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

• US 5,312,024 A
• Filed: 06/02/1993
• Issued: 05/17/1994
• Est. Priority Date: 02/07/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Churchill, Philip J., Grant, Richard L., Lang, Michael, Lawrence, W. Thompson
• Primary Examiner(s): Rada, Rinaldi I.
• Application Number:
  US08/071,280
• Time in Patent Office: 349 Days
• Field of Search: 227/19, 227/176, 227/177, 227/178, 227/179, 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 te 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 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 anvil control means for moving said anvil relative to said staple holder;

a shaft assembly including a longitudinal support shaft with a distal end for mounting said stapling head assembly and a proximal end connected to said actuator handle assembly; and

wherein said anvil control means comprises;

a thumb wheel rotatably mounted on said actuator handle assembly;

a gear wheel on said actuator handle assembly mounted for rotation by said thumb wheel;

a slide mechanism connected to said anvil and slidably mounted for longitudinal movement along said actuator handle assembly;

said gear wheel coupled to said slide mechanism by a first coupling over a first stage of operation of said anvil control means in which tissue is not clamped against the staple holder by the anvil; and

said gear wheel coupled to said slide mechanism by a second coupling over a second stage of operation of said anvil control means in which tissue is clamped against the staple holder by the anvil.

2. The stapling instrument of claim 1, wherein:

said first coupling comprises a drive pin on said gear wheel received by a slot in said slide mechanism for converting rotation of said gear wheel into longitudinal movement of said slide mechanism.

3. The stapling instrument of claim 1, wherein:

said second coupling comprises a rack on said slide mechanism and a pinion gear coupled to said gear wheel for converting rotation of said gear wheel into longitudinal movement of said slide mechanism.

4. The stapling instrument of claim 1, wherein:

said stapling head assembly is pivotable about said support shaft distal end.

5. 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 staple actuator means for actuating said staple driver;

a shaft assembly including a longitudinal support shaft with a distal end for mounting said stapling head assembly and a proximal end connected to said actuator handle assembly; and

wherein said staple actuator means includes;

a staple actuating lever pivotally mounted on said actuator handle assembly;

a cam mounted on said staple actuating lever;

a cam follower coupled to said staple driver and slidably mounted for longitudinal movement along said actuator handle assembly; and

said cam follower including a first cam surface engaged by said cam for actuating said staple driver over a first stage of operation in which said staples are driven through tissue and against said anvil, and a second cam surface engaged by said cam for actuating said staple driver over a second stage of operation in which said staples are formed in the tissue by compression against said anvil.

6. 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 staple actuator means for advancing said staple driver relative to said staple holder;

a shaft assembly including a longitudinal support shaft with a distal end for mounting said stapling head assembly and a proximal end connected to said actuator handle assembly;

a tension member contained within said support shaft and connected to said actuator handle assembly at a proximal end, and to said stapling head assembly at a distal end, said tension member transmitting tension from said actuator handle assembly to said anvil to resist the forces exerted on said anvil when the staples are formed;

a compression member contained within said support shaft and connected to said actuator handle assembly at a proximal end, and to said stapling head assembly at a distal end, said compression member transmitting a compressive force from said staple 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

wherein said staple actuator means includes;

a staple actuating lever pivotally mounted on said actuator handle assembly;

a cam mounted on said staple actuating lever;

a cam follower coupled to said staple driver and slidably mounted for longitudinal movement along said actuator handle assembly; and

said cam follower including a first cam surface engaged by said cam for actuating said staple driver over a first stage of operation in which said staples are driven through tissue and against said anvil and a second cam surface engaged by said cam for actuating said staple driver over a second stage of operation in which said staples are formed in the tissue by compression against said anvil.

7. 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 anvil control means for moving said anvil relative to said staple holder;

a shaft assembly including a longitudinal support shaft with a distal end for mounting said stapling head assembly and a proximal end connected to said actuator handle assembly; and

wherein said anvil control means comprises;

a thumb wheel rotatably mounted on said actuator handle assembly;

a gear wheel on said actuator handle assembly mounted for rotation by said thumb wheel;

a slide mechanism connected to said anvil and slidably mounted for longitudinal movement along said actuator handle assembly;

said gear wheel coupled to said slide mechanism by a first coupling over a first stage of operation of said anvil control means in which tissue is not clamped against the staple holder by the anvil; and

said gear wheel coupled to said slide mechanism by a second coupling over a second stage of operation of said anvil control means in which tissue becomes clamped against the staple holder by the anvil;

first pivot means for pivotably connecting said stapling head assembly to said support shaft; and

second pivot means on said actuator handle assembly controlling said first pivot means.