Surgical stapling device

• US 20050006433A1
• Filed: 06/21/2004
• Published: 01/13/2005
• Est. Priority Date: 06/20/2003
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Heinrich, Russell, Milliman, Keith L.
• Granted Patent: US 7,168,604 B2
• Time in Patent Office: Days
• US Class Current: 227/176.100
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2931 with releasable head

Abstract

A surgical stapling device is disclosed for the treatment of internal hemorrhoids. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The anvil assembly of the stapling device may include an approximation mechanism having an anvil retainer including an elongated distal extension dimensioned to be telescopingly received within a longitudinal bore of an anvil center rod of the anvil assembly. The elongated distal extension is of a length to provide telescopic engagement with the anvil center rod without obstructing visualization of the surgical site. A kit including a surgical instrument having a removable anvil assembly and an anvil assembly insertion handle is also disclosed. The kit may also include a speculum, an anal dialator and/or an obturator.

Claims

1. A surgical stapling device comprising:

a handle assembly;

a body portion extending distally from the handle assembly;

a head portion including an anvil assembly and a shell assembly, the anvil assembly including an anvil head and an anvil center rod defining a longitudinal bore, the shell assembly supporting a plurality of staples, the anvil assembly being movable in relation to the shell assembly between spaced and approximated positions;

an approximation mechanism including an anvil retainer for supporting the anvil assembly, the anvil retainer including an elongated distal extension dimensioned to be telescopingly received in the longitudinal bore of the anvil center rod.

2. A surgical stapling device according to claim 1, wherein the longitudinal bore extends along substantially the entire length of the anvil center rod, the elongated distal extension of the anvil retainer extending substantially the length of the longitudinal bore.

3. A surgical stapling device according to claim 1, wherein the anvil assembly is removably secured to the anvil retainer.

4. A surgical stapling device according to claim 3, wherein the anvil center rod includes a plurality of flexible arms which partially define the longitudinal bore, at least one of the flexible arms including a radial projection, wherein the anvil retainer defines a shoulder which is positioned proximally of the elongated distal extension, the radial projection of the at least one flexible arm being engageable with the anvil retainer shoulder to releasably secure the anvil assembly to the anvil retainer.

5. A surgical stapling device according to claim 1, wherein the elongated distal extension of the anvil retainer has a smaller diameter than the proximal portion of the anvil retainer.

6. A surgical stapling device according the claim 1, wherein the approximation mechanism includes a rotatable approximation knob supported on the handle assembly, a screw operably associated with the approximation knob, and a retainer extension member secured to the screw, the anvil retainer being secured to the distal end of the retainer extension member.

7. A surgical stapling device according to claim 1, wherein the elongated distal extension is of a length to allow telescoping of the elongated distal extension with the anvil center rod without obstructing visibility of a surgical site.

8. A surgical stapling device according to claim 7, wherein the combined length of the anvil center rod and the elongated distal extension is greater than about 4.5 inches.

10. A method of treating internal hemorrhoids according to claim 7, wherein the surgical stapling device includes an approximation mechanism having an anvil retainer with an elongaged distal extension, and wherein the attaching step includes using the distal extension to align the stapling instrument with the anvil assembly.

12. A method according to claim 10, wherein the step of applying a purse string suture includes using a speculum to apply the pursestring suture to the rectal tissue and/or internal hemorrhoids.

9. A method of treating internal hemorrhoids, the method comprising the steps of:

a) inserting an anvil assembly of a surgical stapling device through the anus into the rectum such that an anvil head of the anvil assembly is positioned beyond the internal hemorrhoids;

b) applying a purse string suture to rectal tissue and/or the internal hemorrhoids;

c) attaching a surgical stapling device including a handle assembly and a shell assembly to the anvil assembly after the anvil assembly has been inserted through the anus;

d) drawing the rectal tissue and/or the internal hemorrhoids towards a center rod of the anvil assembly with the purse string suture;

e) approximating the anvil assembly and the shell assembly; and

f) actuating the surgical stapling device to treat the rectal tissue and/or the internal hemorrhoids.

11. A method according to claim 9, wherein the step of inserting the anvil assembly includes the step of attaching an insertion handle to the anvil assembly prior to inserting the anvil assembly through the anus.

13. A kit for treating internal hemorrhoids, the kit comprising:

a surgical stapling device including a handle assembly, a body portion extending distally from the handle assembly, an approximation mechanism including an anvil retainer, a shell assembly including a plurality of staples, and an anvil assembly removably attachable to the anvil retainer; and

an anvil assembly insertion handle removably attachable to the anvil assembly.

14. A kit according to claim 13, wherein the anvil assembly includes a center rod having a longitudinal bore and the anvil retainer includes an elongated distal extension dimensioned to be telescopingly received in the longitudinal bore of the center rod.

15. A kit according to claim 14, wherein the elongated distal extension is of a length to allow telescoping of the elongated distal extension of the anvil retainer and the center rod of the anvil assembly without obstructing visibility of a surgical site during a procedure for treating internal hemorrhoids.

16. A kit according to claim 15, wherein the combined length of the anvil center rod and the elongated distal extension is greater than about 4.5 inches.

17. A kit according to claim 14, further including a speculum having a semi-cylindrical body defining a channel, a blunt tip, and a semi-annular flange.

18. A kit according to claim 17, wherein the semi-annular flange includes at least one finger tab.

19. A kit according to claim 14, wherein the elongated distal extension has a diameter which is smaller than the diameter of a proximal portion of the anvil retainer.

20. A kit according to claim 13, wherein the insertion handle includes a gripping knob, a substantially rigid shaft extending distally from the knob and a detent configured to be received in an opening formed in the anvil center rod.