Method of use of a circular stapler for hemorrhoidal procedure

• US 6,083,241 A
• Filed: 11/23/1998
• Issued: 07/04/2000
• Est. Priority Date: 11/23/1998
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Hacker, Randall L., Bittner, John R., Longo, Antonio
• Primary Examiner(s): Buz, Michael
• Assistant Examiner(s): Ho, Tan-Uyen Thi
• Application Number:
  US09/197,806
• Time in Patent Office: 589 Days
• Field of Search: 606/219, 128/898, 227/179.1, 227/180.1, 227/19
• US Class Current: 606/219
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 2017/1142 Purse-string sutures
• CPC Class Codes: A61B 2017/3452 for the rectum, e.g. for hemorrhoid surgery

Abstract

A method for using a circular stapling instrument for the removal of hemorrhoids is disclosed. The circular stapling instrument has a stapling end effector having a stapling head assembly and an anvil assembly movable from an open position spaced away from the stapling head to a closed position adjacent to the stapling head. A first inner chamber and a second inner chamber communicate within the stapling head assembly wherein the second inner chamber has an open distal end when the anvil is in an open position. A substantially unobstructed passageway extends from an exterior casing surface of the stapling head assembly through the first inner chamber, through the second inner chamber, and through the open distal end of the second inner chamber. A suture is placed into the hemorrhoid of a patient and the open stapling end effector is placed into the anus of a patient. The open stapling end effector is positioned with the suture between the stapling head and the open anvil assembly and a surgical instrument is placed into the passageway to engage the suture through the open distal end of the second chamber. The suture is withdrawn out of the passageway with the surgical instrument. The suture is pulled by the surgeon to draw the hemorrhoids into the open distal end of the stapling end effector and into the first and second inner chambers. The open anvil is closed and the circular stapling instrument is fired to staple and cut the hemorrhoids. The circular stapling instrument and the hemorrhoids are then removed from the patient.

Claims

1. A method for removing internal hemorrhoids from a patient using a circular stapling instrument, said method comprising the steps of:

a) providing a circular stapling instrument having a stapling end effector including;

i) a stapling head assembly having;

a) a substantially hollow casing having an exterior casing surface,

b) a substantially hollow staple driver received in said casing for movement therein between a prefired position and a fired position,

c) an annular blade mounted within said staple driver at a distal end of said staple driver, said annular blade having an open end, and

d) an elongated interior drive shaft reciprocable within said staple driver and said annular blade, and

ii) an anvil assembly having an anvil shaft attached to said elongated interior drive shaft, said anvil assembly movable in response to reciprocation of said interior drive shaft from an open position spaced from said casing to a closed position adjacent to said casing, and when said anvil assembly is in the open position, said interior drive shaft defines a first inner chamber between said staple driver and said shaft, and a second inner chamber between said annular blade and said shaft, said second inner chamber communicating with said first inner chamber and having an open distal end;

wherein when said staple driver is in the prefired position, a substantially unobstructed passageway is provided, said passageway extending from said exterior casing surface of said casing through;

i) said first inner chamber, ii) said second inner chamber (a), and iii) the open distal end of said second inner chamber;

b) placing a suture into the internal hemorrhoids of the patient;

c) inserting said stapling end effector into an anus of the patient with said anvil assembly in the open position;

d) positioning said stapling end effector within the anus of the patient such that said suture and the internal hemorrhoids are located between said stapling head assembly and said anvil assembly;

e) inserting a surgical instrument adapted to grasp said suture into said passageway so as to engage said surgical instrument with said suture;

f) withdrawing said suture through said passageway and out of said casing of said stapling head assembly with said surgical instrument;

g) pulling said suture so as to draw the internal hemorrhoids inwardly around said anvil shaft and said interior drive shaft and into said first and second inner chambers;

h) moving said anvil assembly from the open position spaced from said stapling head assembly to the closed position adjacent to said stapling head assembly so as to clamp the internal hemorrhoids therebetween;

i) firing said circular stapling instrument so as to staple and cut the internal hemorrhoids; and

j) removing said circular stapling instrument from the patient so as to remove the internal hemorrhoids from the patient.

2. The method of claim 1 wherein during the step of inserting said surgical instrument into said passageway, said surgical instrument engages said suture within said first inner chamber.

3. The method of claim 1 wherein during the step of inserting said surgical instrument into said passageway, said surgical instrument engages said suture within said second inner chamber.

4. The method of claim 1 wherein during the step of inserting said surgical instrument into said passageway, said surgical instrument engages said suture distally of the open distal end of said second inner chamber when said anvil assembly is in the open position.

5. The method of claim 1 wherein said surgical instrument has a suture hook.

6. The method of claim 1 wherein during the step of placing said suture into the internal hemorrhoids, a purse string suture is formed.

7. The method of claim 1 further comprising the step of placing a continuous circle of suture circumferentially about the anus of the patient or a rectum of the patient, said continuous circle of suture being placed below a mucosal layer.

8. The method of claim 1 wherein said circular stapling instrument and said surgical instrument each have a longitudinal axis, and during the step of inserting said surgical instrument into said passageway, the longitudinal axis of said surgical instrument is generally parallel with the longitudinal axis of said circular stapling instrument.