Surgical instrument for applying multiple staples and cutting blood vessels and organic structures and method therefor

• US 6,217,590 B1
• Filed: 07/15/1999
• Issued: 04/17/2001
• Est. Priority Date: 01/22/1999
• Status: Expired due to Fees

• Current Assignee: Scion International, Inc.
• Original Assignee: Scion International, Inc.
• Inventors: Levinson, Melvin E.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/354,008
• Time in Patent Office: 642 Days
• Field of Search: 606/139, 606/142, 606/151, 606/157, 606/158
• US Class Current: 606/142
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/2933 camming or guiding means

Abstract

A surgical instrument for stapling and cutting a blood vessel or other organic structure utilizes at least two surgical staple clips. The surgical instrument in one embodiment includes an elongated tube with a longitudinally movable rod disposed therein. A handle, mounted on a proximal end of the tube, includes a movable member which causes the movable rod to move longitudinally. In one embodiment, a pair of surgical staple clip carrying jaw sets are pivotally mounted on a common lateral axis located at the distal end of the elongated tube, each clip jaw set includes at least two jaw members, and each jaw member defines a clip action cam following channel. In a further embodiment, jaw members are ganged together and move as a unit based upon a cam follower surface motivated by a cam actuator member. In a different embodiment with more than eight clip carrying jaws the cam follower channels or surfaces have substantially different shapes such that different clips close on the blood vessel or organic structure at different rates and at different times with respect to the longitudinal position of the movable rod.

Claims

1. A surgical instrument for stapling with surgical clips and cutting a blood vessel or other organic structure comprising:

an elongated tube having a proximal end and a distal end, said tube having a longitudinally movable rod disposed therein;

a handle mounted on said proximal end of said tube, said handle having a movable member coupled to said movable rod which longitudinally moves said rod with respect to said tube upon actuation of said movable member;

at least one pair of surgical staple clip carrying jaw sets, each clip jaw set having two jaw members which pivot about a common lateral axis located at said distal end of said elongated tube, each jaw member defining a clip channel at its jaw mouth

at least one scissor jaw set having upper and lower, opposing scissor jaw members which pivot about said common lateral axis;

a longitudinally extending cam actuator member mounted on said distal end of said moveable rod;

each clip jaw set defining a clip-action cam follower surface and said scissor jaw set defining a cut-action cam follower surface, said longitudinally extending cam actuator member movable with respect to said clip-action and cut-action cam follower surfaces and said clip-action cam follower surfaces shaped to initially close said clip jaw sets and said cut-action cam follower surfaces shaped to subsequently close said scissor jaw set and cut said blood vessel or other organic structure upon longitudinal movement of said longitudinally extending cam actuator member.

2. A surgical instrument as claimed in claim 1 wherein said clip jaw sets and scissor jaw set are rotatably mounted at a stationary position with respect to said common lateral axis and said elongated tube, said longitudinally extending cam actuator member movably protruding beyond said distal end of said elongated tube and traveling over said clip-action and cut-action cam follower surfaces of said clip jaw sets and said scissor jaw set.

3. A surgical instrument as claimed in claim 1 wherein each clip jaw member has a respective clip-action cam follower surface.

4. A surgical instrument as claimed in claim 3 wherein said clip-action and cut-action cam follower surfaces are disposed on outboard, exterior edges of each jaw member and on outboard, exterior edges of said scissor jaw members.

5. A surgical instrument as claimed in claim 1 wherein said one pair of clip carrying jaw sets is a first and a second clip jaw set, said first and second clip jaw sets respectively define an upper clip jaw set and a lower clip jaw set with at least two conjoint upper jaw members and at least two conjoint lower jaw members, said upper and lower jaw sets oppositely disposed at an appliance jaw mouth, and said upper and lower clip jaw sets define respective ones of said clip-action cam follower surfaces.

6. A surgical instrument as claimed in claim 4 wherein said clip-action and cut-action cam follower surfaces are disposed on outboard, exterior edges of at least one jaw member of a respective clip jaw set and on outboard, exterior edges of said scissor jaw members.

7. A surgical instrument for stapling, with a plurality of surgical clips, and cutting a blood vessel or other organic structure comprising:

an elongated tube having a proximal end and a distal end, said tube having a longitudinally movable rod disposed therein;

a handle mounted on said proximal end of said tube, said handle having a movable member coupled to said movable rod which longitudinally moves said rod with respect to said tube upon actuation of said movable member;

a plurality of pairs of clip carrying jaw sets for said plurality of clips each clip jaw set having two opposing jaw members which pivot towards each other about a common lateral axis disposed at said distal end of said elongated tube, each clip jaw member defining a clip channel at its jaw mouth;

at least one scissor jaw set having upper and lower, opposing scissor jaw members which pivot about said common lateral axis;

a longitudinally extending cam actuator member mounted on said distal end of said movable rod;

each clip jaw member defining a respective clip-action cam follower surface and each scissor jaw member defining a respective cut-action cam follower surface, said longitudinally extending cam actuator member movable with respect to said clip-action and cut-action cam follower surfaces and said clip-action cam follower surfaces shaped to initially close said plurality of clip jaw sets and said cut-action cam follower surfaces shaped to subsequently close said scissor jaw set to sequentially and pluralistically clip and then cut said blood vessel or other organic structure upon longitudinal movement of said longitudinally extending cam actuator member.

8. A surgical instrument as claimed in claim 7 wherein said clip jaw sets and scissor jaw set are rotatably mounted at a stationary position with respect to said common lateral axis and said elongated tube, said longitudinally extending cam actuator member movably protruding beyond said distal end of said elongated tube and traveling over said clip-action and cut-action cam follower surfaces of said clip jaw sets and said scissor jaw set.

9. A surgical instrument as claimed in claim 7 wherein at least one clip jaw set and its corresponding clip jaw members have respective clip-action cam follower surfaces that are differently shaped than other clip jaw sets of said plurality of clip jaw sets such that said one clip jaw set closes at a different longitudinal position than said other clip jaw sets of said plurality of clip jaw sets.

10. A surgical instrument as claimed in claim 9 wherein said clip-action and cut-action cam follower surfaces are disposed on outboard, exterior edges of each jaw member of a respective clip jaw set and on outboard, exterior edges of said scissor jaw members.

11. A surgical instrument as claimed in claim 10 wherein each clip jaw set is adapted to retain a single surgical clip in said respective clip channels in corresponding jaw member mouths, and each respective clip jaw set and corresponding jaw members with corresponding clip-action cam follower surfaces have substantially similar cam shapes and wherein clip-action cam follower surfaces of a respectively different clip jaw set have substantially different cam shapes whereby said similar cam shapes cause closure at similar times and said different cam shapes cause closure at different times during said longitudinal movement of said cam actuator member.

12. A surgical instrument as claimed in claim 7 wherein said scissor jaw set is disposed at an intermediate position between said plurality of clip jaw sets.

13. A surgical instrument for stapling, with a plurality of surgical clips, and cutting a blood vessel or other organic structure comprising:

an elongated tube having a proximal end and a distal end, said tube having a longitudinally movable rod disposed therein;

a handle mounted on said proximal end of said tube, said handle having a movable member coupled to said movable rod which longitudinally moves said rod with respect to said tube upon actuation of said movable member;

a plurality of clip carrying jaw sets defining lower jaw sets and upper jaw sets, each clip jaw set having at least two laterally disposed clip jaw members which are ganged together and pivot about a common lateral axis disposed at said distal end of said elongated tube, each clip jaw member defining a clip channel at its jaw mouth and each lower jaw set disposed at an opposing position relative to a corresponding upper jaw set;

at least one scissor jaw set having upper and lower, opposing scissor jaw members which pivot about said common lateral axis;

a longitudinally extending cam actuator member mounted on said distal end of said movable rod;

each clip jaw set defining a clip-action cam follower surface and each scissor jaw member defining a respective cut-action cam follower surface, said longitudinally extending cam actuator member movable with respect to said clip-action and cut-action cam follower surfaces and said clip-action cam follower surfaces shaped to initially close said plurality of clip jaw sets and said cut-action cam follower surfaces shaped to subsequently close said scissor jaw set to sequentially and pluralistically clip and then cut said blood vessel or other organic structure upon longitudinal movement of said longitudinally extending cam actuator member.

14. A surgical instrument as claimed in claim 13 wherein said clip-action and cut-action cam follower surfaces are disposed on outboard, exterior edges of at least one jaw member of a respective clip jaw set and on outboard, exterior edges of said scissor jaw members.

15. A surgical instrument as claimed in claim 13 wherein each upper clip jaw set coacts with a corresponding opposing lower clip jaw set such that ganged closure of opposing clip jaw members occurs due to substantially similar cam shapes on the corresponding clip-action cam follower surfaces of corresponding upper and lower clip jaw sets, and wherein clip-action cam follower surfaces of a respectively different ganged clip jaw set of said plurality of clip jaw sets have substantially different cam shapes whereby said similar cam shapes cause closure at similar times and said different cam shapes cause closure at different times during longitudinal movement of said cam actuator member.

16. A surgical instrument for stapling, with a plurality of surgical clips, and cutting a blood vessel or other organic structure comprising:

an elongated tube having a proximal end and a distal end, said tube having a longitudinally movable rod disposed therein;

a handle mounted on said proximal end of said tube, said handle having a movable member coupled to said movable rod which longitudinally moves said rod with respect to said tube upon actuation of said movable member;

a plurality of pairs of clip carrying jaw sets corresponding to said plurality of clips, each clip jaw set having two opposing jaw members which pivot towards each other about a common lateral axis disposed at said distal end of said elongated tube, each clip jaw member defining a clip channel at its jaw mouth;

at least one scissor jaw set having upper and lower, opposing scissor jaw members which pivot about said common lateral axis;

a laterally extending cam mounted on said distal end of said movable rod;

each clip jaw member defining a respective clip-action cam follower channel and each scissor jaw member defining a respective cut-action cam follower channel, said laterally extending cam disposed in said clip-action and cut-action cam follower channels and said clip-action cam follower channels shaped to initially close said plurality of clip jaw sets and said cut-action cam follower channels shaped to subsequently close said scissor jaw set to sequentially and pluralistically clip and then cut said blood vessel or other organic structure upon longitudinal movement of said laterally extending cam.

17. A surgical instrument as claimed in claim 16 wherein at least one clip jaw set and its corresponding clip jaw members have respective clip-action cam follower channels that are differently shaped than other clip jaw sets of said plurality of clip jaw sets such that said one clip jaw set closes at a different longitudinal position of said laterally extending cam than said other clip jaw sets of said plurality of clip jaw sets.

18. A surgical instrument as claimed in claim 16 wherein each clip jaw set is adapted to retain a single surgical clip in said respective clip channels in corresponding jaw member mouths, and each respective clip jaw set and corresponding jaw members with corresponding clip-action cam follower channels have substantially similar cam shapes and wherein clip-action cam follower channels of a respectively different clip jaw set have substantially different cam shapes whereby said similar cam shapes cause closure at similar times and different cam shapes cause closure at different times during said longitudinal movement of said cam.

19. A surgical instrument as claimed in claim 16 wherein said scissor jaw set is disposed at an intermediate position between said plurality of clip jaw sets.

20. A surgical instrument for stapling, with a plurality of surgical clips, and cutting a blood vessel or other organic structure comprising:

an elongated tube having a proximal end and a distal end, said tube having a longitudinally movable rod disposed therein;

a handle mounted on said proximal end of said tube, said handle having a movable member coupled to said movable rod which longitudinally moves said rod with respect to said tube upon actuation of said movable member;

a plurality of clip carrying jaw sets defining lower jaw sets and upper jaw sets, each clip jaw set having at least two laterally disposed clip jaw members which are ganged together and pivot about a common lateral axis disposed at said distal end of said elongated tube, each clip jaw member defining a clip channel at its jaw mouth and each lower jaw set disposed at an opposing position relative to a corresponding upper jaw set;

at least one scissor jaw set having upper and lower, opposing scissor jaw members which pivot about said common lateral axis;

a laterally extending cam mounted on said distal end of said movable rod;

each clip jaw set defining a clip-action cam follower channel and each scissor jaw member defining a respective cut-action cam follower channel, said laterally extending cam disposed in said clip-action and cut-action cam follower channels and said clip-action cam follower channels shaped to initially close said plurality of clip jaw sets and said cut-action cam follower channels shaped to subsequently close said scissor jaw set to sequentially and pluralistically clip and then cut said blood vessel or other organic structure upon longitudinal movement of said laterally extending cam.

21. A surgical instrument as claimed in claim 20 wherein each upper clip jaw set coacts with a corresponding opposing lower clip jaw set such that ganged closure of opposing clip jaw members occurs due to substantially similar cam shapes on the corresponding clip-action cam follower channels of corresponding upper and lower clip jaw sets, and wherein clip-action cam follower channels of a respectively different ganged clip jaw set have substantially different cam shapes whereby said similar cam shapes cause closure at similar times and said different cam shapes cause closure at different times during longitudinal movement of said cam.

22. A method for surgically stapling and cutting a segment of a blood vessel or other organic structure in a body with an elongated surgical instrument having an elongated movable rod therein extending from an outboard, proximal position to a distal end near a surgical site in said body, said surgical instrument carrying a plurality of surgical staple clips at said distal end of said rod, the method comprising the steps of:

longitudinally moving said rod in a substantially singular, operative stroke;

during said single operative stroke;

sequentially clipping said segment of blood vessel or other organic structure with at least one of said plurality surgical staple clips and then clipping said segment of blood vessel or other organic structure with at least one or more of a remainder of said plurality surgical staple clips during a first portion of said singular operative stroke; and

subsequently cutting said segment of blood vessel or other organic structure during a second portion of said singular operative stroke.

23. A method as claimed in claim 22 wherein said singular operative stroke is caused by a single, generally uniform extension of said rod towards said distal end.

24. A method as claimed in claim 23 wherein said surgical instrument defines a common axis at said distal end and wherein said clipping and cutting steps include the step of translating said singular longitudinal movement of said rod into sequential plural pivotal movements about said common axis.

25. A method as claimed in claim 24 wherein said surgical staple clips are generally U-shaped and the method includes the step of sequentially collapsing said U-shaped clips onto said segment during said first portion of said operative stroke.

26. A method for surgically stapling and cutting a segment of a blood vessel or other organic structure in a body with an elongated surgical instrument having an elongated movable rod therein extending from an outboard, proximal position to a distal end near a surgical site in said body, said surgical instrument carrying a plurality of surgical staple clips at said distal end of said rod, the method comprising the steps of:

longitudinally moving said rod in a substantially singular, operative stroke;

during said single operative stroke;

sequentially and pluralistically clipping said segment of blood vessel or other organic structure with a first group and then a second group of clips of said plurality surgical staple clips at different times during a first portion of said singular operative stroke; and

subsequently cutting said segment of blood vessel or other organic structure during a second portion of said singular operative stroke.

27. A method for surgically stapling and cutting as claimed in claim 26 wherein said first group of clips is at least one clip and said second group of clips is one of a subplurality of clips and a remaining plurality of clips wherein said first group of clips is placed on said blood vessel or other organic structure before said second group of clips and both said first and second group of clips is placed on said blood vessel or other organic structure before said blood vessel or other organic structure is cut.

28. A method as claimed in claim 27 wherein said singular operative stroke is caused by a single, generally uniform extension of said rod towards said distal end.

29. A method as claimed in claim 28 wherein said surgical instrument defines a common axis at said distal end and wherein said clipping and cutting steps include the step of translating said singular longitudinal movement of said rod into sequential plural pivotal movements about said common axis.

30. A method as claimed in claim 29 wherein said surgical staple clips are generally U-shaped and the method includes the step of sequentially collapsing said U-shaped clips onto said segment during said first portion of said operative stroke.