BRIEF DESCRIPTION OF THE DRAWINGS
The present invention will be described in conjunction with reference to the following drawings, in which:
FIG. 1 is a perspective view of an exemplary embodiment of the surgical buttress assembly present invention showing the cartridge and carrier components disengaged;
FIG. 2
a is another perspective view of the embodiment shown in FIG. 1 showing a buttress strip interposed the cartridge and carrier components;
FIG. 2
b is a perspective view showing the buttress strip installed on the cartridge, and the loaded cartridge engaged with the carrier, and ready for loading onto the jaws of a surgical stapler;
FIG. 3 is a perspective view showing a preferred orientation for installing a loaded cartridge onto the jaws of a surgical stapler;
FIG. 4
a is a perspective view of the loaded cartridge from FIG. 3 installed onto the jaws of a surgical stapler'
FIG. 4
b is a side view of the installed loaded cartridge from FIG. 4a;
FIG. 5 is a cross-sectional end view of another exemplary embodiment of the cartridge of the present invention shown engaged with a buttress strip, and ready for loading onto a surgical stapler;
FIGS. 6(
a)-6(e) are close-up cross-sectional partial end views of exemplary gripping edges and fingers of the cartridge from FIG. 5;
FIG. 7
a is a side view of a prior art surgical circular stapler provided with a detachable anvil head assembly;
FIG. 7
b is a close-up view of the anvil head assembly of the surgical circular stapler shown in FIG. 4;
FIG. 8 is a perspective view of another exemplary embodiment of the present invention configured to cooperate with a surgical circular stapler; and
FIG. 9 is a close-up exploded perspective view of a prior art anvil head assembly cooperating with the embodiment shown in FIG. 5.
DETAILED DESCRIPTION OF THE INVENTION
An exemplary preferred embodiment of a surgical buttress-dispensing assembly of the present invention is shown in accompanying FIGS. 1-4 and is generally referred to by the numeral 10. The surgical buttress-dispensing assembly 10 comprises a cartridge 20 and a carrier 15. The cartridge 20 is generally elongate and cylindrically shaped with an anterior end 21 and a posterior end 25. An aperture 26 is provided approximate the posterior end 25 of the cartridge 20. Two opposing channels bisecting the cartridge 20, extend forward from the aperture 26 through to the anterior end 25 of the cartridge 20 thereby providing an upper half 24 separated from the lower half 28 of the cartridge 20 anterior of the aperture 26. The upper half 24 terminates at leading edge 22 while the lower half 28 terminates at leading edge 23. The opposing side edges of the upper and lower halves 24, 28 are preferably integrally provided with forward-facing tabs 27 configured to communicate with and engage the side edges of a suitable buttress strip 30. The carrier 15 generally comprises an elongate semi-circular hollow tube provided with a backward-facing tang 16 approximate one end of the carrier 15. As best seen in FIGS. 2b and 3, the tang 16 is configured to receive and releasingly engage therein the leading edge 22 of the upper half 24 of cartridge 20, or alternatively, the leading edge 23 of lower half 28 of cartridge 20. It is preferred that the cartridge 20 and carrier 15 are made of suitably thin and flexible but durable and resilient materials as exemplified by biocompatible plastics materials known to those skilled in these arts.
As shown in FIGS. 2a and 2b, the carrier 15 may be used to install and engage a buttress strip 30 onto the cartridge by folding the buttress strip 30 approximately in half and then sliding the carrier 15 into the folded buttress strip 30 so that one end of the strip 30 is within the carrier 15 while the other end of the strip 30 overlies the outer surface of the carrier 15. The carrier 15 is then slid and manipulated over one of the halves (e.g., in FIG. 2a, the upper half 24) of the cartridge 20 thereby engaging the side edges of the buttress strip 30 with the tabs 27 on the upper and lower halves 24, 28 of the cartridge 20 until the leading edge (e.g. leading edge 22 on upper half 24 per FIG. 2a) engages the tang 16 of the carrier 16. The loaded surgical buttress assembly is now ready for installation onto the articulable jaws 51, 53 of a surgical stapler 50.
As shown in FIGS. 3, 4a and 4b, the posterior end 25 of the cartridge 20 is configured so that it may slidingly receive therein and therethrough the closed jaws 51, 53 of a surgical stapler 50. By grasping and manipulating the carrier 15, the loaded surgical buttress assembly 10 is slid onto the closed jaws 51, 53 to about the proximal end of the jaws 51, 53 after which the carrier 15 can be retracted and removed from the stapler 50. After installation of the loaded cartridge 20, the upper jaw 51 of the stapler 50 is interposed the upper half 24 of the cartridge 20 and the buttress strip 30, while the lower jaw 53 is interposed the lower half 28 of the cartridge 20 and the buttress strip 30. It is preferable to install the loaded cartridge 20 onto the stapler 50 so that the aperture 26 is approximate the proximal end of the jaws 51, 53. After such installation, the upper half 24 of the cartridge communicates and cooperates with the upper jaw 51 while the lower half 28 of the cartridge 20 communicates and cooperates with the lower jaw 53, to securely retain the buttress strip 30 in a preferred installed position during insertion of the surgical stapler 50 through a trocar (not shown) into a patient's abdominal cavity, after the jaws 51,53 have been opened and are manipulated within and about the abdominal cavity to a desired position, and during the staple-firing process. After staples have been fired by the surgical stapler 50, the buttress strip 30 is separated from the cartridge 20 by severing adjacent to the inner walls of the upper and lower halves 24, 28 of the cartridge 20, with blades that are integral components of the surgical stapler 50. The cartridge 20 is retained by the stapler jaws 51, 53 and is removed from the patient's abdomen through the trocar with the stapler 50.
FIGS. 5 and 6 exemplify another suitable elongate cylindrical cartridge having an anterior end and a posterior end, and generally configured with an aperture approximate the posterior end from which extends forward an upper half separated from the lower half wherein the upper and lower halves are separated by a pair of opposing channels bisecting the cartridge. As exemplified by an upper half portion 60 shown in FIG. 5, the opposing elongate side edges 70 of the upper elongate cartridge partial wall portion 65 are formed to provide clamping means whereby a first pair of upward-facing channels 76 is formed by folding side edges 70 to extend upwards from the cartridge partial wall portion 65 and then a second pair of downward-facing channels 71 is formed by folding the upward extending side edges 70 outward and downward. As shown in FIGS. 6(a) and 6(b) the downward portions 71 of the opposing side edges 70 can be made to bias toward the upward extending portions of the side edges 70 thereby providing clamping means between the upward and downward portions of side edges 70. The downward-facing channels 71 may be optionally provided with at least one pair of opposed inwardly-orientated gripping edges or fingers 72 as shown in FIGS. 6(c)-6(e). The lower half of the cartridge partial wall (not shown) is configured into a mirror-image of the upper half 60 shown in FIG. 5. As shown in FIG. 5, about one half of the length of a suitable buttress strip 80 is installed into the upper half of the cartridge partial wall 60 by inserting its opposing elongate side edges into the opposing downward-facing chambers 71 in between the upward-extending and downward-extending elongate side edges 70. The other half of the buttress strip is inserted in between the corresponding downward-extending and upward-extending elongate side edges of the lower half of the cartridge partial wall. If so desired, the buttress strip 80 may be additionally secured to the cartridge after installation, with a lacing suture 81 as shown in FIG. 5. However, the biasing channels 71 will be sufficient to retain in position an installed buttress 80 on this exemplary cartridge during its delivery to the jaws of a surgical stapler and subsequent use.
Examples of suitable buttress strips comprise biocompatible materials exemplified by synthetic base materials such as expanded polytetrafluoroethylene (ePTFE), VICRYL® (registered trade mark of Johnson and Johnson Corp., New Brunswick, N.J., USA) which is a periodontal mesh prepared from bioabsorbable copolymers derived from glycolic acid and lactic acid, DEXON® (registered trade mark of Sherwood Services AG Corp, Schaffhausen, Swizterland) which is a polyglycolic acid, and TEFLON® (registered trade mark of E.I. DuPont de Nemours and Co., Wilmington, Del., USA) which is a polytetrafluoroethylene, and collagen-absorbable hemostat, and stabilized naturally occurring materials such as a pericardium material, and other such materials.
The exemplary embodiments of the surgical buttress assemblies of the present invention disclosed herein are designed to provide secure sealing of surgical staple lines produced by linear cutting types of staplers, by the precise manipulation and application of biocompatible materials within visceral host tissue for use as buttressing materials for suture lines. The system provides a “sandwich” effect by placing a reinforcing buttress layer on both sides of the stapled union of visceral tissue to visceral tissue. The reinforcement is generally carried out by placement of a buttress assembly comprising an elongate strip of biocompatible material onto the anvil and cartridge of a prior art surgical stapler device. After the biocompatible material is securely but releasingly engaged onto the jaws of the surgical stapler, the jaws are closed for insertion through a trocar into the abdominal cavity after which the jaws are opened. The user then approximates the jaws around the target sections of the tissue to be stapled and separated. The jaws are again compressed and locked into place after which, a second handle is pulled to fire the staples followed by deployment of a knife to cut the host tissue and buttress material between the staple lines. The release mechanism is then activated to release the jaws from the staple line. Jaws are withdrawn from the suture site, closed and then the stapler is removed through the trocar.
FIGS. 7
a and 7b exemplify a prior art surgical circular stapler 100 having a proximal end provided with a handle 110 interconnected to a detachable anvil head assembly 130 at the distal end by a moisture-proof conduit 120. The anvil head assembly 130 comprises shaft 142 cooperating with a leading head portion 140 which facilitates insertion of the stapler 100 into a hollow organ or tissue section, and a cutting washer 146 interposed a first compression surface 144. The distal end of the conduit 120 is enlarged to form a cylindrical cartridge 150 configured for receiving and housing surgical staples. The cylindrical cartridge 150 is fitted with a fixed-in-place second compression surface 148 opposite the first compression surface provided within the anvil head assembly 130. The surgical staples are fired by squeezing an actuating lever 115 toward the handle 110 which results in the release of a trigger mechanism (not shown) housed within the conduit 120. The firing force is controllable by an adjusting knob 112 located at the proximal end of the stapler 100 cooperating with the trigger mechanism. A safety catch 116 is commonly provided to ensure the staples are not accidentally fired.
An exemplary embodiment of the present invention is shown in FIGS. 5 and 6 and provides a generally circular buttress disc 160 comprising a suitable biocompatible material, examples of which include synthetic base material such as ePTFE, VICRYL®, DEXON®, TEFLON®, and collagen-absorbable hemostat. Alternatively, stabilized naturally occurring materials such as a pericardium material, and other such materials may be used. The buttress disc 160 is provided with an aperture 162 positioned about the centre of the disc 160, said aperture 162 configured for slidingly cooperating with the shaft 142 of the anvil head assembly 130 of the stapler 100. The buttress disc 160 may optionally be provided with at least one, and preferably a plurality of slits 164 extending inward from aperture 162 to enable sliding cooperation of the buttress disc 160 with shafts having different diameters. The buttress disc 160 is attached to an orientating disc 155 provided with a plurality of bores 157 therethrough, by suturing the disc 160 to the bores 157 with a suitable running suture material 165. The orientating disc 155 is configured to position and maintain the buttress disc 160 in a coplanar orientation relative to the cartridge 150 and anvil head assembly 130. It is preferable that the outer diameter of the buttress disc 160 is slightly larger than the outer diameters of the first and second compression surfaces 144 and 148.
The orientating disc 155 to which a buttress disc 160 is sutured, is slid over the shaft 142 of the anvil head assembly 130 until the orientating disc is adjacent the first compression surface 144, after which the cutting washer 142 is slid over the shaft 142 until the cutting washer 142 is adjacent the orientating disc 155, thereby producing a loaded anvil head assembly 130. The loaded anvil head assembly 130 is then inserted head portion 140 first into the distal portion of a severed tubular tissue until a sufficient length of the severed tubular tissue extends beyond the shaft 142 to enable securing of the end of the tissue to the shaft 142 with a suture material. The severed end of the tubular tissue opposite the distal end is tied-off with a suture material after which, the distal end of the shaft 120 of the surgical stapler 100 is inserted into the proximal end of the severed tubular tissue until the second compression surface 148 fixed to the cylindrical cartridge 150 abuts the tied-off end of the tissue section. The shaft 142 of the anvil head assembly 130 is then maneuvered against the end of the cylindrical cartridge 150 thereby contacting the opposing tied-off ends of the severed tissues to be rejoined. The actuating lever 115 is then compressed against the handle 110 resulting in the firing of staples in a circular pattern after which they are compressed between the first and second compression surfaces 144 and 148 thereby conjoining the two severed tubular tissue sections. The cutting washer 146 is then activated to severe the opposing tied ends from the conjoined tissues thereby cutting out the centre of the conjoined tissue sections and a center portion of the buttress disc 160, thereby providing a conjoined continuous tubular tissue with the buttress material reinforcing the staple line against the inner surface of the conjoined tubular tissue. Those skilled in these arts will understand that it is optional, if so desired, to reinforce the staple line against the outer surface of the conjoined tissue by providing a second orientating disc 155 to which a buttress disc 160 is sutured, adjacent the second compression surface 148 (not illustrated) prior to inserting the distal end of the shaft 120 of the surgical stapler 100 into the proximal end of the severed tubular tissue against the tied-off end of the tissue section.
In view of numerous changes and variations that will be apparent to persons skilled in the art, the scope of the present invention is to be considered limited solely by the appended claims.
Patent Application
20070246505
