Surgical stapling instruments having flexible channel and anvil features for adjustable staple heights

• US 20070083234A1
• Filed: 09/29/2006
• Published: 04/12/2007
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Murray, Michael, Timperman, Eugene, Spivey, James, Shelton, Frederick, Fugikawa, Leslie, Morgan, Jerome, Voegele, James, Timm, Richard
• Granted Patent: US 7,467,740 B2
• Time in Patent Office: Days
• US Class Current: 606/219
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/07242 achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
• 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 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2090/032 pressure limiting, e.g. hydrostatic
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 90/03 Automatic limiting or abutting means, e.g. for safety

Abstract

A surgical instrument for being endoscopically or laparoscopically inserted into a surgical site for simultaneous stapling and severing of tissue includes force adjusted spacing between an upper jaw (anvil) and a lower jaw (staple cartridge engaged to an elongate staple channel) so that the height of staple formation corresponds to the thickness of the tissue, yet does not exceed the height range that may be accommodated by the length of the staples. In particular, resilient structures may be formed into one or more of the elongate channel that supports the staple cartridge, the anvil that is pivotally attached to the elongate channel, and/or a firing member that includes a cutting surface (knife) that severs tissue between a top pin that engages the anvil and a lower foot that engage the elongate channel. The resilience responds to the force exerted by clamped tissue to vary the spacing between the anvil and the staple cartridge supported within the elongate channel.

Claims

1. A surgical instrument, comprising:

a cartridge supporting assembly configured to operably support a staple cartridge therein;

an anvil movably coupled to said cartridge supporting assembly and being selectively movable between an open position and a closed position in response to opening and closing motions respectively applied thereto; and

a firing member operably supported relative to said cartridge supporting assembly and being selectively translatable from an unfired position to a fired position in a staple firing motion in response to a firing force applied to said firing member and to retract to an unfired position in response to a retraction force applied to said firing member, and wherein at least one of said cartridge supporting assembly and said anvil has a resilient structure configured to flexibly interact with said firing member during said staple firing motion to allow a distance between a staple forming undersurface of said anvil and the upper surface of a staple cartridge supported within said cartridge supporting assembly to vary in relation to a thickness of tissue clamped therebetween.

2. The surgical instrument of claim 1 wherein said firing member has a vertical portion and a foot portion and wherein said cartridge supporting assembly comprises an elongate channel having a flexible structure comprising:

an elongate channel slot therethrough sized to receive said vertical portion of said firing bar;

a first flexible ledge substantially coextensive with a first side of said elongate channel slot and configured to flexibly coact with a first portion of said foot portion of said firing bar; and

a second flexible ledge substantially coextensive with a second side of said elongate channel slot and configured to flexibly coact with a second portion of said foot portion.

3. The surgical instrument of claim 1 wherein said firing member has a vertical portion and a pair of upper protrusions protruding therefrom and wherein said anvil has a flexible anvil structure comprising:

a first flexible anvil ledge formed therein; and

a second flexible anvil ledge formed therein and spaced from said first flexible anvil ledge to define an elongate anvil slot therebetween through which said vertical portion of said firing member may pass when said anvil is in said closed position such that one of said upper protrusions may flexible coact with said first flexible ledge and the other of said upper protrusions may flexibly coact with said second anvil ledge.

4. The surgical instrument of claim 1 wherein at least portions of said staple forming undersurface of said anvil are movable relative to other portions of said anvil.

5. The surgical instrument of claim 4 wherein said anvil comprises:

an anvil body pivotally coupled to said cartridge supporting assembly and having an elongate anvil slot therein and wherein said staple forming undersurface comprises;

at least one right insert movably supported by said anvil body on a first side of said anvil slot and having a first staple forming undersurface thereon; and

at least one left insert movably supported by said anvil body on a left side of said anvil slot and having a second staple forming undersurface thereon.

6. The surgical instrument of claim 5 further comprising:

a right compliant member supported between each right insert and said anvil body; and

a left compliant member supported between each said left insert and said anvil body.

7. The surgical instrument of claim 6 wherein said right compliant member comprises at least one right bladder at least partially filled with a fluid medium and wherein said left compliant member comprises at least one left bladder at least partially filled with the fluid medium.

8. The surgical instrument of claim 7 wherein each of said right and left bladders are fluidically coupled to a fluid reservoir having a pressure adjustment mechanism operably supported therein for selectively increasing or decreasing fluid pressure in said right and left bladders.

9. The surgical instrument of claim 5 wherein said at least one right insert comprises a plurality of right inserts that correspond in number to a number of right staples in a staple cartridge supported within said cartridge supporting assembly and wherein said at least one left insert comprises a plurality of left inserts that correspond in number to a number of left staples in the staple cartridge.

10. The surgical instrument of claim 9 further comprising:

at least one right biasing plate supported within said anvil body on a right side of said anvil slot and supporting a plurality of right biasing members wherein each said right biasing member corresponds to one of said right inserts; and

at least one left biasing plate supported within said anvil body on a left side of said anvil slot and supporting a plurality of left biasing members wherein each said left biasing member corresponds to one of said left inserts.

11. A method for processing an instrument for surgery, said method comprising:

obtaining said surgical instrument of claim 1;

sterilizing said surgical instrument; and

storing said instrument in a sterile container.

12. A surgical instrument, comprising:

an elongate staple channel having a first flexible portion and a second flexible portion spaced from said first flexible portion to define a longitudinal channel slot therebetween;

a staple cartridge operably supported within said elongate staple channel;

an elongate shaft operably coupled to said elongate staple channel;

an anvil pivotally attached to the elongate staple channel and being selectively pivotable between a closed position wherein a staple forming undersurface thereof is in confronting relationship to an upper surface of said staple cartridge supported within said elongate staple channel and an open position wherein a distal end of said anvil is spaced from said upper surface of said staple cartridge, said anvil having a longitudinal anvil slot therein;

a control handle assembly proximally operably coupled through the elongate shaft to selectively apply opening and closing motions to said anvil; and

a firing member operably coupled to the control handle assembly through said elongate shaft for selective longitudinal reciprocating motion in the elongate staple channel such that one portion of said firing member extends through said longitudinal anvil slot and another portion of said firing member extends through said longitudinal channel slot between said first and second flexible portions.

13. The surgical instrument of claim 12 wherein said firing member comprises:

a vertical portion wherein said one portion of said firing member comprises an upper end of said vertical portion and wherein said another portion of said firing member comprises a lower end of said vertical portion;

an upper lateral surface extending from the upper end of said vertical portion positioned to exert an inward compressive force on the anvil during firing translation of said firing member therein; and

a foot portion extending from the lower end of the vertical portion positioned to exert an inward compressive force on the first and second flexible portions of said elongate staple channel during firing translation.

14. The surgical instrument of claim 13 wherein said foot portion has at least one resilient member thereon to bear upon a corresponding one of said first and second flexible portions of said elongate staple channel.

15. A surgical instrument comprising:

an elongate staple channel having a longitudinal channel slot;

a staple cartridge operably supported within said elongate staple channel;

an elongate shaft operably coupled to said elongate staple channel;

an anvil pivotally attached to the elongate staple channel and being selectively pivotable between a closed position wherein a staple forming undersurface thereof is in confronting relationship to an upper surface of said staple cartridge supported within said elongate staple channel and an open position wherein a distal end of said anvil is spaced from said upper surface of said staple cartridge, said anvil having a first resilient anvil portion and a second resilient anvil portion spaced from said first resilient anvil portion to define a portion of an elongate anvil slot therebetween;

a control handle assembly proximally operably coupled through the elongate shaft to selectively apply opening and closing motions to said anvil; and

a firing member operably coupled to the control handle assembly through said elongate shaft for selective longitudinal reciprocating motion in the elongate staple channel such that one portion of said firing member extends through said anvil slot between said first and second resilient anvil portions and another portion of said firing member extends through said longitudinal channel slot.

16. The surgical instrument of claim 15 wherein said firing member comprises:

a vertical portion wherein said one portion of said firing member comprises an upper end of said vertical portion and wherein said another portion of said firing member comprises a lower end of said vertical portion;

laterally extending pins protruding from the upper end of the vertical portion positioned to bear upon the first and second resilient portions of said anvil during firing translation of said firing member therein; and

a foot portion extending from the lower end of the vertical portion positioned to exert an inward compressive force on the elongate channel during firing translation.

17. The surgical instrument of claim 16 wherein said laterally extending pins are flexible relative to said upper end portion of said vertical portion of the firing member.

18. The surgical instrument of claim 15 wherein said first flexible portion of said anvil comprises at least one first staple insert movably supported within said anvil, said first staple insert having a first staple forming undersurface thereon and wherein said second flexible portion of said anvil comprises at least one second staple insert movably supported within said anvil and having a second staple forming undersurface thereon.

19. The surgical instrument of claim 18 further comprising:

at least one first compliant member corresponding to each said first staple insert and supported between said corresponding first staple insert and a portion of said anvil; and

at least one second compliant member corresponding to each said second staple insert and supported between said corresponding second staple insert and another portion of said anvil.

20. The surgical instrument of claim 19 wherein each of said first and second compliant member is selected from the group of compliant members consisting of:

springs, compressible polymer materials and fluid supporting bladders.