Apparatus for applying surgical fasteners

• US 5,706,997 A
• Filed: 06/07/1995
• Issued: 01/13/1998
• Est. Priority Date: 10/18/1991
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Viola, Frank J., Bolanos, Henry, Ratcliff, Keith, Green, David T., Heaton, Lisa W.
• Primary Examiner(s): Rada, Rinaldi I.
• Assistant Examiner(s): Dexter, Clark F.
• Application Number:
  US08/474,504
• Time in Patent Office: 951 Days
• Field of Search: 227/175.1, 227/176.1, 227/19, 227/30, 227/181.1, 227/175.2
• US Class Current: 227/175.2
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 2017/0725 with settable gap between anvil and cartridge, e.g. for different staple heights at different shots

Abstract

A surgical stapling or fastening instrument for applying surgical fasteners to tissue having an adjustable closure mechanism to linearly approximate the distance between the jaw members of the instrument. The adjustable closure mechanism consists of an advancing mechanism and a retaining mechanism, wherein the actuating mechanism is actuable to urge the jaw members towards each other. A coupling arrangement is also provided which permits firing of the staples or fasteners only when the jaw members are approximated a predetermined distance from each other.

Claims

1. An apparatus for applying surgical fasteners to body tissue comprising:

tissue gripping means for positioning and gripping tissue therebetween, said gripping means including a first jaw member and a second jaw member, said first jaw member having a plurality of fasteners positioned thereon; and

an advancing mechanism operatively associated with said first jaw member for urging said first jaw member towards said second jaw member, said advancing mechanism including an advancing member being linearly movable for urging said first jaw member towards said second jaw member a predetermined distance and said advancing member further being rotatable for urging said first jaw member towards said second jaw member to grip said tissue therebetween.

2. An apparatus according to claim 1, further comprising releasable retaining means for retaining said advancing mechanism to selectively position said first jaw member in relation to said second jaw member.

3. An apparatus according to claim 2, wherein said actuator member comprises a rod member which extends from a housing of said apparatus.

4. An apparatus according to claim 3, wherein said advancing member further comprises screw threads integral to said rod member, said screw threads engaging said retaining means for incrementally advancing said first jaw member in relation to said second jaw member.

5. An apparatus according to claim 4, wherein linear movement of said advancing member advances said first jaw member towards said second jaw member a greater distance than rotatable movement of said advancing member.

6. An apparatus according to claim 4, wherein said retaining means comprises a pivotable clamp member having a central bore through which said advancing member passes, an edge of said central bore engaging said advancing member to retain said advancing member and selectively position said first jaw member in relation to said second jaw member.

7. An apparatus according to claim 1, wherein said advancing member is rotatable to urge said first jaw member towards said second jaw member subsequent to the linear movement of said advancing member.

8. An apparatus according to claim 1, further comprising means for driving said fasteners into said tissue, said driving means including means for operating said driving means.

9. An apparatus according to claim 8, further comprising means for coupling said driving means to said operating means, said driving means driving said fasteners only when said first jaw member is approximated a predetermined distance from said second jaw member.

10. An apparatus for applying surgical fasteners to body tissue, comprising:

first and second jaws, the first jaw having a plurality of fasteners positioned thereon;

a first advancing mechanism operably associated with the first jaw and being movable to advance the first jaw towards the second jaw a first predetermined distance;

a second advancing mechanism operably associated with the first jaw and being movable to advance the first jaw towards the second jaw a second predetermined distance subsequent to movement of the first jaw the first predetermined distance; and

a fastener driver movably positioned in relation to the first jaw to eject the fasteners;

wherein the first and second advancing mechanisms have a common actuator member.

11. An apparatus according to claim 10 wherein the first and the second advancing mechanisms include a first ratchet and pawl mechanism and a second ratchet and pawl mechanism, respectively.

12. An apparatus according to claim 10, wherein the common actuator member includes a pusher bar operably connected to the first and second advancing mechanisms, the pusher bar having a proximal end extending from a proximal end of a housing of the apparatus.

13. An apparatus according to claim 12 wherein the pusher bar is pivotably connected to the housing of the apparatus, and the first and second advancing mechanisms include first and second ratchet and pawl mechanisms, respectively.

14. An apparatus according to claim 13 further including a movable rod operably connected to the first jaw, wherein the first and second ratchet and pawl mechanisms include a first ratchet member and first pawl member, and a second ratchet member and second pawl member, respectively, the first and second pawl members being connected to the pusher bar and the first and second ratchet members being connected to the movable rod.

15. An apparatus according to claim 14 wherein the second ratchet and pawl mechanism is configured to advance the first jaw towards the second jaw in smaller increments than the first ratchet and pawl mechanism.

16. An apparatus according to claim 10 wherein the first advancing mechanism includes an advancing rod movable linearly to advance the first jaw towards the second jaw, and the second advancing mechanism includes screw threads operatively associated with said advancing rod and being rotatable to advance the first jaw towards the second jaw.

17. An apparatus according to claim 16 wherein the first predetermined distance is greater than the second predetermined distance.

18. An apparatus for applying surgical fasteners to body tissue, comprising:

first and second jaws, the first jaw having a plurality of fasteners positioned thereon;

a first advancing mechanism operably connected to the first jaw and being linearly movable to advance the first jaw towards the second jaw a first predetermined distance;

a second advancing mechanism operably connected to the first jaw and being rotatable to advance the first jaw towards the second jaw a second predetermined distance subsequent to movement of the first jaw the first predetermined distance; and

a fastener driver movably positioned in relation to the first jaw to eject the fasteners.

19. An apparatus according to claim 18 wherein the first advancing mechanism includes a linearly slidable rod operably connected to the first jaw and the second advancing mechanism includes screw threads formed on the slidable rod.

20. An apparatus according to claim 19 further comprising a retaining mechanism positioned adjacent the slidable rod, at least a portion of the retaining mechanism being movable from a first position spaced from the slidable rod to a second position engaging the slidable rod to thereby selectively position the first jaw in relation to the second jaw.

21. An apparatus according to claim 20 wherein the retaining mechanism includes a pivotable clamp member having a central throughbore through which the slidable rod passes, an edge of the throughbore engaging the slidable rod in the second position of the retaining mechanism.

22. An apparatus according to claim 21 wherein the screw threads are positioned on the slidable rod to engage the clamp member after the first jaw has been advanced the first predetermined distance, to thereby facilitate rotatable incremental advancement of the first jaw towards the second jaw.

23. An apparatus according to claim 20 further including a release bar operably connected to the movable portion of the retaining mechanism, the release bar extending through a housing of the apparatus and being movable to move the movable portion of the retaining mechanism from the second position to the first position.

24. An apparatus for applying surgical fasteners to body tissue, comprising:

first and second jaws, the first jaw having a plurality of fasteners positioned thereon;

an advancing mechanism operably connected to the first jaw, at least a portion of the advancing mechanism being pivotable about an axis transverse to a longitudinal axis of the apparatus and being reciprocable to incrementally advance the first jaw towards the second jaw; and

a fastener driver movably positioned in relation to the first jaw to effect ejection of the fasteners.

25. An apparatus according to claim 24 wherein the advancing mechanism includes a first advancing mechanism operably connected to the first jaw and movable to advance the first jaw towards the second jaw a first predetermined distance, and a second advancing mechanism operably connected to the first jaw and movable to advance the first jaw a second predetermined distance towards the second jaw subsequent to movement of the first predetermined distance.

26. An apparatus according to claim 25 wherein the first and second advancing mechanisms include first and second ratchet and pawl members, respectively.

27. An apparatus according to claim 24 wherein the advancing mechanism includes a pusher bar pivotably connected at a pivot point to a housing of the apparatus, the pusher bar being operably associated with the first jaw and reciprocatingly pivotable about the axis transverse to the longitudinal axis of the apparatus to advance the first jaw towards the second jaw.

28. An apparatus according to claim 27 wherein the advancing mechanism includes a first advancing mechanism operably connected to the first jaw and movable to advance the first jaw towards the second jaw a first predetermined distance, and a second advancing mechanism operably connected to the first jaw and movable to advance the first jaw towards the second jaw a second predetermined distance.

29. An apparatus according to claim 28 wherein the first and the second advancing mechanisms include first and second ratchet and pawl members, respectively.

30. An apparatus according to claim 29 wherein the first and second pawl members are mounted on the pusher bar, and the first and second ratchet members are operably connected to the first jaw, such that upon reciprocating the pusher bar about the pivot point, the first pawl member engages the first ratchet member to advance the first jaw the first predetermined distance and subsequently the second pawl member engages the second ratchet member to advance the first jaw the second predetermined distance.

31. An apparatus according to claim 24 further comprising a movable rod operably connected to the first jaw such that the movable rod is advanced towards the second jaw as the first jaw is advanced towards the second jaw.

32. An apparatus according to claim 31 further comprising a retaining mechanism, at least a portion of the retaining mechanism being movable from a first non-engaging position to a second position engaging the movable rod to selectively position the first jaw in relation to the second jaw.

33. An apparatus according to claim 32 wherein the retaining mechanism includes a pivotable clamp member having a central throughbore through which the movable rod passes, an edge of the central throughbore engaging the movable rod in the second position of the retaining mechanism.

34. An apparatus according to claim 32 wherein the advancing mechanism includes a pusher bar pivotably connected at a pivot point to a housing of the apparatus, the pusher bar being operably connected to the first jaw, such that upon being pivoted in a first direction about the pivot point, the first jaw is advanced towards the second jaw.

35. An apparatus according to claim 34 further comprising a release mechanism operably associated with the pusher bar, such that upon pivoting the pusher bar in a second direction about the pivot point, the release mechanism is moved into engagement with the retaining mechanism to move the retaining mechanism from the second position to the first position to release the first jaw.