HYSTERESIS REMOVAL FEATURE IN SURGICAL STAPLING INSTRUMENT

专利摘要:
an apparatus includes a body, a shaft assembly, an acting end, and an indicator assembly. the terminal manipulator includes a stationary component and a movable component. the indicator set includes a translation element and an indicator member. the translation member translates in relation to the body in response to the movement of the mobile component in relation to the stationary component. the indicator member moves from a first position to a second position. the indicating member includes an integral resilient element configured to press the indicating member towards the first position. the translation member pushes the indicator member towards the second position in response to the movement of the moving component in relation to the stationary component in a first direction. the elastic characteristic drives the indicator member towards the first position in response to the movement of the moving component in relation to the stationary component in a second direction.
公开号:BR112019022496A2
申请号:R112019022496-3
申请日:2018-04-18
公开日:2020-05-12
发明作者:T. Kluener Joseph；C. Cagel Jeffrey
申请人:Ethicon Llc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for RESOURCES OF HYSTERESIS REMOVAL IN SURGICAL STAPLING INSTRUMENT.
BACKGROUND OF THE INVENTION
[0001] In some surgical procedures (for example, colorectal, bariatric, thoracic, etc.), portions of a patient's digestive tract (for example, the gastrointestinal and / or esophageal tract, etc.) can be cut and removed for eliminate unwanted tissue or for other reasons. After the tissue is removed, the remaining portions of the digestive tract can be coupled in an end-to-end anastomosis. End-to-end anastomosis can provide a substantially unobstructed flow path from one portion of the digestive tract to the other portion of the digestive tract, without also providing any type of leak at the anastomosis site.
[0002] An example of an instrument that can be used to provide an end-to-end anastomosis is a circular stapler. Some of these staplers work to trap layers of fabric, cut through the stuck layers of fabric and have the staples go through the stuck layers of fabric to substantially seal the layers of fabric together near the separate ends of the layers of fabric, joining thus, two separate ends of an anatomical lumen together. The circular stapler can be configured to cut the fabric and seal the fabric substantially simultaneously. For example, the circular stapler can separate the excess tissue, which is inside an annular matrix of staples in an anastomosis, to provide a substantially smooth transition between the sections of anatomical lumen that are joined in the anastomosis. Circular staplers can be used in open procedures or in endoscopic procedures. In some cases, a portion of the circular stapler is inserted through the
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2/49 orifice that occurs naturally in a patient.
[0003] Examples of circular staplers are described in US Patent No. 5,205,459, entitled Surgical Anastomoseis Stapling Instrument, issued April 27, 1993; US Patent No. 5,271,544, entitled Surgical Anastomosis Stapling Instrument, issued December 21, 1993; US Patent No. 5,275,322, entitled Surgical Anastomosis Stapling Instrument, issued January 4, 1994; US Patent No. 5,285,945, entitled Surgical Anastomosis Stapling Instrument, issued February 15, 1994; US Patent No. 5,292,053, entitled Surgical Anastomosis Stapling Instrument, issued March 8, 1994; US Patent No. 5,333,773, entitled Surgical Anastomosis Stapling Instrument, issued August 2, 1994; US Patent No. 5,350,104, entitled Surgical Anastomosis Stapling Instrument, issued September 27, 1994; US Patent No. 5,533,661, entitled Surgical Anastomosis Stapling Instrument, issued July 9, 1996; and in US Patent No. 8,910,847, entitled Low Cost Anvil Assembly for Circular Stapler, published on December 16, 2014. The description of each of the aforementioned US patents is incorporated by reference in the present invention.
[0004] Some circular staplers may include a motorized drive mechanism. Examples of circular staplers with motorized drive mechanisms are described in the US patent publication. 2015/0083772, entitled Surgical Stapler with Rotary Cam Drive and Return, published on March 26, 2015; US publication No. 2015/0083773, entitled Surgical Stapling Instrument with Drive Assembly Having Toggle Features, published on March 26, 2015; US publication No. 2015/0083774, entitled Control Features for Motorized Surgical Stapling Instrument, published March 26, 2015; and in US publication No. 2015/0083775, entitled Surgical Stapler with Rotary Cam Drive, published on March 26, 2015.
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The description of each of the aforementioned US patent publications is incorporated by reference into the present invention.
[0005] Although various types of surgical stapling instruments and associated components have been produced and used, it is believed that no one before the inventor (s) has produced or used the invention described in the attached claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] Although the specification concludes with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples, taken in conjunction with the accompanying drawings, in which figures equal reference points identify equal elements, and in which:
[0007] Figure 1 represents a perspective view of an exemplary circular stapler;
[0008] Figure 2 represents a perspective view of the circular stapler of Figure 1, with a battery removed from a handle set and an anvil removed from a staple head set;
[0009] Figure 3 represents a perspective view of the anvil of the circular stapler in Figure 1;
[0010] Figure 4 represents a perspective view of the stapling head assembly of the circular stapler of Figure 1;
[0011] Figure 5 represents an exploded perspective view of the stapling head assembly of Figure 4;
[0012] Figure 6 represents an exploded perspective view of the circular stapler of Figure 1, with portions of the drive shaft assembly shown separately from each other;
[0013] Figure 7 represents a perspective view of the handle assembly of the circular stapler in Figure 1, with one half of the
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4/49 housing omitted to reveal internal components of the handle assembly;
[0014] Figure 8 represents a perspective view of a support of the handle assembly of Figure 7;
[0015] Figure 9 represents a perspective view of an indicator member of the handle assembly of Figure 7;
[0016] Figure 10A represents a perspective view of an anvil drive assembly of the circular stapler of Figure 1, a drive rod in a first position;
[0017] Figure 10B represents a perspective view of the anvil drive assembly of Figure 10A, with the drive rod moved to a second position to engage the support of Figure 8;
[0018] Figure 10C represents a perspective view of the anvil drive assembly of Figure 10A, with the drive rod moved to a third position to retract the support of Figure 8 proximally;
[0019] Figure 10D represents a perspective view of the anvil drive assembly of Figure 10A, with a safety trigger rotated from a first position to a second position; [0020] Figure 10E represents a perspective view of the anvil drive assembly of Figure 10A, with a trigger trigger rotated from a first position to a second position;
[0021] Figure 11 represents a perspective view of a user interface of the handle assembly of Figure 7;
[0022] Figure 12A represents a cross-sectional side view of the anvil of Figure 3 positioned within a first section of a digestive tract and the stapling head assembly of Figure 4 positioned in a second section of the digestive tract, with the anvil separate from the stapling head assembly;
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[0023] Figure 12B represents a cross-sectional side view of the anvil of Figure 3 positioned inside the first section of the digestive tract and the stapling head set of Figure 4 positioned in the second section of the digestive tract, with the anvil attached to the set stapling head;
[0024] Figure 12C represents a side view in cross section of the anvil of Figure 3 positioned inside the first section of the digestive tract and the stapling head assembly of Figure 4 positioned in the second section of the digestive tract, with the anvil retracted towards to the staple head assembly to thereby secure the fabric between the anvil and the staple head assembly;
[0025] Figure 12D represents a side view in cross section of the anvil of Figure 3 positioned within the first section of the digestive tract and the stapling head set of Figure 4 positioned in the second section of the digestive tract, with the head set of stapling actuated to cut and staple the attached fabric; [0026] Figure 12E represents a side view in cross section of the first and second sections of the digestive tract of Figure 12A joined in an end-to-end anastomosis;
[0027] Figure 13 represents a perspective view of an alternative exemplary indicator member that can be incorporated into the instrument of Figure 1;
[0028] Figure 14 represents another perspective view of the indicating member of Figure 13;
[0029] Figure 15 represents a perspective view of an alternative exemplary support that can be incorporated into the instrument of Figure 1;
[0030] Figure 16 represents a perspective view of the indicating member of Figure 13 in combination with the support of Figure 15;
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[0031] Figure 17 represents an exploded perspective view of the indicator member of Figure 13 with an alternative exemplary chassis that can be incorporated into the instrument of Figure 1;
[0032] Figure 18A represents a side elevation view of the indicator member of Figure 13 coupled with the chassis of Figure 17, with the indicator member in a first angular position;
[0033] Figure 18B represents a side elevation view of the indicator member of Figure 13 coupled with the chassis of Figure 17, with the indicator member in a second angular position;
[0034] Figure 18C represents a side elevation view of the indicator member of Figure 13 coupled with the chassis of Figure 17, with the indicator member in a third angular position;
[0035] Figure 18D represents a side elevation view of the indicator member of Figure 13 coupled with the chassis of Figure 17, with the indicator member in a fourth angular position
[0036] Figure 19A represents a side elevation view of the indicating member of Figure 13 and the support of Figure 15, with the support in a first longitudinal position and the indicating member in a first angular position;
[0037] Figure 19B represents a side elevation view of the indicating member of Figure 13 and the support of Figure 15, with the support in a second longitudinal position and the indicating member in the first angular position;
[0038] Figure 19C represents a side elevation view of the indicating member of Figure 13 and the support of Figure 15, with the support in a third longitudinal position and the indicating member in a second angular position; and
[0039] Figure 19D represents a side elevation view of the indicating member of Figure 13 and the support of Figure 15, with the support in a fourth longitudinal position and the indicating member in a third
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[0040] The drawings are not intended to be limiting in any way and it is contemplated that various modalities of technology can be executed in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings that are part of the specification describe several aspects of the present technology and, together with the description, explain the principles of the technology; it is understood, however, that this technology is not limited to the provisions shown. DETAILED DESCRIPTION
[0041] The following description of certain examples of the technology should not be used to limit its scope. Other examples, resources, aspects, modalities and advantages of the technology will become evident to those versed in the technique from the following description, which is given by way of illustration, one of the best ways contemplated to execute the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without disregarding the technology. Consequently, drawings and descriptions should be considered as illustrative and not restrictive in nature.
I. Overview of the exemplary circular stapling surgical instrument
[0042] Figures 1 to 2 represent an exemplary surgical circular stapling instrument 10 that can be used to provide an end-to-end anastomosis between two sections of an anatomical lumen, as a portion of a patient's digestive tract. The instrument 10 of this example comprises a handle assembly 100, a drive shaft assembly 200, a stapling head assembly 300, an anvil 400 and a removable battery 120. Each of these components will be described in more detail below. In addition to or replacing the above,
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8/49 it should be understood that instrument 10 can still be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2016/0374672, entitled Method of Applying an Annular Array of Staples to Tissue, published in December 29, 2016; US patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US patent No. 5,533,661; and / or US Patent No. 8,910,847, the disclosures of which are hereby incorporated by reference. Still other suitable configurations will be evident to one skilled in the art in view of the teachings described herein.
A. Exemplary fabric hitch features of the circular stapling instrument
[0043] As can best be seen in Figure 3, the anvil 400 of the present example comprises a head 410 and a stem 420. The head 410 includes a proximal surface 412 that defines a plurality of staple forming pockets 414. The forming pockets of staples 414 are arranged in two concentric annular arrays in the present example. The staple forming pockets 414 are configured to deform the staples as the staples are pushed into the staple forming pockets 414 (for example, deforming a staple that has a generic U shape to a B shape, as it is known in technique). The stem 420 defines a hole or lumen 422 and includes a pair of pivoting lock members 430 positioned in hole 422. Each lock member 430 includes features that allow the anvil 400 to be removably attached to a trocar 330 of the head assembly staple 300, as will be described in more detail below. It should be understood, however, that the anvil 400 can be removably attached to a trocar 330 using any other components, features or
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9/49 appropriate techniques.
[0044] The stapling head assembly 300 is located at the distal end of the drive shaft assembly 200. As shown in Figures 1 to 2, the anvil 400 is configured to be removably coupled to the drive shaft assembly 200, adjacent to the staple head assembly 300. As will be described in more detail below, the anvil 400 and the staple head assembly 300 are configured to cooperate with the manipulation of the fabric in three ways, including gripping the fabric, the cutting the fabric and stapling the fabric. As can best be seen in Figures 4 to 5, the stapling head assembly 300 comprises a tubular casing 310 that houses a sliding clip driver member 350. A cylindrical inner core member 312 extends distally within the tubular housing 310. O tubular housing 310 is fixedly attached to an outer sheath 210 of the drive shaft assembly 200, so that tubular housing 310 serves as a mechanical support for the staple head assembly 300.
[0045] The trocar 330 is positioned coaxially within the inner core member 312 of the tube housing 310. The trocar 330 is operable to move distally and proximally to the tube housing 310 in response to the rotation of a button 130 located at the end proximal of the handle assembly 100. The trocar 330 comprises a drive shaft 332 and a head 334. The head 334 includes a pointed tip 336 and a proximal surface extending inward 338. The head 334 and the distal portion of the drive 332 are configured for insertion in hole 422 of anvil 420. The proximal surface 338 is configured to complement the features of the locking members 430 to provide a pressure fit between the anvil 400 and the trocar 330.
[0046] The clip trigger member 350 is operable to act
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10/49 longitudinally inside the tubular housing 310 in response to the activation of the motor 160 as will be described in more detail below. Staple trigger member 350 includes two concentric annular arrays presented distally from staple actuators 352. Staple actuators 352 are arranged to match the arrangement of staple forming pockets 414 described above. Thus, each staple driver 352 is configured to drive a corresponding staple into a corresponding staple forming pocket 414 when stapling head assembly 300 is operated. The clip driver member 350 also defines a bore 354 that is configured to receive coaxially a core member 312 of the tube housing 310.
[0047] A cylindrical knife member 340 is positioned coaxially within the clip trigger member 350. The knife member 340 includes a sharp circular cutting edge, presented distally 342. The knife member 340 is dimensioned in such a way that the member knife edge 340 defines an outer diameter that is less than the diameter defined by the internal annular matrix of clamp actuators 352. Knife member 340 also defines an aperture that is configured to coaxially receive a core member 312 of tube housing 310.
[0048] A platform member 320 is fixedly attached to the tubular housing 310.0 platform member 320 includes a distally presented platform surface 322 that defines two concentric annular arrays of staple openings 324. The staple openings 324 are arranged to match the arrangement of the staple actuators 352 and the staple forming pockets 414 described above. In this way, each clamp opening 324 is configured to provide a path for a corresponding clamp trigger 352 to drive a corresponding clamp through
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11/49 of the platform member 320 and into a corresponding staple-forming pocket 414 when the staple head assembly 300 is operated. The layout of the staple openings 322 can be modified exactly like the layout of the staple forming pockets 414 as described above. It should also be understood that various structures and techniques can be used to contain the clamps within the staple head assembly 300 before the staple head assembly 300 is driven. The platform member 320 defines an internal diameter that is only slightly larger than the outside diameter defined by the knife member 340. The platform member 320 is thus configured to allow the knife member 340 to move distally to a point where the cutting edge 342 is distal to the platform surface 322. Just as an example, the platform member 320 can be constructed and operated according to at least some of the teachings of US patent application No. 15 / 350,513, entitled Circular Surgical Stapler with Recessed Deck, filed on November 14, 2016, the description of which is incorporated herein by reference. Other suitable configurations and arrangements that can be used for the platform member 320 will be apparent to those of ordinary skill in the art in view of the teachings of the present invention. [0049] Figure 6 shows various components of the drive shaft assembly 200, which extends distally from the handle assembly 100 and couples the components of the staple head assembly 300 to the components of the handle assembly 100. In particular, and how mentioned above, the drive shaft assembly 200 includes an outer sheath 210 that extends between the handle assembly 100 and the tubular housing 310. In the present example, the outer sheath 210 is rigid and includes a pre-curved section
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12/49 formed 212 which is configured to facilitate the positioning of the stapling head assembly 300 in a patient's colon, as described below. The curved section 212 includes an inner curve 216 and an outer curve 214.
[0050] The drive shaft assembly 200 also includes a trocar actuation rod 220 and a trocar drive band assembly 230. The proximal end of the trocar actuation band assembly 230 is fixedly attached to the proximal end of the shaft the trigger for the trocar 332. The proximal end of the trigger band assembly 230 is fixedly attached to the distal end of the trigger stem 220, so that the trocar 330 will move longitudinally in relation to the outer sheath 210 in response to translation of the trocar actuating band 230 and trocar actuating rod 220 in relation to the outer sheath 210. The trocar actuating band 230 is configured to flex so that the actuating band assembly of the trocar 230 can follow along the pre-formed curve in the drive shaft assembly 200 as the trocar drive drive assembly 230 is translated l ongitudinally in relation to the outer sheath 210. However, the trocar actuation band assembly 230 has sufficient column strength and tensile strength to transfer the distal and proximal forces of the acting rod of the trocar 220 to the drive shaft of the trocar 332 The trigger rod for trocar 220 is rigid. A clamp 222 is fixedly attached to the trocar drive rod 220 and is configured to cooperate with complementary characteristics within the handle assembly 100 to prevent the trocar drive shaft 220 from rotating within the handle assembly 100 while still allowing the stem trocar actuator 220 translates longitudinally within the handle assembly 100. The trocar actuation rod
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220 further includes a thick helical screw 224 and a thin helical screw 226.
[0051] The drive shaft assembly 200 further includes a staple head assembly 240 which is slidably received within the outer sheath 210. The distal end of the staple head assembly 240 is fixedly attached to the proximal end of the staple trigger member 350. The proximal end of the staple head assembly driver 240 is attached to a drive bracket 250 via a pin 242. It is therefore to be understood that the staple trigger member 350 is longitudinally moved in relation to to the outer sheath 210 in response to translation of the staple head assembly 240 and the drive bracket 250 relative to the outer sheath 210. Staple head assembly 240 is configured to flex so that the staple head assembly 240 can follow along the preformed curve in the drive shaft assembly 200 as per the drive set driver staple head 240 is translated longitudinally with respect to outer sheath 210. However, staple head assembly driver 240 has sufficient column strength to transfer distal forces from drive bracket 250 to staple driver member 350.
[0052] The motor 160 is coupled with the drive support 250 through a cam member 162 and a pivot arm 164. The pivot arm 164 is pivotally coupled with the housing 166 of the handle assembly 100 through a pin 116 The motor 160 is operable to rotate the meat member 162. The meat member 162 is configured to drive pivoting movement of the pivot arm 164 when the meat member 162 rotates in response to engine activation. The pivot arm 164 is configured to drive translation of drive support 250 when the pivot arm 164 rotates around the pin
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116 in response to the rotation of the meat member 162. The motor 160 is thus operable to drive the staple head assembly driver 240 through the meat member 162, pivot arm 164 and drive bracket 250. Only as an example, these components can be configured and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0166717, entitled Circular Stapler with Selectable Motorized And Manual Control, Including a Control Ring, published on June 19, 2014, whose description is hereby incorporated by reference.
[0053] Battery 120 is intended to supply electrical power to a motor 160, as noted above. The battery 120 can be removably coupled to the handle assembly 100 by means of a pressure fitting or in any other suitable way. Battery 120 and handle set 100 may have electrical contacts, pins and complementary sockets and / or other features that provide paths for electrical communication of battery 120 with electrically powered components in handle set 100 when battery 120 is coupled to the set of handle 100. It should also be understood that, in some versions, battery 120 is incorporated in a unitary manner within handle set 100, so that battery 120 cannot be removed from handle set 100.
B · Exemplary user input features of the circular stapling instrument
[0054] As shown in Figures 1 and 7, the handle assembly 100 includes a pistol handle 112 and various components that are operable to act on the anvil 400 and the staple head assembly 300. In particular, the handle assembly 100 includes a button 130, a safety trigger 140, a trigger trigger 150, a motor 160 and a motor drive module 180.
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The button 130 is coupled to the trigger rod of the trocar 220 by means of a nut 132, so that the coarse helical thread 224 will selectively engage a thread engaging feature within the nut; and in such a way that the fine helical screw 226 will selectively engage with a thread engagement feature not shown inside the button 130. These complementary structures are configured so that the trocar drive rod 220 will first move proximally at a relatively slow rate, then move proximally at a relatively rapid rate in response to the rotation of knob 130 in a first direction. The trocar actuating rod 220 will travel distally in response to the rotation of the button 130 in a second direction.
[0055] The handle assembly 100 also includes components that are operable to selectively lock the triggers 140, 150 based on the position of the anvil 400 in relation to the staple head assembly 300. When the triggers 140, 150 are locked, the trigger trigger 150 is prevented from starting the actuation of the stapling head assembly 300. In this way, the trigger 150 is operable only to initiate the activation of the stapling head assembly 300 when the position of the anvil 400 in relation to the assembly of the Stapling 300 is within a predefined range. The components of the handle assembly 100 that provide the previous operability will be described in more detail below.
Exemplary anvil drive set
[0056] Knob 130 protrudes proximally from casing 110 of the grip assembly and is rotatable with respect to casing 110. As shown in Figure 7, a nut 132 is attached to the distal end of knob 130. In the present example, nut 132 it is fixedly fixed to the distal end of the button 130 in such a way that the nut 132 will rotate unitarily with the button 130. The nut 132 and the button 130 are configured
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16/49 to cooperate with the trocar drive rod 220 to thus move the trocar drive rod 220 longitudinally with respect to housing 110 in response to the rotation of nut 132 and button 130 with respect to housing 110. As noted above, trocar 330 will translate longitudinally with respect to outer sheath 210 in response to translation of the trocar driver 220 in relation to outer sheath 210 and housing 110.
[0057] The proximal portion of the trocar drive rod 220 is positioned within the handle assembly 100 to engage nut 132 and knob 130. In particular, the trocar drive shaft 220 is positioned within the handle assembly 100 of so that the coarse helical thread 224 selectively engages a thread engaging feature (not shown) inside the nut 132; and in such a way that the thin helical thread 226 will selectively fit a thread engagement feature (not shown) inside the button 130. In some versions, the thread engagement feature of nut 132 comprises an inwardly directed flap; while the thread engagement feature of button 130 comprises helical threading. Other suitable shapes that these threaded coupling characteristics can take will be evident to those skilled in the art in view of the teachings presented here.
[0058] In the present example, when nut 132 and knob 130 are rotated in relation to housing 110, the trocar drive rod 220 travels proximally through a first longitudinal movement band in which the coarse helical thread 224 is engaged with nut 132 to provide a relatively fast translation rate. The thin helical thread 226 is not engaged with the button 130 during this range of motion. When nut 132 and knob 130 are still turned in relation to housing 110 after the trocar drive rod 220
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17/49 complete the first movement range, the trocar drive rod 220 will continue to travel proximally through a second longitudinal movement band in which the thin helical thread 226 is coupled with the button 130 to provide a relatively slow translation rate. In this way, the trocar drive rod 220 will translate proximally through a rapid translation sequence followed by slow translation, based on the fit between the thick helical thread 224 and the nut 132, followed by the fit between the thin helical thread 226 and the button 130.
[0059] It should be understood that when the anvil 400 is coupled to the trocar 330, the rotation of the button 130 will provide the corresponding translation of the anvil in relation to the staple head assembly 300. It should also be understood that the button 130 can be rotated in a first angled direction (for example, clockwise) to retract anvil 400 towards the staple head assembly 300; and in a second angled direction (for example, counterclockwise) to advance the anvil 400 in the opposite direction of the staple head assembly 300. Knob 130 can therefore be used to adjust the gap distance d between the opposite surfaces 412, 322 of the anvil 400 and the stapling head assembly 300 until an adequate span distance (d) has been achieved as shown in Figure 21C and as described in greater detail below.
2. Exemplary trigger lock set
[0060] As mentioned above, the knob can be used to adjust the span distance (d) between the opposite surfaces 412, 322 of the anvil 400 and the staple head assembly 300. Adjusting an appropriate clearance distance (d ) before triggering the stapling head assembly 300 can be critical to the success of an anastomosis. For example, if the gap distance (d) is very large,
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18/49 the staples that are implanted at the anastomosis site may not be sufficiently formed by staple-forming pockets 414. This can result in leakage at the anastomosis site and, in some cases, may lead to the separation of the anatomical lumen sections that join at the anastomosis site. If the gap distance (d) is too small, the internal structure of the compressed tissue between surfaces 412, 322 can be damaged to the extent that the structural integrity of the tissue is compromised. This can prevent the tissue from properly holding the formed clips, which again can result in leakage or another failure in the anastomosis. Consequently, it may be desirable to provide the operator with some form of feedback indicating whether the distance distance (d) is within a suitable range. It may also be desirable to prevent the operator from operating the stapling head assembly 300 unless the span distance (d) is within a suitable range.
[0061] Figures 7 to 11 show the components that provide the operator with feedback to indicate whether the span distance (d) is within a suitable range; and preventing the operator from operating the stapling head assembly 300, unless the span distance (d) is within a suitable range. As best seen in Figures 10B to 10C, a support 500 is configured and positioned to move in response to the movement of the trocar drive rod 220. As best seen in Figure 8, support 500 includes a rigid body 502 which defines a first slot 504, a second slot 506 and a third slot 508. A vertical feature 510 is positioned at the proximal end of the body 502 and defines an opening 512. The trocar drive rod 220 extends coaxially through the opening 512. As shown in Figure 7, a helical spring 170 is interposed between the proximal end of the vertical feature 510 and a bulkhead feature
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19/49 rigid which is defined by the casing 110 and which forms a supporting spindle for the nut 132. The bulkhead is fixed inside the casing 110 and, thus, provides a base for the proximal end of the helical spring 170, so that the helical spring 170 resiliently transmits a distal force to the support 500 through the vertical feature 510. The support 500 further includes a flange 516 shown laterally at the distal end of the body 502. The flange 516 defines a slot 514.
[0062] As best seen in Figures 10B to 10C, an indicator member 520 is configured to rotate in response to the translation of the support 500. As best seen in Figure 9, the indicator member 520 comprises a vertical arm 522, a pressure pin 524 projecting laterally from a lower end of arm 522, an indicator needle 526 projecting laterally from an upper end of arm 522 and a coupling pin 528 projecting laterally from a region intermediate arm 522. Pressure pin 524 is configured to snap into a complementary recess provided by housing 110. Pressure snap pin 524 thus secures indicator member 520 to housing 110 and still allows the member indicator 520 rotate with respect to housing 110 around the longitudinal axis of the push pin 524. Indicator needle 526 is positioned to be visible in a re User feedback stroke 114 of the handle assembly 110 to thus visually indicate the pivoting position of the indicator member 520 as described in more detail below. The coupling pin 528 is slidably received in the slot 514 of the flange 516 of the support 500. This engagement between the indicating member 520, the housing 110 and the support 500 provides the pivoting movement of the indicating member 520 in response to the translation of the support 500 .
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[0063] The support 500 is configured to selectively prevent and allow the actuation of triggers 140, 150. In particular, the slots 504, 506 of the support 500 are configured to selectively provide the clearance for the actuation of the triggers 140, 150. As shown in Figures 10A to 7E, the safety trigger 140 is pivotally coupled with a first vertical member 144. The first vertical member 144 is coupled with housing 110 so that the first vertical member 144 is configured to translate upward in response to the rotation of the safety trigger 140 towards the pistol grip 112. Meanwhile, the body 502 of the support 500 is configured to prevent this movement of the first vertical member 144 and of the safety trigger 140 engaging the upper end 146 of the first member vertical 144. The body 502 thus blocks the movement of the first vertical member 144 and the safety trigger 140 until the support 500 is moved to a position where the slot 506 is aligned with the upper end 146 to provide clearance for the upward movement of the first vertical member 144. It should therefore be understood that the safety trigger 140 cannot be pivoted towards the pistol grip 112 until the slot 506 is positioned on the upper end 146.
[0064] Similarly, trigger trigger 150 is pivotally coupled to a second vertical member 154. The second vertical member 154 is coupled to housing 110 so that the second vertical member 154 is configured to translate upwardly response to rotation of the safety trigger 150 towards the pistol grip 112. However, the body 502 of the support 500 is configured to prevent this movement of the second vertical member 154 and the trigger trigger 150 engaging the upper end 156 of the second vertical member 154. Even if the safety trigger 140 is pivoted out of the way to otherwise allow the trigger to move
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21/49 of firing 150, the body 502 blocks the movement of the second vertical member 154 and the firing trigger 150 until the support 500 is moved to a position where the slot 504 is aligned with the upper end 156 to thus provide the clearance for the upward movement of the second vertical member 154. Consequently, it should be understood that even if the safety trigger 140 is pivoted out of the way to otherwise allow the trigger trigger 150 to move, the trigger firing cap 150 cannot be pivoted toward pistol grip 112 until slot 504 is positioned over the upper end 156.
[0065] The third slot 508 is configured to receive a protrusion 223 that protrudes below the clip 222, which is rigidly attached to the trocar drive rod 220. Although the housing 110 is configured to allow the support 500 to translate longitudinally within of housing 110, housing 110 includes rails, channels and / or other features that prevent the holder 500 from rotating within housing 110. Thus, the position of protrusion 223 in slot 508 prevents the clamp 222 and the drive rod from trocar 220 rotates within the casing 110. The protrusion 223 and slot 508, however, allow the holder 500 to transform longitudinally within the casing 110 as will be described in greater detail below.
[0066] Figures 10A to 10E show the components described above in various stages of operation. In particular, in Figure 10A, the trocar drive rod 220 is in a more distal position, so that trocar 330 is in a more distal position. At this stage, the operator can couple anvil 400 with trocar 330 by inserting trocar 330 into hole 422 until locking members 430 are attached to the head 334 of trocar 330. The operator then turns knob 130, which turns nut 132 As button 130 and nut
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132 rotate, the engagement between the thick helical thread 224 of the trocar drive rod 220 and the complementary feature of nut 132 causes the trocar drive rod 220 to retract proximally at a relatively rapid rate, so that the trocar trocar 220 reaches the position shown in Figure 10B. This causes the proximal retraction of the trocar trigger rod 220 to provide retraction of the trocar 330 and anvil 400. As the trocar trigger rod 220 moves from the position shown in Figure 10A to the position shown in Figure 10B, support 500 remains stationary. This is due to the fact that the clip 222 is removed from the vertical feature 510 at the stage shown in Figure 10A and does not engage the vertical feature 510 until the trocar drive rod 220 reaches the position shown in Figure 10B.
[0067] After reaching the stage shown in Figure 10B, the operator can continue turning the knob 130 and nut 132, which causes additional proximal retraction of the trocar stem 220 as shown in Figure 10C. This, of course, causes additional proximal retraction of the trocar 330 and anvil 400. As the trocar driver 220 moves from the position shown in Figure 10B to the position shown in Figure 10C, clamp 222 rests against the support 500, activating support 500 proximally. This proximal movement of the support 500 causes the indicator member 520 to rotate from the position shown in Figure 10B to the position shown in Figure 10C due to the positioning of the pin 528 in the slot 514 of the flange 516.
[0068] As the indicator member 520 rotates from the position shown in Figure 10B to the position shown in Figure 10C, the operator can observe the position of the indicator needle 526 using the user feedback feedback 114 of the handle set 110. In particular , and as seen best in Figure 11, the data feedback feature
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23/49 user 114 of the present example includes a graphic indicator 550, which includes fixed linear symbols 552, 554, 556, graphic representations 560, 562 of staples, and a check mark graphic 564. The user feedback feature 114 defines still a window 570 through which indicator needle 526 can be seen. In some variations, the user feedback feature 114 also includes a field 566 that can indicate the size of staples in the staple head assembly 300, the span size defined between the anvil 400 and the staple head assembly 300, and / or other information.
[0069] As the operator turns the knob 130 to adjust the longitudinal position of the anvil 400 in relation to the staple head assembly 300, the operator can observe the position of the indicator needle 526 through the window 570. Initially, the indicator needle 526 can be positioned at or near the distal end of window 570. As anvil 400 continues to move proximally, indicator needle 526 will eventually move proximally to window 570. The operator can see the position of indicator needle 526 in relation to the fixed linear symbols 552, 554, 556. The most distal and most proximal symbols 552, 556 can represent the contours of a green zone, which is the acceptable distance range between the anvil 400 and the stapling head set 300 for the successful actuation of the stapling head assembly 300. Thus, if the indicator needle 526 is distal to the most distal symbols 552, the distance between the anvil 400 and the assembly stapling head 300 is too large; and if the indicator needle 526 is proximal to the most proximal symbols 556, the distance between the anvil 400 and the stapling head assembly 300 is very small. Symbols 554 are longitudinally positioned between symbols 552, 556. The graphical representation 560 represents
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24/49 a staple formed relatively high (for example, suitable for use on relatively thick fabric); while the graphical representation 562 represents a relatively short formed clamp (for example, suitable for use on relatively thin fabric). Graphical representations 560, 562 can thus facilitate the operator's decision, based on fabric observations or otherwise, on the possibility and how to achieve a desired formed clamp height by selecting an appropriate corresponding spatial relationship between the needle indicator 526 and the symbols 552, 554, 556.
[0070] In the present example, window 570 is illuminated through a light-emitting diode (LED) (not shown), which makes it easier to see indicator needle 526 in window 570. Also, the check mark graphic 564 is illuminated through another LED (not shown) when stapling head assembly 300 completes a stapling and cutting cycle. Thus, the operator can also depend on the illumination of the check mark graph 564 to verify that it is safe to advance the anvil 400 in the direction distally opposite to anastomosis 70 and remove the instrument 10 from the patient. For example only, the LED associated with window 570 can be configured to emit visible white light while the LED associated with check mark graphic 564 can be configured to emit visible green light.
[0071] In order to provide fine control of the span distance adjustment (d) at the stage shown in Figure 10C, the trocar drive rod 220 will be in a longitudinal position in which the thin helical thread 226 is coupled with a characteristic complementary to button 130 and thick helical thread 224 is disengaged from the complementary feature of nut 132. In some versions, thick helical thread 224 disengages nut 132 and fine helical thread 226 begins to engage button 130 once the trocar actuation 220 reaches the longitudinal position shown in Figure 10B (ie
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25/49 when the clip 222 first engages the vertical member 510). In some other versions, the coupling transition from the thick helical thread 224 to the thin helical thread 226 sometimes occurs between the stage shown in Figure 10B and the stage shown in Figure 10C. Other suitable stages in which the transition from coarse to fine may occur will be evident to those skilled in the art in view of the teachings presented here. It should also be understood that some alternative versions of the trocar driver 220 may have only a single thread section, with the thread pitch being consistent along the thread length. In other words, the trocar drive rod 220 does not necessarily have to have the two different thread sections 224, 226 with different steps.
[0072] At the stage shown in Figure 10C, the slot 506 is aligned with the upper end 146 to thereby provide clearance for the upward movement of the first vertical member 144. Likewise, the slot 504 is aligned with the upper end 156 to thus provide clearance for the upward movement of the second vertical member 154. In the present example, the slots 504, 506 are dimensioned and positioned in such a way that the slots 504, 506 only provide a clearance for the upward movement of the vertical members 144, 154 when the span distance (d) is within a clinically acceptable range. As an example only, a clinically acceptable range for span distance (d) may be between approximately 0.110 inch and approximately 0.040 inch. As another illustrative example, a clinically acceptable range for span distance (d) may be between approximately 0.110 inch and approximately 0.020 inch. Even when slots 504, 506 are positioned to provide clearance for the upward movement of the vertical members 144, 154 as shown in Figure 10C, the safety trigger 140 will still block the pivoting motion of the trigger
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26/49 of firing 150 on a pin 152 (Figure 7) when the safety trigger 140 is in the non-triggered position shown in Figure 10C. Thus, in order to allow the trigger trigger 150 to move, the operator will first have to pull the safety trigger 140 on a pin 142 (Figure 7) from the position shown in Figure 10C to the position shown in Figure 10D.
[0073] As shown in Figure 10D, the upper end 146 passes through slot 506, as the safety trigger 140 is rotated from the position shown in Figure 10C to the position shown in Figure 10D. It should be understood that this upper extremity movement 146 would not be possible in the stages shown in Figures 10A to 7B (when the span distance (d) is very large) because the body 502 would physically block the upward movement of the vertical member 144 thus physically blocking the pivoting movement of the safety trigger 140. In the present example, a cap (not shown) incorporated in the button 130 prevents the button 130 from turning to a point where the anvil 400 would be retracted very proximally that the span distance (d) is very small). In some other variations, even if the button 130 allowed the anvil 400 to be retracted very proximally (so that the span distance (d) is very small), the body 502 would physically block the upward movement of the vertical member 144, thus physically blocking the pivoting movement of the safety trigger 140, in the event that the operator retracts the trocar 330 and the anvil 400 very proximally (so that the span distance (d) is very small). Regardless of whether the body 502, the button 130, or some other characteristic prevents activation, when the gap distance (d) is very small, it must be understood that instrument 10 allows the triggering of the safety trigger 140 only when the distance of span (d) is within the clinically acceptable range.
[0074] As noted above, safety trigger 140 is
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27/49 configured to prevent triggering of trigger 150 until safety trigger 140 has been triggered. When the safety trigger 140 is triggered, the operator can trigger the trigger trigger 150 from the position shown in Figure 10D to the position shown in Figure 10E. As shown in Figure 10E, the upper end 156 passes through slot 504, as the trigger trigger 150 is rotated from the position shown in Figure 10D to the position shown in Figure 10E. It should be understood that, even in the complete absence of the safety trigger 140, this movement of the upper end 156 would not be possible in the stages shown in Figures 10A to 7B (when the span distance (d) is very large because the body 502 would physically blocking the upward movement of the vertical member 154, thereby physically blocking the pivoting motion of the trigger trigger 150. It should also be understood that the body 502 can also physically block the upward movement of the vertical member 154, thereby physically blocking , the articulated movement of the trigger trigger 150, in the event that the operator retracts the trocar 330 and the anvil 400 very proximally (so that the span distance (d) is very small), so even in the complete absence of safety trigger 140, trigger trigger 150 can only be activated when the span distance (d) is within the clinically acceptable range.
[0075] The trigger trigger 150 of the present example includes an integral trigger blade 158. The blade 158 rotates forward as the trigger trigger 150 rotates from the position shown in Figure 10D to the position shown in Figure 10E . Paddle 158 is configured to drive a key for a motor drive module 180, which is shown in Figure 7, when the trigger trigger 150 rotates from the position shown in Figure 10D to the position shown in Figure 10E. The motor drive module 180 is in communication
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28/49 with battery 120 and motor 160, so that motor drive module 180 is configured to provide motor drive 160 with electrical power from battery 120 in response to blade 158 that drives the drive module switch motor 180. In this way, motor 160 will be triggered when trigger trigger 150 is rotated from the position shown in Figure 10D to the position shown in Figure 10E. This drive of the motor 160 will act the stapling head assembly 300, as described in more detail below.
C · Exemplary anastomosis procedure with circular stapling instrument
[0076] Figures 12A to 12E show the instrument 10 being used to form an anastomosis 70 between two anatomical tubular structures 20, 40. Just as an example, the anatomical tubular structures 20, 40 can comprise sections of a patient's esophagus, sections of a patient's colon, other sections of the patient's digestive tract, or any other anatomical tubular structures. In some versions, one or more diseased portions of a patient's colon are removed, with the anatomical tubular structures 20, 40 of Figures 12A to 12E representing the remaining separate portions of the colon.
[0077] As shown in Figure 12A, the anvil 400 is positioned on a anatomical tubular structure 20 and the clamping head assembly 300 is positioned on another anatomical tubular structure 40. In versions where the anatomical tubular structures 20, 40 comprise the colon sections of a patient, the stapling head assembly 300 can be inserted through the patient's rectum. It should also be understood that the procedure depicted in Figures 12A to 12E is an open surgical procedure, although the procedure can instead be performed
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29/49 by laparoscopy. Just as an example, such a surgical procedure can be provided in accordance with at least some of the teachings of US publication No. 2016/0100837, entitled Staple Cartridge, published on April 14, 2016, the description of which is incorporated herein by reference ; and / or US publication No. 2017/0086848, entitled Apparatus and Method for Reprocessing a Medical Device, published on March 30, 2017, the description of which is incorporated herein by reference. The various suitable ways in which the instrument 10 can be used to form an anastomosis 70 in a laparoscopic procedure will be evident to those skilled in the art in view of the teachings presented here.
[0078] As shown in Figure 12A, the anvil 400 is positioned on the anatomical tubular structure 20 so that the stem 420 projects from the open cut end 22 of the anatomical tubular structure 20. A pouch suture 30 is provided over a region medium of the stem 420 to generally hold the anvil position 400 in the anatomical tubular structure 20. Likewise, the stapling head assembly 300 is positioned in the anatomical tubular structure 40 so that the trocar 330 protrudes from the open cut end 42 of the anatomical tubular structure 20. A pouch suture 50 is provided over a middle region of the drive shaft 332 to generally secure the position of the stapling head assembly 300 to the anatomical tubular structure 40.
[0079] Then, the anvil 400 is attached to the trocar 330 by inserting the trocar 330 into a hole 422, as shown in Figure 12B. The locking members 430 engage the head 334 of the trocar 330, thereby providing a secure fit between the anvil 400 and the trocar 330. The operator then turns the knob 130 while holding the handle assembly 100 stationary via the pistol grip 112. This rotation of knob 130 causes the
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30/49 trocar 330 and anvil 400 retract proximally, as described above. As shown in Figure 12C, this proximal retraction of the trocar 330 and the anvil 400 compresses the tissue of the anatomical tubular structures 20, 40 between the surfaces 412, 322 of the anvil 400 and the staple head assembly 300. The operator observes the feedback to user 114 to determine whether the gap distance (d) between the opposing surfaces 412, 322 of the anvil 400 and the stapling head assembly 300 is adequate; and make any necessary adjustments using button 130.
[0080] Once the operator has properly adjusted the span distance (d) using button 130, the operator pulls the safety trigger 140 to allow the trigger trigger 150 to be triggered. The operator then pulls the trigger trigger 150. This actuation of the trigger trigger 150 in turn activates a motor activation module switch 180, which, in turn, activates motor 160 to actuate the clamping head assembly 300 by activating the knife 340 and staple trigger member 350 distally as shown in Figure 12D. As knife member 340 travels distally, the cutting edge 342 of knife member 340 cooperates with the inner edge 416 of anvil 400, thus shearing excess tissue that is positioned within the annular recess 418 of anvil 400 and inside knife member 340.
[0081] As shown in Figure 3, the anvil 400 of the present example includes a breakable washer 417 within the annular cavity 418. This washer 417 is broken by knife member 340 when knife member 340 completes a full range of distal movement from the position shown in Figure 12C to the position shown in Figure 12D. The drive mechanism for knife member 340 can provide an increase in mechanical advantage when knife member 340 reaches the end of its distal movement, providing,
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31/49 thus, a greater force through which the washer breaks 417. Of course, the breakable washer 417 can be omitted entirely in some versions. In versions where washer 417 is included, washer 417 can also serve as a cutting edge for knife member 340 to assist in cutting the fabric. This cutting technique can be used in addition to, or in place of, the aforementioned shearing action between the inner edge 416 and the cut edge 342.
[0082] As the staple trigger member 350 moves distally from the position shown in Figure 12C to the position shown in Figure 12D, the staple trigger member 350 drives the staples 90 through the tissue of tubular anatomical structures 20, 40 and into the staple forming pockets 414 of the anvil 400. The staple forming pockets 414 deform the driven staples 90 in the form of B, as is known in the art. The clips formed 90 in this way hold the ends of the tissue together, thus coupling the tubular anatomical structure 20 with the tubular anatomical structure 40.
[0083] After the operator activates the staple head assembly 300, as shown in Figure 12D, the operator turns the knob 130 to actuate the anvil 400 distally away from the staple head assembly 300, increasing the gap distance d to facilitate the release of tissue between surfaces 412, 322. The operator then removes the instrument 10 from the patient, with the anvil 400 still attached to the trocar 330. Referring again to the example in which the tubular anatomical structures 20, 40 comprise sections of a patient's colon, the instrument 10 can be removed through the patient's rectum. With the instrument 10 removed, the anatomical tubular structures 20, 40 are left attached together by two annular arrays of clamps 90 to an anastomosis 70, as shown in Figure 12E. The internal diameter of the anastomosis
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32/49 is defined by the cut edge 60 on the left by knife member 340. Il · Anvil position and alternative trocar indicative features
[0084] As indicated above, the indicating member 520 and the user feedback feature 114 cooperate to provide the operator with visual feedback information indicating the longitudinal position of the anvil 400 with respect to the staple head assembly 300. Those of ordinary skill in the art will recognize that accuracy and that positioning can be crucial for the successful formation of an anastomosis 70. Thus, the real-time accuracy of the feedback provided by the indicator member 520 and the user feedback feature 114 can be crucial for successful training. success of an anastomosis 70.
[0085] Some versions of support 500 and indicator member 520 may provide some degree of hysteresis, so that there is a slight gap between the adjustment of the longitudinal position of the anvil 400 in relation to the staple head assembly 300 and the position of the indicator member 520 in the user feedback feature 114. This hysteresis may be attributable to manufacturing tolerances and / or other factors. This hysteresis can compromise the real-time accuracy of the feedback provided by indicator member 520 and user feedback feedback 114, which can, in turn, compromise the success of anastomosis 70. Therefore, it may be desirable to configure support 500, the indicator member 520 and the associated resources to eliminate or at least minimize such hysteresis, to thereby promote greater real-time accuracy of the feedback provided by indicator member 520 and user feedback feedback 114, in turn to promote from that thus a greater chance of success in the formation of an anastomosis 70.
[0086] Figures 13 to 19D show alternative exemplifying resources that can be incorporated into instrument 10 to promote
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33/49 greater accuracy in real time of visual feedback that indicates the longitudinal position of the trocar 330 and anvil 400 in relation to the stapling head assembly. In particular, Figures 13 to 14 show an exemplary alternative indicator member 600 that can be used in place of indicator member 520; although Figure 15 shows an alternative exemplary holder 650 that can be used in place of holder 500.
[0087] As shown in Figures 13 to 14, the indicating member 600 of this example comprises a vertical arm 604, a pressure pin 602 that projects laterally from a lower end of arm 604, an indicator needle 606 that projects laterally from an upper end of the arm 604 and a coupling pin 608 that protrudes laterally from an intermediate region of the arm 604. The pressure pin 602 is configured to snap into a complementary recess provided by a 690 chassis , as described below. Indicator needle 606 is positioned so as to be visible on user feedback feature 114 of handle set 110, as described above in relation to indicator needle 526, to thereby visually indicate the pivoting position of indicator member 600, which it will indicate the longitudinal position of the anvil 400 in relation to the stapling head assembly 300. Coupling pin 608 is configured to fit into an opening 672 of a flange 670 of the holder 650, as described below. Also as described below, this engagement between the indicator member 600, the chassis 690 and the support 650 provides pivoting movement of the indicator member 600 in response to the translation of the support 650. Unlike the indicator member 520 described above, the indicator member 600 of the present example comprises a resilient arm 610, which projects upwards and is resiliently forced to define an oblique angle with respect to the vertical arm 604.
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As described in more detail below, resilient arm 610 is configured to interact with chassis 690 to provide resilient angular tilt to indicator member 600.
[0088] As shown in Figure 15, the support 650 of this example comprises a rigid body 656 that defines a first slot 660 (which is analogous to the first slot 504, described above) and a second slot 658 (which is analogous to the second slot 506 , described above). A vertical feature 652 (which is analogous to vertical feature 510, described above) is positioned at the proximal end of body 656 and defines an opening 654 (which is analogous to opening 512, described above). Opening 654 is sized to receive the trocar actuation rod 220; and the vertical feature 652 is configured to engage the spiral spring 170, as well as the analogous features of the support 500 described above. The support 650 further includes a flange 670, which defines an opening 672. The opening 672 extends between a distal edge 674 and a proximal edge 676.
[0089] As shown in Figure 16, and as indicated above, pin 608 is configured to fit opening 672 of flange 670. The width of opening 672 is greater than the width of pin 608, so that pin 608 cannot contact both edges 674, 676 simultaneously. This structural relationship between the width of the opening 672 and the width of the pin 608 provides some degree of loss of movement between the support 650 and the indicating member 600, as described below with reference to Figures 19A to 19D.
[0090] Figure 17 shows an exemplary chassis 690 that can be incorporated into the handle assembly 110. The chassis 690 is configured to provide mechanical support in relation to the moving components of the handle assembly 110. The chassis 690 of this example comprises a crest distally shown 692 which is positioned to engage with resilient arm 610 of indicator member 600.
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As shown in Figure 17, pressure pin 602 is configured to be inserted in chassis 690. Pressure snap pin 602 thus secures indicator member 600 to chassis 690 and still allows indicator member 600 to rotate relative to the chassis 690 around the longitudinal axis of the push pin 602.
[0091] Figures 18A to 18D show various angular positions of the indicator member 600 in relation to the chassis 690 as the trocar 330 and the anvil 400 are retracted proximally in relation to the staple head assembly 300. In particular, Figure 18A shows the indicator member 600 in a first angular orientation. This first angular orientation would be associated with the fact that the trocar 330 and the anvil 400 are in a more distal position in relation to the staple head assembly 300. For example, this orientation may be associated with the operational states represented in Figures 10A and 12B . With the indicator member 600 in this first angular orientation, the resilient arm 610 is not in contact with the crest 692 of the chassis 690, so that a gap is defined between the resilient arm 610 and the crest 692.
[0092] As the operator turns the knob 130 to retract the trocar 330 and the anvil 400 proximally in relation to the stapling head assembly 300, the support 650 eventually pulls the pin 608 proximally, in this way, the indicator member is made 600 rotate clockwise (in the view shown in Figures 18A to 18D) with respect to chassis 690. During this clockwise pivoting movement, the resilient arm 610 eventually comes into contact with the crest 692 of chassis 690, as shown in Figure 18B . During the stages shown in Figures 18A and 18B, the resilient arm 610 is in an unstressed state. However, as the operator continues to turn knob 130 to retract trocar 330 and anvil 400 more proximally to stapling head assembly 300, holder 650 continues to
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36/49 pulling pin 608 proximally, in this way, the indicator member 600 is rotated clockwise in relation to the chassis 690. This results in deformation of the resilient arm 610, as shown in Figure 18C. In the present example, the resilient arm 610 comes into contact with the ridge 692 and begins to deform before the anvil 400 reaches the green zone mentioned above.
[0093] With the resilient arm 610 deformed, as shown in Figure 18C, the resilient arm 610 is in a stressed state, so that the indicator member 600 is tilted resiliently in the counterclockwise direction (in the view shown in Figures 18A to 18D). Despite the stressed state of the resilient arm 610, the operator can continue to turn the knob 130 to retract the trocar 330 and the anvil 400 more proximally to the staple head assembly 300, thereby making the indicator member 600 rotate more clockwise in relation to the 690 chassis, eventually reaching the state shown in Figure 18D. At this stage, the resilient arm 610 can engage the vertical arm 604, so that the resilient arm 610 cannot deform further. In some versions, support 650 may not be allowed to travel proximally far enough for resilient arm 610 to rest against vertical arm 604. When the operator reverses the rotation of knob 130 to thereby advance anvil 400 distally while the resilient arm 610 is in a stressed state, the resilient arm 610 will trigger the indicator member 600 to rotate counterclockwise.
[0094] As indicated above, the structural relationship between the width of the opening 672 and the width of the pin 608 provides some degree of loss of movement between the support 650 and the indicator member 600. This loss of movement is shown in Figures 19A to 19B . Figure 19A shows support 650 in a more distal position. This operational state corresponds to the operational state shown in Figure
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18A. At this stage, the proximal edge 676 of opening 672 is engaged with pin 608; and the pin 608 is separated from the distal edge 674 of the opening 672.
[0095] As support 650 moves proximally with trocar 330 and anvil 400, support 650 eventually reaches the longitudinal position shown in Figure 19B. At this stage, the distal edge 674 of the opening 672 is engaged with the pin 608; and the pin 608 is separated from the proximal edge 676 of the opening 672. However, during the transition from the stage shown in Figure 19A to the stage shown in Figure 19B, the indicating member 600 has not been rotated. Indicator member 600 thus remained stationary while support 650 moved from the position shown in Figure 19A to the position shown in Figure 19B. In the context of the stages shown in Figures 18A to 18D, the indicator member 600 would remain in the position shown in Figure 18A during the stage shown in Figure 19A and the stage shown in Figure 19B. In the present example, opening 672 is sized and configured so that pin 608 will not engage distal edge 674 of opening 670, as shown in Figure 19B, until anvil 400 has reached a distance associated with the green zone, as described above . In addition, resilient arm 610 will not contact edge 692 until after anvil 400 has reached a distance associated with the green zone, as described above. Thus, the indicator needle 606 will not be positioned proximal to the most distal symbols 552 in the user feedback feature 114 until after the indicator member 600 has reached the position shown in Figure 18B, which will not happen until after the support 650 has reached the position shown in Figure 19B.
[0096] As support 650 continues to move proximally with trocar 330 and anvil 400, support 650 eventually reaches the longitudinal position shown in Figure 19C. During the range of motion between the stage shown in Figure 19B and the stage shown in
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Figure 19C, at this stage, the distal edge 674 of the flange 670 rests against the pin 608 to drive the pin 608 proximally, thus, the indicating member 600 in the position shown in Figure 19C. Although chassis 690 is omitted from Figures 19A to 19D, those of ordinary skill in the art will recognize that the resilient arm 610 will be deformed (and thus stressed) due to the engagement between the resilient arm 610 and the edge 692 during the transition from the stage shown in Figure 19B and the stage shown in Figure 19C. Those of ordinary skill in the art will also recognize that the relationship between support 650 and indicator member 600 shown in Figure 19C will be provided along the range of motion associated with the transition between the stages shown in Figures 18Ba18D.
[0097] As indicated above, after anastomosis 70 has been formed, or while the operator adjusts the gap distance (d) between the anvil 400 and the stapling head assembly 300, the operator can activate the trocar 330 and the anvil 400 distally. When this occurs, support 650 will also move distally. This will result in the movement shown in Figure 19D. Since the support 650 is already in a proximal position (for example, the position shown in Figure 19C) before such a distal movement is initiated, the resilient arm 610 is in a stressed state, thereby pushing the indicator member 600 to rotate distally. Due to this resilient inclination, the pin 608 remains engaged with the distal edge 674 of the opening 670 as the support 650 moves distally. As the operator continues to turn the knob 130 to activate the trocar 330 and the anvil 400 distally, the distal translation support 650 allows the resilient arm 610 to drive the indicator member 600 back in the direction of the pivoting position shown in Figures 19A to 19B . After the indicator member 600 reaches the pivoting position shown in Figures 19A to 19B, the distal edge 674 disengages pin 608 and support 650 can
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39/49 continue to move distally through a certain range of motion before reaching the longitudinal position shown in Figure 19A. [0098] In the present example, the movement lost between the support 650 and the indicator 600 between the stage shown in Figure 19A and the stage shown in Figure 19B, and the movement lost between the resilient arm 610 and the edge 692 between the stage shown in Figure 18A and the stage shown in Figure 18B, remove hysteresis from the movement of the indicator arm 600 as the trocar 330 and the anvil 400 are retracted proximally towards the staple head assembly 300. Similarly, the movement lost between the holder 650 and indicator 600 between the stage shown in Figure 19B and the stage shown in Figure 19A, and the motion lost between the resilient arm 610 and the edge 692 between the stage shown in Figure 18B and the stage shown in Figure 18A, remove hysteresis the movement of the indicator arm 600 according to the trocar 330 and the anvil 400 are advanced distally in the opposite direction to the staple head assembly 300. During advance and retraction, this movement per will occur when the anvil 400 is outside the green zone mentioned above. Thus, the lost movement will reduce the likelihood that the operator will be misled into thinking that the anvil 400 is in the green zone due to hysteresis that may otherwise keep the indicator needle 606 between symbols 552, 556 when the anvil 400 is, in fact, outside the green zone.
Ill · Exemplary combinations
[0099] The following examples refer to various non-exhaustive ways in which the teachings of the present invention can be combined or applied. 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.
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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, unless the contrary is explicitly indicated 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 features in addition to those mentioned below, it should not be assumed that these additional features have been added for any reason related to patentability.
Example 1
[0100] Apparatus, characterized by comprising: (a) a body; (b) a drive shaft assembly that extends distally from the body assembly, wherein the drive shaft assembly has a distal end; (c) an end actuator located at the distal end of the drive shaft assembly, wherein the end actuator comprises: (i) a stationary component, wherein the stationary component is fixedly attached to the drive shaft assembly and it is thus configured to remain stationary with respect to the drive shaft assembly, and (ii) a movable component, wherein the mobile component is configured to move with respect to the stationary component; and (d) an indicator assembly, in which the indicator assembly comprises: (i) a translation member, in which the translation member is configured to translate in relation to the body in response to the movement of the moving component in relation to the stationary component, and (ii) an indicator member, in which the indicator member is configured to move through a continuous sequence of movement from a first position in
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41/49 towards a second position, in which the indicating member comprises an integral resilient feature, in which the translation member is configured to drive the indicating member towards the second position in response to the movement of the moving component in relation to the stationary component in a first direction, where the resilient feature is configured to resiliently propel the indicator member towards the first position in response to the movement of the moving component relative to the stationary component in a second direction.
Example 2
[0101] Apparatus, according to example 1, in which the stationary component comprises a stapling platform, in which the mobile component comprises an anvil, in which the end actuator is intended to drive clamps through the platform and towards the anvil.
Example 3
[0102] Apparatus, according to example 2, in which the mobile component also comprises a trocar, in which the anvil is coupled to the anvil.
Example 4
[0103] Apparatus, according to any one or more of examples 2 to 3, in which the stapling platform is annular, in which the end actuator is intended to drive at least one annular matrix of staples through the platform and in the direction to the anvil. Example 5
[0104] Apparatus, according to any one or more of examples 1 to 4, in which the mobile component is configured to move in relation to the stationary compartment.
Example 6
[0105] Apparatus, according to example 5, in which the actuator of
Petition 870190127319, of 12/03/2019, p. 71/90
42/49 end defines a longitudinal geometric axis, in which the movable component is configured to move linearly along the longitudinal geometric axis.
Example 7
[0106] Apparatus, according to any one or more of Examples 1 to 6, wherein the translation member comprises a plate.
Example 8
[0107] Apparatus, according to example 7, in which the plate defines an opening, in which the indicating member comprises a projection arranged in the opening, in which the plate is intended to drive the indicating member through the projection.
Example 9
[0108] Apparatus, according to example 8, in which the projection has a width, in which the opening has a width, in which the width of the opening is greater than the width of the projection, in which the plate is movable through a first range of motion when the plate does not drive the indicator member through the projection, wherein the plate is movable through a second range of motion when the plate drives the indicator member through the projection.
Example 10
[0109] Apparatus, according to any one or more of examples 1 to 9, in which the indicator member is configured to pivot from the first position towards the second position.
Example 11
[0110] Apparatus, according to any one or more of examples 1 to 10, in which the integral resilient feature comprises a resilient arm.
Example 12
[0111] Apparatus, according to example 11, in which the resilient arm is configured to contact a portion of the
Petition 870190127319, of 12/03/2019, p. 72/90
43/49 body and, thus, resiliently supports itself against the body.
Example 13
[0112] Apparatus, according to example 12, in which the index member is configured to move from a first range of motion when the resilient arm does not come into contact with the body portion, in which the index member is still configured to move through a second range of motion when the resilient arm comes into contact with the body portion.
Example 14
[0113] Apparatus, according to any one or more of examples 1 to 13, in which the indicator member comprises an indicator needle, in which the body comprises a user feedback feature, in which the indicator needle is configured to move in relation to the user's feedback feature, thus visually indicating the movement of the moving member in response to the indicating member being triggered to move by one or both of the translation member or the resilient resource.
Example 15
[0114] Apparatus, according to example 14, in which the user feedback feature also includes symbols that indicate a predetermined range of distance between the mobile component and the stationary component, in which the indicator needle is configured to move in with respect to the symbols, thus visually indicating the positioning of the mobile component within the predetermined range of distance in relation to the stationary component.
Example 16
[0115] Apparatus comprising: (a) a body; (b) a drive shaft assembly that extends distally from the body assembly, wherein the drive shaft assembly has a distal end; (c) an end actuator located at the distal end of the
Petition 870190127319, of 12/03/2019, p. 73/90
44/49 drive shaft assembly, wherein the end actuator comprises: (i) a circular staple head assembly, wherein the circular staple head assembly is configured to remain stationary with respect to the drive shaft assembly , (ii) a trocar, in which the trocar is configured to move in relation to the circular stapling head assembly, and (iii) an anvil, in which the anvil is configured to couple with the trocar, in which the set of circular stapling head is configured to drive at least one annular array of staples towards the anvil; and (d) an indicator assembly, in which the indicator assembly comprises: (i) a plate, in which the plate is configured to move in relation to the body in response to the movement of the trocar and the anvil in relation to the stapling head assembly circular, and (ii) an index member, where the index member is configured to move relative to the body from a first position towards a second position, where the index member comprises an integral resilient feature configured to tilt the member indicator towards the first position, where the plate is configured to drive the indicator member towards the second position in response to the movement of the trocar and the anvil in relation to the circular stapling head assembly in a first direction, in which the feature resilient is configured to drive the index member towards the first position in response to the movement of the trocar and anvil in relation to the circular stapling head assembly in a second direction.
Example 17
[0116] Apparatus, according to example 16, in which the plate defines an opening, in which the indicating member comprises a projection arranged in the opening, in which the plate is intended to drive the indicating member through the projection, in which the projection has a
Petition 870190127319, of 12/03/2019, p. 74/90
45/49 width, where the opening has a width, where the width of the opening is greater than the width of the projection, where the plate is movable through a first range of motion when the plate does not drive the indicating member through the projection, in which the plate is movable through a second range of motion when the plate drives the indicating member through the projection.
Example 18
[0117] Apparatus, according to any one or more of examples 16 to 17, in which the resilient arm is configured to contact a portion of the body and, thus, resiliently support the body, in which the indicator member is configured to move from a first range of motion when the resilient arm does not come into contact with the body portion, where the index member is further configured to move through a second range of motion when the resilient arm comes into contact with the body portion. Example 19
[0118] Method for operating a stapler, in which the method comprises: (a) inserting a stapler end actuator in a patient, in which the end actuator comprises a circular stapling head assembly and a trocar; (b) attach an anvil to the trocar; (c) retract the trocar and the anvil proximally through a first linear movement band, in which a staple indicating member remains stationary as the trocar and the anvil and retract through the first linear movement band; (d) retract the trocar and the anvil proximally through a second range of linear movement, in which the index member rotates through a first range of angular movement such as the trocar and the anvil and retracts through the second range of angular movement.
Example 20
Petition 870190127319, of 12/03/2019, p. 75/90
46/49
[0119] Method, according to example 19, in which the integral resilient feature of the index member is disengaged from a corresponding feature of a stapler body such as the trocar and anvil and retracts through the first range of linear movement, in which the integral resilient feature remains disengaged from the corresponding feature of the body as the index member rotates through the first range of angular movement, in which the method is further comprises retracting the trocar and the anvil proximally through a third range of linear movement, in which the index member rotates through a second range of angular movement as the trocar and anvil and retract through the third range of angular movement, where the integral resilient feature engages the corresponding body feature as the index member rotates through the third range of motion thus, a resilient inclination is transmitted to the index member.
IV · Miscellaneous
[0120] It must also be understood that any one or more of the teachings, expressions, modalities, examples, etc. described here can be combined with any one or more of the other teachings, expressions, modalities, examples, etc. that are described here. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen as isolated from each other. Various suitable ways in which the teachings of the present invention can be combined will become readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included in the scope of the appended claims.
[0121] At least some of the teachings of the present invention can readily be combined with one or more of the teachings of US Patent No. 7,794,475, entitled Surgical Staples Having Compressible or Crushable Members for Securing Tissue Therein and
Petition 870190127319, of 12/03/2019, p. 76/90
47/49
Stapling Instruments for Deploying the Same, granted on September 14, 2010, the description of which is incorporated by reference in the present invention; US publication No. 2014/0151429, entitled TransOral Circular Anvil Introduction System with Dilation Feature, published on June 5, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0144968, entitled Surgical Staple with Integral Pledget for Tip Deflection, published on May 29, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0158747, entitled Surgical Stapler with Varying Staple Widths along Different Circumferences, published on June 12, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0144969, entitled Pivoting Anvil for Surgical Circular Stapler, published on May 29, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0151430, entitled Circular Anvil Introduction System with Alignment Feature, published on June 5, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0166717, entitled Circular Stapler with Selectable Motorized And Manual Control, Including a Control Ring, published on June 19, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0166728, entitled Motor Driven Rotary Input Circular Stapler with Modular End Effector, published on June 19, 2014, the description of which is incorporated herein by reference; and / or US publication No. 2014/0166718, entitled Motor Driven Rotary Input Circular Stapler with Modular Flexible Shaft, published on June 19, 2014, the description of which is incorporated herein by reference. Various suitable ways in which such teachings can be combined will be evident to those skilled in the art.
[0122] It should be understood that any patent, publication or other description material that, in whole or in part, is said to be incorporated by reference, is incorporated herein
Petition 870190127319, of 12/03/2019, p. 77/90
48/49 only to the extent that the incorporated material does not conflict with the definitions, statements or other description materials presented in this description. Accordingly, and as necessary, the description as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, that is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict between the embedded material and the existing description material.
[0123] 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. Just as an example, several teachings of the present invention can readily be incorporated into a robotic surgical system such as the DAVINCI ™ system from Intuitive Surgical, Inc., Sunnyvale, California, USA.
[0124] The versions described above can be designed to be discarded after a single use or can be designed to be used multiple times. The versions can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing specific parts and subsequent reassembly. In particular, some versions of the device can be disassembled and any number of parts or parts of the device can be selectively replaced or removed in any combination. By cleaning and / or changing specific parts, some versions of the device can be reassembled for subsequent use, in a reconditioning facility
Petition 870190127319, of 12/03/2019, p. 78/90
49/49 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.
[0125] 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.
[0126] 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 means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will become evident to those skilled in the art. For example, the examples, modalities, geometries, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention should be considered in accordance with the following claims, and it should be 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 shaft assembly that extends distally from the body, wherein the drive shaft assembly has a distal end;
(c) an end actuator located at the distal end of the drive shaft assembly, wherein the end actuator comprises:
(i) a stationary component, in which the stationary component is fixedly fixed in relation to the drive shaft assembly and is thus configured to remain stationary in relation to the drive shaft assembly, and (ii) a movable component, in that the moving component is configured to move relative to the stationary component; and (d) an indicator set, in which the indicator set comprises:
(i) a translation member, in which the translation member is configured to translate in relation to the body in response to the movement of the moving component in relation to the stationary component, and (ii) an indicating member, in which the indicating member is configured to move through a continuous sequence of movement from a first position towards a second position, in which the indicating member comprises an integral resilient feature, in which the translation member is configured to drive the indicating member towards the second position in response to the movement of the moving component relative to the stationary component in a first direction, where the resilient feature is configured to resiliently propel the indicator member towards the first position in
Petition 870190127319, of 12/03/2019, p. 80/90
[2]
2/6 response to the movement of the moving component in relation to the stationary component in a second direction.
Apparatus according to claim 1, characterized in that the stationary component comprises a stapling platform, in which the movable component comprises an anvil, in which the end actuator is intended to drive clamps through the platform and towards the anvil .
[3]
Apparatus according to claim 2, characterized in that the mobile component further comprises a trocar, in which the anvil is coupled to the anvil.
[4]
4. Apparatus according to claim 2, characterized in that the stapling platform is annular, in which the end actuator is intended to drive at least one annular matrix of staples through the platform and towards the anvil.
[5]
Apparatus according to claim 1, characterized in that the mobile component is configured to move in relation to the stationary compartment.
[6]
Apparatus according to claim 5, characterized in that the end actuator defines a longitudinal geometric axis, in which the movable component is configured to move linearly along the longitudinal geometric axis.
[7]
Apparatus according to claim 1, characterized in that the translation member comprises a plate.
[8]
Apparatus according to claim 7, characterized in that the plate defines an opening, in which the indicator member comprises a projection arranged in the opening, in which the plate is intended to drive the indicator member through the projection.
[9]
Apparatus according to claim 8, characterized in that the projection has a width, in which the opening has a width, in which the width of the opening is greater than the width of the projection, in
Petition 870190127319, of 12/03/2019, p. 81/90
3/6 that the plate is movable through a first range of motion when the plate does not drive the indicator member through the projection, where the plate is movable through a second range of motion when the plate drives the indicator member through the projection .
[10]
10. Apparatus according to claim 1, characterized in that the indicator member is configured to pivot from the first position towards the second position.
[11]
Apparatus according to claim 1, characterized in that the integral resilient feature comprises a resilient arm.
[12]
Apparatus according to claim 11, characterized in that the resilient arm is configured to contact a portion of the body and thus resiliently rests against the body.
[13]
13. Apparatus according to claim 12, characterized in that the indicator member is configured to move from a first range of motion when the resilient arm does not come into contact with the body portion, where the indicator member is further configured to move through a second range of motion when the resilient arm comes into contact with the body portion.
[14]
14. Apparatus according to claim 1, characterized in that the indicator member comprises an indicator needle, in which the body comprises a user feedback feature, in which the indicator needle is configured to move in relation to the user feedback feedback feature. user to thus visually indicate the movement of the movable member in response to the indicating member being triggered to move by one or both of the translating member or the resilient resource.
[15]
15. Apparatus according to claim 14, characterized in that the user feedback feature also includes symbols that indicate a predetermined range of distance between the component
Petition 870190127319, of 12/03/2019, p. 82/90 mobile and the stationary component, in which the indicator needle is configured to move in relation to the symbols to thus visually indicate the positioning of the mobile component within the predetermined range of distance in relation to the stationary component.
[16]
16. Apparatus, characterized by comprising:
(a) a body;
(b) a drive shaft assembly that extends distally from the body, wherein the drive shaft assembly has a distal end;
(c) an end actuator located at the distal end of the drive shaft assembly, wherein the end actuator comprises:
(i) a circular stapling head assembly, in which the circular stapling head assembly is configured to remain stationary with respect to the drive shaft assembly, (ii) a trocar, in which the trocar is configured to move in in relation to the circular stapling head assembly, and (iii) an anvil, in which the anvil is configured to couple with the trocar, in which the circular stapling head assembly is configured to drive at least one annular array of staples in direction the anvil; and (d) an indicator set, in which the indicator set comprises:
(i) a plate, in which the plate is configured to move in relation to the body in response to the movement of the trocar and the anvil in relation to the circular stapling head assembly, and (ii) an indexing member, in which the indicating member is configured to move relative to the body from a first position to a second position, where the index member comprises a resilient feature
Petition 870190127319, of 12/03/2019, p. 83/90
Integral 5/6 configured to tilt the indicator member towards the first position, where the plate is configured to drive the indicator member towards the second position in response to the trocar and anvil movement in relation to the circular stapling head assembly in a first direction, in which the resilient feature is configured to drive the index member to the first position in response to the movement of the trocar and anvil in relation to the circular stapling head assembly in a second direction.
[17]
Apparatus according to claim 16, characterized in that the plate defines an opening, in which the indicator member comprises a projection arranged in the opening, in which the plate is intended to drive the indicator member through the projection, in which the projection has a width, where the opening has a width, where the width of the opening is greater than the width of the projection, where the plate is movable through a first range of motion when the plate does not drive the indicating member through the projection , in which the plate is movable through a second movement range when the plate activates the indicating member through the projection.
[18]
18. Apparatus according to claim 16, characterized in that the resilient arm is configured to contact a portion of the body and, thus, resiliently support the body, in which the indicator member is configured to move from a first strip of movement when the resilient arm does not come into contact with the body portion, where the index member is further configured to move through a second range of motion when the resilient arm comes into contact with the body portion.
[19]
19. Method for operating a stapler, characterized in that the method comprises:
Petition 870190127319, of 12/03/2019, p. 84/90
6/6 (a) inserting a stapler end actuator in a patient, where the end actuator comprises a circular stapling head assembly and a trocar;
(b) attach an anvil to the trocar;
(c) retract the trocar and the anvil proximally through a first linear movement band, in which a staple indicating member remains stationary as the trocar and the anvil and retract through the first linear movement band; and (d) retract the trocar and the anvil proximally through a second range of linear movement, wherein the index member rotates through a first range of angular movement such as the trocar and the anvil and retracts through the second range of angular movement.
[20]
20. Method according to claim 19, characterized in that the integral resilient feature of the index member is disengaged from a corresponding feature of a stapler body such as the trocar and the anvil and retracts through the first range of linear movement, in which the integral resilient feature remains disengaged from the corresponding body feature as the index member rotates through the first range of angular movement, in which the method is further comprises retracting the trocar and the anvil proximally through a third range of linear movement, in which the member indicator rotates through a second range of angular movement as the trocar and anvil and retracts through the third range of angular movement, where the integral resilient feature engages the corresponding body feature as the index member rotates through the third range of angular movement thus, a resilient inclination is transmitted to the indicator member.

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

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US15/581,546|2017-04-28|

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US15/581,546|US10695068B2|2017-04-28|2017-04-28|Hysteresis removal feature in surgical stapling instrument|

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PCT/US2018/028128|WO2018200282A1|2017-04-28|2018-04-18|Hysteresis removal feature in surgical stapling instrument|

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