Surgical stapling instrument and method

• US 4,198,982 A
• Filed: 03/31/1978
• Issued: 04/22/1980
• Est. Priority Date: 03/31/1978
• Status: Expired due to Term

• Current Assignee: Memorial Hospital For Cancer & Allied Diseases Incorporated
• Original Assignee: Memorial Hospital For Cancer & Allied Diseases Incorporated
• Inventors: Fortner, Joseph G., Papachristou, Dimitrios
• Primary Examiner(s): Pellegrino, Stephen C.
• Application Number:
  US05/892,363
• Time in Patent Office: 753 Days
• Field of Search: 128/334 R, 128/334 C, 128/305, 128/337, 227/8, 227/19, 227/76
• US Class Current: 227/179.1
• 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

Abstract

A method and a surgical stapling instrument for the stapling together of the free ends of two hollow organs. The instrument comprises an elongated tubular body, a base unit concentrically connected to the body and a head unit mounted to the body and concentric therewith for relative movement with respect to the head unit over a range wherein the inner end thereof is spaced apart from the outer end of the base unit and wherein the inner end of the head unit is substantially adjacent to the outer end of the base unit. Holding elements are mounted on the base and head units and project outwardly from the outer and inner ends thereof respectively to extend between the base and head units and are disposed inwardly from the outer periphery of the ends of the base and head units for holding the free ends of the hollow organs inwardly of actuatable stapling and cutting mechanisms to maintain the free ends in position on the base and head portions while the base and head units are moved towards one another. The method includes inserting the instrument into an incision in one hollow organ with the base and head units substantially adjacent until the head unit is inserted into the free end of the other organ, separating the two units until the base unit is in the free end of the one organ, connecting the free ends to the holding elements, moving the head and base units towards each other until substantially adjacent, actuating the stapling and cutting mechanisms, separating the two units and withdrawing the instrument from the organs.

Claims

1. A surgical stapling instrument for the stapling together of the free ends of two hollow organs comprising:

a. an elongated tubular body;

b. a base unit concentrically connected to the body, said base unit having a substantially cylindrical outer end portion which is positionable in one hollow organ to dispose the outer end portion thereof adjacent to the free end of the one hollow organ;

c. a head unit having a substantially cylindrical inner end portion and means mounting the head unit concentric to the body unit with the inner end thereof face-to-face with the outer end of the body unit and for relative movement with respect to the body unit over a range wherein the inner end thereof is spaced apart from the outer end of the base unit and wherein the inner end of the head unit is substantially adjacent to the outer end of the base unit, the head unit positionable in the other hollow organ when the base unit is positioned in the one hollow organ, to dispose the inner end portion thereof adjacent to the free end of the other hollow organ;

d. actuatable stapling means comprising a first portion thereof disposed in the base unit, a second portion thereof aligned with the first portion and disposed in the head unit, the first and second stapling portions disposed concentric with the tubular body and in the annular area inward of the outer periphery of the outer and inner ends of the base and head units respectively, for stapling together the free ends of the hollow organs, upon actuation, when the base and head units are substantially adjacent;

e. means mounted on the base and head units and projecting outwardly from the outer and inner ends thereof, respectively, to extend therebetween an disposed in the annular area inwardly of the annular area of the first and second stapling portions for holding the free ends of the hollow organs inwardly of the stapling portions to maintain same in position on the base and head units during the relative movement of the base and head units toward each other and during the actuation of the stapling means;

f. actuatable cutting means having a first portion thereof disposed in the base unit and a second portion aligned with the first portion and disposed in the head unit, the first and second cutting portions disposed concentric with the tubular body and in the annular area between the holding means and the stapling means for cutting off excess tissue inwardly of the staples, upon actuation, when the base and head units are substantially adjacent; and

g. manual means for actuating the stapling means and the cutting means.

2. The instrument according to claim 1, wherein the holding means comprise a plurality of barbed spear-like projecting elements on the base and head units.

3. The instrument according to claim 2, wherein the projecting elements on the base and head units are radially aligned so as to be interdigited and overlap longitudinally when the base and head units are substantially adjacent to effect the reception of each element through both free ends.

4. The instrument according to claim 2, wherein the base and head units each have mounting bores therein and the holding means further comprises a plurality of mounting members each for holding one projecting element at one end and each having the other end mountable in one mounting bore.

5. The instrument according to claim 4, wherein the holding means further comprises means for releasably retaining each mounting member in its mounting bore.

6. The instrument according to claim 1, wherein the second stapling portion comprises two concentric rows of staple anvils, the inner row comprising a plurality of evenly distributed anvils and the outer row comprising a plurality of evenly distributed anvils each overlapping two adjacent anvils in the inner row and the first stapling portion comprises two concentric rows of staple chambers, each row having a plurality of chambers and each chamber receptive of one staple and wherein the chambers and anvils are aligned with each other to effect the closing of the staple in response to the staple being foced against its associated anvil and wherein the manual means includes means for pushing the staples from the chambers and into the anvil when the base and head units are substantially adjacent.

7. The instrument according to claim 1, wherein the first cutting portion comprises a cylindrical knife blade and wherein the second cutting portion comprises an annular resilient cutting pad and wherein the manual means comprises means for moving the knife from a first position wherein the blade edge is at the outer end of base unit to a second position wherein the knife edge is against the pad when the base and head portions are substantially adjacent.

8. The instrument according to claim 7, wherein the knife blade is removably mounted in the base unit.

9. In a method for surgically stapling together the free ends of two hollow organs, of the type wherein a surgical stapling instrument is provided having an elongated tubular body, a base unit connected to the body and a head unit mounted for relative movement with respect to the base unit over a range wherein the base and head units are spaced apart and wherein the base and head units are substantially adjacent, wherein the base and head units have actuatable stapling means disposed in an annular area concentric with the tubular body and inward of the periphery of the base and head units and actuatable cutting means disposed in the annular area concentric with the tubular body and inward of the stapling means, the improvement comprising:

a. inserting the instrument through an incision in one hollow organ with the head and base units substantially adjacent until the head unit is inserted into the free end of the other organ;

b. withdrawing the base unit into the free end of the one hollow organ by moving the head and base units apart;

c. connecting the free end of the one hollow organ to the head and the free end of the other hollow organ to the base at points inwardly of the cutting means by positioning the free ends onto elements projecting outwardly from the head and base units and extending therebetween and disposed inwardly of the cutting means;

d. moving the head and base units substantially adjacent to each other;

e. actuating the stapling and cutting means;

f. separating the base and head units; and

g. withdrawing the instrument from the hollow organ.

10. In a surgical stapling instrument for the circular inverted stapling of the free ends of two hollow organs and of the type having relatively movable base and head units having annular actuatable stapling means and annular actuatable cutting means disposed concentric therewith and inwardly thereof, wherein the improvement comprises:

means mounted on the base and head units and disposed inwardly of the cutting means for holding the free ends of the hollow organs inwardly of the stapling means and the cutting means to maintain same in position on the base and head units during movement thereof toward each other and during the actuation of the stapling and cutting means,

a. wherein the holding means comprises a plurality of holding elements projecting outwardly from the inner and outer ends of the head and base units respectively and extending therebetween; and

b. wherein the holding elements are disposed in an annular area concentric with the stapling means and positioned inwardly of the cutting means.