The present disclosure is generally related to surgical stapling apparatus, and more particularly, to surgical buttresses and attachment assemblies for releasably securing the surgical buttresses to anvil assemblies of the surgical stapling apparatus.
Surgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of staples to body tissue for the purpose of joining segments of body tissue together. Such apparatus generally include a pair of jaws between which the body tissue to be joined is placed. When the surgical stapling apparatus is actuated, or “fired”, longitudinally moving firing bars contact staple drive members in one of the jaws. The staple drive members push the staples through the body tissue and into an anvil in the opposite jaw which forms the staples. If body tissue is to be removed or separated, a knife blade can be provided in the jaws of the apparatus to cut the body tissue between the lines of staples.
Surgical supports, e.g., meshes or buttress materials, may be used in combination with surgical stapling apparatus to bridge, repair, and/or reinforce tissue defects within a patient. A clinician may manually attach the buttress materials to the surgical stapling apparatus in the operating room during a surgical procedure, or utilize a surgical stapling apparatus including buttress materials pre-installed thereon. The buttress material reinforces the staple or suture line as well as covers the juncture of the tissues to reduce leakage prior to healing.
The techniques of this disclosure generally relate to anvil buttress material attachment onto a loading unit of a surgical stapling apparatus. The anvil buttress attachment assemblies are designed to make buttress material attachment in the operating room a simple, straightforward, and cost effective procedure.
In one aspect, the disclosure provides a loading unit including a staple cartridge assembly, an anvil assembly, and an anvil buttress. The anvil assembly includes an anvil plate including a tissue facing surface having apertures defined therethrough and an anvil cover disposed over an outwardly facing surface of the anvil plate. The anvil buttress includes a body portion positioned against the tissue facing surface of the anvil plate and arms extending into the apertures of the anvil plate. The arms releasably secure the anvil buttress to the anvil plate.
Each of the apertures of the anvil plate may include a first opening in the tissue facing surface of the anvil plate and a second opening in the outwardly facing surface of the anvil plate. The apertures may taper from the tissue facing surface to the outwardly facing surface of the anvil plate such that the first opening in the tissue facing surface is larger than the second opening in the outwardly facing surface.
Each of the arms of the anvil buttress may extend into the first opening, through the aperture, and out the second opening of the aperture. Terminal end portions of the arms may be biased in a hooked configuration and extend out of the second opening of the aperture such that the terminal end portions grab onto the outwardly facing surface of the anvil plate.
The loading unit may further include a drive bar including an I-beam. The I-beam may include an anvil blade axially movable between the anvil plate and the anvil cover. The anvil blade may be in registration with portions of the arms of the anvil buttress extending out of the second opening of the apertures such that when the anvil blade is moved from a proximal position to a distal position, the anvil blade cuts the portions of the arms and frees the anvil buttress from the anvil assembly. The arms of the anvil buttress may extend from a first side of the body portion and be positioned inwardly of longitudinal edges of the body portion such that the arms are in the path of the anvil blade of the I-beam.
Each of the apertures of the anvil plate may include a cutout defined therein. Each of the arms of the anvil buttress may include a protrusion extending from an outer surface thereof that is received within the cutout of the aperture of the anvil plate to lock the arm to the anvil plate.
The body portion and the arms of the anvil buttress may be formed from biocompatible materials, and the arms may be stiffer than the body portion.
The buttress may further include a base layer positioned on a second side of the anvil buttress, and the arms of the anvil buttress may be coupled to the base layer and extend through the body portion and out a first side of the anvil buttress. The arms and the base layer of the anvil buttress may be stiffer than the body portion of the buttress.
The arms of the anvil buttress may be disposed in pairs on the proximal and distal end portions of the anvil buttress.
In another aspect, the disclosure provides an anvil buttress attachment assembly includes an anvil assembly and a buttress loading tray. The anvil buttress includes a body portion and arms extending from a first surface of the body portion. The buttress loading tray includes a cavity defined in a first side thereof that is sized and shaped to retain the body portion of the anvil buttress therein, and legs extending from a second surface of the buttress loading tray.
Terminal end portions of the arms of the anvil buttress may be disposed in a hooked configuration.
The arms of the anvil buttress may taper away from the body portion and include a protrusion extending from an outer surface thereof.
The arms of the anvil buttress may extend from proximal and distal end portions of the body portion and be positioned inwardly of longitudinal edges of the body portion.
In yet another aspect, the disclosure provides a method of releasably attaching an anvil buttress to a loading unit of a surgical stapling apparatus including: positioning a buttress loading tray onto a cartridge carrier of a staple cartridge assembly of a loading unit that does not contain a staple cartridge therein, the buttress loading tray defining a cavity retaining a body portion of an anvil buttress therein, the anvil buttress including arms extending from the body portion outwardly above the buttress loading tray; and approximating an anvil assembly and the staple cartridge assembly of the loading unit to a closed position such that the arms of the anvil buttress enter apertures defined in the anvil assembly and are retained therein to releasably secure the anvil buttress to the anvil assembly.
Positioning the buttress loading tray onto the cartridge carrier may include placing legs of the buttress loading tray over side walls of the cartridge carrier such that the anvil buttress extends across the cartridge carrier and is aligned with and opposed from the anvil assembly.
The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.
Embodiments of the present disclosure will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. Throughout this description, the term “proximal” refers to a portion of a structure, or component thereof, that is closer to a user, and the term “distal” refers to a portion of the structure, or component thereof, that is farther from the user.
Referring now to
The handle assembly 10 includes a stationary handle member 12a, a movable handle member 12b, and a barrel portion 14. Actuation of the movable handle member 12b applies lines of staples 58 (
The loading unit 30 is a disposable loading unit (“DLU”) that is releasably secured to the elongate tubular body 20 and thus, replaceable with a new loading unit 30. The loading unit 30 is a multi-use loading unit (“MULU”) that is re-useable a predetermined number of times. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and a staple cartridge 54 (
As shown in
The staple cartridge assembly 50 includes a cartridge carrier 52 defining an elongated support channel 51 configured and dimensioned to selectively receive and support a staple cartridge 54 therein. The staple cartridge 54 may be removably and/or replaceably attached to the cartridge carrier 52 by, for example, a snap-fit connection, a detent, a latch, among other types of connectors within the purview of those skilled in the art. The staple cartridge 54 includes an inwardly or tissue facing surface 56 defining staple pockets or retention slots 55 formed therein for receiving a plurality of fasteners or staples 58 and staple pushers 60. A central longitudinal slot 57 is formed in and extends along a substantial length of the staple cartridge 54 which, together with the central longitudinal slot 41 of the anvil plate 42, facilitates passage of a knife blade 78 of a drive bar 70 therethrough.
The drive bar 70 includes an elongated drive beam 72 configured to engage a drive member (not shown) of the elongate tubular body 20 (
During operation of the surgical stapling apparatus 1, distal advancement of the drive bar 70 causes an actuation sled 66 disposed within the staple cartridge assembly 50 to translate through the staple cartridge 54 and to advance cam wedges 68 of the actuation sled 66 into sequential contact with the staple pushers 60 which, in turn, cause the staple pushers 60 to translate vertically within the staple pockets 55 and urge the staples 58 from the staple pockets 55 towards the tissue facing surface 46 of the anvil plate 42 of the anvil assembly 40.
For a detailed description of the structure and function of exemplary surgical stapling apparatus, reference may be made to U.S. Pat. Nos. 6,241,139, 6,330,965, and 7,819,896, the entire contents of each of which are incorporated herein by reference. It should be appreciated that principles of the present disclosure are equally applicable to surgical stapling apparatus having other configurations such as, for example, the types described in U.S. Pat. Nos. 5,964,394, 7,128,253, and 7,334,717, the entire contents of each of which are incorporated herein by reference. Accordingly, it should be understood that a variety of surgical stapling apparatus may be utilized with the techniques of the present disclosure. For example, laparoscopic or open staplers, such as, for example, GIA′, Endo GIA′, TA′, and Endo TA′ staplers and/or linear and radial reloads with, for example, Tri-Staple™ technology, available through Medtronic (North Haven, Conn.) may be utilized with the anvil buttresses and anvil buttress attachment assemblies of the present disclosure.
With reference now to
The surgical buttresses 100, 101 may be porous, non-porous, or combinations thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and/or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films. The surgical buttresses 100, 101 described herein may be a single porous or non-porous layer, or include a plurality of layers including any combination of porous and non-porous layers. For example, the surgical buttresses 100, 101 may include multiple porous and non-porous layers that are stacked in an alternating manner. In another example, the surgical buttresses 100, 101 may be formed in a “sandwich-like” manner wherein the outer layers of the surgical buttress 100, 101 are porous and the inner layer(s) are non-porous, or vice versa. The anvil and cartridge buttresses 100, 101 may have the same or a different structure of layer(s).
Porous layer(s) in a surgical buttress may enhance the ability of the surgical buttress to absorb fluid, reduce bleeding, and/or seal a wound. Also, the porous layer(s) may allow for tissue ingrowth to fix the surgical buttress in place. Non-porous layer(s) in a surgical buttress may enhance the ability of the surgical buttress to resist tears and perforations during the manufacturing, shipping, handling, and/or stapling processes. Also, non-porous layer(s) may retard or prevent tissue ingrowth from surrounding tissues thereby acting as an adhesion barrier and preventing the formation of unwanted scar tissue.
With continued reference to
As shown in
The arms 120 are fabricated from biocompatible materials as described above with respect to the anvil buttress 100, and may be formed from the same or different materials as the body portion 110 of the anvil buttress 100. In embodiments, the body portion 110 and the arms 120 of the anvil buttress 100 are formed from the same material, with the arms 120 being treated (e.g., crosslinked or processed with a stiffening agent) to be stiffer or more rigid than the body portion 110 so that the arms 120 can mechanically engage the anvil assembly 40. In embodiments, the arms 120 extend through the body portion 110 and are coupled to a base layer 122 positioned on a second side 110b of the body portion 110. The base layer 122 may have the same stiffness and/or rigidity as the arms 120 to support and strengthen the arms 120. In such embodiments, a central region 112 of the body portion 110 of the anvil buttress 100 is thickened as compared to longitudinally extending side regions 114 of the body portion 110 by the base layer 122.
The arms 120 are biased to extend at an angle away from body portion 110 (e.g., substantially orthogonally with respect to the body portion 110) such that when the body portion 110 of the anvil buttress 100 is positioned against the tissue facing surface 46 of the anvil assembly 40, the arms 120, which are aligned or in registration with apertures 43 defined through the anvil plate 42 extend into the apertures 43 and are secured therein. Terminal end portions 120a of the arms 120 are biased to extend inwardly (e.g., are bent or curved) towards the body portion 110 of the anvil buttress 100 thereby forming a hook or hooked configuration for grasping onto the anvil plate 42. As seen in
In operation, with the loading unit 30 loaded with both the anvil and cartridge buttresses 100, 101, as shown in
During firing, the knife blade 78 of the I-beam 74 travels distally through the tool assembly 34 and substantially simultaneously cuts and divides the tissue and the surgical buttresses 100, 101 disposed between the rows of formed staples 58. As the arms 120 of the anvil buttress 100 extend into the path of the anvil blade 82, as shown in
The buttress loading tray 150 includes legs 154 extending from a second surface 156 that are configured to engage side walls 53 (
In a method of loading the anvil buttress 100 onto the anvil assembly 40 of the loading unit 30, the anvil buttress attachment assembly 2 is positioned on the cartridge carrier 52 of the staple cartridge assembly 50 prior to loading the cartridge carrier 52 with a staple cartridge 54 (e.g., the cartridge carrier 52 is empty and does not contain a staple cartridge 54 therein). The legs 154 of the buttress loading tray 150 of the anvil buttress attachment assembly 2 are aligned with the side walls 53 of the cartridge carrier 52 and the buttress loading tray 150 is pushed down onto the cartridge carrier 52 such that the first surface 152 of the buttress loading tray 150, which includes the anvil buttress 100 loaded into the cavity 151 thereof, faces the tissue facing surface 46 of the anvil assembly 40.
With the buttress loading tray 150 positioned on the cartridge carrier 52 of the staple cartridge assembly 50, the anvil and staple cartridge assemblies 40, 50 are approximated to the closed position (e.g., by pressing the handle assembly 10 of the surgical stapling apparatus 10) to bring the anvil assembly 40 into contact with the buttress loading tray 150, as shown in
After performing the stapling operation, the used staple cartridge 54 may then be removed from the staple cartridge assembly 50 of the tool assembly 34. In embodiments, additional or replacement staple cartridges 54, which may be pre-loaded with cartridge buttresses 101, may be secured to the loading unit 30, as needed or desired, and an anvil buttress 100 may be secured to the loading unit 30, as described above, prior to loading the staple cartridge 54 into the cartridge carrier 52 of the staple cartridge assembly 50.
With reference now to
The anvil buttress 200 is releasably attached to the anvil assembly 40′ by arms 220 of the anvil buttress 200 that extend into and engage the anvil plate 42′ of the anvil assembly 40′. The arms 220 of the anvil buttress 200 extend perpendicularly from a first side 210a of the body portion 210 of the anvil buttress 200. The arms 220 extend through the body portion 210 and are coupled to base layers 222 positioned on a second side 210b of the body portion 210. The arms 220 have a tapered configuration that tapers away from the body portion 210. Each of the arms 220 includes a protrusion 221 extending from an outer surface of the arm 220 which is configured to engage and be received within a cutout or recess 43a defined in the aperture 43′ of the anvil plate 42′ such that when the anvil buttress 200 is loaded onto the anvil assembly 40′, as seen in
In operation, with the tool assembly 34′ loaded with both the anvil and cartridge buttresses 200, 101, as shown in
The buttress loading tray 250 includes a cavity 251 defined in a first surface 252 thereof that corresponds in size and shape with the body portion 210 of the anvil buttress 200 such that the arms 220 of the anvil buttress 200 extend outwardly above the buttress loading tray 250. The buttress loading tray 250 includes legs 254 extending from a second surface 256 that are configured to engage side walls 53 (
The anvil buttress 200 is loaded onto the anvil assembly 40′ in the same manner as the anvil buttress 100 by positioning the anvil buttress attachment assembly 3 on the cartridge carrier 52 of the staple cartridge 50, as shown in
Although the anvil buttresses and anvil buttress attachment assemblies are discussed above for use with a surgical stapling apparatus having a manually operated, manually driven handle, any of the embodiments disclosed herein can include a surgical stapling apparatus having a hand-held powered handle having a motor, or a stapling unit that is attachable to a motorized drive, or a stapling unit arranged for use in a robotic surgical system. The anvil buttresses and anvil buttress attachment assemblies described herein may also be configured for use with other surgical apparatus, such as electromechanical surgical devices as described, for example, in U.S. Patent Appl. Pub. Nos. 2015/0157320 and 2015/0157321, the entire contents of each of which are incorporated herein by reference.
It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a medical device.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be affected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown and described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variation are also included within the scope of the present disclosure. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Thus, the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.
The present application is a continuation of U.S. patent application Ser. No. 17/177,352, filed on Feb. 17, 2021, which claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 62/991,652, filed on Mar. 19, 2020, the entire content of each of which is hereby incorporated by reference.
Number | Date | Country | |
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62991652 | Mar 2020 | US |
Number | Date | Country | |
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Parent | 17177352 | Feb 2021 | US |
Child | 18070211 | US |