Device for applying adjunct in endoscopic procedure

• US 9,492,170 B2
• Filed: 08/10/2011
• Issued: 11/15/2016
• Est. Priority Date: 08/10/2011
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Bear, Brian W., Le, Thu Anh, Lytle, Thomas W. IV, Overmyer, Mark D., Setser, Michael, Smith, Bret W., Zavatsky, Joseph, Modi, Kreena
• Primary Examiner(s): Long, Robert
• Application Number:
  US13/206,752
• Publication Number:
  US 20130037596A1
• Time in Patent Office: 1,924 Days
• Field of Search: 2271751-1821
• US Class Current: 1/1
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 2017/00495 for two-component glue
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

A modular end effector delivers a therapeutic agent onto tissue that has been severed and/or stapled. The end effector is removably attached to a device. The device applies force to a piston of the end effector. The force causes a distal movement of a piston along a wall disposed within the end effector. The piston engages with agents stored on opposite sides of the wall, moving the agents distally to a mixture space. The agents are mixed in the mixture space and expelled through a tip. Staples may be embedded in or disposed below a foam block, which is disposed within a staple cartridge. Via an endoscopic stapling device, coated staples are driven through tissue while interacting with another agent on the device or the cartridge. The interaction forms a tissue restoring material that is applied onto the tissue.

Claims

1. A surgical instrument comprising a body, a shaft housing a firing bar, an end effector comprising an anvil, a lower jaw, and a stapling and severing mechanism responsive to a longitudinal closing motion produced by the body and the shaft, the lower jaw configured to receive a cartridge when in an open position, the cartridge comprising:

(a) a cartridge bottom including walls defining a chamber;

(b) a plurality of staples disposed in the chamber;

(c) a foam block disposed in the chamber, wherein the foam block comprises a therapeutic material; and

(d) a lid disposed over the foam block and the chamber, wherein the lid comprises a plurality of apertures configured for receipt of the plurality of staples upon activation of the stapling and severing mechanism in response to the longitudinal closing motion, wherein the staples are configured to be driven through the foam block and coated with the therapeutic material in response to activation of the stapling and severing mechanism, wherein the plurality of staples are embedded in the foam block.

2. The cartridge of claim 1, wherein the lid comprises a slot configured for receipt of the firing bar upon activation of the stapling and severing mechanism in response to the longitudinal closing motion.

3. The cartridge of claim 1, wherein the plurality of staples are disposed below the foam block.

4. The cartridge of claim 1, wherein the lid is snap-fit to the cartridge bottom.

5. The cartridge of claim 1, wherein the lid is molded to the cartridge bottom.

6. The cartridge of claim 1, wherein one of the plurality of staples comprises a material selected from at least one of the following materials:

iron, nickel titanium alloy, stainless steel, and titanium.

7. The cartridge of claim 1, wherein the plurality of staples are disposed in vertical slots defined by internals walls within the chamber.

8. The cartridge of claim 1, wherein a staple driver is substantially aligned with a respective one of the plurality of staples and is configured to drive the staple through the foam block upon activation of the stapling and severing mechanism in response to the longitudinal closing motion.

9. The cartridge of claim 8, wherein the instrument comprises a wedge sled configured to drive the staple driver toward the anvil upon activation of the stapling and severing mechanism in response to the longitudinal closing motion.

10. The cartridge of claim 1, wherein the foam block comprises thrombin.

11. The cartridge of claim 1, wherein the foam block comprises fibrin.

12. The cartridge of claim 1, wherein the foam block comprises one of thrombin or fibrin, and the anvil is coated with the other of thrombin or fibrin.

13. The cartridge of claim 1, wherein one of thrombin or fibrin is freeze dried with saline in the foam block.

14. A surgical instrument comprising:

(a) a body;

(b) a shaft housing a firing bar;

(c) an end effector comprising;

(i) an anvil, wherein the anvil is coated with a first coagulating agent,

(ii) an upper jaw,

(iii) a lower jaw, and

(iv) a stapling and severing mechanism responsive to a longitudinal closing motion produced by the body and the firing bar, wherein the upper and lower jaws are configured to move relative to one another to clamp tissue; and

(d) a cartridge configured to be received by the lower jaw when the upper jaw is in an open position, wherein the cartridge comprises;

(i) a cartridge bottom including walls defining a chamber,

(ii) a plurality of staples disposed in the chamber,

(iii) a foam block disposed in the chamber, wherein the foam block comprises a second coagulating agent, and

(iv) a lid disposed over the foam block and the chamber, wherein the staples are configured to be driven out of the foam block and out of the lid and toward the anvil in response to the longitudinal closing motion produced by the body and the firing bar, wherein the staples are configured to be coated with the second coagulating agent as the staples are driven out of the foam block, wherein the first coagulating agent is configured to react with the second coagulating agent when the staples contact the anvil.

15. A surgical instrument, comprising:

(a) a body;

(b) a shaft housing a firing bar;

(c) an end effector comprising;

(i) an anvil,

(ii) a lower jaw, and

(iii) a stapling and severing assembly responsive to a longitudinal closing motion produced by the body and the firing bar; and

(d) a removable cartridge, wherein the lower jaw is configured to receive the cartridge when the end effector is in an open configuration, the cartridge comprising;

(i) a housing having a plurality of sidewalls and a bottom portion,

(ii) a plurality of staples disposed in the housing,

(iii) a foam block disposed in the housing, and

(iii) a deck disposed over the plurality of staples and the foam block, the deck defining apertures, each aperture being substantially disposed over a corresponding staple of the plurality of staples,

wherein a portion of foam block is configured to coat the staples in response to the longitudinal closing motion produced by the body and the firing bar, wherein a portion of the foam block is configured to remain within the housing under the deck after the staples are driven from the cartridge in response to the longitudinal closing motion produced by the body and the firing bar.