surgical stapler with elastically deformable tip

专利摘要:
the present invention relates to a surgical instrument that includes a body, a drive shaft and an end actuator that is operable to compress, staple and cut tissue. the end actuator includes an anvil and a cartridge. the anvil has a curved tip. the curved tip is elastically deformable from a predicted curved position when the tip is subjected to a force, such as the force exerted on the anvil when the fabric is trapped between the anvil and the cartridge. the anvil's curvature and deformation features provide better viewing and maneuverability to an end actuator, particularly during procedures involving gait.
公开号:BR112019016948A2
申请号:R112019016948
申请日:2018-02-12
公开日:2020-04-14
发明作者:E Shelton Frederick Iv；J Bakos Gregory；L Harris Jason；P Schowalter Joseph；Bledsoe Ryan
申请人:Ethicon Llc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for SURGICAL STAPLER WITH ELASTICALLY DEFORMABLE TIP.
BACKGROUND [0001] In some cases, endoscopic surgical instruments may be preferred over traditional open surgery devices, since a smaller incision can reduce recovery time and complications in the postoperative period. Consequently, some endoscopic surgical instruments may be suitable for placing a distal end actuator in a desired surgical site through the trocar cannula. These distal end actuators can engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (for example, cutter, claw, cutter, stapler, clip applicator, access device, drug delivery / gene therapy device and device for application of energy using ultrasound, RF, laser, etc.). Endoscopic surgical instruments may include a drive shaft between the end actuator and a handle portion, which is handled by the clinician. Such a drive shaft can enable insertion to a desired depth and rotation around the longitudinal geometric axis of the drive shaft, thus facilitating the positioning of the end actuator on the patient. The positioning of an end actuator can be further facilitated by the inclusion of one or more articulated joints or features, allowing the end actuator to be selectively articulated or otherwise deflected in relation to the longitudinal geometric axis of the drive shaft.
[0002] Examples of endoscopic surgical instruments include surgical staplers. Some of these staplers work to trap layers of fabric, cut through the layers of fabric attached, and have staples go through the
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2/75 layers of fabric to substantially seal the cut layers of fabric together, close to their cut ends. Merely exemplary surgical staplers are presented in US Patent No. 4,805,823, entitled Pocket Configuration for Internai Organ Staplers, issued on February 21, 1989; US Patent No. 5,415,334, entitled Surgical Stapler and Staple Cartridge, issued May 16, 1995; US Patent No. 5,465,895, entitled Surgical Stapler Instrument, issued November 14, 1995; US Patent No. 5,597,107, entitled Surgical Stapler Instrument, issued November 28, 1997; US Patent No. 5,632,432, entitled Surgical Instrument, issued May 27, 1997; US Patent No. 5,673,840, entitled Surgical Instrument, issued October 7, 1997; US Patent No. 5,704,534, entitled Articulation Assembly for Surgical Instruments, issued January 6, 1998; US Patent No. 5,814,055, entitled Surgical Clamping Mechanism, issued September 29, 1998; US Patent No. 6,978,921, entitled Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism, issued December 27, 2005; US Patent No. 7,000,818, entitled Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems, issued February 21, 2006; US Patent No. 7,143,923, entitled Surgical Stapling Instrument Having a Firing Lockout for an Unclosed Anvil, issued December 5, 2006; US Patent No. 7,303,108, entitled Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack, issued December 4, 2007; US Patent No. 7,367,485, entitled Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission, issued on May 6, 2008; US Patent No. 7,380,695, entitled Surgical Stapling Instrument Having a Single Lockout Mechanism for
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3/75
Prevention of Firing, granted on June 3, 2008; US Patent No. 7,380,696, entitled Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism, issued June 3, 2008; US Patent No. 7,404,508, entitled Surgical Stapling and Cutting Device, issued July 29, 2008; US Patent No. 7,434,715, entitled Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout, issued October 14, 2008; US Patent No. 7,721,930, entitled Disposable Cartridge with Adhesive for Use with a Stapling Device, issued May 25, 2010; US publication No. 2010/0264193, entitled Surgical Stapling Instrument with An Articulatable End Effector, published on October 21, 2010; and in US publication No. 2012/0239012, entitled Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly, published on September 20, 2012; The description of each of the US patents and US patent publications cited above is hereby incorporated by reference.
[0003] Although the aforementioned surgical staplers are described as used in endoscopic procedures, it should be understood that these surgical staplers can also be used in open procedures and / or other non-endoscopic procedures. Just as an example, a surgical stapler can be inserted through a thoracotomy and, thus, between the patient's ribs, to reach one or more organs in a thoracic surgical procedure that does not use a trocar as a conduit for the stapler. Such procedures may include using the stapler to cut and close a blood vessel that leads to a lung. For example, the vessels that lead to an organ can be cut and closed by a stapler before removal of the organ from the chest cavity. Of course, surgical staplers can be used
Petition 870190098578, of 10/02/2019, p. 29/111 in several other scenarios and procedures.
[0004] 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 [0005] The attached drawings, which are incorporated into this specification and form part of it, illustrate modalities of the invention and, together with the general description provided above, and the detailed description of the modalities provided below, serve to explain the principles of the present invention.
[0006] Figure 1 represents a perspective view of an exemplary articulated surgical stapling instrument;
[0007] Figure 2 represents a side view of the instrument of Figure 1;
[0008] Figure 3 represents a perspective view of an open end actuator of the instrument of Figure 1;
[0009] Figure 4A represents a side view in cross section of the end actuator of Figure 3, taken along line 4-4 of Figure 3, with the firing beam in a proximal position;
[0010] Figure 4B represents a side view in cross section of the end actuator of Figure 3, taken along line 4-4 of Figure 3, with the firing beam in a distal position;
[0011] Figure 5 represents a cross-sectional view of the end actuator of Figure 3 taken along line 5-5 of Figure 3.
[0012] Figure 6 represents an exploded perspective view of the end actuator of Figure 3;
[0013] Figure 7 represents a perspective view of the actuator of
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5/75 end of Figure 3, positioned on the fabric and which was actuated once on the fabric;
[0014] Figure 8 represents a perspective view of an alternative version of an end actuator with an inclined anvil and an inclined cartridge;
[0015] Figure 9 represents an enlarged side view of the end actuator of Figure 8;
[0016] Figure 10 represents an enlarged top view of the end actuator of Figure 8;
[0017] Figure 11 represents a perspective view of an exemplary surgical stapling instrument that has an end actuator with an elastically deformable curved tip section;
[0018] Figure 12A represents an enlarged side view of a distal portion of the end actuator of Figure 11;
[0019] Figure 12B represents an enlarged side view of a distal portion of an alternative end actuator similar to that of Figure 11;
[0020] Figure 13 represents a bottom view of a distal portion of the end actuator of Figure 11 with the cartridge shown in dashed line to reveal a surface on the underside of the anvil;
[0021] Figure 14 represents a side view in cross section of a distal portion of the end actuator of Figure 11, taken along line 14-14 of Figure 13;
[0022] Figure 15 represents a cross-sectional end view of an anvil of the end actuator of Figure 11, taken along line 15-15 of Figure 13;
[0023] Figure 16 represents an enlarged side view of a distal portion of an exemplary alternative end actuator
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6/75 for use with the surgical stapling instruments described here, shown in partial cross section to reveal the internal features;
[0024] Figure 17 represents an exploded perspective view of a distal portion of the end actuator of Figure 16;
[0025] Figure 18 represents an enlarged side view of a distal portion of another exemplary alternative end actuator for use with the surgical stapling instruments described here, shown in partial cross section to reveal the internal features;
[0026] Figure 19 represents an exploded perspective view of a distal portion of the end actuator of Figure 18;
[0027] Figure 20 represents an enlarged perspective view of a distal portion of an exemplary alternative anvil for an end actuator for use with the surgical stapling instruments described herein;
[0028] Figure 21 represents an enlarged perspective view of a distal portion of another exemplary alternative anvil for an end actuator for use with the surgical stapling instruments described herein;
[0029] Figure 22 represents a side cross-sectional view of a distal portion of the anvil of Figure 21;
[0030] Figure 23 represents an enlarged perspective view of a distal portion of another exemplary alternative anvil for an end actuator for use with the surgical stapling instruments described herein;
[0031] Figure 24 represents another enlarged perspective view of a distal portion of the anvil of Figure 23;
[0032] Figure 25 represents an enlarged perspective view of a distal portion of another exemplary alternative anvil for an end actuator for use with the clip instruments Petition 870190098578, of 10/02/2019, pg. 11/31
7/75 surgical procedure described here;
[0033] Figure 26 represents a side cross-sectional view of a distal portion of the anvil of Figure 25;
[0034] Figure 27 represents an enlarged perspective view of a distal portion of another exemplary alternative anvil for an end actuator for use with the surgical stapling instruments described herein;
[0035] Figure 28 represents another enlarged perspective view of a distal portion of the anvil of Figure 27, shown with a portion in dashed line to reveal the internal features;
[0036] Figure 29 represents an enlarged perspective view of a distal portion of an alternative exemplary cartridge for an end actuator for use with the surgical stapling instruments described herein;
[0037] Figure 30 represents a side view of a distal portion of an exemplary alternative end actuator that has the cartridge of Figure 29, shown without tissue capture; and [0038] Figure 31 represents a side view of a distal portion of the end actuator of Figure 30, shown with the tissue captured between the anvil and the cartridge.
[0039] The drawings are not intended to be limiting and it is envisaged that various modalities of the invention can be carried out in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings incorporated and which form part of the specification illustrate various aspects of the present invention and, together with the description, serve to explain the principles of the invention; it being understood, however, that this invention is not specifically limited to the provisions shown.
DETAILED DESCRIPTION
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[0040] The following description of specific examples of the invention should not be used to limit the scope of the present invention. Other examples, characteristics, aspects, modalities and advantages of the invention will be evident to those skilled in the art from the description below, which is, by way of illustration, one of the best ways contemplated for carrying out the invention. As will be understood, the invention may have other different and obvious aspects, all without departing from the invention. Consequently, drawings and descriptions should be considered as illustrative and not restrictive in nature.
I · Exemplary surgical stapler [0041] Figures 1 to 7 represent an exemplary surgical stapling and cutting instrument 10 that is sized for insertion, in a non-articulated state as shown in Figure 1, through a trocar cannula to a surgical site on a patient to perform a surgical procedure. For example only, can this trocar be inserted into the patient's abdomen, between two of the patient's ribs, or elsewhere. In some scenarios, instrument 10 is used without a trocar. For example, instrument 10 can be inserted directly through a thoracotomy or other type of incision. The instrument 10 of the present example includes a handle portion 20 connected to a drive shaft 22. The drive shaft 22 ends distally at a hinge joint 11, which is additionally coupled to an end actuator 12. It should be understood that the terms proximal and distal are used in the present invention with reference to a physician holding the handle portion 20 of the instrument 10. Thus, the end actuator 12 is located distal to the most proximal handle portion 20. It will also be understood that, for convenience and clarity, spatial terms such as vertical and horizontal are used in the present invention in relation to the drawings. However,
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9/75 surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and absolute.
[0042] In some versions, drive shaft 22 is constructed in accordance with at least some of the teachings of US publication No. 2014/0239038, entitled Surgical Instrument with MultiDiameter Shaft, published on August 28, 2014, the disclosure of which is incorporated as a reference. Other configurations suitable for the drive shaft 22 will be apparent to those skilled in the art in view of the teachings of the present invention. [0043] Once the articulated joint 11 and the end actuator 12 are inserted through the passage of a trocar cannula, the articulated joint 11 can be articulated remotely, as shown in dashed line in Figure 1, by a joint control 13, so that the end actuator 12 can be deflected from the longitudinal axis LA of the drive shaft 22 at a desired angle α. The end actuator 12 can thus reach behind an organ or approach the tissue from a desired angle or for other reasons. In some versions, the articulated joint 11 allows deflection of the end actuator 12 along a single plane. In some other versions, the articulated joint 11 allows the deflection of the end actuator along more than one plane. The articulated joint 11 and the articulated control 13 can be configured according to the teachings of any of the numerous references that are cited in the present invention. Alternatively, the hinge joint 11 and / or the hinge control 13 can have any other suitable configuration. Just as an example, the articulation control 13 can instead be configured as a button that rotates about a geometry axis that is perpendicular to the longitudinal geometry axis LA of the drive axis 22.
[0044] In some versions, the articulated joint 11 and / or the control
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10/75 articulation 13 is constructed and operable in accordance with at least some of the teachings of US Patent No. 9,186,142, entitled Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks, granted on November 17, 2015, whose disclosure is incorporated here for reference The articulated joint 11 can also be constructed and operable in accordance with at least some of the teachings of US publication No. 2014/0239038, entitled Surgical Instrument with Multi-Diameter Shaft, published on August 28, 2014 , the disclosure of which is incorporated by reference. Other suitable shapes that the articulated joint 11 and the articulated control 13 can take will be evident to those skilled in the art, in view of the teachings of the present invention.
[0045] The end actuator 12 of the present example includes a lower jaw 16 and a pivoting anvil 18. In some versions, the lower jaw 16 is constructed in accordance with at least some of the teachings of US publication No. 2014/0239044, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28, 2014, the disclosure of which is hereby incorporated by reference The anvil 18 can be constructed in accordance with at least some of the teachings of US publication No. 2014/0239042, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, published on August 28, 2014, the disclosure of which is hereby incorporated by reference; at least some of the teachings of US publication No. 2014/0239036, entitled Jaw Closure Feature for End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is incorporated by reference in this document; and / or at least some of the teachings of US publication No. 2014/0239037, entitled Staple Forming Features for Surgical Stapling Instrument, published on 28
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August 11/75, 2014, the disclosure of which is hereby incorporated by reference. Other suitable shapes that the lower jaw 18 and the anvil 18 can take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0046] The grip portion 20 includes a pistol grip 24 and a closing trigger 26. The closing trigger 26 is pivoted towards the pistol grip 24 to cause the anvil 18 to clamp, or close, towards the claw. bottom 16 of the end actuator 12. Such anvil closure 18 is provided through a closing tube 32 and a closing ring 33, which travel longitudinally in relation to the handle portion 20 in response to the pivot of the closing trigger 26 in in relation to the pistol grip 24. The closing tube 32 extends along the drive shaft 22; and the closing ring 33 is positioned distally to the hinge joint 11. The hinge joint 11 has the purpose of communicating / transmitting the longitudinal movement of the closing tube 32 to the closing ring 33.
The grip portion 20 also includes a trigger trigger 28. An elongated member (not shown) extends longitudinally through the drive shaft 22 and transmits a longitudinal trigger movement from the handle portion 20 to a trigger beam 14 in response to the trigger trigger 28. This distal translation of the trigger beam 14 causes stapling and separation of the tissue trapped in the end actuator 12, as will be described in more detail below. Thereafter, triggers 26, 28 can be released to release tissue from end actuator 12.
[0048] Figures 3 to 6 represent the end actuator 12 which employs an electron beam form of the firing beam 14 to perform various functions. It should be understood that an electron beam shape is just an illustrative example. The dis beam
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12/75 paro 14 can take any other suitable shape, including but not limited to different forms of electron beam. As can best be seen in Figures 4A to 4B, the firing beam 14 includes a transverse oriented upper pin 38, a firing beam cover 44, a transverse oriented intermediate pin 46 and a cutting edge shown distally 48. The upper pin 38 is positioned and translatable within a longitudinal anvil slot 42 of the anvil 18. The firing beam cover 44 slidably engages a lower surface of the lower jaw 16 as the firing beam 14 extends through the lower jaw groove 45 shown in Figure 4B which is formed through the lower jaw 16. The intermediate pin 46 slidably engages a top surface of the lower jaw 16, cooperating with the firing beam cover 44. Thus, firing beam 14 is positively spaced of the end actuator 12 during firing.
[0049] Some different forms of electron beams from the firing beam 14 may be devoid of upper pin 38, intermediate pin 46 and / or firing beam cover 44. Some such versions of instrument 10 may simply depend on the closing ring 33 or some other feature for turning the anvil 18 to a closed position and holding the anvil 18 in the closed position while the firing beam 14 advances to the distal position. Just as an example, the firing beam 14 and / or associated locking features can be constructed and operable according to at least some of the teachings of US publication No. 2014/0239041, entitled Lockout Feature for Movable Cutting Member of Surgical Instrument , published on August 28, 2014, the disclosure of which is hereby incorporated by reference. Other suitable forms which the firing beam 14 can take will be evident to those skilled in the art in view of the teachings of the present invention.
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13/75 [0050] Figure 3 shows the firing beam 14 of the present example positioned proximally and the anvil 18 pivoted to an open position, allowing an unconsumed staple cartridge 37 to be removably installed in a lower jaw channel 16. As can best be seen in Figures 5 to 6, the staple cartridge 37 of the present example includes a cartridge body 70, which has an upper platform 72 and is coupled with a lower cartridge tray 74. As can best be seen in Figure 3, a vertical slot 49 is formed through part of the staple cartridge 37. As can be seen better in Figure 3, three rows of staple openings 51 are formed through the upper platform 72 on one side of the vertical slot 49 , with another set of three rows of clip openings 51 being formed through the upper platform 72 on the other side of the vertical slot 49. Certainly, any other suitable number of rows of gram pos (for example, two rows, four rows, any other number) can be provided. Referring again to Figures 4A to 6, a wedge slide 41 and a plurality of clamp actuators 43 are captured between the cartridge body 70 and tray 74, with the wedge slide 41 being located next to the clamp drivers 43 The wedge slide 41 is movable longitudinally within the staple cartridge 37; while the clamp actuators 43 are movable vertically inside the clamp cartridge 37. The clamps 47 are also positioned inside the cartridge body 70, above corresponding clamp drivers 43. In particular, each clamp 47 is driven vertically within the cartridge body 70 by a clamp driver 43 to drive clamp 47 outwardly through an associated clamp aperture 51. As can best be seen in Figures 4A to 4B and 6, the wedge slide 41 presents
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14/75 inclined meat surfaces that force the clamp actuators 43 upward as the wedge slide 41 is distally driven through the clamp cartridge 37.
[0051] In some versions, the staple cartridge 37 is constructed and operable in accordance with at least some of the teachings of US publication No. 2014/0239042, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, published on August 28 2014, the disclosure of which is incorporated by reference in this document; In addition or alternatively, the staple cartridge 37 can be constructed and operable in accordance with at least some of the teachings of US publication No. 2014/0239044, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28, 2014 , the disclosure of which is hereby incorporated by reference. Other suitable forms which the staple cartridge 37 may take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0052] With the end actuator 12 closed, as shown in Figures 4A to 4B by the distal advance of the closing tube 32 and the closing ring 33, the firing beam 14 is then advanced in engagement with the anvil 18 for having the upper pin 38 entering the longitudinal anvil slot 42. A drive block 80 shown in Figure 5 is located at the distal end of the firing beam 14, and is configured to engage the wedge slider 41 so that the wedge slider 41 is pushed distally by drive block 80 as firing beam 14 is advanced distally through staple cartridge 37 when firing trigger 28 is actuated. During such firing, the cutting edge 48 of the firing beam 14 enters the vertical slot 49 of the staple cartridge 37, cutting the tissue trapped between the staple cartridge 18
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15/75 and anvil 37. As shown in Figures 4A to 4B, intermediate pin 46 and drive block 80 actuate the staple cartridge 37 by entering the vertical slot 49 inside the staple cartridge 37, driving the wedge slide 41 in flesh contact with the clamp actuators 43 which, in turn, drive the clamps 47 out through the clamp openings 51 and in forming contact with clamp formation pockets 53 (shown in Figure 3) on the internal surface of the anvil 18. Figure 4B represents the firing beam 14 completely and distally translated after the completion of the separation and stapling of the tissue. It is to be understood that the staple forming pockets 53 are intentionally omitted from the view in Figures 4A to 4B; but the staple forming pockets 53 are shown in Figure 3. It should also be understood that the anvil 18 is intentionally omitted from the view in Figure 5.
[0053] Figure 7 shows the end actuator 12 having been actuated through a single stroke through the fabric 90. As shown, the cutting edge 48 (omitted in Figure 7) cuts through the fabric 90, while the clip drivers 43 guide two alternating rows of staples 47 through the fabric 90 on each side of the cutting line produced by the cutting edge 48. The staples 47 are all oriented substantially parallel to the cutting line in this example, although it should be understood that the staples 47 can be positioned in any suitable orientations. In the present example, end actuator 12 is removed from the trocar after the first stroke is completed, the consumed staple cartridge 37 is replaced with a new staple cartridge and end actuator 12 is then reinserted through the trocar to reach the stapling location for additional cutting and stapling. This process can be repeated until the
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16/75 desired number of cuts and staples 47 has been provided. It may be necessary to close anvil 18 to facilitate insertion and removal through the trocar; and it may be necessary to open the anvil 18 to facilitate the replacement of the staple cartridge 37.
[0054] It should be understood that the cutting edge 48 can cut the fabric substantially contemporary to the activation of the staples 47 through the fabric during each stroke of action. In the present example, the cutting edge 48 has a small delay in relation to the activation of the staples 47, so that a staple 47 is guided through the fabric just before the cutting edge 48 passes through the same region of the fabric, although it must be understand that this order can be reversed or that the cutting edge 48 can be directly synchronized with the adjacent clamps. Although Figure 7 shows the end actuator 12 being acted on two layers 92, 94 of tissue 90, it should be understood that the end actuator 12 can be acted through a single layer of tissue 90 or more than two layers 92, 94 of fabric. It should also be understood that the formation and positioning of staples 47 adjacent to the cutting line produced by the cutting edge 48 can substantially seal the tissue at the cutting line, thereby reducing or preventing bleeding and / or leakage from other body fluids in the cut-line. In addition, although Figure 7 shows the end actuator 12 being acted on two substantially smooth flat layers 92, 94 of fabric, it should be understood that the end actuator 12 can also be acted along a tubular structure like a vessel blood, a section of the gastrointestinal tract, etc. Figure 7 should not, therefore, be seen as a demonstration of any limitation of the uses contemplated for the end actuator 12. Various suitable scenarios and procedures in which the instrument 10 can be used will be evident to those versed in the technique in view of the teachings
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17/75 of the present invention.
[0055] In one version, instrument 10 provides motorized control of firing beam 14. Exemplary components that can be used to provide motorized control of firing beam 14 are shown and described in US publication No. 2014/0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is hereby incorporated by reference. In addition to or in place of the aforementioned, at least part of the motorized control can be configured according to at least some of the teachings of US patent No. 8,210,411, entitled Motor-Driven Surgical Instrument, granted on July 3, 2012, whose disclosure is hereby incorporated by reference In addition to or in place of the aforementioned, the resources intended to trigger the firing beam 14 can be configured according to at least some of the teachings of US publication No. 2012/0239012, whose disclosure is incorporated by reference in this document; and / or in accordance with at least some of the teachings of US publication No. 2012/0239012, the disclosure of which is hereby incorporated by reference Other components, features and configurations suitable to provide motorization of the firing beam 14 will be evident to those skilled in technique in view of the teachings of the present invention. It should also be understood that some other versions can provide manual activation of the firing beam 14, so that a motor can be omitted. Just as an example, the firing beam 14 can be operated in accordance with at least some of the teachings of any other patent / publication reference cited in the present invention.
[0056] Instrument 10 may also include a locking key and a locking indicator as shown and described in US publication No. 2014/0239043, entitled Distal Tip Features for
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18/75
End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is hereby incorporated by reference. Additionally, a locking key and / or locking indication and associated components / functionality can be configured in accordance with at least some of the teachings of US Patent No. 7,644,848, entitled Electronic Lockouts and Surgical Instrument Including Same, granted on 12 January 2010, the disclosure of which is hereby incorporated by reference.
[0057] Instrument 10 also includes a manual return key 116 configured to act as a rescue feature, which allows the operator to quickly start firing beam 14 proximally during a firing stroke. In other words, the manual return switch 116 can be actuated manually when the firing beam 14 has only been partially distally advanced. The manual return key 116 can provide additional functionality according to at least some of the teachings of US publication No. 2014/0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is incorporated reference to this document.
[0058] In revealing the operation of instrument 10, the use of the term pivot (and similar terms with pivot as a base) should not be read as necessarily requiring a pivoting movement around a fixed geometric axis. In some versions, anvil 18 pivots around a geometric axis that is defined by a pin (or similar feature) that slides along an elongated slot or channel as anvil 18 moves towards the lower claw 16. In such versions, the pivot geometric axis travels along the path defined by the slot or channel while the anvil 18 pivots simultaneously around that geometric axis. Additionally or alternatively, the pivot geometry axis can slide first along
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19/75 of the slot / channel, with anvil 18 then pi voting around the pivot geometry axis after the pivot geometry axis has slid a certain distance along the slot / channel. It must be understood that such sliding / transfer pivoting movement is covered within terms such as pivot, pivots, pivot. swivel, articulated and the like. Certainly, some versions can provide pivoting movement of the anvil 18 around a geometric axis that remains fixed and does not move inside a slot or channel, etc.
[0059] It should be understood that instrument 10 can be configured and operable in accordance with any of the teachings of US Patent No. 4,805,823; US patent No. 5,415,334; US patent No. 5,465,895; US patent No. 5,597,107; US patent No. 5,632,432; US patent No. 5,673,840; US patent No. 5,704,534; US patent No. 5,814,055; US patent No. 6,978,921; US patent No. 7,000,818; US patent No. 7,143,923; US patent No. 7,303,108; US patent 7,367,485; US patent 7,380,695; US patent 7,380,696; US patent No. 7,404,508; US patent No. 7,434,715; US patent No. 7,721,930; in US publication No. 2010/0264193; and / or 2012/0239012. As noted above, the descriptions of each of these patents and publications are incorporated by reference in the present invention. Additional exemplary modifications that can be provided for instrument 10 will be described in more detail below. Various suitable ways in which the teachings below can be incorporated into the instrument 10 will become evident to those skilled in the art. Similarly, various suitable ways in which the teachings below can be combined with the various teachings of the patents / publications cited in the present invention will be apparent to those skilled in the art. It should also be understood that the teachings below are not limited to the instrument 10 or the devices taught in the patents cited in the present invention. The teachings below can
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20/75 be readily applied to several other types of instruments, including instruments that would not be classified as surgical staplers. Various other suitable devices and scenarios to which the teachings below can be applied will be apparent to those skilled in the art based on the teachings of the present invention.
Il · Exemplary end actuator with visualization, entry and collection area [0060] In some cases, it may be desirable to provide the user with a better view of end actuator 12. In particular, as end actuator 12 is inserted in a surgical site, the user can rotate the drive shaft 22 of the instrument 10 during the procedure. As a result, end actuator 12 also rotates. As the end actuator 12 rotates, it may be desirable for the user to have visual access to the surgical site. For example, the user may wish to see the interface or contact between the fabric 90 and the end actuator 12. Since the end actuator 12 can be rotated about the longitudinal axis LA relative to the handle portion 20, the user can view the surgical site so that the lower claw 16 of the end actuator is visible instead of the anvil 18. Alternatively, the end actuator 12 can be rotated so that when the user views the end actuator 12, the anvil 18 is visible to the user. It may be desirable to provide visibility of the surgical site to the user beyond what is possible in the instrument 10 in Figure 1. For example, in the case of some surgical procedures where the vessels that carry fluid are transected and stapled, it may be desirable to have visual confirmation that the anvil 18 and the lower claw 16 completely cover the vessel to be cut, so that the vessel can be completely cut and stapled in a single actuation. In other words, the user may wish to avoid cutting and stapling
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21/75 just a portion of a vase. Thus, some means of monitoring and / or visual feedback may be desirable to let the user know that the end actuator 12 has been properly positioned within the surgical site for the anvil 18 and the lower claw 16 to fully clamp the vessel. A potential way of monitoring the surgical site may include improving the visualization of the area adjacent to the distal tip of the lower jaw 16 and the anvil 18. Additionally, not only the visualization of the distal end of the end actuator 12 may be desirable, but it may also be desirable. it is desirable to construct the end actuator 12 so that the distal end of the anvil 18 is configured to urge the fabric, for example, a large vessel proximally into the space between the anvil 18 and the lower claw 16 as the anvil 18 closes towards the lower claw 16.
[0061] Figure 8 represents an example end actuator 212 comprising an anvil 218 and a lower claw 216. It will be understood that end actuator 212 can be used in place of end actuator 12 of instrument 10. The end actuator 212 can be integrally formed with instrument 10 or, alternatively, it can be interchangeable with end actuator 12 of instrument 10.
[0062] The anvil 218 is intended to pivot in relation to the lower jaw 216. The anvil 218 and the lower jaw 216 can pinch the fabric 90 in a similar way to the locking performed by the anvil 18 and the lower jaw 16 shown in Figure 1. The End actuator 212 further comprises a cartridge 237 which is intended to be placed in the lower jaw 216 in a similar manner to the cartridge 37 shown in Figure 3.
[0063] The anvil 218, as can be seen in Figures 8 to 10, has an elongated shape in which the distal portion of the anvil 218 in
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22/75 bends towards cartridge 237. The distal anvil portion 218 tilts toward the cartridge, 237 so that the most distal tip 219 of anvil 218 extends distally longitudinally beyond cartridge 237. Although in some versions, the distal tip 219 can extend a distance longitudinally equal to the cartridge 237 or proximal to the most distal point on the cartridge 237. Additionally, the anvil 218 tilts towards the cartridge 237 through a smooth slope. As best seen in Figure 10, anvil 218 includes sides 241 that taper as they approach the most distal tip 219 of anvil 218. For example, anvil 218 is shaped in Figure 8 similarly to a tip inverted ski. The inclined shape of anvil 218 can provide easier insertion of end actuator 212 into a surgical site. For example, the smooth slope or inverted ski tip shape of the anvil 218 can provide an atraumatic tissue deflection surface as the anvil 218 contacts or moves through the fabric. This deflection of atraumatic tissue may include propelling the tissue (for example, a large vessel) proximally into the space between the anvil 218 and the lower jaw 216 as the anvil 218 closes towards the lower jaw 216. When placed in a surgical site, the angled shape of anvil 218 can also provide better maneuverability of end actuator 212 and better visibility of the distal end of end actuator 212 in relation to anatomical structures at the surgical site. Other suitable variations of the anvil 218 will be apparent to those skilled in the art in view of the teachings in the present invention.
[0064] The purpose of the cartridge 237 is to retain staples similar to the staples 47 shown in Figure 4A to lead to the fabric. As shown in Figure 9, the distal end of cartridge 237
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23/75 has a triangular profile. In particular, the distal end of the cartridge 237 comprises an upper tapered surface 239 and a lower tapered surface 238. Additionally, the distal end of the cartridge 237 comprises a tapered side surface 243 on each side. In the present example, each tapered side surface 243 of cartridge 237 generally aligns with the taper shown by sides 241 of anvil 218. Thus, as shown in Figure 10, side surfaces 243 of cartridge 237 do not extend to out from the longitudinal geometric axis LA of the end actuator 212 beyond the sides 241 of the anvil 218. The upper tapered surface 239 and the lower tapered surface 238 lead to the more distal end of the cartridge 237. The lower tapered surface 238 defines a line of sight 240 so that when the end actuator 212 is inserted into a surgical site, the user can observe along line of sight 240. Line of sight 240 extends along the edge of the lower tapered surface 238. It will be understood that the flat shape of the lower tapered surface 238 may be intended to allow the user to view and / or almost visualize the distal tip 219 of anvil 218. In particular , line of sight 240 crosses the longitudinal geometric axis LA, which extends longitudinally through end actuator 212, to form a split angle Θ.
[0065] The viewing angle Θ can establish the relative visibility that a user has in relation to distal tip 219. In particular, the user can see in front of distal tip 219 along any line of sight that passes through the intersection of line of sight 240 and longitudinal geometric axis LA within the viewing angle Θ. For example, as the viewing angle Θ increases, the user has greater visibility of the area immediately in front of the distal tip 219 from the proximal views; whereas, when the viewing angle Θ decreases, the user has less visibility of the area in front of the tip
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Distal 24/75 219 from the proximal views. In some versions, ο viewing angle Θ defines an angle greater than 90 degrees. Additionally, in some versions, the viewing angle Θ defines an angle greater than 135 degrees. Other angles suitable for the viewing angle Θ will be evident to those skilled in the art in view of the teachings of the present invention. In the illustrated version, the user looks, in general, along line of sight 240 or along some other line of sight within the angle of view Θ, thus, the user has visibility along the line of sight as well as in any area within the viewing angle θ. The underside of the distal tip 219 is also slightly rounded to aid in the visibility of the intersection between the longitudinal geometric axis LA and the line of sight 240.
[0066] When tissue 90 is clamped between a closed cartridge 237 and anvil 218, the user can look along line of sight 240 or elsewhere within the viewing angle Θ to see, for example, precisely where the anvil 218 pinched the fabric 90. Additionally, the user would be able to determine whether the fabric is completely trapped between the anvil 218 and the cartridge 237, so that the fabric does not spread over the end of the end actuator 212. The user can be also able to visualize the quality of the attachment between the anvil 218 and the cartridge 237 against the fabric 90. It will be understood that, in some cases, the end actuator 212 can be rotated before, during or after the fabric fixation 90. As a result , the tapered shape of the anvil 218 can also provide more accessible visualization of the distal tip 219 or substantially adjacent to the distal tip 219. The tapering of the anvil 218 together with the lower tapered surface 238 of the cartridge 237 can promote see even more the easy insertion of the 212 end actuator into the tissue in an atraumatic way. In addition, it may be easier to fit the end actuator 212 through
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25/75 a trocar or other devices designed to introduce end actuator 212 into a surgical site due to the tapered end of end actuator 212. For example, since the distal tip 219 is fitted into a trocar, the surface bottom taper 238 and the tapered shape of anvil 218 can provide an entry area, which guides the rest of end actuator 212 into the trocar. In view of the teachings of the present invention, those skilled in the art will additionally recognize that visibility and maneuverability can be improved through the tapered design for both sides 241 of anvil 218 and each side 243 of cartridge 237.
[0067] In addition to the above, end actuator 212 and versions of instrument 10 that incorporate end actuator 212 can be configured and operable in accordance with at least some of the teachings of US patent No. 9,186,142, entitled Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks, granted on November 17, 2015, the disclosure of which is hereby incorporated by reference; US publication No. 2014/0239041, entitled Lockout Feature for Movable Cutting Member of Surgical Instrument, published on August 28, 2014, the disclosure of which is hereby incorporated by reference; US patent No. 9,517,065, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, issued December 13, 2016, the disclosure of which is incorporated herein by reference; US publication No. 2014/0239036, entitled Jaw Closure Feature for End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is hereby incorporated by reference; in US publication No. 2014/0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the disclosure of which is incorporated into this document by way of re
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26/75 ference; US publication No. 2014/0239037, entitled Staple Forming Features for Surgical Stapling Instrument, published on August 28, 2014, the disclosure of which is incorporated by reference in this document; US publication No. 2014/0239038, entitled Surgical Instrument with Multi-Diameter Shaft, published on August 28, 2014, the disclosure of which is incorporated by reference; and / or US publication No. 2014/0239044, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28, 2014, the disclosure of which is hereby incorporated by reference. Additional modifications that can be incorporated into the 212 end actuator will be described in more detail below.
Ill · End actuators with elastically deformable curved anvil tips [0068] In some procedures, it may be necessary to cut along the fabric or through the fabric where more than one cutting sequence is needed to complete the procedure - in other words, doing sequential cuts along a continuous path. In such procedures, this sequential cutting technique can be defined as walking. With procedures that involve walking, the instrument 10 can be placed in the surgical site, acted to cut and staple, and then removed from the surgical site to install a new cartridge 37, and then be placed back in the surgical site for the next cut. and stapling along the same path in which the previous cutting and stapling cycle occurred. This process is repeated until the cutting and stapling procedure is complete. As can be seen in Figures 4A to 4B and Figure 7, the distal end configuration of the end actuator 12 provides a gap between the distal end of the anvil 18 and the distal end of the cartridge 37. This gap can facilitate walking by providing of an atraumatic space for the tissue to enter the distal end of the actPetition 870190098578, of 10/02/2019, p. 11/111
27/75 extremity pain 12 at the beginning of each gait step.
[0069] As noted above, the distal end configuration of end actuator 212 is different from the distal end configuration of end actuator 12; with the different configuration of the end actuator 212 providing different potential advantages. In particular, the distal end configuration of end actuator 212 can provide improved maneuverability and visibility of the relationship between the distal end of end actuator 212 and adjacent anatomical structures. In addition, the distal end configuration of end actuator 212 can provide tissue harvesting effects by propelling the tissue proximally in the space between the anvil 218 and the lower jaw 216 as the anvil 218 is closed towards the lower jaw 216. However, in versions in which all structures of the end actuator 212 are rigid, the flexed configuration of the distal tip 219 of the anvil 218 may not be suitable for walking operations, as the distal tip 219 may confer trauma to the tissue that is not retracted in the space between the anvil 218 and the lower jaw 216, as the anvil 218 is closed towards the lower jaw 216. Thus, in versions in which all the structures of the end actuator 212 are rigid, the end actuator 212 may be more suitable for cutting and stapling operations (for example, vessel transection) where all the tissue that is to be cut and stapled is collected proximal to the distal tip 219.
[0070] In view of the above, it may be desirable to provide a variation of end actuators 12, 212 that provides the travel capabilities of end actuator 12, the improved visibility associated with end actuator 212, and tissue collection capabilities of the 212 end actuator, without providing an increased risk of trauma that could otherwise be associated with versions
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28/75 fully rigid end actuator 212. The following text describes several merely illustrative examples of such variations of end actuators 12, 212. In the Examples below, an anvil has a distal tip that is resiliently pulled into a configuration flexed or inclined as the distal tip 219; yet the resiliently propelled distal tip is deflectable in the direction opposite to the lower jaw in response to a sufficient load on the distal tip. It will be understood in view of the teachings of the present invention that the provision of an anvil with an elastically deformable tipped distal tip portion can provide an additional level of maneuverability benefits in terms of navigating through the tissue at a surgical site. In this way, the deformable distal tip portion can deflect or deform to promote smooth and atraumatic movement of the end actuator through the fabric, particularly during walking operations. Additionally, with an anvil that has a propensity for an inclined position when it is not in a charged state or placed in contact with the surrounding tissue, improved visualization during tissue capture and cutting can be achieved compared to using end actuators with a straight or not angled anvil. In addition, an anvil with a distal tip that is inclined to an inclined position can provide some degree of tissue harvesting effects until it reaches a loading point that would be associated with walking rather than being associated with simply capturing a relatively tissue structure between the anvil and the lower claw.
[0071] Figure 11 shows another example instrument 310 configured as a surgical stapler. Instrument 310 comprises a handle portion 320 and a drive shaft 322. Instrument 310 has a modular configuration so that drive shaft 322 is selectively removable from and
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29/75 fixable to handle portion 320. Instrument 310 is configured similarly to instrument 10 so that the operability and use of instrument 310 are the same, as described above for instrument 10 with the additional feature of instrument 310 be a modular configuration. With its modular configuration, the 310 instrument provides a way to change the end actuator. Such a change in the end actuator can be made to replace an end actuator otherwise used, or to provide a different end actuator configuration based on the procedure or user preference. In addition to or in place of the aforementioned, the resources that are intended to provide the modular configuration of the 310 instrument can be configured according to at least some of the teachings of US patent application No. 14 / 868,718, entitled Surgical Stapling Instrument with Shaft Release , Powered Firing, and Powered Articulation, filed on September 29, 2015, the disclosure of which is hereby incorporated by reference. Other components, features and configurations suitable for providing the instrument 310 with a modular configuration will be apparent to those skilled in the art in view of the teachings of the present invention. In addition, it will be understood by those skilled in the art in view of the teachings of the present invention, that instrument 10 can be modified to incorporate a modular configuration as shown and described in relation to instrument 310 or other instruments incorporated by reference in the present invention. .
[0072] In the illustrated example of Figure 11, instrument 310 comprises an end actuator 312 that has an anvil 318 that has an angled distal tip 319. In addition, the distal end 319 of anvil 318 is elastically deformable. In this way, and as best shown in Figures 12A and 12B, the distal tip in
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30/75 clinada 319 is intended to deform elastically from a first inclined position to a second position. The second position for the inclined distal tip 319 may be substantially straight in some versions, but may be inclined to a degree (for example, slightly above or slightly below the longitudinal geometric axis A1) in other versions. It should be understood that the second position for the inclined distal tip 319 can be defined by the characteristics (for example, thickness, density, etc.) of the tissue being captured between the anvil 318 and the lower claw 16. In the present example, the end actuator 312 is provided on the drive shaft 322 which is separable from the handle portion 320. Just by way of example, the instrument 322 can be separable from the handle portion 320 according to at least some of the teachings of US publication no. 2015/0272575, entitled Surgical Instrument Comprising a Sensor System, published on October 1, 2015, the disclosure of which is hereby incorporated by reference. In some other versions, the drive shaft 322 is not separable from the handle portion 320.
[0073] It will be understood that end actuator 312 can be used in place of end actuator 12 shown in Figure 1. In some versions, end actuator 312 can be integrally formed with drive shaft 22 or alternatively it can be formed separately and then combined. In some versions, the 312 end actuator can be supplied for use in robotic systems. In such robotic systems, the modular drive shaft 322 that has end actuator 312 can be clamped to a portion of the robotic system for use so that the handle portion 320 is replaced with components from the robotic system. In still other examples, end actuator 312 can be adapted for use with a robotic system in a way that the actuator of ex
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31/75 tremor 312 connects to the robotic system without necessarily connecting the entire modular drive shaft 322. In view of the teachings of the present invention, other ways of incorporating an end actuator that has an elastically deformable angled tip into an operated instrument by robot or by the user will be evident to those skilled in the art.
[0074] Figure 12A shows an enlarged side view of the distal end of end actuator 312. End actuator 312 comprises anvil 318 and the lower jaw 16 that accepts cartridge 37 as described above with respect to instrument 10. The anvil 318 rotates pivotally towards the lower claw 16 in the same way as the anvil 18, as described above in relation to the instrument 10. In this configuration, the end actuator 312 is similar to the end actuator 12, however, the anvil 318 comprises the slanted distal tip 319 which is elastically deformable. As shown in Figure 12A, the tip 319 is conferred with a propensity for an inclined position which is shown in Figure 11 and in dashed line in Figure 12A. Tip 319 assumes this tilted position when end actuator 312 is not pinching tissue and is open, as shown in Figure 11; or closed without clamping tissue, as shown in dashed line in Figure 12A. In cases in which end actuator 312 is in this tilted state or position, end actuator 312 can be considered unloaded or in an unloaded state or position. On the other hand, when end actuator 312 is pinching tissue, end actuator 312 can be considered loaded or in a loaded state or position. [0075] When closed and not pinching fabric between the anvil
318 and the lower jaw 16, the tip 319 comes into contact with the cartridge 37. In that position, a surface of the bottom side 324 of the tip
319 defines a plane that crosses a longitudinal geometric axis A1
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32/75 defined by the drive shaft 322 to form an angle Θ. When closed and pinching fabric 90 between the anvil 318 and the lower jaw 16, the surface of the bottom side 324 of the tip 319 comes into contact with the fabric 90. In that position, the surface of the bottom side 324 of the tip 319 defines a plane that crosses the longitudinal geometric axis A1 to form an angle 02. In the example shown in Figure 12A, the angles 01, 02 are in relation to the longitudinal geometric axis A1, and the sum of the angles 01,02 represents the range of motion that the distal tip 319 is submitted. By way of example only, and not by way of limitation, in some instances, the angle 01 is between approximately 20 and approximately 70 degrees, or more particularly between approximately 30 degrees and approximately 50 degrees, in a downward direction from the longitudinal geometric axis A1 towards the cartridge 37. Just as an example, and not as a limitation, in some examples, the angle 02 is between approximately 0 and approximately 90 degrees in an upward direction from the longitudinal geometric axis A1 in the opposite direction to the cartridge 37. By way of example only, and not by way of limitation, in some instances, the range of motion submitted by the tip 319 is between approximately 20 degrees and approximately 110 degrees. The angles described for angles 01, 02 are exemplary only and not limiting. Other suitable angles will be apparent to those skilled in the art in view of the teachings of the present invention.
[0076] Additionally, in some cases, the longitudinal geometric axis 1 represents a zero degree reference and the angles in relation to it can be positive or negative. For example, when an angle is in a downward direction from the longitudinal geometric axis A1 towards cartridge 37, the angle can be characterized as a negative angle. Similarly, when
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33/75 an angle is in an upward direction from the longitudinal geometric axis A1 in the opposite direction to the cartridge 37, the angle can be characterized as a positive angle. Using these conventions, the range of motion of the distal tip 319 due to deformation can be understood as the sum of the absolute value of the angle when the distal tip 319 is in the position that comes in contact with the cartridge 37, and the angle when the distal tip 319 is in the deformed state by means of tissue clamping.
[0077] Figure 12B shows another side view of an alternative end actuator 412 similar to end actuator 312 of Figure 12A. With end actuator 312, when the anvil 318 is in its undeformed and inclined state (as seen in dashed line in the view in Figure 12A), the anvil 318 extends to a point flush with or proximal to the most distal end of the cartridge 37 When the anvil 318 is deformed so that it deflects upward, the end of the distal tip 319 extends to a point just distal to the most distal end of the cartridge 37. With end actuator 412, as shown in Figure 12B, when the anvil 318 is in its undeformed and tilted state (as seen in dashed line in the view in Figure 12B), anvil 318 extends to a point flush with or proximal to the most distal end of cartridge 37. When anvil 318 is deformed from In order to be deflected upward, the end of a distal end 319 of the anvil 318 extends to a point flush with or proximal to the most distal end of the cartridge 37. In this way, the anvil 318 of the end actuator 412 remains flush with or proximal to the most distal end of the cartridge 37 when the anvil 318 is in its tilted or deformed state, so that the anvil 318 does not extend beyond the most distal end of the cartridge 37 if the anvil 318 is in its inclined and not deformed state or in
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34/75 its deformed state. In some cases, this can be achieved by modifying the anvil 318 so that the distal tip 319 of the anvil has its length shortened. In other cases, instruments 10, 310 can be modified to provide a slight proximal retraction of anvil 318 by clamping. In view of the teachings of the present invention, other ways of modifying end actuator 412, since this refers to controlling the position of anvil 318, will be apparent to those skilled in the art. A. Anvil shaped overlap [0078] Figures 13 to 15 show distal enlarged views of end actuator 312 to illustrate an exemplary construction. The constructions shown in Figures 13 to 15 also apply to the end actuator 412 shown in Figure 12B, except for the anvil length difference 318 noted above. As shown in the top view of Figure 13, end actuator 312 comprises anvil 318 wherein distal tip 319 comprises a rigid portion 326 and a deflectable portion 328. In the present example, deflectable portion 328 is molded by overlapping over the rigid portion 326 to form the distal tip 319 of anvil 318. In the illustrated example, as shown in Figure 13, the outline of the cartridge 37 is shown in dashed line to reveal the bottom side surface 324 of the anvil 318. The rigid portion 326 of distal tip 319 extends from anvil body 330 of anvil 318. In the present example, body 330 is comprised of metal and rigid portion 326 is an extension of metallic body 330 at distal tip 319. In other versions, body 330 and / or the rigid portion 326 may be comprised of materials other than metal, including, but not limited to, plastic, ceramic, combinations of metal with plastic or ceramic, and other suitable materials or combinations of materials materials that will be evident to those skilled in the art
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35/75 in view of the teachings of the present invention. Additionally, the rigid portion 326, in some versions, is completely rigid, yet in other versions, the rigid portion 326 may be resilient to a lesser extent than the deflectable portion 328.
[0079] In the illustrated version of Figures 13 and 14, the metal portion 326 comprises a bottom side surface 332 that is generally straight or flat, and a top surface 334 that is similarly generally straight or flat. The metal portion 326 further comprises an opening 336 which extends through the metal portion 326 from the upper surface 334 to the surface of the lower side 332. Additionally, the metal portion 326 comprises a neck region 338, a head region 340 that extends distally from neck region 338, and bulkheads 342 at the transition between neck region 338 and head region 340. In the present example, neck region 338 extends from body 330 of anvil 318. With In this arrangement, metal portion 326 provides fastening interfaces or features, such as aperture 336 and bulkheads 342, where elastomeric portion 328 can connect with metal portion 326 in a secure manner using a molding process. overlap.
[0080] Figure 15 illustrates a cross-sectional view of anvil 318 in a position immediately proximal to the distal tip 319. As shown, anvil 318 comprises a longitudinal slot 344 that divides six rows of staple-forming pockets 346 into two sets of three rows each. The slot 344 and the staple forming pockets 346 are structurally and functionally similar to the slot 42 and the staple forming pockets 53 described above in relation to the anvil 18. The slot 344 comprises a t-shaped cross section as shown in Figure 15. Again with reference to Figures 13 and 14, opening 336 in the portion
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36/75 metal 326 is positioned adjacent to a laterally extended portion of slot 344. In view of the teachings of the present invention, other ways of configuring metal portion 326 for proper connection with elastomeric portion 328 using a molding process overlapping will become evident to those skilled in the art.
[0081] The elastomeric portion 328 is molded on the metallic portion 326 and in the molding process is given an inclined configuration so that the elastomeric portion 328 defines a plane that crosses and is not coplanar to a plane defined by the body 330 of the anvil 318. In this way, the elastomeric portion 328 is formed with a propensity to maintain its inclined configuration unless some other force is conferred on the elastomeric portion 328 that causes it to deflect from its initial inclined position. During the molding process, the elastomeric material flows through and fills the opening 336 in the metal portion 326. The elastomeric material also flows around and adjacent to the shields 342. In this way, the elastomeric portion 328 is securely connected with the portion 326 during the overlap molding process. The elastomeric portion 328 may comprise rubber, plastic, or any other natural or synthetic material that has the desired elastomeric properties that will allow the distal tip 318 to deform when subjected to force, yet resiliently return to its initial inclined state when the force does not. is more applied or is no longer present. During the molding process, a locking member (not shown) can be inserted into a slot 349 formed distally from slot 344 to prevent elastomeric material from entering slot 344. In view of the teachings of the present invention, other ways of configuring the elastomeric portion 328 for proper connection with metallic portion 326 using a mol process
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37/75 overlapping will be evident to those skilled in the art. [0082] With the configuration for distal tip 319 as described above and shown in Figures 13 and 14, the extension of metal portion 326 in distal tip region 319 defines a deflection zone 348. Deflection zone 348 coincides with a portion distal tip 319 located at a proximal end of distal tip 319. With this area of increased stiffness, distal tip 319 will deflect, for example, as shown in Figure 12A, with deflection zone 348 serving as a point or location pivot around which the rest of the distal tip 319 rotates during deflection. In view of the teachings of the present invention, those skilled in the art will recognize other ways in which distal tip 319 is modified to alter, modify or control deflection zone 348 so that a desired deflection of distal tip 319 is obtained. Some of these forms will be described in further detail below.
B · Anvil tip and cartridge with interlocking features [0083] In some cases, when the end actuators include anvils that incorporate a deformable distal tip that is curved or tilted, features can be incorporated into the distal tip of the anvil, which work cooperatively with the features built into the distal end of the cartridge to provide an interlock feature for the end actuator. This interlock feature can be particularly useful when making a final cut in a procedure that involves walking, or in procedures where a vessel is cut. For example, when the final portion of the tissue is held inside the end actuator, or when the vessel is held inside the end actuator, the distal end of the anvil closes and comes in contact with the distal end of the cartridge. The features of each portion can then engage to provide the interlock feature. This interlock feature can provide retroali
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38/75 ment to a user that indicates that the tissue or vessel that is attached is completely captured within the end actuator. In other cases, interlocking features can be useful by directing an instrument using this end actuator configuration to a surgical site by retaining the end actuator in a closed configuration, so that the curved tip provides better maneuverability through the surrounding tissue while presenting an atraumatic tip to the surrounding tissue. For use in the present invention, the terms slope and curve (o) should be read as being synonymous with one another when referring to a distal end configuration of a component of an end actuator.
[0084] Figures 16 and 17 show an enlarged portion of the distal end of an exemplary end actuator 512 that incorporates an interlock feature as introduced above. It will be understood that end actuator 512 can be used in place of end actuator 12 shown in Figure 1, or in place of end actuator 312 shown in Figure 11. In some versions, end actuator 512 can be integrally formed with the drive shaft 22, 322 or, alternatively, can be formed separately and then combined. In some versions, the 512 end actuator may be provided for use in robotic systems, as described above.
[0085] The end actuator 512 comprises the anvil 518, the lower jaw 16 and the cartridge 537. The lower jaw 16 is structurally and functionally the same, as described above in relation to instrument 10. The lower jaw 16 is configured to receive selectively the cartridge 537. The cartridge 537 is structurally and functionally similar to the cartridge 37 described above in relation to the instrument 10. However, the cartridge 537 incorporates two recesses 538 in a distal end 540 of the cartuPetição 870190098578, of 10/02/2019, p. 64/111
39/75 cho 537. The recesses 538 each comprise a lower cut feature 546. In the present example, the recesses 538 with lower cut features 546 are shaped at the distal end 540 by forming the cartridge 537. In other examples , recesses 538 and lower cut features 546 can be machined at distal end 540 after cartridge 537 is formed.
[0086] As shown in Figures 16 and 17, the present example includes two separate longitudinally extending recesses 538. In addition, each lower cut feature 546 also extends longitudinally at the distal end 540 of the cartridge 537. Each lower cut feature 546 is defined by a portion of each respective recess 538. In this way, each recess 538 comprises a base 542, side walls 544 and lower cut feature 546. A cutout 548 is formed between each recess 538 and connects each of them. The remaining features of cartridge 537 are similar to cartridge 37 as described above.
[0087] The anvil 518 comprises the body 530 and the distal tip 519. The distal tip 519 has an inclined configuration, as illustrated and described above in relation to the end actuators 312, 412. In the present example, the distal tip 519 is configured as a deformable tip that has a rigid portion and a deflectable portion 528, which are similar in structure and function to the rigid portion 326 and the deflectable portion 328 of the anvil 312. In some other versions, the distal tip 519 can be configured as angled, but rigid so that the distal tip 519 is not deformable. To achieve a deformable tip configuration for distal tip 519, as in the present example, distal tip 519 can be shaped by overlapping on anvil body 530 518 in the same manner as described above with respect to anvil 318. For this purpose, a slit 549 is formed to receive a blocking member (not shown) at
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40/75 in order to prevent the elastomeric material from entering the anvil slot 518. As will be discussed further below, there are other structures and ways of providing a deformable tip configuration for the distal tip 519 in addition to the overlap molding configuration described above.
[0088] The distal tip 519 of the anvil 518 further comprises a lock 550 which extends from a surface on the underside 524 of the distal tip 519. The lock 550 is deformable in the present example, and is constructed of an elastomeric material. In some versions, lock 550 is an overlap molded feature formed during the same molding process as when deflectable portion 528 is formed. In view of the teachings of the present invention, other materials for the construction of the lock 550 and other ways to form the lock 550 will be apparent to those skilled in the art.
[0089] The lock 550 comprises hook members 552 on each side of the lock 550. Each hook member 552 includes a tip 554 on the most proximal end of the lock 550. At each end 554 has a chamfer 557. The lock 550 additionally comprises an empty space 556 that is situated between each hook member 552. As shown in Figure 16, lock 550 is configured to engage with lower cut features 546 of cartridge 537. This engagement provides a selective interlock between anvil 518 and the cartridge 537. With the resilient nature of the elastomeric lock 550 and hook members 552, by closing the end actuator 512 to engage the anvil 518 with the cartridge 537, the hook members 552 will deflect when in contact with a tapered surface 539 of the distal tip 540. Hook members 552 can also deflect upon contact with a vertical face 547 of the lower cut features 546. This deflection will allow anvil 518 to continue to close and allow hook members 552 to engage within
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41/75 lower cut features 546. In the present example, each hook member 552 comprises chamfer 556 which first comes into contact with the tapered surface 539 and / or vertical face 547 to promote the gradual deflection of the hook members 552 when engaging anvil 518 with cartridge 537.
[0090] From an engaged position, as shown in Figure 16, anvil 518 can be separated from cartridge 537 by providing sufficient opening force to overcome the propensity of hook members 552 so that they deform and disengage from the lower cutting features 546 of the recesses 538. Instead of or additionally, the anvil 518 can be separated from the cartridge 537 by providing sufficient opening force to deflect the distal tip 519 so that the hook members 552 disengage of the lower cut features 546. For example, the deformability of the hook members 552 and the rest of the distal tip 519 can be configured so that the hook members 552 deflect more easily than the rest of the distal tip 519. In this configuration, the hook members 552 will deflect first to disengage anvil 518 from cartridge 537. On the other hand, the deformability of hook members 552 and the rest of the distal tip i 519 can be configured so that hook members 552 deflect less easily than the rest of distal tip 519. In this configuration, distal tip portions 519 in addition to hook members 552 will deflect first to finally disengage anvil 518 from the cartridge 537. In addition, the deformability of hook members 552 and the rest of distal tip 519 can be configured so that hook members 552 deflect as easily as the rest of distal tip 519. In this configuration, both distal tip portions 519 and hook members 552 will deflect to finally disengage anvil 518 from cartridge 537.
[0091] When lock 550 engages with lower cut features
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42/75 or 546, a distal portion 558 of latch 550 is configured to fit within slot 548 of cartridge 537. Similarly, void 556 is configured to receive a proximal portion 560 of a dividing wall 562 that separates and defines recesses 538. In this way, the hook members 552 are insertable in a longitudinal direction at a depth sufficient within each recess 538 to reach and finally engage with the lower cut features 546. With this configuration for lock 550 and distal tip 540 of the cartridge 537, the end actuator 512 comprises four complementary features between the anvil 518 and the cartridge 537. Two of these complementary features being each hook member 552 and each respective lower cutting feature 546, another complementary feature being the cutout 548 and the distal portion 558 of the lock 550, and the fourth complementary feature being the void 556 and the proximal portion 560 of the dividing wall 562.
[0092] As described above, and as illustrated in Figures 16 and 17, the interlocking feature is configured so that the engagement between the lower cut features 546 and hook members 552 of the latch 550 is oriented longitudinally. In other words, the hook members 552 of the lock 550 extend longitudinally towards the proximal end of the end actuator 512. Similarly, the recesses 538 extend longitudinally as well as the lower cut features 546. Therefore, the cut features lower section 546 are engaged by hook members 552 from a longitudinal direction. Disengagement, when the anvil 518 is separated from the cartridge 537, occurs in reverse, as described above, and such disengagement occurs through the deflection that occurs along a longitudinal geometric axis of the cartridge 537.
[0093] Figures 18 and 19 show an enlarged portion of the ex
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43/75 distal tremor of another example end actuator 612 that incorporates an interlock feature. It will be understood that end actuator 612 can be used in place of end actuator 12 shown in Figure 1, or in place of end actuator 312 shown in Figure 11. In some versions, end actuator 612 can be integrally formed with the drive shaft 22, 322 or alternatively can be formed separately and then combined. In some versions, the 612 end actuator may be provided for use in robotic systems, as described above.
[0094] The end actuator 612 comprises the anvil 618, the lower jaw 16 and the cartridge 637. The lower jaw 16 is structurally and functionally the same, as described above in relation to the instrument 10. The lower jaw 16 is configured to receive selectively the cartridge 637. The cartridge 637 is structurally and functionally similar to the cartridge 37 described above in relation to the instrument 10. However, the cartridge 637 incorporates a recess 638 at a distal tip 640 of cartridge 637. The recess 638 comprises lower cut features 646 In the present example, the recess 638 with lower cut features 646 is molded at the distal tip 640 by forming the cartridge 637. In other examples, the recess 638 and the lower cut features 646 can be machined at the distal tip 640 after the cartridge 637 is formed.
[0095] As shown in Figures 18 and 19, indentation 638 extends longitudinally at distal tip 640 of cartridge 637. Each lower cut feature 646 extends at distal tip 640 of cartridge 637 orthogonally with respect to a longitudinal geometric axis defined by cartridge 637. Each bottom cut feature 646 comprises a base 642, side walls 644 and a top surface 648. Each top surface 648 defines a plane that is parallel to a defined plane
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44/75 by a tapered surface 639 of the cartridge 637. In this way, each lower cut feature 646 comprises a tapered profile. However, in some other versions, the lower cut features may have a straight profile instead. The remaining features of cartridge 637 are similar to cartridge 37 as described above. In view of the teachings of the present invention, other ways of forming the recess 638 and the lower cut features 646 will be apparent to those skilled in the art.
[0096] Anvil 618 comprises body 630 and distal tip 619. Distal tip 619 has an inclined configuration, as illustrated and described above in relation to end actuators 312, 412, 512. In the present example, distal tip 619 it is configured as a deformable tip that has a rigid portion and a deflectable portion 628, which are similar in structure and function to the rigid portion 326 and the deflectable portion 328 of anvil 312. In some other versions, distal tip 619 can be configured as inclined, but rigid so that the distal tip 619 is not deformable. In order to achieve a deformable tip configuration for distal tip 619, as in the present example, distal tip 619 can be molded by overlapping on body 630 of anvil 618 in the same manner as described above in relation to anvil 318. As will be discussed further below, there are other structures and ways to provide a deformable tip configuration for distal tip 619 in addition to the overlap molding configuration described above.
[0097] The distal tip 619 of the anvil 618 further comprises a lock 650 which extends from a surface of the underside 624 of the distal tip 619. The lock 650 is deformable in the present example, and is constructed of an elastomeric material. In some versions, the 650 lock is an overlap-shaped feature formed during
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45/75 same molding process as when the deflectable portion 628 is formed. In view of the teachings of the present invention, other materials for the construction of the lock 650 and other forms for forming the lock 650 will be apparent to those skilled in the art.
[0098] Latch 650 comprises hook members 652 on each side of latch 650. Each hook member 652 extends outwardly from latch 650 orthogonally with respect to a longitudinal geometric axis of anvil 618. Each hook member 652 includes a 654 tip at its end. Each tip 654 is configured to engage with a respective bottom cut feature 646 of cartridge 637 as shown in Figure 18. This engagement provides a selective interlock between anvil 618 and cartridge 637. With the resilient nature of the 650 and limb elastomeric lock hook 652, by closing the end actuator 612 to engage the anvil 618 with the cartridge 637, the hook members 652 will deflect when in contact with the side walls of the recess 638. This deflection will allow the anvil 618 to continue to close and allow hook members 652 to engage within lower cut features 646. In the present example, each hook member 652 comprises a chamfer 656 which contacts the side walls of recess 638 to promote gradual deflection of members hook 652 when engaging anvil 618 with cartridge 637.
[0099] As shown and described in the present example, a lock width 650 can be defined as the distance from the end of one hook member 652 to the end of the other hook member 652. Similarly, a width of the recess 638 can be defined as the distance from a side wall of the recess 638 to the opposite side wall of the recess 638. In the present example, the width of the lock 650 is greater than the width of the recess 638. However, the lower cut features 646 provide additional width within the reenPetition 870190098578, of 10/02/2019, p. 71/111
ABUS trance 638. Additionally, the resilient nature of latch 650 allows hook members 652 of latch 650 to deform inwardly so that the width of latch 650 can be reduced during closing of end actuator 612 to allow engagement of the hook members 652 with lower cut features 646. By engaging, the width of the lock 650 can return to its initial width, thus promoting a safe, but selective connection between the anvil 518 and the cartridge 637.
[0100] From an engaged position, as shown in Figure 18, anvil 618 can be separated from cartridge 637 by providing sufficient opening force to overcome the propensity of hook members 652 so that they deform and disengage from the lower cutting features 646 of cartridge 637. Instead of or additionally, anvil 618 can be separated from cartridge 637 by providing sufficient opening force to deflect distal tip 619 so that hook members 652 disengage of the lower cut features 646. For example, the deformability of the hook members 652 and the rest of the distal tip 619 can be configured so that the hook members 652 deflect more easily than the rest of the distal tip 619. In this configuration, the hook members 652 will deflect first to disengage anvil 618 from cartridge 637. On the other hand, the deformability of hook members 652 and the rest of distal tip 619 it can be configured so that hook members 652 deflect less easily than the rest of distal tip 619. In this configuration, distal tip portions 619 in addition to hook members 652 will deflect first to finally disengage anvil 618 from cartridge 637. In addition, the deformability of the hook members 652 and the rest of the distal tip 619 can be configured so that the hook members 652 deflect as easily as the rest of the distal tip 619. In this configuration,
Petition 870190098578, of 10/02/2019, p. 72/111 both the distal tip portions 619 and hook members 652 will deflect to eventually disengage anvil 618 from cartridge 637.
[0101] As described above, and as illustrated in Figures 18 and 19, the interlock feature is configured so that the engagement between the lower cut features 646 and the hook members 652 of the lock 650 is oriented orthogonally with respect to a longitudinal geometric axis of cartridge 637. In other words, hook members 652 of lock 650 extend transversely in the opposite direction to a longitudinal geometric axis of cartridge 637. Similarly, recess 638 extends longitudinally as lower cut features 646 extend orthogonally with respect to a longitudinal geometric axis of cartridge 637. Therefore, the lower cut features 646 are engaged by hook members 652 from a transverse direction, or direction that is generally orthogonal to the longitudinal geometric axis defined by cartridge 637 Disengagement, when anvil 618 is separated from cartridge 637, occurs in reverse as described above, and such disengagement occurs through the deflection that generally occurs orthogonal to a longitudinal geometric axis of the cartridge 637.
[0102] The anvil 618 of the end actuator 612 additionally comprises a span adjustment feature 658. The span adjustment feature 658 is located at the proximal end of the distal tip 619. The span adjustment feature 658 is dimensioned so that contact a surface facing the anvil of cartridge 637 when end actuator 612 is in a closed configuration as shown in Figure 18. Additionally, when span adjustment feature 658 comes in contact with cartridge 637, the tips 654 of hook members 652 of the lock 650 come into contact with the top surface 648 of the respective lower cut features 646. In this way, when the anvil 618 is engaged with the
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48/75 cartridge 637, the additional closure of anvil 618 is restricted by the span adjustment feature 658. In the illustrated example of Figures 18 and 19, the span adjustment feature 658 comprises a rectangular bar section; however, other formats and configurations suitable for the span adjustment features 658 will be apparent to those skilled in the art, in view of the teachings of the present invention.
C · Anvil with a deformable tip and tissue stabilizing features [0103] In some cases, when the end actuators include anvils that incorporate a slanted and deformable distal tip, features may be incorporated in the distal tip of the anvil that help stabilize the tissue that is stuck between the anvil and the end actuator cartridge. These tissue stabilizing features can be particularly useful when the end actuator is being used in a procedure that involves walking. In particular, they can be useful for stabilizing the fabric to ensure that the current cut is performed as intended while maintaining a cut line designed for the next cuts in the sequence. Additionally, the tissue stabilizing features can be comprised of an elastomeric material that is resiliently deformable. The combination of providing tissue stabilizing features on an anvil tip that is also angled and deformable can provide a way to improve tissue retention and capture while also providing a way to handle captured tissue with less chance of tissue trauma due to the deformability features of the distal anvil tip and tissue stabilizing features.
[0104] Figure 20 shows an enlarged portion of a distal end of another anvil 718 exemplifying an end actuator where anvil 718 incorporates tissue stabilizing features 714. Anvil 718 comprises a body 730 and a distal tip 719 connected with body 730. It will be understood that the
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49/75 anvil 718 can be paired with the lower jaw 16 and the cartridge 37 to provide the end actuator for an instrument such as instruments 10, 310. Similarly, anvil 718 can be used in place of anvil 18 on the actuator of end 12, or in place of anvil 218 on end actuator 212, or in place of anvil 318 on end actuators 312, 412.
[0105] In the present example, tissue stabilizer features 714 are configured as two arched ridges located at a distal end of distal tip 719 of anvil 718. In other versions, a greater or lesser number of tissue stabilizer features 714 can be used. In addition, in other versions, the tissue stabilizer features 714 can be configured with alternative or local shapes along a surface on the underside 724 of the anvil 718.
[0106] The tissue stabilizing features 714 are further formed as part of a deflectable portion 728 of the distal tip 719. In the present example, the deflectable portion 728 and the tissue stabilizing features 714 are formed from an elastomeric material. In addition, tissue stabilizing features 714 can be formed in a molding process during the formation of the remainder of the deflectable portion 728. For this purpose, a slot 749 is formed to receive a blocking member (not shown) in order to prevent the elastomeric material enters the anvil slit 718. With this configuration, as shown and described, the anvil 718 is provided with a slanted deformable distal tip 719 which has one or more resilient tissue stabilizing features 714. In view of the teachings of the present invention , other configurations for the distorted and deformable distal tip 719 for the anvil 718 which has resilient tissue stabilizing features 714 will be evident to those skilled in the art.
IV. Elastic deformable curved biqorna tips with endPetition 870190098578, of 10/02/2019, p. 75/111
50/75 rigid des [0107] As discussed above, in some cases, it may be desirable to provide the user with a range of end actuators 12, 212 that provide the travel capabilities of end actuator 12, the improved visibility associated with the end actuator end 212, and tissue collection capabilities of end 212 actuator, without providing an increased risk of trauma that might otherwise be associated with fully rigid versions of end 212 actuator. In some cases, it may be desirable to provide a angled and deformable anvil tip while also maintaining a rigid distal end of the anvil. With this configuration, the end actuator can provide the added benefit of having a dissecting end in an end actuator configuration that provides the enhanced visualization, maneuverability and tissue collection capabilities as described above. In addition or alternatively, the provision of a rigid portion at the distal end of an end actuator can assist in inserting the end actuator into tight spaces, expanding openings, etc. While providing such capabilities, it may also be desirable to maintain at least some degree of elasticity to allow for deformation in response to substantial transverse loads.
A. Anvil with a thin profile nose [0108] Figures 21 and 22 show an example anvil 818 for an end actuator. It will be understood that the anvil 818 can be paired with the lower jaw 16 and the cartridge 37 to provide the end actuator for an instrument such as instruments 10, 310. Similarly, anvil 818 can be used in place of anvil 18 in the end actuator 12, or in place of anvil 218 on end actuator 212, or in place of anvil 318 on end actuators 312, 412. Anvil 818
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51/75 comprises the body 830 and the curved distal tip 819. The anvil 818 additionally comprises staple forming pockets 846 and the slot 844, which are structurally and functionally similar to the staple forming pockets 53 and the slot 49 described above.
[0109] In the present example, the body 830 comprises a metallic material of rigid construction. The curved distal tip 819 extends distally from the body 830. The curved distal tip 819 comprises an elastomeric block 816, the nose portion 820 and the distal end 822. The nose portion 820 connects with and extends from the body 830 and is made of the same metallic construction material. The distal end 822 connects with and extends from the nose portion 820 and is also of the same metallic construction material. In this way, both the nose portion 820 and the distal end 822 can be considered extensions of the body 830 formed as part of the curved distal tip 819. The nose portion 820 comprises a thin profile that allows and promotes deflection of the nose portion 820 of the anvil 818. In the present example, the nose portion 820 defines a deflection zone. Distal end 822 comprises a thick profile so that distal end 822 is rigid and any deflection at distal end 822 is due to deflection of nose portion 820 as mentioned. In this way, the distal end 822 can be operationally configured to dissect tissue or vessels.
[0110] The elastomeric block 816 connects with a surface on the underside of the nose portion 820. This connection can be made chemically or mechanically; and in view of the teachings of the present invention, those skilled in the art will understand the various ways of connecting block 816 with the rest of anvil 818. In some versions, elastomeric block 816 is connected to anvil 818 using a molding process . In such examples, the bottom side of the
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52/75 nose 820 can comprise structural features configured to engage with block 816 during molding to thereby secure block 816 to anvil 818. Just by way of example, and not by way of limitation, anvil 818 can be configured with a rigid portion similar to the rigid portion 326 of the anvil 318. In such an example, the block 816 can be molded by overlapping with the rigid portion similar to the molding by overlapping the deflectable portion 328 to the rigid portion 326, as shown and described above in relation to Figures 13 to 15. For this purpose, a slot 849 is formed to receive a locking member (not shown) in order to prevent the elastomeric material from entering the slot 844 of the anvil 818.
[0111] In another version of the anvil 818, the body 830, the nose portion 820 and the distal end 822 can be constructed from another suitable material other than a metallic material. By way of example, and not by way of limitation, other suitable materials may include various plastics, among others, which will be apparent to those skilled in the art in view of the teachings of the present invention. Consequently, although the above example describes a metallic construction for the body 830, the nose portion 820 and the distal end 822, the construction of the anvil 818 should not be limited to a metallic construction.
B · Anvil with elastomeric insert [0112] Figures 23 and 24 show an example anvil 918 for an end actuator. It will be understood that the anvil 918 can be paired with the lower jaw 16 and the cartridge 37 to provide the end actuator for an instrument such as instruments 10, 310. Similarly, anvil 918 can be used in place of anvil 18 in the end actuator 12, or in place of anvil 218 on end actuator 212, or in place of anvil 318 on end actuators 312, 412. Anvil 918
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53/75 comprises the body 930 and the curved distal tip 919. The anvil 918 additionally comprises the staple forming pockets 946 and the slot 944, which are structurally and functionally similar to the staple forming pockets 53 and the slot 49 described above. .
[0113] In the present example, the body 930 comprises a metallic material of rigid construction. The curved distal tip 919 extends distally from the body 930. The curved distal tip 919 comprises an elastomeric insert 916, the nose portion 920 and the distal end 922. The nose portion 920 connects with and extends to body 930 and is made of the same metallic construction material. The distal end 922 connects with and extends from the nose portion 920 and is also of the same metallic construction material. In this way, both the nose portion 920 and the distal end 922 can be considered extensions of the body 930 formed as part of the curved distal tip 919. The nose portion 920 comprises an opening 948 that extends from a top surface 926 from the nose portion 920 to a surface of the lower side 924 of the nose portion 920. The elastomeric insert 916 is configured so that it fits within and fills the opening 948, and this configuration allows and promotes deflection of the nose portion 920 of anvil 918. In the present example, the elastomeric insert 916 defines a deflection zone. The distal end 922 comprises a thick profile so that the distal end 922 is rigid and any deflection at the distal end 922 is due to the deflection of the nose portion 920 on the elastomeric insert 916, as mentioned. In this way, the distal end 922 can be operatively configured to dissect tissue or vessels. Additionally, distally adjacent to the elastomeric insert 916 is the bottom side surface 924 of the nose portion 920. The bottom side surface
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54/75
924 is generally flat and extends to the distal end 922, which is illustrated with a chamfer surface. With this configuration, the bottom side surface 924 can provide additional contact area beyond the distal end 922 for tissue or vessel dissection. It should be understood that the insert 916 can be molded or it can be formed as one or more separate parts which are later joined to the anvil 918.
[0114] As mentioned, the elastomeric insert 916 fills the opening 948 within the nose portion 920 of the curved distal tip 919. The elastomeric insert 916 can connect the nose portion 920 with the use of mechanical or chemical fixation . In view of the teachings of the present invention, those skilled in the art will understand the various ways of connecting the insertion element 916 with the rest of the anvil 918. In some versions, the elastomeric insertion element 916 is connected to the anvil 918 using a molding process. For this purpose, a slot 949 is formed to receive a locking member not shown in order to prevent the elastomeric material from entering the slot 944 of the anvil 918. It should also be understood that the opening 948 of the nose portion 920 can comprise several features structural elements configured to engage with the insertion element 916 during molding to thereby secure the insertion element 916 to the anvil 918.
[0115] In another version of the anvil 918, the body 930, the nose portion 920 and the distal end 922 can be constructed from another suitable material other than a metallic material. By way of example, and not by way of limitation, other suitable materials may include various plastics, among others, which will be apparent to those skilled in the art in view of the teachings of the present invention. Consequently, although the example above describes
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55/75 a metallic construction for the body 930, the nose portion 920 and the distal end 922, the construction of the anvil 918 should not be limited to a metallic construction.
C · Anvil with connecting member for improved deformability [0116] Figures 25 and 26 show an example anvil 1018 for an end actuator. It will be understood that the anvil 1018 can be paired with the lower jaw 16 and the cartridge 37 to provide the end actuator for an instrument such as instruments 10, 310. Similarly, anvil 1018 can be used in place of anvil 18 in the end actuator 12, or in place of anvil 218 in end actuator 212, or in place of anvil 318 in end actuators 312, 412. Anvil 1018 comprises body 1030, curved distal tip 1019 and connecting member 1016 The anvil
1018 further comprises staple forming pockets 1046 and slit 1044, which are structurally and functionally similar to the staple forming pockets 53 and slit 49 described above.
[0117] In the present example, the body 1030 comprises a metallic material of rigid construction. Connecting member 1016 extends distally from body 1030 and comprises the same metallic construction material. The curved distal tip 1019 extends distally from the connecting member 1016 and further comprises the same metallic construction material. The distal curved tip
1019 comprises a nose portion 1020 and the distal end 1022. The nose portion 1020 connects with and extends from the connecting member 1016. The distal end 1022 connects with and extends from the nose portion 1020. With this configuration, both the curved distal tip 1019 and the connecting member 1016 can be considered extensions of the body 1030. The connecting member 1016 comprises a thin profile that allows and promotes deflection of the nose portion 1020. In the present example, the connecting member
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1016 defines a deflection zone for the curved distal tip 1019. The curved distal tip 1019 comprises a thick profile so that the nose portion 1020 and the distal end 1022 are rigid and any deflection thereof is due to the deflection on the limb of connection 1016 as mentioned. With the thicker profile of the distal curved tip 1019, the distal curved tip 1019 can be configured operationally to dissect tissue or vessels.
[0118] In addition to its thin profile, the connecting member 1016 comprises additional features that promote or improve the deformability of the curved distal tip 1019. This feature includes a narrower width for the connecting member 1016 in relation to the body width 1030 and to the nose portion 1020 of the curved distal tip 1019. Another feature configured to improve the deformability of the curved distal tip 1019 comprises a slit 1048 that extends longitudinally along a midline of the connecting member 1016. Both the slit 1048 and the width closer to the connecting member 1016 are configured to reduce the stiffness of the connecting member 1016 so that the connecting member 1016 is more easily able to deflect, as shown in Figure 26, when subjected to clamping force or otherwise contact of the fabric. In view of the teachings of the present invention, other ways of modifying the connecting member 1016 to remove material in order to improve the deformability will be apparent to those skilled in the art.
[0119] In another version of the anvil 1018, one or more of the body 1030, the distal curved tip 1019 and / or the connecting member 1016 can be constructed from another suitable material other than a metallic material. By way of example, and not by way of limitation, other suitable materials may include various plastics, among others, which will be apparent to those skilled in the art in view of the teachings of the present invention. Consequently, although the example
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57/75 above, describe a metallic construction for the body 1030, the distal curved tip 1019 and the connecting member 1016, the construction of the anvil 1018 should not be limited to a metallic construction.
D. Anvil with integrated elastomeric contact block and rigid end [0120] Figures 27 and 28 show an example anvil 1118 for an end actuator. It will be understood that the anvil 1118 can be paired with the lower jaw 16 and the cartridge 37 to provide the end actuator for an instrument such as instruments 10, 310. Similarly, anvil 1118 can be used in place of anvil 18 in the end actuator 12, or in place of anvil 218 on end actuator 212, or in place of anvil 318 on end actuators 312, 412. Anvil 1118 comprises the body 1130 and the distal curved tip 1119. The anvil 1118 further comprises staple forming pockets 1146 and slot 1144, which are structurally and functionally similar to the staple forming pockets 53 and slot 49 described above. [0121] In the present example, the body 1130 comprises a metallic material of rigid construction. The curved distal tip 1119 extends distally from the body 1130. The curved distal tip 1119 comprises an elastomeric block 1116, the nose portion 1120 and the distal end 1122. The nose portion 1120 connects with and extends from the body 1130 and is made of the same metallic construction material. The nose portion 1120 is configured with a narrower width compared to the body width 1130 or the width of an elastomeric block 1116. As shown in Figure 28, the nose portion 1120 further comprises a plurality of notches 1148 that extend transversely across the nose portion width 1120. The notches 1148 are configured in various sizes as the nose portion 1120 extends distally. For example, the most pro notch
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58/75 ximal in the illustrated version is configured as the major notch, with the most distal notch configured as the minor notch. Slot size control 1148 promotes improved deformability of the curved distal tip 1119.
[0122] The distal end 1122 connects with and extends from the nose portion 1120 and is also of the same metallic construction material. In this way, both the nose portion 1120 and the distal end 1122 can be considered extensions of the body 1130 formed as part of the curved distal tip 1119. As shown in the illustrated example, the distal end 1122 has a width that corresponds generally to the width of the portion nose 1120. In this way, both the nose portion 1120 and the distal end 1122 are configured with a narrower width compared to the body width 1130 or the width of the elastomeric block 1116. The distal end 1122 additionally supplies the anvil 1118 with a metallic distal contact zone.
[0123] In the present example, the elastomeric block 1116 is molded by overlapping over the nose portion 1120. During the overlapping molding process, elastomeric material from the 1116 block fills the spaces defined by the plurality of notches 1148 and extends along side portions of nose portions 1120. In its finished molded state, elastomeric block 1116 is configured so that exposed areas of nose portion 1120 and distal end 1122 remain prominent in relation to elastomeric block 1116, as shown in the example illustrated. In view of the teachings of the present invention, several other modifications that could be made to the nose portion 1120 to provide additional features or other structural features in addition to the notches 1148 for overlapping the elastomeric block 1116 therein will be apparent to those skilled in the art.
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59/75 technique. In some versions, the tissue stabilizer features may be molded on the 1116 elastomeric block. For example, such tissue stabilizer features may be the same or similar to the tissue stabilizer features 714 described above. However, other configurations for, and methods for providing, the tissue stabilizing features will be apparent to those skilled in the art, in view of the teachings of the present invention.
[0124] In another version of the anvil 1118, the body 1130 and the distal curved tip 1119 can be constructed from another suitable material other than a metallic material. By way of example, and not by way of limitation, other suitable materials may include various plastics, among others, which will be apparent to those skilled in the art in view of the teachings of the present invention. Consequently, although the above example describes a metallic construction for the body 1130, the nose portion 1120 and the distal end 1122, the construction of the anvil 1118 should not be limited to a metallic construction for these components.
V · End actuators with elastically deformable cartridge tips [0125] In some cases, when a straight and rigid anvil is desired, another approach to modifying an end actuator for improved visualization, maneuverability and tissue collection with an atraumatic tip includes the addition of an elastomeric curved tip to the distal end of a cartridge. In this way, when the end actuator is closed and by maneuvering to a procedure site, the elastomeric curved tip added at the distal end of the cartridge fills the space that would otherwise exist at the distal end of the end actuator. This configuration can reduce drag at the distal end by maneuvering the end actuator helping to deflect the fabric in the opposite direction from the distal end
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60/75 of the end actuator when moving the end actuator through and across the fabric.
[0126] Figures 29 to 31 show an exemplary end actuator 1212 or components thereof that incorporates an elastomeric curved tip 1214 attached to a distal end of a cartridge 1237. In addition to curved tip 1214 and cartridge 1237, the end actuator 1212 further comprises lower jaw 16 and anvil 1218. Lower jaw 16 is configured to receive cartridge 1237 in the same or similar manner as lower jaw 16 receives cartridge 37, as described above. Anvil 1218 is similar to anvil 18 described above, but with a more pointed distal end similar to anvil 218, but being straight instead of curved. Cartridge 1237 is similar to cartridge 37 as described above with one difference being the incorporation of the elastomeric curved tip 1214. As shown in Figure 29, cartridge 1237 additionally comprises tissue gripping features 1216 located on an upper platform 1272 of cartridge 1237. Such 1216 fabric hold features are optional features and can be omitted in other versions.
[0127] As mentioned above, the elastomeric curved tip 1214 is fixed with the tilted distal end of the cartridge 1237. The connection of the curved tip 1214 to the cartridge 1237 can be achieved using a mechanical or chemical fixation. In view of the teachings of the present invention, those skilled in the art will understand the various ways of connecting the curved tip 1214 with the distal end of the cartridge 1237. In some versions, the curved tip 1214 is connected to the cartridge 1237 using a process of molding. In such examples, the distal end of the cartridge 1237 may comprise several structural features configured to engage with the elastomeric material of the curved tip 1214 during molding to secure
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61/75 thus the curved tip 1214 at the distal end of the cartridge 1237. In the present example, the curved tip 1214 is resiliently prone to extend substantially perpendicularly from the tilted distal face of the cartridge 1237, although it should be understood that the tip bend 1214 can have any other suitable angular relationship to the slanted distal face of cartridge 1237. In addition, curved tip 1214 is resiliently prone to extend along a plane that is oriented obliquely to the longitudinal geometric axis of the end actuator 1212 in the present example.
[0128] The curved tip 1214 comprises lower lip 1220, upper lip 1222 and dividers 1224. The lower lip 1220 is secured with the slanted distal end of cartridge 1237 as described above. The upper flange 1222 extends and connects with a proximal portion of the lower flange 1220. Dividers 1224 extend vertically from the lower flange 1220 and connect the lower flange 1220 and the upper flange 1222. In the present example, the upper flange 1222 comprises top surface 1226 which includes gripping features 1228 configured to improve gripping of the tissue trapped between the anvil 1218 and the cartridge 1237, for example as shown in Figure 31.
[0129] With reference to Figures 30 and 31, the end actuator 1212 is shown in the closed position both when not clamping the fabric and when clamping the fabric. As shown, in the closed position in any scenario, the distal end of anvil 1218 aligns with the longitudinal position of the distal end of cartridge 1237. In other versions, end actuator 1212 can be configured so that the distal end of anvil 1218 extend beyond cartridge 1237 when end actuator 1212 is closed. In still other versions, the end actuator 1212 can be configured so that the distal end of the
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62/75 anvil 1218 ends near the distal end of cartridge 1237 when end actuator 1212 is closed.
[0130] As shown in Figure 31, when the fabric 90 is captured between the anvil 1218 and the cartridge 1237, the curved elastomeric tip 1214 deforms from its open state in Figure 30 to a closed state, as shown in Figure 31 In this deformed state, the upper edge 1222 deflects downwards towards the lower edge 1220. Additionally, dividers 1224 are compressed and deflect laterally. As shown in Figure 31, in its deformed state, the upper edge 1222 of the curved tip 1214 extends distally from the anvil 1218 and the cartridge 1237. With fabric clamped between the end actuator 1212, a cutting and stapling sequence can now occur with end actuator 1212 in a manner similar to that described above in relation to end actuator 12. When the clamping force is released, the curved tip 1214 can resiliently return to the configuration and orientation shown in Figures 29 to 30.
[0131] In view of the teachings of the present invention, it will be understood that end actuator 1212 can be used in place of any of the other end actuators described herein. For example, end actuator 1212 can be used in place of end actuator 12 shown in Figure 1, or in place of end actuator 312 shown in Figure 11. In some versions, end actuator 1212 can be integrally formed with the drive shaft 22, 322 or alternatively can be formed separately and then combined. In some versions, the 1212 end actuator may be supplied for use in robotic systems, as described above.
VL Exemplary combinations [0132] The following examples refer to various non-exhaustive forms
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63/75 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 subsequent filings of 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 mentioned in the examples below. Therefore, none of the aspects or resources mentioned below should be considered as of critical importance, except where explicitly stated otherwise as such at a later date, by the inventors or by a successor in the interest of the inventors. If any claims are made in this application or in subsequent filings related to this application that include additional resources in addition to those mentioned below, it is not assumed that these additional resources have been added for any reason related to patentability.
Example 1 [0133] An apparatus comprising: a body; b a drive axis that extends from the body, the drive axis defining a longitudinal geometric axis; c an end actuator in communication with the drive shaft, the purpose of the end actuator is to compress, staple and cut the fabric, the end actuator comprising: i a cartridge configured to retain one or more clamps, ii a movable anvil in relation to the cartridge between an open position and a closed position; and iii a curved distal tip located at a distal end of the cartridge or the anvil, the distal tip being
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The curved 64/75 comprises an elastically deformable portion configured to deflect at least a portion of the curved distal tip in response to a clamping force applied to the curved distal tip.
Example 2 [0134] The apparatus, according to Example 1, in which the curved distal tip is tended to maintain an undeformed state when the curved distal tip is not subjected to the clamping force. Example 3 [0135] The apparatus, according to any one or more of Examples 1 to 2, in which the curved distal tip comprises a lower surface that defines a foreground when the curved distal tip is in an undeformed state, being that a first angle is defined by the intersection of the longitudinal geometric axis with the first plane, the lower surface defining a second plane when the distal curved tip is in a deformed state, and a second angle is defined by the intersection of the longitudinal geometric axis with the background.
Example 4 [0136] The apparatus, according to Example 3, in which the first angle is in a range of approximately 20 degrees to approximately 50 degrees in a downward direction towards the cartridge, and the second angle is in a range of approximately 10 degrees to approximately 30 degrees in an upward direction away from the cartridge.
Example 5 [0137] The apparatus, according to any one or more of Examples 3 to 4, in which the curved distal tip is configured to move through a range of elastic deformation movement in a range of approximately 30 degrees to approximately 80 degrees.
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65/75
Example 6 [0138] The apparatus, according to any one or more of Examples 1 to 5, in which the curved distal tip of the anvil comprises a rigid portion extending distally from an anvil body, the portion being elastically deformable is shaped by overlapping on the rigid portion.
Example 7 [0139] The apparatus, according to Example 6, wherein the rigid portion comprises an opening extending through the rigid portion, the material of the elastically deformable portion being situated in the opening.
Example 8 [0140] The apparatus, according to any one or more of Examples 1 to 7, wherein the curved distal tip of the anvil comprises one or more tissue stabilizing features located on a lower surface of the curved distal tip.
Example 9 [0141] The apparatus, according to any one or more of Examples 1 to 8, in which the curved distal end of the anvil comprises a first engaging feature, the cartridge comprising a second engaging feature, the first and second engagement features are configured to engage to provide an interlock feature for the end actuator.
Example 10 [0142] The apparatus, according to Example 9, in which the first coupling feature comprises a lock connected to a lower surface of the curved distal tip, and the second coupling feature comprises a recess formed at one end away from the cartridge.
Example 11
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66/75 [0143] The apparatus, according to Example 10, in which the lock comprises a hook member, the recess comprising a lower cut feature, the hook member being configured to selectively engage the feature lower cut.
Example 12 [0144] The apparatus, according to Example 11, in which the hook member and the lower cutting feature are oriented longitudinally in relation to the anvil and the cartridge.
Example 13 [0145] The apparatus according to claim 11, wherein the hook member and the lower cutting feature are oriented transversely with respect to the anvil and the cartridge.
Example 14 [0146] The apparatus, according to any one or more of Examples 1 to 13, wherein the curved distal tip of the anvil comprises a span adjustment feature configured to maintain a desired spacing between a lower surface of the curved distal tip and the cartridge when the anvil is closed.
Example 15 [0147] The apparatus, according to any one or more of Examples 1 to 14, wherein the cartridge comprises a distally presented surface, the distally presented surface of the cartridge being oriented obliquely with respect to a defined longitudinal geometric axis by the end actuator, the distal curved tip extending distally from the distally presented surface of the cartridge.
Example 16 [0148] An apparatus comprising: (a) a body; (b) a drive shaft that extends from the body, with the drive shaft
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67/75 drive defines a longitudinal geometric axis; (c) an end actuator in communication with the drive shaft, the purpose of the end actuator is to compress, staple and cut the fabric, the end actuator comprising: (i) a cartridge configured to retain one or more clamps, and (ii) a movable anvil between an open position and a closed position, the anvil comprising a curved distal tip, the curved distal tip comprising an elastically deformable portion configured to deflect at least a portion of the distal tip curved in response to a clamping force applied to the curved distal tip, and the curved distal tip comprises a rigid distal end operably configured for tissue dissection. Example 17 [0149] The apparatus according to Example 16, in which the curved distal tip comprises a portion of the nose that connects to an anvil body and extends therefrom, and which additionally connects to the distal end rigid, the distal curved tip additionally comprising an elastomeric member connected to the nose portion.
Example 18 [0150] The apparatus, according to any one or more of Examples 16 to 17, wherein the curved distal tip comprises a portion of the nose that connects to an anvil body and extends from it, and which additionally connects to the rigid distal end, the nose portion comprising a plurality of notches that decrease in size as the nose portion extends distally, the plurality of notches being configured to receive overlapping molded elastomeric material with the nose portion.
Example 19
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68/75 [0151] The apparatus, according to any one or more of Examples 16 to 18, wherein the curved distal tip comprises a nose portion which connects to an anvil connecting member and which additionally connects to the end rigid distal, the connecting member being narrow in relation to the adjacent nose portion and the adjacent body of the anvil, the connecting member additionally comprising a slot extending from one end of the connecting member to an opposite end of the connecting member.
Example 20 [0152] An apparatus comprising: (a) a body; and (b) an end actuator in communication with the body, the end actuator comprising: (i) an anvil, (ii) a lower jaw, the anvil being movable towards the lower jaw, and (ii ) a cartridge removably received in the lower jaw, the purpose of the cartridge being to direct staples towards the anvil, the cartridge comprising a distal end and an elastically deformable curved tip connected to the distal end, the curved tip being elastically deformable comprises a deformable upper rim, a deformable divider connected to the upper rim at a first end of the divider and a lower rim connected to the divider at a second end of the divider. VIL Miscellaneous [0153] It should 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 in the present invention. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen in isolation from each other. Several suitable ways in which
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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 appended claims.
[0154] It should also be understood that the teachings of the present invention can be readily combined with several teachings of US patent application No. [attorney document number END8113USDP.0641895], entitled Surgical Stapler End Effector with Varying Deck Height and Tissue Gripping Features, filed on the same date as this application, whose disclosure is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8113USDP.0641895] will be apparent to those skilled in the art.
[0155] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US patent application No. [attorney document number END8114USDP.0641876], entitled Circular Surgical Stapler End Effector with Varying Deck Height and Tissue Gripping Features, filed on the same date as this application, whose disclosure is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8114USDP.0641876] will be apparent to those skilled in the art.
[0156] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US patent application No. [attorney document number]
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70/75
END8116USNP.0641882], entitled Surgical Stapler with Insertable Distal Anvil Tip, deposited 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 can be combined with the teachings of US patent application No. [attorney document number END8116USNP.0641882] will be apparent to those skilled in the art.
[0157] It should also be understood that the teachings of the present invention can be readily combined with several teachings of US patent application No. [attorney document number END8117USNP.0641884], entitled Surgical Stapler with Cooperating Distal Tip Features on Anvil and Staple Cartridge, 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 can be combined with the teachings of US patent application No. [attorney document number END8117USNP.0641884] will be apparent to those skilled in the art.
[0158] It should also be understood that the teachings of the present invention can readily be combined with various teachings of US patent application No. [attorney document number END8118USDP.0641887], entitled Surgical Stapler with Bent Anvil Tip and Angled Staple Cartridge Tip, 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 can be combined with the teachings of US patent application No. [attorney document number END8118USDP.0641887] will be apparent to those skilled in the art.
[0159] It should also be understood that the teachings of the present invention can be readily combined with various
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71/75 teachings of US patent application No. [attorney document number END8118USNP.0641889], entitled Surgical Stapler with Bent Anvil Tip, Angled Staple Cartridge Tip, and Tissue Gripping Features, filed on the same date as this application, whose disclosure is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8118USNP.0641889] will be apparent to those skilled in the art.
[0160] It should be understood that any patent, publication or other disclosure material which, in whole or in part, is considered to be incorporated herein by reference, is incorporated herein only to the extent that the incorporated material does not enter in conflict with the definitions, statements, or other disclosure materials presented 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.
[0161] 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. Simi
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72/75 home, those skilled in the art will recognize that various teachings here can be readily combined with various teachings from any of the following: US Patent No. 5,792,135, entitled Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity, granted on August 11, 1998, the disclosure of which is hereby incorporated by reference; US Patent No. 5,817,084, entitled Remote Center Positioning Device with Flexible Drive, issued October 6, 1998, the disclosure of which is incorporated herein by reference; US Patent No. 5,878,193, entitled Automated Endoscope System for Optimal Positioning, issued on March 2, 1999, the disclosure of which is incorporated herein by reference; US Patent No. 6,231,565, entitled Robotic Arm DLUS for Performing Surgical Tasks, issued May 15, 2001, the disclosure of which is incorporated herein by reference; US Patent No. 6,783,524, entitled Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument, issued on August 31, 2004, the disclosure of which is incorporated herein by reference; US Patent No. 6,364,888, entitled Alignment of Master and Slave in a Minimally Invasive Surgical Apparatus, issued April 2, 2002, the disclosure of which is incorporated herein by reference; US Patent No. 7,524,320, entitled Mechanical Actuator Interface System for Robotic Surgical Tools, issued April 28, 2009, the disclosure of which is incorporated herein by reference; US Patent No. 7,691,098, entitled Platform Link Wrist Mechanism, issued April 6, 2010, the disclosure of which is incorporated herein by reference; US Patent No. 7,806,891, entitled Repositioning and Reorientation of Master / Slave Relationship in Minimally Invasive Telesurgery, issued on October 5, 2010, the disclosure of which is incorporated herein by reference; US Publication No. 2013/0012957, entitled Automated End Effector Component Reloading System for Use with a Robotic System ”, published
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73/75 on January 10, 2013, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0199630, entitled Robotically Controlled Surgical Instrument with Force-Feedback Capabilities, published on August 9, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0132450, entitled Shiftable Drive Interface for Robotically-Controlled Surgical Tool, published on May 31, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0199633, entitled Surgical Stapling Instruments with Cam-Driven Staple Deployment Arrangements, published on August 9, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0199631, entitled Robotically Controlled Motorized Surgical End Effector System with Rotary Actuated Closure Systems Having Variable Actuation Speeds, published on August 9, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0199632, entitled Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector, published on August 9, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0203247, entitled Robotically Controlled Surgical End Effector System, published on August 9, 2012, the disclosure of which is hereby incorporated by reference; US Publication No. 2012/0211546, entitled Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot, published on August 23, 2012; US Publication No. 2012/0138660, entitled Robotically Controlled Cable-Based Surgical End Effectors, published on June 7, 2012, the disclosure of which is hereby incorporated by reference; and / or US publication No. 2012/0205421, entitled Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems, published on August 16, 2012, the disclosure of which is hereby incorporated by reference.
[0162] Versions of the devices described above can be designed
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74/75 can be discarded after a single use, or they 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. [0163] 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.
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75/75 [0164] Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described in the present invention can be made by suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention needs to be considered in accordance with the terms of the following claims, and it is understood that it is not limited to the details of structure and operation shown and described in the specification and drawings.

权利要求:
Claims (20)
[1]
1. Apparatus characterized by comprising:
(a) a body;
(b) a drive axis that extends from the body, the drive axis defining a longitudinal geometric axis; and (c) an end actuator in communication with the drive shaft, the purpose of the end actuator is to compress, staple and cut the fabric, the end actuator comprising:
(i) a cartridge configured to contain one or more clips, (ii) an anvil movable in relation to the cartridge between an open position and a closed position, and (iii) a curved distal tip located at a distal end of the cartridge or anvil , the distal curved tip comprising an elastically deformable portion configured to deflect at least a portion of the curved distal tip in response to a clamping force applied to the curved distal tip.
[2]
Apparatus according to claim 1, characterized in that the curved distal tip is provided to maintain an undeformed state when the curved distal tip is not subject to the clamping force.
[3]
Apparatus according to claim 1, characterized in that the curved distal tip comprises a underside surface that defines a foreground when the curved distal tip is in a non-deformed state, the first angle being defined by the intersection the longitudinal geometric axis with the foreground, with the underside surface defining a second plane when the distal curved tip is in a deformed state,
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2/5 being that a second angle is defined by the intersection of the longitudinal geometric axis with the second plane.
[4]
Apparatus according to claim 3, characterized in that the first angle is in a range of about 20 degrees to about 50 degrees in a downward direction towards the cartridge, and the second angle is in a range about 10 degrees to about 30 degrees in an upward direction away from the cartridge.
[5]
Apparatus according to claim 3, characterized in that the curved distal tip is configured to move through a range of movement of elastic deformation in a range of about 30 degrees to about 80 degrees.
[6]
Apparatus according to claim 1, characterized in that the curved distal tip of the anvil comprises a rigid portion extending distally from an anvil body, the elastically deformable portion being molded by overlapping the rigid portion.
[7]
Apparatus according to claim 6, characterized in that the rigid portion comprises an opening extending through the rigid portion, the material of the elastically deformable portion being situated in the opening.
[8]
Apparatus according to claim 1, characterized in that the curved distal tip of the anvil comprises one or more tissue stabilizing features located on a underside surface of the curved distal tip.
[9]
Apparatus according to claim 1, characterized in that the curved distal tip of the anvil comprises a first engaging feature, the cartridge comprising a second engaging feature, the first and second engaging features being configured to to engage in order to provide an interlocking feature
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3/5 for the end actuator.
[10]
Apparatus according to claim 9, characterized in that the first engagement feature comprises a latch connected to a underside surface of the curved distal tip, and the second engagement feature comprises a recess formed at a distal end the cartridge.
[11]
Apparatus according to claim 10, characterized in that the lock comprises a hook member, the recess comprising a lower cutting feature, the hook member being configured to selectively engage the lower cutting feature.
[12]
Apparatus according to claim 11, characterized in that the hook member and the lower cutting feature are oriented longitudinally in relation to the anvil and the cartridge.
[13]
Apparatus according to claim 11, characterized in that the hook member and the lower cutting feature are oriented transversely with respect to the anvil and the cartridge.
[14]
Apparatus according to claim 1, characterized in that the curved distal tip of the anvil comprises a span adjustment feature configured to maintain a desired spacing between a underside surface of the curved distal tip and the cartridge when the anvil is closed.
[15]
Apparatus according to claim 1, characterized in that the cartridge comprises a distally presented surface, the distally presented surface of the cartridge being oriented obliquely with respect to a longitudinal geometric axis defined by the end actuator, the distal tip being curve extends distally from the distally presented surface of the cartridge.
[16]
16. Apparatus characterized by comprising:
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4/5 (a) a body;
(b) a drive axis that extends from the body, the drive axis defining a longitudinal geometric axis; and (c) an end actuator in communication with the drive shaft, the purpose of the end actuator is to compress, staple and cut the fabric, the end actuator comprising:
(i) a cartridge configured to contain one or more clips, and (ii) a movable anvil between an open position and a closed position, the anvil comprising a curved distal tip, the curved distal tip comprising an elastically deformable portion configured to deflect at least a portion of the curved distal tip in response to a clamping force applied to the curved distal tip, and the curved distal tip comprises a rigid distal end operably configured for tissue dissection.
[17]
Apparatus according to claim 16, characterized in that the curved distal tip comprises a portion of the nose that connects to an anvil body and extends therefrom, and that additionally connects to the rigid distal end, being that the curved distal tip further comprises an elastomeric member connected to the nose portion.
[18]
Apparatus according to claim 16, characterized in that the curved distal tip comprises a portion of the nose that connects to an anvil body and extends therefrom, and which additionally connects to the rigid distal end, being that the nose portion comprises a plurality of notches that decrease in size as the nose portion extends distally
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5/5, the plurality of notches being configured to receive elastomeric material molded by overlapping with the nose portion.
[19]
Apparatus according to claim 16, characterized in that the curved distal tip comprises a nose portion which connects to an anvil connecting member and which additionally connects to the rigid distal end, the connecting member comprising a narrow width in relation to the adjacent nose portion and the adjacent body of the anvil, the connecting member further comprising a slit extending from one end of the connecting member to an opposite end of the connecting member.
[20]
20. Apparatus characterized by comprising:
(a) a body; and (b) an end actuator in communication with the body, the end actuator comprising:
(i) an anvil, (ii) a lower jaw, the anvil being movable towards the lower jaw, and (ii) a cartridge removably received in the lower jaw, the purpose of which the cartridge is to direct staples towards to the anvil, the cartridge comprising a distal end and an elastically deformable curved tip connected to the distal end, with the elastically deformable curved tip comprising a deformable upper lip, a deformable divider connected to the upper lip at a first end of the divider and a lower lip connected to the divider at a second end of the divider.

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同族专利:

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公开号 | 公开日

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CN110520065A|2019-11-29|

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US20180235609A1|2018-08-23|

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EP3363390B1|2021-07-14|

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JP2020508124A|2020-03-19|

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EP3363390A3|2018-09-05|

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EP3363390A2|2018-08-22|

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US10828031B2|2020-11-10|

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WO2018152044A1|2018-08-23|

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法律状态:
2021-10-19| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US15/435,573|US10828031B2|2017-02-17|2017-02-17|Surgical stapler with elastically deformable tip|

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PCT/US2018/017751|WO2018152044A1|2017-02-17|2018-02-12|Surgical stapler with elastically deformable tip|

---