Hollow body organ stapling instrument and disposable cartridge employing relief vents

• US 4,573,468 A
• Filed: 08/26/1981
• Issued: 03/04/1986
• Est. Priority Date: 05/26/1977
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Conta, Robert L., Wallach, Harvey N.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US06/296,525
• Time in Patent Office: 1,651 Days
• Field of Search: 128/334 R, 128/334 C, 128/305, 227/19, 227/DIG. 1
• 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

Apparatus for circular surgical stapling of hollow organs comprising an instrument and disposable cartridge assembly. The instrument comprises a housing with a throughbore in which a tube is received for reciprocation by means of a manually operable squeeze handle. A rod reciprocates within the tube by means of a wing nut cooperating with a threaded part of the rod. A two-part disposable cartridge assembly comprised of an anvil-carrying part and a staple-carrying part are detachably mounted on the rod and housing, respectively. Keys are provided to hold the anvil-carrying part and the staple-carrying part in rotational orientation relative to the rod. Mutually coacting stops on the tube and rod determine the extent of reciprocation which is variable in dependence upon the position of the rod which, in turn, is dependent upon the juxtaposition of the anvil-carrying part with the staple-carrying part when the apparatus is closed on tissue preparatory to effecting a circular anastomoses. A novel geometric configuration for the anvil-carrying part is provided for easy removal of the instrument from a stapled anastomosis. Further, the interior of the stapling mechanism is generously vented to prevent the build up of excessive pressure in tissue confined within the stapling mechanism.

Claims

1. A surgical stapling apparatus, at least part of which fits within two disconnected sections of hollow tubular organs made of tissue, each of said sections having an end portion, for joining together said end portions of said sections with an arrangement of a plurality of staples driven simultaneously within a time period of about one second and forming a closed annular pattern, said sections releasing fluids, such as blood, during joining, said apparatus comprising:

a staple-carrying part including (a) a staple guide body defining a closed annular pattern including two concentric rows of staple-holding grooves within which said staples are carried, (b) staple ejector means movably mounted in said staple-carrying part for ejecting said staples from said staple-holding grooves, and (c) an annular knife movably mounted in said staple-carrying part inside said staple guide body and concentric with said closed annular pattern of staple-holding grooves for cutting the tissue inside said closed annular pattern of staples substantially simultaneously with the driving of said staples;

an anvil-carrying part including (a) an anvil body defining a closed annular pattern including two concentric rows of spaced staple-clinching grooves against which said staples are formed, and (b) a longitudinal anvil-supporting member extending from the staple-carrying part to the anvil body for supporting the anvil body relative to the staple-carrying part, said anvil-supporting member being located inside said closed annular pattern of staple-holding and staple-clinching grooves and also inside said annular knife, said anvil-supporting member being supported for longitudinal reciprocal motion relative to said staple-carrying part parallel to the axes along which said staples are ejected from said staple-holding grooves by means for slidably engaging a first annular portion of the peripheral surface of said anvil-supporting member, said anvil body being supported by contact with a second annular portion of the peripheral surface of said anvil-supporting member, said end portion of a first of said sections being fitted over said staple guide body with the end of said first section being gathered and secured around said anvil-supporting member between said staple guide body and said anvil body, and said end portion of a second of said sections being fitted over said anvil body with the end of said second section being gathered and secured around said anvil-supporting member between said staple guide body and said anvil body;

means for moving said staple-carrying part and said anvil-carrying part, one towards the other, to clamp an annulus of said end portions to be stapled between said staple guide body and said anvil body and, thereupon, to define a closed cavity between and within said staple guide body and said anvil body, said closed cavity being partly bounded by said annulus of clamped tissue, said ends of said first and second sections which are gathered around said anvil-supporting member being disposed within said cavity;

means for moving said staple ejector means and said annular knife toward said anvil-carrying part to eject said staples from said staple-holding grooves to staple said annulus of clamped tissue with two concentric rows of staples and to cut the tissue inside said annulus of stapled clamped tissue, the movement of said staple ejector means and said annular knife occupying a time period of about one second and resulting in a correspondingly rapid reduction in the volume of said closed cavity; and

relief means defined by at least one of said staple-carrying and said anvil-carrying parts to communicate said closed cavity to the exterior of the apparatus for relieving and venting said closed cavity to allow gas and liquid in the cavity to escape and thereby prevent any buildup of pressure in said closed cavity as a result of the sudden reduction in volume in said closed cavity produced by the rapid movement of said staple ejector means and said annular knife, said relief means passing through the structure of said staple-carrying part or said anvil-carrying part or both of said parts without using any part of the first or second annular portions of the peripheral surface of the anvil-supporting member to define any portion of said relief means.

2. The apparatus defined in claim 1 wherein said relief means comprises vent holes extending from an interior surface of said anvil-carrying part, which is in juxtaposition to the staple-carrying part, to an exterior surface of said anvil-carrying part.

3. The apparatus defined in claim 1 wherein said relief means comprises vent holes extending from an interior surface of said staple-carrying part, which is in juxtaposition to said anvil-carrying part, to an exterior surface of said staple-carrying part.

4. Apparatus for joining the ends of two hollow tubular organ sections with an annular array of surgical staples extending through abutting, inwardly turned end portions of the organ sections, the operating portion of said apparatus being inserted longitudinally through a first of the organ sections and being withdrawn from the organ sections immediately after joining by pulling the apparatus longitudinally out through the first organ section, said apparatus comprising:

a longitudinal shaft assembly having a cylindrical outer surface characterized by a relatively small circumference;

actuator means mounted on the proximal end of the shaft assembly, said actuator means remaining outside the organ sections at all times;

a staple-holding assembly mounted on the distal end of the shaft assembly, the staple-holding assembly having a cylindrical outer surface characterized by a relatively large circumference selected to fit snugly within said first organ section, the staple-holding assembly containing an annular array of distally directed surgical staples which are driven in response to operation of the actuator means and having at least one vent hole extending from the interior of the staple-holding assembly to the exterior of the apparatus proximally of the cylindrical outer surface of the staple-holding assembly; and

an anvil assembly mounted for longitudinal reciprocal motion relative to the distal end of the staple-holding assembly in response to operation of the actuator means, the anvil assembly having a cylindrical outer surface characterized by said relatively large circumference, the anvil assembly being adapted to fit within the second organ section and to clamp the abutting, inwardly turned end portions of the organ sections against the distal end of the staple-holding assembly so that the anvil assembly clinches the ends of the surgical staples when they are driven from the staple-holding assembly through the clamped end portions of the organ sections, the anvil assembly having at least one vent hole extending from the interior of the anvil assembly to the exterior of the apparatus distally of the cylindrical outer surface of the anvil assembly, the anvil assembly vent hole communicating with the staple-holding assembly vent hole through the space between the interiors of the anvil assembly and the staple-holding assembly to facilitate insertion and withdrawal of the apparatus by allowing gases and liquids in the organ sections to flow around the portions of the apparatus having the cylindrical surfaces of relatively large circumference via the interior of those portions of the apparatus.