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

• US 5,632,433 A
• Filed: 04/06/1995
• Issued: 05/27/1997
• 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.
• Assistant Examiner(s): SCHROCK, ALLAN
• Application Number:
  US08/417,587
• Time in Patent Office: 782 Days
• Field of Search: 227/19, 227/179.1, 227/180.1, 227/176.1, 227/175.1
• 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
• 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 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 staple 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 staple against said anvil; and

said support shaft being flexible in any radial direction 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; and

means for coupling said support shaft to said actuator handle assembly, said means for coupling comprising means for compensating for differences in deflection of said tension member and said compression member relative to said support shaft.

2. The stapling instrument of claim 1, wherein said means for coupling comprises:

a coupling member slidably mounted on said actuator handle assembly and coupled to said support shaft, said coupling member being slidable longitudinally relative to said actuator handle assembly in response to changes in length of said tension member and said compression member when said staple driver is actuated.

3. The stapling instrument of claim 1, wherein said means for coupling comprises:

a tubular sleeve extending longitudinally from said actuator handle assembly and secured to the proximal end of said support shaft, said tubular sleeve being slidable longitudinally relative to said actuator handle assembly;

said means for compensating comprises a compensating spring for biasing said tubular sleeve proximally relative to said actuator handle assembly; and

said tubular sleeve being slidable distally against the bias of said compensating spring to allow said support shaft to move distally to compensate for changes in length of said tension member and said compression member when said staple driver is actuated.

4. 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 driven 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 any radial direction 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; and

means for coupling said support shaft to said actuator handle assembly, said means for coupling comprising means for compensating for differences in deflection of said tension member and said compression member relative to said support shaft.

5. The stapling instrument of claim 4, wherein said means for coupling comprises:

a coupling member slidably mounted on said actuator handle assembly and coupled to said support shaft, said coupling member being slidable longitudinally relative to said actuator handle assembly in response to changes in length of said tension member and said compression member when said staple driver is actuated.

6. The staple instrument of claim 4, wherein said means for coupling comprises:

a tubular sleeve extending longitudinally from said actuator handle assembly and secured to the proximal end of said support shaft, said tubular sleeve being slidable longitudinally relative to said actuator handle assembly;

said means for compensating comprises a compensating spring for biasing said tubular sleeve proximally relative to said actuator handle assembly; and

said tubular sleeve being slidable distally against the bias of said compensating spring to allow said support shaft to move distally to compensate for changes in length of said tension member and said compression member when said staple driver is actuated.