Endoscopic surgical instrument with pivotable and rotatable staple cartridge

• US 5,797,536 A
• Filed: 03/30/1995
• Issued: 08/25/1998
• 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., Graves, Thomas Howard Jr., Smith, Jack Edward
• Primary Examiner(s): Hail, III, Joseph J.
• Assistant Examiner(s): Stelacone, Jay A.
• Application Number:
  US08/413,654
• Time in Patent Office: 1,244 Days
• Field of Search: 227/19, 227/175.1, 227/176.1, 227/177.1, 227/179.1
• US Class Current: 227/175.1
• 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, said instrument comprising:

a support shaft having a longitudinal axis;

a staple cartridge containing a plurality of staples and mounted on said support shaft for pivotal movement about a transverse axis of articulation perpendicular to said shaft longitudinal axis to at least one articulated position, said cartridge containing a staple advancing and forming mechanism for effecting application of one of said staples to said tissue, said cartridge also being rotatable relative to said shaft about a cartridge axis defined along the length of said cartridge;

an operating rod generally traversing the length of said shaft longitudinal axis extending along said support shaft to said cartridge and connected with said staple advancing and forming mechanism, said rod including a flexible portion adjacent said transverse axis to accommodate the articulation of said instrument;

a knob connected to said rod proximally of said cartridge to rotate said cartridge relative to said shaft; and

a staple actuator mechanism connected to said rod and operable from a location proximally of said cartridge to move said rod longitudinally for actuating said staple advancing and forming mechanism in said cartridge and to accommodate the rotation of said cartridge relative to said shaft;

wherein each said staple has a generally U-shaped body including a crown with a central offset portion between two non-offset portions and a pair of legs at opposite ends of said crown each depending from one of said non-offset portion; and

said staple cartridge includes

a staple storage region defined by a guide surface for supporting and guiding said staple crowns and includes a cavity for receiving said staple legs, said staples being arranged in a side-by-side stack in said storage region with each staple oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis;

a staple feeder shoe in said storage region and a spring biasing said feeder shoe distally along the length of said cartridge to engage the most proximal staple in said stack and urge said stack distally;

an inclined surface and an inclined ramp spaced from said inclined surface for receiving therebetween the distalmost staple from the stack at the distal end of said guide surface, said inclined surface and ramp each being oriented at an oblique angle relative to said cartridge axis; and

spaced-apart extension surfaces for receiving said staple crown as said staple advances distally from said inclined surface and inclined ramp whereby said non-offset portions engage said ramp to rotate said staple about 90°

into an orientation with the staple legs oriented parallel to said cartridge axis and pointing toward the distal end of said cartridge.

2. The instrument in accordance with claim 1 in which said rod includes a rigid portion in said support shaft and that includes said flexible portion extending from said rigid portion.

3. The instrument in accordance with claim 2 in which said staple advancing and forming mechanism is connected to the distal end of said rod flexible portion;

said instrument includes a handle from which said support shaft extends;

said staple actuator mechanism includes a trigger on said handle operatively engaged with said rod for effecting longitudinal movement thereof to drive said staple advancing and forming mechanism to advance and form one of said staples; and

said knob is rotatably mounted on said handle and engaged with said rod to effect rotation of said rod relative to said shaft to rotate said cartridge about said cartridge axis.

4. The stapling instrument in accordance with claim 1 in which said instrument includes a pivot connection structure connecting said staple cartridge to said support shaft for accommodating the pivotal movement of said staple cartridge about said transverse axis;

said pivot connection structure includes a pivotable member that is pivotable relative to said support shaft;

said staple cartridge is mounted to said pivotable member for rotation about said cartridge axis; and

said instrument includes an articulation driver operable from a location proximally of said pivotable member for pivoting said member.

5. The stapling instrument in accordance with claim 4 in which said staple cartridge includes a hollowing cartridge housing containing said staple advancing and forming mechanism operatively connected to said rod, said staple advancing and forming mechanism including a former that is longitudinally reciprocable within said hollow cartridge housing;

and

said former has a proximal end for engaging said rod to accommodate rotation of said former with said cartridge about the cartridge axis relative to said support shaft.

6. The staple instrument in accordance with claim 5 in which said instrument further includes a retainer having

(A) a proximal end mounted to said pivotable member to accommodate rotation of said retainer relative to said pivotable member;

and

(B) a distal end received in said hollow cartridge housing for rotation of said retainer.

7. The instrument in accordance with claim 1 in which said instrument includes

a pivotable member at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about said transverse axis;

an articulation driver operable from a location proximally of said cartridge to pivot said staple cartridge relative to said support shaft, said articulation driver including at its distal end one of a guide pin and arcuate groove, said pivotable member including the other of said guide pin and arcuate groove, said guide pin being received in said arcuate groove for converting the longitudinal movement of said articulation driver into pivotal movement of said pivotable member and staple cartridge mounted thereon relative to said support shaft.

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

a support shaft having a longitudinal axis;

a staple cartridge containing a plurality of staples and mounted on said support shaft for pivotal movement about a transverse axis of articulation perpendicular to said shaft longitudinal axis to at least one articulated position, said cartridge containing a staple advancing and forming mechanism for effecting application of one of said staples to said tissue, said cartridge also being rotatable relative to said shaft about a cartridge axis defined along the length of said cartridge;

an operating rod generally traversing the length of said shaft longitudinal axis extending along said support shaft to said cartridge and connected with said staple advancing and forming mechanism, said rod including a flexible portion adjacent said transverse axis to accommodate the articulation of said instrument;

a knob connected to said rod proximally of said cartridge to rotate said cartridge relative to said shaft; and

a staple actuator mechanism connected to said rod and operable from a location proximally of said cartridge to move said rod longitudinally for actuating said staple advancing and forming mechanism in said cartridge and to accommodate the rotation of said cartridge relative to said shaft;

wherein each said staple has

(A) a generally U-shaped body including a crown, and

(B) a pair of legs each depending from opposite end of said crown;

said staples are arranged in a side-by-side stack oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis; and

said staple advancing and forming mechanism engages the distalmost staple to advance the distalmost staple distally to effect engagement of part of said staple crown with a part of said cartridge whereby the staple rotates about ninety degrees to an orientation with the staple legs oriented parallel to the cartridge axis.