Varying tissue compression with an anvil configuration

• US 9,016,541 B2
• Filed: 04/22/2009
• Issued: 04/28/2015
• Est. Priority Date: 05/09/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Viola, Frank, Zemlok, Michael
• Primary Examiner(s): Long, Robert
• Application Number:
  US12/427,796
• Publication Number:
  US 20090277949A1
• Time in Patent Office: 2,197 Days
• Field of Search: 2271751-1821, 606/142, 606/219
• US Class Current: 227/176.1
• 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 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07235 containing different staples, e.g. staples of different shapes, sizes or materials
• 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 2017/07264 characterised by its staple forming cavities, e.g. geometry or material
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder

Abstract

The present disclosure relates to surgical fastener applying apparatus and the application of variable compression to tissue. More specifically, the presently disclosed surgical fastener applying apparatus act to limit the flow of blood through tissue immediately adjacent a cut-line formed therein to effectuate hemostasis, while maximizing the flow of blood through tissue more removed from the cut-line to limit unnecessary necrosis. In one embodiment, a surgical fastener applying apparatus is disclosed having a tool assembly coupled to a distal end thereof with first and second jaws respectively including an anvil and a surgical fastener cartridge. The surgical fastener cartridge includes, among other things, angled pushers that engage surgical fasteners of varying lengths.

Claims

1. A surgical fastener applying apparatus, comprising:

an anvil member having a tissue contacting surface;

a cartridge member extending along a longitudinal axis and being movably coupled to the anvil member, the cartridge member including a plurality of surgical fasteners and a plurality of pushers operatively associated with the plurality of surgical fasteners, each pusher including a base portion and a plurality of pusher plates extending from the base portion such that adjacent pusher plates define an acute angle therebetween; and

a sled operably engagable with the plurality of pushers, wherein engagement of the sled with the pushers urges the surgical fasteners toward the anvil member such that a first row of surgical fasteners applies a first compressive force to tissue disposed between the anvil member and the cartridge member, and a second row of surgical fasteners applies a second, different compressive force to tissue disposed between the anvil member and the cartridge member.

2. The surgical fastener applying apparatus of claim 1, wherein the pushers and the surgical fasteners are configured and dimensioned such that the compressive forces are varied along an axis transverse to the longitudinal axis of the cartridge member.

3. The surgical fastener applying apparatus of claim 2, wherein the pushers and the surgical fasteners are configured and dimensioned such that the compressive forces applied to the tissue decrease outwardly relative to a centerline of the cartridge member such that blood flow through tissue nearer to the centerline of the cartridge member is less than blood flow through tissue further from the centerline of the cartridge member.

4. The surgical fastener applying apparatus of claim 2, wherein each pusher plate extends from the base portion to define a different length.

5. The surgical fastener applying apparatus of claim 4, wherein the pusher plates positioned nearer to a centerline of the cartridge member are shorter than the pusher plates positioned further from the centerline.

6. The surgical fastener applying apparatus of claim 5, wherein the plurality of pusher plates includes a first pusher plate, a second pusher plate, and a third pusher plate, the first pusher plate being positioned nearest to the centerline of the cartridge member, the second pusher plate being positioned outwardly of the first pusher plate and further from the centerline, and the third pusher plate being positioned outwardly of the second pusher plate and furthest from the centerline.

7. The surgical fastener applying apparatus of claim 6, wherein the first pusher plate extends from the base portion to define a first length, the second pusher plate extends from the base portion to define a second length, and the third pusher plate extends from the base portion to define a third length, wherein the third length is greater than the second length, and the second length is greater than the first length.

8. The surgical fastener applying apparatus of claim 1, wherein the pusher plates are connected to the base portion at a hinge member configured to allow the pusher plates to diverge as the pushers are driven towards the anvil member by the sled such that the angles described between adjacent pusher plates are increased.

9. The surgical fastener applying apparatus of claim 8, wherein the hinge member is configured as a living hinge.

10. The surgical fastener applying apparatus of claim 1, wherein the cartridge member includes a top wall having a plurality of retention slots formed therein configured and dimensioned to allow the surgical fasteners to pass therethrough during ejection from the cartridge member, each fastener retention slot being aligned with a corresponding pocket formed in the tissue contacting surface of the anvil member.

11. The surgical fastener applying apparatus of claim 10, wherein the surgical fasteners are positioned within the cartridge member to define a distance between penetrating tips thereof and the corresponding pocket formed in the tissue contacting surface of the anvil member.

12. The surgical fastener applying apparatus of claim 11, wherein the surgical fasteners positioned nearer to a centerline of the cartridge member are shorter than the surgical fasteners positioned further from the centerline such that the distance defined between the penetrating tips of the surgical fasteners and the corresponding pockets formed in the tissue contacting surface of the anvil member varies with the distance between the surgical fasteners and the centerline of the cartridge member.

13. The surgical fastener applying apparatus of claim 12, wherein the distance defined between the penetrating tips of the surgical fasteners and the corresponding pockets formed in the tissue contacting surface of the anvil member increases with the distance between the surgical fasteners and the centerline of the cartridge member.

14. The surgical fastener applying apparatus of claim 1, wherein the surgical fasteners are arranged into a plurality of rows including a first row of surgical fasteners positioned nearer to a centerline of the cartridge member, and a second row of surgical fasteners positioned outwardly of the first row and further from the centerline.

16. The surgical fastener applying apparatus of claim 1, wherein the plurality of pusher plates are interconnected via the base portion.

15. A surgical fastener applying apparatus, comprising:

an anvil member;

a cartridge member movably coupled to the anvil member and extending along a longitudinal axis, the cartridge member being configured and dimensioned to retain a plurality of surgical fasteners therein; and

at least one pusher positioned within the cartridge member, the at least one pusher being movable to eject the plurality of surgical fasteners from the cartridge member into the anvil member to effectuate formation of the plurality of surgical fasteners such that at least two different compressive forces are applied to tissue, the at least one pusher including a base portion and a plurality of pusher plates connected to the base portion such that the plurality of pusher plates are repositionable relative to a centerline of the cartridge member during movement of the at least one pusher, wherein the pusher plates extend from the base portion such that adjacent pusher plates define an acute angle therebetween.

17. The surgical fastener applying apparatus of claim 15, wherein the plurality of pusher plates are configured and dimensioned such that the acute angle defined between adjacent pusher plates is varied as the pushers are moved towards the anvil member.

18. The surgical fastener applying apparatus of claim 17, wherein the plurality of pusher plates are configured and dimensioned such that the pusher plates diverge as the pushers are moved towards the anvil member, whereby the acute angle defined between adjacent pusher plates is increased.

19. A pusher configured and dimensioned to eject one or more surgical fasteners from a surgical fastener applying apparatus, the pusher comprising a plurality of pusher plates configured and dimensioned such that at least one of the pusher plates is moved in first and second directions during ejection of the surgical fasteners, the first direction extending along a first axis, and the second direction extending along a second axis transverse in relation to the first axis.

20. The pusher of claim 19, wherein the plurality of pusher plates are interconnected via a common base portion.

21. The pusher of claim 19, wherein the plurality of pusher plates are configured and dimensioned such that adjacent pusher plates define an angle therebetween that is varied during ejection of the one or more surgical fasteners.

22. The surgical fastener applying apparatus of claim 21, wherein the angle defined between adjacent pusher plates is acute.

23. The surgical fastener applying apparatus of claim 21, wherein the plurality of pusher plates are configured and dimensioned such that the pusher plates diverge during ejection of the one or more surgical fasteners, whereby the angle defined between adjacent pushers plates is increased.