Surgical stapling device

• US 20090050671A1
• Filed: 10/31/2007
• Published: 02/26/2009
• Est. Priority Date: 06/17/2003
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Olson, Lee Ann, Beardsley, John W., Racenet, David C., Roy, Philip, Stearns, Ralph
• Granted Patent: US 7,584,880 B2
• Time in Patent Office: Days
• US Class Current: 227/175.200
• 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 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 2017/0688 Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/291 the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• 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
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms

Abstract

A surgical device is disclosed which includes a handle portion, a central body portion and a SULU. The SULU includes a proximal body portion, an intermediate pivot member and a tool assembly. The intermediate pivot member is pivotally secured to the proximal body portion about a first pivot axis and the tool assembly is pivotally secured to the intermediate pivot member about a second pivot axis which is orthogonal to the first pivot axis. The SULU includes a plurality of articulation links which are operably connected to the tool assembly by non-rigid links. The articulation links are adapted to releasably engage articulation links positioned in the central body portion. The body portion articulation links are connected to an articulation actuator which is supported for omni-directional movement to effect articulation of the tool assembly about the first and second axes. The handle portion includes a spindle and barrel assembly drive mechanism for advancing and retracting a drive member positioned in the tool assembly. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly.

Claims

1. A surgical stapling device comprising:

a handle portion including an articulation actuator and a drive mechanism;

a trigger operatively connected to the handle portion;

an elongated body portion secured to the handle portion, the elongated body portion having proximal and distal ends and extending distally from the handle;

a pivot member connected to the elongated body portion adjacent a distal end thereof body portion, the pivot member including a first set of hinge members defining a first pivot axis and a second set of hinge members defining a second pivot axis, and first and second engagement members;

a loading unit pivotably connected to the pivot member, the loading unit having at least one set of teeth; and

at least one cable having proximal and distal ends, the proximal end of the at least one cable being connected to the handle portion and the distal end of the at least one cable being connected to the loading unit, the at least one cable extending through the pivot member.

2. The surgical stapling device of claim 1, wherein the first pivot axis and the second pivot axis are substantially orthogonal in relation.

3. The surgical stapling device of claim 1, wherein the loading unit includes an anvil assembly and a cartridge assembly.

4. The surgical stapling device of claim 1, wherein the first set of hinge members includes a first elongated slot configured and dimensioned for the receipt of a first pivot pin and the second set of hinge members includes a second elongated slot configured and dimensioned for the receipt of a second pivot pin, the first pivot pin being configured and dimensioned to translate from a first position to a second position within the first slot and the second pivot pin being configured and dimensioned to translate from a first position to a second position within the second slot.

5. The surgical stapling device of claim 4, wherein at least a first pulley is secured to the first set of hinge members and at least a second pulley is secured to the second set of hinge members, the at least a first pulley and the at least a second pulley each defining a channel.

6. The surgical stapling device of claim 5, wherein the first pivot pin traverses the first set of hinge members and the loading unit.

7. The surgical stapling device of claim 6, wherein the second pivot pin traverses the second set of hinge members and a mounting member.

8. The surgical stapling device of claim 7, wherein the mounting member includes a third set of hinge members and at least one set of teeth.

9. The surgical stapling device of claim 8, wherein the first engagement member engages the at least one set of teeth of the mounting member when the first pivot pin is in the second position.

10. The surgical stapling device of claim 8, wherein the second engagement member engages the at least one set of teeth of the loading unit when the second pivot pin is in the second position.

11. The surgical stapling device of claim 10 further including a biasing member, the biasing member urging the first and second pivot pins into their respective first positions.

12. The surgical stapling device of claim 11, wherein the biasing member is a spring.

13. The surgical stapling device of claim 11, wherein the first and second pivot pins transition from the first position to the second position through by manipulating the articulation actuator.

60. The surgical stapling device of claim 9, wherein the carrier portion further includes at least one cutout and at least one slot, the at least one slot being configured and dimensioned to releasably receive a tab of at least one channel cover, the at least one channel cover defining at least one cable channel.

61. The surgical stapling device of claim 60, wherein the knife bar has at least one hole configured and dimensioned to receive the at least one cable.

62. The surgical stapling system of claim 61, wherein the at least one cable includes a firing cable having first and second ends, and a retraction cable having first and second ends.

63. The surgical stapling device of claim 62 further including a sled operatively engaged with the knife bar.

64. The surgical stapling system of claim 63, wherein the firing cable operatively engages the guide cap, the carrier portion, the sled, and the at least one slot of the knife bar.

65. The surgical stapling system of claim 64, wherein the retraction cable operatively engages the at least one slot of the bar.

66. The surgical stapling system of claim 65, wherein the first and second ends of the firing cable traverse the throughbore of the guide cap and the at least one track of the guide cap, the first and second ends of the firing cable extending proximally through the al least one cable channel and traversing the at one cutout of the carrier portion.

14. A surgical stapling device comprising:

a handle portion including an articulation actuator and a drive mechanism;

a trigger operatively connected to the handle portion;

an elongated body portion extending distally from the handle;

a pivot member connected to the elongated body portion adjacent a distal end thereof, the pivot member being configured and dimensioned to pivot about at least one axis and including at least one pulley;

a loading unit pivotably connected to the pivot member; and

at least one cable having first and second ends.

15. The surgical stapling device of claim 14, wherein the elongated body portion includes at least one articulation link.

16. The surgical stapling device of claim 15, wherein the at least one articulation link is operably connected to the loading unit.

17. The surgical stapling device of claim 16, wherein the first and second ends of the at least one cable are attached to the at least one articulation link.

18. The surgical stapling device of claim 17 further including a mounting member.

19. The surgical stapling device of claim 18, wherein the at least one cable traverses the pivot member, the mounting member, and the at least one pulley.

20. The surgical stapling device of claim 19, wherein the at least one pulley includes a first pulley, a second pulley, a third pulley, and a fourth pulley.

21. The surgical stapling device of claim 20, wherein the at least one cable includes a first articulation cable having first and second ends, and a second articulation cable having first and second ends.

22. The surgical stapling device of claim 21, wherein the at least one articulation link includes a first articulation link, a second articulation link, a third articulation link, and a fourth articulation link.

23. The surgical stapling device of claim 22, wherein the first end of the first articulation cable is removably attached to the first articulation link and the second end of the first articulation link is removably attached to the second articulation link.

24. The surgical stapling device of claim 23, wherein the first end of the second articulation cable is removably attached to the third articulation link and the second end of the second articulation link is removably attached to the fourth articulation link.

25. The surgical stapling device of claim 24, wherein the first articulation cable traverses the mounting member, the pivot member, the first pulley, the second pulley, and the third pulley.

26. The surgical stapling device of claim 24, wherein the second articulation cable traverses the mounting member, the pivot member, the second pulley, the third pulley, and the fourth pulley.

27. A surgical stapling device comprising:

a handle portion including a handle body and a drive mechanism, the handle body including at least one elongated rib, the drive mechanism being configured and dimensioned to selectively engage a firing rack and a retraction rack;

a trigger operatively connected to the handle portion;

an elongated body portion secured to the handle portion, the elongated body portion having proximal and distal ends and extending distally from the handle; and

a tool assembly pivotably connected to the pivot member and configured to grasp tissue wherein grasping, firing, and retraction is accomplished by operation of the trigger.

28. The surgical system of claim 27, wherein the drive mechanism includes a barrel assembly having a barrel assembly body portion, a firing pawl, a retraction pawl, and a grasper pawl.

29. The surgical system of claim 28 further including a biasing member.

30. The surgical system of claim 29, wherein the biasing member is a spring.

31. The surgical system of claim 29, wherein the firing rack includes at least first and second surfaces, the first surface including a first set of gear teeth and the second surface including a second set of gear teeth, the first set of gear teeth being engagable with the firing pawl.

32. The surgical system of claim 31, wherein the firing pawl is urged into operative engagement with the firing rack by the biasing member.

33. The surgical system of claim 29, wherein the retraction rack includes first and second surfaces, the first surface including a first set of gear teeth and the second surface including a second set of gear teeth, the first set of gear teeth being engagable with the retraction pawl.

34. The surgical system of claim 33, wherein the retraction pawl is configured to be urged into operative engagement with the retraction rack by the biasing member.

35. The surgical system of claim 34, wherein the barrel assembly further comprises a first shift ring assembly slidably positioned about the barrel assembly body portion, the first shift ring assembly including an outer ring and an inner ring, the outer ring and the inner ring each being adapted to transition from an advanced position to a retracted position, the outer ring and the inner ring being operatively connected such that the inner ring may transition from an advanced position to a retracted position as the outer ring transitions from the advanced position to the retracted position.

36. The surgical system of claim 35, wherein the firing pawl is in operative engagement with the firing rack when the outer ring is in the advanced position, the firing pawl being disengaged from the firing rack when the outer ring is in the retracted position, the retraction pawl being in operative engagement with the retraction rack when the outer ring is in the retracted position, the retraction pawl being disengaged from the retraction rack when the outer ring is in the advanced position.

37. The surgical system of claim 35, wherein the outer ring includes at least one rib, the at least one rib defining at least one slot dimensioned to slidably receive the at least one elongated rib in the handle body.

38. The surgical system of claim 37, wherein the outer ring further includes at least one prong.

39. The surgical system of claim 38, wherein the handle body includes at least one slot configured and dimensioned to receive the at least one prong.

40. The surgical system of claim 35, wherein the outer ring includes at least one spring arm, the at least one spring arm including an abutment member and a protrusion.

41. The surgical system of claim 40, wherein the inner ring includes a recess configured and dimensioned to releasably receive the protrusion.

42. The surgical system of claim 41, wherein the handle body includes at least one cam surface configured and dimensioned to operatively engaged the abutment member.

43. The surgical system of claim 42, wherein the at least one cam surface includes at least one raised surface and at least one recess, the at least one raised surface configured and dimensioned to engage the abutment member.

44. The surgical system of claim 43, wherein the firing pawl includes a first cam slot configured and dimensioned to receive a first pin, the first pin traversing the inner ring, and the retraction pawl includes a second cam slot configured and dimensioned to receive a second pin, the second pin traversing the inner ring.

45. The surgical system of claim 35, wherein the firing pawl is in operative engagement with the firing rack when the outer ring is in the advanced position, the firing pawl being disengaged from the firing rack when the outer ring is in the retracted position.

46. The surgical system of claim 35, wherein the retraction pawl is in operative engagement with the retraction rack when the outer ring is in the retracted position, the retraction pawl being disengaged from the retraction rack when the outer ring is in the advanced position.

47. The surgical system of claim 27, wherein the barrel assembly further comprises a second shift ring assembly slidably positioned about the barrel assembly body portion, the second shift ring assembly including an outer ring and an inner ring, the outer ring and the inner ring each being adapted to transition from an advanced position to a retracted position, the outer ring and the inner ring being operatively connected such that the inner ring may transition from an advanced position to a retracted position as the outer ring transitions from the advanced position to the retracted position.

48. The surgical system of claim 47, wherein the grasper pawl is in operative engagement with the firing rack when the outer ring is in the advanced position and is disengaged from the firing rack when the outer ring is in the retracted position.

49. The surgical system of claim 48, wherein the outer ring includes at least one rib, the at least one rib defining at least one slot dimensioned to slidably receive the at least one elongated rib.

50. The surgical system of claim 49, wherein the outer ring further includes at least one prong.

51. The surgical system of claim 50, wherein the handle body includes at least one slot configured and dimensioned to receive the at least one prong.

52. The surgical system of claim 47, wherein the outer ring includes at least one spring arm, the at least one spring arm including an abutment member and a protrusion.

53. The surgical system of claim 52, wherein the inner ring includes a recess configured and dimensioned to releasably receive the protrusion.

54. The surgical system of claim 53, wherein the handle body includes at least one cam surface configured and dimensioned to operatively engaged the abutment member.

55. The surgical system of claim 54, wherein the at least one cam surface includes at least one raised surface and at least one recess, the at least one raised surface configured and dimensioned to engage the abutment member.

56. The surgical system of claim 55, wherein the grasper pawl includes a cam slot configured and dimensioned to receive a pin, the pin traversing the inner ring.

57. The surgical system of claim 56, wherein the grasper pawl further includes a projection configured and dimensioned to be received by a cutout in the firing rack.

58. A surgical stapling device comprising:

a handle portion including;

a trigger operatively connected to the handle portion;

an elongated body portion extending distally from the handle portion;

a carrier portion operatively connected to the elongated body portion and including a tool assembly, the tool assembly including a cartridge assembly housing staples and an anvil assembly; and

a cable drive system including at least one cable, the at least one cable being connected to the handle portion and configured for approximating the cartridge assembly and the anvil assembly and firing the staples.

59. The surgical stapling device of claim 58, wherein the carrier portion further includes a guide cap positioned adjacent the distal end thereof, the guide cap including at least one track configured and dimensioned to receive the at least one cable, the guide cap further including a throughbore.

67. A surgical stapling device comprising:

a handling portion with a pivotable articulation actuator;

an elongated body portion extending distally from the handle portion;

a pivot member connected to the body portion adjacent a distal end of the body portion so that the pivot member is pivotable a first pivot axis;

a tool assembly pivotably connected to the pivot member for pivoting about a second pivot axis, the tool assembly including an anvil and a cartridge assembly having a staple cartridge; and

a first cable and a second cable connected to the articulation actuator, extending through the pivot member, and connected to the tool assembly, the articulation actuator being pivotable to pull on at least one of the first and second cable to pivot the tool assembly about the first pivot axis and the second pivot axis.

68. The surgical stapling device according to claim 67, wherein the cartridge assembly includes a carrier portion for receiving the staple cartridge.

69. The surgical stapling device according to claim 68, wherein the carrier portion is configured to receive the first and second cables.

70. The surgical stapling device according to claim 67, further comprising a mounting member at the distal end of the body portion, the mounting member defining first teeth.

71. The surgical stapling device according to claim 70, wherein the pivot member has a first engagement member for engaging the first teeth to lock the angular position of the pivot member about the first pivot axis.

72. The surgical stapling device according to claim 68, wherein the cartridge assembly has second teeth.

73. The surgical stapling device according to claim 72, wherein the pivot member has a second engagement member for engaging the second teeth to lock the angular position of the tool assembly about the second pivot axis.

74. The surgical stapling device according to claim 67, wherein the pivot member has a first and a second pulley.

75. The surgical stapling device according to claim 74, wherein the first cable extends through the pivot member, around the first pulley, through the cartridge assembly and then around the second pulley.

76. The surgical stapling device according to claim 75, wherein the first cable has a first end and a second end, and applying a force to the first and second ends of the first cable directed proximally pivots the tool assembly about the second pivot axis in a first direction.

77. The surgical stapling device according to claim 74, wherein the second cable extends through the pivot member, around the first pulley, through the cartridge assembly and then around the second pulley.

78. The surgical stapling device according to claim 77, wherein the second cable has a first end and a second end, and applying a force to the first and second ends of the second cable directed proximally pivots the tool assembly about the second pivot axis in a second direction.

79. The surgical stapling device according to claim 78, wherein the pivot member has a third pulley and the first cable extends around the third pulley.

80. The surgical stapling device according to claim 79, wherein the pivot member has a fourth pulley and the second cable extends around the fourth pulley.

81. The surgical stapling device according to claim 80, wherein pulling on the first_ends of the first and second cables pivots the pivot member around the first pivot axis in a first direction.

82. The surgical stapling device according to claim 81, wherein pulling on the second_ends of the first and second cables pivots the pivot member around the first pivot axis in a second direction.

83. The surgical stapling device according to claim 78, wherein the first and second ends of the first and second cables are operatively connected to a pivoting actuator on the handle portion.

84. A surgical stapling device comprising:

a handle portion;

an elongated body portion extending distally from the handle portion;

a pivot member connected to the body portion adjacent a distal end of the body portion so that the pivot member is pivotable about a pivot axis;

a tool assembly connected to the pivot member, the tool assembly including an anvil and a cartridge assembly having a staple cartridge;

at least one cable connected to the handle portion, extending through the pivot member; and

a knife bar having at least one hole for receiving the at least one cable.

85. The surgical stapling device according to claim 84, wherein the at least one cable includes a firing cable, and the tool assembly includes a guide cap at a distal end of the tool assembly for guiding the firing cable so that the knife bar is pulled distally through the tool assembly.

86. The surgical stapling device according to claim 85, wherein the at least one cable includes a retraction cable for pulling the knife bar proximally through the tool assembly.

87. The surgical stapling device according to claim 84, further comprising an actuation sled configured for engagement with the tool assembly, the knife bar being positioned proximal to the actuation sled.