U.S. patent number 3,638,847 [Application Number 05/052,337] was granted by the patent office on 1972-02-01 for ratchet-driven cartridge for surgical instruments.
This patent grant is currently assigned to United States Surgical Corporation. Invention is credited to Graham W. Bryan, Douglas G. Noiles.
United States Patent |
3,638,847 |
Noiles , et al. |
February 1, 1972 |
RATCHET-DRIVEN CARTRIDGE FOR SURGICAL INSTRUMENTS
Abstract
A disposable staple-housing cartridge adapted for mounting on a
surgical instrument and particularly suited for stapling skin and
fascia. The cartridge comprises, basically, a stationary sawtooth
staple-retaining member, a sawtooth staple-driving member mounted
for reciprocating movement, an anvil, and a staple pusher. For each
reciprocation of the staple-driving member, each of the staples
housed in the cartridge is driven forward from one tooth to the
next successive tooth of the retaining member. The pusher element
controls the movement of the reciprocating drive member, advances
each of the staples, ejects a staple from the cartridge and bends
the ejected staple around the anvil; this occurs for each drive
cycle of the pusher. The pusher is, in turn, operated by the
associated surgical instrument.
Inventors: |
Noiles; Douglas G. (Ridgefield,
CT), Bryan; Graham W. (New Canaan, CT) |
Assignee: |
United States Surgical
Corporation (Baltimore, MD)
|
Family
ID: |
21976964 |
Appl.
No.: |
05/052,337 |
Filed: |
July 6, 1970 |
Current U.S.
Class: |
227/120;
227/19 |
Current CPC
Class: |
A61B
17/105 (20130101) |
Current International
Class: |
A61B
17/03 (20060101); A61B 17/10 (20060101); B25c
005/16 () |
Field of
Search: |
;227/19,120,125,126,127,128,134,135,136,138 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Custer, Jr.; Granville Y.
Claims
We claim:
1. A surgical stapling cartridge adapted to house a plurality of
staples, to associate with a surgical instrument having only
rectilinear thrust capabilities, and being particularly suited for
stapling skin and fascia of a surgical patient, the cartridge
comprising: an elongated retaining member fixed against movement in
its longitudinal direction; an elongated driving member having a
length less than the length of said retaining member, said driving
member being slidably mounted with respect to said retaining
member; a plurality of staple-retaining teeth resiliently
associated with said retaining member; a plurality of
staple-driving teeth resiliently associated with said driving
member; the teeth in said retaining member and the teeth in said
driving member being related, when relaxed, in such a manner that
the peaks of said teeth lie in a single plane; means to drive said
driving member, thereby advancing each of the staples in said
cartridge toward the front thereof; and pusher means for expelling
and bending a single staple for each forward thrust thereof.
2. The cartridge recited in claim 1, wherein said retaining member
and said driving member are U-shape and wherein said teeth are
positioned at the extremities of the arms of the respective U-shape
members.
3. The cartridge recited in claim 1, and further comprising: ledge
means defined in said cartridge and serving to support and guide
said plurality of staples out of the plane of said pusher means;
and ramp means at the forwardmost region of said ledge means, and
serving to move the forwardmost staple into the plane of the pusher
means.
4. The cartridge recited in claim 1, wherein the stroke of said
pusher means is longer than the stroke of said driving member, and
further comprising: means for releasing said driving member from
said pusher means during the forward stroke of said pusher means;
and means for ensuring the engagement of said pusher means with
said driving member during the rearward stroke of said pusher.
5. The cartridge recited in claim 4, wherein said driving member is
released from said pusher means only after the forwardmost staple
is in the plane of said pusher.
6. The cartridge recited in claim 1, wherein said retaining member
and said driving member are U-shape; wherein said driving member is
slidably mounted within the arms of said retaining member; and
wherein said retaining member and said driving member are flexible
so as to allow the respective teeth to move out of said single
plane.
7. The cartridge recited in claim 6, wherein said plurality of
staples are driven by the teeth of said driving member; wherein the
teeth of said retaining member move out of said single plane during
the forward stroke of said driving member; wherein the teeth of
said retaining member maintain the positions of said staples during
the rearward stroke of said driving member; and wherein the teeth
of said driving member move out of said single plane during the
rearward stroke thereof.
8. The cartridge recited in claim 7, wherein the length of the
stroke of said driving member is substantially equal to the
distance between successive teeth.
9. The cartridge recited in claim 7, wherein the length of the
stroke of said driving member is somewhat greater than the distance
between successive teeth.
10. The cartridge recited in claim 7, wherein the dimensions of the
teeth in said retaining member are substantially identical to the
dimensions of the teeth in said driving member.
11. The cartridge recited in claim 1, wherein the depth of the
teeth in said retaining member and in said driving member is
substantially equal to the diameter of said staples.
Description
BACKGROUND OF THE INVENTION
While the use of stainless steel staples in surgical procedures has
been practiced for a number of years, it has only been a very short
time since the development of an efficient instrument and cartridge
for effecting the stapling of the skin of a surgical patient. See
copending U.S. Pat. application Ser. No. 852,822, filed on Aug. 25,
1969, and assigned to the present assignee. And, since the initial
effort in providing a stapler useful for suturing the skin of a
surgical patient, two further efforts have been made to improve and
simplify both the disposable cartridge and the instrument itself.
See copending U.S. Pat. application Ser. No. 14,614, filed on Feb.
26, 1970, and copending U.S. Pat. application Ser. No. 21,465,
filed on Mar. 20, 1970, each assigned to the present assignee.
In the first of the above-referenced copending U.S. patent
applications, there are disclosed a gas-powered surgical instrument
and a disposable staple-carrying cartridge unit adapted to be
mounted on the instrument. In that application, a plurality of
staples are guided and are driven by a pair of helical screws
forming a part of the cartridge. The basic instrument is provided
with a complex gearbox arrangement for rotating the helical screws,
thereby advancing the staples. The complexity and the cost of such
an arrangement should be immediately apparent.
In the second of the above-noted copending U.S. patent
applications, two improved cartridge arrangements are disclosed.
However, each of these arrangements carries forth the principle of
using helical screws for advancing and guiding the staples and the
use of a complex gearbox for perfecting the rotation of the
screws.
In the third of the above-noted copending U.S. patent applications,
a cartridge is disclosed which results both in the simplification
and in the reduction of costs involved in practicing the known
stapling techniques. In this cartridge, helical screws are still
used for advancing and guiding the staples. However, the complex
gearbox arrangement is eliminated from the basic instrument and is
replaced by a simple helical cam, integral with each
staple-advancing screw. Therefore, by the teachings in the last of
the three copending patent applications, the basic instrument is
relieved of the functions of both ejecting the staples and rotating
the staple-advancing screws; the basic instrument needs only
perfect the ejection of the staples, the screw rotation being
simply, efficiently and economically carried out in the
cartridge.
Notwithstanding the many advances in the surgical stapling art,
referred to above, there remain areas wherein improvement and
redesign are desirable. It is toward the advancement of the prior
art described immediately above that the present invention is
directed.
SUMMARY OF THE INVENTION
The present invention relates to a disposable staple-carrying
cartridge particularly suited for suturing skin and fascia and
adapted to be mounted on an instrument having only rectilinear
thrust capabilities. The inventive cartridge brings about the
staple advancement operation by the interaction of a U-shape
sawtooth retaining member fixedly mounted in the cartridge housing
and a U-shape sawtooth staple-driving member mounted on the
retaining member for reciprocal motion. The retaining and driving
members, mounted in the housing, associate with a plurality of
staples preferably equal in number to the number of teeth in the
movable driving member. A pusher, slidably mounted in the housing,
controls the operation of the movable driving member; a drive bar
in the basic instrument controls the operation of the pusher.
When the forward thrust of the pusher is initiated by the basic
surgical instrument, the movable driving member travels forward a
distance somewhat greater than the common length of the teeth in
the retaining member and in the driving member. At this occurrence,
each of the staples housed in the cartridge is advanced by the same
distance, each traveling from one tooth to the next successive
tooth in the retaining member. After the staples have so moved, the
driving member comes into contact with a stop, becomes free from
the pusher, and allows the pusher to continue its forward motion,
eject and form a staple in the skin of a patient. At this
occurrence, the return stroke begins.
The basic instrument, after the stapling operation, returns the
pusher to its retracted position, and, because the pusher
associates with the driving member, the latter is also returned to
its retracted position. Then, the cartridge is ready for another
firing operation.
From the above, the simplicity of the inventive staple-housing
cartridge should be evident. The staples are housed, advanced and
discharged with a minimum effort and with a minimum number of
moving parts. At the same time, however, the cartridge operation is
both reliable and efficient.
Accordingly, it is the main object of the present invention to
provide a simplified disposable cartridge adapted to be mounted on
a surgical instrument having only rectilinear thrust capabilities,
and being particularly suited for stapling skin and fascia.
It is a further object of the present invention to provide a
disposable staple-carrying cartridge having a minimum number of
movable parts and yet being both reliable and efficient.
It is a further object of the present invention to provide a
disposable staple-carrying cartridge wherein staples are advanced
by means of a novel and simple sawtooth arrangement.
These and other objects of the present invention, as well as many
of the attendant advantages thereof, will become more readily
apparent when reference is made to the following description taken
in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an exploded perspective view of the disposable
staple-carrying cartridge forming a part of the present
invention;
FIG. 2 is a partial side view of the inventive cartridge during the
staple-advancing operation;
FIG. 3 is a view similar to FIG. 2 but showing the cartridge during
its return stroke;
FIG. 4 is a partial cross section of the inventive staple-housing
cartridge in its fully retracted position;
FIG. 5 is a view similar to FIG. 4 but showing the cartridge during
the staple-advancing operation;
FIG. 6 is a view similar to FIG. 5 but showing the cartridge at the
end of the staple advancing and forming operations;
FIG. 7 is a top view, partially in section, of the inventive
cartridge illustrated in FIG. 6;
FIG. 8 is a cross section of the cartridge taken along line 8--8 of
FIG. 6; and
FIG. 9 is a cross section of the cartridge taken along line 9--9 of
FIG. 6.
DETAILED DESCRIPTION OF THE DRAWINGS
With reference first to FIG. 1, the construction of the inventive
staple-carrying cartridge will be described. The cartridge is shown
generally at 10 and comprises a lower casing 12, an upper casing
14, a flexible U-shape retaining member 16, a flexible U-shape
driving member 18, and a pusher 20. A single staple is shown at
22.
As seen in FIGS. 1 and 8, the lower casing 12 defines a hollow
bounded by a front wall 24, a rear wall 25, a pair of sidewalls 26
and a bottom wall 28. On the top of each sidewall 26, there is
present a staple guide surface 30 terminating in a ramp 32. The
ramps 32 are positioned at the front of the cartridge 10 adjacent
the front wall 24 of the lower casing 12.
As best seen in FIGS. 8 and 9, the bottom wall 28 of the lower
casing 12 is provided with a pair of upstanding rails 34 defining
therebetween, a mounting track 35. Rails 34 extend substantially
the entire length of the casing 12. And, as seen best in FIGS. 1, 8
and 9, a guide bar 36 projects from the bottom of the U-shape
retaining member 16, the guide 36 extending substantially the
entire length of the retaining member. The interaction between the
mounting track 35 and the guide bar 36 maintains the bottom of the
retaining member 16 in a fixed and central position with respect to
the lower casing 12. The length of the retaining member 16 is made
substantially equal to the length of the hollow in the lower casing
12 and, therefore, there is no longitudinal motion of the retaining
member in the lower casing.
The U-shape driving member 18 is adapted to slide in its
longitudinal direction, along the U-shape retaining member 16. For
this purpose, the retaining member is provided with a pair of
upstanding rails 38, defining a guide track 39, and the driving
member is provided with a guide bar 40. The rails 38 extend
substantially the entire length of the retaining member 16, and the
guide bar 40 extends substantially the entire length of the driving
member 18.
A plurality of retaining teeth 42 are defined in the upstanding
arms 44 of the U-shape retaining member 16. Similarly, a plurality
of driving teeth 46 are defined in the upstanding arms 48 of the
driving member 18. The relative dimensions of the teeth 42 and 46
and of the arms 44 and 48 are as follows. The retaining teeth 42 in
the U-shape retaining member 16 have the same depth and length as
the driving teeth 46 in the U-shape driving member 18. The depth of
the teeth 42 and 46, as seen best in FIGS. 2 and 3, is made equal
to the diameter of the staples 22. And, as best seen in FIGS. 1, 8
and 9, the height of the arms 44 is substantially larger than the
height of the arms 48, these relative heights being defined so that
when the U-shape driving member 18 is mounted in the U-shape
retaining member 16, the peaks of the retaining teeth 42 lie in the
same plane as the peaks of the driving teeth 46. The reason for
this alignment will become clear when the operation of the
cartridge is described.
The rear of the U-shape driving member 18 takes the form of an
extension bar 50 which terminates in a rectangular tooth 52. A
rectangular slot, shown generally at 54, is defined in the rear of
the pusher 20 and is dimensioned so as to comfortably house the
rectangular tooth 52. The rear wall 56 of the slot 54 is beveled,
as seen in FIGS. 1 and 4, for reasons which will be more fully
explained below. The rearwardmost wall 58 of the pusher 20 is also
beveled, as best seen in FIGS. 1 and 4. Again, the reason for this
beveling will be explained below.
A second slot 60 is defined in the body of the pusher 20 and is
sized so as to communicate with a drive bar 62 taking the form of
the thrust member of the associated medical instrument. The medical
instrument is of the type fully described in the first of the two
above-noted U.S. patent applications, and, consequently, will not
again be described in detail. Suffice it to say that when the
instrument is triggered by the physician, the drive bar 62 moves in
the direction of the arrow 64 (FIG. 4). Then, after the maximum
drive stroke is reached, the drive bar returns to its fully
retracted position.
To facilitate the insertion of the drive bar 62 in the slot 60, the
upper casing 14 is provided with an elongated slot 66. The length
of the slot 66 is made so as to allow the drive bar 62 complete
freedom of movement in both its forward and rearward drive strokes.
Upstanding tabs 68 are also fit on the upper casing member 14, and,
as explained in the first of the two above-noted U.S. patent
applications, tabs 68 serve to maintain the cartridge 10 in the
body of the associated medical instrument while allowing freedom of
movement of the bar 62.
From FIGS. 1, 8 and 9, one further feature of the upper casing 14
should be noted. This feature relates to the manner in which the
staples 22 are guided by the guide ledge 30, the ramp 32 and the
internal surface of the upper casing 14. In FIG. 1, it can be seen
that the height of the casing, as it affects the staples 22,
changes near its front. This can be seen by comparing FIGS. 8 and
9. In FIG. 9, a cross section taken near the middle of the
cartridge 10, the staples 22 are held by the ledges 30 and the
internal wall of the upper casing 14 at a height below the plane of
the pusher 20. In FIG. 8, on the other hand, a cross section taken
near the front of the cartridge 10, the staples are held by the
ramps 32 and the internal wall of the upper casing 14 at a height
which puts them in the plane of the pusher 20. The reason for this
will become clear from the following.
As previously noted, the inventive staple-housing cartridge is made
disposable. Accordingly, the components of the cartridge are
sterilized, the cartridge is fully assembled and is then packaged
and sealed in a presterilized envelope for transportation and
sales. The construction of the cartridge, shown exploded in FIG. 1,
is quite simple. The U-shape retaining member 16 is fitted within
the hollow of the lower casing 12. Then, the U-shape driving member
18 is positioned within the track 39 of the retaining member 16.
The driving member 18 is moved to its rearwardmost position and a
plurality of staples, preferably equal in number to the number of
teeth in the driving member 18, are positioned in the aligned teeth
of the driving member 18 and the retaining member 16 (FIG. 4).
Then, the pusher 20 is fit on the top of the driving member 18 with
the rectangular tooth 52 extending into the slot 54. The upper
casing 14 is snapped in place and the cartridge is ready to be
packaged for shipment.
The operation of the disposable cartridge is as follows. With the
cartridge 10 properly mounted in the associated medical instrument
and the drive bar 62 extending through the slot 66 in the upper
casing 14 and engaging the slot 60 in the pusher 20, the relative
positions of the elements are as shown in FIG. 4. As can be seen
from this Figure, the teeth of both the retaining member 16 and the
driving member 18 are in substantial transverse alignment, the
teeth of member 18 being retracted slightly more, in the rearward
direction, than the teeth of member 16. This ensures that the teeth
46 in member 18 engage the staples 22. And, as also evident, the
staple 22 nearest the forward end of the cartridge 10 is supported
by the ramp 32.
When the instrument is fired, as shown in FIG. 5, the drive bar 62
moves in the direction of arrow 64. With the downwardly projecting
portion of the drive bar 62 engaging the slot 60 in the pusher 20,
the movement of the drive bar 62 brings about a corresponding
movement in the pusher 20. And, because the rectangular tooth 52
integral with the driving member 18 is housed within the slot 54 in
the pusher 20, movement of the pusher causes movement in the
driving member.
With the driving member 18 moving in the direction of arrow 64,
each tooth 48 drives its associated staple toward the front of the
cartridge 10. As seen in FIGS. 2 and 8, the movement of the driving
member 18 in the direction of arrow 64 causes the arms 44 of the
retaining member 16 to flex out of the plane of the staples. The
flexing of the retaining member 16 is shown, in phantom, in FIG. 8
and is indicated in FIG. 2 by the arrows 70.
As best seen in FIG. 4, with the driving member 18 in its
rearwardmost position, the stroke, designated by S is defined by
the distance between the front of the driving member 18, when in
its rearwardmost position, and the forward wall 24 in the lower
casing 12. As also seen in FIG. 4, the distance S is somewhat
greater than the peak-to-peak dimension L of the teeth 42 and 46,
as is common in all ratchet and pawl drive mechanisms, to ensure
proper tooth engagement.
When the drive bar 62 drives the pusher 20 and, in turn, moves the
driving member 18, there is unison of motion until the front wall
of the driving member 18 abuts the wall 24 in the lower casing 12.
At this instance, the relative positions of the elements are as
shown in FIG. 5. It will be noted that the forwardmost jaw of the
pusher 20 is behind the forwardmost staple 22 and that the
forwardmost staple 22 is in the plane of the pusher ready for
ejection.
With further movement of the drive bar 62 in the direction of arrow
64, the pusher 20 attempts to continue its movement of the driving
member 18 in the direction of arrow 64. However, this is not
possible. Further movement of the pusher 20 causes the extension
50, integral with the driving member 18, to slide along the
inclined surface 56 and out of the slot 54 at the rear of the
pusher 20. With the pusher 20 free from engagement with the driving
member 18, the forward motion of the pusher continues until the
forwardmost staple 22 is ejected from the body of the cartridge 10
and formed around the anvil 72 in a manner fully described in each
of the above-referenced copending U.S. patent applications. The
condition of the cartridge 10 at the completion of the staple
advancing and ejecting operations is shown in FIGS. 6 and 7. It
should be evident that for each forward stroke of the driving
member 18, all staples are moved from their respective teeth in the
retaining member 16 to the next successive teeth.
Once the drive bar 62 and the pusher 20 have reached the
forwardmost portions of their strokes, they begin their return
strokes. For the first portion of the return stroke, the pusher 20
moves while out of engagement with the driving member 18. However,
when the rear wall 58 of the pusher 20 contacts the front wall of
the rectangular tooth 52, the sloping wall 58 flexes the extension
50 in a downward direction and causes the tooth 52 to enter the
slot 54. Then, the drive member 18 is retracted, by the pusher 20,
into its preadvance position.
As shown in FIGS. 3 and 9, the movement of the pusher 20 in the
direction of arrow 74, and the corresponding movement of the drive
member 18, causes the arms 48 of the drive member 18 to flex out of
the plane of the staples 22, as shown in phantom in FIG. 9 and as
indicated by arrows 76 in FIG. 3. As is evident from FIG. 3, the
flexing of the arms 48 is necessitated by the engagement of the
staples 22 by the teeth 42 of the retaining member 16. The return
stroke of the drive member 18 continues until the drive member
again takes the position shown in FIG. 4. The cartridge is then
ready for another firing operation.
The U-shape retaining member 16 and the U-shape driving member 18,
because of the requirement that the respective arms 44 and 48 be
capable of bending, is made of a material which yields under force.
However, because of the requirement that the respective teeth 42
and 46 be capable of retaining or driving staples, the material of
the retaining member 16 and the driving member 18 must be
relatively incompressible. While many plastic materials meet these
requirements, one suitable material is sold under the trade name
"Lexan."
As is evident from the above, the staple-carrying cartridge of the
present invention can house a number of staples limited only by the
length of the cartridge. As should also be evident, the inventive
cartridge can be fired by a powering unit having only rectilinear
thrust capabilities. And, while the cartridge is extremely simple
in design, having but two moving parts, its operation is both
efficient and reliable.
Above, a specific embodiment of the present invention has been
described. It should be appreciated, however, that this embodiment
is described for purposes of illustration only and that numerous
alterations and modifications may be practiced by those skilled in
the art without departing from the spirit and scope of the
invention. Accordingly, it is the intent that the invention not be
limited by the above but be limited only as defined in the appended
claims.
* * * * *