SURGICAL CIRCULAR STAPLER WITH TISSUE RETENTION ARRANGEMENTS

• US 20120029547A1
• Filed: 07/30/2010
• Published: 02/02/2012
• Est. Priority Date: 07/30/2010
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Willis, John W.
• Granted Patent: US 8,801,735 B2
• Time in Patent Office: Days
• US Class Current: 606/180
• 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 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07257 characterised by its anvil
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/1132 End-to-end connections
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/2943 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/0427 : Prevention of contact
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/0801 : Prevention of accidental cutting or pricking
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 2090/0807 : Indication means
• CPC Class Codes: A61B 2090/0816 : for preventing adhesion
• CPC Class Codes: A61B 2090/309 : using white LEDs
• CPC Class Codes: A61B 2090/3912 : Body cavities
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3966 : Radiopaque markers visible in an X-ray image

Abstract

Surgical instruments and procedures for performing a circular anastomosis of a tubular organ. The surgical instruments may include selectively deployable tissue acquisition members configured to puncture through a portion of the tubular organ and position the portion of the organ adjacent to a fastener face of a staple cartridge supported in the instrument. At least one cutting member may be radially deployed and rotated to sever the positioned portion of organ from a distal portion of the organ. An anvil may be employed to draw another portion of the organ adjacent to the portion of organ positioned adjacent to the fastener face of the staple cartridge. The staples may then be deployed through the adjacent portions of organ and an annular knife may be advanced through the adjacent organ portions to complete the anastomosis.

Claims

1. A surgical instrument comprising:

an elongated shaft defining a central axis, said elongated shaft having a distal end portion configured to operably support a circular staple cartridge therein;

at least one acquisition member operably supported within said elongated shaft, each said acquisition member having a flexible tissue-piercing distal portion that is radially deployable away from said central axis upon application of a deployment motion to said acquisition member; and

at least one flexible knife member movably supported in said elongated shaft, each said knife member having a distal cutting portion that is axially advanceable out of said distal end portion of said elongated shaft upon application of an axial actuation motion thereto, each said knife member being selectively rotatable about said central axis upon application of a rotary actuation motion thereto.

2. The surgical instrument of claim 1 further comprising a tissue piercing barb on said tissue-piercing distal portion of each said acquisition member.

3. The surgical instrument of claim 1 wherein each said acquisition member is movably supported in an acquisition housing that is movably supported within said elongated shaft.

4. The surgical instrument of claim 1 wherein said distal cutting portion of each said knife member naturally bends radially away from said central axis when said distal cutting portion is axially advanced out of said distal end portion of said elongated shaft.

5. The surgical instrument of claim 4 wherein each said knife member has a tissue-piercing point formed thereon.

6. The surgical instrument of claim 1 wherein each said knife member is supported in a cutter housing that is axially and rotatably supported within said elongated shaft.

7. The surgical instrument of claim 1 further comprising an annular cutting member that is supported by said distal end of said elongated shaft for selective axial travel relative thereto.

8. The surgical instrument of claim 7 wherein said annular cutting member is supported to receive axial firing motions from a firing member operably supported in said elongated shaft.

9. The surgical instrument of claim 1 wherein said at least one acquisition member comprises a plurality of acquisition members.

10. The surgical instrument of claim 1 wherein said at least one flexible knife member comprises a plurality of flexible knife members.

11. A surgical instrument comprising:

a handle assembly;

an elongated shaft protruding from said handle assembly and defining a central axis, said elongated shaft terminating in a stapler head comprising;

a circular staple cartridge having a fastener face; and

an axially movable cutting member;

a firing member operably supported in said elongated shaft and oriented to apply a firing motion to said circular staple cartridge;

an anvil shaft assembly operably supported within said elongated shaft and configured to receive actuation motions from said handle assembly to cause said anvil shaft assembly to move axially within said elongated shaft such that a distal connection portion thereof moves axially relative to said fastener face;

an anvil removably attachable to said distal connection portion of said anvil shaft assembly;

an acquisition housing movably supported with said elongated shaft and operably supporting therein a plurality of acquisition members that each have a distal tissue acquisition portion that is selectively axially advanceable out of a distal end of said acquisition housing, each said tissue acquisition portion configured to flex radially away from said central axis when axially advanced out of said distal end of said acquisition housing;

a cutter housing movably supported within said elongated shaft such that said cutter housing may be selectively axially and rotatably moved relative to said elongated shaft; and

a plurality of knife members movably supported in said cutter housing, each said knife member having a distal cutting portion that is axially advanceable out of a distal end portion of said cutter housing upon application of an axial actuation motion thereto.

12. The surgical instrument of claim 11 wherein each said acquisition member has a tissue piercing acquisition tip formed thereon.

13. The surgical instrument of claim 11 wherein each said knife member has a tissue piercing knife point formed thereon.

14. A surgical procedure for performing a circular anastomosis of a tubular organ, said surgical procedure comprising:

inserting a stapler head of a surgical instrument into the tubular organ;

puncturing through a proximal portion of the tubular organ with a plurality of tissue acquisition members of the surgical instrument;

positioning the punctured proximal portion of the tubular organ adjacent to the stapler head;

severing the punctured proximal portion of the tubular organ from a distal portion of the tubular organ;

inserting an anvil into the distal portion of the tubular organ such that a connection portion of the anvil protrudes proximally out of an open end of the distal portion of the tubular organ;

securing the distal portion of the tubular organ to the anvil;

coupling the connection portion of the anvil to the surgical instrument;

drawing the anvil proximally toward the stapler head such that another portion of the distal portion of the tubular organ and the punctured proximal portion of the tubular organ are adjacent to each other and captured between the anvil and the stapler head;

stapling the another portion and the punctured proximal portion together; and

cutting through the another portion and punctured proximal portion adjacent to the staples.

15. The surgical procedure of claim 14 wherein said severing comprises:

inserting at least one knife member through the distal portion of the tubular organ; and

applying a rotary motion to the at least one knife member to sever the distal portion of the tubular organ from the punctured proximal portion.

16. The surgical procedure of claim 14 wherein said puncturing comprises axially advancing the plurality of tissue acquisition members such that a distal acquisition portion of each tissue acquisition member protrudes distally out of the stapler head to puncture through the distal portion of the tubular organ.

17. The surgical procedure of claim 16 wherein said positioning the punctured proximal portion comprises axially withdrawing the plurality of tissue acquisition members at least partially back into the stapler head until the punctured proximal portion is adjacent to the stapler head.

18. The surgical procedure of claim 16 wherein each of the tissue acquisition members has a barb formed thereon that hookingly engages the proximal portion of the tubular organ as the tissue acquisition member punctures through the proximal portion and wherein said positioning the punctured proximal portion comprises withdrawing the plurality of tissue acquisition members at least partially back into the stapler head until the hooked proximal portion is adjacent to the stapler head.

19. The surgical procedure of claim 14 wherein said securing the distal portion of the tubular organ to the anvil comprises suturing the distal portion of the tubular organ to the connection portion of the anvil such that a proximal end portion of the connection portion protrudes proximally out of the open end of the distal portion of the tubular organ.

20. The surgical procedure of claim 14 wherein said cutting through the another portion and punctured proximal portion adjacent to the staples comprises axially advancing an annular cutting member through the another portion and punctured proximal portion at a location adjacent to the staples.