Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism

• US 20050263562A1
• Filed: 09/30/2004
• Published: 12/01/2005
• Est. Priority Date: 05/20/2003
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Setser, Michael Earl, Doll, Kevin Ross, Morgan, Jerry R.
• Granted Patent: US 7,380,696 B2
• Time in Patent Office: Days
• US Class Current: 227/176.100
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/0725 with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Claims

1. A surgical instrument comprising:

a handle portion operable to produce a firing motion; and

an implement portion responsive to the firing motions from the handle portion, the implement portion comprising;

an elongate channel coupled to the handle portion and including a channel slot,

a staple cartridge received by the elongate channel and incorporating a proximally positioned wedge member aligned to cam upward a driver supporting a staple,

an anvil pivotally coupled to the elongate channel and including an anvil channel,

a firing device including a distally presented cutting edge longitudinally received between the elongate channel and the anvil, an upper member engageable to the anvil channel, a lower member engaging the channel slot, and a middle member operable to actuate the staple cartridge by distally translating the wedge member of the staple cartridge, the firing device positively engaging both the elongate channel and the anvil during longitudinal firing travel to provide spacing therebetween for staple formation,

an articulation joint proximally coupled to the elongate channel, and

a thinned firing strip proximally attached to the firing device for transferring the firing motion from the handle portion through the articulation joint.

2. The surgical instrument of claim 1, wherein the anvil forms a pivotal attachment to the elongate channel inwardly biased at respective distal ends to assist the firing device in affirmatively spacing between the anvil and elongate channel during actuation of the staple cartridge.

3. The surgical instrument of claim 1, wherein the staple cartridge is a selected type of a plurality of staple cartridge types, each staple cartridge type characterized by a thickness selected for a desired spacing between the anvil and elongate channel and characterized by staples having a length suitable for the desired spacing.

4. The surgical instrument of claim 3, wherein the wedge member comprises a wedge sled having a plurality of connected camming wedges each having a preselected height configured for the selected type of staple cartridge, the middle member of the firing device oriented to abut each of the plurality of staple cartridge types.

5. A surgical instrument comprising:

a handle portion operable to produce a firing motion and a closing motion; and

an implement portion responsive to the firing motions from the handle portion and diametrically dimensioned for endo-surgical use, the implement portion comprising;

a shaft coupled to the handle portion operable to separately transfer the firing motion and the closing motion,

an elongate channel coupled to the shaft and including a channel slot,

an anvil pivotally coupled to the elongate channel, responsive to the closing motion from the shaft, and including an anvil channel,

a firing device including a distally presented cutting edge longitudinally received between the elongate channel and the anvil, the firing device including a lower portion slidingly engaged to the elongate channel and an upper portioned positioned to slidingly engage the anvil during firing, engagement of the firing device to the elongate channel and the anvil maintaining a spacing therebetween; and

a thinned strip proximally attached to the firing device operable to transfer the firing motion to the firing device.

6. The surgical instrument of claim 5, further comprising a staple cartridge engaged by the elongate channel and including a proximally opened slot for receiving the cutting edge of the firing device, the staple cartridge including a plurality of staples cammed upwardly by the distal longitudinal movement of the firing mechanism.

7. The surgical instrument of claim 6, wherein the staple cartridge further includes a plurality of drivers supporting the plurality of staples and a wedge sled responsive to the distal longitudinal movement of the firing mechanism to cam upwardly the drivers and thus form the plurality of staples against the anvil.

8. The surgical instrument of claim 5, wherein the shaft includes an articulation mechanism through which the thinned strip bends and longitudinally translates.

9. The surgical instrument of claim 6, wherein the staple cartridge is a selected type of a plurality of staple cartridge types, each staple cartridge type characterized by a thickness selected for a desired spacing between the anvil and elongate channel and characterized by staples having a length suitable for the desired spacing.

10. The surgical instrument of claim 9, wherein the wedge sled comprises a plurality of connected camming wedges each having a preselected height configured for the selected type of staple cartridge, the middle member of the firing device oriented to abut each of the plurality of staple cartridge types.

11. The surgical instrument of claim 5, wherein the firing device is configured to affirmatively space the anvil from the elongate channel during longitudinal travel between the anvil and elongate channel by including a lower portion having an upper surface and a lower surface that slidingly engage the elongate channel.

12. The surgical instrument of claim 11, wherein the lower portion of the firing device comprises a lower pin having the upper surface abutting the elongate channel and the lower portion further comprises a middle pin having the lower surface opposingly abutting the elongate channel.

13. The surgical instrument of claim 12, wherein the firing device further comprises an upper member having an upper surface and a lower surface that longitudinally slidingly engage the anvil.

14. The surgical instrument of claim 13, wherein the anvil includes an internal longitudinal slot having a narrowed vertical slot, and wherein the firing device translates in the narrowed vertical slot and includes an upper member having upper and lower surfaces that reside within the internal longitudinal slot for affirmatively spacing the anvil from the elongate channel.

15. The surgical instrument of claim 5, wherein the firing device is configured to affirmatively space the anvil from the elongate channel during longitudinal travel between the anvil and elongate channel by including an upper member having an upper surface and a lower surface that longitudinally slidingly and opposingly engage the anvil.

16. The surgical instrument of claim 15, wherein the anvil includes a longitudinal slot having an upper surface and a lower surface that slidingly abut respectively the lower surface and upper surface of the upper member of the firing device.

17. The surgical instrument of claim 16, wherein the longitudinal slot comprises an internal longitudinal channel communicating with a narrowed vertical slot, and wherein the firing device translates in the narrowed vertical slot and includes an upper member having the upper and lower surfaces that reside within the internal longitudinal channel for affirmatively spacing the anvil from the elongate channel.

18. A surgical instrument, comprising:

a handle means for producing a closing motion and a firing motion;

a clamping means responsive to the closing motion to clamp tissue;

a firing means responsive to the firing motion for vertically spacing the clamping means and for causing severing and stapling of clamped tissue therein; and

an articulation mechanism operably configured to articulate the clamping means relative to the handle means; and

a thinned firing strip proximally attached to the firing means for bending through the articulation mechanism and for longitudinally transferring the firing motion.

19. The surgical instrument of claim 18, wherein the anvil includes an internal longitudinal slot having a narrowed inward opening, the firing device translating within the narrowed inward opening and having the upper member slidingly engaged within the longitudinal slot.

20. The surgical instrument of claim 19, further comprising a closure member operatively configured to longitudinally transfer the closure motion to the end effector to inwardly bias distal ends of the anvil and the elongate channel to assist the firing device in affirmatively spacing the anvil and elongate channel during actuation of the staple cartridge.