1. Technical Field
The present disclosure relates to a surgical fastener applying apparatus and, more particularly, to a surgical fastener applying apparatus having reusable and disposable components.
2. Discussion of Related Art
Surgical fastener applying apparatus, wherein tissue is first grasped or clamped between opposing jaw structures and then joined by means of surgical fasteners, are well known in the art. In some such apparatus, a knife is provided to cut the tissue which has been joined by the fasteners. The fasteners are typically in the form of surgical staples, although, other surgical fasteners may also be utilized, such as, for example, clips or two part polymeric surgical fasteners.
Surgical fastener applying apparatus typically include two elongated beam members which are used to capture or clamp tissue therebetween. Typically, one of the beam members carries a disposable cartridge assembly which houses a plurality of staples arranged in at least two lateral rows, while the other beam member includes an anvil which defines a surface for forming the staple legs as the staples are driven from the cartridge assembly. Where two part fasteners are used, the beam member which includes the anvil carries a mating part of the two part fastener, e.g. the receiver. Generally, the staple formation process is affected by the interaction between one or more longitudinally moving camming members and a series of individual staple pushers. As the camming members travel longitudinally through the cartridge carrying beam member, the individual pusher members are biased upwardly into a backspan of the staples supported within the cartridge assembly to sequentially eject the staples from the cartridge. A knife may be provided to travel with the camming members between the staple rows to cut the tissue between the rows of formed staples. An example of such an instrument is disclosed in U.S. Pat. No. 7,631,794, which is incorporated herein in its entirety by reference.
Because of the dangers associated with improper sterilization, fastener applying apparatus are typically disposable after use. Although the cartridge assembly may be replaced to perform multiple fastener applying operations on a single patient, the staple applying apparatus is typically disposable after a surgical procedure has been completed. This requirement of disposability may increase the costs associated with surgical procedures. Although reusable fastener applying apparatus have been developed, such apparatus can be overly complex and prove difficult to sterilize.
A need exists in the art for a fastener applying apparatus which includes reusable components, is not overly complex and is configured to facilitate proper sterilization after use in a surgical procedure.
The present disclosure relates to surgical fastener applying apparatus for applying surgical fasteners to tissue. The surgical fastener applying apparatus in one aspect comprises an anvil half-section including a distal anvil portion, a cartridge receiving half-section defining an elongated channel member, and a stationary housing. The stationary housing is configured to be releasably supported within the elongated channel member of the cartridge receiving half-section. The stationary housing supports firing components of the apparatus. The stationary housing is also dimensioned to releasably receive a single use loading unit. A lockout structure prevents full insertion of the stationary housing into the cartridge receiving half-section if the single use loading unit is not mounted in the stationary housing.
In some embodiments, the lockout structure may define a first position which prevents insertion of the stationary housing into the cartridge receiving half-section and a second position which permits insertion of the stationary housing into the cartridge receiving half-section.
In some embodiments, the lockout structure includes a flexible member movable from the first position to the second position in response to insertion of the single use loading unit into the stationary housing. In one embodiment, the flexible member includes a protrusion extending beyond a bottom surface of the stationary housing and the cartridge receiving half-section defines a groove therein to receive the protrusion of the flexible member. Thus, in this embodiment, when the flexible member is in the first position, the protrusion of the flexible member is misaligned with respect to the groove of the cartridge receiving half-section and when the flexible member is in the second position, the protrusion of the flexible member is aligned with respect to the groove of the cartridge receiving half-section and readily insertable into the groove.
In another embodiment, the flexible member defines a recess configured to receive a top edge of a sidewall of the cartridge receiving half-section therein when the flexible member is in the second position. In this embodiment, when the flexible member is in the first position, the recess defined by the flexible member is misaligned with respect to the top edge of the cartridge receiving half-section, and when the flexible member is in the second position, the recess defined by the flexible member is aligned with respect to the top edge of the cartridge receiving half-section and is configured to readily receive the top edge of the cartridge receiving half-section.
In another aspect, the present disclosure provides a surgical fastener applying apparatus comprising a reusable anvil half-section, a reusable cartridge receiving half-section, and a disposable firing assembly configured to be releasably supported within the cartridge receiving half section. The firing assembly includes a disposable pusher assembly and a disposable single use loading unit mountable to the pusher assembly, wherein the firing assembly is fully insertable into the cartridge receiving half section for actuation of the apparatus only if the firing assembly contains the single use loading unit.
The apparatus may further include a blocking member movable between a first position which prevents full insertion of the firing assembly into the cartridge receiving half-section and a second position which permits full insertion of the firing assembly into the cartridge receiving half-section.
In some embodiments, the blocking member is a flexible member extending from a wall of a housing of the pusher assembly and biased to the first position, and the single use loading unit applies a force to the flexible member to move the flexible member to the second position when mounted to the firing assembly to enable full insertion of the firing assembly.
In some embodiments, the flexible member includes a protrusion extending beyond a bottom surface of a housing of the pusher assembly to contact a surface of the cartridge receiving half section, and the cartridge receiving half-section defines a groove therein to receive the protrusion of the flexible member when the single use loading unit is mounted to the pusher assembly, the protrusion of the flexible member being misaligned with respect to the groove of the cartridge receiving half-section when the single use loading unit is not mounted to the pusher assembly. In other embodiments, the flexible member includes a hook defining a recess, the recess configured to receive a top edge of a sidewall of the cartridge receiving half-section therein when the flexible member is in the second position and configured to abut the top edge when the flexible member is in the first position.
In another aspect, the present disclosure provides a disposable firing assembly for use with a surgical fastener applying apparatus comprising a disposable single use loading unit and a disposable pusher assembly. The firing assembly is insertable into a cartridge receiving half section of the fastener applying apparatus and the single use loading unit is operably mountable to the pusher assembly, wherein the firing assembly includes a lockout member movable from a first blocking position preventing operable insertion of the firing assembly into the fastener applying apparatus and a second unblocking position to enable full operable insertion of the firing assembly into the fastener applying apparatus.
In some embodiments, the lockout member is biased to the first position, and the single use loading unit when mounted to the pusher assembly applies a force to the lockout member to move it to the second position.
In some embodiments, the lockout member includes a protrusion enagable with a groove in the fastener applying apparatus when in the second position, the protrusion being misaligned with respect to the groove in the first position of the lockout member. In other embodiments, the lockout member includes a recess configured to receive a top edge of a sidewall of a cartridge receiving half-section of the fastener applying apparatus when the lockout member is in the second position and configured to abut the top edge when the lockout member is in the first position.
Various embodiments of the presently disclosed surgical fastener applying apparatus will now be described herein with reference to the accompanying figures wherein:
Embodiments of the presently disclosed surgical fastener applying apparatus in accordance with the present disclosure will now be described in detail with reference to the drawings wherein like reference numerals identify similar or identical structural elements. As used herein, as is traditional, the term “proximal” refers to the end of the apparatus which is closer to the user and the term distal refers to the end of the apparatus which is further away from the user.
Referring to
Referring to
Guide block 48 includes a body defining three longitudinal slots 70a-c and a pair of outwardly extending protrusions 72. In one embodiment, each protrusion 72 is substantially cylindrical and includes a tapered portion 72a (
Slide block 52 includes a hub 80 which includes a resilient finger 80a configured to be snap-fit into a pivot hole 82 formed in firing lever 50. Firing lever 50 is pivotal about hub 80 when the slide block 52 is in a retracted position to facilitate actuation of the firing assembly 20 from either side of stapler 10. Pedal 54 is reciprocally received within a hole 84 formed in slide block 52. Pedal 54 includes a split body portion 54a which is configured to straddle a proximal end 102 of knife actuating bar 44. In one embodiment, split body portion 54a includes an angled distal surface 86. A pin 88 extends upwardly from pedal 54 through hole 84 in slide block 52. A biasing member 90 is positioned between split body portion 54a and slide block 52, about pin 88 to urge pedal 54 downwardly away from slide block 52 to an extended position. In the retracted position of slide block 52, pedal 54 is received in a cutout 55 formed in a bottom wall 22a of channel member 22 (
Firing lever 50 includes first and second finger engagement members 50a and 50b, either one of which can be selectively engaged to move the firing lever 50 through a firing stroke from either side of stapler 10. An arcuate recess 94 (
Knife actuating bar 44 includes a proximal end having a stepped portion 100 which includes a proximal first step 102 having a first height and a second step 104 having a second height which is greater than the first height. A distal end of actuating bar 44 includes an upturned hook portion 106 and upper and lower notches 49 and 51. A finger 108 projects upwardly from knife actuating bar 44 between first and second steps 102 and 104. As shown in
Referring to
Sidewalls 114 of cam bar 46 are slidably positioned in slots 70a and 70c of guide block 48 and knife actuating bar 44 is slidably positioned in longitudinal slot 70b of guide block 48. When firing assembly 20 is supported in channel member 22 and firing lever 50 is pivoted to one side of stationary housing 26 and pushed distally, slide block 52 is moved distally within stationary housing 26. As slide block 52 begins to move distally, tapered surface 86 of pedal 54 engages a proximal edge of channel member 22 defining cutout 55 to urge pedal 54 upwardly out of cutout 55, through slot 121 of cam bar 46, and onto an inner surface of stationary housing 26 of firing assembly 20 (
U.S. Pat. No. 7,631,794 (“the '794 patent”) discloses a surgical fastener applying apparatus which includes a firing assembly similar to that described above. The '794 patent is incorporated herein by reference in its entirety.
In the illustrated embodiment, body 120 includes two staggered rows of slots 130 formed on either side of linear slotted knife track 132. The staggered rows of slots 130 extend beyond the distal end of knife track 132 to facilitate staple formation beyond the distal end of the stroke of the knife blade 40.
Staple pushers 122 may be configured to extend into one or more slots 130. In one embodiment, a single pusher is associated with each slot 130. Alternately, as illustrated in
Bottom cover 124 partially encloses a channel 125 (
Safety lockout 128 is pivotally disposed on an upper proximal end of body 120 and is pivotal about a pivot member 150 from a locked orientation (
Referring again to
A central portion of anvil half-section 12 includes a pair of cylindrical lateral support members 172. During assembly of anvil half-section 12 and cartridge receiving half-section 14, lateral support members 172 are supported in U-shaped recesses 174 defined in a central portion 173 of cartridge receiving half-section 14 (
Cartridge receiving half-section 14 includes spaced centrally disposed U-shaped recesses 174 positioned to support lateral support members 172 of anvil half-section 12. The proximal end of cartridge receiving half-section 14 includes a pair of vertical support members 188. Each vertical support member 188 includes an elongated vertical slot 188a having a rounded bottom surface. Vertical slots 188a are dimensioned to receive protrusions 186 formed on finger 184 of anvil half-section 12 (
Clamping lever 16 also includes a handle portion 190 including a grip 190a and a thumb engaging abutment 192. As discussed above, a pair of spaced flange portions 178 are supported on the distal end of clamping lever 16. Each flange portion 178 defines a cutout 176 dimensioned to receive a respective lateral support member 172 of anvil half-section 12 when stapler 10 is moved towards clamped position (
As shown in
In order to load firing assembly 20 into proximal portion 24b of channel member 22, the stationary housing 26 of firing assembly 20 is slid into the channel member 22 through the proximal end of channel member 22 until pivot members 29 are received in recesses 30 formed in the proximal end of channel member 22. After firing assembly 20 is loaded, the SULU 18 can be loaded into distal portion 24a in the manner discussed above.
Referring to
In order to position surgical stapler 10 in the clamped position, clamping lever 16 is rotated in a counter-clockwise direction from the position shown in
Referring to
Referring to
Referring to
Referring to
Referring to
Referring to
As shown in phantom in
Referring to
Referring to
During a surgical procedure, SULU 18 can be replaced multiple times to facilitate multiple uses of stapler 10 on a single patient. Since each SULU 18 is provided with a fresh knife 40, tearing of tissue is minimized. After the surgical procedure, the used SULU(S) 18 and the firing assembly 20 can be removed from the channel member 22 and disposed of in an appropriate manner. The anvil half-section 12, cartridge receiving half-section 14 and clamping lever 16 can now be sterilized, such as by autoclaving, and reused with a sterilized SULU 18 and firing assembly 20 in the manner discussed above. Because the locking member 206 forms part of the firing assembly 20 and is disposable, fewer areas remain on the reusable components for tissue and fluids to become trapped. As such, the reusable components of the apparatus can be more easily sterilized.
In the surgical stapler described above, the SULU 18 and the firing assembly 20 are independently secured to and independently removed from the channel member 22 of the cartridge receiving half-section 14. In alternative embodiments illustrated in
The proximal portion 530 of the stationary housing 526 is configured to support the firing components of the surgical stapler 10 as shown in
The distal portion 532 and the center portion 540 of the stationary housing 526 together are of a length substantially similar to that of the SULU 18 shown in
The center portion 540 of the stationary housing 526 has a pair of sidewalls 542 that define cutouts 546 configured to receive protrusions 65 shown in
The distal portion 532 includes at least one flexible member 533 which is movable within at least one cutout 536 defined in the U-shaped frame 560. As shown in
The flexible members 533 define a first position as shown in
As shown in
When the stationary housing 526 is properly received within the cartridge receiving half-section 514, the bottom surface 562 of the stationary housing 526 is placed against the bottom surface 528 of the cartridge receiving half-section 514, and the protrusions 539 of the flexible members 533 are positioned within the grooves 570 of the cartridge receiving half-section 514.
The pair of grooves 570 is disposed immediately adjacent to the pair of sidewalls 527 of the cartridge receiving half-section 514. Due to the close proximity between the grooves 570 and the sidewalls 527, the grooves 570 receive the protrusions 539 of the flexible members 533 only when the flexible members 533 are in their second position. That is, when the flexible members 533 are in their second position, the protrusions 539 are aligned with respect to the grooves 570 and are thus insertable into the grooves 570.
On the other hand, when the flexible members 533 are in their first position, the protrusions 539 are misaligned with respect to the grooves 570. In this situation, the protrusions 539 abut the bottom surface 528 of the cartridge receiving half-section 514, and prevent full insertion of the stationary housing 526 into the cartridge receiving half-section 514.
Accordingly, when the flexible members 533 are in the first position, absent a SULU, the stationary housing 526 cannot be fully and operably inserted into the cartridge receiving half-section 514. In contrast, when the flexible members 533 are in the second position, in the presence of a SULU, the stationary housing 526 can be fully and operably inserted into the cartridge receiving half-section 514.
During operation, a user first positions a SULU 18 into the center portion 540 and the distal portion 532 of the stationary housing 526. As the SULU 18 enters the stationary housing 526 in a downward direction, the SULU 18 applies an outward force to each flexible member 533, and biases the flexible members 533 from the first position to the second position. After the SULU 18 is placed within the stationary housing 526, the SULU 18, the stationary housing 526 and the firing components carried by the stationary housing 526 together form a single disposable unit. The user then mounts the single disposable unit into the cartridge receiving half-section 514 by placing the stationary housing 526 into the channel member 522 of the cartridge receiving half-section 514.
If the user attempts to mount the stationary housing 526 into the cartridge receiving half-section 514 without first inserting the SULU 18 into the stationary housing 526, the flexible members 533 of the stationary housing 526 are in their first position as described above, thereby preventing the stationary housing 526 from being mounted within the cartridge receiving half-section 514.
Each flexible member 670 is extended from an associated sidewall 664 and positioned about the cutout 674 defined in the associated sidewall 664. Each flexible member 670 has a first portion 672 hingedly attached to its associated sidewall 664 at the lower edge 676 of the cutout 674. The first portion 672 is of a height “H” identical or substantially similar to that of the cutout 674. Additionally, each flexible member 670 includes a second portion 678 exhibiting a hook, U-shaped, or concave configuration with a recess 679 defined therein, and facing in opposing radial directions. Each recess 679 faces a generally downward direction, as viewed in the orientation of
Due to the hinge connection between each flexible member 670 and its associated sidewall 664, each flexible member 670 is pivotable with respect to its associated wall 664. Specifically, the flexible members 670 have a first position, as illustrated in
Additionally, the flexible members 670 define a second position, as illustrated in
The flexible members 670 normally assume their first position in the absence of any force or pressure applied thereto. However, application of external force to the flexible members 670, such as by inserting the SULU 618 (similar to SULU 18) into the stationary housing 626, urges each flexible member 670 from the first position to the second position. Due to the resilient nature of the flexible members 670, removal of the SULU 618 from the stationary housing 626 returns the flexible members 670 from the second position to the first position.
Accordingly, when the flexible members 670 are in the second position, the stationary housing 626 can be fully and operably inserted into the cartridge receiving half-section 614. By contrast, when the flexible members 670 are in the first position, the stationary housing 626 cannot be fully inserted into the cartridge receiving half-section 614.
During operation, a user first positions a SULU (e.g. SULU 618, 18) into the stationary housing 626, moving the flexible members 670 from their first position to their second position, such that the stationary housing 626 can be readily received by the cartridge receiving half-section 614. After the SULU 618 is fully inserted into the stationary housing 626, the SULU 618, the stationary housing 626 and the firing components carried by the stationary housing 626 together form a single disposable unit. The user then mounts the single disposable unit into the cartridge receiving half-section 614 by placing the stationary housing 626 into the channel member 622 of the cartridge receiving half-section 614.
If the user attempts to mount the stationary housing 626 into the cartridge receiving half-section 614 without first inserting the SULU 618 into the stationary housing 626, the flexible members 670 of the stationary housing 626 will abut the top edges 628 of sidewalls 627 of the cartridge receiving half-section 614 to prevent entry of the stationary housing 626 into the cartridge receiving half-section 614.
Flexible members 533 illustrated in
It will be understood that various modifications may be made to the embodiments of the surgical fastener applying apparatus disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.
This application claims priority from provisional application Ser. No. 61/521,078, filed Aug. 8, 2011, the entire contents of which are incorporated herein by reference.
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