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

• US 5,439,156 A
• Filed: 02/01/1994
• Issued: 08/08/1995
• 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): Rada, Rinaldi I.
• Application Number:
  US08/189,346
• Time in Patent Office: 553 Days
• Field of Search: 227/19, 227/179, 227/175, 227/180, 227/177, 227/178, 227/129
• 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 arranged in a circular array, 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 cable operated first actuator means for moving said anvil over a first distance relative to said staple holder to open and close said stapling head assembly, second actuator means for adjusting the gap between said anvil and said staple holder over a second distance to adjust the staple height to be produced, wherein said second distance is less than said first distance and third actuator means for actuating said staple driver to drive the staples into the tissue and against said anvil;

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

wherein;

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

2. 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.

3. 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 flexible shaft assembly including a longitudinal 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 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 for transmitting a compressive force from said actuator handle assembly to advance said staple driver to drive the staples from said staple holder into the tissue and to form the staples against said anvil;

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

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

wherein said means for actuating 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.

4. The stapling instrument of claim 3, wherein:

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

5. The stapling instrument of claim 3, which includes:

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

6. The stapling instrument of claim 5, 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.