This disclosure is directed to a surgical stapling device and, more particularly, to a linear surgical stapling device having a tool assembly that defines a tissue gap and includes a locking member to maintain the tissue gap during firing of the stapling device.
Surgical stapling devices are commonly used during a variety of surgical procedures to staple and/or cut tissue. Stapling and cutting of tissue can be accomplished more quickly using surgical stapling devices than can be accomplished using traditional suturing techniques. In addition, endoscopic stapling devices can be used to perform less invasive surgical procedures than possible using traditional suturing techniques. As such, the use of surgical stapling devices to perform certain surgical procedures to reduce patient trauma and improve patient recovery times is desirable.
Typically, linear endoscopic surgical stapling devices include a tool assembly that includes a staple cartridge and an anvil assembly that are movable in relation to each other between open and clamped positions. The staple cartridge defines a plurality of staple pockets that receive staples and the anvil assembly defines a plurality of staple deforming pockets. When the tool assembly is in the clamped position, the staple deforming pockets of the anvil assembly are aligned with the staple pockets of the staple cartridge such that legs of the staples are received and deformed within the staple deforming pockets when the stapling device is fired. The staple cartridge and the anvil assembly must be properly aligned to effect proper staple formation.
Generally, the staple cartridge and the anvil assembly have proximal ends that are secured to each other by a pivot member such that the staple cartridge and the anvil assembly can be pivoted from the open position in which distal ends of the staple cartridge and the anvil assembly are spaced from each other to the clamped position in which the staple cartridge and the anvil assembly are in juxtaposed alignment. During firing of the staples from the staple cartridge, forces on the staple cartridge and the anvil assembly for firing the staples tend to deflect the staple cartridge and anvil assembly outwardly away from each other. In certain stapling devices, a knife bar is provided that includes upper and lower beams that engage the anvil assembly and staple cartridge to minimize deflection of the anvil and cartridge assemblies during firing.
One aspect of this disclosure is directed to a tool assembly including an anvil, a cartridge assembly, a sled, and a locking member. The anvil and the cartridge assembly each have a proximal portion and a distal portion. The proximal portion of the cartridge assembly is pivotally coupled to the proximal portion of the anvil. The distal portion of the anvil defines a bore therein. The sled is slidably received in the cartridge assembly and configured to move from a proximal position to a distal position to advance staples from the cartridge assembly. The locking member is rotatably supported on the distal portion of the cartridge assembly and positioned for receipt in the bore. The locking member is operably coupled to the sled, such that advancement of the sled from the proximal position toward the distal position rotates the locking member relative to the bore to approximate the distal portions of the anvil and cartridge assembly.
In aspects, the locking member may have an extension having a threaded outer surface. The bore in the distal portion of the anvil may be defined by a threaded inner surface configured to threadedly engage the threaded outer surface of the extension of the locking member.
In aspects, the anvil and cartridge assembly may be movable between an expanded position, in which the extension of the locking member is spaced from the bore in the anvil, and a first approximated position, in which the threaded outer surface of the extension of the locking member is engaged with the threaded inner surface of the anvil.
In aspects, the anvil and cartridge assembly may be configured to move from the first approximated position to a second approximated position in response to rotation of the locking member while the threaded outer surface of the locking member is engaged with the threaded inner surface of the anvil.
In aspects, the tool assembly may further include a tether having a proximal end portion coupled to the sled, and a distal end portion disposed about the locking member, such that translation of the sled rotates the locking member via the tether.
In aspects, the locking member may have a barrel portion rotatably supported in the cartridge assembly. The distal end portion of the tether may be fixed about the barrel portion.
In aspects, the tool assembly may further include a biasing member received in the barrel portion and coupled to the cartridge assembly. The biasing member may be configured to urge the tether in a distal direction.
In aspects, the locking member may be spring-biased to urge the tether in a distal direction.
In aspects, the tether may be a looped band defining a plurality of apertures. The locking member may have a plurality of circumferentially spaced protuberances configured for receipt in the corresponding plurality of apertures.
In aspects, the sled may have a pin extending therefrom and received in an aperture of the plurality of apertures, such that translation of the sled moves the band along a looped path.
In aspects, the distal portion of the anvil may have a tissue dissector, and the tissue dissector may define the bore.
In accordance with another aspect of the disclosure, a surgical stapling device is provided and includes a handle assembly, an elongated body extending distally from the handle assembly, a drive shaft, and a tool assembly. The handle assembly includes a trigger, and the drive shaft has a proximal end portion operably coupled to the trigger. The tool assembly is coupled to a distal portion of the elongate body and includes an anvil, a cartridge assembly, a tether, and a locking member. The anvil and cartridge assembly each has a proximal portion and a distal portion. The proximal portion of the cartridge assembly is pivotally coupled to the proximal portion of the anvil between an expanded position and an approximated position. The distal portion of the anvil defines a bore therein. The tether has a proximal end portion coupled to a distal end portion of the drive shaft. The locking member is rotatably supported on the distal portion of the cartridge assembly and positioned for receipt in the bore. The tether has a distal end portion disposed about and coupled to the locking member, such that when the cartridge assembly and anvil are in the approximated position, advancement of the drive shaft rotates the locking member relative to and within the bore to approximate the distal portions of the anvil and cartridge assembly.
In aspects, the locking member may have an extension having a threaded outer surface. The bore in the distal portion of the anvil may be defined by a threaded inner surface configured to threadedly engage the threaded outer surface of the extension of the locking member when the anvil and cartridge assembly are in the approximated position.
In aspects, in the expanded position, the extension of the locking member may be spaced from the bore in the anvil, and in the approximated position, the threaded outer surface of the extension of the locking member may be engaged with the threaded inner surface of the anvil.
In aspects, the locking member may have a barrel portion rotatably supported in the cartridge assembly. The barrel portion may have the distal end portion of the tether fixed thereabout.
In aspects, the tool assembly may further include a biasing member received in the barrel portion and coupled to the cartridge assembly. The biasing member may be configured to urge the tether in a distal direction.
In aspects, the locking member may be spring-biased to urge the tether in a distal direction.
In aspects, the tether may be a looped band defining a plurality of apertures. The locking member may have a plurality of circumferentially spaced protuberances configured for receipt in the corresponding plurality of apertures.
In aspects, the tool assembly may further include a sled slidably received in the cartridge assembly. The sled may interconnect the distal end portion of the drive shaft and the proximal end portion of the tether. The sled may be configured to move from a proximal position to a distal position to advance staples from the cartridge assembly in response to an actuation of the trigger.
In aspects, the locking member may be configured to rotate in response to movement of the sled between the proximal and distal positions.
Various embodiments of the disclosed linear surgical stapling device including a tool assembly are described herein below with reference to the drawings, wherein:
The disclosed surgical stapling devices 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. However, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure.
The present disclosure provides a tool assembly including a locking member rotatably supported in a cartridge assembly of the tool assembly. An anvil of the tool assembly has a threaded inner surface that defines a bore in a distal end portion of the anvil. The locking member is positioned for receipt in the bore of the anvil when the tool assembly is approximated about tissue a selected distance. The locking member has a threaded outer surface configured for threaded engagement with the threaded inner surface of the anvil. The locking member is operably coupled to a staple firing member, such that actuation of the staple firing member rotates the locking member. The tool assembly is configured to further approximate about the tissue in response to the rotation of the locking member within the bore of the anvil to maintain a gap distance between distal ends of the anvil and cartridge assembly.
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.
In
The handle assembly 12 includes a housing 22 that defines a stationary handgrip 24 and supports a movable trigger 26 and a rotation knob 28. The rotation knob 28 is coupled to a distal portion of the housing 22 for rotation and supports the elongate body 14 such that rotation of the rotation knob 28 causes rotation of the elongate body 14 about the longitudinal axis “X”. The movable trigger 26 is supported by the housing 22 and can be pivoted in relation to the stationary handgrip 24 to actuate the tool assembly 20. In embodiments, the rotation knob 28 also supports an articulation knob 30 that can pivot or rotate about an axis perpendicular to the longitudinal axis “X” to articulate the tool assembly 20 from a position aligned with the longitudinal axis “X” to a position misaligned with the longitudinal axis “X”. Although illustrated as being a manually operated handle assembly 12, it is envisioned that the handle assembly 12 may be electrically or pneumatically powered, and may be adapted for use or coupled to a robotic surgical system.
The anvil 34 defines a tissue engaging surface 52 (
The dissecting tip 54, or any suitable location of the distal end portion 34b of the anvil, defines a bore 56 therein. In embodiments, the anvil 34 is devoid of the dissecting tip 54 while still having the bore 56. The bore 56 in the distal end portion 34b of the anvil 34 defines an axis that extends transversely relative to a longitudinal axis of the anvil 34. The dissecting tip 54 has a circular inner surface 58 that defines the bore 52. The inner surface 58 has a threaded, first segment 58a (
The tool assembly 20 also includes a drive assembly that includes a resilient firing shaft 62, a clamping member 64, and a sled 66. The firing shaft 62 may be fabricated from a plurality of elongated laminates and has a proximal end portion (not explicitly shown) operably coupled to the trigger 26 (
The clamping member 64 may be coupled to the firing shaft 62 in such a manner that allows for advancement therewith for a selected distance, and independent movement of the firing shaft 62 relative to the clamping member 64 thereafter. The clamping member 64 is configured to advance with the firing shaft 62 the length of a slot 74 (
The tool assembly 20 includes a tether 72 (
The locking member 60 is positioned in a distal end of the longitudinal slot 42 (
With reference to
With reference to
In operation, when the surgical stapling device 10 is actuated to move the tool assembly 20 from the open position (
Upon moving the tool assembly 20 to the first, approximated position, further advancement of the firing shaft 62 results in advancement of the sled 66 through the cartridge assembly 36 and into engagement with a plurality of pushers 73 (
The threaded engagement between the extension 89 of the locking member 60 and the threaded first segment 58a of the inner surface 58 of the dissection tip 54 further approximates the anvil 34 and cartridge assembly 36 toward a second, approximated position, as shown in
Immediately prior to the tool assembly 20 entering the second, approximated position, the bottom-most threading of the threaded second portion 89b of the extension 89 of the locking member 60 passes over the top-most threading of the threaded first segment 58a of the inner surface 58 of the dissection tip 54, whereby the threaded second portion 89b of the extension 89 of the locking member 60 disengages the threaded first segment 58a of the inner surface 58 of the dissection tip 54 and engages the non-threaded second segment 58b of the inner surface 58, such that further rotation of the locking member 60 fails to result in a further approximation of the tool assembly 20. In this way, as the sled 66 continues to advance to eject the staples 70 from the staple cartridge 44, the locking member 60 and the dissecting tip 54 maintain the tissue gap (
The staple cartridge 144 includes a flexible, looped band 172 operably interconnecting the sled 166 and the locking member 160. The looped band 172 defines a plurality of apertures 174 spaced along the length of the looped band 172. One aperture in a proximal end portion 172a of the looped band 172 receives a pin 182 extending from the sled 166, thereby coupling the sled 166 and the looped band 172. The proximal end portion 172a of the looped band 172 is wrapped about a proximal post 180a (
The base portion 186 of the locking member 160 has a plurality of circumferentially spaced protuberances 182 configured for receipt in respective apertures 174 of the looped band 172. The base portion 186 of the locking member 160 is rotatably supported on a first, distal post 180b that extends upwardly from a distal end of the channel 140 of the cartridge assembly 136. A second, distal post 180c of the channel 140 is engaged to an outer surface of the distal end portion 172b of the looped band 172 to maintain the distal end portion 172b of the looped band 172 tightly wound about the locking member 160. The looped band 172 is rotatable about the first distal post 180b and the proximal post 180a to rotate the base portion 186 of the locking member 160 about the first distal post 180b in response to movement of the sled 166 within the staple cartridge 144. As the looped band 172 is rotated within the staple cartridge 144, the protuberances 182 of the locking member 160 are sequentially received in the respective apertures 174 in the looped band 172. In some aspects, rather than the locking member 160 having protuberances 182 received in the respective apertures 174 in the looped band 172, the distal end portion 172b of the looped band 172 may be frictionally engaged with an outer surface of the locking member 160. Alternately, other known techniques or devices may be used to couple the looped band 172 to the base portion 186 of the locking member 160.
The locking member 160 has an extension 189 extending from the base portion 186. The extension 189 has a threaded outer surface 190 positioned for receipt in the bore 156 of the anvil 14, whereby the threaded outer surface 190 of the extension 189 threadedly engages a threaded inner surface 158 that defines the bore 156 in the anvil 134.
The tool assembly 120 functions in a similar manner to the tool assembly 20. More specifically, after the tool assembly 120 moves from the open position to the first, approximated position, advancement of the firing shaft 162 causes the sled 166 to advance through the cartridge assembly 136 and into engagement with a plurality of pushers 173 to sequentially eject the staples 170 from the staple cartridge 144 into the tissue. Due to the sled 166 being coupled to the looped band 172, advancement of the sled 166 causes the looped band 172 to travel about the first distal post 180b and the proximal post 180a of the channel 140 along a looped path, thereby rotating the locking member 160.
In the first, approximated position of the tool assembly 120, the threaded outer surface 190 of the extension 189 of the locking member 160 is in contact with the threaded inner surface 158 in the dissection tip 154 of the anvil 134. Accordingly, the rotation of the locking member 160 via the looped band 172 causes the threaded outer surface 190 of the extension 189 of the locking member 160 to threadedly engage the threaded inner surface 158 of the dissection tip 154 and move linearly through the bore 156.
Rotation of the extension 189 of the locking member 160 drives a further approximation of the anvil 134 and cartridge assembly 136 toward the second, approximated position to lock the dissecting tip 154 to the distal portion of the cartridge assembly 136. Engagement of the locking member 160 with the dissecting tip 154 of the anvil 134 prevents outward movement of the anvil 134 in relation to the cartridge assembly 136 beyond a predetermined distance to set a pre-determined tissue gap between the anvil 134 and cartridge assembly 136 at a distal end of the tool assembly 120.
Immediately prior to entering the second, approximated position, the bottom-most threading of the threaded outer surface 190 of the extension 189 passes over the top-most threading of the threaded inner surface 158 of the anvil 134, whereby the threaded outer surface 190 disengages the threaded inner surface 158, such that further rotation of the locking member 160 fails to result in a further approximation of the tool assembly 120. In this way, as the sled 166 continues to advance to eject the staples 170 from the staple cartridge 144, the locking member 160 and the dissecting tip 154 of the anvil 134 cooperate to maintain the tissue gap defined between the anvil 134 and the cartridge assembly 136 of the tool assembly 120.
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 this 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.
This application claims the benefit of and priority to U.S. Provisional Application No. 62/913,961, filed on Oct. 11, 2019, the entire contents of which being incorporated by reference herein.
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Number | Date | Country | |
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62913961 | Oct 2019 | US |