Surgical stapling instruments having flexible channel and anvil features for adjustable staple heights

• US 7,467,740 B2
• Filed: 09/29/2006
• Issued: 12/23/2008
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Timm, Richard W., Morgan, Jerome R., Shelton, Frederick E. IV, Voegele, James W., Murray, Michael A., Timperman, Eugene L., Spivey, James T., Fugikawa, Leslie M
• Primary Examiner(s): Nash; Brian D
• Application Number:
  US11/540,735
• Publication Number:
  US 20070083234A1
• Time in Patent Office: 816 Days
• Field of Search: 227/178.1, 227/19, 227/175.1, 606/8, 606/153, 606/144, 411/21, 411/24
• US Class Current: 227/178.1
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/07242 achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
• CPC Class Codes: A61B 2017/0725 with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2090/032 pressure limiting, e.g. hydrostatic
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 90/03 Automatic limiting or abutting means, e.g. for safety

Abstract

A surgical instrument for being endoscopically or laparoscopically inserted into a surgical site for simultaneous stapling and severing of tissue includes force adjusted spacing between an upper jaw (anvil) and a lower jaw (staple cartridge engaged to an elongate staple channel) so that the height of staple formation corresponds to the thickness of the tissue, yet does not exceed the height range that may be accommodated by the length of the staples. In particular, resilient structures may be formed into one or more of the elongate channel that supports the staple cartridge, the anvil that is pivotally attached to the elongate channel, and/or a firing member that includes a cutting surface (knife) that severs tissue between a top pin that engages the anvil and a lower foot that engage the elongate channel. The resilience responds to the force exerted by clamped tissue to vary the spacing between the anvil and the staple cartridge supported within the elongate channel.

Claims

1. A surgical instrument comprising:

an elongate staple channel having a longitudinal channel slot;

a staple cartridge operably supported within said elongate staple channel;

an elongate shaft operably coupled to said elongate staple channel;

an anvil pivotally attached to the elongate staple channel and being selectively pivotable between a closed position wherein a staple forming undersurface thereof is in confronting relationship to an upper surface of said staple cartridge supported within said elongate staple channel and an open position wherein a distal end of said anvil is spaced from said upper surface of said staple cartridge, said anvil having a first longitudinally extending anvil ledge portion cantilevering inwardly from a first anvil portion and a second longitudinally extending anvil ledge portion cantilevering inwardly from a second anvil portion in spaced confronting relationship to said first anvil ledge portion to define a portion of an elongate anvil slot therebetween;

a first undercut area extending into said first anvil portion adjacent an upper surface of said first anvil ledge;

a second undercut area extending into said second anvil portion adjacent an upper surface of said second anvil ledge;

a control handle assembly proximally operably coupled through the elongate shaft to selectively apply opening and closing motions to said anvil; and

a firing member operably coupled to the control handle assembly through said elongate shaft for selective longitudinal reciprocating motion in the elongate staple channel such that one portion of said firing member extends through said anvil slot between a first and a second resilient anvil portion and another portion of said firing member extends through said longitudinal channel slot.

2. The surgical instrument of claim 1 wherein said firing member comprises:

a vertical portion wherein said one portion of said firing member comprises an upper end of said vertical portion and wherein said another portion of said firing member comprises a lower end of said vertical portion;

laterally extending pins protruding from the upper end of the vertical portion positioned to bear upon the first and second anvil ledges during firing translation of said firing member therein; and

a foot portion extending from the lower end of the vertical portion positioned to exert an inward compressive force on the elongate channel during firing translation.

3. The surgical instrument of claim 2 wherein said laterally extending pins are flexible relative to said upper end portion of said vertical portion of the firing member.

4. The surgical instrument of claim 1 wherein said first flexible portion of said anvil comprises at least one first staple insert movably supported within said anvil, said first staple insert having a first staple forming undersurface thereon and wherein said second flexible portion of said anvil comprises at least one second staple insert movably supported within said anvil and having a second staple forming undersurface thereon.

5. The surgical instrument of claim 4 further comprising:

at least one first compliant member corresponding to each said first staple insert and supported between said corresponding first staple insert and a portion of said anvil; and

at least one second compliant member corresponding to each said second staple insert and supported between said corresponding second staple insert and another portion of said anvil.

6. The surgical instrument of claim 5 wherein each of said first and second compliant members is selected from the group of compliant members consisting of:

springs, compressible polymer materials and fluid supporting bladders.

7. A surgical stapling instrument comprising:

an elongate staple channel having a longitudinal channel slot;

a staple cartridge operably supported within said elongate staple channel;

an elongate shaft operably coupled to said elongate staple channel;

an anvil pivotally attached to the elongate staple channel, said anvil comprising;

a first staple insert movably supported within said anvil, said first staple insert having a first staple forming undersurface thereon and defining a first staple zone;

a first compliant member corresponding to said first staple insert and supported between said corresponding first staple insert and a portion of said anvil;

a second staple insert supported within said anvil and being independently movable relative to said first staple insert to define a second staple zone, said second staple insert having a second staple forming undersurface thereon; and

a second compliant member corresponding to said second staple insert and supported between said corresponding second staple insert and another portion of said anvil;

a control handle assembly proximally operably coupled through the elongate shaft to selectively apply opening and closing motions to said anvil; and

a firing member operably coupled to the control handle assembly through said elongate shaft for selective longitudinal reciprocating motion in the elongate staple channel such that one portion of said firing member extends through an anvil slot defined by said first and second staple inserts and another portion of said firing member extends through said longitudinal channel slot.

8. The surgical stapling instrument of claim 7 wherein each of said first and second compliant members is selected from the group of compliant members consisting of:

springs, compressible polymer materials and fluid supporting bladders.

9. The surgical stapling instrument of claim 7 wherein said first and second staple zones are axially displaced from each other in said anvil.

10. The surgical stapling instrument of claim 7 wherein said first and second staple zones are laterally displaced from each other in said anvil.

11. The surgical stapling instrument of claim 10 wherein said first staple insert comprises at least one right side staple insert and wherein said second staple insert comprises at least one left side staple insert spaced laterally from said right side staple inserts to define said anvil slot therebetween.

12. The surgical stapling instrument of claim 11 wherein said right side insert comprises at least two right side staple inserts axially aligned on a right side of said anvil slot, each said right side staple insert independently movable relative to each other and having a corresponding right side compliant member associated therewith and wherein said left side insert comprises at least two left side staple inserted axially aligned on a left side of said anvil slot, each said left side staple insert independently movable relative to each other and having a corresponding left side compliant member associated therewith.

13. The surgical stapling instrument of claim 12 wherein each of said right and left compliant members is selected from the group of compliant members consisting of:

springs, compressible polymer materials and fluid supporting bladders.

14. A surgical instrument, comprising:

a cartridge supporting assembly configured to operably support a staple cartridge therein;

an anvil body movably coupled to said cartridge supporting assembly and being selectively movable between an open position and a closed position in response to opening and closing motions respectively applied thereto, said anvil body having an elongate anvil slot therein and a resilient structure configured to flexibly interact with said firing member during said staple firing motion to allow a distance between a staple forming undersurface associated with said anvil body and an upper surface of said staple cartridge supported within said cartridge supporting assembly to vary in relation to a thickness of tissue clamped therebetween, said resilient structure comprising;

at least one right insert movable relative to said anvil body on a first side of said anvil slot and having a first staple forming undersurface thereon; and

at least one left insert movable relative to said anvil body on a second side of said anvil slot and having a second staple forming undersurface thereon; and

a firing member operably supported relative to said cartridge supporting assembly and being selectively translatable from an unfired position to a fired position in response to a firing force applied to said firing member and to retract to an unfired position in response to a retraction force applied to said firing member.

15. The surgical instrument of claim 14 further comprising:

a right compliant member supported between each right insert and said anvil body; and

a left compliant member supported between each said left insert and said anvil body.

16. The surgical instrument of claim 15 wherein said right compliant member comprises at least one right bladder at least partially filled with a fluid medium and wherein said left compliant member comprises at least one left bladder at least partially filled with the fluid medium.

17. The surgical instrument of claim 16 wherein each of said right and left bladders are fluidically coupled to a fluid reservoir having a pressure adjustment mechanism operably supported therein for selectively increasing or decreasing fluid pressure in said right and left bladders.

18. The surgical instrument of claim 14 wherein said at least one right insert comprises a plurality of right inserts that correspond in number to a number of right staples in a staple cartridge supported within said cartridge supporting assembly and wherein said at least one left insert comprises a plurality of left inserts that correspond in number to a number of left staples in the staple cartridge.

19. The surgical instrument of claim 18 further comprising:

at least one right biasing plate supported within said anvil body on a right side of said anvil slot and supporting a plurality of right biasing members wherein each said right biasing member corresponds to one of said right inserts; and

at least one left biasing plate supported within said anvil body on a left side of said anvil slot and supporting a plurality of left biasing members wherein each said left biasing member corresponds to one of said left inserts.

20. A surgical instrument, comprising:

a cartridge supporting assembly configured to operably support a staple cartridge therein, said cartridge supporting assembly having a first longitudinally extending ledge cantilevering inwardly from a first portion of said cartridge supporting assembly and a second longitudinally extending ledge cantilevering inwardly in spaced confronting relationship relative to said first ledge, said first and second ledge defining an elongate channel track thereunder and an elongate slot therebetween that extends into said elongate channel track;

an anvil movably coupled to said cartridge supporting assembly and being selectively movable between an open position and a closed position in response to opening and closing motions respectively applied thereto;

a firing member operably supported relative to said cartridge supporting assembly and being selectively translatable from an unfired position to a fired position in a staple firing motion in response to a firing force applied to said firing member and to retract to an unfired position in response to a retraction force applied to said firing member, said firing member having a vertical portion movably received in said elongate slot for axial travel therein and a lower foot movably received in said elongate channel track for axial travel therein, and wherein an upper portion of said firing member movably engages said anvil when said anvil is in said closed position;

at least one first undercut area in said first portion of said cartridge supporting assembly and at least one second undercut area in said second portion of said cartridge supporting assembly to enable said first and second ledges, respectively to flexibly interact with said firing member during said staple firing motion to allow a distance between a staple forming undersurface of said anvil and the upper surface of a staple cartridge supported within said cartridge supporting assembly to vary in relation to a thickness of tissue clamped therebetween.

21. The surgical instrument of claim 20 wherein said at least one first undercut area comprises:

a first upper undercut area in said first portion of said cartridge supporting assembly; and

a first lower undercut area in said second portion of said cartridge supporting assembly and wherein said at least one second undercut area comprises;

a second upper undercut area in said second portion of said cartridge supporting assembly; and

a second lower undercut area in said second portion of said cartridge supporting assembly.

22. A surgical instrument comprising:

an elongate staple channel having a longitudinal channel slot;

a staple cartridge operably supported within said elongate staple channel;

an elongate shaft operably coupled to said elongate staple channel;

an anvil pivotally attached to the elongate staple channel and being selectively pivotable between a closed position wherein a staple forming undersurface thereof is in confronting relationship to an upper surface of said staple cartridge supported within said elongate staple channel and an open position wherein a distal end of said anvil is spaced from said upper surface of said staple cartridge, said anvil having a first resilient anvil portion and a second resilient anvil portion spaced from said first resilient anvil portion to define a portion of an elongate anvil slot therebetween;

a control handle assembly proximally operably coupled through the elongate shaft to selectively apply opening and closing motions to said anvil; and

a firing member operably coupled to the control handle assembly through said elongate shaft for selective longitudinal reciprocating motion in the elongate staple channel such that one portion of said firing member extends through said anvil slot between said first and second resilient anvil portions and another portion of said firing member extends through said longitudinal channel slot, said firing member comprising;

a vertical portion wherein said one portion of said firing member comprises an upper end of said vertical portion and wherein said another portion of said firing member comprises a lower end of said vertical portion;

laterally extending pins protruding from the upper end of the vertical portion and being flexible relative thereto to bear upon the first and second resilient portions of said anvil during firing translation of said firing member therein; and

a foot portion extending from the lower end of the vertical portion positioned to exert an inward compressive force on the elongate channel during firing translation.

23. The surgical instrument of claim 22 wherein said first flexible portion of said anvil comprises at least one first staple insert movably supported within said anvil, said first staple insert having a first staple forming undersurface thereon and wherein said second flexible portion of said anvil comprises at least one second staple insert movably supported within said anvil and having a second staple forming undersurface thereon.

24. The surgical instrument of claim 23 further comprising:

at least one first compliant member corresponding to each said first staple insert and supported between said corresponding first staple insert and a portion of said anvil; and

at least one second compliant member corresponding to each said second staple insert and supported between said corresponding second staple insert and another portion of said anvil.

25. The surgical instrument of claim 24 wherein each of said first and second compliant members is selected from the group of compliant members consisting of:

springs, compressible polymer materials and fluid supporting bladders.