Endocutter With Staple Feed

• US 20090065552A1
• Filed: 09/06/2007
• Published: 03/12/2009
• Est. Priority Date: 09/06/2007
• Status: Active Grant

• Current Assignee: Touchstone International Medical Science Co. Ltd
• Original Assignee: Cardica Incorporated
• Inventors: Knodel, Bryan D., Hausen, Bernard A., Clauson, Luke W.
• Granted Patent: US 7,988,026 B2
• 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 17/068 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 17/0686 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 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1222 Packages or dispensers therefor clip magazines incorporated in a clip-applying instrument A61B17/128; for surgical articles A61B50/30
• CPC Class Codes: A61B 17/295 combined with cutting implements
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07228 Arrangement of the staples
• CPC Class Codes: A61B 2017/07235 containing different staples, e.g. staples of different shapes, sizes or materials
• 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 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/144 : Wire
• CPC Class Codes: A61B 2018/1452 : including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 2090/037 : with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes

Abstract

A surgical endocutter may include an end effector, at least one feeder belt that extends at least partially into the end effector; and two or more staples, where each staple has a first end frangibly connected to a corresponding feeder belt and a second, free end, and where the staples form at least one row. The endocutter may be used to treat a patient by inserting the end effector into the body of a patient through an opening such as a trocar port, engaging tissue with the end effector, stapling tissue along two staple lines with the end effector; cutting tissue between the staple lines with the end effector, releasing the tissue from the end effector, and repeating the holding, stapling and engaging on tissue at a different location within the body of the patient without removing the end effector from within the body of the patient.

Claims

1. A surgical endocutter, comprising:

a staple holder;

at least one feeder belt having two lateral edges, at least part of at least one said feeder belt extending into said staple holder; and

a plurality of staples, wherein each said staple comprises a first end frangibly connected to a corresponding said feeder belt and a second free end; and

wherein said staples form at least one row, each said row including at least two said staples.

2. The surgical endocutter of claim 1, incorporating by reference all of the limitations of claim 1, and wherein each said staple is oriented generally perpendicular to the corresponding said feeder belt.

3. The surgical endocutter of claim 1, incorporating by reference all of the limitations of claim 1, and wherein a plurality of said staples in at least one said row are organized into a plurality of groups, and wherein the corresponding said feeder belt includes blanks between adjacent said groups.

4. The surgical endocutter of claim 1, incorporating by reference all of the limitations of claim 1, and wherein at least one row of staples is frangibly connected to a corresponding said lateral edge of the corresponding said feeder belt.

5. The surgical endocutter of claim 1, incorporating by reference all of the limitations of claim 1, and wherein at least one row of staples is frangibly connected to the corresponding said feeder belt along a line located between said lateral edges of said feeder belt.

6. The surgical endocutter of claim 1, incorporating by reference all of the limitations of claim 1, and wherein at least one said row of said staples is staggered relative to at least one other said row of said staples.

7. A surgical endocutter, comprising:

a staple holder;

at least one feeder belt, wherein at least part of at least one said feeder belt extends into said staple holder;

a plurality of staples frangibly connected to each said feeder belt, said staples organized into at least one generally linear row on each said feeder belt;

a plurality of wedges, wherein each wedge is movable from an initial position to a second position generally linearly along a corresponding said row of staples to deform said staples and separate said staples from the corresponding said feeder belt.

8. The surgical endocutter of claim 7, incorporating by reference all of the limitations of claim 7, and wherein said wedges are movable along a fixed distance.

9. The surgical endocutter of claim 7, incorporating by reference all of the limitations of claim 7, and wherein said wedges are movable along a selectable distance.

10. The surgical endocutter of claim 7, incorporating by reference all of the limitations of claim 7, and further comprising a knife positioned between and movable along with two said wedges.

11. The surgical endocutter of claim 7, incorporating by reference all of the limitations of claim 7, and wherein said staple holder includes a curved nose defined therein and wherein each said feeder belt is configured to be advanced around a corresponding said nose;

and wherein said wedges are movable back to said initial position before said feeder belt is advanced.

12. The surgical endocutter of claim 7, incorporating by reference all of the limitations of claim 7, and further comprising at least one sliding clamp corresponding to at least one said feeder belt, wherein said sliding clamp is movable into contact with said feeder belt.

13. The surgical endocutter of claim 12, incorporating by reference all of the limitations of claim 12, and wherein at least one sliding clamp comprises an upper clamp and a lower clamp in contact with one another, each of which includes a cam surface defined thereon, wherein at least one of said upper clamp and said lower clamp is slidable relative to the other such that engagement between said cam surfaces causes said upper clamp to move into contact with said feeder belt.

14. A surgical endocutter, comprising:

a staple holder including a space defined therein;

a shaft attached to said staple holder, said shaft including a lumen defined therethrough;

a handle attached to said shaft;

at least one feeder belt having a plurality of staples frangibly connected thereto, wherein at least part of at least one said feeder belt is positioned within said space defined in said staple holder and within said lumen of said shaft, such that said staples are located within said staple holder and within said shaft.

15. The surgical endocutter of claim 14, incorporating by reference all of the limitations of claim 14, and wherein said staple holder is configured to deploy less than all of said staples, and wherein a remainder of said staples then may be advanced into said space in said staple holder.

16. The surgical endocutter of claim 14, incorporating by reference all of the limitations of claim 14, and wherein said feeder belt extends into said handle.

17. The surgical endocutter of claim 16, incorporating by reference all of the limitations of claim 16, and wherein said feeder belt is a continuous loop.

18. The surgical endocutter of claim 14, incorporating by reference all of the limitations of claim 14, and wherein said staple holder is nondetachable from said shaft.

19. A surgical method of treating tissue within the body of a patient, comprising:

providing an endocutter having an end effector;

inserting said end effector into the body of a patient through an opening;

engaging tissue with said end effector;

stapling tissue along two staple lines with said end effector;

cutting tissue between the staple lines with said end effector;

releasing the tissue from said end effector; and

repeating said engaging, stapling, cutting and releasing within the body of the patient on tissue at a different location within the body of the patient while maintaining said end effector within the body of the patient.

20. The surgical method of claim 19, incorporating by reference all of the limitations of claim 19, and wherein said opening is no greater than 10 millimeters in diameter.

21. The surgical method of claim 19, incorporating by reference all of the limitations of claim 19, and wherein the length of said staple lines is selectable.

22. The surgical method of claim 19, incorporating by reference all of the limitations of claim 19, and wherein said end effector includes a knife;

wherein said cutting is performed by moving said knife upward and then proximally.

23. A surgical method of treating tissue within the body of a patient, comprising:

providing an endocutter having an end effector, the end effector comprising at least one feeder belt movable relative thereto;

said feeder belt including a plurality of staples frangibly connected thereto;

placing said end effector adjacent to tissue;

deforming at least one said staple into tissue;

separating at least one said deformed staple from said feeder belt;

advancing said feeder belt; and

repeating said placing, deploying and separating.

24. The surgical method of claim 23, incorporating by reference all of the limitations of claim 23, and wherein said end effector includes a nose defined therein around which said feeder belt is routed;

and wherein said moving includes advancing said feeder belt about said nose.

25. The surgical method of claim 23, incorporating by reference all of the limitations of claim 23, and further comprising clamping said feeder belt before said deforming and unclamping said feeder belt before said advancing.

26. The surgical method of claim 23, incorporating by reference all of the limitations of claim 23, and further comprising providing feedback from said end effector as to the location of said feeder belt, wherein said advancing is performed based on said feedback.

27. A surgical method of treating tissue within the body of a patient, comprising:

providing an endocutter comprising an end effector, comprising at least one wedge fixed in place therein, and a feeder belt movable relative to said fixed wedge, said feeder belt including a plurality of staples frangibly connected thereto;

placing said end effector adjacent to tissue to be stapled; and

moving said feeder belt relative to said fixed wedge, wherein said motion causes the distalmost said staple aligned with said fixed wedge to encounter said fixed wedge, deform, and separate from said feeder belt.

28. The surgical method of claim 27, incorporating by reference all of the limitations of claim 27, and wherein said moving comprises moving said feeder belt to cause a plurality of said staples generally aligned with said fixed wedge to sequentially encounter said fixed wedge, while maintaining said end effector within the body of the patient.

29. A surgical method of treating a plurality of discrete tissue structures within the body of a patient in which an incision has been made, comprising:

providing an endocutter that holds a plurality of staples;

inserting the distal end of said endocutter through the incision in the patient; and

transecting a plurality of the discrete tissue structures with the distal end of said endocutter, without withdrawing the distal end of said endocutter through the incision in the patient and without inserting additional staples into said endocutter.

30. A surgical endocutter, comprising:

a carrier;

a plurality of staples frangibly connected to said carrier; and

at least one wedge movable relative to said staples;

wherein said wedge both engages a plurality of said staples and disconnects a plurality of said staples from said carrier in a single continuous motion of said wedge.

31. The surgical endocutter of claim 30, incorporating by reference all of the limitations of claim 30, wherein at least one said wedge serially engages said staples and serially disconnects said staples from said carrier.