SURGICAL STAPLERS WITH TISSUE PROTECTION AND RELATED METHODS

• US 20120255986A1
• Filed: 03/02/2012
• Published: 10/11/2012
• Est. Priority Date: 04/07/2011
• Status: Active Grant

• Current Assignee: Wake Forest University Health Sciences
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Petty, John K., Neff, Lucas P.
• Granted Patent: US 9,370,362 B2
• Time in Patent Office: Days
• US Class Current: 227/176.1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/072 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 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07228 Arrangement of the staples
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

Surgical staplers include: (a) a stapler head having opposed first and second elongate jaws with opposing proximal and distal end portions; (b) a staple cartridge held in at least one of the first and second jaws, the stapler cartridge configured to concurrently deliver a plurality of parallel rows of staples; and (c) a tissue protection segment held in a proximal portion of at least one of the first and second jaws. The jaws are configured to close against target tissue and, at stapler firing, staples are delivered to a subset of tissue held inside the jaws so that tissue held by the tissue protection segment adjacent the proximal end portion of the stapler is not stapled.

Claims

1. A surgical stapler, comprising:

a stapler head having opposed first and second elongate jaws with opposing proximal and distal end portions;

a staple cartridge held in at least one of the first and second jaws, the stapler cartridge configured to concurrently deliver a plurality of parallel rows of staples from a length of the cartridge;

a tissue protection segment held in a proximal portion of at least one of the first and second jaws,

wherein, the jaws are configured to close against target tissue and, at stapler firing, staples are delivered to a subset of tissue held inside the jaws so that tissue held by the tissue protection segment adjacent the proximal end portion of the stapler is not stapled.

2. The stapler of claim 1, wherein the tissue protection segment is longitudinally spaced apart from staples held in the staple cartridge.

3. The stapler of claim 1, wherein the tissue protection segment is formed by or held in the stapler cartridge.

4. The stapler of claim 1, wherein the tissue protection segment is defined by at least one inner surface of the first and/or second jaw of the stapler head.

5. The stapler of claim 1, wherein the jaws have a straight configuration arranged to be substantially parallel with or axially aligned with a centerline of a shaft extending from the staple head, and wherein at least one of the jaws has an arched leading edge portion.

6. The stapler of claim 1, wherein the tissue protection segment is configured as an interior facing recess configured to inhibit tissue crushing for tissue held thereat when the jaws close.

7. The stapler of claim 1, wherein the tissue protection segment comprises at least one resilient member configured to translate transversely outward in a direction substantially orthogonal to a longitudinally extending centerline of a shaft of the stapler when the jaws close against tissue to thereby inhibit tissue crushing for tissue held thereat when the jaws close.

8. The stapler of claim 1, wherein the tissue protection segment has a length of between about 10-30 mm.

9. The stapler of claim 1, wherein the stapler cartridge is configured to deliver staples from a forward portion having a length of between about 30-80 mm.

10. The stapler of claim 1, further comprising a cutting member configured to extend and retract from one of the first or second jaws, wherein the cutting member is configured to cut only tissue proximate the stapled tissue held against the staple cartridge.

11. The stapler of claim 10, wherein the cutting member is configured to pivotably translate upward or downward to be aligned with an axially extending centerline of the stapler head to cut tissue between two adjacent stapled rows of tissue.

12. The stapler of claim 1, wherein the tissue protection segment comprises a scalloped interior-facing surface.

13. The stapler of claim 1, wherein, when the jaws close against target tissue held by the tissue protection segment adjacent the proximal end portion of the stapler, the tissue thereat is held snugly without introducing undue compressive injury.

14. The stapler of claim 1, further comprising an on-board circuit configured to direct the stapler to operate in a tissue protection mode or in a full length stapling mode, wherein the circuit is in communication with a staple drive mechanism that delivers the staples from the staple cartridge, wherein, in the tissue protection mode, the stapler cartridge delivers staples only from a distal to medial portion of the stapler head, and wherein in the full length stapling mode, the staple cartridge delivers staples from the proximal portion of the stapler head as well as the distal and medial portions.

15. The stapler of claim 1, wherein the stapler head is configured to releasably interchangeably hold a first stapler cartridge that includes the tissue protection segment and a second stapler cartridge that is devoid of the tissue protection segment.

16. A gastrointestinal treatment, comprising:

providing a stapler with a staple head having first and second opposed jaws, with at least one of the jaws having a tissue protection segment proximate a staple cartridge;

inserting the stapler into a patient in an inferior to superior direction so that one jaw resides over one outer wall of the stomach and the other jaw resides under an opposing outer wall of the stomach;

closing the jaws against the stomach whereby an inferior portion of the stomach is held in the tissue protection portion of the stapler head and a more superior portion of the stomach is held against the stapler cartridge, wherein tissue held against the tissue protection segment is protected from undue injury;

then

applying a plurality of parallel rows of staples to only the more superior portion of the stomach and not to tissue held in the tissue protection segment of the stapler jaws; and

cutting between two adjacent rows of stapled tissue to divide the stomach tissue.

17. The method of claim 16, wherein the applying and cutting steps are carried out to form a first opening through the stomach with a stapled perimeter of tissue.

18. The method of claim 17, further comprising:

applying staples to additional tissue above the first opening in a length sufficient to reach a junction of a natural esophagus at an upper portion of the stomach; and

cutting the additional stapled tissue to form a neo-esophagus.

19. The method of claim 17, further comprising using a lower portion of the stapled tissue of the first opening to form part of a base portion of a neo-esophagus and/or an upper wall of a junction merging with a common channel.

20. A method of applying staples to a limited region of tissue, comprising:

inserting a surgical stapler into a patient, the surgical stapler having first and second cooperating opposed jaws;

closing the jaws about a target region of tissue;

then

applying a plurality of rows of staples to a first sub-portion of tissue held between the jaws while protecting a second sub-portion of tissue from compressive injury; and

cutting between two adjacent parallel rows of applied staples to form an opening with a stapled perimeter of divided tissue that is spaced apart from but proximate to the second sub-portion of tissue.

21. The method of claim 20, wherein the target tissue is stomach tissue.

22. The method of claim 20, wherein the target tissue is esophageal tissue.

23. A computer program product for bimodal operation of a surgical stapler, the computer program product comprising:

a computer readable non-transitory storage medium having computer readable program code embodied in the medium, the computer-readable program code comprising;

computer readable program code that allows a user to select whether to operate in a full staple mode or in a tissue protection mode; and

computer readable program code that communicates with a loaded cartridge and/or a staple drive mechanism to selectively deliver a full length of staples in the full staple mode or a subset of a length of staples in the tissue protection mode.