Endoscopic surgical instrument with pivotable and rotatable staple cartridge

• US 5,431,323 A
• Filed: 06/21/1993
• Issued: 07/11/1995
• Est. Priority Date: 10/09/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Bedi, James J., Sierocuk, Thomas J., Smith, Jack E., Graves, Thomas H. Jr.
• Primary Examiner(s): Rada, Rinaldi I.
• Application Number:
  US08/080,462
• Time in Patent Office: 750 Days
• Field of Search: 227/19, 227/175, 227/177, 227/178, 227/180, 227/181, 227/176, 227/182
• US Class Current: 227/177.1
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/2903 transferring rotary motion
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

A surgical instrument is provided which is insertable through an endoscopic tube to enable a surgeon to perform a surgical technique inside a body cavity. The surgical instrument includes a shaft with a pivotally mounted tip attached thereto, the shaft extending from a handle for gripping the instrument for insertion to the body cavity. The tip of the shaft is adjustable to different angular orientations relative to the support shaft and is rotatable at any angular orientation of the tip. The support shaft may be rotatable about its longitudinal axis relative to the handle, or it may be fixed with respect to the handle, in which case the handle may be rotated to rotate the shaft inside the body cavity. In one embodiment, the surgical instrument comprises an endoscopic stapling device and the tip of the instrument comprises a staple cartridge which is rotatable 360° about its axes after the cartridge has been articulated with respect to the support shaft. An improved device for articulating the shaft tip is also provided in which a control knob is mounted to the support shaft for providing sweeping articulation of the shaft tip. Separate actuator mechanisms are provided on the handle to control the pivotal movement of the shaft tip, as well as the rotation of the shaft tip and the rotation of the support shaft.

Claims

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

a handle including a staple actuator mechanism;

a tubular support shaft defining a first longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge mounted on said support shaft and connected to said staple actuator mechanism for applying one or more staples to the tissue;

said staple cartridge being mounted for articulatable movement relative to said support shaft about an axis of articulation, said axis of articulation being transverse to said longitudinal axis of said support shaft;

said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

said support shaft being either rotatable about said first longitudinal axis or fixed relative to said handle, said staple cartridge being rotatable relative to said shaft about a second longitudinal axis defined by said staple cartridge;

a cartridge rotating means for accommodating rotation of said cartridge relative to said support shaft about said second longitudinal axis of said cartridge;

first means formed from a memory metal for articulating said staple cartridge about said axis of articulation, wherein said first means also comprises a means for providing a staple driving force to said staple cartridge to drive staples contained in said staple cartridge.

2. The stapling instrument of claim 1 which includes:

second means for rotating said support shaft about its longitudinal axis.

3. The stapling instrument of claim 1 wherein said first means comprises a memory metal band having a permanent bend in one end thereof for articulating said staple cartridge as said band is slid with respect to said staple cartridge.

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

a handle including a staple actuator mechanism;

a tubular support shaft defining a first longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge mounted on said support shaft and connected to said staple actuator mechanism for applying one or more staples to the tissue;

said staple cartridge being mounted for articulatable movement relative to said support shaft about an axis of articulation, said axis of articulation being transverse to said longitudinal axis of said support shaft;

said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

said support shaft being either rotatable about said first longitudinal axis or fixed relative to said handle, said staple cartridge being rotatable relative to said shaft about a second longitudinal axis defined by said staple cartridge;

a cartridge rotating means for accommodating rotation of said cartridge relative to said support shaft about said second longitudinal axis of said cartridge; and

wherein said stapling instrument includes means for providing rotational motion of said staple cartridge, comprising torque transfer means rotatably positioned within said support shaft, said torque transfer means being fastened at its distal end to said rotatable staple cartridge via flexible attachment means, said torque transfer means being attached at its proximal end to external torque transfer means.

5. The surgical stapling instrument of claim 4, said flexible attachment means comprising flexible cable means adapted for flexing through any said angle of articulation of said staple cartridge and for transferring torque from, and initiated at, said external torque transfer means to said rotatable staple cartridge.

6. The surgical stapling instrument of claim 5, wherein said flexible cable means is fabricated from material selected from the group consisting of wire, rod, chain, flex shaft, and multi-strand cable.

7. The surgical stapling instrument of claim 4, wherein said flexible cable means is fastened at its distal end to said rotatable staple cartridge and fastened at its proximal end to a rigid portion of said torque transfer means.

8. The surgical stapling instrument of claim 7, wherein said rigid portion comprises a rod rotatably disposed within said support shaft.

9. The surgical stapling instrument of claim 5, wherein said flexible cable is slidably positioned within a flexible conduit.

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

a handle including a staple actuator mechanism;

a tubular support shaft defining a first longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge mounted on said support shaft and connected to said staple actuator mechanism for applying one or more staples to the tissue;

said staple cartridge being mounted for articulatable movement relative to said support shaft about an axis of articulation, said axis of articulation being transverse to said longitudinal axis of said support shaft;

said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

said support shaft being either rotatable about said first longitudinal axis or fixed relative to said handle, said staple cartridge being rotatable relative to said shaft about a second longitudinal axis defined by said staple cartridge;

a cartridge rotating means for accommodating rotation of said cartridge relative to said support shaft about said second longitudinal axis of said cartridge;

wherein said cartridge rotating means is operable from a location proximally of said cartridge for providing rotational motion of said staple cartridge, and comprises torque transfer means rotatably positioned within said support shaft, said torque transfer means being fastened at its distal end to said rotatable staple cartridge via flexible attachment means, said torque transfer means being attached at its proximal end to external torque transfer means, said torque transfer means further comprising staple driver means;

means for articulating said staple cartridge about said axis of articulation comprising means for providing pushing and/or pulling forces in a direction generally parallel to said support shaft and for directing said forces around clevis means for pivoting said staple cartridge about said axis of articulation;

wherein said means for articulating said staple cartridge comprises an articulation driver means slidably positioned in said support shaft and spaced from said torque transfer means; and

further including spacer means for maintaining spacing between said torque transfer means and said articulation driver means.

11. The surgical stapling instrument of claim 10, wherein said articulation driver means comprises a rigid section having fastened to its distal end a flexible member, said flexible member providing both sufficient flexibility for bending about said axis of articulation and sufficient stiffness and tensile strength for transferring pushing and pulling forces, respectively, around said clevis means.

12. The surgical stapling instrument of claim 11, wherein said flexible member comprises a flexible cable.

13. The surgical stapling instrument of claim 12, wherein said flexible cable is fabricated from material selected form the group consisting of wire, rod, chain, flex shaft, and multi-strand cable.

14. The surgical stapling instrument of claim 12, wherein said flexible cable is fabricated from material selected from the group consisting of steel, nitinol, nylon, and fiberglass.

15. The surgical stapling instrument of claim 11, wherein said instrument further includes:

a control means mounted externally on said support shaft proximate said handle for transferring motion to said articulation driver means in a longitudinal direction generally parallel to the longitudinal axis of said support shaft.