Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets

• US 20090001130A1
• Filed: 06/29/2007
• Published: 01/01/2009
• Est. Priority Date: 03/15/2007
• Status: Abandoned Application

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Cilag Gmbh International (Johnson & Johnson)
• Inventors: Morgan, Jerome R., Hess, Christopher J., Weisenburgh, William B. II
• Application Number:
  US11/824,524
• Publication Number:
  US 20090001130A1
• Time in Patent Office: Days
• US Class Current: 227/180.100
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• 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 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/00898 : expandable upon contact with fluid
• CPC Class Codes: A61B 2017/07228 : Arrangement of the staples
• CPC Class Codes: A61B 2017/07257 : characterised by its anvil
• CPC Class Codes: A61B 2017/07264 : characterised by its staple forming cavities, e.g. geometry or material
• 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
• CPC Class Codes: A61B 2017/2929 : with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments
• CPC Class Codes: A61B 2090/031 : torque limiting
• CPC Class Codes: A61B 2090/037 : with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like
• CPC Class Codes: F01P 2023/08 : Microprocessor; Microcomputer
• CPC Class Codes: F01P 2031/30 : Cooling after the engine is stopped
• CPC Class Codes: F01P 2037/02 : starting
• CPC Class Codes: F01P 5/04 : Pump-driving arrangements
• CPC Class Codes: F01P 5/10 : Pumping liquid coolant; Arrangements of coolant pumps
• CPC Class Codes: F01P 7/08 : by cutting in or out of pumps
• CPC Class Codes: F01P 7/16 : by thermostatic control
• CPC Class Codes: F01P 7/162 : by cutting in and out of pumps
• CPC Class Codes: F02D 11/105 : characterised by the function converting demand to actuation, e.g. a map indicating relations between an accelerator pedal position and throttle valve opening or target engine torque
• CPC Class Codes: F02D 2011/102 : at least one throttle being moved only by an electric actuator
• CPC Class Codes: F02D 2011/104 : using electric step motors
• CPC Class Codes: F02D 2041/0095 : Synchronisation of the cylinders during engine shutdown
• CPC Class Codes: F02D 2041/389 : for injecting directly into the cylinder
• CPC Class Codes: F02D 2200/501 : Vehicle speed
• CPC Class Codes: F02D 2200/602 : Pedal position
• CPC Class Codes: F02D 2200/604 : Engine control mode selected by driver, e.g. to manually start particle filter regeneration or to select driving style
• CPC Class Codes: F02D 31/002 : controlling air supply
• CPC Class Codes: F02D 35/025 : by determining temperatures inside the cylinder, e.g. combustion temperatures
• CPC Class Codes: F02D 41/042 : for stopping the engine
• CPC Class Codes: F02D 41/065 : at hot start or restart F02D41/067 takes precedence
• CPC Class Codes: F02D 41/3094 : the fuel injection being effected by at least two different injectors, e.g. one in the intake manifold and one in the cylinder
• CPC Class Codes: F02D 41/3809 : Common rail control systems common rail apparatus F02M55/025, F02M63/0225
• CPC Class Codes: F02D 41/401 : Controlling injection timing F02D41/402 takes precedence
• CPC Class Codes: F02D 41/402 : Multiple injections
• CPC Class Codes: F02N 11/0814 : comprising means for controlling automatic idle-start-stop
• CPC Class Codes: F02N 19/02 : Aiding engine start by thermal means, e.g. using lighted wicks
• CPC Class Codes: Y02T 10/40 : Engine management systems
• CPC Class Codes: Y10S 227/902 : Surgical clips or staples

Abstract

A surgical procedure including the steps of performing a plurality of cutting strokes to cut a patient'"'"'s stomach into a first part and a second part. For one cutting stroke an endocutter is used that is loaded with a staple cartridge. The staple cartridge includes a plurality of staples to staple the first and second parts of the stomach. One or more staples in the staple cartridge have an integrated crown and staple driver.

Claims

1. A surgical procedure comprising:

performing a plurality of cutting strokes to cut a patient'"'"'s soft tissue into a first part and a second part, wherein for one cutting stroke an endocutter is used that is loaded with a staple cartridge having a plurality of staples to staple the first and second parts of the soft tissue, and wherein one or more staples in the staple cartridge have an integrated crown and staple driver.

2. The surgical procedure of claim 1, wherein one or more of the integrated crown and staple drivers of the staples define one or more staple-end recesses for turning the staples.

3. The surgical procedure of claim 2, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the staple cartridge having staples with integrated crowns and staple drivers is used.

4. The surgical procedure of claim 3, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

5. The surgical procedure of claim 1, wherein for the at least one of the cutting strokes the endocutter further comprises an anvil comprising one or more releasable pocket elements that are separately releasable from the anvil upon firing of the instrument, wherein the one or more releasable pocket elements each comprise at least one staple-end retaining surface.

6. The surgical procedure of claim 5, wherein:

the one or more releasable pocket elements comprise a bioabsorbable material; and

the integrated crown and staple driver of the one or more staples comprise a bioabsorbable material.

7. The surgical procedure of claim 5, wherein:

the one or more releasable pocket elements comprise a non-bioabsorbable material; and

the integrated crown and staple driver of the one or more staples comprise a non-bioabsorbable material.

8. The surgical procedure of claim 5, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the staple cartridge having staples with integrated crowns and staple drivers is used.

9. The surgical procedure of claim 8, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

10. The surgical procedure of claim 1, wherein the procedure comprises a Roux-en-Y gastric bypass procedure.

11. A surgical procedure comprising:

using a first endocutter to make a first series of one or more cuts to a patient'"'"'s soft tissue;

using a second endocutter to make a second series of one or more cuts to the patient'"'"'s soft tissue after the first series is made; and

using the first endocutter to make a third series of one or more cuts to the patient'"'"'s tissue after the second series is made, such that upon completion of the third series the patient'"'"'s soft tissue is cut into a first part and a second part, and

wherein for each of the one or more cuts by the second endocutter, the second endocutter is loaded with a staple cartridge having a plurality of staples to staple the parts of the patient'"'"'s soft tissue, wherein one or more staples in the staple cartridge have an integrated crown and staple driver.

12. The surgical procedure of claim 11, wherein one or more of the integrated crown and staple drivers of the staples define one or more staple-end recesses for turning the staples.

13. The surgical procedure of claim 12, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the second endocutter was used to make the second series of cuts.

14. The surgical procedure of claim 13, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

15. The surgical procedure of claim 11, wherein for each of the one or more cuts by the second endocutter, the second endocutter further comprises an anvil comprising one or more releasable pocket elements that are separately releasable from the anvil upon firing of the instrument, wherein the one or more releasable pocket elements each comprise at least one staple-end retaining surface.

16. The surgical procedure of claim 15, wherein:

the one or more releasable pocket elements comprise a bioabsorbable material; and

the integrated crown and staple driver of the one or more staples comprise a bioabsorbable material.

17. The surgical procedure of claim 15, wherein:

the one or more releasable pocket elements comprise a non-bioabsorbable material; and

the integrated crown and staple driver of the one or more staples comprise a non-bioabsorbable material.

18. The surgical procedure of claim 15, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the second endocutter was used to make the second series of cuts.

19. The surgical procedure of claim 18, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

20. The surgical procedure of claim 11, wherein for each of the one or more cuts by the first endocutter, the first endocutter is loaded with a staple cartridge having a plurality of staples to staple the parts of the patient'"'"'s stomach, wherein one or more staples in the staple cartridge have an integrated crown and staple driver.

21. The surgical procedure of claim 11, wherein the procedure comprises a Roux-en-Y gastric bypass procedure.

22. A surgical procedure comprising:

using an endocutter to make a first series of one or more cuts to a patient'"'"'s soft tissue;

using an endocutter to make a second series of one or more cuts to the patient'"'"'s soft tissue after the first series is made;

prior to each of the second series of cuts, loading the endocutter with a staple cartridge having a plurality of staples to staple the parts of the patient'"'"'s stomach, wherein one or more staples in the staple cartridge have an integrated crown and staple driver; and

using the first endocutter to make a third series of one or more cuts to the patient'"'"'s soft tissue after the second series is made, such that upon completion of the third series the patient'"'"'s soft tissue is cut into a first part and a second part.

23. The surgical procedure of claim 22, wherein one or more of the integrated crown and staple drivers of the staples define one or more staple-end recesses for turning the staples.

24. The surgical procedure of claim 23, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the endocutter was used to make the second series of cuts.

25. The surgical procedure of claim 24, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

26. The surgical procedure of claim 22, wherein for each of the second series of cuts the endocutter further comprises an anvil comprising one or more releasable pocket elements that are separately releasable from the anvil upon firing of the instrument, and wherein the one or more releasable pocket elements each comprise at least one staple-end retaining surface.

27. The surgical procedure of claim 26, wherein:

the one or more releasable pocket elements comprise a bioabsorbable material; and

the integrated crown and staple driver of the one or more staples comprise a bioabsorbable material.

28. The surgical procedure of claim 26, wherein:

the one or more releasable pocket elements comprise a material that is non-absorbable by the patient'"'"'s stomach; and

the integrated crown and staple driver of the one or more staples comprise a material that is non-absorbable by the patient'"'"'s stomach.

29. The surgical procedure of claim 26, wherein the patient'"'"'s soft tissue comprises the patient'"'"'s stomach, and wherein the surgical procedure further comprises placing a gastric band around the first part of the patient'"'"'s stomach, wherein the gastric band is placed in an area of the first part of the patient'"'"'s stomach where the second series of cuts were made.

30. The surgical procedure of claim 29, further comprising connecting the patient'"'"'s middle intestine to the first part of the patient'"'"'s stomach.

31. The surgical procedure of claim 22, wherein the procedure comprises a Roux-en-Y gastric bypass procedure.