The present disclosure relates to medical instruments and the use thereof. More particularly, the present disclosure is directed to medical staplers and pressure distribution during a clamping and/or stapling procedure.
Generally, surgical fastener applying instruments grasp or clamp tissue between opposing jaw structures and join the tissue by means of surgical fasteners. In some such instruments, 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.
Certain surgical fastener applying instruments include two elongated jaw members which are used to capture or clamp tissue therebetween. Typically, one of the jaw members carries a cartridge assembly which houses a plurality of staples arranged in at least two lateral rows, while the other jaw 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 jaw 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 jaw member, the individual staple pushers are urged upwardly into a backspan of the staples supported within the cartridge assembly to sequentially eject the staples from the cartridge assembly. 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.
Pinching may occur at the site of clamped tissue along the periphery of the jaw members due to a very localized high pressure gradient between the clamped tissue and the tissue lying outside the jaws. This pinching may affect the quality of the procedure. Solutions to these issues are described hereinbelow.
In accordance with at least one aspect of the present disclosure, a surgical apparatus includes an anvil jaw configured to form at least one surgical staple, a cartridge jaw configured to deploy one or more surgical staples against the anvil jaw, and a pressure distribution device attached to at least one of the anvil jaw and the cartridge jaw, wherein the pressure distribution device is configured to distribute a clamping pressure to a target tissue during a clamping and a stapling of the target tissue.
Each pressure distribution device may include at least one flap extending from a side of a respective anvil jaw and cartridge jaw.
Each pressure distribution device may be made of a shape memory material, or can be reinforced with a shape memory material.
Each pressure distribution device may be furled up in a retracted state against at least one of the anvil jaw and the cartridge jaw such that the apparatus has a low profile.
Each of the anvil jaw and the cartridge jaw may comprise at least one pressure distribution device attached to a surface thereof.
Each pressure distribution device may be furled up in a retracted state such that the apparatus has a low profile.
Each pressure distribution device may be substantially U-shaped and extends beyond a distal end of the respective anvil jaw and cartridge jaw.
At least one pressure distribution device may include an inflatable bladder that is deflated in a retracted state and inflated in an extended state.
At least one pressure distribution device may further include a deployment member that holds the at least one flap in a retracted state, and is configured to allow the at least one flap to move to an extended state.
The deployment member may be a tubular member slidably disposed on the apparatus, configured to slide between a distal position surrounding the at least one flap and holding the at least one flap in the retracted state, and a proximal position to release the at least one flap and allow the at least one flap to move to an extended state.
The deployment member may include at least one or more ties that bind the at least one flap in the retracted state.
In accordance with still yet another aspect of the present disclosure, a method includes providing a surgical apparatus including an anvil jaw, a cartridge jaw configured to deploy one or more surgical staples into the anvil jaw, and a pressure distribution device attached to at least one of the anvil jaw and the cartridge jaw, wherein the pressure distribution device is configured to distribute pressure to a target tissue during clamping and stapling of a target tissue, and deploying the pressure distribution device before clamping and stapling a target tissue.
The deploying of the pressure distribution device may be performed after clamping but before stapling.
Each pressure distribution device may be furled up in a retracted state against at least one of the anvil jaw and the cartridge jaw such that the apparatus has a low profile, the method further comprising passing the surgical apparatus through a cannula in the retracted state.
The method may further include the step of unfurling the pressure distribution device from the retracted state to a deployed state after passing the pressure distribution device through a cannula.
The method may further include the step of clamping target tissue after unfurling the pressure distribution device.
The method may further include the step of stapling target tissue after clamping target tissue.
The method may further include the step of unclamping target tissue after stapling.
The method may further include the step of furling the pressure distribution device back into the retracted state after unclamping target tissue.
The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:
Like reference numerals may refer to similar or identical elements throughout the description of the figures. As shown in the drawings and described throughout the following description, as is traditional when referring to relative positioning on a surgical instrument, the term “proximal” refers to the end of the apparatus that is closer to the user and the term “distal” refers to the end of the apparatus that is farther away from the user. The term “clinician” refers to any medical professional (e.g., doctor, surgeon, nurse, or the like) performing a medical procedure involving the use of embodiments described herein.
Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings; however, the disclosed embodiments are merely examples of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present 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 present disclosure in virtually any appropriately detailed structure.
In accordance with at least one aspect of the present disclosure, a surgical instrument is described herein. The surgical instrument may be a tissue stapling apparatus or a tissue clamping apparatus, such as, for example, an end effector, disposable loading unit (DLU), single use loading unit (SULU), multi use loading unit (MULU), etc. The apparatus can include removable and replaceable parts, such as a reload or loading unit that includes the anvil and cartridge assembly (SULU). The cartridge assembly may be removable and replaceable in an instrument that has jaws that are intended to be reused during the same procedure, or removable and replaceable in a SULU.
A tissue stapling apparatus, as shown in
Each embodiment shown in the figures further includes at least one embodiment of a pressure distribution device or attachment in accordance with the present disclosure. Generally, the at least one pressure distribution device or attachment may be permanently or selectively attached to one or both of the anvil jaw and the cartridge jaw.
The pressure distribution device or attachment may be made into any suitable shape to contact a target tissue and reduce the pressure associated with a clamping of the target tissue by the surgical instrument. Specific embodiments of the pressure distribution device or attachment are described in more detail below.
The apparatus can include a manually operated and manually powered handle portion, a motorized powered handle portion with an internal or external power source, or other interface for actuating the end effector.
Referring specifically to
As depicted, the end effector 100 is clamped down on the target tissue “T” with the pressure distribution device or attachment 110 shown in an extended or deployed state. The pressure distribution device or attachment 110 is configured to distribute a clamping pressure to the target tissue “T” during clamping and stapling of the target tissue “T”.
The pressure distribution device or attachment 110 includes at least one anvil flap 112 and/or at least one cartridge flap 114 extending from a side of the anvil jaw 102 or the cartridge jaw 104, respectively.
As shown in
In operation, when anvil jaw 102 and cartridge jaw 104 are clamped onto target tissue “T”, flaps 112, 114 of pressure distribution device or attachment 110 extend outwardly therefrom and across the target tissue “T”. In so doing, flaps 112, 114 increase a surface area of the tissue contacting surfaces of anvil jaw 102 and cartridge jaw 104. By increasing the surface area of the tissue contacting surfaces of anvil jaw 102 and cartridge jaw 104, pressure distribution device 110 distributes a clamping load away from the hard edges of anvil jaw 102 and cartridge jaw 104, wherein the clamping load gradually transitions.
Flaps 112, 114 may be sized to any desired width or length on jaws 102 and 104. Flaps 112, 114 do not have to be of identical size or shape. For example, flap 112 may be wider, thicker, and/or longer than flap 114 and vice versa.
Each flap 112, 114 of pressure distribution device or attachment 110 may be made of a high durometer rubber, shape memory material, a foam, a gel, a plastic, a spring loaded plastic, or any other suitable material.
Referring to
With reference to
Referring now to
As seen in
Referring now to
It is important to note that while the flaps 412, 414 are shown as rigid linkages attached to the anvil jaw 402 and cartridge jaw 404 via a mechanical hinge, flaps 412, 414 may be of any suitable material and attached as described herein or otherwise.
Referring now to
As shown in
Referring now to
The deployment members 118 are configured to selectively separate from flaps 412′, 414′ to allow the flaps 412′, 414′ to unfurl to the extended or deployed state. For example, deployment members 118 may be manually cut, snapped, or untied. In other embodiments, the deployment members 118 may be made of a dissolvable material such that the introduction of a fluid (e.g., saline or water) will dissolve the deployment members 118 and allow the flaps 412′, 414′ to unfurl to the extended or deployed state.
As shown in
It is important to note that while the flaps 412′, 414′ are shown as rigid linkages attached to the anvil jaw 402′ and the cartridge jaw 404′ via a mechanical hinge, flaps 412′, 414′ may be of any suitable material and attached as described herein or otherwise.
In at least some embodiments, the above described pressure distribution devices or attachments may be combined in any suitable manner. For example, a pressure distribution device or attachment may include at least one of a flap having an inflatable bladder, a flap having a tie that binds the flap into the retracted position, and a tubular member that prevents the flap from moving to the extended or deployed position. Many other combinations are contemplated, but are not expressly disclosed herein for the sake of brevity.
In at least one aspect of the present disclosure, a method includes providing a surgical instrument and/or end effector having a pressure distribution device or attachment as described herein, and deploying the pressure distribution device or attachment before clamping and stapling a target tissue.
Sensors may be used, in any of the embodiments disclosed herein. A pressure sensor can be incorporated in or on the pressure distribution device. An inflatable device can include a sensor for the pressure of the fluid or other medium inside the pressure distribution device. The flaps may be constructed of or include thin film sensors (strain gauges, capacitive sensors, etc.) that will provide feedback to the handle and ultimately the user with regards to tissue thickness and the pressure being applied to the tissue by the flaps. This electrical data may be communicated to the handle by means of a hardwired connection as well as a wireless data communication.
It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.
This application is a continuation application claiming the benefit of and priority to U.S. patent application Ser. No. 15/367,260, filed Dec. 2, 2016, which is a divisional application claiming the benefit of and priority to U.S. patent application Ser. No. 13/713,260, filed Dec. 13, 2012, now U.S. Pat. No. 9,522,002, the entire disclosures of each of which being incorporated by reference herein.
Number | Date | Country | |
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Parent | 13713260 | Dec 2012 | US |
Child | 15367260 | US |
Number | Date | Country | |
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Parent | 15367260 | Dec 2016 | US |
Child | 16938210 | US |