This disclosure is generally related to surgical stapling devices and, more particularly, to surgical stapling devices for endoscopic use.
Circular stapling devices typically include a tool assembly that has an anvil assembly and a shell or reload assembly. The reload assembly includes a staple cartridge, a staple pusher, and an annular knife. The staple cartridge supports one or more annular rows of staples, and the staple pusher is movable within the staple cartridge to eject the staples from the staple cartridge into the anvil assembly. The annular knife is positioned radially inward of the annular rows of staples and is movable from a retracted position to an advanced position to cut or core tissue against the anvil assembly. Circular stapling devices are commonly used to perform anastomoses procedures including esophagectomy procedures.
During an esophagectomy procedure, all or part of the esophagus is removed and the reload assembly of a circular stapling device is inserted through an intercostal space of a patient into a body cavity. Typically, the anvil assembly is delivered through the esophagus and is attached to the stapling device within or adjacent the body cavity. The stapling device is fired to attach the stomach to the remaining portion of the esophagus. During this procedure, the diameter of the circular stapling device may prohibit insertion of the circular stapling device through the intercostal space. Insertion may require breaking a rib or ribs.
This disclosure generally relates to a surgical stapling device for performing anastomoses procedures within a body of a patient. The surgical stapling device includes a tool assembly that is configured to access a body cavity with minimal trauma to the patient.
Aspects of the disclosure are directed to a surgical stapling device including an elongate body, an anvil retainer, a reload assembly, and an anvil assembly. The elongate body has a distal portion and a proximal portion. The anvil retainer is supported within and extends from the distal portion of the elongate body and is movable between an advanced position and a retracted position. The reload assembly is supported on the distal portion of the elongate body and includes a shell housing, a staple cartridge supported on the shell housing, staples supported within the staple cartridge, and a staple pushing member that is movable within the housing from a retracted position to an advanced position to eject the staples from the staple cartridge. The staple cartridge has an oval configuration with a width “W” and a length “L”. The length “L” is greater than the width “W”. The anvil assembly is supported on the anvil retainer and includes an anvil having an oval configuration that corresponds to the oval configuration of the staple cartridge. The anvil assembly is movable in relation to the staple cartridge in response to movement of the anvil retainer between its retracted and advanced positions between open and clamped positions. The anvil is in juxtaposed alignment with the staple cartridge in the clamped position.
In aspects of the disclosure, the anvil assembly includes the anvil, a center rod and an anvil head assembly that is coupled to the center rod by a pivot member and movable in relation to the center rod between a tilted position and an operative position.
In some aspects of the disclosure, the longitudinal axis of the anvil head assembly is aligned with the longitudinal axis of the center rod when the anvil head assembly is in the tilted position.
In certain aspects of the disclosure, the anvil head assembly is urged towards the tilted position.
In aspects of the disclosure, the reload assembly includes a knife carrier and a knife that is supported on the knife carrier.
In some aspects of the disclosure, the knife has an oval configuration and is movable within the shell housing between retracted and advanced positions into engagement with the anvil head assembly.
In certain aspects of the disclosure, the anvil head assembly includes a housing having a post, a backup member, and a cut ring that is supported on the backup member.
In aspects of the disclosure, the post and the anvil define an annular recess, and the backup member and the cut ring are movable within the annular recess from a retracted position to an advanced position.
In some aspects of the disclosure, the backup member includes at least one finger that is engaged with the center rod when the backup member and the cut ring are in their retracted position, and engagement between the at least one finger of the backup member and the center rod retains the anvil head assembly in the operative position.
In certain aspects of the disclosure, the reload assembly includes a coupling mechanism that releasably couples the reload assembly to the distal portion of the elongate body.
In aspects of the disclosure, the surgical stapling device includes a handle assembly that is coupled to the proximal portion of the elongate body.
In aspects of the disclosure, the width “W” is about half of the length “L”.
Other aspects of the disclosure are directed to a reload assembly including a shell housing, a staple cartridge, staples, and a staple pushing member. The staple cartridge is supported on the shell housing, and the staples are supported within the staple cartridge. The staple pushing member is movable within the shell housing from a retracted position to an advanced position to eject the staples from the staple cartridge. The staple cartridge has an oval configuration with a width “W” and a length “L” that is greater than the width “W”.
Other aspects of the disclosure are directed to an anvil assembly including a center rod and an anvil head assembly. The anvil head assembly is supported on the center rod by a pivot member and is pivotable in relation to the center rod from an operative position to a tilted position. The anvil head assembly includes a housing having a post, an anvil supported on the housing, a backup member, and a cut ring that is supported on the backup member. The post and the anvil define an annular recess. The backup member and the cut ring are movable within the annular recess from a retracted position to an advanced position. The anvil has an oval configuration having a width “W” and a length “L” that is greater than the width “W”.
Other aspects, features, and advantages will be apparent from the description, the drawings, and the claims that follow.
Various aspects and features of the disclosure are described with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views and:
The disclosed surgical stapling device including a tool assembly according to various aspects of the disclosure will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. However, it is to be understood that the disclosed aspects are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the 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 disclosure in virtually any appropriately detailed structure.
In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. The term “endoscopic” is used generally used to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through small diameter incision or cannula. In addition, the term “about” is intended to include a range that includes listed parameter and plus or minus ten percent of the listed parameter. Further, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel.
This disclosure is directed to a surgical stapling device for performing anastomoses procedures. The surgical stapling device includes a tool assembly that has a reload assembly and an anvil assembly that have oval configurations to facilitate passage of the tool assembly into a body cavity of a patient while minimizing trauma to the patient.
The handle assembly 18 includes a body 24 that defines a stationary hand grip 26 that supports actuation buttons 28 for controlling operation of various functions of the stapling device 10 including approximation of the reload assembly 14 and anvil assembly 16, firing of staples from the reload assembly 14, and cutting or coring of tissue.
The stapling device 10 is illustrated as an electrically powered stapling device and includes the handle assembly 18 that is electrically powered and may support one or more batteries (not shown). The adaptor assembly 20 translates power from the handle assembly 18 to the reload and anvil assemblies 14 and 16, respectively, to move the tool assembly 12 between the open and clamped positions and to staple and cut tissue. Examples of electrically powered stapling devices can be found in U.S. Pat. Nos. 9,055,943, 9,023,014, and U.S. Publication Nos. 2018/0125495, and 2017/0340351. Alternately, it is envisioned the tool assembly 12 could be incorporated into a manually powered stapling device such as disclosed in, e.g., U.S. Pat. No. 7,303,106 (the '106 patent), or a stapling device that is configured for use with a robotic system as disclosed in, e.g., U.S. Pat. No. 9,962,159, that does not include a handle assembly.
The backup member 60 defines a central opening 70 that receives the post 56 of the housing 54 of the anvil head assembly 52 to facilitate movement of the backup member 60 about the post 56 from a pre-fired, retracted position (
The backup member 60 includes a pair of inwardly extending fingers 74 that are movable into and out of engagement with a distal flat 76 of the center rod assembly 50 of the anvil assembly 16. When the fingers 74 are engaged with the distal flats 76, the engagement prevents pivotal movement of the anvil head assembly 52 in relation to the center rod assembly 50. When the backup member 60 moves out of engagement with the distal flats 76, the anvil head assembly 52 can pivot in relation to the center rod assembly 50 between an operative position (
In aspects of the disclosure, the cut ring 62 (
The body 78 of the cut ring 62 includes an outer wall 84 that has a series of projections 86 and the housing 54 of the anvil assembly 16 includes an inner wall 88 that defines an annular groove 88a (
The deformable support member 66 is supported about the post 56 of the housing 54 of the anvil head assembly 52 between a proximal surface of the backup member 60 and an inner surface 91 of the housing 54. The deformable support member 66 retains the backup member 60 and the cut ring 62 in their retracted positions within the recess 68 of the housing 54 until a pre-determined force sufficient to deform the support member 66 is applied to the cut ring 62 during firing of the stapling device 10 (
The center rod assembly 50 includes a center rod 90, a plunger 92, and a plunger spring 94. The center rod 90 has a first end that includes spaced arms 96 that define a cavity 98 (
The post 56 of the housing 54 of the anvil head assembly 52 is positioned within the cavity 98 defined between the spaced arms 96 of the center rod 90 and defines a transverse through bore 102. A pivot member 104 extends through the through bores 100 of the spaced arms 96 and the through bore 100 of the post 56 to pivotally secure the post 56 to the center rod 90 such that the anvil head assembly 52 is pivotally mounted to the center rod assembly 50 between the operative position (
The cam latch member 64 is received in a slot 108 defined within the post 56 of the anvil head assembly 52. The cam latch member 64 defines a through bore 64a (
For a more detailed description of an anvil assembly including operation of the cam latch member 64, the plunger 92, and the plunger spring 94, see the '132 patent.
The pusher assembly 130 of the reload assembly 100 includes an annular pusher 132 and a staple pushing member 134 that together define a longitudinal through bore 135. The annular pusher 132 has a distal portion that abuts a proximal portion of the staple pushing member 134 such that distal movement of the annular pusher 132 within the shell housing 110 causes distal movement of the staple pushing member 132 within the shell housing 110. The staple pushing member 134 of the reload assembly 100 has a plurality of fingers 136. Each of the plurality of fingers 136 is received within a respective one of the staple pockets 121 of the staple cartridge 120 and is movable through the respective staple pocket 121 to eject the staples “S” from the staple pockets 121 when the staple pushing member 132 is moved from its retracted position to its advanced position within the shell housing 110.
The shell housing 110 of the reload assembly 100 includes an outer housing portion 112 and an inner housing portion 114 that is spaced from the outer housing portion 112 to define an annular cavity 113 that receives the pusher assembly 130, the knife carrier 140, and the annular knife 142. The annular cavity 113 has an oval configuration. The pusher assembly 130, the knife carrier 140, and the annular knife 142 have oval configurations that correspond to the configuration of the staple cartridge 120 and are movable within the annular cavity 113 between retracted and advanced positions when the stapling device 10 is fired to staple and cut tissue clamped between the anvil assembly 16 and the reload assembly 14. In aspects of the disclosure, the pusher assembly 130 can be movable independently of the knife carrier 140 or in unison with the knife carrier 140 to eject the staples “S” from the staple cartridge 120 and cut tissue.
The reload assembly 14 includes a proximal portion that supports a coupling mechanism 150 that is operable to couple the reload assembly 14 to the adaptor assembly 20 (
The inner housing portion 114 of the shell housing 110 defines a through bore 115 that receives the anvil retainer 32 (
With the backup member 60 in its retracted position, the inwardly extending fingers 74 (
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described embodiments. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
This application claims the benefit of and priority to U.S. Provisional Patent Application No. 63/081,485, filed Sep. 22, 2020, the entire contents of which is incorporated by reference herein.
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