End effector for use with a flexible endoscopic surgical instrument for invagination and fundoplication

• US 6,663,640 B2
• Filed: 09/17/2001
• Issued: 12/16/2003
• Est. Priority Date: 11/03/1997
• Status: Expired due to Term

• Current Assignee: Symbiosis Corporation (Boston Scientific Corporation)
• Original Assignee: Symbiosis Corporation (Boston Scientific Corporation)
• Inventors: Kortenbach, Juergen Andrew
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/953,428
• Publication Number:
  US 20020035370A1
• Time in Patent Office: 820 Days
• Field of Search: 606/139, 606/219, 606/142, 606/220, 606/116, 606/120, 606/151
• US Class Current: 606/142
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00179 for off-axis viewing
• CPC Class Codes: A61B 1/273 for the upper alimentary canal, e.g. oesophagoscopes, gastroscopes
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to the proximal end of the tube. The manual actuator is coupled to the end effector by a plurality of flexible cables which extend through the tube. The tube contains a lumen for receiving a manipulable endoscope and the end effector includes a passage for the distal end of the endoscope. The end effector has a store for a plurality of male fastener parts, a store for a plurality of female fastener parts, a rotatable grasper, a rotatable fastener head for aligning a female fastener part and a male fastener part with tissues therebetween, and a firing member for pressing a male fastener part through tissues grasped by the grasper and into a female fastener part. According to a presently preferred embodiment the overall diameters of the flexible tube and the end effector (when rotated to the open position) do not exceed approximately 20 mm so that the instrument may be delivered transorally to the fundus of the stomach. The manual actuator is provides with a lock-out feature which prevents firing male fastener parts before the fastener head is closed. The instrument is advantageously utilized in a fundoplication procedure.

Claims

1. An end effector for use with an endoscopic surgical instrument for deploying a two-part fastener, comprising:

a first end effector member having a proximal end, a distal end, and a first holding device configured to hold a first part of the two-part fastener; and

a second end effector member rotatably coupled to the distal end of the first end effector member and including a second holding device configured to hold a second part of the two-part fastener in an opposed relation to the first part of the two-part fastener when he second end effector member is rotated to a closed position.

2. The end effector of claim 1, further comprising a grasping mechanism for grasping tissue.

3. The end effector of claim 2, wherein the grasping mechanism comprises a grasping member rotatably coupled to the first end effector member.

4. The end effector of claim 3, wherein the grasping member includes a first gripping surface and the grasping mechanism further comprises a second gripping surface located on the first end effector member.

5. The end effector of claim 4, wherein the grasping member is configured to rotate to a position in opposed relation to the second gripping surface for grasping tissue therebetween.

6. The end effector of claim 4, wherein the second gripping surface is tapered.

7. The end effector of claim 3, wherein the first grasping member and the second end effector member rotate about a same axis.

8. The end effector of claim 3, wherein the first grasping member and the second end effector member rotate about different axes.

9. The end effector of claim 3, wherein, in the closed position, the grasping member proximally extends a smaller distance along the first end effector member than a distance the second end effector member proximally extends along the first end effector member.

10. The end effector of claim 1, wherein the second end effector member is configured to rotate between an open position and the closed position.

11. The end effector of claim 2, wherein the second end effector member extend distally away from the first end effector member in the open position and the second end effector member extends substantially proximally from the distal end of the first end effector member in the closed position.

12. The end effector of claim 10, wherein the second end effector member rotates more than 90°

from the open position to the closed position.

13. The end effector of claim 5, when the second end effector member extends distally away from the first end effector member in the open position and the second end effector member extends substantially proximally from the distal end of the first end effector member in the closed position.

14. The end effector of claim 1, wherein the first holding device includes a firing mechanism for ejecting the first part of the two-part fastener from the first end effector member causing first of the two-part fastener to mate with the second part of the two-part fastener.

15. The end effector of claim 14, wherein the first end effector defines a first storage chamber for storing a plurality of first parts of the two-part fastener and the second end effector member defines a second storage chamber for storing a plurality of second parts of the two-part fastener.

16. The end effector of claim 15, wherein the first holding device further includes a biasing member for biasing one of the plurality of first parts of the two-part fastener from the first storage chamber into the firing mechanism.

17. The end effector of claim 16, wherein the biasing member comprises a spring device.

18. The end effector of claim 15, wherein the firing mechanism is configured to pivot from a first position in communication with the first storage chamber to a second position for ejecting the first part of the two-part fastener.

19. The end effector of claim 14, wherein the first end effector defines an ejection port through which the first part of the two-part fastener is ejected by the firing mechanism.

20. The end effector of claim 15, wherein the second holding device includes a shuttle device for moving one of the plurality second parts of the two-part fastener from the second storage chamber into position to engage with the first part of the two-part fastener.

21. The end effector of claim 20, wherein the shuttle device comprises a slidable tray.

22. The end effector of claim 1, wherein the first end effector member defines an exit port for an endoscope.

23. The end effector of claim 1, wherein the first end effector member comprises a relatively flexible proximal portion and a relatively rigid distal portion.