Surgical stapling instrument and method thereof

• US 20010010320A1
• Filed: 02/02/2001
• Published: 08/02/2001
• Est. Priority Date: 06/17/1994
• Status: Active Grant

• Current Assignee: Heartport, Inc. (Johnson & Johnson)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Bolduc, Lee R., Heck, Christopher F.
• Granted Patent: US 6,588,643 B2
• Time in Patent Office: Days
• US Class Current: 227/176.1
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1152 applying the staples on the outside of the lumen
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/081 Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11

Abstract

A stapler for stapling a tubular structure to another structure. The stapler has an anvil which is expandable from a collapsed position to an expanded position. The stapler has a recess which receives at least a portion of the tubular structure and a shoulder which receives an everted end of the tubular structure. A first actuator moves the anvil relative to the shoulder for compressing the structures which are to be stapled together. A second actuator is used for driving the staples through the structures to be stapled together.

Claims

1. A method of attaching a graft to a body structure comprising the steps of:

providing a stapler having an anvil, a rod, a staple pusher and a shoulder, the anvil being attached to the rod and the staple pusher being configured to drive staples, the shoulder being positioned opposite the anvil;

positioning the rod in a graft;

everting the end of the graft around the shoulder;

inserting the anvil through an opening in a body structure to which the graft is to be stapled;

compressing the graft and the body structure between the anvil and the shoulder; and

moving the staple pusher so that the staple pusher engages the staples and drives the staples against the anvil thereby stapling the graft to the body structure.

2. The method of

claim 1

, wherein:

the compressing and firing steps are independent of one another.

3. The method of

claim 1

, wherein:

the compressing step is carried out by moving the anvil.

4. The method of

claim 1

, wherein:

the providing step is carried out with the anvil having a plurality of segments, the segments being movable between an expanded shape and a compressed shape.

5. The method of

claim 4

, further comprising the step of:

expanding the anvil segments from the expanded shape to the compressed shape after the moving step.

6. The method of

claim 5

, wherein:

the providing step is carried out with the stapler having an expander longitudinally movable with respect to the plurality of segments;

the expanding step being carried out by moving the expander longitudinally to engage and expand the anvil segments.

7. A method of attaching a graft to a body structure, comprising the steps of:

providing a stapler having a rod, a plurality of anvil segments, a movable staple pusher and a shoulder, each of the plurality of anvil segments having a recess adapted to deform a staple, the staple pusher being configured to drive a plurality of staples toward the recesses of the plurality of anvil segments, the shoulder being positioned opposite the anvil, the plurality of anvil segments being mounted to the rod and being movable between an expanded position and a collapsed position;

positioning the rod in a graft;

everting an end of the graft around the shoulder;

inserting the plurality of anvil segments through an opening in a body structure to which the graft is to be stapled, the plurality of anvil segments being inserted into the body structure in the collapsed position;

compressing the graft and the body structure between the plurality of anvil segments and the shoulder;

expanding the plurality of anvil segments to the expanded shape;

moving the staple pusher so that the staple pusher engages the staples and drives the staples against the plurality of anvil segments;

collapsing the plurality of anvil segments from the expanded shape to the collapsed shape after the moving step; and

removing the rod from the graft when after the collapsing step.

8. The method of

claim 7

, wherein:

the providing step is carried out with the stapler having an expander, the expander being slidably coupled to the plurality of anvil segments for moving the plurality of anvil segments between the expanded and collapsed positions.

9. The method of

claim 8

, wherein:

the compressing and moving steps are performed independently.

10. A stapler for stapling a graft to a body structure, comprising:

a handle;

a housing coupled to the handle, the housing having a shoulder;

a staple pusher movably coupled to the housing;

a rod coupled to the handle and extending at least partially through the housing;

an anvil connected to the rod;

a first actuator configured to move the anvil relative to the shoulder of the housing for compressing tissue layers positioned therebetween;

a second actuator coupled to the handle, the second actuator being configured to drive the staple pusher for driving staples toward the anvil.

11. The stapler of

claim 10

, wherein:

the staple pusher includes a plurality of staple drivers for driving a plurality of staples.

12. The stapler of

claim 10

, wherein:

the anvil is separated into a plurality of anvil segments, the plurality of anvil segments being movable between an expanded position and a collapsed position.

13. The stapler of

claim 12

, further comprising:

an expander slidably coupled to the handle, the expander slidably engaging the plurality of anvil segments for moving the plurality of anvil segments between the expanded and collapsed positions.

14. The stapler of

claim 12

, wherein:

the plurality of anvil segments each include a recess for engaging and deforming a staple, the plurality of anvil segments having a smaller cross-sectional area when in the collapsed position than the recesses of the plurality of anvil segments when the plurality of anvil segments are in the expanded position for facilitating withdrawal of the anvil from a stapled area.

15. A staple for use in securing a body structure to another body structure, the staple comprising:

a first leg having a first sharp end;

a second leg having a second sharp end;

a tissue compression portion extending between the first and second legs;

a top coupled to the tissue compression portion, a first distance between the top and the tissue compression portion being at least 15% of a second distance between the top and the first and second sharp ends.

16. The staple of

claim 15

, wherein:

the first distance is at least 30% of the second distance.

17. The staple of

claim 15

, wherein:

the first and second legs each include a notch, the first and second legs bending at the notch when the staple is fired.

18. The staple of

claim 15

, wherein the staple is solid between the top and tissue compression portion.