BACKGROUND
1. Technical Description
The present disclosure is directed to circular stapling devices, and more particularly, to circular stapling devices including splines having an A-frame structure to prevent malformation of staples due to spline crashing.
2. Background of Related Art
Circular stapling devices are utilized by clinicians to apply one or more surgical fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together and/or for the creation of an anastomosis. Circular stapling devices generally include a shell assembly including a staple cartridge supporting a plurality of annular rows of staples and an anvil assembly operatively associated with the shell assembly and having annular arrays of staple receiving pockets. The staple receiving pockets are aligned with the annular rows of staples to provide a surface against which the plurality of annular rows of staples can be formed.
During a typical tissue fastening procedure, the anvil assembly of the stapling device is positioned within one segment of body tissue and the shell assembly is positioned in an adjacent segment of body tissue. The anvil assembly is then attached to the body portion of the stapling device and the stapling device is actuated to move the anvil assembly in relation to the staple cartridge of the shell assembly to clamp the body tissue segments together.
Typically, the anvil assembly includes an anvil shaft that includes splines that mate with splines formed within a shell housing of the shell assembly to align the staple forming pockets of the anvil assembly with staple receiving pockets of the staple cartridge of the shell assembly. The splines on the anvil shaft and on the shell housing of the shell assembly include left and right tapered ends that define an apex. When the tapered ends of the splines of the anvil assembly engage the tapered ends of the shell assembly, the anvil assembly is cammed into rotation to align the staple forming pockets of the anvil assembly with staple receiving pockets of the staple cartridge of the shell assembly. However, if the apexes of the splines of the anvil assembly and the shell assembly engage head on, i.e., crash, the splines of the anvil assembly and the shell assembly may be damaged such that proper alignment of the anvil and shell assemblies is prevented such that malformation of the staples may occur during firing of the stapling device.
A continuing need exists for a circular stapling device having a more reliable alignment structure for aligning the staple forming pockets of the anvil assembly with the staple receiving pockets of the staple cartridge of the shell assembly to minimize the occurrence of staple malformation.
SUMMARY
One aspect of the disclosure is directed to a surgical stapling device including an approximation assembly, an anvil assembly, and a shell assembly. The approximation assembly includes an anvil retainer. The anvil assembly includes an anvil shaft having at least one anvil spline and an anvil head having an anvil surface defining a plurality of staple deforming recesses. The anvil head is supported on a distal portion of the anvil shaft. The shell assembly includes a shell housing having an inner housing portion defining a bore. A plurality of shell splines are supported on the inner housing portion within the bore. Each of the plurality of shell splines has spaced side walls and a pair of tapered surfaces extending from the spaced side walls that intersect at an apex. Each of the spaced side walls of adjacent shell splines of the plurality of shell splines defines a primary channel and the spaced side walls of each of the plurality of shell splines defines a secondary channel. The secondary channels are positioned proximally of and in axial alignment with the apex of the respective shell spline. The primary and secondary channels are dimensioned to receive one of the at least one anvil splines.
Another aspect of the disclosure is directed to a shell assembly for a circular stapling device including a shell housing having an inner housing portion defining a bore, and a plurality of shell splines supported on the inner housing portion within the bore. Each of the plurality of shell splines has spaced side walls and a pair of tapered surfaces that intersect at an apex and extend distally from the spaced side walls. Each of the spaced side walls of adjacent shell splines of the plurality of shell splines defines a primary channel and the spaced side walls of each of the plurality of shell splines defines a secondary channel that is positioned proximally of and in axial alignment with the apex of the respective shell spline. The primary and secondary channels are dimensioned to receive an anvil spline of a surgical stapling device.
Another aspect of the present disclosure is directed to a tool assembly for a surgical stapling device including an anvil assembly and a shell assembly. The anvil assembly includes an anvil shaft having at least one anvil spline and an anvil head having an anvil surface defining a plurality of staple deforming recesses. The anvil head is supported on a distal portion of the anvil shaft. The shell assembly includes a shell housing having an inner housing portion defining a bore. A plurality of shell splines are supported on the inner housing portion within the bore. Each of the plurality of shell splines has spaced side walls and a pair of tapered surfaces extending from the spaced side walls that intersect at an apex. Each of the spaced side walls of adjacent shell splines of the plurality of shell splines defines a primary channel and the spaced side walls of each of the plurality of shell splines defines a secondary channel. The secondary channels are positioned proximally of and in axial alignment with the apex of the respective shell spline. The primary and secondary channels are dimensioned to receive one of the at least one anvil splines.
In embodiments, the tapered surfaces of each of the shell splines are positioned on a distal portion of the shell spline.
In some embodiments, the at least one anvil spline includes a pair of tapered surfaces that intersect at an apex.
In certain embodiments, the primary and secondary channels are positioned to receive the at least one anvil spline to properly align the anvil assembly with the shell assembly.
In embodiments, the apex of each of the shell splines is constructed to fracture upon engagement with the apex of the at least one anvil spline to allow passage of the at least one anvil spline into a respective one of the secondary channels.
In some embodiments, the at least one anvil spline includes a plurality of anvil splines.
In certain embodiments, the tapered surfaces of each of the plurality of shell splines is configured to cam the at least one anvil spline into a respective primary channel when the apex of the at least one anvil spline engages one of the tapered surfaces.
In embodiments, the shell assembly includes a staple cartridge supported within the shell housing.
BRIEF DESCRIPTION OF THE DRAWINGS
Various embodiments of the presently disclosed circular stapling device are described herein below with reference to the drawings, wherein:
FIG. 1 is a side perspective view of an exemplary embodiment of the presently disclosed surgical stapling device with a tool assembly in a clamped position;
FIG. 2 is a side perspective view of the surgical stapling device shown in FIG. 1 with shell and anvil assemblies of the tool assembly separated from the remaining portion of the stapling device;
FIG. 3 is a perspective view from a distal end of a “Prior Art” surgical stapling device with the anvil assembly of the tool assembly of the surgical stapling device separated from an anvil retainer (shown in phantom) of the surgical stapling device;
FIG. 4 is a schematic view of a spline configuration of the anvil assembly of the “Prior Art” surgical stapling device shown in FIG. 3;
FIG. 5 is a side perspective view of the anvil assembly of the surgical stapling device shown in FIG. 1;
FIG. 5A is a cross-sectional view taken along section line 5A-5A of FIG. 5;
FIG. 6 is a side view taken in the direction indicated by arrows 6-6 of FIG. 5;
FIG. 7 is a perspective view from the distal end of the shell housing of the shell assembly of the surgical stapling device shown in FIG. 1;
FIG. 8 is a cross-sectional view taken along section line 8-8 of FIG. 7;
FIG. 9 is an enlarged view of the indicated area of detail shown in FIG. 8;
FIG. 10 is a cross-sectional view taken along section line 10-10 of FIG. 8;
FIG. 11 is a cross-sectional view taken along section line 11-11 of FIG. 8;
FIG. 12 is a schematic view of splines of the anvil assembly of the surgical stapling device shown in FIG. 1 and the splines of the shell assembly of the surgical stapling device shown in FIG. 1 prior to engagement of the splines with each other;
FIG. 13 is a schematic view of the splines of the anvil assembly and the splines of the shell assembly shown in FIG. 12 immediately after engagement of the splines with each other;
FIG. 14 is a schematic view of the splines of the anvil assembly and the splines of the shell assembly shown in FIG. 13 after the anvil assembly has rotated into alignment with the shell assembly and the splines of the anvil assembly have moved into the primary channels of the shell assembly;
FIG. 15 is cross-sectional view taken through the splines of the anvil and shell assemblies as the splines of the anvil assembly move into the primary channels of the shell assembly;
FIG. 16 is a schematic view of splines of the anvil assembly and the splines of the shell assembly of the surgical stapling device shown in FIG. 1 as the splines crash;
FIG. 17 is a schematic view of splines of the anvil assembly and the splines of the shell assembly of the surgical stapling device shown in FIG. 1 as the splines of the anvil assembly penetrate into the splines of the shell assembly;
FIG. 18 is a schematic view of the splines of the anvil assembly of the surgical stapling device shown in FIG. 1 and the splines of the shell assembly of the surgical stapling device shown in FIG. 1 after the splines of the anvil assembly have penetrated the splines of the shell assembly and moved into secondary channels defined by the splines of the shell assembly;
and
FIG. 19 is cross-sectional view taken through the splines of the anvil and shell assemblies as the splines of the anvil assembly move into the secondary channels of the shell assembly.
DETAILED DESCRIPTION OF EMBODIMENTS
The presently disclosed stapling device will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel.
The presently disclosed surgical stapling device includes an anvil assembly and a shell assembly. The shell assembly includes splines having an A-frame configuration that are supported on a shell housing of the shell assembly of the surgical stapling device. The A-frame splines include a triangular tip that defines an apex. The triangular tip is positioned to engage splines on a center rod of the anvil assembly to properly align the anvil assembly with the shell assembly. The A-frame splines are spaced from each other to define primary channels that are dimensioned to receive the splines on the center rod of the anvil assembly to properly align the anvil assembly with the shell assembly. The A-frame splines also define secondary channels that are positioned proximally of the apex of the A-frame splines. In situations in which an apex of the splines on center rod of the anvil assembly “crash” into the apex of the A-frame splines of the shell assembly, i.e., the apexes of the splines meet head on, the A-frame splines of the shell assembly are constructed to fracture to allow the splines of the anvil center rod of the anvil assembly to penetrate into the A-frame splines and pass into the secondary channels of the A-frame splines to properly align the anvil assembly with the shell assembly of the stapling device. The inclusion of A-frame splines having secondary channels on the shell assembly reduces the likelihood of staple malformation when the splines “crash”.
Referring to FIGS. 1 and 2, the presently disclosed surgical stapling device shown generally as stapling device 10 includes a handle assembly 12, an elongate body portion 14 that extends distally from the handle assembly 12, and a tool assembly 16 that is supported on a distal portion of the elongate body portion 14. The tool assembly 16 includes a shell assembly 18 that supports a staple cartridge 18a and an anvil assembly 20 that includes an anvil head 34 having an anvil surface 34a that defines a plurality of staple deforming recesses (FIG. 2.) The handle assembly 12 includes an approximation knob 22 of an approximation assembly that is operable to move the anvil assembly 20 between unclamped and clamped positions in relation to the cartridge assembly 18, a firing trigger 24 that that operates a firing mechanism (not shown) to fire staples (not shown) from the staple cartridge 18a into tissue, and a firing trigger lockout 26 that is pivotally supported on the handle assembly 12 and is positioned to prevent inadvertent firing of the stapling device 10. For a detailed description of an exemplary circular stapling device including known approximation, firing, and lockout mechanisms, see U.S. Pat. No. 7,857,187 (“the '187 Patent”) which is incorporated herein by reference in its entirety.
Although the presently disclosed stapling device 10 is shown and described as being a manually powered device, it is envisioned that the stapling device 10 can also be an electrically powered device such as described in U.S. Patent Publication No. 2015/0048140 which is incorporated herein by reference in its entirety.
The staple cartridge 18a of the shell assembly 18 and the anvil surface 34a (FIG. 2) of the anvil assembly 20 have an annular configuration. The anvil assembly 20 is movable in relation to the shell assembly 18 between a spaced position and a clamped position to move the anvil surface 34a into juxtaposed alignment with the staple cartridge 18a. The staple cartridge 18a defines staple receiving slots 28 (FIG. 1) that are aligned with the staple deforming recesses of the anvil surface 34a when the staple cartridge 18a and the anvil surface 34a are properly aligned such that staples ejected from the staple receiving slots 28 are deformed within the staple deforming recesses when the stapling device 10 is fired.
The anvil assembly 20 is releasably supported on an anvil retainer 30 (FIG. 2) of the stapling device 10. The anvil retainer 30 forms part of an approximation mechanism of the stapling device 10 and includes a distal portion 30a and a proximal portion 30b (FIG. 2). The distal portion 30a of the anvil retainer 30 extends from a distal end of the elongate body portion 14 of the stapling device 10 and through the shell assembly 18 to a position to engage the anvil assembly 20. The proximal portion 30b of the anvil retainer 30 is operatively connected to the approximation knob 22 such that rotation of the approximation knob 22 causes the anvil retainer 30 to move within the shell assembly 18 to move the anvil assembly 20 in relation to the staple cartridge 18a between the spaced position and the clamped position.
The shell assembly 18 includes an annular knife (not shown) that is movable from a retracted position to an advanced position within the shell assembly 18 during firing of the stapling device 10 to transect tissue clamped between the staple cartridge 18a and the anvil surface 34a. (See the '187 Patent.) In some embodiments, the shell assembly 18 is releasably coupled to a distal portion of the elongate body 14 of the stapling device 10 to facilitate replacement of the shell assembly 18 after each firing of the stapling device 10. Mechanisms for releasably coupling the shell assembly 18 to the elongate body portion 14 of the stapling device 10 are described in U.S. Patent Publication Nos. 2016/0310141, 2016/0192938, and 2016/0192934 which are incorporated herein in their entirety by reference. Alternately, the shell assembly 18 can be fixedly secured to the distal portion of the elongate body 14.
Referring to FIG. 3, prior art circular stapling devices 100 include an anvil assembly 120 having an anvil head 122 and an anvil shaft or center rod 124, and a shell assembly 118 having a staple cartridge 118a and a shell housing 126 having an inner housing portion 128 that defines a through bore 128a. The anvil head 122 defines an anvil surface 122a that defines annular arrays of staple deforming recesses 122b and the staple cartridge 118a defines an annular array of staple receiving slots 118b. An anvil retainer 130 (shown in phantom) includes a distal end that is configured to releasably engage the anvil shaft 124 of the anvil assembly 120. The anvil retainer 130 is received within the through bore 128a of the shell housing 126 and is movable between retracted and advanced positions. When the anvil shaft 124 is coupled to the anvil retainer 130 and the anvil retainer 130 is retracted (via actuation of the approximation knob 22, FIG. 1), the anvil shaft 124 is drawn into the through bore 128a of the inner housing portion 128 of the shell housing 126.
In order to align the staple deforming recesses 122b of the anvil surface 122a of the anvil assembly 120 with the staple receiving slots 118b of the staple cartridge 118a of the shell assembly 118, the anvil shaft 124 includes a plurality of splines 134 including adjacent splines 134a, 134b (FIG. 4) that are received in channels 148 defined between splines 136 formed along an inner wall of the inner housing portion 128 of the shell housing 126. Each of the splines 134 of the anvil assembly 120 defines a central axis “Z” and left and right tapered cam surfaces 138a, 138b positioned on opposite sides of the central axis “Z” as viewed in FIG. 4. The tapered surfaces 138a, 138b meet at their proximal ends at an apex 140. Similarly, each of the splines 136 of the shell assembly 118 defines a central axis “X” and left and right tapered cam surfaces 142a, 142b positioned on opposite sides of the central axis “X”. The tapered surfaces 142a, 142b meet at their distal ends at an apex 144.
When the anvil assembly 120 is attached to the anvil retainer 130 (FIG. 3) and the anvil retainer 130 and anvil assembly 120 are retracted into the through bore 128a (FIG. 3) of the inner housing portion 128 of the shell housing 126, the splines 134 of the anvil assembly 120 move towards the splines 136 of the shell assembly 118. If the splines 134 of the anvil assembly 120 are misaligned with channels 148 defined between the splines 136 of the shell assembly 118, the apexes 140 of the anvil splines 134a, 134b will engage one of the cam surfaces 142a, 142b of the splines 136. When the apexes 140 of the splines 134a, 134b (only two are shown) engage the left tapered cam surface 142a of the splines 136, the engagement urges or cams the anvil assembly 120 to rotate in the direction indicated by arrow “S” to realign the splines 134a, 134b so that they enter into the channels 148 defined between the splines 136 of the shell assembly 118. However, if the apexes 140 of the splines 134a-b of the anvil assembly 120 are aligned with the apexes 144 of the splines 136 of the shell assembly 118 such that the apexes 140 and 144 meet head on or “crash”, the apexes 140 and 144 may be damaged to that extent that the anvil assembly 120 is not rotated into alignment with the shell assembly 118. When this occurs, alignment between the staple receiving slots 118b of the staple cartridge 118a may not be properly aligned with the staple deforming recesses 122b of the anvil assembly 120 when the staples are fired. This may result staple malformation.
Referring to FIGS. 5-6, in the presently disclosed surgical stapling device 10 (FIG. 1), the anvil assembly 20 includes an anvil head assembly 34 which includes the anvil surface 34a defining a plurality of staple deforming recesses similar to recesses 122b of FIG. 3 and an anvil shaft 36 that defines a longitudinal axis “SH” (FIG. 5). The anvil shaft 36 supports at least one spline 38 positioned on the anvil shaft 36. In some embodiments, the at least one spline 38 includes a first spline 38a, a second spline 38b, a third spline 38c, and a fourth spline 38d. Alternately, the at least one spline 38 may include one or more splines, e.g., 2 or 3. Each of the splines 38a-d (FIG. 5A) defines a longitudinal axis “Z” (FIG. 6) that extends in a direction that is substantially parallel to the longitudinal axis “SH” (FIG. 5) of the anvil shaft 36 and includes left and right tapered cam surfaces 42 and 44 (as viewed in FIG. 6), respectively, that meet to define an apex 46 positioned at a proximal end of the respective spline 38a-d.
Referring to FIGS. 7-11, the shell assembly 18 (FIG. 1) includes a shell housing 50 having an inner housing portion 52. The inner housing portion 52 includes an inner surface 54 that defines an inner bore 56. The inner surface 54 includes a plurality of spaced A-frame splines 58. Each of the A-frame splines 58 defines a primary channel 60 with each adjacent A-frame spline 58. Each of the A-frame splines 58 includes left and right cam surfaces 62 and 64 respectively as viewed in FIG. 9, an apex 66 and side walls 68. The side walls 68 define secondary channels 70 that are positioned proximally of (or beneath as viewed in FIG. 9) the apex 66 of a respective A-frame spline 58.
As discussed above in regard to the stapling device 100 shown in FIG. 3, the inner bore 56 of the inner housing portion 52 of the shell housing 50 receives the anvil retainer 30 of the stapling device 10. When the anvil shaft 36 (FIG. 5) of the anvil assembly 20 is secured to the anvil retainer 30 and the anvil assembly 20 is moved to the clamped position, the anvil retainer 30 and the anvil shaft 36 of the anvil assembly 20 are retracted into the inner bore 56 of the shell housing 50. As the anvil shaft 36 (FIG. 5) is drawn into the inner bore 56 of the shell housing 50, the splines 38a-d of the anvil shaft 36 approach and subsequently engage the A-frame splines 58 of the shell housing 50.
Referring to FIGS. 12-15, as the anvil shaft 36 is drawn into the inner bore 56 of the shell housing 50 in the direction indicated by arrow “B” in FIG. 13, if the apex 46 of the splines 38a-d are positioned to engage one of the cam surfaces 62 and 64 of the A-frame splines 58 (FIG. 12), the apex 46 of the splines 38a-d will be cammed along the cam surfaces 62 or 64 of the A-frame splines 58 (FIG. 13) such that the anvil assembly 20 will rotate in relation to the shell assembly 18 and the splines 38a-d will be directed into the respective primary channels 60 defined between adjacent A-frame splines 58 (FIG. 14). This rotational movement of the anvil assembly 20 in relation to the shell assembly 18 moves the staple receiving slots 28 (FIG. 1) of the staple cartridge 18a into alignment with the staple deforming recesses of the anvil surface 34a such that staples ejected from the staple receiving slots 28 will be properly deformed within the staple deforming recesses on the anvil surface 34a when the stapling device 10 is fired.
Referring to FIGS. 16-19, as the anvil shaft 36 is drawn into the inner bore 56 of the shell housing 50 in the direction indicated by arrow “C” in FIG. 16, if the apex 46 of the splines 38a-d are positioned to engage head on or “crash” with the apex 66 of the A-frame splines 58 (FIG. 16), the apex 46 of the splines 38a-d will penetrate the A-frame splines 58 (FIG. 17) such that the splines 38a-d will be directed into the secondary channels 70 defined between the side walls 68 of the A-frame splines 58 (FIG.). In this position, the staple receiving slots 28 (FIG. 1) of the staple cartridge 18a are aligned with the staple deforming recesses formed on the anvil surface 34a such that staples ejected from the staple receiving slots 28 will be properly deformed within the staple deforming recesses formed on the anvil surface 34a when the stapling device 10 is fired.
By providing A-frame splines 58 on the shell housing 50 that define secondary channels 70 that are positioned beneath the apex 66 of the A-frame splines 58, the combination of the splines 38a-d on the anvil shaft 36 of the anvil assembly 20 and the A-frame splines 58 on the shell housing 50 of the shell assembly 18 can properly align the anvil assembly 20 and the shell assembly 18 even when the splines crash.
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described embodiments. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
Patent Application
20190290284
