Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism

• US 5,271,543 A
• Filed: 02/07/1992
• Issued: 12/21/1993
• Est. Priority Date: 02/07/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Lang, Michael, Churchill, Philip J., Grant, Richard L., Lawrence, W. Thompson
• Primary Examiner(s): Yost, Frank T.
• Assistant Examiner(s): RADA, RINALDI I
• Application Number:
  US07/832,299
• Time in Patent Office: 683 Days
• Field of Search: 227/178, 227/179, 227/19, 227/180
• 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
• CPC Class Codes: A61B 2017/07257 characterised by its anvil
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

A surgical stapling instrument for performing a circular anastomosis stapling operation is provided. The surgical instrument includes a stapling head assembly mounted by a flexible support shaft to an actuator handle assembly. The support shaft is capable of bending in any radial direction relative to its centerline into a curved configuration suitable for insertion into a patient. The flexible support shaft includes a dual coil structure which is adapted to support itself in any curved configuration and to resist deflection upon insertion into the patient and actuation of the stapling head assembly. The stapling head assembly includes a driver assembly which is operable in multiple stages to separate the staple forming and tissue cutting actions to reduce the peak force required to operate the instrument. The actuator handle assembly includes a staple actuating lever and a cam follower assembly which operate in two stages with different mechanical advantages to facilitate the operation of the instrument by a surgeon. The actuator handle assembly includes a thumb wheel for opening and closing the anvil and an adjusting knob for adjusting the anvil gap. A control lever is provided for pivoting the stapling head assembly relative to the flexible support shaft.

Claims

1. A surgical stapling instrument for applying one or more surgical staples to tissue, comprising:

a stapling head assembly including a staple holder for receiving one or more surgical staples, an anvil for clamping the tissue against said staple holder, and a staple driver for engaging and driving the staples from said staple holder into the tissue and against said anvil;

an actuator handle assembly including means for actuating said staple driver;

a shaft assembly including a flexible support shaft for mounting said stapling head assembly on said actuator handle assembly; and

said support shaft being flexible in any radial direction relative to its centerline into a curved configuration, said support shaft being self-supporting and adapted to retain said curved configuration and to resist deflection; and

wherein said flexible support shaft comprises one or more helical elements including a series of helical coils which are adapted to slidably engage each other with sufficient friction to resist deflection and to retain said curved configuration.

2. The stapling instrument of claim 1, wherein:

said flexible support shaft comprises first and second concentric helical elements each having a series of helical coils arranged with the coils of said first helical element interspersed with the coils of said second helical element.

3. The stapling instrument of claim 2, wherein:

each coil of said first helical element slidably engages the adjacent coils of said second helical element with sufficient friction to retain said support shaft in its curved configuration and to resist deflection.

4. The stapling instrument of claim 3, wherein:

each coil of said first helical element has a round cross section; and

each coil of said second helical element has a triangular cross section.

5. The stapling instrument of claim 4, wherein:

each coil of said second helical element defines a set of inwardly sloped surfaces which slidably engage the adjacent round surfaces of the coils of said first helical element.

6. The stapling instrument of claim 5, wherein:

each coil of said second helical element defines a flat outer surface.

7. The stapling instrument of claim 6, which includes:

a flexible tubular sheath for covering said support shaft.

8. The stapling instrument of claim 1, which includes:

means for pivotally connecting said stapling head assembly to said support shaft; and

means on said actuator handle assembly for pivoting said stapling head assembly relative to said support shaft.

9. The stapling instrument of claim 8, wherein:

said stapling head assembly is pivotable on an axis perpendicular to the longitudinal axis of said support shaft.

10. A surgical stapling instrument for applying a plurality of surgical staples to tissue, comprising:

a stapling head assembly including a staple holder for receiving a plurality of surgical staples, an anvil for clamping the tissue against said staple holder, and a staple driver for engaging and driving the staples from said staple holder into the tissue and against said anvil;

an actuator handle assembly including first actuator means for adjusting the gap between said anvil and said staple holder and second actuator means for actuating said staple driver; and

a shaft assembly including a flexible support shaft for mounting said stapling head assembly on said actuator handle assembly;

a tension member contained within said support shaft for transmitting tension from said first actuator means to said anvil to resist the forces exerted on said anvil when the staples are formed;

a compression member contained within said support shaft for transmitting a compressive force from said second actuator means to advance said staple driver to drive the staples from said staple holder into the tissue and to form the staples against said anvil; and

said support shaft being flexible in three or more radial directions relative to its centerline into a curved configuration for insertion into a patient, said flexible support shaft being adapted to support itself in said curved configuration and to resist deflection upon insertion of said support shaft into the patient and actuation of said stapling head assembly.

11. The stapling instrument of claim 10, wherein:

said flexible support shaft comprises one ore more helical elements including a series of helical coils which are adapted to slidably engage each other with sufficient friction to resist deflection and to retain said curved configuration.

12. The stapling instrument of claim 11, wherein:

said flexible support shaft comprises first and second concentric helical elements each having a series of helical coils arranged with the coils of said first helical element interspersed with the coils of said second helical element.

13. The stapling instrument of claim 12, wherein:

each coil of said first helical element slidably engages the adjacent coils of said second helical element with sufficient friction to retain said support shaft in its curved configuration and to resist deflection.

14. The stapling instrument of claim 13, wherein:

each coil of said first helical element has a round cross section; and

each coil of said second helical element has a triangular cross section.

15. The stapling instrument of claim 14, wherein:

each coil of said second helical element defines a set of inwardly sloped surfaces which slidably engage the adjacent round surfaces of the coils of said first helical element.

16. The stapling instrument of claim 15, wherein:

each coil of said second helical element defines a flat outer surface.

17. The stapling instrument of claim 16, which includes:

a flexible tubular sheath for covering said support shaft.

18. The stapling instrument of claim 10, which includes:

means for pivotally connecting said stapling head assembly to said support shaft; and

means on said actuator handle assembly for pivoting said stapling head assembly relative to said support shaft.

19. The stapling instrument of claim 18, wherein:

said stapling head assembly is pivotable on an axis perpendicular to the longitudinal axis of said support shaft.

20. The stapling instrument of claim 18, which includes:

an articulated pivot connection for coupling said compression member to said staple driver.

21. The stapling instrument of claim 20, wherein said articulated pivot connection includes:

a hollow coupling member pivotally coupled at its opposite ends to said compression member and said staple driver with said tension member extending longitudinally therethrough.

22. A surgical stapling instrument for joining a pair of hollow organ sections with a plurality of surgical staples around a hollow lumen between the organ sections, comprising:

a stapling head assembly including a staple holder containing a plurality of surgical staples, an anvil for forming the staples, said anvil being mounted on an anvil shaft slidably supported for movement relative to said stapling head assembly to allow the tissue of the organ sections to be clamped between said anvil and said staple holder, and a staple driver for engaging and driving the staples from said staple holder into the tissue and against said anvil;

an actuator handle assembly remote from said stapling head assembly and having first actuator means for controlling the motion of said anvil and second actuator means for controlling the motion of said staple driver;

a shaft assembly including a flexible tubular support shaft for mounting said stapling head assembly on said actuator handle assembly;

a tension member contained within said tubular support shaft for transmitting longitudinal tension and longitudinal motion relative to said support shaft from said first actuator means to said anvil shaft to move said anvil toward said staple holder to clamp the tissue and resist the forces exerted on said anvil when the staples are driver through the tissue and formed against said anvil;

a compression member contained within said tubular support shaft for transmitting longitudinal compressive force and longitudinal motion relative to said support shaft from said second actuator means to said staple driver to advance said staple driver to drive the staples from said staple holder into the tissue and against said anvil; and

said support shaft being flexible in three or more radial directions relative to its centerline into a curved configuration for insertion into a patient, said flexible support shaft being adapted to support itself in said curved configuration and to resist deflection upon insertion of said support shaft into the patient and actuation of said stapling head assembly.

23. The stapling instrument of claim 22, wherein:

said flexible support shaft comprises one or more helical elements including a series of helical coils which are adapted to slidably engage each other with sufficient friction to resist deflection and to retain said curved configuration.

24. The stapling instrument of claim 23, wherein:

each of said helical coils is slidable radially relative to the adjacent coils to allow said support shaft to be flexed into a curved configuration, each coil engaging the adjacent coils with sufficient friction to retain said support shaft in said curved configuration and to resist deflection.

25. The stapling instrument of claim 22, wherein:

said flexible support shaft comprises first and second concentric helical elements each having a series of helical coils arranged with the coils of said helical element interspersed with the coils of said second helical element.

26. The stapling instrument of claim 25, wherein:

each coil of said first helical element slidably engages the adjacent coils of said second helical element with sufficient friction to retain said support shaft in its curved configuration and to resist deflection.

27. The stapling instrument of claim 26, wherein:

each coil of said first helical element has a round cross section; and

each coil of said second helical element has a triangular cross section.

28. The stapling instrument of claim 27, wherein:

each coil of said second helical element defines a set of inwardly sloped surfaces which slidably engage the adjacent round surfaces of the coils of said first helical element.

29. The stapling instrument of claim 28, wherein:

each coil of said second helical element defines a flat outer surface.

30. The stapling instrument of claim 29, which includes:

a flexible tubular sheath for covering said support shaft.

31. The stapling instrument of claim 22, which includes:

means for pivotally connecting said stapling head assembly to said support shaft; and

means on said actuator handle assembly for pivoting said stapling head assembly relative to said support shaft.

32. The stapling instrument of claim 31, wherein:

said stapling head assembly is pivotable on an axis perpendicular to the longitudinal axis of said support shaft.

33. The stapling instrument of claim 31, which includes:

an articulated pivot connection for coupling said compression member to said staple driver.

34. The stapling instrument of claim 33, wherein said articulated pivot connection includes:

a hollow coupling member pivotally coupled at its opposite ends to said compression member and said staple driver with said tension member extending longitudinally therethrough.

35. A surgical stapling instrument for applying a plurality of surgical staples to tissue, comprising;

a stapling head assembly including a staple holder for receiving a plurality of surgical staples, an anvil for clamping the tissue against said staple holder, and a staple driver for engaging and driving the staples from said staple holder into the tissue and against said anvil;

an actuator handle assembly remote from said stapling head assembly and including first actuator means for moving said anvil over a large distance relative to said staple holder to open and close said stapling head assembly, second actuator means comprising staple height adjusting means for adjusting the gap between said anvil and said staple holder over a small distance to define the staple height to be produced, and third actuator means for actuating said staple drive to drive the staples into the tissue and against said anvil; and

a shaft assembly including a longitudinal support shaft for mounting said stapling head assembly on said actuator handle assembly.

36. The stapling instrument of claim 35, wherein:

said support shaft being flexible in any radial direction relative to its centerline into a curved configuration, said support shaft being self-supporting and adapted to retain said curved configuration and to resist deflection.

37. The stapling instrument of claim 36, wherein:

said flexible support shaft comprises one or more helical elements including a series of helical coils which are adapted to slidably engage each other with sufficient friction to resist deflection and to retain said curved configuration.

38. The stapling instrument of claim 36;

wherein;

said flexible support shaft comprises first and second concentric helical elements each having a series of helical coils arranged with the coils of said first helical element interspersed with the coils of said second helical element.

39. The stapling instrument of claim 38, wherein:

each coil of said first helical element slidably engages the adjacent coils of said second helical element with sufficient friction to retain said support shaft in its curved configuration and to resist deflection.