DEVICE FOR APPLYING ADJUNCT IN ENDOSCOPIC PROCEDURE

• US 20130037596A1
• Filed: 08/10/2011
• Published: 02/14/2013
• Est. Priority Date: 08/10/2011
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Thomas W. Lytle IV
• Inventors: Overmyer, Mark D., Setser, Michael, Smith, Bret W., Zavatsky, Joseph, Bear, Brian W., Le, Thu Anh, Lytle, Thomas W. IV, Modi, Kreena
• Granted Patent: US 9,492,170 B2
• Time in Patent Office: Days
• US Class Current: 227/176.1
• 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 handle portion, 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 handle portion 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; and

(d) a lid disposed over the foam block and the chamber.

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

3. 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.

4. The cartridge of claim 1, wherein the plurality of staples are embedded in the foam block.

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

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

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

8. 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.

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

10. 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.

11. The cartridge of claim 10, wherein the instrument comprises a wedge sled configured to drive the a staple driver toward the anvil upon activation of the stapling and severing mechanism in response to the longitudinal closing motion.

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

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

14. 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.

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

17. The apparatus of claim 1, wherein the trigger of the device is configured to receive the application of force and is configured to provide the application of force on the piston of the end effector.

16. An endoscopic instrument apparatus comprising a device and an end effector, the device comprising a trigger, a handle portion including an articulation knob, a shaft, and an articulation segment, the end effector configured to be removably attached to a distal end of the device, the articulation knob configured to articulate to effect a corresponding articulation of the articulation segment of the device, the end effector comprising:

(a) exterior walls defining a proximal portion and a distal portion, the distal portion comprising a mixing space and a tip;

(b) an interior wall disposed within the proximal portion, the interior wall and exterior walls defining a first holding space and an opposite, second holding space;

(c) a first agent disposed in the first holding space;

(d) a second agent disposed in the second holding space, the second agent being different from the first agent; and

(e) a piston movable via an application of force along the interior wall, the piston being configured to engage proximal ends of the first agent and the second agent to move the first and second agents distally towards the mixing space, whereby the first and second agents create a mixture capable of expulsion through the tip;

wherein the end effector includes one of a pair of protrusions or a pair of notches, and the distal end of the device includes the other of the pair of protrusions or the pair of notches.

18. The apparatus of claim 16, wherein the articulation segment is configured to articulate on a horizontal plane with respect to a longitudinal axis of the shaft of the device to which the end effector is attached.

19. The apparatus of claim 16, wherein the articulation segment is configured to articulate on a vertical plane transverse to the longitudinal axis of the shaft of the device to which the end effector is attached.

20. A method of dispensing agent through a dispensing end effector removably attachable to a device, the end effector comprising exterior walls defining a proximal portion and a distal portion, the distal portion comprising a mixing space and a tip, an interior wall disposed within the proximal portion, and a piston movable along the interior wall, a first agent disposed on a first side of the wall, a second agent disposed on a second side of the wall, the device comprising a trigger, a handle portion, a shaft, and an articulation segment, the end effector being configured to removably attach to a distal end of the device, the method comprising the steps of:

(a) removably receiving a surgical end effector configured to staple and sever tissue onto the distal end of the device;

(b) using the surgical end effector attached to the device to staple and sever tissue;

(c) removing the surgical end effector from the device;

(d) removably receiving the dispensing end effector onto the distal end of the device;

(e) applying force upon the piston of the dispensing end effector via the device;

(f) moving the first and second agents via the piston distally towards the mixing space;

(g) mixing the first and second agents in the mixing space to create a mixture; and

(h) expelling the mixture through the tip onto the severed and stapled tissue.