U.S. patent application number 14/191100 was filed with the patent office on 2014-06-26 for surgical stapler with reduced clamp gap for insertion.
This patent application is currently assigned to Cardica, Inc.. The applicant listed for this patent is Cardica, Inc.. Invention is credited to Bryan D. Knodel, Philipe R. Manoux.
Application Number | 20140175147 14/191100 |
Document ID | / |
Family ID | 50481714 |
Filed Date | 2014-06-26 |
United States Patent
Application |
20140175147 |
Kind Code |
A1 |
Manoux; Philipe R. ; et
al. |
June 26, 2014 |
SURGICAL STAPLER WITH REDUCED CLAMP GAP FOR INSERTION
Abstract
A surgical apparatus may include a staple holder, an anvil
connected to and movable relative to the staple holder, and at
least one axle extending outward from the anvil; and an overtube
slidable relative to the end effector, the overtube including at
least one slot defined therein; where each slot receives a
corresponding axle. A surgical method for treating tissue of a
patient may include providing an end effector that includes a
staple holder and an anvil connected to and movable relative to the
staple holder, and an overtube slidable relative to said end
effector, making an incision in the patient; inserting the end
effector and at least part of the overtube through the incision in
a first, insertion configuration in which substantially no gap
exists between the anvil and staple holder, and moving the overtube
relative to the end effector to open the end effector to a second,
unclamped position where at least part of the anvil is spaced apart
from the staple holder.
Inventors: |
Manoux; Philipe R.;
(Oakland, CA) ; Knodel; Bryan D.; (Flagstaff,
AZ) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Cardica, Inc. |
Redwood City |
CA |
US |
|
|
Assignee: |
Cardica, Inc.
Redwood City
CA
|
Family ID: |
50481714 |
Appl. No.: |
14/191100 |
Filed: |
February 26, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
12489397 |
Jun 22, 2009 |
8701960 |
|
|
14191100 |
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Current U.S.
Class: |
227/175.1 |
Current CPC
Class: |
A61B 2017/0725 20130101;
A61B 2017/2936 20130101; A61B 17/068 20130101; A61B 17/07207
20130101 |
Class at
Publication: |
227/175.1 |
International
Class: |
A61B 17/068 20060101
A61B017/068 |
Claims
1. A surgical stapling apparatus, comprising: a staple holder; an
anvil pivotally coupled to said staple holder; a bias member
deposed between said staple holder and said anvil, wherein said
bias member allows said staple holder and said anvil to be
pivotally biased open or to be pivotally biased close; and an
overtube slidably engages with at least a portion of said staple
holder and said anvil, wherein: the overtube slidably engages with
said staple holder and said anvil in a first position causing no
gap or substantially no space between the staple holder and the
anvil, the overtube slidably engages with said staple holder and
said anvil in a second position allowing a first gap or a first
space between the staple holder and the anvil, and the overtube
slidably engages with said staple holder and said anvil in a third
position allowing a second gap or a second space between the staple
holder and the anvil.
2. The surgical stapling apparatus of claim 1, wherein the first
gap or the first space is larger than the second gap or the second
space.
3. The surgical stapling apparatus of claim 1, wherein the overtube
include a pair of through-slots and an axle-pin deposed through
said pair of through-slots, the axle-pin engages at least a portion
of the anvil.
4. The surgical stapling apparatus of claim 1, wherein a proximal
portion of the anvil includes a ramp feature, wherein the ramp
feature engages with said overtube as the overtube slidably engages
with the staple holder and the anvil.
5. The surgical stapling apparatus of claim 4, wherein engagement
of said overtube with said ramp feature changes a gap distance or a
gap space between said staple holder and said anvil.
6. The surgical stapling apparatus of claim 3, wherein the axle-pin
is positioned in a substantially bottom-most position in the pair
of through-slots of the overtube when the overtube in is the first
position and no gap or substantially no space is between the staple
holder and the anvil.
7. The surgical stapling apparatus of claim 3, wherein the axle-pin
is positioned in a substantially top-most position or a position
substantially between the top-most and the bottom-most position in
the pair of through-slots of the overtube when the overtube in is
the second position and the first gap or the first space is between
the staple holder and the anvil.
8. The surgical stapling apparatus of claim 3, wherein the axle-pin
is positioned in a substantially top-most position or a position
substantially between the top-most and the bottom-most position in
the pair of through-slots of the overtube when the overtube in is
the third position and the second gap or the second space is
between the staple holder and the anvil.
9. The surgical stapling apparatus of claim 1, wherein an
outer-perimeter of a portion of the staple holder and the anvil
combination fits within an inner-perimeter of the overtube.
Description
CROSS-REFERENCE TO RELATED APPLICATION(S)
[0001] This application is a continuation of U.S. patent
application Ser. No. 12/489,397 (attorney docket no. 283), filed
Jun. 22, 2009, which is herein incorporated by reference in its
entirety.
FIELD OF THE INVENTION
[0002] The invention generally relates to surgical staplers and
stapling.
BACKGROUND
[0003] An endocutter is a surgical tool that staples and cuts
tissue to transect that tissue while leaving the cut ends
hemostatic. An endocutter is small enough in diameter for use in
minimally invasive surgery, where access to a surgical site is
obtained through a trocar, port, or small incision in the body. A
linear cutter is a larger version of an endocutter, and is used to
transect portions of the gastrointestinal tract. A typical
endocutter receives at its distal end a disposable single-use
cartridge with several rows of staples, and includes an anvil
opposed to the cartridge. The surgeon inserts the endocutter
through a trocar or other port or incision in the body, orients the
end of the endocutter around the tissue to be transected, and
compresses the anvil and cartridge together to clamp the tissue.
Then, a row or rows of staples are deployed on either side of the
transection line, and a blade is advanced along the transection
line to divide the tissue. Traditionally, it has been important to
maintain a substantially constant gap between the anvil and the
cartridge for proper staple formation. A staple urged outward from
the cartridge or other staple holder is designed to encounter a
staple pocket or other feature in the anvil at a certain point in
its travel. If the staple encounters that staple pocket or other
feature in the anvil too soon or too late, the staple may be
malformed. For example, if the gap is too large, the staple may not
be completely formed. As another example, if the gap is too small,
the staple may be crushed.
BRIEF DESCRIPTION OF THE DRAWINGS
[0004] FIG. 1 is a side view of an exemplary staple holder and
anvil in a first, delivery configuration with no gap
therebetween.
[0005] FIG. 2 is a side view of the staple holder and anvil of FIG.
1 in a second, unclamped configuration.
[0006] FIG. 3 is a side view of the staple holder and anvil of FIG.
1 in a third, clamped configuration with a gap therebetween.
[0007] The use of the same reference symbols in different figures
indicates similar or identical items.
DETAILED DESCRIPTION
[0008] U.S. Patent Application Publication No. 2009/0065552,
published on Mar. 12, 2009 (the "Endocutter Document"), is hereby
incorporated by reference herein in its entirety.
[0009] Referring to FIG. 1, an end effector 2 may include a staple
holder 4 movable relative to an anvil 6. The staple holder 4 and
anvil 6 may be configured substantially as set forth in the
Endocutter Document, as modified by the contents of this document.
The proximal end of the end effector 2 may be slidably held within
an overtube 8. The proximal end of the end effector 2 may extend
into the distal end of the overtube 8. The staple holder 4 may
include at least one generally vertically-oriented slot 10 defined
therein, as viewed from the side. Advantageously, one slot 10 is
defined in each side of the staple holder 4, in proximity to the
proximal end of the staple holder 4. Alternately, a different
number of slots 10 is provided, and/or the location of at least one
slot 10 is different. Alternately, at least one slot 10 may be
oriented other than generally vertically. An axle 12 extends
outward from the anvil 6 into each slot 10. Each axle 12 is
slidable within the corresponding slot 10.
[0010] Initially, the end effector 2 may be in a first
configuration for insertion through a trocar port or other opening
in a patient, where substantially no gap exists between the anvil 6
and the staple holder 4. This distance between the anvil 6 and the
staple holder 4 optionally may be referred to as a "zero gap." In
the first, insertion configuration, each axle 12 may be located at
or near the bottom of the corresponding slot 10, in order to
minimize the gap between the anvil 6 and the staple holder 4. When
the end effector 2 is in the first, insertion configuration, the
outer dimensions of the end effector 2 may be equal to or less than
the outer dimensions of the overtube 8. That is, the outer
dimensions of the end effector 2 may fit within the perimeter of
the distal end of the overtube 8 as viewed on end. In this way, the
cross-sectional area of the end effector 2 is minimized.
Alternately, the end effector 2 may be sized or shaped differently
in the first, insertion configuration. At least part of the
overtube 8 may be inserted into the patient along with the end
effector 2.
[0011] Referring also to FIG. 2, after insertion into the patient,
the end effector 2 may be opened to a second, unclamped
configuration in any suitable manner. As one example, the overtube
8 may be withdrawn proximally relative to the end effector 2. The
anvil 6 may be pivotable upward relative to the staple holder 4,
and/or the anvil 6 may be biased upward relative to the staple
holder 4 such as by a leaf spring or compression spring 14. As the
overtube 8 is withdrawn proximally, that spring 14 pushes the anvil
6 upward relative to the staple holder 4. The anvil 6 may be
pivotally connected to the staple holder 4 such that the upward
bias of the spring 14 pushes the distal end of the anvil 6 upward.
(The use of terms such as "upward" in this document refers to the
orientation of parts on the page, and in no way limits the
orientation of the device in use.) As the anvil 6 is pushed upward,
each axle 12 is also pushed upward within the corresponding slot
10. Each axle 12 may be pushed upward to the upper end of the
corresponding slot 10, or to a location between the upper and lower
ends of the slot 10. As another example, the anvil 6 is not biased
relative to the staple holder 4, and a mechanical linkage (not
shown) or other mechanism acts to push the distal end of the anvil
6 upward as the overtube 8 is withdrawn proximally relative to the
end effector 2. As the anvil 6 is urged upward by the linkage or
other mechanism, each axle 12 is also pushed upward within the
corresponding slot 10. Each axle 12 may be pushed upward to the
upper end of the corresponding slot 10, or to a location between
the upper and lower ends of the slot 10. Where each axle 12 is
located in the upper end of the corresponding slot 10, the end
effector 2 can open to its widest position.
[0012] The opened end effector 2 in the second, unclamped position
is moved relative to tissue to be treated in order to place the
anvil 6 on one side of that tissue and the staple holder 4 on the
other side. The end effector 2 is then moved to the third, clamped
position. Referring also to FIG. 3, the overtube 8 is advanced
distally relative to the end effector 2. As the overtube 8
advances, the distal end of the overtube 8 encounters an angled
ramp 16 of the anvil 6 on the upper surface of the anvil 6.
Alternately, the ramp 16 is located on a different surface of the
anvil 6, and/or more than one ramp 16 is provided. The ramp 16 is
angled or curved downward proximally. As the overtube 8 contacts
that ramp 16, further distal motion of that overtube 8 pushes the
anvil 6 downward. Where the anvil 6 is rotationally connected to
the staple holder 4, such as at the axles 12, the anvil 6 rotates
such that the distal end of the anvil 6 moves closer to the staple
holder 4. The anvil 6 moves downward, compressing tissue between
the anvil 6 and the staple holder 4. The thickness of the tissue
stops the clamping motion of the end effector 2. Where the tissue
is thick, each axle 12 may be located at the upper end of the
corresponding slot 10 when the end effector is in the third,
clamped position of FIG. 3. Where the tissue is thinner, each axle
12 may be located in the corresponding slot 10 between the upper
and lower ends thereof. That is, each axle 12 may float in the
corresponding slot 10, and the position of the axle in that slot 10
is determined by the thickness of the clamped tissue. After the
tissue is treated, the end effector 2 is moved back to the second,
unclamped position of FIG. 1 by retracting the overtube 8
proximally relative to the end effector 2. The end effector 2 may
then be moved back to the third, clamped position to treat tissue
in a different location; if so, additional staples may be advanced
into the staple holder 4 as set forth in the Endocutter Document.
Alternately, if treatment of tissue is complete, the overtube 8 may
be advanced distally relative to the end effector 2. Without tissue
located between the anvil 6 and the staple holder 4, as the
overtube 8 advances distally relative to the end effector 2, the
distal end of the overtube 8 encounters the ramp 16 and urges the
anvil 6 downward to the first, insertion configuration with
substantially no gap between the anvil 6 and staple holder 4. The
absence of a gap between the anvil 6 and the staple holder 4
results from the absence of tissue between the anvil 6 and staple
holder 4, allowing the anvil 6 and staple holder 4 to move together
to the first, insertion configuration without resistance from
tissue.
[0013] While the invention has been described in detail, it will be
apparent to one skilled in the art that various changes and
modifications can be made and equivalents employed, without
departing from the present invention. It is to be understood that
the invention is not limited to the details of construction, the
arrangements of components, and/or the method set forth in the
above description or illustrated in the drawings. Statements in the
abstract of this document, and any summary statements in this
document, are merely exemplary; they are not, and cannot be
interpreted as, limiting the scope of the claims. Further, the
figures are merely exemplary and not limiting. Topical headings and
subheadings are for the convenience of the reader only. They should
not and cannot be construed to have any substantive significance,
meaning or interpretation, and should not and cannot be deemed to
indicate that all of the information relating to any particular
topic is to be found under or limited to any particular heading or
subheading. Therefore, the invention is not to be restricted or
limited except in accordance with the following claims and their
legal equivalents.
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