 30 ° and approximately 90 ° of a circumference of the platform member.
    Example 12 [0077] Apparatus according to claim 10, characterized in that the drive shaft assembly comprises a curved section that includes an internal curve and an external curve.
    Example 13 [0078] Apparatus according to claim 12, characterized in that the first angular region is angularly positioned to correspond with the external curve, the second angular region being angularly positioned to correspond with the internal curve.
    Example 14 [0079] Apparatus according to claim 1, characterized by the fact that the first platform surface is flat.
    Example 15 [0080] Apparatus according to claim 1, characterized in that the platform member additionally comprises an internal annular wall extending distally from the second platform surface.
    Example 16 [0081] Apparatus according to claim 15, characterized in that the internal annular wall has a distal edge that is coplanar with the first platform surface.
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    32/38
    Example 17 [0082] Apparatus according to claim 15, characterized in that the internal annular wall is spaced inwardly from the spacer features so that a recess is defined between the inner annular wall and the spacer features . Example 18 [0083] Apparatus characterized by the fact that it comprises a staple head assembly, the staple head assembly comprising: (a) an annular platform member, the annular platform member comprising: (i) a first platform surface that extends along a first angular strip of the annular platform member, (ii) a second surface platform that extends along a second angular strip of the annular platform member, (iii) a matrix outer annular openings for staples formed through the first and second platform surfaces, (iv) an inner annular array of openings for staples formed through the first and second platform surfaces, (v) a plurality of fabric engaging features extend distally from or are recessed within the second platform surface, and (vi) an internal annular wall that extends distally from the second platform surface, the inner annular wall being positioned inward from the fabric engaging features; (b) a plurality of clips; and (c) an operable actuator for driving the clamps through the clamp openings.
    Example 19 [0084] Apparatus according to claim 18, characterized in that the second platform surface is lowered in relation to the first platform surface.
    Example 20
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    33/38 [0085] Apparatus characterized by the fact that it comprises: (a) a drive shaft assembly that extends distally from the body, the drive shaft assembly comprising: (i) a proximal end, ( ii) a distal end, and (iii) a curved section located between the proximal end and the distal end, the curved section including an internal curve and an external curve; and (b) a stapling head assembly located at the distal end of the drive shaft assembly, the stapling head assembly comprising: (i) a first platform surface that has an angular extension positioned to correspond with the curve outer drive shaft assembly, (ii) a second platform surface that has an angular extension positioned to correspond with the inner curve of the driving shaft assembly, (iii) an external annular matrix of openings for clamps formed through the first and second platform surface, (iv) an internal annular matrix of clip openings formed through the first and second platform surface, (v) a plurality of fabric engaging features that extend distally from or are recessed within the second surface, (vi) a plurality of clamps, and (vii) an operable actuator for driving the clamps through the clamp openings.
    IV. Miscellaneous [0086] It should be understood that the above teachings can be readily combined with the teachings of US patent application No. [attorney document number END7975USNP.0637659], entitled Circular Surgical Stapler with Recessed Deck and Raised Circumferential Edges deposited at same date as this application, the disclosure of which is hereby incorporated by reference. Various suitable ways according to which the teachings of the invention and the teachings of US patent application no.
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    34/38 proxy79 END7975USNP.0637659] can be combined will be evident to those skilled in the art.
    [0087] It should be understood that the above teachings can be readily combined with the teachings of US patent application No. [attorney document number END7976USNP.0637662], entitled Atraumatic Stapling Head Features for Circular Surgical Stapler, filed in the same date of this application, the disclosure of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention and the teachings of US patent application No. [attorney document number END7976USNP.0637662] can be combined will be apparent to those skilled in the art.
    [0088] It should be understood that the above teachings can be readily combined with the teachings of US patent application No. [attorney document number END7977USNP.0637664], entitled Staple Pocket Configurations for Circular Surgical Stapler, filed on the same date of this application, the disclosure of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention and the teachings of US patent application No. [attorney document number END7977USNP.0637662] can be combined will be apparent to those skilled in the art.
    [0089] It must also be understood that any one or more of the teachings, expressions, modalities, examples, etc. described here can be combined with any one or more of the other teachings, expressions, modalities, examples, etc. that are described here. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen in isolation from each other. Several suitable ways in which the teachings of the present invention can be combined,
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    35/38 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 in the scope of the attached claims.
    [0090] At least some of the teachings of the present invention can readily be combined with one or more of the teachings of US Patent No. 7,794,475, entitled Surgical Staples Having Compressible or Crushable Members for Securing Tissue Therein and Stapling Instruments for Deploying the Same, granted September 14, 2010, the disclosure of which is incorporated into the present invention, as a reference; US publication No. 2014/0151429, entitled Trans-Oral Circular Anvil Introduction System with Dilation Feature, published on June 5, 2014, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0144968, entitled Surgical Staple with Integral Pledget for Tip Deflection, published on May 29, 2014, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0158747, entitled Surgical Stapler with Varying Staple Widths along Different Circumferences, published on June 12, 2014, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0144969, entitled Pivoting Anvil for Surgical Circular Stapler, published on May 29, 2014, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0151430, entitled Circular Anvil Introduction System with Alignment Feature, published on June 5, 2014, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0166717, entitled Circular Stapler with Selectable Motorized And Manual Control, Including a Control Ring, published on June 19, 2014, the disclosure of which is hereby incorporated by reference; in US publication No. 2014/0166728, entitled Motor Driven Rotary Input Circular Stapler with Modular End Effector, pu
    Petition 870190051999, of 6/3/2019, p. 39/68
    36/38 opened on June 19, 2014, the disclosure of which is hereby incorporated by reference; and / or US publication No. 2014/0166718, entitled Motor Driven Rotary Input Circular Stapler with Modular Flexible Shaft, published on June 19, 2014, the disclosure of which is hereby incorporated by reference. Various suitable ways in which such teachings can be combined will be evident to those skilled in the art.
    [0091] It should be understood that any patent, publication, or other disclosure material taken as incorporated into the present invention for reference, in whole or in part, is incorporated into the present invention only insofar as the incorporated material does not conflict with the definitions, statements or other material disclosed in this disclosure. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials contained herein, will be incorporated here only insofar as there is no conflict between the material embedded and existing disclosure material.
    [0092] 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 medical treatments and procedures assisted by robotics. As an example only, several teachings of the present invention can readily be incorporated into a robotic surgical system such as the DAVINCI ™ system by Intuitive Surgical, Inc., of Sunnyvale, California, USA. [0093] The versions described above can be designed to be discarded after a single use or can be designed to
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    37/38 be used multiple times. The versions can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing specific parts and subsequent reassembly. Specifically, some versions of the device can be disassembled into any number of particular parts or parts of the device can be selectively replaced or removed in any combination. By cleaning and / or replacing specific parts, some versions of the device can be reassembled for subsequent use in a reconditioning facility or by a user immediately before a surgical procedure. Those skilled in the art will understand that the reconditioning of a device can use a variety of disassembly, cleaning / replacement and reassembly techniques. The use of these techniques, as well as the resulting refurbished device, are all within the scope of this application.
    [0094] Just as an example, the versions described here can be sterilized before and / or after a procedure. In a sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the device can then be placed in a radiation field, such as gamma radiation, X-rays or high-energy electrons, which can penetrate the container. Radiation can kill bacteria on the device and the container. The sterile device can then be stored in a sterile container for later use. The device can also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.
    [0095] Having shown and described various modalities of this
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    38/38 invention, other adaptations of the methods and systems described in the present invention can be made by means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention must be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of the structure and operation shown and described in the specification and drawings.
    权利要求:
    Claims (20)
    [1]
    1. Apparatus characterized by the fact that it comprises:
    (a) a body;
    (b) a drive shaft assembly that extends distally from the body, wherein the drive shaft assembly has a distal end;
    (c) a stapling head assembly located at the distal end of the drive shaft assembly, wherein the stapling head assembly comprises:
    (i) a platform member, where the platform member comprises:
    (A) a first platform surface, (B) a second platform surface, where the second platform surface is recessed in relation to the first platform surface, (C) an external annular matrix of clamp openings formed through the first and second platform surfaces, (D) a second annular array of clamp openings formed through the first and second platform surfaces, and (E) a plurality of spacing features extending distally from the second platform surface, ( ii) a plurality of clamps, and (iii) an operable driver for driving the clamps through the clamp openings; and (d) an anvil, where the anvil is operable to compress the tissue against the platform surface.
    [2]
    2. Apparatus, according to claim 1, characterized by the fact that each distance feature partially
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    2/6 comprises one end of a corresponding clamp opening of the external annular matrix of clamp openings.
    [3]
    Apparatus according to claim 1, characterized in that each spacer partly comprises an end of a corresponding clamp opening of the internal annular matrix of clamp openings.
    [4]
    4. Apparatus according to claim 1, characterized in that each spacing feature comprises an outer wall portion and an inner wall portion, wherein the outer wall portion partially covers one end of a corresponding clamp opening of the outer annular matrix of the staple openings, wherein the inner wall portion partially covers one end of a staple opening of the inner annular matrix of the staple openings.
    [5]
    5. Apparatus according to claim 4, characterized by the fact that the external wall portion and the internal wall portion of each spacer feature forms a respective zigzag configuration.
    [6]
    6. Apparatus according to claim 1, characterized by the fact that each spacing feature has a rounded outer edge that has a curvature.
    [7]
    7. Apparatus according to claim 6, characterized by the fact that the first platform surface has a rounded outer edge, in which the rounded outer edge of the first platform surface has the same curvature as the curvature of the rounded outer edges of the features. distance.
    [8]
    8. Apparatus according to claim 1, characterized by the fact that each spacing feature has an upper edge located along a plane, in which the first plate surface
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    3/6 the shape is coplanar as the plane along which the upper edges of the distance features are located.
    [9]
    Apparatus according to claim 1, characterized in that the platform member additionally includes a gradual transition from the first platform surface to the second step surface.
    [10]
    10. Apparatus according to claim 1, characterized by the fact that the platform member defines a first angular region and a second angular region, in which the first platform surface extends along only the first angular region, in which the second platform surface extends along only the second angular region.
    [11]
    11. Apparatus according to claim 10, characterized by the fact that the first angular region extends along an angular range between approximately 30 ° and approximately 90 ° of a circumference of the platform member.
    [12]
    12. Apparatus according to claim 10, characterized by the fact that the drive shaft assembly comprises a curved section that includes an internal curve and an external curve.
    [13]
    13. Apparatus according to claim 12, characterized by the fact that the first angular region is angularly positioned to correspond with the external curve, in which the second angular region is angularly positioned to correspond with the internal curve.
    [14]
    14. Apparatus according to claim 1, characterized by the fact that the first platform surface is flat.
    [15]
    Apparatus according to claim 1, characterized in that the platform member additionally comprises an internal annular wall extending distally from the second platform surface.
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    4/6
    [16]
    16. Apparatus according to claim 15, characterized by the fact that the inner annular wall has a distal edge that is coplanar with the first platform surface.
    [17]
    17. Apparatus according to claim 15, characterized by the fact that the internal annular wall is spaced inwardly from the distance features so that a recess is defined between the internal annular wall and the distance features.
    [18]
    18. Apparatus characterized by the fact that it comprises a staple head assembly, in which the staple head assembly comprises:
    (a) an annular platform member, wherein the annular platform member comprises:
    (i) a first platform surface that extends along a first angular strip of the annular platform member, (ii) a second platform surface that extends along a second angular strip of the annular platform member, (iii ) an external annular matrix of clamp openings formed through the first and second platform surfaces, (iv) an internal annular matrix of clamp openings formed through the first and second platform surfaces, (v) a plurality of coupling features of tissue extending distally from or recessed within the second platform surface, and (vi) an inner annular wall extending distally from the second platform surface, wherein the inner annular wall is positioned inwardly from the fabric hitch features;
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    5/6 (b) a plurality of clips; and (c) an operable actuator for driving the clamps through the clamp openings.
    [19]
    19. Apparatus according to claim 18, characterized by the fact that the second platform surface is lowered in relation to the first platform surface.
    [20]
    20. Device characterized by the fact that it comprises:
    (a) a drive shaft assembly that extends distally from the body, wherein the drive shaft assembly comprises:
    (i) a proximal end;
    (ii) a distal end; and (iii) a curved section located between the proximal end and the distal end, where the curved section includes an internal curve and an external curve; and (b) a stapling head assembly located at the distal end of the drive shaft assembly, wherein the stapling head assembly comprises:
    (i) a first platform surface that has an angular extension positioned to correspond with the external curve of the drive shaft assembly, (ii) a second platform surface that has an angular extension positioned to correspond with the internal curve of the drive shaft assembly drive shaft, (iii) an external annular matrix of clamp openings formed through the first and second platform surface, (iv) an internal annular matrix of clamp openings formed through the first and second platform surface,
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    6/6 (v) a plurality of fabric engaging features that extend distally from or are recessed within the second surface, (vi) a plurality of clips, and (vii) an operable actuator for driving the clips through the staple openings.
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    公开号 | 公开日
    EP3320859B1|2020-12-23|
    JP6995853B2|2022-01-17|
    US10603041B2|2020-03-31|
    US20180132854A1|2018-05-17|
    JP2019533547A|2019-11-21|
    CN110177510A|2019-08-27|
    EP3320859A1|2018-05-16|
    WO2018089053A1|2018-05-17|
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    法律状态:
    2021-10-05| B350| Update of information on the portal [chapter 15.35 patent gazette]|
    2022-02-15| B06W| Patent application suspended after preliminary examination (for patents with searches from other patent authorities) chapter 6.23 patent gazette]|
    优先权:
    申请号 | 申请日 | 专利标题
    US15/350,624|US10603041B2|2016-11-14|2016-11-14|Circular surgical stapler with angularly asymmetric deck features|
    PCT/US2017/035121|WO2018089053A1|2016-11-14|2017-05-31|Circular surgical stapler with angularly asymmetric deck features|
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