U.S. patent application number 15/576291 was filed with the patent office on 2018-10-11 for small diameter surgical stapling device.
This patent application is currently assigned to Covidien LP. The applicant listed for this patent is Covidien LP. Invention is credited to Zhaokai Wang, Jiangfeng Zhang, Xiliang Zhang.
Application Number | 20180289371 15/576291 |
Document ID | / |
Family ID | 57392373 |
Filed Date | 2018-10-11 |
United States Patent
Application |
20180289371 |
Kind Code |
A1 |
Wang; Zhaokai ; et
al. |
October 11, 2018 |
SMALL DIAMETER SURGICAL STAPLING DEVICE
Abstract
A surgical stapling device (10) includes an outer tube (14)
having a proximal body portion (70) and a distal channel portion
(74). A distal end (80) of the proximal body portion (70) defines a
pair of cutouts (82). An anvil assembly (22) includes an anvil body
(26) defining a tissue contact surface (30) and a pair of pivot
members (40) which are supported within the cutouts (82). A staple
cartridge (44) is supported in the distal channel portion (74) of
the outer tube (14) and defines a tissue contact surface (44a). The
cutouts (82) are dimensioned to allow movement of the pivot members
(40) within the cutouts (82) to allow the tissue contact surface
(30) of the anvil body (26) to move in relation to the tissue
contact surface (44a) of the staple cartridge (44) from a "parked
position" in which the tissue contact surfaces (30, 44a) are in
juxtaposed engagement to a "clamped position" in which the tissue
contact surfaces (30, 44a) defining a tissue gap (G). A drive
member (62) is provided that is formed from sheet metal and
includes upper and lower extending members (90, 92) that are
positioned to engage the anvil body (26) and the distal channel
portion (74) to define a maximum tissue gap (G) between the tissue
contact surfaces (30, 44a) of the anvil body (26) and the staple
cartridge (44).
Inventors: |
Wang; Zhaokai; (Shanghai,
CN) ; Zhang; Jiangfeng; (Shanghai, CN) ;
Zhang; Xiliang; (Shanghai, CN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Covidien LP |
Mansfield |
MA |
US |
|
|
Assignee: |
Covidien LP
Mansfield
MA
|
Family ID: |
57392373 |
Appl. No.: |
15/576291 |
Filed: |
May 25, 2015 |
PCT Filed: |
May 25, 2015 |
PCT NO: |
PCT/CN2015/079659 |
371 Date: |
November 22, 2017 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/07214
20130101; A61B 2017/07285 20130101; A61B 2017/00473 20130101; A61B
2017/00526 20130101; A61B 2017/2944 20130101; A61B 2017/07278
20130101; A61B 2017/07271 20130101; A61B 2017/2937 20130101; A61B
2017/07257 20130101; A61B 17/07207 20130101; A61B 2017/2947
20130101 |
International
Class: |
A61B 17/072 20060101
A61B017/072 |
Claims
1. A surgical stapling device comprising: an outer tube having a
proximal body portion and a distal channel portion, a distal end of
the proximal body portion defining cutouts, the channel portion
having an outer surface; a tool assembly including: an anvil
assembly including an anvil body defining a longitudinal axis and
having an outer surface, a tissue contact surface and a pair of
pivot members positioned proximally of the tissue contact surface,
the pivot members being pivotally received within the cutouts of
the proximal body portion of the outer tube; and a cartridge
assembly including a staple cartridge and a plurality of staples,
the staple cartridge defining a longitudinal axis, a tissue contact
surface, and a plurality of staple retention pockets, each of the
staple retention pockets supporting one of the plurality of
staples, the staple cartridge being supported within the distal
channel portion of the outer tube, the anvil body being pivotally
supported on the outer tube in relation to the staple cartridge
such that the tool assembly is movable between a closed position in
which longitudinal axes of the anvil body and the staple cartridge
are parallel and an open position in which the longitudinal axes of
the anvil body and the staple cartridge define an acute angle; and
a drive member supported within the staple cartridge, the drive
member being translatable through the staple cartridge to eject the
plurality of staples from the staple cartridge; wherein the cutouts
are dimensioned to allow movement of the pivot members within the
cutouts such the when the tool assembly is in the closed position,
the anvil body can be positioned in relation to the staple
cartridge in a parked position in which the contact surfaces of the
anvil body and the staple cartridge are in juxtaposed engagement to
a clamped position in which the contact surfaces of the anvil body
and the staple cartridge are spaced to define a tissue gap.
2. The surgical stapling device according to claim 1, wherein the
outer tube supports a coupling member, the coupling member being
adapted to releasably secure the surgical stapling device to an
actuator for effecting movement of the drive member.
3. The surgical stapling device according to claim 1, wherein the
drive member includes a distal working portion having upper and
lower extended members, wherein the upper extended member is
positioned to engage the outer surface of the anvil body and the
lower extended member is positioned to engage the outer surface of
the distal channel portion of the outer tube.
4. The surgical stapling device according to claim 1, wherein the
anvil body, the staple cartridge and the distal channel portion
each define a longitudinal slot, and the working portion of the
drive member has an I-beam configuration including a vertical
strut, the vertical strut extending through the slots of the anvil
body, the staple cartridge, and the distal channel portion.
5. The surgical stapling device according to claim 4, wherein the
upper and lower extended members include an upper pair of radially
extended and a lower pair of extended members.
6. The surgical stapling device according to claim 5, wherein one
of the pair of upper extended members extends from the vertical
strut transversely in a first direction and the other of the pair
of upper extended members extends from the vertical strut in a
second direction opposite to the first direction, and wherein one
of the pair of lower extended members extends from the vertical
strut transversely in the first direction and the other of the pair
of lower extended members extends from the vertical strut in the
second direction opposite to the first direction.
7. The surgical stapling device according to claim 6, wherein the
drive member is formed from sheet metal.
8. The surgical stapling device according to claim 1, wherein the
drive member supports a connector that is adapted to releasably
couple the drive member to an actuator.
9. The surgical stapling device according to claim 6, wherein one
of the pair of upper extended members is positioned distally of the
other of the pair of the extended members and one of the pair of
lower extended members is positioned distally of the other of the
pair of the lower extended members.
10. The surgical stapling device according to claim 1, wherein the
cartridge assembly further includes a plurality of pushers and a
sled, each of the plurality of staples being associated with a
respective pusher, the sled being translatable through the
cartridge in response to distal movement of the drive member into
sequential engagement with the pushers to eject the plurality of
staples from the staple cartridge.
11. The surgical stapling device according to claim 1, further
including a biasing member to urge the tool assembly toward the
open position.
12. A surgical stapling device comprising: an outer tube having a
proximal body portion and a distal channel portion, the channel
portion having an outer surface; a tool assembly including : an
anvil assembly including an anvil body defining a longitudinal
axis, the anvil body having an outer surface, a tissue contact
surface and a pair of pivot members positioned proximally of the
tissue contact surface; and a cartridge assembly including a staple
cartridge and a plurality of staples, the staple cartridge defining
a longitudinal axis, a tissue contact surface and a plurality of
staple retention pockets, each of the staple retention pockets
supporting one of the plurality of staples, the staple cartridge
being supported within the distal channel portion of the outer
tube, the anvil body being pivotally supported on the outer tube in
relation to the staple cartridge such that the tool assembly is
movable between a closed position in which the longitudinal axes of
the anvil body and the staple cartridge are parallel and an open
position in which the longitudinal axes of the anvil body and the
staple cartridge define an acute angle; and a drive member
supported within the staple cartridge, the drive member being
translatable through the staple cartridge to eject the plurality of
staples from the staple cartridge, the drive member including a
body formed of sheet metal, the body having a distal working
portion including a pair of upper extended members and a pair of
lower extended members, the pairs of upper and lower extended
members being formed by bending upper and lower edges of the sheet
metal.
13. The surgical stapling device according to claim 12, wherein a
distal end of the proximal body portion defines cutouts, the pivot
members being pivotally received within the cutouts of the proximal
body portion of the outer tube.
14. The surgical stapling device according to claim 12, wherein the
pair of upper extended members is positioned to engage the outer
surface of the anvil body and the pair of lower extended members is
positioned to engage the outer surface of the channel portion of
the outer tube to define a maximum tissue gap between the tissue
contact surfaces of the anvil body and the staple cartridge when
the anvil is in a closed position.
15. The surgical stapling device according to claim 14, wherein the
anvil body, the staple cartridge and the distal channel portion
each define a longitudinal slot and the working portion of the
drive member has an I-beam configuration including a vertical
strut, the vertical strut extending through the slots of the anvil
body, staple cartridge, and the distal channel portion.
16. The surgical stapling device according to claim 15, wherein one
of the pair of upper extended members extends from the vertical
strut transversely in a first direction and the other of the pair
of upper extended members extends from the vertical strut in a
second direction opposite to the first direction, and wherein one
of the pair of lower extended members extends from the vertical
strut transversely in the first direction and the other of the pair
of lower extended members extends from the vertical strut in the
second direction opposite to the first direction.
17. The surgical stapling device according to claim 15, wherein one
of the pair of upper extended members is positioned distally of the
other of the pair of the radially extending members and one of the
pair of lower extended members is positioned distally of the other
of the pair of the lower extended members.
18. The surgical stapling device according to claim 13, wherein the
cutouts are dimensioned to allow movement of the pivot members
within the cutouts such that when the tool assembly is in the
closed position, the anvil body can move in relation to the staple
cartridge from a parked position in which the tissue contact
surfaces of the anvil body and the staple cartridge are in
juxtaposed engagement to a clamped position in which the tissue
contact surfaces of the anvil body and the staple cartridge are
spaced to define a tissue gap.
19. The surgical stapling device according to claim 12, further
including a biasing member to urge the tool assembly toward the
open position.
Description
BACKGROUND
1. Technical Field
[0001] The present disclosure relates to surgical stapling devices,
and more particularly, to surgical stapling devices for
laparoscopic or endoscopic use.
2. Background of Related Art
[0002] Surgical stapling devices for stapling tissue typically
include a tool assembly having a staple cartridge, an anvil, and a
knife that can be actuated to effect simultaneous dissection and
suturing of tissue. When compared to traditional methods of
manually applying threaded sutures to tissue, the use of surgical
stapling devices to suture and dissect tissue has increased the
speed of the suturing procedure and thus, minimized patient
trauma.
[0003] In an endoscopic surgical procedure, a surgical stapler is
inserted through a small incision in the skin or through a cannula
to access a surgical site. Due to the complexity of known surgical
stapling devices, a continuing need exists for small diameter
surgical stapling devices that are suitable for insertion through a
small diameter cannula, e.g., a 5 mm cannula, and can effectively
suture and dissect tissue.
SUMMARY
[0004] The present disclosure is directed to small diameter
surgical stapling devices that can be inserted through a small
diameter cannula. The stapling device includes a cartridge assembly
and an anvil pivotally supported in relation to the cartridge
assembly via a floating pivot member. This arrangement allows the
anvil to be positioned in a "parked position" in which the anvil is
juxtaposed engagement with the cartridge assembly. In the parked
position, the dimension of the stapling device is minimized so that
it can be inserted through a small diameter cannula.
[0005] More specifically, the present disclosure provides in one
aspect a surgical stapling device including an outer tube, a tool
assembly and a drive member. The outer tube has a proximal body
portion and a distal channel portion. A distal end of the proximal
body portion defines cutouts and the channel portion has an outer
surface. The tool assembly has an anvil assembly including an anvil
body defining a longitudinal axis and having an outer surface, a
tissue contact surface and a pair of pivot members positioned
proximally of the tissue contact surface. The pivot members are
pivotally received within the cutouts of the proximal body portion
of the outer tube. The cartridge assembly includes a staple
cartridge and a plurality of staples. The staple cartridge defines
a longitudinal axis, a tissue contact surface, and a plurality of
staple retention pockets. Each of the staple retention pockets
supports one of the plurality of staples. The staple cartridge is
supported within the distal channel portion of the outer tube. The
anvil body is pivotally supported on the outer tube in relation to
the staple cartridge such that the tool assembly is movable between
a closed position in which longitudinal axes of the anvil body and
the staple cartridge are parallel and an open position in which the
longitudinal axes of the anvil body and the staple cartridge define
an acute angle. The drive member is supported within the staple
cartridge and is translatable through the staple cartridge to eject
the plurality of staples from the staple cartridge. The cutouts are
dimensioned to allow movement of the pivot members within the
cutouts such the when the tool assembly is in the closed position,
the anvil body can be positioned in relation to the staple
cartridge in a "parked position" in which the contact surfaces of
the anvil body and the staple cartridge are in juxtaposed
engagement to a "clamped position" in which the contact surfaces of
the anvil body and the staple cartridge are spaced to define a
tissue gap.
[0006] In some embodiments, the outer tube supports a coupling
member that is adapted to releasably secure the surgical stapling
device to an actuator for effecting movement of the drive
member.
[0007] In certain embodiments, the drive member includes a distal
working portion having upper and lower radially extending members.
The upper radially extending member is positioned to engage the
outer surface of the anvil body and the lower radially extending
member is positioned to engage the outer surface of the distal
channel portion of the outer tube.
[0008] In embodiments, the anvil body, staple cartridge and distal
channel portion each define a longitudinal slot and the working
portion of the drive member has an I-beam configuration including a
vertical strut that extends through the slots of the anvil body,
the staple cartridge, and the distal channel portion.
[0009] In some embodiments, the upper and lower radially extending
members include an upper pair of radially extending members and a
lower pair of radially extending members.
[0010] In certain embodiments, one of the pair of upper radially
extending members extends from the vertical strut transversely in a
first direction and the other of the pair of upper radially
extending members extends from the vertical strut in a second
direction opposite to the first direction. In addition, one of the
pair of lower radially extending members extends from the vertical
strut transversely in the first direction and the other of the pair
of lower radially extending members extends from the vertical strut
in the second direction opposite to the first direction.
[0011] In embodiments, the drive member is formed from sheet
metal.
[0012] In some embodiments, the drive member supports a connector
that is adapted to releasably couple the drive member to an
actuator.
[0013] In certain embodiments, one of the pair of upper radially
extending members is positioned distally of the other of the pair
of the radially extending members and one of the pair of lower
radially extending members is positioned distally of the other of
the pair of the lower radially extending members.
[0014] In embodiments, the cartridge assembly further includes a
plurality of pushers and a sled. Each of the plurality of staples
is associated with a respective pusher and the sled is translatable
through the cartridge into sequential engagement with the pushers
in response to distal movement of the drive member to eject the
plurality of staples from the staple cartridge.
[0015] In some embodiments, a biasing member is provided to urge
the tool assembly toward the open position.
[0016] The present disclosure provides in another aspect a surgical
stapling device including an outer tube, a tool assembly and a
drive member. The outer tube has a proximal body portion and a
distal channel portion having an outer surface. The tool assembly
includes an anvil assembly and a cartridge assembly. The anvil
assembly includes an anvil body defining a longitudinal axis. The
anvil body has an outer surface, a tissue contact surface and a
pair of pivot members positioned proximally of the tissue contact
surface. The cartridge assembly includes a staple cartridge and a
plurality of staples. The staple cartridge defines a longitudinal
axis, a tissue contact surface and a plurality of staple retention
pockets. Each of the staple retention pockets supports one of the
plurality of staples. The staple cartridge is supported within the
distal channel portion of the outer tube and the anvil body is
pivotally supported on the outer tube in relation to the staple
cartridge such that the tool assembly is movable between a closed
position in which the longitudinal axes of the anvil body and the
staple cartridge are parallel and an open position in which the
longitudinal axes of the anvil body and the staple cartridge define
an acute angle. The drive member is supported within the staple
cartridge and is translatable through the staple cartridge to eject
the plurality of staples from the staple cartridge. The drive
member includes a body formed of sheet metal having a distal
working portion including a pair of upper radially extending
members and a pair of lower radially extending members. The pairs
of upper and lower radially extending members are formed by bending
upper and lower edges of the sheet metal.
[0017] In embodiments, a distal end of the proximal body portion
defines cutouts and the pivot members are pivotally received within
the cutouts.
[0018] In some embodiments, the pair of upper radially extending
members is positioned to engage the outer surface of the anvil body
and the pair of lower radially extending members is positioned to
engage the outer surface of the channel portion of the outer tube
to define a maximum tissue gap between the tissue contact surfaces
of the anvil body and the staple cartridge when the anvil is in a
closed position.
[0019] In certain embodiments, the anvil body, the staple cartridge
and the distal channel portion each define a longitudinal slot and
the working portion of the drive member has an I-beam configuration
including a vertical strut that extends through the slots of the
anvil body, staple cartridge, and the distal channel portion.
[0020] In some embodiments, one of the pair of upper radially
extending members extends from the vertical strut transversely in a
first direction and the other of the pair of upper radially
extending members extends from the vertical strut in a second
direction opposite to the first direction, and wherein one of the
pair of lower radially extending members extends from the vertical
strut transversely in the first direction and the other of the pair
of lower radially extending members extends from the vertical strut
in the second direction opposite to the first direction.
[0021] In certain embodiments, one of the pair of upper radially
extending members is positioned distally of the other of the pair
of the radially extending members and one of the pair of lower
radially extending members is positioned distally of the other of
the pair of lower radially extending members.
[0022] In embodiments, the cutouts are dimensioned to allow
movement of the pivot members within the cutouts such that when the
tool assembly is in the closed position, the anvil body can move in
relation to the staple cartridge from a "parked position" in which
the tissue contact surfaces of the anvil body and the staple
cartridge are in juxtaposed engagement to a clamped position in
which the tissue contact surfaces of the anvil body and the staple
cartridge are spaced to define a tissue gap.
[0023] In embodiments, a biasing member is provided to urge the
tool assembly toward the open position.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] Various embodiments of the presently disclosed surgical
stapling device are described herein with reference to the
drawings, wherein:
[0025] FIG. 1 is a side, perspective view of one embodiment of the
presently disclosed surgical stapling device in the form of a
reload with the tool assembly in the open position;
[0026] FIG. 2 is an enlarged view of the indicated area of detail
shown in FIG. 1;
[0027] FIG. 3 is a side perspective view of the reload shown in
FIG. 1 secured to a powered handle assembly;
[0028] FIG. 4 is a side, perspective exploded view of the reload
shown in FIG. 1;
[0029] FIG. 5 is a side, perspective, cutaway view of the proximal
end of the anvil and a central portion of the outer tube of the
reload shown in FIG. 1 with parts separated;
[0030] FIG. 6 is a side, perspective view of a central portion of
the reload shown in FIG. 1;
[0031] FIG. 7 is a side perspective view of the central portion of
the reload shown in FIG. 6 with the outer tube shown in
phantom;
[0032] FIG. 8 is a side perspective view of the distal end of the
knife bar including the I-beam and the sled with the parts
separated;
[0033] FIG. 9 is a side view of the reload shown in FIG. 1 with the
tool assembly in a parked position;
[0034] FIG. 10 is a side view of the reload shown in FIG. 9 as the
reload is inserted into a 5 mm trocar;
[0035] FIG. 10 A is a top view of the reload shown in FIG. 9;
[0036] FIG. 11 is an enlarged view of the indicated area of detail
shown in FIG. 10;
[0037] FIG. 12 is a cross-sectional view taken along section line
12-12 of FIG. 10A;
[0038] FIG. 13 is a side view of the distal end of the reload shown
in FIG. 1 with the tool assembly in the open position;
[0039] FIG. 14 is an enlarged view of the indicated area of detail
shown in FIG. 13;
[0040] FIG. 15 is a side view of the distal end of the reload shown
in FIG. 1 with the tool assembly in the clamped position;
[0041] FIG. 16 is an enlarged view of the indicated area of detail
shown in FIG. 15;
[0042] FIG. 17 is a side cross-sectional view of the central
portion of the reload showing the I-beam in the clamped
position;
[0043] FIG. 18 is side, perspective view of the distal end of the
reload shown in FIG. 1 with the tool assembly in the clamped
position;
[0044] FIG. 19 is an enlarged view of the indicated area of detail
shown in FIG. 18;
[0045] FIG. 20 is bottom, perspective view of the distal end of the
reload shown in FIG. 1 with the tool assembly in the clamped
position;
[0046] FIG. 21 is bottom, perspective view of the distal end of the
reload shown in FIG. 1 with the tool assembly in the clamped
position and the outer tube removed;
[0047] FIG. 22 is a side, cross-sectional view taken along section
line 22-22 of FIG. 21; and
[0048] FIG. 23 is side, cross-sectional view of the tool assembly
of the reload shown in FIG. 1 during a firing stroke of the
reload.
DETAILED DESCRIPTION OF EMBODIMENTS
[0049] Embodiments of the presently disclosed surgical stapling
device will now be described in detail with reference to the
drawings wherein like reference numerals designate identical or
corresponding elements in each of the several views. In this
description, the term "clinician" is used generally to refer to
medical personnel including doctors, nurses, and support personnel.
In addition, the term "endoscopic" procedures is used generally to
refer to endoscopic, laparoscopic, arthroscopic, and any other
surgical procedure performed through a small incision or a cannula
inserted into a patient's body. Finally, the term "proximal" is
used generally to refer to the portion of the apparatus that is
closer to a clinician, while the term "distal" is used generally to
refer to the portion of the apparatus that is farther from the
clinician.
[0050] The present disclosure is directed to a small diameter
surgical stapling device that can be inserted through a small
diameter cannula, e.g., a 5 mm cannula. The stapling device
includes a cartridge assembly and an anvil pivotally supported in
relation to the cartridge assembly via a floating pivot member. The
floating pivot member allows the anvil to be positioned in a
"parked position" in which the anvil is juxtaposed engagement with
the cartridge assembly as will be discussed in detail below. The
surgical stapling device also includes a drive member of reduced
size formed of sheet metal.
[0051] FIGS. 1-3 illustrate one embodiment of the presently
disclosed surgical stapling device shown generally as 10. Surgical
stapling device 10 is illustrated in the form of a reload that is
adapted to be releasably coupled to an actuation device 12 (FIG.
3). Alternately, the reload 10 can be fixedly secured to the distal
end of the actuation device 12. In embodiments, the actuation
device 12 can be a powered actuation device as shown in FIG. 3.
Alternately, the actuation device 12 can be a manually actuated
actuation device, a robotically controlled actuation device, or any
other suitable manually or electrically driven device configured to
operate the stapling device 10.
[0052] The reload 10 includes an outer tube 14, a coupling member
16 and a tool assembly 18. The coupling member 16 defines a
longitudinal bore 16a (FIG. 4) that fixedly receives the proximal
end of the outer tube 14 and includes a pair of diametrically
opposed nubs 20. The nubs 20 are configured to engage the distal
end of the actuation device 12 (FIG. 3) to secure the reload 10 to
the actuation device 12 such as disclosed in U.S. Pat. No.
8,070,033 ("the '033 Patent") which is incorporated herein by
reference in its entirety. Alternately, the coupling member 16 can
be integrally formed with the outer tube 14.
[0053] Referring to FIG. 4, the tool assembly 18 includes an anvil
assembly 22 and a cartridge assembly 24. The anvil assembly 22
includes an anvil body 26 and a cover 28. The anvil body 26
includes an inner tissue contact surface 30 defining a plurality of
staple deforming depressions 32 (FIG. 22), an outer cam surface
26a, and an outer surface 34 defining a longitudinal groove 36 that
will be described in detail below. An elongated slot 38 extends
through the anvil body 26 from a position adjacent a distal end of
the anvil body 26 to the proximal end of the anvil body 26. The
proximal end of the anvil body 26 includes a pair of pivot members
40 which will be described in detail below.
[0054] The cartridge assembly 24 includes a staple cartridge 44, a
plurality of staples 46, and a plurality of staple pushers 48. The
staple cartridge 44 defines a plurality of staple retention slots
50. Each staple retention slot 50 supports one of the plurality of
staples 46 and is associated with one of the plurality of pushers
48 such that movement of the pusher 48 in relation to the retention
slot 50 ejects a staple 46 from the retention slot 50. For a more
detailed description of the interaction between the pushers 48 and
the staples 46, see the '033 Patent. The cartridge 44 also defines
a longitudinal slot 60 that receives the distal end of a drive
member 62 as described in detail below.
[0055] Referring also to FIGS. 4 and 6, the outer tube 14 includes
a proximal body portion 70 and a distal body portion 72. In
embodiments, the outer tube 14 is substantially rigid and can be
formed from a metal such as stainless steel. Alternately, the outer
tube 14 can be formed of other substantially rigid materials
suitable for medical use.
[0056] In embodiments, the proximal body portion 70 is
substantially cylindrical and is dimensioned to slidably receive
the drive member 62. A distal end 80 of the proximal body portion
70 defines upper and lower slots 73 which are described in detail
below. The distal body portion 72 is substantially U-shaped and
defines a channel portion 74 that receives the cartridge assembly
24. The distal body portion 72 includes sidewalls 72athat are
positioned to support an outer wall of the staple cartridge 44. The
staple cartridge 44 can be frictionally retained within the channel
portion 74. Alternately, the staple cartridge 44 can be retained
within the channel portion 74 using interlocking and/or snap-fit
connections. A bottom wall 76 of the distal body portion 72 defines
a longitudinal slot 78 that is aligned with the slot 38 in the
anvil body 26 and with the slot 60 in the staple cartridge 44 such
that the drive member 62 extends through each of the slots 38, 60,
and 78 as described below.
[0057] The proximal body portion 70 has a distal end 80 that
defines a pair of spaced cutouts 82 that are dimensioned to receive
the pivot members 40 of the anvil body 26. The pivot members 40 are
received within the respective cutouts 82 to facilitate pivotal
movement of the anvil assembly 22 in relation to the cartridge
assembly 24 and allow movement of the tool assembly from an "open
position" in which longitudinal axes of the anvil and cartridge
assemblies 22, 24 define an acute angle to a "closed position" in
which the longitudinal axes of the anvil and cartridge assemblies
22, 24 are substantially parallel. In embodiments, the cutouts 82
are oversized in relation to the pivot members 40 such that pivot
members 40 are able to move vertically within the cutouts 82.
Vertical movement of the pivot members 40 within the cutouts 82 of
the outer tube 14 allows a proximal end of the anvil body 26 to
move in relation to the cartridge assembly 24 when the tool
assembly 18 is in the "closed position" to allow the anvil body 26
to move between a "parked position" in juxtaposed engagement with
the cartridge assembly 24 and a "clamped position" in which the
anvil body 26 and the cartridge assembly 24 define a tissue
gap.
[0058] Referring to FIGS. 4, 7 and 8, the drive member 62 is
elongated and has a reduced thickness to facilitate movement
through the longitudinal slots 38, 60 and 78 of the anvil body 26,
the staple cartridge 44, and the distal body portion 72,
respectively. A distal end 62a of the drive member 62 supports a
knife blade 86. In embodiments, the knife blade 86 is machined into
the distal end of the drive member 62. Alternately, the knife blade
86 can be formed separately from the drive member 62 and secured to
the drive member 62 such as by welding or the like. The drive
member 62 includes a working distal end portion 62a having an
I-beam configuration that includes vertical strut 89 and a pair of
upper and lower extended members 90 and 92, respectively. The upper
extended members 90 are positioned to slide along an outer surface
of the anvil body 26 within the groove 36. Engagement of the upper
extended members 90 with the cam surface 26a formed on the proximal
end of the anvil body 26 causes the tool assembly 18 to move from
the "open position" (FIG. 1) to the "clamped position" (FIG. 16).
The cover 28 of the anvil assembly 22 encloses the upper extended
members 90 within the groove 34. The lower extended members 92 are
positioned to slide along an outer surface of the distal body
portion 72 of the outer tube 14. In embodiments, the drive member
62 is formed from sheet metal and is deformed to form the upper and
lower extended members 90 and 92 and machined to define the knife
blade 86. More specifically, upper and lower ends of the sheet
metal forming the distal end 62a of the drive member 62 can be bent
outwardly to define the upper and lower extended members 90 and
92.
[0059] A proximal end 62b (FIG. 4) of the drive member 62 supports
a connector 94. The connector 94 defines a longitudinal slot 96
that receives the drive member 62 to secure the drive member 62 to
the connector 94. The connector 94 is configured to releasably
engage a drive shaft (not shown) of the actuation device 12 (FIG.
3). For a more detailed discussion of a suitable connector 94, see
the '033 Patent.
[0060] A sled 100 is supported within the staple cartridge 44 at a
position distally of the distal end 62a of the drive member 62. The
sled 100 includes cam members 102 that are configured to translate
through channels (not shown) defined within the staple cartridge 44
into engagement with the pushers 48 to eject the staples 46 from
the staple cartridge 44.
[0061] Referring to FIGS. 9-12, when the drive member 62 is in a
fully retracted position, the vertical strut 89 of the drive member
62 (FIG. 8) extends through slots 73 defined in the distal end 80
of the proximal body portion 70 of the outer tube 14 such that the
upper and lower extended members 90 and 92 are positioned along an
outer surface of the outer tube 14 at a location spaced proximally
of cam surface 26a of the anvil body 26. In this position, the
anvil assembly 22 can be manually moved against the urging of a
biasing member 106 to the "parked position" wherein the tissue
contact surface 30 of the anvil body 26 is in juxtaposed engagement
with the a tissue contact surface 44a of the staple cartridge 44 to
minimize the outer diameter of the tool assembly 18. It is noted
that surface to surface contact of the anvil body 26 and the staple
cartridge 44 is possible because the pivot members 40 of the anvil
body 26 float within the cutouts 82 formed in the distal face 80 of
the proximal body portion 70 of the outer tube 14 to facilitate
movement of the proximal end of the anvil body 26 to a position
supported in a lower portion of the cutout 82 (FIG. 11). With the
diameter of the tool assembly 18 minimized, the tool assembly 18
can be inserted through a small diameter cannula 107.
[0062] Referring to FIGS. 13 and 14, as discussed above, the tool
assembly 18 includes a biasing member 106 including one or more
springs 108. Each of the springs 108 is positioned between a
proximal end 26b of the anvil body 26 and an inner surface of the
outer tube 14 to urge the anvil body 26 towards the "open
position". The proximal end 26b of the anvil body 26 is positioned
proximally of the pivot members 40 such that downward movement of
the proximal end 26b of the anvil body 26 as indicated by the arrow
A in FIG. 14 causes the tissue contact surface 30 of the anvil body
26 to move in a direction away from the tissue contact surface 44a
of the staple cartridge 44 as indicated by the arrow "B" in FIG.
14.
[0063] Referring to FIGS. 15-21, when the actuation device 12 (FIG.
3) is actuated to advance the drive member 62 within the cartridge
assembly 24, the upper extended members 90 move distally along the
outer surface of the anvil body 26 and pass over the cam surface
26a. Simultaneously, the lower extended members 92 translate along
the outer surface of the channel portion 74 of the outer tube 14 to
prevent outward deflection of the outer tube 14. Engagement of the
upper extended members 90 with the cam surface 26a of the anvil
body 26 causes the anvil assembly 22 to pivot to the "clamped
position". More specifically, when the upper extended members 90
(FIG. 19) of the drive member 62 engage the cam surface 26a of the
anvil body 26, the pivot members 40 pivot within the cutouts 82 and
the anvil assembly 22 moves in the direction indicated by arrow "C"
in FIG. 15 to the "clamped position" about tissue "T". As best seen
in FIG. 16, as the tissue contact surface 30 of the anvil body 26
contacts tissue "T", the proximal end of the anvil body 26 moves
away from the staple cartridge 44 and the pivot members 40 move
upwardly within the cutouts 82 of the outer tube 14 to allow the
anvil assembly 22 to lift off of the staple cartridge 44 and move
to the "clamped position" defining a tissue gap "G". The tissue gap
"G" accommodates placement of tissue between the tissue contact
surfaces 30 and 44a of the anvil body 26 and the staple cartridge
44, respectively. A maximum tissue gap "G" is determined by the
distance between the upper and lower radially extending members 90
and 92, respectively, which are positioned to move along the outer
surfaces of the anvil assembly 22 and the channel portion 74 of the
outer tube 14.
[0064] As illustrated in FIG. 17, the distal end 62a of the drive
member 62 is positioned to engage the proximal end of the sled 100
such that distal movement of the drive member 62 causes
corresponding distal movement of the sled 100 through the staple
cartridge 44. When the tool assembly 18 is in the "clamped
position", the sled 100 is positioned proximally of the pushers 48
(FIG. 4).
[0065] As illustrated in FIG. 19, the pair of upper extended
members 90 include a first upper extended member 90a that extends
transversely from the vertical strut 89 of the drive member 62 in a
first direction along the outer surface of the anvil body 26 and a
second upper extended member 90b that extends transversely from the
vertical strut 89 in a second direction opposite to the first
direction. The first upper extended member 92a is positioned
distally of the second upper extended portion 90b. Similarly, as
shown in FIGS. 20 and 21, the pair of lower extended members 92
include a first lower extended member 90a that extends transversely
from the vertical strut 89 and the longitudinal slot 78 of the
channel portion 74 in a first direction along the outer surface of
the channel portion 74 of the outer tube 14 and a second lower
extended member 92b that extends transversely from the vertical
strut 89 and the longitudinal slot 78 in a second direction
opposite to the first direction. The first lower extended portion
92a is positioned distally of the second lower extended member 92b.
The pair of upper and lower extended members 90 and 92 are
configured to provide secure engagement with the anvil assembly 22
and outer tube 14 to define the maximum tissue gap "G" (FIG.
15).
[0066] In embodiments, the upper and lower edges of the sheet metal
forming the drive member 62 can be cut and bent in opposite
directions to form the upper and lower pairs of extended members 90
and 92.
[0067] Referring to FIGS. 22 and 23, when the drive member 62 is
advanced in the direction indicated by arrow "D" in FIG. 23 by the
actuator 12 (FIG. 3), the distal working portion 62a of the drive
member 62 advances the sled 100 in the direction indicated by arrow
"E" through the staple cartridge 44 into sequential engagement with
the pushers 48 to eject the staples 46 from the staple retention
slots 50 of the staple cartridge 44. For a more detailed
description of the operation of the sled 100 and the pushers 48,
see the '033 Patent. As the working end portion 62a of the drive
member 62 translates through the staple cartridge 44, the knife
blade 86 (FIG. 4) on the distal end of the working end 62a of the
drive member 62 dissects the tissue "T" positioned between the
anvil assembly 22 and the staple cartridge 44.
[0068] In use, the tool assembly 18 of the surgical stapling device
10 is manually moved to the "parked position" and inserted into a
small diameter cannula 107 (FIG. 10). As the tool assembly 18 of
the surgical stapling device 10 exits the cannula 107 adjacent a
surgical site, e.g., the abdomen, the tool assembly 18 will be
moved to the "open position" by the biasing member 106, e.g.,
springs 108 (FIG. 13). In the "open position", the tool assembly 18
is positioned to capture tissue to be treated "T". Once the tool
assembly 18 is properly positioned about tissue "T", the actuation
device 12 (FIG. 3) can be actuated to advance the drive member 62
to move the tool assembly 18 to the "clamped position" (FIG. 15).
The tool assembly 18 can be inspected by the clinician to ensure
that the tool assembly 18 is properly clamped about the tissue "T".
Thereafter, the actuation device 12 can be actuated to suture and
dissect the tissue "T" (FIG. 23).
[0069] Persons skilled in the art will understand that the devices
and methods specifically described herein and illustrated in the
accompanying drawings are non-limiting exemplary embodiments. It is
envisioned that the elements and features illustrated or described
in connection with one exemplary embodiment may be combined with
the elements and features of another embodiment without departing
from the scope of the present disclosure. As well, one skilled in
the art will appreciate further features and advantages of the
disclosure based on the above-described embodiments. Accordingly,
the disclosure is not to be limited by what has been particularly
shown and described, except as indicated by the appended
claims.
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