circular surgical stapler with lowered platform

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 platform surface, an outer annular array of staple openings formed through the platform surface, an internal annular array of staple openings formed through the platform surface, and a plurality of recesses formed in the platform surface. . at least a portion of the recesses are positioned between at least some of the staple openings. 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:BR112019009703A2
申请号:R112019009703
申请日:2017-05-31
公开日:2019-08-06
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 PLATFORM
LOWERED.
BACKGROUND OF THE INVENTION [0001] 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.) 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.
[0002] 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 trap layers of fabric, cut through the stuck layers of fabric and have the staples go through the stuck layers of fabric to substantially seal the layers of fabric together near the separate ends of the layers of fabric, thus joining 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 endoscopic procedures.
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In some cases, a portion of the circular stapler is inserted through the hole that occurs naturally in a patient.
[0003] Examples of circular staplers are described in US Patent No. 5,205,459, entitled Surgical Anastomoseis Stapling Instrument, issued April 27, 1993; US Patent No. 5,271,544, entitled Surgical Anastomosis Stapling Instrument, issued December 21, 1993; US Patent No. 5,275,322, entitled Surgical Anastomosis Stapling Instrument, issued January 4, 1994; US Patent No. 5,285,945, entitled Surgical Anastomosis Stapling Instrument, issued February 15, 1994; US Patent No. 5,292,053, entitled Surgical Anastomosis Stapling Instrument, issued March 8, 1994; US Patent No. 5,333,773, entitled Surgical Anastomosis Stapling Instrument, issued August 2, 1994; US Patent No. 5,350,104, entitled Surgical Anastomosis Stapling Instrument, issued September 27, 1994; US Patent No. 5,533,661, entitled Surgical Anastomosis Stapling Instrument, issued July 9, 1996; and 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.
[0004] Some circular staplers may include a motorized drive mechanism. Examples of circular staplers with motorized drive mechanisms are described in the US patent publication. No. 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 Control Features for Motorized Surgical
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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 into the present invention.
[0005] 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 [0006] 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:
[0007] Figure 1 represents a perspective view of an exemplary circular stapler;
[0008] 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;
[0009] Figure 3 represents a perspective view of the anvil of the circular stapler in 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 of the circular stapler of Figure 1, with portions of the axis assembly
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Drive 4/42 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 stapling head assembly and the driving shaft assembly of the circular stapler of Figure 1 inserted in the colon.
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5/42 a patient, with the stapling head set positioned close to the patient's sacrum, and with the patient's anatomy shown in cross 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 platform member that can be incorporated into the staple head assembly of Figure 4;
[0021] Figure 11 represents a top plan view of the platform member of Figure 10;
[0022] Figure 12 represents a partial top plan view of a first portion of the platform member of Figure 10;
[0023] Figure 13 represents a partial top plan view of a second portion of the platform member of Figure 10;
[0024] Figure 14 represents a cross-sectional view of the platform member of Figure 10 taken along line 14-14 of Figure 13;
[0025] Figure 15 represents a cross-sectional view of the platform member of Figure 10 taken along line 15-15 of Figure 13;
[0026] Figure 16 represents a perspective view of another exemplary alternative platform member that can be incorporated into the staple head assembly of Figure 4; and [0027] Figure 17 represents a top plan view of the platform member of Figure 16.
[0028] The drawings are not intended to be limiting in any way
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6/42 and it is contemplated that various modalities of technology can be executed 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 [0029] 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.
I. Overview of the Exemplifying Circular Stapling Surgical Instrument [0030] 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, such as an portion of a patient's digestive tract. The instrument 10 of 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. In addition to or replacing the aforementioned, it should be understood that instrument 10 can still be built and operable
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7/42 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, filed 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 configurations will be evident to one skilled in the art in view of the teachings described herein.
A. Tissue Exemplifying Features of the Circular Stapling Instrument [0031] 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.
[0032] Stapling head assembly 300 is located
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8/42 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 attached to the drive shaft assembly 200, adjacent to the staple head assembly 300. As will be described in more detail below, anvil 400 and stapling head assembly 300 are configured to cooperate with fabric handling in three ways, including 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.
[0033] 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.
[0034] The clip trigger 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. O
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3/42 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 corresponding staple forming pocket 414 when the staple head assembly 300 is operated. The clip driver member 350 also defines a bore 354 that is configured to receive coaxially a core member 312 of tubular casing 310.
[0035] 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 so 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.
[0036] 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 correspond with the arrangement of the staple actuators 352 and the staple forming pockets 414 described above. In this way, each clamp opening 324 is configured to provide a path for a corresponding clamp trigger 352 to drive a corresponding clamp through the platform member 320 and into a pocket forming the
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10/42 corresponding staples 414 when stapling head assembly 300 is actuated. 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 is also to be understood that various structures and techniques can be used to contain the clamps within the staple head assembly 300 before the staple head assembly 300 is driven. 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.
[0037] Figure 6 shows several 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.
[0038] 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 drive. The proximal end of the trocar 230 drive band assembly is secured
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11/42 fixedly to the distal end of the trocar drive rod 220, so that the trocar 330 will move longitudinally in relation to the outer sheath 210 in response to the translation of the drive band assembly of the trocar 230 and the drive rod of the trocar 220 in relation to the outer sheath 210. The trocar band 230 is configured to flex so that the trocar band 230 may act along the preformed curve in the drive shaft assembly 200 in accordance with the set of trocar actuation band 230 is translated longitudinally in relation to the outer sheath 210. However, the set of trocar actuation band 230 has sufficient column strength and tensile strength to transfer the distal and proximal forces of the stem of actuation of trocar 220 for the drive shaft of trocar 332. The drive shaft of trocar 220 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.
[0039] The drive shaft assembly 200 additionally includes a staple head assembly 240 which is slidably received inside 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 secured to a drive bracket 250 by means of a pin 242. It should therefore be understood that the trigger member of
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12/42 clamp 350 travels longitudinally with respect to outer sheath 210 in response to translation of staple head assembly 240 and drive bracket 250 with regard to outer sheath 210. Staple head assembly 240 is configured to flex so that the staple head assembly 240 can follow along the preformed curve in the drive shaft assembly 200 as the staple head assembly 240 is translated longitudinally in relation to the outer sheath 210. However , the staple head assembly driver 240 has sufficient column strength to transfer distal forces from the drive bracket 250 to the staple driver member 350.
B · Exemplary user input features of the circular stapling instrument [0040] 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.
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13/42 [0041] 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 angled direction (for example, clockwise) to retract 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 has been obtained.
[0042] 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 position 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 of 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.
[0043] The trigger trigger 150 is operable to drive the motor 160 to thus activate the stapling head assembly 300. The
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14/42 safety trigger 140 is operable to selectively lock the trigger trigger 150 based on the longitudinal position of the anvil 400 in relation to the staple head assembly 300. The cable assembly 100 also includes components that are operable to lock selectively 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 locked, the trigger trigger 150 is prevented from starting the actuation of the staple head assembly 300. In this way, trigger 150 is operable only to initiate the triggering of the stapling head assembly 300 when the position of the anvil 400 in relation to the stapling head assembly 300 is within a predefined range.
[0044] 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, deposited 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.
[0045] The purpose of battery 120 is to supply electrical energy to a
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15/42 engine 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 electrical contacts, pins and complementary sockets and / or other features that provide paths for electrical communication of battery 120 with electrically powered components in cable assembly 100 when battery 120 is attached 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 [0046] 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 in Figures 7A to 7E representing the remaining separate portions of the colon.
[0047] 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 represented in Figures 7A to 7E is an open surgical procedure,
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16/42 although the procedure can instead be performed by laparoscopy. Just as an example, such a surgical procedure can be provided in accordance with at least some of the teachings 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.
[0048] 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.
[0049] 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 head 334 of trocar 330, thus providing a secure fit between anvil 400 and trocar 330. The operator then turns knob 130
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17/42 while holding the cable assembly 100 stationary by means of the pistol grip 112. This rotation of the knob 130 causes the trocar 330 and the anvil 400 to retract proximally, as described 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 via button 130. [0050] Once the operator has properly adjusted the gap distance d via button 130, the operator pulls the safety trigger 140 to allow the trigger trigger 150 to be triggered. The operator then activates the trigger trigger 150. This actuation of the trigger trigger 150 in turn activates a motor activation module switch 180, which in turn activates the motor 160 to actuate the head assembly of stapling 300 by driving knife member 340 and staple 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.
[0051] 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
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18/42 can provide an increase in mechanical advantage when knife member 340 reaches the end of its distal movement, thus providing 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.
[0052] 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.
[0053] 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 instrument 10
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19/42 removed, the anatomical tubular structures 20, 40 are left attached together by two annular arrays of clamps 90 to an anastomosis 70, as shown in Figure 7E. The internal diameter of anastomosis 70 is defined by the cut edge 60 left by knife member 340.
IL First exemplary alternative platform member for the stapling head assembly [0054] 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 can 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 according to
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20/42 stapling head assembly 300 and drive shaft assembly 200 are being inserted into the patient's colon C.
[0055] Similarly, as shown in Figure 9, persons of ordinary skill in the art will recognize that the T tissue of colon C defines a plurality of F-folds, and that the staple head assembly 300 may bump into such F-folds as the staple 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.
[0056] Therefore, it may be desirable to provide a version of the stapling head assembly 300 that minimizes the risk of damaging the T tissue of the patient's colon C 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.
[0057] Figures 10 to 15 show an exemplary alternative platform member 500 that can be readily incorporated into the staple head assembly 300 in place of platform member 320. Unless otherwise noted below, the
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21/42 platform 500 of the present example is substantially similar to the platform member 320 described above. The platform member 500 of this example includes a platform surface 522 that defines two concentric annular arrays of staple openings 524. The staple openings 524 are arranged to match the arrangement of the 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 a staple head assembly 300 incorporating the platform member 500 is triggered. The platform member 500 defines an internal diameter that is only slightly larger than the outside diameter defined by the knife member 340. The platform member 500 is thus configured to allow the knife member 340 to move distally to a point where the cutting edge 342 is distal to the plane of the platform surface 522.
[0058] Unlike the platform member 320 described above, the platform member 500 of the present example includes a first zone 510 and a second zone 550. As is best seen in Figures 10 to 12, the first zone 510 is characterized by the fact that that the platform surface 522 is substantially flat within the first zone 510. In contrast, as can best be seen in Figures 10 to 11 and 13 to 15, the second zone 550 is characterized by the fact that a plurality of recesses 560, 570 are formed on the platform surface 522 within the second zone 550. 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 500. Only as a additional example, the
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22/42 first zone 510 can extend along an angular band Θ less than approximately 90 ° from the circumference of the platform member 500. For example, the first zone 510 can extend along an angular band Θ between approximately 30 ° approximately 90 ° from the circumference of the platform member 500; or between approximately 45 ° and approximately 90 ° of the circumference of the floor member 500.
[0059] It should be understood that providing the two different zones 510, 520 is merely optional. For example, some variations of the platform member 500 may include the features of the second zone 550 around the entire circumference of the platform member 500, rather than being limited to only a portion of the circumference of the platform member 500, as shown in Figures 10 to 11. In other words, the angular range Θ of the first zone 510 can be 0 ^o in some versions.
[0060] As also shown in Figures 10 to 11, the outer edge 520 of the platform member 500 extends around the complete circumference of the platform member 500 with a consistent surface geometry. In particular, and as can best be seen in Figures 14 to 15, the outer edge 520 is curved in this example to prevent the outer edge 520 from touching the T fabric.
[0061] Figures 13 to 15 show blade 550 in greater detail. In particular, Figure 13 shows how, within the second zone 550, the recesses 560 are spaced between the outermost annular matrix of the staple openings 524; while portions of recesses 570 are spaced between the clamp openings 524 of the internal annular matrix of the clamp openings 524. In the present example, the recesses 560 are in the form of isosceles trapezoids, with the wider sides 562 of the trapezoidal shapes being positioned as the radially outer sides of the trapezoids.
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It should be understood that the 560 recesses can have any other suitable shape. It should also be understood that, in the present example, the platform surface region 522 surrounding the recesses 560 is flush with the surface of the platform region 522 in the first zone 520.
[0062] The recesses 570 of the present example are generally shaped as isosceles triangles, with each triangle being defined by a pair of straight walls 574 having the same length and an internal annular wall 572. The vertices 575 formed by the walls 574 are positioned at the points radially outermost of the recesses 570. In particular, the vertices 575 are located in radial positions corresponding to the same circumference in which the most angularly outer points 526 of the clip openings 524 are located. In other words, vertices 575 and points 526 are all points positioned at the same radial distance along the same circumference in this example. Alternatively, the position and configuration of the recesses 570 can have any other suitable relationship with the position and configuration of the openings for clamps 524. The recesses 570 of the present example are joined together by channels 580 which are defined between the inner annular wall 572 and respective opposite annular walls 576. The walls 572, 576 are parallel to each other and are positioned close to each other, so that the channels 580 are substantially small compared to recesses 560, 570.
[0063] The recesses 560, 570 and channels 580 are configured to receive the fabric as the fabric is being pressed against the platform surface 522 by the anvil 400 as described above. In particular, when anvil 400 is actuated via button 130 to compress the tissue between the anvil 400 and the platform surface 522, portions of the compressed tissue enter the recesses
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560, 570 and channels 580. Having part of the fabric within these recesses 560, 570 and channels 580 can reduce the total pressure that would otherwise be applied to the fabric if the fabric was being compressed against a consistently flat platform surface such as the platform 322. By reducing the total pressure on the fabric, the platform member 500 can reduce the risk of the fabric becoming fractured by excessive compression. In addition to reducing the total pressure on the fabric, the entry of portions of fabric into recesses 560, 570 and channels 580 can provide a tightness in the compressed fabric that is greater than the tightness that could otherwise be obtained using a surface of 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 340 and also promote the more satisfactory positioning of the staples 90 in the fabric. In this way, the presence of recesses 560, 570 and channels 580 can reduce the risk of overcompression of the fabric and also promote more effective cutting and stapling of the fabric.
[0064] In the present example, and as best seen in Figures 14 to 15, recesses 560, 570 and channels 580 extend substantially at the same depth within platform member 500. In some other versions, recesses 560, 570 and channels 580 extend to different depths. For example, recesses 560 can extend to depths greater than recesses 570 or vice versa. It should also be understood that the recesses 560 can have alternating depths, so that the recesses 560 alternate between a relatively shallow recess 560 and a relatively deep recess 560 along at least a portion of the second zone angular range 550. similarly, the 570 recesses can have alternating depths, so that the 570 recesses alternate between a
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25/42 relatively shallow indentation 570 and a relatively deep indentation 570 along at least a portion of the second zone angular range 550. As with yet another merely illustrative variation, the depth of a particular indentation 560, 570 may vary within that indentation specific 560, 570. For example, the radially innermost region of a given indentation 560 may be deeper or shallower than the radially outermost region of that same indentation 560. Similarly, the region of each indentation 570 near vertex 575 it may be deeper or shallower than the region of each indentation 570 next to the inner annular wall 572. Other suitable relationships that can be provided in the depth of indentations 560, 570 and / or channels 580 will be evident to those skilled in the art. view of the teachings of the present invention.
[0065] The inner annular wall 572 consistently extends along the complete circumference of the platform member 500. In particular, the height of the highest edge 573 of the inner annular wall 572 is consistent across the total circumference of the platform member 500. The uppermost edge 573 is then configured to provide firm pressure against the adjacent annular region of the tissue as the tissue is being compressed against the platform member 500 by the anvil 400. This application of consistent pressure against the adjacent annular region of the tissue can additionally assist in precise cutting of the fabric by knife member 340, particularly as knife member 340 will cut the fabric just beside the highest edge 573. As best seen in Figures 14 to 15, the top edge 573 of the wall internal ring 572 is substantially flush with the platform surface 522 in the present example. In some other variations, the upper edge 573 protrudes slightly or is raised from the platform surface 522.
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26/42 [0066] As noted above, the entry of the tissue into the recesses 560, 570 and channels 580 can reduce the risk of overcompression of the tissue and promote a more effective cutting and stapling of the tissue during the operation of the anvil 400 and the set of stapling head 300. However, this same tissue entry in recesses 560, 570 and channels 580 may present some risks when inserting the stapling head assembly 300 and the drive shaft assembly 200 into the fabric. In other words, in the variations of the platform member 500 where the recesses 560, 570 are positioned along the complete circumference of the platform member 500, the T fabric may have a tendency to enter the recesses 560, 570 and channels 580 during insertion the drive shaft assembly 200 and a stapling head assembly 300 incorporating the variation of the platform member 500 in the patient's colon C. Any entry of tissue into recesses 560, 570 and channels 580 may 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.
[0067] To avoid the aforementioned risks that could otherwise be associated with the entry of the fabric into the recesses 560, 570 and channels 580 during the insertion of the drive shaft assembly 200 and the staple head assembly 300 incorporating the platform member 500 in the patient's colon C, the first zone 510 is positioned to correspond with the external 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 which corresponds to the external curve 214 is the region of the stapling head assembly 300 that would tend to compress the T tissue against the sacrum S. Thus, by having a first zone 510 in this region, the platform member 500 avoids the risks that could
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27/42 otherwise be associated with the recesses 560, 570 and channels 580 during the insertion of the drive shaft assembly 200 and the clamping head assembly 300 incorporating the platform member 500 into the colon of the patient's C; while still providing the advantages of having recesses 560, 570 and channels 580 in the second zone when anvil 400 and stapling head assembly 300 are actuated.
Ill · Exemplifying Alternative Platform Member for the Stapling Head Assembly [0068] Figures 16 to 17 show another alternative exemplifying platform member 600 that can be readily incorporated into the Stapling Head Assembly 300 in place of the 320 platform member Unless otherwise described below, the platform member 600 of the present example is substantially similar to the platform member 500 described above. The platform member 600 of this example includes a first platform surface 622, a second platform surface 630, and two concentric annular arrays of staple openings 624. Staple openings 624 are arranged to correspond with the arrangement of staple actuators 352 and the staple forming pockets 414 described above. In this way, each staple opening 624 is configured to provide a path for a corresponding staple driver 352 to drive a corresponding staple through the platform member 600 and into a corresponding staple forming pocket 414 when a staple head assembly 300 incorporating the platform member 600 is triggered. The platform member 600 defines an internal diameter that is only slightly larger than the outside diameter defined by the knife member 340. The platform member 600 is thus configured to allow the knife member 340 to move
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28/42 distally to a point where the cutting edge 342 is distal to the plane of the second platform surface 630.
[0069] Unlike the platform member 500 described above, the platform member 600 of the present example does not include different zones that provide different structures based on the angular position around an axis that passes through the center of the platform member 600. Thus Accordingly, the structure of the platform member 600 is consistent across the complete circumference of the platform member.
[0070] In the present example, an outer edge 620 extends around the complete circumference of the platform member 500 with a consistent surface geometry. In the present example, the outer edge 620 is configured to prevent the outer edge 520 from hitting the T fabric. In some versions, the outer edge 620 has a curved profile. In some other versions, the outer edge 620 has a beveled profile. Alternatively, the outer edge 620 may have any other suitable type of profile.
[0071] The second platform surface 630 protrudes slightly from the first platform surface 620, so that the first platform surface 620 is recessed in relation to the second platform surface 630. As shown, the second platform surface 630 completely surrounds each staple opening 624, including the internal matrix of staple openings 624 and the external matrix of staple openings 624. However, the first platform surface 620 extends inwardly between the staple openings 624 of the external matrix of staple openings 624, thereby creating gaps 626 in the second platform surface 630 between the staple openings 624 of the external matrix of staple openings 624.
[0072] A plurality of recesses 670 are spaced between the openings for clamps 624 of the internal annular matrix of openings of
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29/42 clamp 624. The recesses 670 in this example are identical to the recesses 570 described above. In particular, the recesses 670 of the present example are generally shaped as isosceles triangles, with each triangle being defined by a pair of straight walls 674 having the same length and an internal annular wall 672. The vertices formed by the walls 674 are positioned at the points radially outermost recesses 670. In particular, these vertices are located in radial positions corresponding to the same circumference in which the angularly outermost points of clamp openings 624 are located. In other words, these vertices of the recesses 670 and the corresponding points of the staple openings 624 are all positioned at the same radial distance along the same circumference in this example. Alternatively, the position and configuration of the 670 recesses may have any other suitable relationship to the position and configuration of the 624 clamp openings.
[0073] The recesses 670 of the present example are joined together by channels 680 which are defined between the inner annular wall 672 and respective opposite annular walls 676. The walls 672, 676 are parallel to each other and are positioned in close proximity to each other to the other, so that channels 680 are substantially small compared to recesses 670.
[0074] Spans 626, recesses 670 and channels 680 are configured to receive the fabric as the fabric is compressed against the platform surfaces 622, 630 by the anvil 400 as described above. In particular, when the anvil 400 is actuated through the button 130 to compress the fabric between the anvil 400 and the platform surfaces 622, 630, portions of the compressed fabric 626 will enter the gaps, recesses 670 and channels 680. Have part of the fabric inside of these spans 626, recesses 670 and channels 680 can reduce the total pressure that
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30/42 otherwise 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 600 can reduce the risk of tissue becomes fractured due to excess compression. In addition to reducing the total pressure on the fabric, the entry of portions of fabric into the gaps 626, recesses 670 and channels 680 can provide a tightness in the compressed fabric that is greater than the tightness that could otherwise be obtained using a surface of 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 340 and also promote the more satisfactory positioning of the clips 90 on the fabric. In this way, the presence of gaps 626, recesses 670 and channels 680 can reduce the risk of overcompression of the fabric and also promote more effective cutting and stapling of the fabric.
[0075] In the present example, and as can best be seen in Figures 14 to 15, the gaps 626, the recesses 670, and the channels 680 all extend substantially at the same depth in relation to the second platform surface 630. In some others versions, the gaps 626, the recesses 670, and the channels 680 extend to different depths in relation to the second surface of platform 630. For example, the gaps 626 may extend to depths greater than the recesses 670 in relation to the second surface of platform 630 or vice versa. It should also be understood that the spans 626 may have alternating depths in relation to the second platform surface 630, so that the spans 626 alternate between a relatively shallow gap 626 and a relatively deep span 626 along at least a portion of the strip angle of the platform member 600. Similarly, the recesses 670 may have alternating depths in relation to the second platform surface 630, so that the
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31/42 recesses 670 alternate between a relatively shallow recess 670 and a relatively deep recess 670 along at least a portion of the angular range of the platform member 600. As yet another merely illustrative variation, the depth of a given span 626 or recess 670 may vary within that specific gap 626 or specific recess 670. For example, the radially innermost region of a given span 626 may be deeper or shallower than the radially outermost region of that same span 626. Similarly, the region of each indentation 670 near the vertex may be deeper or deeper. shallow that the region of each recess 670 next to the internal annular wall 672. Other suitable variations that can be provided in the depth of the gaps 626, recesses 670 and / or channels 680 in relation to the second platform surface 630 will be evident to those skilled in technique in view of the teachings of the present invention.
[0076] The internal annular wall 672 extends consistently along the complete circumference of the platform member 600. In particular, the height of the uppermost edge of the internal annular wall 672 is consistent across the complete circumference of the platform member 500. A uppermost edge of the inner annular wall 672 is thereby configured to provide consistent pressure against the adjacent annular region of tissue as the tissue is being compressed against the platform member 600 by the anvil 400. This application of consistent pressure against the adjacent annular region of the fabric can further assist in the precise cutting of the fabric by the knife member 340, particularly since the knife member 340 will cut the fabric very close to the upper edge of the inner annular wall 672. In the present example, the uppermost edge of the wall internal ring 672 is substantially flush with the second platform surface 630. In some others variations, the uppermost edge of the annular wall
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Internal 32/42 672 protrudes slightly or rises in relation to the second platform surface 630.
IV · Exemplifying Combinations [0077] 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 [0078] 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
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33/42 stapling comprises: (i) a platform member, the platform member comprising: (A) a platform surface, (B) an external ring matrix of staple openings formed across the platform surface, (C ) an internal ring matrix of openings for staples formed across the platform surface, and (D) a plurality of recesses formed on the platform surface, with at least a portion of the recesses being positioned between at least some of the staple openings, ( ii) a plurality of clamps, and (iii) a driver that is operable 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 [0079] The apparatus of Example 1 wherein the plurality of recesses comprises a first plurality of recesses and a second plurality of recesses, with at least a portion of the recesses of the first plurality of recesses being positioned between the clip openings of the external annular matrix of staple openings, at least a portion of the recesses of the second plurality of recesses is positioned between the staple openings of the internal annular matrix of staple openings.
Example 3 [0080] The apparatus of any one or more of Examples 1 to 2 wherein the plurality of recesses comprises a plurality of external recesses, the recesses of the plurality of external recesses being positioned between the openings for clips of the external annular die. of staple openings.
Example 4 [0081] The apparatus of Example 3 in which the recesses of the plurality of external recesses are formed external
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34/42 discretely in relation to each other so that the recesses of the plurality of external recesses are isolated in relation to each other.
Example 5 [0082] The apparatus of Example 3 in which at least some of the recesses in the plurality of external recesses are trapezoidal in shape.
Example 6 [0083] The apparatus of any one or more of Examples 1 to 5 wherein the plurality of recesses comprises a plurality of internal recesses, the recesses of the plurality of internal recesses being positioned between the openings for clamps of the internal annular matrix. of staple openings.
Example 7 [0084] The apparatus of Example 6 in which the recesses of the plurality of external recesses are in communication with each other via channels.
Example 8 [0085] The apparatus of any one or more of Examples 6 to 7 wherein at least some of the recesses in the plurality of external recesses are triangular in shape.
Example 9 [0086] The apparatus of Example 8 in which the triangular shape is defined in part by a pair of corresponding side walls joined at a vertex, the vertex being situated in a radial position on a circumference corresponding to the radial positions of the ends of the staple openings of the internal annular matrix of staple openings.
Example 10 [0087] The apparatus of any one or more of Examples 1 to 9 in
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35/42 that the platform member defines a first angular region along the platform surface, the platform member additionally defining a second angular region along the platform surface, the clip openings extending along the first and second angular regions, the plurality of recesses extending along the second angular region, the plurality of recesses not extending along the first angular region.
Example 11 [0088] The apparatus of Example 10 wherein the first angular region extends over an angular range between approximately 30 ° and approximately 90 ° of a circumference of the platform member.
Example 12 [0089] The apparatus of any one or more of Example 10 to 11 wherein the drive shaft assembly comprises a curved section that includes an internal curve and an external curve.
Example 13 [0090] The apparatus of Example 12 in which 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 [0091] The apparatus of any one or more of Examples 1 to 13 in which the drive shaft assembly further comprises a cover.
Example 15 [0092] The apparatus of any one or more of Examples 1 to 14 wherein the platform member additionally comprises an internal annular wall having a higher edge, the edge being
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36/42 taller has a uniform height along a complete circumference of the platform member.
Example 16 [0093] The apparatus of Example 15 where the highest edge is at the same level as the platform surface.
Example 17 [0094] The apparatus comprising a staple head assembly, the staple head assembly comprising: (a) an annular platform member, the annular platform member comprising: (i) a surface of (ii) an external ring matrix of openings for clamps formed across the platform surface, (iii) a plurality of external recesses formed on the platform surface, with at least a portion of the recesses of the plurality of external recesses being positioned between at least some of the staple openings in the external annular matrix of staple openings, (iv) an internal annular matrix of staple openings formed across the platform surface, and (v) a plurality of internal recesses formed in the platform surface, being that at least a portion of the recesses of the plurality of internal recesses is positioned between at least some of the openings p for staples of the internal annular matrix of staple openings; (b) a plurality of clips; and (c) an operable actuator for driving the clamps through the clamp openings. Example 18 [0095] The apparatus of Example 17 in which the platform member defines a first angular region along the platform surface, the platform member further defining a second angular region along the platform surface, the first and second angular regions extend together along a complete circumference of the platform member,
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37/42 being that the internal and external annular matrices of staple openings extend along the first and second angular regions, with the plurality of internal and external recesses being absent from the first angular region.
Example 19 [0096] The apparatus of any one or more of Examples 17 to 18 in which the recesses of the plurality of recesses have the same depth as the recesses of the plurality of external recesses. Example 20 [0097] The apparatus comprising: (a) a drive shaft assembly extending distally from the body, the drive shaft assembly comprising: (i) a proximal end, (ii) an end distal, 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 staple head assembly located at the distal end of the drive shaft assembly, the staple head assembly comprising: (i) an annular platform surface defining a first angular region and a second angular region, the first angular region being positioned to correspond with the external curve of the drive shaft assembly, the second angular region being positioned to correspond with the internal curve of the driving axis assembly, (ii) an external annular matrix of staple openings formed across the platform surface along the first and second angular regions, (iii) an internal ring matrix of staple openings formed across the platform surface along the first and second angular regions, (iv) an plurality of recesses formed on the platform surface, the recesses being located in the second angular region ma s not in the first angular region, (v) a plurality of clamps, and (vi) a
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38/42 actuator that is operable to drive the clamps through the clamp openings.
V · Other components [0098] 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 on the same date as 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.
[0099] 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.
[0100] It should be understood that the above teachings can be readily combined with the teachings of US patent application No. [attorney document number END7978USNP.0637666], entitled Circular Surgical Stapler with Angularly Asymmetric Deck Features, 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 the patent application
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39/42
US No. [Attorney Document No. END7978USNP.0637666] may be combined will be evident to those skilled in the art. [0101] It should 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. Various suitable ways in which the teachings of the present invention can 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 in the scope of the attached claims.
[0102] 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 TransOral 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; in US publication No. 2014/0144969, entitled Pivoting Anvil for Surgical Circular Stapler, published on May 29, 2014, the disclosure of which is
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40/42 incorporated herein 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; in 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, published 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.
[0103] It should be understood that any patent, publication, or other disclosure material that is incorporated by reference 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.
[0104] Versions of the devices described above may have
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41/42 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.
[0105] The versions described above can be designed to be discarded after a single use or can be designed to 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.
[0106] 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
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42/42 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.
[0107] Having shown and described various modalities of the present 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, stages and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention should 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, 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:
(i) a platform member, the platform member comprising:
(A) a platform surface, (B) an external annular matrix of clamp openings formed across the platform surface, (C) a second annular matrix of clamp openings formed across the platform surface, and (D) a plurality of recesses formed on the platform surface, with at least a portion of the recesses being positioned between at least some of the clamp openings, (ii) a plurality of clamps, and (iii) an operable actuator to drive the clamps through the openings for Bobby pins; and (d) an anvil, the anvil being operable to compress the tissue against the first platform surface.
[2]
2. Apparatus according to claim 1, characterized by the fact that the plurality of recesses comprises a first plurality of recesses and a second plurality of recesses, with at least a portion of the recesses of the first plurality of recesses being positioned between the openings
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2/6 staples of the external annular matrix of staple openings, with at least a portion of the recesses of the second plurality of indentations being positioned between the staple openings of the internal annular matrix of staple openings.
[3]
3. Apparatus according to claim 1, characterized by the fact that the plurality of recesses comprises a plurality of external recesses, the recesses of the plurality of external recesses being positioned between the openings for clamps of the external annular matrix of openings of Bobby pins.
[4]
4. Apparatus according to claim 3, characterized by the fact that the recesses of the plurality of external recesses are formed externally discretely in relation to each other so that the recesses of the plurality of external recesses are isolated in relation to each other.
[5]
5. Apparatus according to claim 3, characterized by the fact that at least some of the recesses of the plurality of external recesses have a trapezoidal shape.
[6]
6. Apparatus according to claim 1, characterized by the fact that the plurality of recesses comprises a plurality of internal recesses, the recesses of the plurality of internal recesses being positioned between the openings for clamps of the internal annular matrix of openings of Bobby pins.
[7]
7. Apparatus according to claim 6, characterized by the fact that the recesses of the plurality of external recesses are in communication with each other through channels.
[8]
8. Apparatus, according to claim 6, characterized by the fact that at least some of the recesses of the plurality of
Petition 870190052392, of 06/04/2019, p. 48/75
3/6 external recesses have a triangular shape.
[9]
9. Apparatus according to claim 8, characterized by the fact that the triangular shape is defined in part by a pair of corresponding side walls joined at a vertex, the vertex being situated in a radial position over a circumference that correspond to the radial positions of the ends of the staple openings of the internal annular matrix of staple openings.
[10]
10. Apparatus according to claim 1, characterized by the fact that the platform member defines a first angular region along the platform surface, the platform member additionally defining a second angular region along the platform surface , with the staple openings extending along the first and second angular regions, the plurality of recesses extending along the second angular region, whereas the plurality of recesses does not extend along the first 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, the second angular region being angularly positioned to
Petition 870190052392, of 06/04/2019, p. 49/75
4/3 correspond with the internal curve.
[14]
14. Apparatus according to claim 1, characterized by the fact that the platform member additionally comprises a rounded outer edge.
[15]
15. Apparatus according to claim 1, characterized by the fact that the platform member additionally comprises an internal annular wall that has a higher edge, the highest edge having a uniform height along a total circumference of the platform member.
[16]
16. Apparatus according to claim 15, characterized by the fact that the highest edge is at the same level as the platform surface.
[17]
17. 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 platform surface, (ii) an external annular matrix of clip openings formed across the platform surface, (iii) a plurality of external recesses formed in the platform surface, with at least a portion of the recesses of the plurality of external recesses is positioned between at least some of the staple openings of the external annular matrix of staple openings, (iv) an internal annular matrix of staple openings formed across the platform surface, and (v) a plurality of internal indentations formed on the platform surface, with at least a portion of the recesses of the plurality of internal recesses being positioned between
Petition 870190052392, of 06/04/2019, p. 50/75
5/6 at least some of the staple openings of the internal annular matrix of staple openings;
(b) a plurality of clips; and (c) an operable actuator for driving the clamps through the clamp openings.
[18]
18. Apparatus according to claim 17, characterized in that the platform member defines a first angular region along the platform surface, the platform member additionally defining a second angular region along the platform surface , with the first and second angular regions extending together along a complete circumference of the platform member, with the internal and external annular matrices of clamp openings extending along the first and second angular regions, the pluralities being internal and external recesses are absent from the first angular region.
[19]
19. Apparatus, according to claim 17, characterized by the fact that the recesses of the plurality of recesses have the same depth as the recesses of the plurality of external recesses.
[20]
20. Device 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 on the
Petition 870190052392, of 06/04/2019, p. 51/75
6/6 distal end of the drive shaft assembly, the staple head assembly comprising:
(i) an annular platform surface defining a first angular region and a second angular region, the first angular region being positioned to correspond with the external curve of the drive shaft assembly, the second angular region being positioned to correspond with the internal curve of the drive shaft assembly, (ii) an external annular matrix of openings for clamps formed through the platform surface along the first and second angular regions, (iii) an internal annular matrix of openings for clamps formed through of the platform surface along the first and second angular regions, (iv) a plurality of recesses formed on the platform surface, the recesses being located in the second angular region, but not in the first angular region, (v) a plurality of clamps, and (vi) an operable actuator to drive the clamps through the clamp openings.

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同族专利:

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公开号 | 公开日

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US10980542B2|2021-04-20|

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EP3320858A1|2018-05-16|

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CN110167465A|2019-08-23|

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JP2019535395A|2019-12-12|

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WO2018089050A1|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]|

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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:

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