CA1182710A - Pressure sensitive and working gap controlled medical stapling device - Google Patents
Pressure sensitive and working gap controlled medical stapling deviceInfo
- Publication number
- CA1182710A CA1182710A CA000410260A CA410260A CA1182710A CA 1182710 A CA1182710 A CA 1182710A CA 000410260 A CA000410260 A CA 000410260A CA 410260 A CA410260 A CA 410260A CA 1182710 A CA1182710 A CA 1182710A
- Authority
- CA
- Canada
- Prior art keywords
- drive
- clutch plate
- movable jaw
- rearward end
- nut
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07228—Arrangement of the staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
Abstract
ABSTRACT OF THE DISCLOSURE
PRESSURE SENSITIVE AND WORKING-GAP -CONTROLLED SURGICAL STAPLING INSTUMENT
A surgical stapling instrument for suturing tissues or organs. The instrument is of the type having a fixed anvil jaw, a movable staple cartridge-carrying jaw shiftable toward and away from the anvil Jaw, and a staple driver actuator shiftable to actuate the staple driver of the staple cartridge to implant the staples of the cartridge in the tissue or organ located between the anvil jaw and the staple cartridge-carrying jaw. The instrument is provided with a clutch to control the gap between the fixed anvil jaw and the staple cartridge in response to the pressure being applied to the organ or tissue therebetween to preclude over-compression or under-compressIon thereof. The instrument is also provided with a latch to preclude shifting of the staple driver actuator to actuate the staple driver when the gap determined by the clutch is not within the limits of the proper working gap of the instrument required by the forming limits of the staples. The latch means further assures proper sequential operation of the instrument by the surgeon.
PRESSURE SENSITIVE AND WORKING-GAP -CONTROLLED SURGICAL STAPLING INSTUMENT
A surgical stapling instrument for suturing tissues or organs. The instrument is of the type having a fixed anvil jaw, a movable staple cartridge-carrying jaw shiftable toward and away from the anvil Jaw, and a staple driver actuator shiftable to actuate the staple driver of the staple cartridge to implant the staples of the cartridge in the tissue or organ located between the anvil jaw and the staple cartridge-carrying jaw. The instrument is provided with a clutch to control the gap between the fixed anvil jaw and the staple cartridge in response to the pressure being applied to the organ or tissue therebetween to preclude over-compression or under-compressIon thereof. The instrument is also provided with a latch to preclude shifting of the staple driver actuator to actuate the staple driver when the gap determined by the clutch is not within the limits of the proper working gap of the instrument required by the forming limits of the staples. The latch means further assures proper sequential operation of the instrument by the surgeon.
Description
PRESSURE SE~lSITIVE ~ID WORKING-GAP
CONTROLL~D SURCICAL STAPLING INSTRUM~NT
CA~L T. BEC~IT
BAC~GROUND OF THE INVENTIQN
The invention rela~es to a surgical stapling instrumen~
for suturing tissue or organs and more par~icularly to such an ins~rument which is sensi-tive ~o the pressure being applied to the tissue or organ by ~he instrument and which is working gap-controlled.
Prior art workers have devised numerous embodiments of the type of surgical s~apling ins~rumen~ to whlch ~he improvements of the presen~ invention are direc~:ed.
Examples of such surgical stapling instruments are taught in United States Let~ers Paten~s 3,~80,564; 3,252,h43; Y
3,269,630; 3,275,211; 3,3l5,,~63; 3,494,533; 3,589,589 and 3,795,034. All such surgical stapling instruments are intended for use in suturing ~issue or organs such as pulmonary tissue, gastric stumps, bronchial s~umps, small and large intestines, the s~omach, the duodenum and the like. These prior art surgical s~apling instruments are, in general, characterized by a fixed anvil or anvil supporting j8w and a movahle staple cartridge-carrying ~aw. The s~aple car~ridge-carrying jaw is shlftable tot~ard and away ~roln ~he anvil jaw. The organ or tissue to be sutured is located between ~he fixed anvil jaw and the shiftable staple cartridge-carrying jaw.
The typical staple car~ridge contains staples arranged to provide one or more staple suture lines. The car~ridge is also provided with one or more staple drivers which, when shift,ed toward the fixed jaw of the ins~rument, will cause the staples to be'driven from the cartridge and through the tissue or organ. The staples ~ill be clinched 7 by staple clinching grooves in ~he anvil por~ion of ~he fixed jaw. Finally, each such instrumen~ is typically provided wi~h a s~aple driver actua~or by which ~he '~ ' surgevn may cause ~he s~aple sutures ~v be implan~ed and clinched.
Prior ar~ workers have devised various means ~o shif~
~he s~aple car~ridge-carrying jaw ~oward ~he fixed jaw.
The most commonly encountered means is a h~nd-operated screw mechanism which directly powers ~he staple car~ridge-carrying jaw toward the ~ixed anvil jaw. It will be understood that, for proper operation of the surgical instrument, the working ~ap between th~ staple cartridge-carrying jaw and the anvil jaw, in which the organ or ~issue to be sutured is loca~ed, should be wi~hin the Eorming limi~s of ~he s~aples. In other words, ~he s~ples must he adequa~ely clinched while, on ~he o~her hand, ~hey mus~ not be deformed or crushed.
With prior art surgical stapling instruments of the type under considera~ion, ~he surgeon simply ro~ated the screw mechanism (or manipulated some other form oE
advancing means) ~o shif~ ~he s~aple cartridge-carrying jaw ~oward ~he fixed anvil jaw until a predetermined gap or dis~ance be~ween ~he jaws, within the working gap o the instrumen~ and i~s staples, was a~ained. The dlfflculty wikh ~his arrangemen~ lies in ~he fac~ ~ha~ ~he thickness and compressibill~y of organs and tissues vary.
Therefore, when ~he s~aple car~ridge-carrying jaw ls driven or shi~ed ~o a predetermined dis~ance ~rom the fixed anvil jaw, it is very improbable ~hat a correct compression will be placed on the organ or ~issue ~o be su~ured. If the organ or Lissue is over-compressed, it can become strangulated and can undergo necroses. On the other hand, if the ~lssue or organ is under-compressed, hemostasis of ~he suture line wlll no~ be achieved with the ~ccompanying well known undesirable effec~s.
The surgical ins~rumen~ of ~he present inven~ion overcomes ~his difficulty by dr;ving the staple cartridge-carrying jaw ~oward ~he fixed anvil jaw by means of a pressure respons;ve clutch means. This provides an arrangemen~ wherein ~he ins~r~en~ closing and ~he establishment oE the gap of Lhe instrument are controlled by the pressure pu~ upon the organ or ~is~sue by ~he instrumen~. ~ith prior ar~ ins~rumen~s, once the surgeon advanced ~he staple cartridge-carrying jaw ~o ~he predetermined position relative to ~he fixed anvil jaw, he could be assured ~hat the gap ~herebetween was within the proper working gap of the instrument and its staples, assuring correc~ Eormation of the s~aple sutures. In ~he surgical stapling instrumen~ GE the present invention, since the closing vf the instrument is controlled by the pressure applied to the organ or tissue ~o be sutured, ~he gap be~ween ~he Eixed jaw and ~he staple cartridge-carrying jaw may not ~all wi~hin ~he range oE
the proper working gap of ~he ins~rumen~. As a consequence, ~he instrument of the present invention is provided with latch means whic~ preclude movemen~ oE ~he staple driver actuator unless the gap of the instrument ls within the limits oE its proper workin~ gap. ~h-us, if ~he gap established in response ~o ~he pressure being applied to the organ or tlssue does not all within the proper working gap o the instrument, use of the ins~rument is contraindicated. The pressure sensitive mechanism which controls the closure of ~he instrument has a posi~lve drive to open the instrument. The staple driver actuator la~ch means also assures ~hat ~he instrumen~ is sequence cont~olled.
~ISCLOSURE OF T~E INVENTION
The surgical stapling instrument of the present invention comprises a fixed anvil jaw and a movable s~aple cartridge-carrying Jaw. The s~aple cartridge contains a plurality of staple sutures and a driver ~herefore. The staple cartridge-carrying jaw i5 shif~able toward and away from the an~il jaw. The ins~rument is also provided wi~h ~ 7~ ~
a staple driver actua~or ~o activa~e the staple driver of ~he staple cartridge and to cause ~he staple sutures thereoE to pass through the ~issue or organ to be sutured.
The tissue or organ is located between the anvil jaw and the staple cartridge of the s~aple cartridge-carrying jaw.
The staples are clinched by grooves in ~he anvil jaw.
The staple cartridge-carrying jaw is shif~able toward and away from ~he fixed anvil jaw by means of a ro~a~able drive knob operatively connected to the s~aple cartridge-carrying jaw by a clu~ch means. The clutch means is posi~ive ac~ing during shifting of the staple car~ridge-carrying jaw away from the fixecl anvil jaw, but is pressure responsive when driving the s~aple cartridge-carrying jaw toward ~he fixed anvil jaw so as ~o efectively disengage the drive Icnob from the staple cartridge-carrying jaw when a prede~ermined pressure is applied to the organ or tissue to ~e sutured.
The staple driver actuator is shifted toward and away Erom the fixed anvil jaw by a wing nut-screw assembly. An automatic la~ch means is provided to preclude shiEting of the staple driver actua~or un].ess the gap between ~he staple cartridge-earrying jaw and ~he Eixed anvil jaw (determined by the above men~ione~ clutch means) is wit:hin the limits oE ~he woLking gap of the Lnstrumen~.
~RIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a ~ragmentary elevational view of the instrument o the present inven~ion.
Figure ~ is a fragmen~ary elevational view of the instrument as seen from the left of Figure 1.
Figure 3 is a fragmentary elevational view of the ins~rument of Figure 1 as seen from the righ~ of tha~
Figure.
Figure 4 is a cross sectional view taken along sec~ion line 4-4 of Figure 3.
Figure 5 is a cross sec~ional, elevational view of the ti~
instrument ~rive knob.
Figure 6 is a ~ot~om view of ~he clu~ch plaLe of the instrument.
Figure 7 is a cross sectional view taken along section line 7-7 oE Figure 6.
Figure 8 is a side eleva~ional view of ~he clutch plate of Figures 6 and 7.
Figure 9 is a cross sectional view taken along sec~ion line 9-9 of Figure 4.
Figure lO is a cross sectional view taken along section line lO-lO of Figure 4.
Figure 11 is a cross sectional view taken along section line ll-ll of Flgure ~.
Flgure 12 is a fragmentary cross sectional view taken along section line l2-12 o.f Figure ll.
Figure 13 is a fragmentary perspective view o~ ~he upper end of the staple driver actuator of the surgical instrument.
Figure 14 is a cross sectional view ~aken along section line 14-14 of Figure 4.
Figure 15 is a cross sectional view taken along section line 15-15 of Figure 14.
Figure 16 is a side elevational view. of the s~aple car~idge used with ~he s~ ~ical ins~rument of the presen~
invention.
Figure 17 is an end elevational view of the cartridge of Figure 16 as seen from the right of that Figure.
Figure l~ is a plan view of the s~aple car~ridge of Figure 16.
Figue 19 is a fragmentary cross sectional view taken along section line 19-19 of Figure 4.
Figure 2~ is a fragmentary cross sectional view taken along. sectlon line 20-20 of Figure 19.
Figure 21 is an eleva~ional ViPW of a s~aple suture of ~he type used wi~h ~he surgical stapling instrument of the presenL inven~ion, ~he surgical suture being illustra~ed in its uncrimped condition.
Figure 22 is an elevational view oE ~he staple suture of Figure 21 illus~ra~ed in its crimpled condition when the gap of the instrument is at ~he upper limi~ oE ~he proper working gap.
Figure 23 is a plan view of the staple suture of Figure 22.
Figure 24 is an elevational view of ~he s~aple suture of Figure 21 in its crimped condition when the gap of the instrument is at the maximum lower limit of the proper working gap.
Figure 25 is a persp~ctive view oE the drive nut oE ~he surgical stapling ins~rument.
~ETAILED DESCRIPTION,OF THE INVE~ITION
Reference i.s first made to Figures 1, 2 and 3 which illustrate ~he instrument oE the present invention and in which like p~rts have been given like index numerals.
The ins~rument is generally indicated at 1 and comprises a body 2 having a fron~ cover 3. The lower end of body 2 is C-shaped as at 4, providing a fixed jaw 5.
The fixed jaw 5 has an anvil surface 6. While the anvil surface 6 may cons~itute a separa~e elemen~ af~ixed ~o and supported by the fixed jaw 5, Eor purpose~s oE thls 2S exemplary showing, ~he anvil sur~ace 6 is illustrated as being an in~egral, one-piece part of f'ixed jaw 5.
Shiftably mounted within the body 2 there is a movable staple cartridge-carrying jaw 7. The s~aple car~ridge-carrying jaw supports a s~aple car~ridge 8 provided with a plurality of s~aple sutures ~not shown) and a s~aple driver 9 (see Figure 2~ for driving the staple su~ures from the staple cartridge 8, through the tissue or organ to be sutured, and against the anvil surface 6 which clinches the staple sutures. The movable staple cartridge-containing jaw 7 is shif~able,toward and away from ~he fixed jaw 5 by a d~ive knoh 10 a~ ~he upper end of ~he ins~rumen~, as will be described hereinaEter.
Shiftably mounted within the s~aple car~ridge-caxrying jaw 7 ~here is a staple driver ac~ua~or 11 (see Figure 2).
The s~aple driver actua~or 11 is shif~able to ac~iva~e staple driver 9 by a wing nut 12 at ~he upper end of the ins~rumen~, again as will be described in detail hereinafter.
Reference is now made to Figure 4. In Figure 4 (as in all of the Figures) like parts have been given like index numerals. The upper portion 13 of body 2 is substantially semi-cylindrical (see Flgure 11). The body 2 has an intermedia~e elonga~ed portion 14 of U~shaped cross section (see Figure 10). The elongated portion 14 of body
CONTROLL~D SURCICAL STAPLING INSTRUM~NT
CA~L T. BEC~IT
BAC~GROUND OF THE INVENTIQN
The invention rela~es to a surgical stapling instrumen~
for suturing tissue or organs and more par~icularly to such an ins~rument which is sensi-tive ~o the pressure being applied to the tissue or organ by ~he instrument and which is working gap-controlled.
Prior art workers have devised numerous embodiments of the type of surgical s~apling ins~rumen~ to whlch ~he improvements of the presen~ invention are direc~:ed.
Examples of such surgical stapling instruments are taught in United States Let~ers Paten~s 3,~80,564; 3,252,h43; Y
3,269,630; 3,275,211; 3,3l5,,~63; 3,494,533; 3,589,589 and 3,795,034. All such surgical stapling instruments are intended for use in suturing ~issue or organs such as pulmonary tissue, gastric stumps, bronchial s~umps, small and large intestines, the s~omach, the duodenum and the like. These prior art surgical s~apling instruments are, in general, characterized by a fixed anvil or anvil supporting j8w and a movahle staple cartridge-carrying ~aw. The s~aple car~ridge-carrying jaw is shlftable tot~ard and away ~roln ~he anvil jaw. The organ or tissue to be sutured is located between ~he fixed anvil jaw and the shiftable staple cartridge-carrying jaw.
The typical staple car~ridge contains staples arranged to provide one or more staple suture lines. The car~ridge is also provided with one or more staple drivers which, when shift,ed toward the fixed jaw of the ins~rument, will cause the staples to be'driven from the cartridge and through the tissue or organ. The staples ~ill be clinched 7 by staple clinching grooves in ~he anvil por~ion of ~he fixed jaw. Finally, each such instrumen~ is typically provided wi~h a s~aple driver actua~or by which ~he '~ ' surgevn may cause ~he s~aple sutures ~v be implan~ed and clinched.
Prior ar~ workers have devised various means ~o shif~
~he s~aple car~ridge-carrying jaw ~oward ~he fixed jaw.
The most commonly encountered means is a h~nd-operated screw mechanism which directly powers ~he staple car~ridge-carrying jaw toward the ~ixed anvil jaw. It will be understood that, for proper operation of the surgical instrument, the working ~ap between th~ staple cartridge-carrying jaw and the anvil jaw, in which the organ or ~issue to be sutured is loca~ed, should be wi~hin the Eorming limi~s of ~he s~aples. In other words, ~he s~ples must he adequa~ely clinched while, on ~he o~her hand, ~hey mus~ not be deformed or crushed.
With prior art surgical stapling instruments of the type under considera~ion, ~he surgeon simply ro~ated the screw mechanism (or manipulated some other form oE
advancing means) ~o shif~ ~he s~aple cartridge-carrying jaw ~oward ~he fixed anvil jaw until a predetermined gap or dis~ance be~ween ~he jaws, within the working gap o the instrumen~ and i~s staples, was a~ained. The dlfflculty wikh ~his arrangemen~ lies in ~he fac~ ~ha~ ~he thickness and compressibill~y of organs and tissues vary.
Therefore, when ~he s~aple car~ridge-carrying jaw ls driven or shi~ed ~o a predetermined dis~ance ~rom the fixed anvil jaw, it is very improbable ~hat a correct compression will be placed on the organ or ~issue ~o be su~ured. If the organ or Lissue is over-compressed, it can become strangulated and can undergo necroses. On the other hand, if the ~lssue or organ is under-compressed, hemostasis of ~he suture line wlll no~ be achieved with the ~ccompanying well known undesirable effec~s.
The surgical ins~rumen~ of ~he present inven~ion overcomes ~his difficulty by dr;ving the staple cartridge-carrying jaw ~oward ~he fixed anvil jaw by means of a pressure respons;ve clutch means. This provides an arrangemen~ wherein ~he ins~r~en~ closing and ~he establishment oE the gap of Lhe instrument are controlled by the pressure pu~ upon the organ or ~is~sue by ~he instrumen~. ~ith prior ar~ ins~rumen~s, once the surgeon advanced ~he staple cartridge-carrying jaw ~o ~he predetermined position relative to ~he fixed anvil jaw, he could be assured ~hat the gap ~herebetween was within the proper working gap of the instrument and its staples, assuring correc~ Eormation of the s~aple sutures. In ~he surgical stapling instrumen~ GE the present invention, since the closing vf the instrument is controlled by the pressure applied to the organ or tissue ~o be sutured, ~he gap be~ween ~he Eixed jaw and ~he staple cartridge-carrying jaw may not ~all wi~hin ~he range oE
the proper working gap of ~he ins~rumen~. As a consequence, ~he instrument of the present invention is provided with latch means whic~ preclude movemen~ oE ~he staple driver actuator unless the gap of the instrument ls within the limits oE its proper workin~ gap. ~h-us, if ~he gap established in response ~o ~he pressure being applied to the organ or tlssue does not all within the proper working gap o the instrument, use of the ins~rument is contraindicated. The pressure sensitive mechanism which controls the closure of ~he instrument has a posi~lve drive to open the instrument. The staple driver actuator la~ch means also assures ~hat ~he instrumen~ is sequence cont~olled.
~ISCLOSURE OF T~E INVENTION
The surgical stapling instrument of the present invention comprises a fixed anvil jaw and a movable s~aple cartridge-carrying Jaw. The s~aple cartridge contains a plurality of staple sutures and a driver ~herefore. The staple cartridge-carrying jaw i5 shif~able toward and away from the an~il jaw. The ins~rument is also provided wi~h ~ 7~ ~
a staple driver actua~or ~o activa~e the staple driver of ~he staple cartridge and to cause ~he staple sutures thereoE to pass through the ~issue or organ to be sutured.
The tissue or organ is located between the anvil jaw and the staple cartridge of the s~aple cartridge-carrying jaw.
The staples are clinched by grooves in ~he anvil jaw.
The staple cartridge-carrying jaw is shif~able toward and away from ~he fixed anvil jaw by means of a ro~a~able drive knob operatively connected to the s~aple cartridge-carrying jaw by a clu~ch means. The clutch means is posi~ive ac~ing during shifting of the staple car~ridge-carrying jaw away from the fixecl anvil jaw, but is pressure responsive when driving the s~aple cartridge-carrying jaw toward ~he fixed anvil jaw so as ~o efectively disengage the drive Icnob from the staple cartridge-carrying jaw when a prede~ermined pressure is applied to the organ or tissue to ~e sutured.
The staple driver actuator is shifted toward and away Erom the fixed anvil jaw by a wing nut-screw assembly. An automatic la~ch means is provided to preclude shiEting of the staple driver actua~or un].ess the gap between ~he staple cartridge-earrying jaw and ~he Eixed anvil jaw (determined by the above men~ione~ clutch means) is wit:hin the limits oE ~he woLking gap of the Lnstrumen~.
~RIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a ~ragmentary elevational view of the instrument o the present inven~ion.
Figure ~ is a fragmen~ary elevational view of the instrument as seen from the left of Figure 1.
Figure 3 is a fragmentary elevational view of the ins~rument of Figure 1 as seen from the righ~ of tha~
Figure.
Figure 4 is a cross sectional view taken along sec~ion line 4-4 of Figure 3.
Figure 5 is a cross sec~ional, elevational view of the ti~
instrument ~rive knob.
Figure 6 is a ~ot~om view of ~he clu~ch plaLe of the instrument.
Figure 7 is a cross sectional view taken along section line 7-7 oE Figure 6.
Figure 8 is a side eleva~ional view of ~he clutch plate of Figures 6 and 7.
Figure 9 is a cross sectional view taken along sec~ion line 9-9 of Figure 4.
Figure lO is a cross sectional view taken along section line lO-lO of Figure 4.
Figure 11 is a cross sectional view taken along section line ll-ll of Flgure ~.
Flgure 12 is a fragmentary cross sectional view taken along section line l2-12 o.f Figure ll.
Figure 13 is a fragmentary perspective view o~ ~he upper end of the staple driver actuator of the surgical instrument.
Figure 14 is a cross sectional view ~aken along section line 14-14 of Figure 4.
Figure 15 is a cross sectional view taken along section line 15-15 of Figure 14.
Figure 16 is a side elevational view. of the s~aple car~idge used with ~he s~ ~ical ins~rument of the presen~
invention.
Figure 17 is an end elevational view of the cartridge of Figure 16 as seen from the right of that Figure.
Figure l~ is a plan view of the s~aple car~ridge of Figure 16.
Figue 19 is a fragmentary cross sectional view taken along section line 19-19 of Figure 4.
Figure 2~ is a fragmentary cross sectional view taken along. sectlon line 20-20 of Figure 19.
Figure 21 is an eleva~ional ViPW of a s~aple suture of ~he type used wi~h ~he surgical stapling instrument of the presenL inven~ion, ~he surgical suture being illustra~ed in its uncrimped condition.
Figure 22 is an elevational view oE ~he staple suture of Figure 21 illus~ra~ed in its crimpled condition when the gap of the instrument is at ~he upper limi~ oE ~he proper working gap.
Figure 23 is a plan view of the staple suture of Figure 22.
Figure 24 is an elevational view of ~he s~aple suture of Figure 21 in its crimped condition when the gap of the instrument is at the maximum lower limit of the proper working gap.
Figure 25 is a persp~ctive view oE the drive nut oE ~he surgical stapling ins~rument.
~ETAILED DESCRIPTION,OF THE INVE~ITION
Reference i.s first made to Figures 1, 2 and 3 which illustrate ~he instrument oE the present invention and in which like p~rts have been given like index numerals.
The ins~rument is generally indicated at 1 and comprises a body 2 having a fron~ cover 3. The lower end of body 2 is C-shaped as at 4, providing a fixed jaw 5.
The fixed jaw 5 has an anvil surface 6. While the anvil surface 6 may cons~itute a separa~e elemen~ af~ixed ~o and supported by the fixed jaw 5, Eor purpose~s oE thls 2S exemplary showing, ~he anvil sur~ace 6 is illustrated as being an in~egral, one-piece part of f'ixed jaw 5.
Shiftably mounted within the body 2 there is a movable staple cartridge-carrying jaw 7. The s~aple car~ridge-carrying jaw supports a s~aple car~ridge 8 provided with a plurality of s~aple sutures ~not shown) and a s~aple driver 9 (see Figure 2~ for driving the staple su~ures from the staple cartridge 8, through the tissue or organ to be sutured, and against the anvil surface 6 which clinches the staple sutures. The movable staple cartridge-containing jaw 7 is shif~able,toward and away from ~he fixed jaw 5 by a d~ive knoh 10 a~ ~he upper end of ~he ins~rumen~, as will be described hereinaEter.
Shiftably mounted within the s~aple car~ridge-caxrying jaw 7 ~here is a staple driver ac~ua~or 11 (see Figure 2).
The s~aple driver actua~or 11 is shif~able to ac~iva~e staple driver 9 by a wing nut 12 at ~he upper end of the ins~rumen~, again as will be described in detail hereinafter.
Reference is now made to Figure 4. In Figure 4 (as in all of the Figures) like parts have been given like index numerals. The upper portion 13 of body 2 is substantially semi-cylindrical (see Flgure 11). The body 2 has an intermedia~e elonga~ed portion 14 of U~shaped cross section (see Figure 10). The elongated portion 14 of body
2 terminates in the C~shaped portion 4 providing fixed jaw 5 and anvil surace 6. The free end oE fixed ~aw 5 is upturned as at 15.
The front cover 3 of ~he instrument has an upper semi-cylindrical por~ion 16, similar to the por~ion 13 o~
body 2 (see Figure 11). Extending downwardly from the upper portion 16, the front cover 3 has an elongated fla~
portion 17 (see Figure 10). The lowermost end of ~he portion 17 slopes downwardly and inwardly, as shown at 17a.
The fron~ cover 3 is detachably moun~ed to ~he body 2.
To ~his end, the body 2 is provided with a pair of spaced ears 18 and-l9 which provide notches 18a and 19a adapted to receive the downwardly and inwardly sloped end 17a of front cover 3.
The upper por~ion 16 of front cover 3 has a pair of forwardly extending bosses 20 and 21 adap~ed to lie adjacent ~he inside sur~ace of the upper portion 13 of body 2 and having latch pins 22 and 23 engaging notches 24 and 251 respec~ively, on ~he inside sur-face of ~he uppex por~ion 13 of body 2.
7`~3 Reference is ~ade to Figures 11 and 12 wherein ~he boss 20 is shown. The boss 20 carri.es a resilien~ spring finger 26 affixed ~here~o by a rive~ or pin means 27. The boss 20 also carries a bushing 28 in which the latch pin 22 is slidably moun~ed~ The upper end of spring finger 26 rests agains~ ~he head of latch pin 22 urgin~ ~he pin ~o its latching posi~ion in no~ch 24.
As is eviden~ from Figure 11, the boss 21 and la~ch pin 23 constitute an arrangemen~ which is iden~ical to and a mirror image of ~he boss 20 and la~ch pin 22 arrangement.
Thus, ~he pin 23 is mounted in a bushing 29 and is urged to lts la~ching position by a spring mem~er 30 held in place by rivet or pin 31.
To moun~ ~he front cover 3 on ~he body 2 it is only necessary to loca~e the lowermost portion 17a of the Front cover in the notches l8a and 19a of ears 18 and 19. The front cover 3 is then pivo~ed ~hereabout ~oward ~he body 2. Bosses 20 and 21 will en~er ~he body 2 and the latch pins 22 and 23 will be depressed agaihst the action o:E
~heir respective spring fingers 26 and 30 until the upper portion 16 o front cover 3 is fully seated agains~ ~he upper portion l3 of body 2, a~ which time the latch pins 22 an~ 23 are ~ree to enter ~helr respec~ive notches 24 and 25 in the upper portion 13 of body 2. A~ this point, the cov~r member 3 will be firmly held in place on the body 2.
Adjacent portions of the upper part 16 of front cover 3 and the upper part 13 of body 2 may be relieved so as to form notches 32 and 33 (see Figures 1 and 11). By insertion of an appropriate tool in one or bo~h of ~he notches 32 and 33, the upper portion 16 of fron~ cover 3 may be pried away from the upper portion 13 oE body 2.
The no~ches 24 and 25 on the in~erior surface of t~e upper portion 13 o.f body 2 are so configured ~ha~ such a prying 35. action will cause latch pins 22 and 23 ~o shif~ ~oward 7~
each o~her, agains~ the action of their respec~ive spring fingers 26 and 30, releasing ron~ cover 3 from ~he body 2.
So tha~ ~he movable s~aple cartridge-carrying jaw 7 may be better understood, reference is first made ~o Figures 16 through 1~ wherein the staple car~ridge 8 is shown.
The cartridge comprises an elonga~ed body having an ups~anding por ion 34 and a base por~ion 35 so as to be of inverted T-shaped cross section. The base por~ion 35 forms shoulders 36 and 37 to ei~her side of ~he upstanding portion 34. Adjacen~ ~he shoulders 36 and 37 the upstanding portion 34 has a pair of longi~udinal slots 38 and 39. It will be evident from Figure l6 that ~he longitudinal slot 39 terminates short oE the lef~ hand end o the upstanding body portion 34 (as viewed in tha~
Figure), as a~ 39. I~ will be understood tha~ ~he slot 38 also ~erminates shor~ of ~he lef~ hand end of ~he upstanding portion 34 (as viewed in Figure 16) in ~he same manner.
The upstanding portion 34 and base portion 35 o cartridge 8 have parallel rows of recesses therein, each recess con~aining a generally U-shaped wire s~aple suture.
One row o such recesses is shown a~ 40 ln Figure 4, each containing a staple suture 41. An exemplary wire staple suture 41 is illustrated in Figure 21. The o~her row of staple suture containing recesses (no~ shown) is staggered w~th respect ~o the recesses 40. This enabl~s ~he provision of a single zig-zag shaped staple driver 9. The staple driver 9 has firs~ segments 9a which overlie one row of s~aple su~ures and second segments 9b overlying ~he second row of staple sutures. The s~aple driver 9 is shiftable downwardly in~o the body of s~aple cartridge 8 so as to drive the staple su~ures ~herefrom, as will be described hereinafter.
~hile ~he staple car~ridge has been illus~rated in an 7~
embodimen~ havin~ a single s~aple clriver 9, staple cartridges are known having a separate driver for each row of staples and ~such a cartridge could be used in ~he ins~rumen~ of ~he present inven~ion. Fur~hermore, ~he ins~rumen~ of the present inven~ion is noL limi~ed to a staple cartridge containing ~wo rows of staple sutures.
Cartridges containing a single row of staple sutures or mo~e ~han 2 rows vf staple sutures can be used so long as the anvil surface 6 is provided wi~h the correct number of staple clinching grooves, appropriately arranged, as-will be discussed hereinaEter.
Returning to Figure 4, ~he movable staple cartridge-carrying jaw 7 has an inverted U-shaped portion 42 at its lowermost end. The IJ-shaped portion 42 has lS downwardly depending legs 43 and 44 (see Figure 2) between which the cartridge 8 may be located. The lowermost ends of legs 43 and 44 rest upon s~aple cartridge shoulders 36 and 37, respectively. The inside surfaces of ~he legs 43 and 44 are provided wi~h lugs ~no~ shown) adapted to extend in~o ~he staple car~ridge grooves 38 and 39 so that the s~aple cartridge is locked in place wi~hin ~he s~aple cartridge-carrying jaw.
The legs 43 and 44 are sligh~ly ex~ended a~ ~hat end of ~he U-shaped por~ion 42 of ~he s~aple car~ridge-carrying jaw 7 adjacent the C-shaped por~ion 4 oE body 2. The extended portion of leg 43 is shown a~ 43a in Figure 4.
The leg 44 has a similar extension ~not shown~. The portion 4 of ~he body 2 has a pair of parallel slo~s, one of which is shown a~ 45 in Figure 4 ~o accommoda~e the extension 43a. The extension of ~eg 44 will be similarly accommoda~ed in ~he o~her slot o~ the pair, no~ shown.
This will assure tha~ the staple cartridge-carrying jaw 7 and ~he s~aple car~ridge 8 will be properly aligned with respec~ to fixed jaw S and anvil surface ~.
The s~aple car~ridge-carrying jaw 7 has an interme~lia~e ~ 7~ ~
portion 46 of C-shaped cross sec~ion which is slidably received in the intermediate por~ion 14 of body 2. This is mosL clearly shown in Figure lO.
The uppermos~ portion 47 oE s~aple car~ridge-carrying jaw 7 is cylindrical and is ex~ernally threaded as at 48.
The upper cylindrical portion 47 has a central threaded bore 49. The bore 49 leads into an upper coaxial bore 50 which is unthreaded and of sligh~ly larger diameter. The uppermost end of por~ion 47 of ~he staple cartridge carrying jaw 7 is provided with an upstanding annular flange 51 having a plurality of radial slots 52 formed therein. This is ~e~t shown in Figures 4 and 15. The A purposes of-t^~eR ~ bore 49, bore 50, flange 51 and radial slots 52 will be described hereinaf~er.
lS ~ cylindrical drive nut 53 is moun~ed in the upper por~ion 13 of body 2 and the upper portion 16 of front cover 3 (see Figures 4 and 25). The drive nut 53 has an annular groove 53a adap~ed to receive an annulsr rib 53b ormed in bo~h the upper por~ion 13 of body 2 and the upper portion 16 of front cover 3, thus permitting rotation o~ drive nut 53 while preven~ing axial shifting ~hereof wi~h respect ~o ~he upper por~ion 13 of body 2 and ~he upper portion 16 of ron~ cover 3. The drive nut 53 has a firs~ axial bore $4 which is threaded and is threadedly engaged by the threads 48 of the upper portion 47 of the s~aple car~ridge-carrying jaw 7. The threaded bore 54 leads to a second unthreaded axial bore 55 in drive nu~ 53. The bore 55 is of slightly larger diame~er and is adap~ed ~o accommodate the lower end of wing nu~
12, as will be described hereinaf~er.
The drive nut 53 is surrounded by a thrust bearing 56 which rests upon the upper ends of body portion 13 and front cover por~ion 16. Thrust bear;ng 56, in turna is surmoun~ed by retainer ring 57. Re~ainer ring 57 has a ~irsc axial bore 58 of such diameter as to jus~ nicely receive ~he drive nut 53. Re~ainer ring 57 has a second axial bore 59 of largel diameter, forming a shoulder 60 therebetween. Drive nut 53 has an annular rib 61 which abuts ~he re~ainer ring shoulder 60.
Within retainer ring 57 and resting upon ~he upper end of drive nut 53 there is a clutch plate 62. The clutch plats is most clearly shown in Figures 6, 7 and 8. The clutch pla~e 62 has an annular body 63 of an exterior diame~er to be just nicely received within retainer ring 57 (see Figure 4~. The upper surface o the hody has four upstanding spacing elements arranged in diametricallv opposed pairs 64-65 and 66 67. The spacing elements 64 and 65 are bifurcated for purposes to be ~aught hereinafter.
The lower surface of ~he clutch plate body 63 carries at least one drive tooth. For purposes o an exemplary showing, the clutch plate is illustra~ed as being provided wlth a diame~rically opposed pair of iden~ical drive ~ee~h 68 and 69. Drive tooth 68 hss a ront surface 68a whlch slopes forwardly and upwardly and a vertical rear surace 68b. Drive tooth 69 has a slmilar sloping Evrward surEace 69a and a vertical rear surface 69b.
As indicated above and as shown in Figure 4, ~he clu~ch plate 62 is adapted to lie on the uppermost sur~ace of drive nut S3. Reference is again made to Figure 25 which is a perspective view of drive nut 53. I~ will be no~ed ~hat ~he upper edge of the drive nut is provided with a pair of diame~rically opposed no~ches 70 and 71, the configuration o which corresponds to the confi~uration of drive ~ee~h 68 Mnd 69. Thus, no~ch 70 has an upwardly and outwardly sloping front surface 70a and a vertical rear surface 70b while notch 71 has an upwardly and outwardly sloping front surface 71a and a ver~ical rear surface 71b.
The notches 70 and 71 will accommodate ei~her oE the drive teet~ 68 and 69 3 as will be apparen~ hereinaf~er.
Reference is now made to Figures 4 and 5. The instrument o~ ~he presen~ inven~ion is provided wi~h a drive knob lO, as s~ated above. The drive knob 10 is a hollow cylindrical element having a firs~ in~ernally S threaded portion 73 adap~ed to cooperate wi~h the exterior surface of re~ainer ring 57 which is threaded as at 74.
The drive knob has a second portion 75 having an ;nternal diame~er to just nicely receive the upstanding spacing elemen~s 64 through 67 of clutch pla~e 62 (see Figure 4).
As is clearly shown in Figures 4 and 9, ~he portion 75 of drive knob lO is provided wi~h a pair of diame~rically opposed pins 76 and 77, the ends of which e~tend in~o ~he in~erior of the drive knob. The pins 76 and 77 are so located as ~o engage ~he bLEurcated upstanding spacer elemen.~s 64 and 65 of clu~ch plate ~2. This assures ~hat as ~he drive knob 10 is rota~ed, the clu~ch pla~e 62 will ro~ate wi~h it.
The interlor por~ion 75 of drive knob 10 is also provided wi~h four evenly spaced recesses 78 through 81 which are shown in Figure 9 and ~wo of which are shown in Figure 5. These recçsses are adapted ~o accommoda~e four compression springs 82 through 85, respec~ively. The upper ends of compression springs 8?. ~rough 85 abu~ the upper inside surace oE drive knob lO. The lower ends of springs 82 ~hrough 85 abut ~he body portion 63 oE clutch plate 62 between Ehe ups~anding spacer elements 64 ~hrough 67. As a consequence, ~he compression springs 82 ~hrough 85 yleldably urge ~he clutch plate 62 against.the upper end of drive nu~ 53. Finally, drive knob 10 has an axial bore portion 86 (see Figure 4 and 5) so sized as ~o ro~atively receive wing nut 12.
The staple driver actuator ll is most clearly shown in Figure 4. The s~aple driver actuator 11 is shiftably mounted within ~he s~aple cartridge-carrying jaw 7 and has at its lower end a portion 87 which extends longitudinally .
above staple car~ridge 8 and s~aple driver 9. As will be described hereinaf~er, i~ is ~he portion 87 wh;ch con~acts s~aple driver 9 to drive ~he s~aple sutures 41 fIom the car~ridge, through the organ or ~issue to be su~ured, and against anvil surface 6. The staple driver actuator 11 has an elonga~ed portion 88 which ex~ends longitudinally within the intermediate portion 46 of staple car~ridge-carrying jaw 7 (see Figure 10).
The uppermost end of ~he s~aple driver ac~ua~or 11 is provided with a transverse slot 89 and a ver~ical slot 90 forming bifur~ations 91 and 92 (see Figure 13). The slot 89 is adapted to receive the head 93 and the slo~ 90 ls adapted to receive the neck 94 of a screw 95. The screw 95 is threadedly engaged in the threaded bore 49 oE ~he upper por~ion 47 of the s~aple cartridge-carrying ~aw 7.
This is clearly shown in Figure 4. The screw 95 is operatively connec~ed to wing nut 12. It will be understood tha~ rotation o~ wing nut 12 will, by virtue of the threaded engagement between screw 95 and ~he upper end 47 of the staple car~ridge-carrying jaw 7 (and by virtue o the rotatable connection of screw 95 with non-ro~atable staple driver actuator 11) result in axial shi~ing of ~he staple driver actuator 11. The po~tion 8~ of s~aple driver ac~ua~o~ 11 is provided wi~h a no~ch 88a. The limit pin 8~b extends ~ransversely o notch 88a with i~s ends mounted in coaxial bores (not shown) in the intermedia~e portion 46 of staple cartridge-carrying jaw 7. The pin 88b limits the travel of staple driver actuator 11.
Wing nut 12 is provided with a bore 96 adap~ed to accommodate the uppermost end of screw 95. As will be evident from Figure 14, the upper end of screw 95 is sloted as at 97 and ~he lower end of wing nu~ 12 is slotted as at 9~. Located within slo~s 97 and 98 is a latch 99. A pin 100 passes ~hrough ~he lower slotted end of wing nut 12, ~he upper slotted end of screw 95 and la~ch 99. Thus, pin 100 no~ only attaches ~he upper end of screw 95 ~o ~he lower end of wing nu~ l2, but also pivo~ally moun~s la~ch 99 in screw slot 97 and wing nu~
slot 98. A second pin 101 (see Figures 4 and 14) passes through the lower end of wing nu~ 12 and perfora~ion 102 in la~ch 99. The perforation 102 is of a larger diameter than ~he diameter of pin 101 and cooperates wi~h pin 101 to limit the amount oE pivo~ing of latch 99 about pin 100.
Referring particularly to Figure 4, ~he latch 99 has a nose por~ion 103 which, when the gap be~ween fixed jaw 5 and s~aple car~ridge-carrying jaw 7 is wi~hin the proper working gap of the ins~ru~en~, wlll con~ac~ beveled surace 104 on drive nut 53. A spring 105 is provlded wi~h one end moun~ed ln a perforation 106 of wing nu~ 12 and the o~her end wrapped abou~ latch 99 in such a way ~hat ~he latch is urged ~o pivot sbout pin 1~ in a clockwise direction as viewed in Figure- 4. This will assure that the latch nose 103 will remain in con~ac~ with surface 104 whPn ~he proper working gap of the instrument is achievPd. If the gap between the s~aple cartridge-carrying jaw 7 ~nd fixed jaw 5 is greater than ~he proper working gap, ~he nose 103 of latch 99 will be opposite the inside. surface of clu~ch plate 62 and, under the urging of 2S spring 105 and wl~hin the limits permi~ed by pln 101 and perforation 102, the la~ch will shif~ in a clockwise direc~ion (as viewed in Figure 4) entering one of ~he no~ches 52 in the upper annular portion 51 of staple cartridge-carrying jaw 7. Thus, the latch 99 will preclude rota~ion of wing nut 12 and screw 95, thereby preventing shif~ing o staple driver actuator 11 to ac~uate s~aple driver 9. Al~ernatively, if ~oo small a working gap is achieved by ~he surgeon, ~he nose por~ion 103 of la~ch 99 will con~ac~ the inside surface 55 of drive nu~ 53. This will cause a counter-clockwise rotation of latch 99 about pin 100 within the limits dictated by pin 10l and la~ch perforation 102 and agains~
the action of spring 105. Such counter-cl~ckwise rotation of latch 99 will also cause it to enter on~ of the slots 52 in the upper annular portion 5l oE staple car~ridge-carrying jaw 7. This again will preclude ~urning of wing nut 12 and advancement of s~aple driver ac~ua~or 11 agains~ staple driver 9.
Reference is now made to Figures 19 through 24. Figure 19 is a fragmentary view taken along section line 19-19 of Figure 4 illustra~ing ~he anvil surface 6 on fixed jaw 5.
The anvil surface 6 is provided wi~h a plurallty of clinching grooves which clinch the legs of ~he staple sutures when the staple sutures are driven from ~he staple cartridge 8, through the organ or ~issue to be sutured, and into ~he clinching grooves. The anvll surface 6 is provided with a pair of clinching grooves for each s~aple suture. One such pair is shown at 107 and 108. Another pair of clinching grooves is shown at 109 and 110. From the relative positions of the pairs 107-108 and 109-110 it will be noted tha~ the staple su~ure to be clinched by clinching grooves 109 and lln lies in a diEeren~ row and is staggered with respec~ to ~he staple suture to be clinched hy clinching grooves 107 and 10~. The 2S conigurakion oE clinching grooves 107 and 108 is clearly shown in Figure 20.
Figure 21 illustrates an exemplary wire s~aple suture 41 having a crown portion 41a and downwardly depending legs 41b and 41c. Figure 22 illus~rates ~he staple suture
The front cover 3 of ~he instrument has an upper semi-cylindrical por~ion 16, similar to the por~ion 13 o~
body 2 (see Figure 11). Extending downwardly from the upper portion 16, the front cover 3 has an elongated fla~
portion 17 (see Figure 10). The lowermost end of ~he portion 17 slopes downwardly and inwardly, as shown at 17a.
The fron~ cover 3 is detachably moun~ed to ~he body 2.
To ~his end, the body 2 is provided with a pair of spaced ears 18 and-l9 which provide notches 18a and 19a adapted to receive the downwardly and inwardly sloped end 17a of front cover 3.
The upper por~ion 16 of front cover 3 has a pair of forwardly extending bosses 20 and 21 adap~ed to lie adjacent ~he inside sur~ace of the upper portion 13 of body 2 and having latch pins 22 and 23 engaging notches 24 and 251 respec~ively, on ~he inside sur-face of ~he uppex por~ion 13 of body 2.
7`~3 Reference is ~ade to Figures 11 and 12 wherein ~he boss 20 is shown. The boss 20 carri.es a resilien~ spring finger 26 affixed ~here~o by a rive~ or pin means 27. The boss 20 also carries a bushing 28 in which the latch pin 22 is slidably moun~ed~ The upper end of spring finger 26 rests agains~ ~he head of latch pin 22 urgin~ ~he pin ~o its latching posi~ion in no~ch 24.
As is eviden~ from Figure 11, the boss 21 and la~ch pin 23 constitute an arrangemen~ which is iden~ical to and a mirror image of ~he boss 20 and la~ch pin 22 arrangement.
Thus, ~he pin 23 is mounted in a bushing 29 and is urged to lts la~ching position by a spring mem~er 30 held in place by rivet or pin 31.
To moun~ ~he front cover 3 on ~he body 2 it is only necessary to loca~e the lowermost portion 17a of the Front cover in the notches l8a and 19a of ears 18 and 19. The front cover 3 is then pivo~ed ~hereabout ~oward ~he body 2. Bosses 20 and 21 will en~er ~he body 2 and the latch pins 22 and 23 will be depressed agaihst the action o:E
~heir respective spring fingers 26 and 30 until the upper portion 16 o front cover 3 is fully seated agains~ ~he upper portion l3 of body 2, a~ which time the latch pins 22 an~ 23 are ~ree to enter ~helr respec~ive notches 24 and 25 in the upper portion 13 of body 2. A~ this point, the cov~r member 3 will be firmly held in place on the body 2.
Adjacent portions of the upper part 16 of front cover 3 and the upper part 13 of body 2 may be relieved so as to form notches 32 and 33 (see Figures 1 and 11). By insertion of an appropriate tool in one or bo~h of ~he notches 32 and 33, the upper portion 16 of fron~ cover 3 may be pried away from the upper portion 13 oE body 2.
The no~ches 24 and 25 on the in~erior surface of t~e upper portion 13 o.f body 2 are so configured ~ha~ such a prying 35. action will cause latch pins 22 and 23 ~o shif~ ~oward 7~
each o~her, agains~ the action of their respec~ive spring fingers 26 and 30, releasing ron~ cover 3 from ~he body 2.
So tha~ ~he movable s~aple cartridge-carrying jaw 7 may be better understood, reference is first made ~o Figures 16 through 1~ wherein the staple car~ridge 8 is shown.
The cartridge comprises an elonga~ed body having an ups~anding por ion 34 and a base por~ion 35 so as to be of inverted T-shaped cross section. The base por~ion 35 forms shoulders 36 and 37 to ei~her side of ~he upstanding portion 34. Adjacen~ ~he shoulders 36 and 37 the upstanding portion 34 has a pair of longi~udinal slots 38 and 39. It will be evident from Figure l6 that ~he longitudinal slot 39 terminates short oE the lef~ hand end o the upstanding body portion 34 (as viewed in tha~
Figure), as a~ 39. I~ will be understood tha~ ~he slot 38 also ~erminates shor~ of ~he lef~ hand end of ~he upstanding portion 34 (as viewed in Figure 16) in ~he same manner.
The upstanding portion 34 and base portion 35 o cartridge 8 have parallel rows of recesses therein, each recess con~aining a generally U-shaped wire s~aple suture.
One row o such recesses is shown a~ 40 ln Figure 4, each containing a staple suture 41. An exemplary wire staple suture 41 is illustrated in Figure 21. The o~her row of staple suture containing recesses (no~ shown) is staggered w~th respect ~o the recesses 40. This enabl~s ~he provision of a single zig-zag shaped staple driver 9. The staple driver 9 has firs~ segments 9a which overlie one row of s~aple su~ures and second segments 9b overlying ~he second row of staple sutures. The s~aple driver 9 is shiftable downwardly in~o the body of s~aple cartridge 8 so as to drive the staple su~ures ~herefrom, as will be described hereinafter.
~hile ~he staple car~ridge has been illus~rated in an 7~
embodimen~ havin~ a single s~aple clriver 9, staple cartridges are known having a separate driver for each row of staples and ~such a cartridge could be used in ~he ins~rumen~ of ~he present inven~ion. Fur~hermore, ~he ins~rumen~ of the present inven~ion is noL limi~ed to a staple cartridge containing ~wo rows of staple sutures.
Cartridges containing a single row of staple sutures or mo~e ~han 2 rows vf staple sutures can be used so long as the anvil surface 6 is provided wi~h the correct number of staple clinching grooves, appropriately arranged, as-will be discussed hereinaEter.
Returning to Figure 4, ~he movable staple cartridge-carrying jaw 7 has an inverted U-shaped portion 42 at its lowermost end. The IJ-shaped portion 42 has lS downwardly depending legs 43 and 44 (see Figure 2) between which the cartridge 8 may be located. The lowermost ends of legs 43 and 44 rest upon s~aple cartridge shoulders 36 and 37, respectively. The inside surfaces of ~he legs 43 and 44 are provided wi~h lugs ~no~ shown) adapted to extend in~o ~he staple car~ridge grooves 38 and 39 so that the s~aple cartridge is locked in place wi~hin ~he s~aple cartridge-carrying jaw.
The legs 43 and 44 are sligh~ly ex~ended a~ ~hat end of ~he U-shaped por~ion 42 of ~he s~aple car~ridge-carrying jaw 7 adjacent the C-shaped por~ion 4 oE body 2. The extended portion of leg 43 is shown a~ 43a in Figure 4.
The leg 44 has a similar extension ~not shown~. The portion 4 of ~he body 2 has a pair of parallel slo~s, one of which is shown a~ 45 in Figure 4 ~o accommoda~e the extension 43a. The extension of ~eg 44 will be similarly accommoda~ed in ~he o~her slot o~ the pair, no~ shown.
This will assure tha~ the staple cartridge-carrying jaw 7 and ~he s~aple car~ridge 8 will be properly aligned with respec~ to fixed jaw S and anvil surface ~.
The s~aple car~ridge-carrying jaw 7 has an interme~lia~e ~ 7~ ~
portion 46 of C-shaped cross sec~ion which is slidably received in the intermediate por~ion 14 of body 2. This is mosL clearly shown in Figure lO.
The uppermos~ portion 47 oE s~aple car~ridge-carrying jaw 7 is cylindrical and is ex~ernally threaded as at 48.
The upper cylindrical portion 47 has a central threaded bore 49. The bore 49 leads into an upper coaxial bore 50 which is unthreaded and of sligh~ly larger diameter. The uppermost end of por~ion 47 of ~he staple cartridge carrying jaw 7 is provided with an upstanding annular flange 51 having a plurality of radial slots 52 formed therein. This is ~e~t shown in Figures 4 and 15. The A purposes of-t^~eR ~ bore 49, bore 50, flange 51 and radial slots 52 will be described hereinaf~er.
lS ~ cylindrical drive nut 53 is moun~ed in the upper por~ion 13 of body 2 and the upper portion 16 of front cover 3 (see Figures 4 and 25). The drive nut 53 has an annular groove 53a adap~ed to receive an annulsr rib 53b ormed in bo~h the upper por~ion 13 of body 2 and the upper portion 16 of front cover 3, thus permitting rotation o~ drive nut 53 while preven~ing axial shifting ~hereof wi~h respect ~o ~he upper por~ion 13 of body 2 and ~he upper portion 16 of ron~ cover 3. The drive nut 53 has a firs~ axial bore $4 which is threaded and is threadedly engaged by the threads 48 of the upper portion 47 of the s~aple car~ridge-carrying jaw 7. The threaded bore 54 leads to a second unthreaded axial bore 55 in drive nu~ 53. The bore 55 is of slightly larger diame~er and is adap~ed ~o accommodate the lower end of wing nu~
12, as will be described hereinaf~er.
The drive nut 53 is surrounded by a thrust bearing 56 which rests upon the upper ends of body portion 13 and front cover por~ion 16. Thrust bear;ng 56, in turna is surmoun~ed by retainer ring 57. Re~ainer ring 57 has a ~irsc axial bore 58 of such diameter as to jus~ nicely receive ~he drive nut 53. Re~ainer ring 57 has a second axial bore 59 of largel diameter, forming a shoulder 60 therebetween. Drive nut 53 has an annular rib 61 which abuts ~he re~ainer ring shoulder 60.
Within retainer ring 57 and resting upon ~he upper end of drive nut 53 there is a clutch plate 62. The clutch plats is most clearly shown in Figures 6, 7 and 8. The clutch pla~e 62 has an annular body 63 of an exterior diame~er to be just nicely received within retainer ring 57 (see Figure 4~. The upper surface o the hody has four upstanding spacing elements arranged in diametricallv opposed pairs 64-65 and 66 67. The spacing elements 64 and 65 are bifurcated for purposes to be ~aught hereinafter.
The lower surface of ~he clutch plate body 63 carries at least one drive tooth. For purposes o an exemplary showing, the clutch plate is illustra~ed as being provided wlth a diame~rically opposed pair of iden~ical drive ~ee~h 68 and 69. Drive tooth 68 hss a ront surface 68a whlch slopes forwardly and upwardly and a vertical rear surace 68b. Drive tooth 69 has a slmilar sloping Evrward surEace 69a and a vertical rear surface 69b.
As indicated above and as shown in Figure 4, ~he clu~ch plate 62 is adapted to lie on the uppermost sur~ace of drive nut S3. Reference is again made to Figure 25 which is a perspective view of drive nut 53. I~ will be no~ed ~hat ~he upper edge of the drive nut is provided with a pair of diame~rically opposed no~ches 70 and 71, the configuration o which corresponds to the confi~uration of drive ~ee~h 68 Mnd 69. Thus, no~ch 70 has an upwardly and outwardly sloping front surface 70a and a vertical rear surface 70b while notch 71 has an upwardly and outwardly sloping front surface 71a and a ver~ical rear surface 71b.
The notches 70 and 71 will accommodate ei~her oE the drive teet~ 68 and 69 3 as will be apparen~ hereinaf~er.
Reference is now made to Figures 4 and 5. The instrument o~ ~he presen~ inven~ion is provided wi~h a drive knob lO, as s~ated above. The drive knob 10 is a hollow cylindrical element having a firs~ in~ernally S threaded portion 73 adap~ed to cooperate wi~h the exterior surface of re~ainer ring 57 which is threaded as at 74.
The drive knob has a second portion 75 having an ;nternal diame~er to just nicely receive the upstanding spacing elemen~s 64 through 67 of clutch pla~e 62 (see Figure 4).
As is clearly shown in Figures 4 and 9, ~he portion 75 of drive knob lO is provided wi~h a pair of diame~rically opposed pins 76 and 77, the ends of which e~tend in~o ~he in~erior of the drive knob. The pins 76 and 77 are so located as ~o engage ~he bLEurcated upstanding spacer elemen.~s 64 and 65 of clu~ch plate ~2. This assures ~hat as ~he drive knob 10 is rota~ed, the clu~ch pla~e 62 will ro~ate wi~h it.
The interlor por~ion 75 of drive knob 10 is also provided wi~h four evenly spaced recesses 78 through 81 which are shown in Figure 9 and ~wo of which are shown in Figure 5. These recçsses are adapted ~o accommoda~e four compression springs 82 through 85, respec~ively. The upper ends of compression springs 8?. ~rough 85 abu~ the upper inside surace oE drive knob lO. The lower ends of springs 82 ~hrough 85 abut ~he body portion 63 oE clutch plate 62 between Ehe ups~anding spacer elements 64 ~hrough 67. As a consequence, ~he compression springs 82 ~hrough 85 yleldably urge ~he clutch plate 62 against.the upper end of drive nu~ 53. Finally, drive knob 10 has an axial bore portion 86 (see Figure 4 and 5) so sized as ~o ro~atively receive wing nut 12.
The staple driver actuator ll is most clearly shown in Figure 4. The s~aple driver actuator 11 is shiftably mounted within ~he s~aple cartridge-carrying jaw 7 and has at its lower end a portion 87 which extends longitudinally .
above staple car~ridge 8 and s~aple driver 9. As will be described hereinaf~er, i~ is ~he portion 87 wh;ch con~acts s~aple driver 9 to drive ~he s~aple sutures 41 fIom the car~ridge, through the organ or ~issue to be su~ured, and against anvil surface 6. The staple driver actuator 11 has an elonga~ed portion 88 which ex~ends longitudinally within the intermediate portion 46 of staple car~ridge-carrying jaw 7 (see Figure 10).
The uppermost end of ~he s~aple driver ac~ua~or 11 is provided with a transverse slot 89 and a ver~ical slot 90 forming bifur~ations 91 and 92 (see Figure 13). The slot 89 is adapted to receive the head 93 and the slo~ 90 ls adapted to receive the neck 94 of a screw 95. The screw 95 is threadedly engaged in the threaded bore 49 oE ~he upper por~ion 47 of the s~aple cartridge-carrying ~aw 7.
This is clearly shown in Figure 4. The screw 95 is operatively connec~ed to wing nut 12. It will be understood tha~ rotation o~ wing nut 12 will, by virtue of the threaded engagement between screw 95 and ~he upper end 47 of the staple car~ridge-carrying jaw 7 (and by virtue o the rotatable connection of screw 95 with non-ro~atable staple driver actuator 11) result in axial shi~ing of ~he staple driver actuator 11. The po~tion 8~ of s~aple driver ac~ua~o~ 11 is provided wi~h a no~ch 88a. The limit pin 8~b extends ~ransversely o notch 88a with i~s ends mounted in coaxial bores (not shown) in the intermedia~e portion 46 of staple cartridge-carrying jaw 7. The pin 88b limits the travel of staple driver actuator 11.
Wing nut 12 is provided with a bore 96 adap~ed to accommodate the uppermost end of screw 95. As will be evident from Figure 14, the upper end of screw 95 is sloted as at 97 and ~he lower end of wing nu~ 12 is slotted as at 9~. Located within slo~s 97 and 98 is a latch 99. A pin 100 passes ~hrough ~he lower slotted end of wing nut 12, ~he upper slotted end of screw 95 and la~ch 99. Thus, pin 100 no~ only attaches ~he upper end of screw 95 ~o ~he lower end of wing nu~ l2, but also pivo~ally moun~s la~ch 99 in screw slot 97 and wing nu~
slot 98. A second pin 101 (see Figures 4 and 14) passes through the lower end of wing nu~ 12 and perfora~ion 102 in la~ch 99. The perforation 102 is of a larger diameter than ~he diameter of pin 101 and cooperates wi~h pin 101 to limit the amount oE pivo~ing of latch 99 about pin 100.
Referring particularly to Figure 4, ~he latch 99 has a nose por~ion 103 which, when the gap be~ween fixed jaw 5 and s~aple car~ridge-carrying jaw 7 is wi~hin the proper working gap of the ins~ru~en~, wlll con~ac~ beveled surace 104 on drive nut 53. A spring 105 is provlded wi~h one end moun~ed ln a perforation 106 of wing nu~ 12 and the o~her end wrapped abou~ latch 99 in such a way ~hat ~he latch is urged ~o pivot sbout pin 1~ in a clockwise direction as viewed in Figure- 4. This will assure that the latch nose 103 will remain in con~ac~ with surface 104 whPn ~he proper working gap of the instrument is achievPd. If the gap between the s~aple cartridge-carrying jaw 7 ~nd fixed jaw 5 is greater than ~he proper working gap, ~he nose 103 of latch 99 will be opposite the inside. surface of clu~ch plate 62 and, under the urging of 2S spring 105 and wl~hin the limits permi~ed by pln 101 and perforation 102, the la~ch will shif~ in a clockwise direc~ion (as viewed in Figure 4) entering one of ~he no~ches 52 in the upper annular portion 51 of staple cartridge-carrying jaw 7. Thus, the latch 99 will preclude rota~ion of wing nut 12 and screw 95, thereby preventing shif~ing o staple driver actuator 11 to ac~uate s~aple driver 9. Al~ernatively, if ~oo small a working gap is achieved by ~he surgeon, ~he nose por~ion 103 of la~ch 99 will con~ac~ the inside surface 55 of drive nu~ 53. This will cause a counter-clockwise rotation of latch 99 about pin 100 within the limits dictated by pin 10l and la~ch perforation 102 and agains~
the action of spring 105. Such counter-cl~ckwise rotation of latch 99 will also cause it to enter on~ of the slots 52 in the upper annular portion 5l oE staple car~ridge-carrying jaw 7. This again will preclude ~urning of wing nut 12 and advancement of s~aple driver ac~ua~or 11 agains~ staple driver 9.
Reference is now made to Figures 19 through 24. Figure 19 is a fragmentary view taken along section line 19-19 of Figure 4 illustra~ing ~he anvil surface 6 on fixed jaw 5.
The anvil surface 6 is provided wi~h a plurallty of clinching grooves which clinch the legs of ~he staple sutures when the staple sutures are driven from ~he staple cartridge 8, through the organ or ~issue to be sutured, and into ~he clinching grooves. The anvll surface 6 is provided with a pair of clinching grooves for each s~aple suture. One such pair is shown at 107 and 108. Another pair of clinching grooves is shown at 109 and 110. From the relative positions of the pairs 107-108 and 109-110 it will be noted tha~ the staple su~ure to be clinched by clinching grooves 109 and lln lies in a diEeren~ row and is staggered with respec~ to ~he staple suture to be clinched hy clinching grooves 107 and 10~. The 2S conigurakion oE clinching grooves 107 and 108 is clearly shown in Figure 20.
Figure 21 illustrates an exemplary wire s~aple suture 41 having a crown portion 41a and downwardly depending legs 41b and 41c. Figure 22 illus~rates ~he staple suture
3`0 of Figure 21 aEter having been clinched by clinching grooves 107 and 108 when the gap between ~he s~aple cartridge-carrying jaw 7 and fixed jaw 5 is at ~he maximum proper working gap of the ins~rumen~. Since ~he clinching grooves 107 and 108 lie at an angle ~o ~he long axis o~
anvil surface 6 and the long axis of the staple cartridge ~, the legs 41b and 41c of s~aple suture 41 will not only be clinched as shown in Figure 22 bu~ will be slightly twisted (as shown in Flgure 23) so as to lie to either side of crown portion 41a. F~guxe 24 illustrate~s the staple of Figure 21 in its formed condition when the gap between the staple car~ridge-carrying jaw 7 and the fixed jaw 5 is a~ ~he minimum proper working 'gap of the ins~rument.
The various elements of instrument 1 having been described in detail, the operation of the instrument 1 may be set for~h as follows. When the instrument is ready for use, the U-shaped portion 42 of the staple cartridge-carrying jaw 7 will be provided with a staple car~ridge and the jaw 7 will be in a retracted position, i.e. at its maximum distance from fixed jaw 5. The s~aple driver actuator 11 will also be in its fully retracted position with respect to the staple cartridge-carrying jaw 7. The organ or tissue to be sutured is located be~ween .Eixed jaw S and staple caxtridge-carrying jaw 7. The s~aple cartrid&e-carrying ,jaw 7 is then advanced toward fixed jaw 5 by the surgeon. This is accomplished by clockwise rotation of drive kno~ 10. Drive knob 10 transmits the rotative force to clutch pla~e 62 by means of pins 76 and 77. The clutch plate 6~., having drive teeth ~8 and 69 engaged in notches 70 and 71 under ~he ~orce supplied by compression springs 82 through 85, will cause rotation of drive nut 53. Since ~he staple cartridge-carrying jaw is non-rotatively moun~ed in the instrument body 2 and.since its upper end 4~ is threadedly engaged by drive nut 53, the rotation oE the drive nut 53 will cause ~he s~aple cartridge-carrying jaw 7 to advance toward fixed jaw 5 and against the ~.issue or organ being su~ured. This will continue until the resistance of the organ.or tissue to compression exceeds ~he torque limits of clu~ch plate 62 and springs 82 through 8S. A~ ~his poin~, clutch plate 62 will disengage from drive nu~ 53~ the sloping surfaces 68a and 69a of drive teeth 68 and 69 riding up and over the sloping surEaces 70a and 71a of no~ches 70 and 71. As a result, continued rotation of drive knob 10 will not further advance staple cartridge-containing jaw 7 toward fixed jaw 5, but will result in a ratcheting noise signaling ~ha~ the clutch plate 62 is disengaged from drive nut 53, This arrangemen~ es~ablishes a gap between the staple car~ridge-carrying jaw 7 and fixed ~aw 5 controlled by the pressure ~hey apply to the organ or tissue located therebetween.
The staple driver actua~or 11 should initially be in its fully retracted position as illustrated in Figure 4.
IE the gap between s~aple car~ridge-carrying jaw 7 and lS fixed jaw S (8s established by the compressive force on the organ or tissue to be sutured) falls wi~hin the proper working gap o ~he instrument, the latch 99 will be in the position illustrated in Figure 4. ~ith the latch 99 in this position, the wing nut 12 may be rotated in a clockwise dirèction which will resul~ in rotation of screw 95. Rotation of ,screw 95 will cause axial shif~ing o the s~aple driver ~e~ 1 into con~act wlth staple drlver 9. Continued rotation of wing nut 12 will cause ~he staple drive~ 9 to drive the staple sutures 41 through the organ or tissue belng sutured and in~o the clinchlng grooves of anvil surface 6, resulting in clinching of ~he staple sutures somewhere a~ or between ~he minimum safe clinching illustra~ed in Flgure 22 (where ~he gap is at its safe maximum) and the maximum clinching as illus~rated ln Figure 24 (where ~he gap is at its saEe minimum).
As indica~ed above, if ~he closing of ~he staple car~ridge-carrying jaw 7 toward fixed jaw 5 (by means of the pressure responsive clutch plate described above) has provided a gap which exceeds the maximum propèr working gap of the instrument, the nose por~ion 103 of latch 99 .
'7~
wilL be located opposi~e the in~erior surEace of clu~ch plate 62 which wil.l permit the latch 99 to rotAte under the influence of spring 105 into one of the grooves 52 of the uppermost annular flange 51 on the staple car~ridge-carrying jaw 7. This will preclude advancemen~
of the s~aple driver actuator 11 and will indicate ~o ~he surgeon that ~he instrument of the presén~ invention should not.be used. Similarly9 if the gap established in response to the pressure applied rO the tissue or organ to be su~ured is smaller than ~he minimum proper working gap of the instrumen~ 1, the latch nose 103 will contact the inside surface 55 of drive nut 53 causing the la~ch to be shifted in a counterclockwise direction, agains~: the influence of spring 105, and into one of ~he grooves 52.
Thls will also preclude advancement of the staple driver actuator ll, again contraindica~ing use of the ins~rumen~
1.
~ hen the gap es~ablished in response to ~he pressure applied to the tissue.or organ to be sutured does fall wil-hin ~he proper working gap of instrumen~ 1 and the staple driver actua~or 11 has been advanced by wing nut 12 to implant ~nd properly clinch ~he double row of staples 41, the surgeon then rotates the drive knob lO in a counter~clockwise direction, re~rac~ing staple 2S cartridge-carrying jaw 7 away from Eixed jaw 5. This permits easy removal of the instrument 1 from the now sutured organ or tissue. When the drive knoh 10 is rotated in a counter-clockwise direc~ion, the vertical surfaces 68b and 69b of drive ~eeth 6~ and 69 will cooperate wi~h the vertical surfaces 7~b and 71b of no~ches 70 ~nd 71. As a result, ~he coaction of clu~ch pla~e 6? and drive nu~ 53 is always positive ~o re~ract the staple cartridge-carrying jaw.
Modifications may be made in the invention without departing from the spirit of it.
anvil surface 6 and the long axis of the staple cartridge ~, the legs 41b and 41c of s~aple suture 41 will not only be clinched as shown in Figure 22 bu~ will be slightly twisted (as shown in Flgure 23) so as to lie to either side of crown portion 41a. F~guxe 24 illustrate~s the staple of Figure 21 in its formed condition when the gap between the staple car~ridge-carrying jaw 7 and the fixed jaw 5 is a~ ~he minimum proper working 'gap of the ins~rument.
The various elements of instrument 1 having been described in detail, the operation of the instrument 1 may be set for~h as follows. When the instrument is ready for use, the U-shaped portion 42 of the staple cartridge-carrying jaw 7 will be provided with a staple car~ridge and the jaw 7 will be in a retracted position, i.e. at its maximum distance from fixed jaw 5. The s~aple driver actuator 11 will also be in its fully retracted position with respect to the staple cartridge-carrying jaw 7. The organ or tissue to be sutured is located be~ween .Eixed jaw S and staple caxtridge-carrying jaw 7. The s~aple cartrid&e-carrying ,jaw 7 is then advanced toward fixed jaw 5 by the surgeon. This is accomplished by clockwise rotation of drive kno~ 10. Drive knob 10 transmits the rotative force to clutch pla~e 62 by means of pins 76 and 77. The clutch plate 6~., having drive teeth ~8 and 69 engaged in notches 70 and 71 under ~he ~orce supplied by compression springs 82 through 85, will cause rotation of drive nut 53. Since ~he staple cartridge-carrying jaw is non-rotatively moun~ed in the instrument body 2 and.since its upper end 4~ is threadedly engaged by drive nut 53, the rotation oE the drive nut 53 will cause ~he s~aple cartridge-carrying jaw 7 to advance toward fixed jaw 5 and against the ~.issue or organ being su~ured. This will continue until the resistance of the organ.or tissue to compression exceeds ~he torque limits of clu~ch plate 62 and springs 82 through 8S. A~ ~his poin~, clutch plate 62 will disengage from drive nu~ 53~ the sloping surfaces 68a and 69a of drive teeth 68 and 69 riding up and over the sloping surEaces 70a and 71a of no~ches 70 and 71. As a result, continued rotation of drive knob 10 will not further advance staple cartridge-containing jaw 7 toward fixed jaw 5, but will result in a ratcheting noise signaling ~ha~ the clutch plate 62 is disengaged from drive nut 53, This arrangemen~ es~ablishes a gap between the staple car~ridge-carrying jaw 7 and fixed ~aw 5 controlled by the pressure ~hey apply to the organ or tissue located therebetween.
The staple driver actua~or 11 should initially be in its fully retracted position as illustrated in Figure 4.
IE the gap between s~aple car~ridge-carrying jaw 7 and lS fixed jaw S (8s established by the compressive force on the organ or tissue to be sutured) falls wi~hin the proper working gap o ~he instrument, the latch 99 will be in the position illustrated in Figure 4. ~ith the latch 99 in this position, the wing nut 12 may be rotated in a clockwise dirèction which will resul~ in rotation of screw 95. Rotation of ,screw 95 will cause axial shif~ing o the s~aple driver ~e~ 1 into con~act wlth staple drlver 9. Continued rotation of wing nut 12 will cause ~he staple drive~ 9 to drive the staple sutures 41 through the organ or tissue belng sutured and in~o the clinchlng grooves of anvil surface 6, resulting in clinching of ~he staple sutures somewhere a~ or between ~he minimum safe clinching illustra~ed in Flgure 22 (where ~he gap is at its safe maximum) and the maximum clinching as illus~rated ln Figure 24 (where ~he gap is at its saEe minimum).
As indica~ed above, if ~he closing of ~he staple car~ridge-carrying jaw 7 toward fixed jaw 5 (by means of the pressure responsive clutch plate described above) has provided a gap which exceeds the maximum propèr working gap of the instrument, the nose por~ion 103 of latch 99 .
'7~
wilL be located opposi~e the in~erior surEace of clu~ch plate 62 which wil.l permit the latch 99 to rotAte under the influence of spring 105 into one of the grooves 52 of the uppermost annular flange 51 on the staple car~ridge-carrying jaw 7. This will preclude advancemen~
of the s~aple driver actuator 11 and will indicate ~o ~he surgeon that ~he instrument of the presén~ invention should not.be used. Similarly9 if the gap established in response to the pressure applied rO the tissue or organ to be su~ured is smaller than ~he minimum proper working gap of the instrumen~ 1, the latch nose 103 will contact the inside surface 55 of drive nut 53 causing the la~ch to be shifted in a counterclockwise direction, agains~: the influence of spring 105, and into one of ~he grooves 52.
Thls will also preclude advancement of the staple driver actuator ll, again contraindica~ing use of the ins~rumen~
1.
~ hen the gap es~ablished in response to ~he pressure applied to the tissue.or organ to be sutured does fall wil-hin ~he proper working gap of instrumen~ 1 and the staple driver actua~or 11 has been advanced by wing nut 12 to implant ~nd properly clinch ~he double row of staples 41, the surgeon then rotates the drive knob lO in a counter~clockwise direction, re~rac~ing staple 2S cartridge-carrying jaw 7 away from Eixed jaw 5. This permits easy removal of the instrument 1 from the now sutured organ or tissue. When the drive knoh 10 is rotated in a counter-clockwise direc~ion, the vertical surfaces 68b and 69b of drive ~eeth 6~ and 69 will cooperate wi~h the vertical surfaces 7~b and 71b of no~ches 70 ~nd 71. As a result, ~he coaction of clu~ch pla~e 6? and drive nu~ 53 is always positive ~o re~ract the staple cartridge-carrying jaw.
Modifications may be made in the invention without departing from the spirit of it.
Claims (25)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. In a surgical stapling instrument of the type having a fixed jaw with an anvil surface thereon with staple clinching grooves therein, a movable jaw shiftable toward and away from said fixed jaw and carrying a plurality of staples and a driver therefor, means to shift said movable jaw, a staple driver actuator shiftable between a retracted position and an advanced position wherein it actuates said staple driver to cause said staples to pass through tissue located between said fixed jaw and said movable jaw and to be clinched by said anvil grooves, and means to shift said staple driver actuator, said surgical stapling instrument having a working gap comprising a range of distances between said fixed jaw and said movable jaw throughout which said staples can be properly implanted and clinched, the improvement comprising means operatively connecting said movable jaw and said movable jaw shifting means to shift said movable jaw away from said fixed jaw to advance said movable jaw toward said fixed jaw to establish a gap therebetween in accordance with a predetermined pressure applied by said jaws to said tissue therebetween, and latch means permitting shifting of said staple driver actuator by said staple driver actuator shifting means only when said established gap falls within said working gap of said instrument.
2. The structure claimed in claim 1 wherein said surgical instrument comprises an elongated hollow body having an interme-diate portion, a rearward end and forward end terminating in said fixed jaw extending perpendicularly to the long axis of said instrument body, a hollow, cylindrical, drive nut captively and rotatably mounted at said rearward end of said instrument body, said drive nut having forward and rearward ends, the interior surface of said drive nut being threaded from said forward end of said drive nut to a point short of said rearward end of said drive nut, the remainder of said interior surface being unthreaded, said drive nut being non-shiftable axially with respect to said instrument body, a rearward portion of said drive nut extending beyond said rearward end of said instrument body, an elongated shank terminating at its forward end in said movable jaw and at its rearward end in an externally threaded cylindrical portion, said shank being mounted in said hollow instrument body so as to be axially shiftable and non-rotatable therein, said externally threaded cylindrical rearward end of said movable jaw shank being threadedly engaged in said drive nut, an externally threaded retainer ring mounted at said rearward end of said instrument body about said rearward portion of said drive nut extending beyond said instrument body rearward end, a clutch plate located within said retainer ring, said clutch plate having a first side facing and located adjacent said rearward end of said drive nut, a hollow internally threaded drive knob threadedly engaged on said retainer ring and operatively connected to said clutch plate such that rotation of said drive knob will cause rotation of said clutch plate, yieldable means urging said clutch plate into driving engagement with said rearward end of said drive nut, such that rotation of said drive knob in a first direction will impart similar rotation to said clutch plate and said drive nut resulting in shifting of said movable jaw and its shank away from said fixed jaw and rotation of said drive knob in a second direction will impart similar rotation to said clutch plate and said drive nut to advance said movable jaw and its shank toward said fixed jaw until said predetermined pressure is achieved at which point said yieldable means will no longer maintain said clutch plate in driving engagement with said drive nut thus setting said clutch-established gap.
3. The structure claimed in claim 1 wherein each of said staples is of inverted U-shaped configuration having a crown portion and a pair of downwardly depending legs, said anvil surface staple clinching grooves being arranged in pairs, each pair adapted to receive and clinch the legs of one of said staples, said clinching grooves of each pair lying at an angle to the long axis of said anvil surface whereby said legs of each staple, when clinched will be slightly twisted so as to lie to either side of their respective staple crown portion.
4. The structure claimed in claim 2 including at least one drive tooth on said first side of said clutch plate, said at least one tooth having a first drive surface perpendicular to said clutch plate, said at least one drive tooth having a second drive surface facing in said second direction and sloping in said second direction toward said clutch plate, said rearward end of said drive nut having at least one notch for said at least one clutch plate drive tooth, said at least one notch having first and second drive surfaces corresponding to and similarly shaped to said first and second drive surfaces of said at least one drive tooth, whereby when said drive knob is rotated in said first direction said perpendi-cular first drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw away from said fixed jaw, and when said drive knob is rotated in said second direction said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw toward said fixed jaw until said predetermined pressure is achieved whereupon said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said at least one drive tooth out of said at least one notch against the influence of said yieldable means, disengaging said clutch plate from said drive nut and thus setting said clutch-established gap.
5. The structure claimed in claim 2 including a plurality of upstanding spaced lugs on said second side of said clutch plate a diametrically opposed pair of said lugs being bifurcated, a pair of diametrically opposed pins being mounted in said hollow drive knob and extending radially inwardly thereof, said pins being located between said bifurcations of said pair of clutch plate lugs, whereby rotation of said drive knob will be imparted to said clutch plate by the cooperation of said pins and said bifurcations and said clutch plate and said drive knob can independently shift axially.
6. The structure claimed in claim 2 wherein said yieldable means com-prises a plurality of springs, one end of each of said springs being located in a socket formed therefor in the interior of said hollow drive knob, the other end of each of said springs abutting said second side of said clutch plate.
7. The structure claimed in claim 2 including a staple driver actuator shank mounted within said movable jaw shank and being axially shiftable and non-rotatable therein, the forward end of said staple driver actuator shank terminat-ing in said staple driver actuator located within said movable jaw, the rear-ward end of said staple driver actuator shank terminating short of said cylin-drical rearward end of said movable jaw shank, said cylindrical rearward end of said movable jaw shank having an axial bore extending therethrough, a first portion of said bore being threaded and a second portion of said bore near the rearwardmost end of said movable jaw shank being unthreaded and of slightly larger diameter, an elongated rod-like screw having a forward end followed by a threaded portion and an unthreaded portion terminating in a rearward end of said screw, the forward end of said screw being rotatably attached to said rearward end of said staple driver actuator shank, said screw being located in said bore of said cylindrical rearward end of said movable jaw shank with its threaded portion threadedly engaged in said threaded portion of said last mentioned bore, said unthreaded portion of said screw being partially located within said last mentioned bore and extending rearwardly beyond said rearward end of said movable jaw shank, a wing nut having a forward cylindrical portion rotatably mounted and axially shiftable in coaxial perforations in said drive knob, said clutch plate and said unthreaded portion of said hollow drive nut, said forward cylindrical portion of said wing nut having an axial bore therein, said rearward end of said screw being located within said wing nut bore and being non-rotatably affixed therein, whereby rotation of said wing nut in a first direction will result in rotation of said screw in said internally threaded portion of said movable jaw cylindrical rearward end to shift said staple driver actuator via its shank toward said retracted position thereof and rotation of said wing nut in a second direction will cause rotation of said screw in said internally threaded portion of said movable jaw cylindrical rearward end to shift said staple driver actuator via its shank toward said advanced position thereof.
8. The structure claimed in claim 7 wherein said rearward end of said screw and said forward cylindrical end of said wing nut are slotted, a latch located in said slots, a pin extending through transverse coaxial perforations in said rearward end of said screw, said forward end of said wing nut and said latch non-rotatably affixing said screw to said wing nut and pivotally mounting said latch in said slots, said rearward cylindrical end of said movable jaw shank having an annular flange thereon surrounding said screw and having a plurality of radial notches formed therein, said latch being pivotable between first and second positions in engagement with one of said radial notches wherein it will prevent rotation of said wing nut and said screw to prevent shifting of said staple driver actuator to said advanced position and an intermedite third position out of engagement with said radial notches wherein it will permit rota-tion of said wing nut and said screw to shift said staple driver actuator to said advanced position thereof, and means to shift said latch from one of said first and second positions to said third position only when said clutch-estab-lished gap falls within said working gap of said surgical stapling instrument.
9. The structure claimed in claim 8 wherein said shifting means for said latch comprises a laterally extending nose on said latch, said nose being located to contact the inside surface of said perforation in said clutch plate to maintain said latch in said first position when said clutch-extablished gap exceeds said working gap, said nose being locating to contact said unthreaded interior surface of said drive nut to maintain said latch in said second posi-tion when said clutch-established gap is less than said working gap, said un-threaded interior surface of said drive nut terminating in a narrow annular flared interior surface at said rearward end of said drive nut, said latch nose contacting said flared interior surface to maintain said latch in said inter-mediate third position when said clutch-established gap falls within said working gap.
10. The structure claimed in claim 9 including at least one drive -tooth on said first side of said clutch plate, said at least one drive toothe having a first drive surface perpendicular to said clutch plate, said at least one drive tooth having a second drive surface facing in said second direction and sloping in said second direction toward said clutch plate, said rearward end of said drive nut having at least one notch for said at least one clutch plate drive tooth, said at least one notch having First and second drive surfaces correspond-ing to and similarly shaped to said first and second drive surfaces of said at least one drive tooth, whereby when said drive knob is rotated in said first direction said perpendicular first drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw away from said fixed jaw, and when said drive knob is rotated in said second direction said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw toward said fixed jaw until said predetermined pressure is achieved whereupon said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said at least one drive tooth out of said at least one notch against the influence of said yieldable means, disengaging said clutch plate from said drive nut and thus setting said clutch-established gap.
11. The structure claimed in claim 10 including a plurality of upstanding spaced lugs on said second side of said clutch plate, a diametrically opposed pair of said lugs being bifurcated, a pair of diametrically opposed pins being mounted in said hollow drive knob and extending radially inwardly thereof, said pins being located between said bifurcations of said pair of clutch plate lugs, whereby rotation of said drive knob will be imparted to said clutch plate by the cooperation of said pins and said bifurcations and said clutch plate and said drive knob can independently shift axially.
12. The structure claimed in claim 11 wherein said yieldable means com-prises a plurality of springs, one end of each of said springs being located in a socket formed therefor in the interior of said hollow drive knob, the other end of each of said springs abutting said second side of said clutch plate.
13. In a surgical stapling instrument of the type having a fixed jaw with an anvil surface thereon with staple clinching grooves therein, a movable jaw shiftable toward and away from said fixed jaw and carrying a plurality of staples and a driver therefor, means to shift said movable jaw, a staple driver actuator shiftable between a retracted position and an advanced position wherein it actuates said staple driver to cause said staples to pass through tissue located between said fixed jaw and said movable jaw and to be clinched by said anvil grooves, and means to shift said staple driver actuator, the improvement comprising clutch means operatively connecting said movable jaw and said movable jaw shifting means to shift said movable jaw away from said fixed jaw and to ad-vance said movable jaw toward said fixed jaw to establish a gap therebetween in accordance with a predetermined pressure applied by said jaws to said tissue therebetween.
14. The structure claimed in claim 13 wherein said surgical instrument comprises an elongated hollow body having and intermediate portion, a rearward end and a forward end terminating in said fixed jaw extending perpendicularly to the long axis of said instrument body, a hollow cylindrical drive nut captively and rotatably mounted at said rearward end of said instrument body, said drive nut having forward and rearward ends, the interior surface of said drive nut being threaded from said forward end of said drive nut to a point short of said rearward end of said drive nut, the remainder of said interior surface being unthreaded, said drive nut being non-shiftable axially with respect to said instrument body, a rearward portion of said drive nut extending beyond said rearward end of said instrument body, an elongated shank terminating at its for-ward end in said movable jaw and at its rearward end in all externally threaded cylindrical portion, said shank being mounted in said hollow instrument body so as to be axially shiftable and non-rotatable therein, said externally threaded cylindrical rearward end of said movable jaw shank being threadedly engaged in said drive nut, an externally threaded retainer ring mounted at said rearward end of said instrument body about said rearward portion of said drive nut ex-tending beyond said instrument body rearward end, a clutch plate located within said retainer ring, said clutch plate having a first side facing and located adjacent said rearward end of said drive nut, a hollow internally threaded drive knob threadedly engaged on said retainer ring and operatively connected to said clutch plate such that rotation of said drive knob will cause rotation of said clutch plate, yieldable means urging said clutch plate into driving engagement with said rearward end of said drive nut such that rotation of said drive knob in a first direction will impart similar rotation to said clutch plate and said drive nut resulting in shifting of said movable jaw and its shank away from said fixed jaw and rotation of said drive knob in a second direction will impart similar rotation to said clutch plate and said drive nut to advance said movable jaw and its shank toward said fixed jaw until said pre-determined pressure is achieved at which point said yieldable means will no longer maintain said clutch plate in driving engagement with said drive nut thus setting said clutch-established gap.
15. The structure claimed in claim 13 wherein each of said staples is of inverted U-shaped configuration having a crown portion and a pair of downwardly depending legs, said anvil surface staple clinching grooves being arranged in pairs, each pair adapted to receive and clinch the legs of one of said staples, said clinching grooves of each pair lying at all angle to the long axis of said anvil surface whereby said legs of each staple, when clinched, will be slightly twisted so as to lie to either side of their respective staple crown portion.
16. The structure claimed in claim 14 including at least one drive tooth on said first side of said clutch plate, said at least one drive tooth having a first drive surface perpendicular to said clutch plate, said at least one drive tooth having a second drive surface facing in said second direction and sloping in said second direction toward said clutch plate, said rearward end of said drive nut having at least one notch for said at least one clutch plate drive tooth, said at least one notch having first and second drive surfaces correspond-ing to and similarly shaped to said first and second drive surfaces of said at least one drive tooth whereby when said drive knob is rotated in said first direction said perpendicular first drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw away from said fixed jaw, and when said drive knob is rotated in said second direction said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said movable jaw toward said fixed jaw until said predetermined pressure is achieved whereupon said sloping second drive surfaces of said at least one clutch drive tooth and said at least one drive nut notch will cooperate to shift said at least one drive tooth out of said at least one notch against the influence of said yieldable means, disengaging said clutch plate from said drive nut and thus setting said clutch-established gap.
17. The structure claimed in claim 14 including a plurality of upstanding spaced lugs on said second side of said clutch plate, a diametrically opposed pair of said lugs being bifurcated, a pair of diametrically opposed pins being mounted in said hollow drive knob and extending radially inwardly thereof, said pins being located between said bifurcations of said pair of clutch plate lugs, whereby rotation of said drive knob will be imparted to said clutch plate by the cooperation of said pins and said bifurcations and said clutch plate and said drive knob can independently shift axially.
18. The structure claimed in claim 14 wherein said yieldable means com-prises a plurality of springs, one end of each of said springs being located in a socket formed therefor in the interior of said hollow drive knob, the other end of each of said springs abutting said second side of said clutch plate.
19. The structure claimed in claim 16 including a plurality of upstanding spaced lugs on said second side of said clutch plate, a diametrically opposed pair of said lugs being bifurcated, a pair of diametrically opposed pins being mounted in said hollow drive knob and extending radially inwardly thereof, said pins being located between said bifurcations of said pair of clutch plate lugs, whereby rotation of said drive knob will be imparted to said clutch plate by the cooperation of said pins and said bifurcations and said clutch plate and said drive knob can independently shift axially.
20. The structure claimed in claim 19 wherein said yieldable means com-prises a plurality of springs, one end of each of said springs being located in a socket formed therefor in the interior of said hollow drive knob, the other end of each of said springs abutting said second side of said clutch plate.
21. In a surgical stapling instrument of the type having a fixed jaw with an anvil surface thereon with staple clinching grooves therein, a movable jaw shiftable toward and away from said fixed jaw and carrying a plurality of staples and a driver therefor, means to shift said movable jaw, a staple driver actuator shiftable between a retracted position and an advanced position where-in it actuates said staple driver to cause said staples to pass through tissue located between said fixed jaw and said movable jaw and to be clinched by said anvil surface, and means to shift said staple driver actuator, said surgical stapling instrument having a working gap comprising a range of distances between said fixed jaw and said movable jaw throughout which said staples can be proper-ly implanted and clinched, the improvement comprising latch means permitting shifting of said staple driver actuator by said staple driver actuator shifting means only when the distance between said fixed jaw and said movable jaw falls within said working gap of said instrument.
22. The structure claimed in claim 21 wherein said surgical stapling instrument comprises an elongated hollow body having an intermediate portion, a rearward end and a forward end terminating in said fixed jaw, an elongated shank terminating at its forward end in said movable jaw and at its rearward end in a cylindrical portion, said shank being mounted in said hollow instrument body so as to be non-rotatable therein and to be axially shiftable therein by said mov-able jaw shifting means, a staple driver actuator shank mounted within said movable jaw shank and being axially shiftable and non-rotatable therein, the forward end of said staple driver actuator shank terminating in said staple driver actuator, the rearward end of said staple driver actuator shank terminat-ing short of said cylindrical rearward end of said movable jaw shank, said cylin-drical rearward end of said movable jaw shank having an axial bore extending therethrough, a first portion of said bore being threaded and a second portion of said bore near the rearwardmost end of said movable jaw shank being unthread-ed and of slightly larger diameter, an elongated rod-like screw having a forward end followed by a threaded portion and an unthreaded portion terminating in a rearward end of said screw, the forward end of said screw being rotatably attached to said rearward end of said staple driver actuator shank, said screw being located in said bore of said cylindrical rearward end of said movable jaw shank with its threaded portion threadedly engaged in said threaded portion of said last mentioned bore, said unthreaded portion of said screw being partially located within said last mentioned bore and extending rearwardly beyond said rearward end of said movable jaw shank, a wing nut having a forward cylindrical portion rotatably and axially shiftably mounted at said rearward end of said instrument, said forward cylindrical portion of said wing nut having an axial bore therein, said rearward end of said screw being located within said wing nut bore and being non-rotatably affixed therein, whereby rotation of said wing nut in a first direction will result in rotation of said screw in said internally threaded portion of said movable jaw cylindrical rearward end to shift said staple driver via its shank toward said retracted position thereof and rotation of said wing nut in a second direction will cause rotation of said screw in said internally threaded portion of said movable jaw cylindrical rearward end to shift said staple driver actuator via its shank toward said advanced position thereof.
23. The structure claimed in claim 21 wherein each of said staples is of inverted U-shaped configuration having a crown portion and a pair of downwardly depending legs, said anvil surface staple clinching grooves being arranged in pairs, each pair adapted to receive and clinch the legs of one of said staples, said clinching grooves of each pair lying at an angle to the long axis of said anvil surface whereby said legs of each staple, when clinched, will be slightly twisted so as to lie to either side of their respective staple crown portion.
24. The structure claimed in claim 22 wherein said rearward end of said screw and said forward cylindrical end of said wing nut are slotted, a latch located in said slots, a pin extending through transverse coaxial perforations in said rearward end of said screw, said forward end of said wing nut and said latch non-rotatably affixing said screw to said wing nut and pivotally mounting said latch in said slots, said rearward cylindrical end of said movable jaw shank having an annular flange thereon surrounding said screw and having a plurality of radial notches formed therein, said latch being pivotable between first and second positions in engagement with one of said radial notches wherein it will prevent rotation of said wing nut and said screw to prevent shifting of said staple driver actuator to said advanced position and an intermediate third position out of engagement with said radial notches wherein it will permit rota-tion of said wing nut and said screw to shift said staple driver actuator to said advanced position thereof, and means to shift said latch from one of said first and second positions to said third position only when said gap between said movable jaw and said fixed jaw falls within said working gap of said surgical stapling instrument.
25. The structure claimed in claim 24 wherein said shifting means for said latch comprises a laterally extending nose on said latch, said instrument having a first surface contactable by said nose to maintain said latch in said first position when said gap between said fixed and movable jaws exceeds said working gap, said instrument having a second surface contactable by said nose to maintain said latch in said second position when said gap between said fixed and movable jaws is less than said working gap, said instrument having a third surface between said first and second surfaces, said third surface being con-tactable by said nose to maintain said latch in said intermediate third position when said gap between said fixed and movable jaws falls within said working gap.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US06/327,932 US4442964A (en) | 1981-12-07 | 1981-12-07 | Pressure sensitive and working-gap controlled surgical stapling instrument |
| US327,932 | 1994-10-24 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1182710A true CA1182710A (en) | 1985-02-19 |
Family
ID=23278708
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000410260A Expired CA1182710A (en) | 1981-12-07 | 1982-08-26 | Pressure sensitive and working gap controlled medical stapling device |
Country Status (11)
| Country | Link |
|---|---|
| US (1) | US4442964A (en) |
| JP (1) | JPS5897350A (en) |
| AU (1) | AU555133B2 (en) |
| BR (1) | BR8206899A (en) |
| CA (1) | CA1182710A (en) |
| DE (1) | DE3232769C2 (en) |
| FR (1) | FR2517534B1 (en) |
| GB (1) | GB2115736B (en) |
| IT (1) | IT1155971B (en) |
| SE (1) | SE446814B (en) |
| ZA (1) | ZA825565B (en) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US3080564A (en) * | 1959-09-10 | 1963-03-12 | Strekopitov Alexey Alexeevich | Instrument for stitching hollow organs |
| US3252643A (en) * | 1962-12-24 | 1966-05-24 | Strekopytov Alexey Alexcevich | Instrument for suturing living tissue |
| US3269630A (en) * | 1964-04-30 | 1966-08-30 | Fleischer Harry | Stapling instrument |
| US3275211A (en) * | 1965-05-10 | 1966-09-27 | United States Surgical Corp | Surgical stapler with replaceable cartridge |
| US3315863A (en) * | 1965-07-06 | 1967-04-25 | United States Surgical Corp | Medical instrument |
| US3494533A (en) * | 1966-10-10 | 1970-02-10 | United States Surgical Corp | Surgical stapler for stitching body organs |
| DE1791114B1 (en) * | 1967-09-19 | 1971-12-02 | Vnii Chirurgitscheskoj Apparat | Surgical device for stapling tissues |
| BE758685A (en) * | 1970-10-14 | 1971-05-10 | Vnii Khirurgicheskoi Apparatur | SURGICAL APPARATUS FOR TISSUE SUTURE WITH STAPLES |
| CH550578A (en) * | 1971-05-03 | 1974-06-28 | Vnii Khirurgicheskoi Apparatur | SURGICAL SEWING DEVICE FOR SEWING TISSUE AND ORGANS WITH THE HELP OF METAL CLIPS. |
| GB1339394A (en) * | 1972-04-06 | 1973-12-05 | Vnii Khirurgicheskoi Apparatur | Dies for surgical stapling instruments |
| DE2218203A1 (en) * | 1972-04-14 | 1973-10-18 | Vnii Chirurgitscheskoj Apparat | MATRICE FOR SURGICAL SEWING DEVICES |
| SU886900A1 (en) * | 1979-03-26 | 1981-12-07 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgical apparatus for applying line sutures |
| US4315589A (en) * | 1979-10-01 | 1982-02-16 | Xerox Corporation | Stapler apparatus |
| US4319576A (en) * | 1980-02-26 | 1982-03-16 | Senco Products, Inc. | Intralumenal anastomosis surgical stapling instrument |
| US4296881A (en) * | 1980-04-03 | 1981-10-27 | Sukoo Lee | Surgical stapler using cartridge |
| US4354628A (en) * | 1980-09-29 | 1982-10-19 | United States Surgical Corporation | Surgical stapler apparatus having pivotally related staple holder and anvil |
-
1981
- 1981-12-07 US US06/327,932 patent/US4442964A/en not_active Expired - Lifetime
-
1982
- 1982-07-29 AU AU86576/82A patent/AU555133B2/en not_active Ceased
- 1982-08-02 ZA ZA825565A patent/ZA825565B/en unknown
- 1982-08-18 SE SE8204748A patent/SE446814B/en not_active IP Right Cessation
- 1982-08-26 CA CA000410260A patent/CA1182710A/en not_active Expired
- 1982-09-02 FR FR8215020A patent/FR2517534B1/en not_active Expired
- 1982-09-03 DE DE3232769A patent/DE3232769C2/en not_active Expired
- 1982-09-28 JP JP57169463A patent/JPS5897350A/en active Granted
- 1982-10-05 IT IT68168/82A patent/IT1155971B/en active
- 1982-11-22 GB GB08233239A patent/GB2115736B/en not_active Expired
- 1982-11-29 BR BR8206899A patent/BR8206899A/en unknown
Also Published As
| Publication number | Publication date |
|---|---|
| ZA825565B (en) | 1983-06-29 |
| IT8268168A0 (en) | 1982-10-05 |
| JPS5897350A (en) | 1983-06-09 |
| SE8204748D0 (en) | 1982-08-18 |
| FR2517534A1 (en) | 1983-06-10 |
| IT1155971B (en) | 1987-01-28 |
| GB2115736B (en) | 1985-06-26 |
| SE446814B (en) | 1986-10-13 |
| DE3232769A1 (en) | 1983-06-16 |
| GB2115736A (en) | 1983-09-14 |
| DE3232769C2 (en) | 1985-06-20 |
| US4442964A (en) | 1984-04-17 |
| AU8657682A (en) | 1983-06-16 |
| FR2517534B1 (en) | 1986-09-05 |
| AU555133B2 (en) | 1986-09-11 |
| JPS6157020B2 (en) | 1986-12-04 |
| SE8204748L (en) | 1983-06-08 |
| BR8206899A (en) | 1983-10-04 |
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