Anastomosis instrument and method

• US 20010029384A1
• Filed: 06/06/2001
• Published: 10/11/2001
• Est. Priority Date: 07/23/1996
• Status: Active Grant

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Smith, Robert C., Nicholas, David A., Manzo, Scott E.
• Granted Patent: US 6,440,146 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1152 applying the staples on the outside of the lumen
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections

Abstract

A surgical instrument for performing an anastomosis includes a housing having a proximal end and a distal end; a shaft extending from the housing distal end; and a disposable loading unit configured and dimensioned to retain a plurality of surgical fasteners, the disposable loading unit extending from the shaft and forming a juncture with the shaft, the disposable loading unit including: i) opposed split-sections pivotably connected to facilitate movement of the opposed split-sections between open and closed configurations, the opposed split sections being movable through a firing stroke from a first position to a second position and back to the first position to form a plurality of surgical fasteners; and ii) a pivot lockout member including a latch portion which extends between the opposed split-sections, the latch portion including a contact surface which interacts with a corresponding surface formed on at least one of the opposed split-sections to retain the opposed split-sections in the closed configuration, wherein upon return of the fastener pusher member to the first position from the second position, the pivot lockout member is displaced relative to the opposed split sections to an unlocked configuration.

Claims

1. A surgical instrument for performing an anastomosis, which comprises:

a) a housing having a proximal end and a distal end;

b) a shaft extending from the housing distal end; and

c) a disposable loading unit configured and dimensioned to retain a plurality of surgical fasteners, the disposable loading unit extending from the shaft and forming a juncture with the shaft, the disposable loading unit including;

i) opposed split-sections pivotably connected to facilitate movement of the opposed split-sections between open and closed configurations, the opposed split sections being movable through a firing stroke from a first position to a second position and back to the first position to form a plurality of surgical fasteners; and

ii) a pivot lockout member including a latch portion which extends between the opposed split-sections, the latch portion including a contact surface which interacts with a corresponding surface formed on at least one of the opposed split-sections to retain the opposed split-sections in the closed configuration, wherein upon return of the fastener pusher member to the first position from the second position, the pivot lockout member is displaced relative to the opposed split sections to an unlocked configuration.

2. A surgical instrument for performing an anastomosis according to

claim 1

, which further comprises a lock member disposed relative to the juncture of the disposable loading unit and the shaft, the lock member operable from the housing and movable between an unlocked position wherein the disposable loading unit is unsecured relative to the shaft and a locked position wherein the disposable loading unit is secured relative to the shaft.

3. A surgical instrument for performing an anastomosis according to

claim 2

wherein the lock member is biased towards the locked position.

4. A surgical instrument for performing an anastomosis according to

claim 1

which further comprises an actuator lever disposed on the housing and operatively associated with the opposed split sections such that movement of the actuator lever from an initial position to a secondary position effects movement of the opposed split sections being from the first position to the second position to effect deformation of the plurality of surgical fasteners.

5. A surgical instrument for performing an anastomosis according to

claim 4

which further comprises a firing safety assembly which operatively interacts with the actuator lever to prevent unintended movement of the actuator lever from the initial position to the secondary position.

6. A surgical instrument for performing an anastomosis according to

claim 5

wherein the firing safety assembly is normally biased towards a locked out configuration.

7. A surgical instrument for performing an anastomosis according to

claim 1

wherein the shaft and the disposable loading unit each define respective central longitudinal axes which are substantially axially aligned with each other.

8. A surgical instrument for performing an anastomosis, which comprises:

a) a housing having a proximal end and a distal end;

b) a shaft extending from the housing distal end;

c) a disposable loading unit rotatably and detachably extending from the shaft and forming a juncture with the shaft, the disposable loading unit including;

i) a fastener support member configured and dimensioned to support a plurality of surgical fasteners in a predetermined array of a generally close-ended geometric configuration; and

ii) a fastener pusher member disposed adjacent the fastener support member, the fastener pusher member being movable from a first position relative to the plurality of surgical fasteners to a second position relative to the plurality of surgical fasteners so as to deform the plurality of surgical fasteners to a tissue gripping orientation;

d) a lock member disposed relative to the juncture of the disposable loading unit and the shaft, the lock member operable from the housing and movable between an unlocked position wherein the disposable loading unit is unsecured relative to the shaft and a locked position wherein the disposable loading unit is secured relative to the shaft.

9. A surgical instrument for performing an anastomosis according to

claim 8

wherein the lock member is biased towards the locked position.

10. A surgical instrument for performing an anastomosis according to

claim 8

which further comprises an actuator lever disposed on the housing and operatively associated with the fastener pusher member such that movement of the actuator lever from an initial position to a secondary position effects movement of the fastener pusher member from the first position to the second position to effect deformation of the plurality of surgical fasteners.

11. A surgical instrument for performing an anastomosis according to

claim 10

which further comprises an actuator rod which is connected to the actuator lever and wherein the disposable loading unit further includes an actuator member which interacts with the actuator lever to effect movement of the fastener pusher member from the first position to the second position to effect deformation of the surgical fasteners.

12. A surgical instrument for performing an anastomosis according to

claim 10

which further comprises a firing safety assembly which operatively interacts with the actuator lever to prevent unintended movement of the actuator lever from the initial position to the secondary position.

13. A surgical instrument for performing an anastomosis according to

claim 12

wherein the firing safety assembly is normally biased towards a locked out configuration.

14. A surgical instrument for performing an anastomosis according to

claim 8

wherein the shaft and the fastener pusher member each define respective central longitudinal axes which are substantially axially aligned with each other.

15. A surgical instrument for performing an anastomosis according to

claim 8

wherein the fastener support member and the fastener pusher member are each formed of respective opposing split-sections, at least two of the split-sections being pivotably connected to facilitate movement of the opposed split-sections between open and closed configurations.

16. A surgical instrument for performing an anastomosis according to

claim 15

which further comprises a pivot lockout member which extends between the opposed split-sections and includes a contact surface which interacts with a corresponding surface formed on at least one of the opposed split-sections to retain the opposed split-sections in the closed configuration.

17. A surgical instrument for performing an anastomosis according to

claim 16

wherein the fastener pusher member is biased to return to the first position after movement to the second position.

18. A surgical instrument for performing an anastomosis according to

claim 17

wherein upon return of the fastener pusher member to the first position from the second position, the pivot lockout member is displaced to an unlocked configuration.

19. A surgical instrument for performing an anastomosis according to

claim 8

wherein the disposable loading unit extends pivotably from the shaft.

20. A surgical instrument for performing an anastomosis according to

claim 19

wherein the disposable loading unit is pivotable about a longitudinal axis of the shaft.

21. A disposable loading unit for a surgical anastomosis instrument, which comprises:

a) an elongated fastener support member defining a pathway extending at least partially therethrough and including a first opening at a distal end thereof and a second opening spaced from the distal end and in communication with the pathway, the second opening configured and dimensioned to receive a tubular vessel therethrough such that the tubular vessel can pass through the pathway and extend outward from the first opening at the distal end, the fastener support member further including a plurality of spaced apart retention slots defined therein, each retention slot being adapted to support a respective surgical fastener of a plurality of surgical fasteners;

b) a fastener pusher member disposed adjacent the fastener support member, the fastener pusher member movable from a first position relative to the plurality of surgical fasteners to a second position relative to the plurality of surgical fasteners so as to deform the plurality of surgical fasteners;

c) an actuator operatively associated with the fastener pusher member to effect movement of the fastener pusher member from the first position to the second position; and

d) a mounting hub disposed adjacent the actuator and defining an access opening, such that a portion of the actuator is accessible through the access opening, the mounting hub being configured and dimensioned to be removably and rotatably attached to a distal portion of the surgical instrument thereby facilitating removable attachment of the disposable loading unit to the surgical instrument.

22. A surgical instrument for performing an anastomosis according to

claim 21

wherein the fastener support member and the fastener pusher member are each formed of respective opposing split-sections, at least two of the split-sections being pivotably connected to facilitate movement of the opposed split-sections between open and closed configurations.

23. A surgical instrument for performing an anastomosis according to

claim 22

which further comprises a pivot lockout member which extends between the opposed split-sections and includes a contact surface which interacts with a corresponding surface formed on at least one of the opposed split-sections to retain the opposed split-sections in the closed configuration.

24. A surgical instrument for performing an anastomosis according to

claim 23

wherein the fastener pusher member is biased to return to the first position after movement to the second position.

25. A surgical instrument for performing an anastomosis according to

claim 24

wherein upon return of the fastener pusher member to the first position from the second position, the pivot lockout member is displaced to an unlocked configuration.

26. A method of performing a vascular anastomosis comprising the steps of:

a) providing a disposable loading unit having a fastener support member defining a passage therethrough for reception of a first vessel, a plurality of surgical fasteners supported by the fastener support at a distal end thereof;

b) positioning an end of the first vessel through the passage and everting the end of the vessel over the distal end of the fastener support adjacent the plurality of surgical fasteners;

c) engaging the first vessel with the surgical fasteners;

d) inserting the distal edge of the fastener support into an opening in a side wall of a second vessel;

e) engaging the side wall of the second vessel with the surgical fasteners adjacent the opening;

f) connecting the disposable loading unit to an actuator handle assembly after step e) such that the disposable loading unit is rotatable with respect to the actuator handle assembly; and

g) deforming the legs of each surgical fastener by actuation of the actuator handle assembly to secure the first and second vessels together in fluid communication with each other.

27. A method of performing a vascular anastomosis according to

claim 26

, which further comprises the step of removing the first vessel from the disposable loading unit by opening a split-section of the disposable loading unit.