Methods and devices for cutting and fastening tissue

• US 8,945,163 B2
• Filed: 04/01/2009
• Issued: 02/03/2015
• Est. Priority Date: 04/01/2009
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Voegele, James W., Weisenburgh, William B. II, Hess, Christopher J., Murray, Michael A., Gill, Robert P., Powell, Darrel M.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): Papeika, Rachel S
• Application Number:
  US12/416,546
• Publication Number:
  US 20100256634A1
• Time in Patent Office: 2,134 Days
• Field of Search: 227/175.1, 227/180.1, 606/139, 606/167, 606/170, 606/219, 606205-209
• US Class Current: 606/170
• 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 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

Methods and devices are provided for cutting and fastening tissue. In one embodiment, a surgical device can be used to at least partially transect a stomach by not cutting and/or not fastening a portion of tissue engaged in an end effector located at the device'"'"'s distal end. A portion of the stomach can be engaged by the end effector, and the end effector can be actuated to cut and/or to apply one or more fasteners to tissue engaged in a distal portion of the end effector but not to cut and/or apply fasteners to tissue engaged in a proximal portion of the end effector. In a similar way, the surgical device can be used in any surgical procedure in which it is desired to cut and/or fasten a distal portion of tissue engaged by the end effector but not a proximal portion of tissue engaged by the end effector.

Claims

1. A surgical device, comprising:

first and second jaws configured to be movable relative to one another and configured to engage tissue therebetween, the first jaw having a first tissue-engaging surface and the second jaw having a second tissue-engaging surface, the first and second tissue-engaging surfaces facing each other substantially along entire length thereof, and least one of the first and second jaws including a surface feature extending from an interior surface thereof; and

a knife configured to translate between proximal and distal ends of the first and second jaws, the knife being movable between a proximal region of the first and second tissue-engaging surfaces of the first and second jaws and a distal region of the first and second tissue-engaging surfaces of the first and second jaws, tissue not being cut throughout the proximal region and tissue being cut in the distal region, the knife being in a first position in the proximal region and in a second position in the distal region, and the knife including a complementary feature formed therein that is complementary to the surface feature and is configured to engage the surface feature to move the knife between the first and second positions, wherein the proximal region comprises at least about 20% of a total length extending between the proximal and distal ends of the first and second jaws.

2. The device of claim 1, wherein the knife is configured to pivot between the first and second positions as the knife translates through the first and second jaws.

3. The device of claim 2, wherein the complementary feature includes a cut-out formed in the knife that is configured to allow the knife to pivot between the first and second positions.

4. The device of claim 1, wherein the knife is configured to translate in a distal to proximal direction through the first and second jaws to cut tissue.

5. The device of claim 1, wherein the knife is configured to translate in a proximal to distal direction through the first and second jaws to cut tissue.

6. The device of claim 1, wherein the second position is rotated about 90°

from the first position.

7. The device of claim 1, wherein, when the complementary feature includes a cut-out formed in the knife.

8. The device of claim 7, wherein, when the knife is in the second position, the cut-out is formed in a distal-facing side of the knife cutting element.

9. The device of claim 7, wherein, when the knife is in the second position, the cut-out is formed in a proximal-facing side of the knife.

10. The device of claim 1, wherein the proximal region comprises up to 70% of the total length extending between the proximal and distal ends of the end effector.

11. A surgical device, comprising:

an elongate shaft;

an end effector coupled to a distal end of the elongate shaft, the end effector configured to engage tissue, and the end effector having a longitudinal slot formed in a distal region thereof but not in a proximal region thereof such that the longitudinal slot extends along a partial longitudinal length of the end effector; and

a cutting blade configured to translate between proximal and distal ends of the end effector and throughout entireties of the proximal and distal regions, the cutting blade having a first position in the proximal region of the end effector in which tissue is not cut and having a second position in the distal region of the end effector in which tissue is cut, the cutting blade being movable between the first and second positions, and the cutting blade extending through the longitudinal slot in the distal region.

12. The device of claim 11, wherein the cutting blade is configured to translate in a distal to proximal direction along the end effector to cut tissue.

13. The device of claim 11, wherein the cutting blade is configured to rotate between the first and second positions.

14. The device of claim 11, further comprising a cam element configured to move the cutting blade from one of the first and second positions to another of the first and second positions during translation of the cutting blade along the end effector.

15. The device of claim 11, wherein the proximal region comprises at least about 20% of a total length extending between the proximal and distal ends of the end effector.

16. The device of claim 11, wherein the proximal region has a longitudinal length at least as long as a longitudinal length of the distal region.

17. The device of claim 11, wherein the proximal region has a length in a range of about 20% to 70% of a total length extending between the proximal and distal ends of the end effector.