Patent Application
20120234895
1. Technical Field
The present invention relates to surgical instruments and, in various embodiments, to surgical end effectors used to manipulate and/or treat tissue as well as surgical stapling instruments, end effectors and staple cartridges therefor that are designed to cut and staple tissue.
2. Background
Surgical cutting and stapling instruments have been used to simultaneously make a longitudinal incision in tissue and apply lines of staples on opposing sides of the incision. Such instruments commonly include a pair of cooperating jaw members that, if the instrument is intended for endoscopic or laparoscopic applications, are capable of passing through a cannula passageway. One of the jaw members commonly supports a staple cartridge that operably supports at least two laterally spaced rows of unformed staples therein. The other jaw member defines an anvil that has staple-forming pockets that, when the anvil is closed, are aligned with rows of unformed staples supported in the cartridge.
In use, a clinician is able to close the jaw members of the cutting and stapling instrument upon tissue to position the tissue prior to actuating the instrument. Once the clinician has determined that the jaw members are properly gripping the target tissue, the clinician can then actuate or “fire” the instrument, thereby severing and stapling the tissue. The simultaneous severing and stapling avoids complications that may arise when performing such actions sequentially with different surgical tools that respectively only sever or staple.
A variety of surgical cutting and stapling instruments are known that may be employed laparoscopically and/or in connection with various “open” surgical procedures. Some surgical cutting and stapling instruments are configured to actuate replaceable cartridges that support the unformed staples therein. Such devices commonly employ a retractable cutting member that remains with the stapling instrument and may be reused with several cartridges. After the staples are fired in one cartridge, the cutting member is retracted and the spent cartridge is removed to enable a new cartridge to be installed if desired. As the cutting member is driven distally through the cartridge, the unformed staples are fired out of their respective pockets in the cartridge into forming contact with the underside of the anvil. Examples of such devices are disclosed in U.S. Pat. No. 7,000,818, entitled “Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems”, issued Feb. 21, 2006, the disclosure of which is herein incorporated by reference in its entirety.
Other surgical cutting and stapling instruments employ what is commonly referred to as a “disposable loading unit” or “DLU”. Such devices support a staple cartridge and a fresh knife in the form of a “unit” that is configured to be operably attached to the cutting and stapling instrument. The units are designed to be discarded after the staples have been fired. Examples of such instruments are disclosed in U.S. Pat. No. 5,865,361 entitled “Surgical Stapling Apparatus”, issued Feb. 2, 1999, the entire disclosure of which is herein incorporated by reference.
In many surgical procedures and, in particular, in many vascular-related surgical procedures, it may be advantageous for the surgeon to know the size (i.e., diameter) of the vessel being transected and stapled for hemostatic purposes. Some of the existing surgical cutting and stapling devices provide measurement lines on the lateral sides of a channel that supports the surgical staple cartridge. However, such measurement lines are typically only visible from the sides of the end effector and thereby may be obscured by the vessel being cut and stapled. If the surgeon views the end effector from above, such measurement lines are not viewable and may be of little use in determining the size of the vessel being stapled. Accordingly, there is a need for surgical staple cartridge and end effector arrangements that provide feedback concerning the size of tissue being transected and stapled.
A variety of other end effector arrangements are also used by surgeons to manipulate tissue. Such devices, for example surgical grasping devices, include movable jaws for grasping tissue therebetween. It would also be advantageous for such devices and others used to treat/manipulate vascular tissue and the like to provide feedback to the user concerning the size of the tissue being treated/manipulated.
The foregoing discussion is intended only to illustrate some of the shortcomings present in the field of the invention at the time, and should not be taken as a disavowal of claim scope.
In accordance with general aspects of at least one form, there is provided a surgical staple cartridge that includes a cartridge body that operably supports a plurality of surgical staples therein. The cartridge body has a proximal end and a distal end and a deck that extends therebetween. Tissue measurement means are provided on the deck for determining a size of tissue placed thereon.
In accordance with other general aspects of at least one form, there is provided a surgical end effector for use with a surgical instrument. In various forms, the end effector includes an elongated channel that is operably couplable to the surgical instrument. A staple cartridge that has a cartridge body is operably supported in the elongated channel. The cartridge body has a deck surface that is substantially split into a first deck portion and a second deck portion by a longitudinal slot that extends therebetween. The cartridge body operably supports a first plurality of unformed staples therein that correspond to the first deck portion. The cartridge body further operably supports a second plurality of unformed staples that correspond to the second deck portion. A tissue cutting member is operably supported in the cartridge body for axial advancement in the longitudinal slot upon application of a cutting actuation motion thereto by the surgical instrument. An anvil is supported for movable travel toward and away from the deck surface in response to opening and closing motions applied thereto by the surgical instrument. Measurement means is provided on at least one of the deck surface and the anvil for determining a size of tissue placed thereon.
In accordance with still other general aspects of at least one form, there is provided a method for severing and stapling tissue. In various forms, the method comprises clamping a piece of the tissue between a surgical staple cartridge and an anvil and forming a mark on a deck portion of the surgical staple cartridge that corresponds to a size of the clamped tissue. The method further comprises cutting the clamped tissue to form two severed end portions and stapling each severed end portion.
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the instruments and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment”, or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation. Such modifications and variations are intended to be included within the scope of the various invention embodiments disclosed herein and their respective equivalents.
The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
Various exemplary instruments and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the person of ordinary skill in the art will readily appreciate that the various methods and instruments disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with “open” surgical procedures. As the present Detailed Description proceeds, those of ordinary skill in the art will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device such as a trocar that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.
Turning to the Drawings wherein like numerals denote like components throughout the several views,
As can be seen in
The handle 6 includes a pistol grip 26 toward which a closure trigger 18 may be pivotally drawn by the clinician to cause clamping or closing of the anvil 24 toward the staple channel 22 of the end effector 12. A firing trigger 20 is farther outboard of the closure trigger 18. As shown in
After the knife/sled driving member 32 has been driven to the distal end of the staple cartridge 50, the clinician releases the firing trigger 20 to enable the firing trigger 20 to return to an open position, which will result in the application of a rotary retraction motion to the knife/sled driving member 32 to cause it to move proximally to a starting position. Once the knife/sled driving member 32 has been moved to a starting position out of the staple cartridge 50, the clinician may unlock the closure trigger 18 by means of a release button 30 on the handle to permit the closure trigger 18 to move to the open position and thereby cause the anvil 24 to pivot open and release the divided and stapled tissue.
In the embodiments depicted in
In various embodiments, measurement means generally represented as 60 is on at least one of the staple cartridge 50 and the anvil 24. In the embodiment depicted in
Also in the embodiment depicted in
In various embodiments, the mark-forming material 190 may be applied as a coating on the cartridge deck. In other embodiments, the mark-forming material 190 may comprise a substrate that is attached to the cartridge deck or jaw portion of the non-stapler form of end effector. The mark forming material may comprise, for example, a material that contains an indicator that identifies the tissue based on its PH or chemical composition. For example, the mark-forming material 190 may comprise material that changes color or tint or shade of the same color when merely contacted by tissue without requiring the tissue to be compressed thereon.
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.
