Pliers type surgical stapler for joining disunited skin or fascia

• US 3,873,016 A
• Filed: 11/30/1973
• Issued: 03/25/1975
• Est. Priority Date: 11/30/1973
• Status: Expired due to Term

• Current Assignee: Meyer Fishbein
• Original Assignee: Meyer Fishbein
• Inventors: Fishbein, Meyer
• Primary Examiner(s): Custer, Jr., Granville Y.
• Application Number:
  US05/420,661
• Time in Patent Office: 480 Days
• Field of Search: 227/19,83,85,87,108,120,121,123,124,144
• US Class Current: 227/83
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 2017/2837 with a locking ratchet
• CPC Class Codes: B25C 5/11 operated by manual or foot power

Abstract

A plier-like implement for surgeon'"'"''"'"'s use in stapling together disunited skin or fascia. The staple driving ram in a staple guide and an anvil operate from the outside of the severed skin. The ram is movable by jaws of a pliers-like instrument in a plane at right angles to the skin to drive the staple into the skin and thereafter close it. A ratchet means is provided to prevent the pliers handles from reverse or opening movement once they have begun their closing movement, until the staple has been installed across the parted skin, at which time the staple is released by the implement, and the ratchet means then becomes inoperative to stop opening movement of the handles. This prevents the handles from opening, once a staple has been pushed a short distance down the guide, but is not yet ejected. Thus, a second staple is prevented from being fed into the guide while the one ahead of it is still in it.

Claims

1. A surgical stapling instrument for applying staples to unite skin or fascia, comprising:

a pair of horizontally elongated pliers-like members pivoted together between their ends at a horizontal pivot axis and formed to provide on one side of said axis upper and lower pliers-like handles and, on the other side of said axis, corresponding lower and upper jaw-like arms which close and open with jaw-like movements as the handles are closed and opened;

a staple housing fixed on said lower arm generally longitudinally thereof having a staple feedway extending longitudinally therethrough, said feedway terminating in an exit aperture facing generally in a direction away from said pivot axis;

spring means for urging a stack of staples along said feedway and out of said exit aperture;

an elongate, generally vertical staple and ram guide mounted on said lower arm over said feedway exit aperture and extending upwardly from said lower arm adjacent and past the extremity of said upper arm, said guide having opposed, spaced, forward and rearward walls defining a generally vertical guideway for a single staple and a ram thereabove, said exit aperture of said feedway opening into said guideway in opposition to the inner face of said forward wall, whereby staples from said feedway may be moved by the pressure of said spring through said exit opening and into said guideway and be spring-pressed against said inner face, a ram vertically reciprocable in said guideway, an operative connection between said upper pliers arm and said ram, whereby closure of said handles drives said ram downwarDly in said guideway to engage and lower the staple, said guideway extending downwardly through the lower end of said guide, a staple forming anvil supported on said end of said lower arm in alignment with said guideway; and

forming means on the lower end of said ram cooperable with said anvil to progressively close said staple around said anvil as said handles are closed, said anvil being dimensioned for disengagement from within the staple when the staple has been closed thereabout.

2. The instrument according to claim 1, wherein:

said forward wall of said guide has said guideway sunk therein immediately inwardly of a substantially plane backface thereof, and said ram is flat and of a thickness to be slidingly receivable in said guideway inside the plane of said substantially plane back face of said forward wall, and said rearward wall of said guide being substantially the thickness of a staple wire, and substantially flat, and having a staple passing window registered with said exit aperture of said housing to pass staples from said exit aperture to said guideway, and to contain one staple until the stable ahead is displaced below said window by said ram and the ram is retracted above said window.

3. The subject matter according to claim 1, including:

an extension arm supported by said lower arm and housing for positioning said anvil a predetermined distance downward therefrom.

4. The subject matter of claim 1, wherein said operative connection between said upper pliers arm and said ram comprises a pin projecting from the extremity of said upper arm engaged loosely in an aperture in said ram.

5. The subject matter according to claim 1, wherein the staple feedway in said staple housing is substantially perpendicular to said vertical guideway, and at an acute angle relative to a line from said exit aperture of said feedway to said pivot axis.

6. The instrument according to claim 2, wherein said rearward wall and said forward wall extend downwardly to the lower boundary of said anvil, and have notches in their lower edges to accommodate said anvil, said notch in said forward wall being spaced from said anvil by a clearance distance sufficient for passage of the upper portion of a closed staple therethrough.

7. The instrument according to claim 2, including also:

parallel staple support rails positioned in the staple feedway for engaging staple preforms consisting of a crown and legs bent at right angles thereto, said rails having end portions projecting outside said feedway and terminating within the confines of said staple passing window in said rearward wall.

8. The instrument according to claim 1, including also ratchet means acting during closing of the handles to permit reverse travel of the handles sufficiently for a retraction of the ram to a position clearing the exit aperture of the staple feedway.

9. The instrument according to claim 1, including a ratchet means on one of said handles affording a succession of ratchet teeth, and a spring biased pawl pivotally mounted on the other of said handles engageable successively with said ratchet teeth as the handles are closed, in order to lock said handles against opening movement after engagement with said ratchet teeth, said pawl being rockable, after clearing the last of said succession of ratchet teeth, to pass each of said teeth in succession upon subsequent opening of said handles.

10. The instrument according to claim 1, wherein:

said forward wall of said guide has said guideway sunk therein immediately inwardly of a substantially plane backface thereof, and said ram is flat and of a thickness to be slidingly receivable in said guideway inside the plane of said substantially plane back face of said forward wall, and said rearward wall of said guide being substantially the thickness of a staple wire, and substantially flat, having a staple passing window registered with said exit aperture of said housing to pass staples from said exit aperture to said guideway, and to contain one staple until the staple ahead is displaced below said window by said ram, and means for constraining said ram to complete its ram driving and forming stroke before it can be retracted above said window.