SURGICAL STAPLER

专利摘要:
SURGICAL STAPLER UNDERSTANDING A CLAMP POCKET. The present invention relates to a surgical stapler that can comprise an anvil comprising a pocket of staples formed on a surface that contacts the tissue. The staple pocket may comprise a longitudinal loop, a first forming insert, and a second forming insert. The first forming container may comprise a pre-formed Inner side wall comprising a first vertical portion which is substantially perpendicular to the tissue contact surface. The second forming insert can comprise a second anterior side wall comprising a first vertical option which is substantially perpendicular to the contact surface having the fabric. The second forming container may comprise a second inner side wall comprising a second vertical portion which is substantially perpendicular & to the surface of contact with the fabric. The first vertical portion and the second vertical portion may extend through the longitudinal axis, wherein the first inner side wall and the second inner side wall may comprise a cavity for deforming a first clamp leg from a clamp to a first side of the axis longitudinal and to deform a second leg of (...).
公开号:BR112012008269B1
申请号:R112012008269-8
申请日:2010-10-04
公开日:2020-11-24
发明作者:Adam R. Dunki-Jacobs；James J. Bedi
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

REFERENCE CROSSED ON RELATED REQUEST
[001] This non-provisional patent application claims benefit under 35 USC §119 (e) of US provisional patent application No. 61 / 250,377, entitled SURGICAL STAPLER, which was filed on October 9, 2009, whose The description is incorporated in this document as a reference in its entirety. BACKGROUND OF THE INVENTION I. Field of Technology
[002] The present invention relates to stapling instruments and, in various embodiments, to a surgical stapling instrument to produce one or more rows of staples. ii. Related Technology Background
[003] In recent years, there has been a growing trend regarding the use of stapling instruments by surgeons to suture body tissues, such as lungs, esophagus, stomach, duodenum and / or other organs in the intestinal tract. The use of an appropriate stapling instrument can, in many cases, result in more satisfactory work in less time and simplify previously difficult surgical procedures, such as gastrointestinal anastomoses. The two- and four-row linear cutting staplers comprised instruments without a cartridge into which the staples were loaded manually and individually. Other prior devices included a pre-sterilized disposable staple loading unit and a cutting element that could be used to divide the fabric and form rows of staples simultaneously. An example of such a surgical stapler is shown in U.S. Patent No. 3,499,591, entitled INSTRUMENT FOR PLACING LATERAL GASTROINTESTINAL ANASTOMOSES, which was granted on March 10, 1970, the description of which is hereby incorporated by reference in this document.
[004] A stapling instrument may include a pair of elongated cooperating claw elements, wherein each claw element may be adapted to be inserted into an internal tubular body organ to be joined by anastomosis. In various embodiments, one of the claw elements can apply a staple cartridge with at least two rows of staples spaced laterally, and the other claw element can apply an anvil with staple forming pockets aligned with the staple rows in the cartridge of staples. In general, the stapling instrument may further include a propeller bar and a knife blade that are slidable with respect to the claw elements to sequentially eject staples from the staple cartridge through cam surfaces on the propeller bar. In at least one embodiment, the cam surfaces can be configured to activate a plurality of cartridge-loaded clamp boosters and associated with the individual clamps to push the clamps against the anvil and form laterally spaced rows of clamps deformed in the tissue trapped between the claw elements. In typical stapling instruments, however, the anvil is not movable relative to the staple cartridge once the clamping elements have been joined and the formed height of the staples cannot be adjusted. In at least one embodiment, the knife blade may follow the propellant bar and cut the fabric along a line between the staple rows. Examples of these stapling instruments are presented in U.S. Patent No. 4,429,695, entitled SURGICAL INSTRUMENTS, which was issued on February 7, 1984, the complete description of which is hereby incorporated by reference. SUMARIQ
[005] In at least one form of the present invention, a surgical stapler may comprise a first portion of the cable comprising a staple cartridge channel configured to receive a staple cartridge and a second portion of the cable comprising an anvil. The stapler additionally comprises a pivoting latch and a latch projection, in which the latch is rotatably coupled to one of the portion and cable and the second portion of cable and in which the latch projection extends from the first portion of cable or the second cable portion. The latch is configured to engage the latch projection to move the first latch portion and the second latch portion towards each other. In various embodiments, the locking projection comprises a rotating bearing in which the locking is configured to be in contact with the rotating bearing when the lock engages with the locking projection.
[006] In at least one form of the present invention, a surgical stapler may comprise an anvil that has a plurality of staple pockets formed on a tissue contact surface. Each staple pocket may comprise a longitudinal axis, a first forming container, and a second forming container. The first forming container can comprise a first inner side wall comprising a first vertical portion which is substantially perpendicular to the surface of contact with the fabric. The second forming container can comprise a second inner side wall comprising a second vertical portion which is substantially perpendicular to the fabric contact surface. In various embodiments, the first vertical portion and the second vertical portion may extend across the longitudinal axis, wherein the first inner side wall and the second inner side wall may comprise a cavity for deforming a first staple leg from a staple to a staple. first side of the longitudinal axis and to deform a second staple leg of the staple to a second side of the longitudinal axis.
[007] In at least one form of the present invention, a method for deforming a staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second leg clips are positioned on a standard piano before being deformed, the method comprises positioning the first clip leg within a first container of a clip pocket, the first container comprising a first internal surface, applying a first compression force to a end of the first staple leg to flex the first staple leg towards the base and the second staple leg, place the first inner surface with the end of the first staple leg to flex the end of the first staple leg towards an first side of the base, and deform the first staple leg so that the end of the first staple leg crosses a midline line of the staple defined between the first leg staple and the second staple leg. BRIEF DESCRIPTION OF THE DRAWINGS
[008] The aforementioned features and other features and advantages of this invention, and the way to achieve them, will become more apparent and the invention itself will be better understood by reference to the following description of the invention's modalities, obtained in conjunction with the attached drawings, in which:
[009] Figure 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment of the present invention;
[0010] Figure 2 is an exploded perspective view of the surgical stapling instrument in Figure 1;
[0011] Figure 3 is an exploded elevation view of the surgical stapling instrument of Figure 1;
[0012] Figure 4 is a partial cross-sectional view of the surgical stapling instrument of Figure 1 illustrating the first and second porbs being assembled together;
[0013] Figure 5 is a partial cross-sectional view of the surgical stapling instrument of figure 1 illustrating the proximal end of the first portion of figure 4 being attached to the proximal end of the second portion of figure 4 and illustrating the second portion being rotated in towards the first porQao;
[0014] Figure 6 is a partial cross-sectional view of the surgical stapling instrument of Figure 1 illustrating a lock rotatably mounted in the first portion, in which the lock is engaged with the second portion and in which the lock was rotated in a partially closed position;
[0015] Figure 7 is a partial cross-sectional view of the surgical stapling instrument of Figure 1 illustrating the lock of Figure 6 in a closed position;
[0016] Figure 8 is a perspective view of a staple cartridge assembly of the surgical stapling instrument of Figure 1;
[0017] Figure 9 is an exploded view of the staple cartridge assembly of Figure 8;
[0018] Figure 10 is a cross-sectional view of the staple cartridge assembly of figure 8 along line 10-10 in figure 9;
[0019] Figure 11 is an exploded view of a staple sleigh and the cutting element assembly of the staple cartridge assembly of figure 8;
[0020] Figure 12 is a perspective view of the staple trend and the cutting element set of figure 11;
[0021] Figure 13 is a perspective view of the surgical stapling instrument of figure 1 illustrating a staple discharge actuator moved in distal position along a first side of the surgical stapling instrument;
[0022] Figure 14 is a perspective view of the surgical stapling instrument of figure 1 illustrating the staple discharge actuator of figure 13 moved in a distal position along a second side of the surgical stapling instrument;
[0023] Figure 15 is a cross-sectional view of a surgical stapling instrument according to at least one alternative embodiment of the present invention illustrating a lock in a partially closed position and a locking mechanism engaged with a clamp discharge actuator;
[0024] Figure 16 is a cross-sectional view of the surgical stapling instrument of figure 15 in which the lock was moved to a closed position and disengaged the locking mechanism of the clamp discharge actuator;
[0025] Figure 17 is a perspective view of an anvil set of the surgical stapling instrument of figure 1;
[0026] Figure 18 is an exploded perspective view of the anvil set of figure 17;
[0027] Figure 19 and another view in exploded perspective of the anvil set of figure 17;
[0028] Figure 20 is an exploded cross-section elevation view of the anvil assembly of figure 17;
[0029] Figure 21 is a cross-sectional view of the anvil assembly of Figure 17 illustrating the anvil adjustment element in a first position;
[0030] Figure 22 is a cross-sectional view of the anvil assembly of Figure 17 illustrating the adjustment element of the anvil of Figure 21 in a second position;
[0031] Figure 23 is a cross-sectional view of the anvil assembly of Figure 17 illustrating the adjustment element of the anvil of Figure 21 in a third position;
[0032] Figure 24 is a perspective view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention;
[0033] Figure 25 is a cross-sectional view of the surgical stapling instrument of figure 24 along line 25-25 in figure 24;
[0034] Fig. 26 is a partial exploded view of the proximal end of the surgical stapling instrument of Fig. 24 including a detent mechanism for reliably retaining a rotating anvil adjustment element in position;
[0035] Figure 27 is a perspective view of the surgical stapling instrument of Figure 24 with some components removed and others shown in cross section;
[0036] Figure 28 is an exploded view of portions of the surgical stapling instrument of Figure 24 illustrating a rotating anvil adjustment element in a first orientation;
[0037] Figure 29 is a perspective view of the adjustment element of the rotating anvil of Figure 28;
[0038] Figure 30 is an end view of the surgical stapling instrument of figure 24 with some components removed and others shown in broken lines illustrating the rotating anvil adjustment element in the first orientation of figure 28;
[0039] Figure 31 is an end view in cross section of the surgical stapling instrument of figure 24 along line 31-31 in figure 24;
[0040] Figure 32 is an end view of the surgical stapling instrument of figure 24 illustrating the adjusting element of the rotating anvil of figure 28 rotated in a first direction in a second orientation;
[0041] Figure 33 is an end view in cross section of the surgical stapling instrument of figure 24 illustrating the anvil adjustment element in the second orientation of figure 32;
[0042] Fig. 34 is an end view of the surgical stapling instrument of Fig. 24 illustrating the adjustment element of the rotating anvil of Fig. 28 rotated in a second direction in a third orientation;
[0043] Figure 35 is a cross-sectional end view of the surgical stapling instrument of figure 24 illustrating the anvil adjustment element in the third orientation of figure 34;
[0044] Figure 36 is a perspective view of an actuator for rotating the adjustment element of the anvil of figure 28;
[0045] Figure 37 is a partial cross-sectional view of a surgical stapling instrument including a spring configured to pull the distal end of a first portion of the cable away from the distal end of a second portion of the cable when the stapling instrument it is in a partially closed configuration;
[0046] Figure 38 is a perspective view of the surgical stapling instrument of figure 1 similar to that of figure 17;
[0047] Figure 39 is a detailed view of a locking projection extending from an anvil of a surgical stapling instrument according to at least one alternative embodiment of the present invention;
[0048] Figure 40 is a diagram illustrating the lock projection of figure 39 and a lock configured to engage the lock projection and move the lock projection to a recess of the lock;
[0049] Figure 41 is an elevation view of the lock projection of figure 39;
[0050] Figure 42 is a perspective view of a staple pocket according to at least one embodiment of the present invention;
[0051] Figure 43 is a top view of the clip pocket of figure 42;
[0052] Figure 44 is a cross-sectional view of the clip pocket of figure 42 along line 44-44 in figure 43;
[0053] figure 45 is a cross-sectional view of the clip pocket of figure 42 along line 45-45 in figure 43;
[0054] Figure 46 and another top view of the clip pocket of Figure 42;
[0055] Figure 47 is a cross-sectional view of the clip pocket of figure 42 along line 47-47 in figure 46;
[0056] Figure 48 is a cross-sectional view of the clip pocket of figure 42 along line 48-48 in figure 46;
[0057] Figure 49 is an elevation view of a surgical clamp in a non-deformed shape;
[0058] Figure 50 is an elevation view of the surgical clamp of figure 49 in a deformed format according to at least one embodiment of the present invention;
[0059] Figure 51 is a side view of the surgical clamp of figure 49 in the deformed shape of figure 50;
[0060] Figure 52 is a plan view of the surgical clamp of figure 49 in the deformed shape of figure 50;
[0061] Figure 52A is another plan view of the surgical clamp of figure 49 in the deformed shape of figure 50;
[0062] Figure 53 is an elevation view of a surgical clamp in a non-deformed shape;
[0063] Figure 54 is a bottom view of the surgical clamp of Figure 53 in a non-deformed shape;
[0064] Figure 55 is a bottom view of the surgical clamp of Figure 53 in a deformed shape according to at least one embodiment of the present invention;
[0065] Figure 56 is a partial cross-sectional view of the surgical clamp of Figure 53;
[0066] Figure 57 is an elevation view of a surgical clamp in a deformed shape in accordance with at least one embodiment of the present invention; and
[0067] Figure 58 is an elevation view of a surgical clamp in a deformed shape.
[0068] The corresponding reference characters indicate the corresponding parts through the various views. The examples described herein illustrate preferred embodiments of the invention, in one form, and such examples are not to be considered as limiting the scope of the invention in any way. DETAILED DESCRIPTION
[0069] Certain exemplary modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the devices and methods described here. One or more examples of three modalities are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described and illustrated in the accompanying drawings are exemplary and non-limiting modalities, and that the scope of the various modalities of the present invention is defined only by the claims. The aspects illustrated or described in connection with an exemplary embodiment can be combined with aspects of other embodiments. Such modifications and variations are intended to be included in the scope of the present invention.
[0070] The full descriptions of the following non-provisional, commonly owned American patent applications are hereby incorporated by reference:
[0071] SURGICAL STAPLING INSTRUMENT WITH CUTTING MEMBER ARRANGEMENT, US Patent Application Serial No. 12 / 234,149, Attorney Summary Number END6414USNP / 080203;
[0072] SURGICAL STAPLER WITH APPARATUS FOR ADJUSTING STAPLE HEIGHT, US Patent Application Serial No. 12 / 234,133, Attorney Summary Number END6406USNP / 080195;
[0073] LOCKOUT ARRANGEMENT FOR A SURGICAL STAPLER, US Patent Application Serial No. 12 / 234,113, Attorney Summary Number END6405USNP / 080194;
[0074] SURGICAL STAPLER HAVING AN INTERMEDIATE CLOSING POSITION, US Patent Application Serial No. 12 / 234,143, Attorney Summary Number END6411USNP / 080200;
[0075] SURGICAL STAPLER HAVING A CLOSURE MECHANISM, filed on the same date as this document, attorney's summary number END6612USNP / 090242; and
[0076] METHOD FOR FORMING A STAPLE, filed on the same date as this document, Attorney Summary Number END6614USNP / 090244.
[0077] With reference to figure 1, a surgical stapling instrument, generally 100, can comprise a first portion of the cable 102 and a second portion of the cable 104. In various embodiments, the first portion of the cable 102 and the second portion of the cable 104 may be configured to be held by a surgeon, for example, and may comprise a hand grip portion 106. In at least one embodiment, the first portion of cable 102, referring to figures 2 and 3, may include a the first cap 108 attached to a first frame 110 and, similarly, the second portion of cable 104 may include a second cap 112 attached to a second frame 114. Caps 108 and 112 may have ergonomic curves or otherwise have suitable curves to assist a surgeon in handling the stapling instrument 100 within a surgical site. In various embodiments, the cable covers 108 and 112, for example, can include extended protrusions 109 and 113, respectively, which can facilitate the insertion of the stapling instrument 100 in a surgical site. In various embodiments, cable covers 108 and 112 can be produced from plastic and lightweight materials and / or any other suitable material, for example, while cable structures 110 and 114 can be produced from stainless steel, titanium , and / or any other suitable material, for example.
[0078] In various embodiments, with respect to figures 1 to 3 again, the distal ends of the cable portions 102 and 104 may comprise an end effector 120 which can be configured to treat tissue within a surgical site, for example example. In at least one such embodiment, end effector 120 may include a staple cartridge channel 122 configured to receive and / or retain a staple cartridge, as described in more detail below. In certain embodiments, the staple cartridge channel 122 may comprise a one-piece structure in the form of an elongated channel extending from the first cable portion structure 110. In at least one embodiment, the staple cartridge channel staples 122 may include a pair of opposing elongated side walls 124 connected by a bottom wall 126. Along the rear or proximal portion of the staple cartridge channel 122, a pair of upright and spaced side flanges 128 may extend upwards from opposite side walls 124. In various embodiments, the width of the staple cartridge channel 122 between the side flanges 128 may be greater than the width of the upper jaw element, or anvil, 130 extending from the second portion the cable 104. In at least one embodiment, the distance between the flanges 128 can be configured to allow at least a portion of the anvil 130 to be received between the side flanges 128 when the grain instrument and mounted for operation. As shown in figure 2, each side flange 128 can include a notch, or recess, 127, for example, which can be configured to receive one or more lock projections 131, for example, extending from anvil 130 , and / or any other suitable portion of the second portion of cable 104, as described in more detail below.
[0079] As indicated above, again referencing figures 1 to 3, the staple cartridge channel 122 can be configured to support and / or refer to a staple cartridge, such as, for example, staple cartridge 150, for example , within end effector 120, wherein the staple cartridge may include one or more staples (not shown) removably stored there. In various embodiments, referring to figures 8 to 10, the staple cartridge 150 may include one or more staple cavities 151 that can be configured to store staples in any suitable arrangement, such as, for example, in at least two longitudinal rows. sideways, for example. In at least one embodiment, referring to figures 9 and 10, the staple cartridge 150 can include the body 152 and / or reservoir 154 of the staple cartridge, where the body 152 and / or reservoir 154 of the staple cartridge can be configured to define a channel, or trajectory, to receive a trend of staples and / or cutting element in a sliding way. In at least one embodiment, the reservoir 154 may include flexible hoses 155, for example, which can be configured to engage the body of the staple cartridge 152 in a quick-fit and / or snap-fit arrangement. Referring to figures 10 to 12, the staple cartridge 150 may further include the staple trend set 160 which may include the portion of the staple trend 162 and, furthermore, the cutting element 164. In various embodiments , the cutting element 164 can include cutting edge 165 and locking blade 166, for example, where locking blade 166 can be configured to be snap-fit and / or snap-fit into opening 163 in clamp trend 162 when the cutting element 164 is mounted on the portion of the staple trend 162. In several other embodiments, the portion of the staple trend 162 can be integrally molded to the cutting element 164.
[0080] In addition to the above, referring to figures 8 to 10, the body of the staple cartridge 152 can include a slot, such as slot 156, for example, which can be configured to receive at least a portion of the cut 164 and / or any other portion of the staple trend assembly 160 and the propeller bar assembly 200 (discussed below), where slot 156 can be configured to allow cutting element 164 to be moved between a first and a second second positions within the staple cartridge 150. In various embodiments, the slot 156 can be configured to allow the cutting element 164 to be moved between a proximal position (figure 10) and a distal position in order to cut the fabric positioned between the staple cartridge 150 and anvil 130, for example. With reference again to figures 10 to 12, the portion of the staple trend 162 can include cam surfaces, ramp, or actuator 167 that can be configured to engage staple boosters positioned within the staple cartridge 150. In various modalities, with reference In Figure 9, the staple cartridge 150 may include the staple boosters 168 which can be lifted or slid upward into staple cavities 151 by the trend 162 so that the upward movement of the staple boosters 168 can eject or dispense the clamps at least partially positioned within the clamp cavities 151. While clamp boosters 168 can, in fact, be lifted vertically upwards, the term upwards, and the like, may mean that clamp boosters 168, for example they are moved towards the top or deck surface 158 of the staple cartridge and / or towards the anvil 130, for example. In certain embodiments, as shown in figure 9, each clamp pusher 168 may include one or more inclined surfaces 169 oriented at the same angle as the cam surface 167, and / or any other suitable angle, which may provide a sliding contact surface relatively flat or at least substantially flat between staple trend 162 and staple boosters 168. In various embodiments, a staple booster can be configured to dispense with only one staple, while in certain embodiments, a staple booster can be configured to simultaneously dispense two or more staples located in adjacent rows, for example. Other devices are presented in U.S. Patent Application Serial No. 12 / 030,424, entitled SURGICAL STAPLING INSTRUMENT WITH IMPROVED FIRING TRIGGER ARRANGEMENT, which was filed on February 13, 2008, the description of which is incorporated herein by reference.
[0081] In various modalities, as described above, a surgical stapling instrument can include a cutting element / staple trend set configured to cut the tissue and dispense staples from a staple cartridge. However, in certain embodiments, a surgical stapling instrument may not require or include a cutting element. In at least one such embodiment, a staple cartridge can include a staple trend positioned in it and / or a surgical instrument can be configured to move a staple trend in a staple cartridge in order to staple tissue, for example, without dissect it in another way. In certain other embodiments, a staple cartridge may include a staple trend positioned therein when a surgical instrument may include a cutting element that can move within or in relation to the staple cartridge. In at least one such mode, the cutting element can be moved to contact the staple trend so that the cutting element and the staple trend can be moved together. Thereafter, the cutting element can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge that has a new staple trend. Such modalities can be useful when a trend of staples becomes worn or deformed during use. Other modalities are envisaged, in which a staple cartridge may include a cutting element positioned therein when a surgical instrument may include a staple trend that can move within or in relation to the staple cartridge. In at least one such modality, similarly to that described above, the staple trend can be moved to contact the cutting element so that the cutting element and the staple trend can be moved together. Thereafter, the staple trend can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge that has a new cutting element. Such modalities can be useful when a cutting element becomes worn or deformed during use. In various embodiments, as described in more detail below, the staple cartridge can include a protective cover or casing configured to prevent, or at least reduce the possibility of a surgeon or other doctor touching the cutting element positioned inside the staple cartridge while handles the staple cartridge, for example.
[0082] In various embodiments, in addition to the above, the staple cartridge channel 122 and / or the staple cartridge 150, for example, can include one or more cooperating projections and / or recesses, for example, which can be configured for removably referring to the staple cartridge 150 within the staple cartridge channel 122. Once the staple cartridge 150 has been inserted into the staple cartridge channel 122, in various embodiments, the first portion of the cable 102 may it will be installed in the second portion of the cable 104. In several other embodiments, the staple cartridge can be inserted into the staple cartridge channel after the first and second portions of the cable have been assembled together. In any case, referring to figures 1 to 7, the first portion of cable 102 and the second portion of cable 104 may include the proximal ends 103 and 105, respectively, which can be assembled together so that the first and second portions of the cable can be swiveled or pivoted to each other. In various modalities, referring to figures 2 and 3, the first portion of cable 102 may include one or more pins, or projections, 111 extending from it, which can be configured to be received by sliding within a or more grooves, channels, or slots 115 in the second portion of the cable 104. In certain embodiments, the slits 115 can be defined in the second cable structure 114 and the projections 111 can extend from a proximal end column 107 extending if from the first cable structure 110, for example. In order to assemble the first portion of the cable 102 and the second portion of the cable 104, referring to figure 4, the open ends of the slits 115 can be aligned with the projections 111 so that the second portion of the cable 104, for example, can the first portion of the cable 102 will be transferred and the projections 111 can be slid into the slits 115. In at least one embodiment, as shown in figures 2 and 3, the open ends of the slits 115 can be located proximally to their closed ends. In at least one such embodiment, the proximal end 105 of the second portion of cable 104 can be positioned distally with respect to the proximal end 103 of the first portion of cable 102 so that the second portion of cable 104 can be moved proximally so that positioning the projections 111 within the slits 115. In several other circumstances, the first portion of the cable 102 can be positioned proximally to the second portion of the cable 104 and sliding in a distal position in order to position the projections 111 within the slits 115.
[0083] In various embodiments, referring to figure 5, the second portion of the cable 104 can be rotated towards the first portion of the cable 102 so that the anvil 130 can be placed in relation to the staple cartridge 150 and / or to the staple cartridge channel 122. In certain embodiments, the first portion of the cable 102 can be rotated towards the second portion of the cable 104 and / or the first and second portions of the cable can be rotated towards each other. In any case, the projections 111 and the slits 115, when engaged with each other, can comprise a pivot around which one or both of the first and second portions of the cable can be moved relative to the other. In various embodiments, the second portion of the cable 104 can be moved relative to the first portion of the cable 102 so that the anvil 130 is placed in opposition to the staple cartridge 150. In certain embodiments, with reference to figure 6, the second portion of the cable 104, the first portion of the cable 102 can be moved relative to that the locking projections 131 extending from the second portion of the cable 104 can be aligned with and / or inserted into the recesses 127 within the first portion of the cable 102 In various embodiments, with reference mainly to figures 2 and 3, the first portion of the cable 102 may also include a locking mechanism 180 pivotally mounted thereto, which can be used to engage the locking projections 131 that extend to from the second portion of the cable 104 and hold the first and second portions of the cable together. Although not illustrated, other modalities are intended, in which a locking mechanism is rotatably mounted to the second portion of the cable and locking projections may extend from the first portion of the cable. In any case, in at least one embodiment, the locking mechanism 180 can be mounted on the first frame 110 by one or more pivb pins 182 which can be configured to define an axis around which the lock 180 can be rotated.
[0084] In certain embodiments, now with reference to figures 4 and 5, the lock mechanism 180 may include the lock structure 184 and, in addition, the lock cover 186 mounted on the lock structure 184. In several other modalities, the lock cover and the lock structure may comprise an integral unit or, in certain embodiments, the lock mechanism may not even include a cover. In certain embodiments, the latch structure 184 may be channel-shaped and may include a pair of elongate opposite side walls 185 that are separated by a distance sufficient to cover the first portion of the frame 110. In at least one embodiment, the lid of the frame latch 186 can be made of plastic and lightweight materials and / or any other suitable material, for example, while the structure of latch 184 can be made of stainless steel and / or any other suitable material, for example. In certain embodiments, when the locking mechanism 180 is closed, as shown in figure 7, the locking cap 186 can be aligned with the first cap of the cable 108. The locking cap 186 can include a curved portion 187 which can be configured to assist a surgeon in manipulating the surgical instrument 100 in which, in at least one embodiment, the curved portion 187 can be aligned with, or at least substantially aligned with, the protrusion 109 extending from the first cap of the handle 108 The locking mechanism 180 may further include one or more locking clips 188 extending therefrom, which can be configured to engage one or more locking projections 131 extending from the second portion of cable 104 and pulling and / or securing the projections 131 inside the recesses 127, as shown in figure 7. In at least one embodiment, at least one of the locking holes 188 can be formed integrally with the latch structure 1 84. In certain embodiments, with reference to figure 6, at least one of the locking holes 188 may include a distal hook 189 that can be configured to wrap around at least a portion of the projections 131 so as to encompass or surround, or at least partially encompass and surround the projections 131. In at least one embodiment, the locking arms 188 can act as an upper central lock to hold lock mechanism 180 in its locked or closed position.
[0085] In use, in various circumstances, the first portion of the cable 102 or the second portion of the cable 104 can be positioned on a first side of tissue within a surgical site and the other portion of the cable can be rotated to position itself from the opposite side of the fabric. In such embodiments, the staple cartridge 150 can be positioned on one side of the fabric and the anvil 130 can be positioned on the other side of the fabric. Later, as also described above, the locking mechanism 180 can be activated so that it can be moved between an open position and a closed position in order to lock the second portion of cable 104 with the first portion of cable 102 and apply a force fastening to the fabric positioned between the staple cartridge 150 and the anvil 130. In certain circumstances, the locking mechanism 180 can be moved between an open position (figure 5), a partially closed or intermediate position (figure 6), and a closed position (figure 7). In at least one such modality, referring to figures 5 and 6, the locking mechanism 180 can be moved between an open position in which the locking arms 188 are not engaged with the projections 131 and a partially closed position in which the locking arms 188 are engaged with the projections 131 so that, although the anvil 130 has at least partially been placed in opposition to the staple cartridge 150, a sufficient gap can remain between the anvil 130 and the staple cartridge 150 which can allow end effector 120 is repositioned relative to the fabric, for example. Once the anvil 130 and the staple cartridge 150 have been sufficiently positioned in relation to the fabric, the locking mechanism 180 can be moved between its partially closed position and a closed position, as shown in figure 7.
[0086] In various embodiments, in addition to the above, a surgical stapling instrument may also include an induction element that can be configured to induce the first portion of the cable from a stapling instrument away from a second portion of the cable. In at least one embodiment, as described in more detail below, a spring and / or any suitably resilient material can be positioned between the first and second portions of the cable so that the anvil and the staple cartridge of the stapling instrument can be removed from one another. In certain embodiments, the spring can be configured to at least partially separate the first and second portions of the handle, so that there is a gap between the anvil and the staple cartridge, where the gap can be sufficient to allow the fabric be positioned between them. In use, a surgeon can position such a surgical stapling instrument without having to separate and secure the first and second portions of the cable separate from each other. This instrument can be especially useful when the stapling instrument is in a partially closed configuration and the surgeon is manipulating the instrument within a surgical site. After the surgeon is satisfied with the positioning of the stapling instrument, he can compress and / or disengage the spring and place the stapling instrument in a closed configuration.
[0087] In various embodiments, in addition to the distal end of the first portion of the cable 102, it can be moved relative to the distal end of the second portion of the cable 104, specifically when the locking mechanism 180 is not engaged, or is only partially engaged, with the projections 131 of the second cable portion 104. In these circumstances, the projections 111 and slots 115 at the proximal ends of the first and second cable portions can be configured to retain at least the proximal ends of the first and second cable portions together when the distal ends of the first and second portions of the cable are being moved relative to each other, for example. In other words, projections 111 and slots 115 can cooperate to prevent, or at least inhibit, that the first portion of the cable 102 completely detaches from the second portion of the cable 104. In certain embodiments, a first portion of the cable may include a the first locking portion and a second cable portion may include a second locking portion, wherein the first and second locking portions may be configured to engage with each other and prevent the first cable portion from detaching completely from the second by cable. In at least one embodiment, the projections 111 may comprise the first lock portion and the slits 115 may comprise the second lock portion. The previous stapling instruments did not have these locking portions and, instead, depended on a single locking mechanism to hold the first and second cable portions together. In circumstances in which the locking mechanisms of these earlier stapling instruments were not fully engaged with the first and second portions of the cable, the first and second portions of the cable could detach completely from each other, thus requiring, for example, a surgeon would reposition and reassemble the cable portions. In certain circumstances, a complete detachment of the first and second cable portions of these previous clips could expose at least a portion of a cutting element.
[0088] In various embodiments, as described above, the locking mechanism 180 can be configured to be moved between an open position, a partially closed position, and a closed position. When locking mechanism 180 is in its open position, as also described above, projections 111 can be inserted and / or removed from slots 115. When locking mechanism 180 is in its partially closed position, referring to figure 6, locking arms 188 can be configured to engage lock projections 131 so that these projections 111 cannot be removed from slots 115. In at least one such mode, locking arms 188 and lock projections 131 can be configured to avoid , or at least inhibit that the second portion of the cable 104 is moved distally with respect to the first portion of the cable 102 and, as a result, prevent, or at least inhibit, that the projections 111 are disengaged from the slits 115. corresponding locking arms 188 and lock projections 131 can be configured to prevent the first portion of cable 102 from being moved proximally to the second portion of cable 104. Similar to the above, in various embodiments, locking arms 188 and locking projections 131 can also be configured to prevent, or at least inhibit, that projections 111 are removed from slots 115 when locking mechanism 180 is in place. its closed position (figure 7). In certain embodiments, in addition to the above, lock projections 131 may extend from the second portion of cable 104 to a location between its proximal and distal ends. In at least one such embodiment, the projections 111 and slots 115 can be configured to secure the first and second portions of the cable together at their proximal ends, while locking mechanism 180 can be used to secure the first and second portions cable together in an intermediate location. In any case, in certain embodiments, the first and second portions of the cable cannot be disengaged from each other unless the locking mechanism 180 is moved to its fully open position. In at least one such embodiment, the projections 111 and the slits 115 cannot be disengaged from each other when the locking mechanism 180 is in a closed and / or partially closed position.
[0089] When the anvil 130 and the staple cartridge 150 are sufficiently positioned, the fabric positioned between the anvil 130 and the staple cartridge 150 can be stapled and / or cut. In various modalities, referring to figure 3, the surgical stapling instrument 100 can also include a set of the propeller bar 200 that can be configured to advance and / or retract the set of staple trends 160 within the staple cartridge 150, for example example. In at least one embodiment, the drive bar assembly 200 may include drive bar 202 and clamp discharge actuator 204, where clamp discharge actuator 204 may be configured to move drive bar 202 and the trend assembly of staples 160 in a distal position to dispense the staples from the staple cartridge 150 and deform the staples against the anvil 130, as described above. In at least one embodiment, referring to figures 11 and 12, the staple trend 162 can include a groove, channel, or slot 161 that can be configured to receive, and can be connected in a functional way to a distal end 201 ( figure 3) of the propeller bar 202. In certain embodiments, the staple trend assembly 160 can be functionally engaged with the propeller bar 202 when the staple cartridge 150 is inserted into the staple cartridge channel 122. In at least one embodiment, the distal end 201 and the slot 161 can include cooperating elements which can allow the distal end 201 and the slot 161 to be mounted in a transverse direction, but prevent or at least inhibit the distal end 201 and the slot 161 from being disassembled one the other in a proximal and / or distal direction. In other embodiments, the drive bar 202 can be moved in a distal position before contacting and engaging the staple trend set 160. In at least one such mode, the staple trend set 160 may remain stationary until the prop bar 202 contact him. In any case, as described above, the actuator 204 can be functionally connected to the propeller bar 202 so that a propulsion and / or pull force can be applied to the actuator 204 and transmitted to the propeller bar 202. In certain embodiments, as described in more detail below, the actuator 204 can be pivotally connected to a proximal end 203 of the propellant bar 202 so that the actuator 204 can be selectively rotated between at least the first and second positions.
[0090] In addition to the above, referring to figures 1, 13, and 14, the actuator 204 can be movable between a first position of a first side 116 of the surgical stapling instrument 100 (figure 13), a second position of a second side 117 (figure 14), and an intermediate position (figure 1) located at the proximal ends 103 and 105 of the first and second portions of the cable 102 and 104. When the actuator 204 has been rotated to the first or second position sides 116, 117, the actuator 204 can be moved in a distal position. In various circumstances, as a result, a surgeon may select whether to move the actuator 204 in a distal position along the first side 116 or the second side 117. Such circumstances may arise when the actuator 204 is more likely to collide with the surrounding tissue the surgical site, for example, when the actuator 204 is moved in a distal position along one side of the surgical instrument compared to the other. In various modalities, referring to figures 2 and 3, the actuator 204 can include a bracket 206 that extends from it and the bracket 206 can be installed articulated to the proximal end 203 of the propeller bar 202. In certain modalities, again referencing figures 1, 13, and 14, the surgical instrument 100 may include a first slot (not shown) extending along the first side 116 and a second slot 118 extending along the second side 117, wherein the first and the second slots can be configured to receive at least one portion of the actuator 204 in a sliding manner. In at least one embodiment, the side walls of the first and second slits can delimit or at least help delimit the movement of the actuator 204 so that it can be moved along a predetermined path. Referring to figure 14, the second slot 118, for example, can be defined between the first portion of the cable 102 and the second portion of the cable 104 so that when the actuator 204 is moved in a distal position along the second side 117, arm 206 of actuator 204 can be slid between the first and second portions of the cable. Similar to the above, the first slot can also be defined between the first and second portions of the cable. In various modalities, with reference again to figures 13 and 14, the surgical instrument 100 may also include an intermediate slot 119 that can also be configured to allow arm 206, and / or any other suitable portion of actuator 204, to slide into it . In at least one such mode, the intermediate slot 119 can connect the first and second slots so that, when the actuator 204 is positioned in its intermediate position, the actuator 204 can be moved to one of its first and second positions. In certain embodiments, the first slot, the second slot 117, and the intermediate slot 119 may be parallel, or at least substantially parallel to each other and / or be on the same piano, although other modalities are intended in which one or more of the slots is not are parallel to each other and / or are on a different piano. In addition, although the first and second sides of the illustrated embodiment are located on opposite sides of the surgical instrument 100, other embodiments are intended in which the first and second slits are located, for example, on adjacent sides and / or sides that are directly opposite each other. In addition, other modalities are considered in which the sides of a stapling instrument are not readily discernible, such as, for example, instruments that have round and / or arched portions.
[0091] In several modalities, in addition to the above, the surgical stapling instrument 100 may also include a locking mechanism that can prevent, or at least inhibit, that the actuator 204 and, correspondingly, the trend set staples 160, are moved prematurely. In at least one embodiment, the locking mechanism can be configured to prevent, or at least inhibit, that the actuator 204 is moved in a distal position before the locking mechanism 180 is moved to a closed position, or at least partially closed. In certain embodiments, referring generally to figure 5, the surgical stapling instrument 100 may also include the locking mechanism 220 that can be engaged with the actuator 204 and can remain engaged with the actuator 204 while the locking mechanism 180 is in a fully open position (figure 5) and / or a position at least substantially open. In various embodiments, locking mechanism 220 can include lock 222 which can be pulled to engage actuator 204 by a pulling force applied to it by locking spring 224, for example. In at least one such embodiment, actuator 204 may include one or more grooves, channels, or slots (not shown) that can be configured to receive at least a portion of latch 222. In use, locking mechanism 220 can secure the actuator 204 in position until locking mechanism 180 is moved to its completely closed position (figure 7) and / or a position at least substantially closed. In such circumstances, in at least one mode, the locking mechanism 180 can be configured to engage locking mechanism 220 and disengage lock 222 from actuator 204. In at least one such mode, referring to figures 5 to 7, the locking mechanism 180 may further include a cam 183 which can be configured to engage the cam surface 223 with lock 222 when the locking mechanism 180 is moved to its closed position and, as a result, sliding and / or moving away from another latch 222 of actuator 204 is used. In various embodiments, cam 183 may comprise a wall, rib, and / or ridge extending from latch cover 186 and / or latch structure 184. In any case, once lock 222 has been sufficiently disengaged from actuator 204, in at least one mode, actuator 204 can be moved from its intermediate position, shown in figure 1, to one of its first and second positions, as shown in figures 13 and 14.
[0092] As above it can be configured to prevent, or at least inhibit, that the actuation bar 202 is moved in a distal position before the locking mechanism 180 is moved to a predetermined position, such as, for example, a closed position and / or a partially closed position. Advantageously, the locking mechanism 220 can also prevent, or at least inhibit, that the clamp trend assembly 160 is displaced before the first portion of the cable 102 and the second portion of the cable 104 are assembled together. In fact, the locking mechanism 220 can prevent the fabric positioned between the anvil 130 and the staple cartridge 150 from being cut and / or stapled before the anvil 130 and staple cartridge 150 are properly positioned in relation to the fabric. In addition, the locking mechanism 220 can prevent the clips from being dispensed into the fabric before a suitable clamping force is applied to the fabric. In any case, when the locking mechanism 180 is placed back in its fully open position, and / or in a partially open position, the cam 183 can be removed from the lock 222 so that the locking spring 124 can place the lock 222 in engagement with actuator 204 again. In various other embodiments, referring to figures 15 and 16, the locking mechanism 220 'may include a lock 222' comprising a cam surface 223 'and, in addition, a stop 226' which may limit the relative movement of the locks 222 '. In at least one embodiment, the cam 183 can be configured, for example, to contact the cam surface 223 'and, due to the curved, chamfered and / or inclined surface of the cam surface 223', the cam 183 can be configured to direct lock 222 'in a distal position, as shown in figure 16. Lock 222' can be directed in a distal position so that pin 228 ', which extends from lock 222', can be moved between a first position (figure 15) in which it is positioned inside opening 229 'in actuator 204' and a second position (figure 16) in which pin 228 'has been sufficiently removed from opening 229'. In various embodiments, the stop 226 'can be configured so that when the lock 222' is directed in a distal position, the stop 226 'can come into contact with the cam 183 when the lock 222' has been sufficiently displaced. In such embodiments, the stop 226 'can be configured to control the second position, or offset position, of the lock 222'. Similar to the above, when actuator 180 is removed from its closed position and cam 183 is disengaged from locking mechanism 220 ', locking spring 224' can lock lock 222 'in engagement with actuator 204' again .
[0093] In various modalities, as described above, a discharge actuator can be used to move a propellant bar, a clamp trend, and / or a cutting element between a first and a second position. As also described above, the propeller bar assembly 200, for example, can be used to move a staple trend set, such as, for example, the staple trend set 160, for example, between a proximal position (figure 10 ) and a distal position. In certain embodiments, a staple cartridge, such as the staple cartridge 150, may include a staple trend set 160 contained therein, wherein the staple trend set 160 may be positioned in a distal position, as shown in figure 10, when the staple cartridge is installed or inserted into the staple cartridge channel 122. In at least one such embodiment, referring to figures 8 to 10, the staple cartridge 150 may include an additional compartment 170 that it can be configured to cover at least a portion of the cutting element 164 when the staple trend set 160 is in its distal position, for example. In various embodiments, compartment 170 can be configured to protect a surgeon, for example, when handling the staple cartridge, when inserting the staple cartridge into the surgical stapler, and / or when joining two or more portions of the surgical stapler, for example . In at least one such embodiment, at least a top portion of the cutting edge 165 may extend above the deck or top surface 158 of the staple cartridge 150 and, if there is no protective compartment, such as compartment 170, for example, the because the top of the cutting edge 165 may be exposed.
[0094] In various embodiments, as described above, the cutting element 165 can be at least partially positioned inside the slot or channel 156 and, as shown in figure 10, at least the top or top portion of the cutting element 164 can extends above deck 158. In at least one embodiment, referring to figures 8 to 10, compartment 170 may include a first wall, or, for example, 172 extending from a first portion 157 of the cartridge body staples 152, a second wall, or portion 174, extending from a second portion 159 of the staple cartridge body 152, and a top wall or portion 176 extending between the first wall 172 and the second wall 174. In certain embodiments, a compartment further comprises only a support wall, or support portion, extending from a staple cartridge body and, in addition, an upper wall or upper portion extending therefrom. In other embodiments, a compartment additionally comprises one or more side walls or portions and no upper wall. In at least one such embodiment, the side walls of the compartment can be configured to extend above the upper face of the cutting element, or to extend at least above a cutting edge of the cutting element, for example. In any case, as shown in figure 10, at least a portion of the cutting element 164 can be positioned under the upper wall 176 and / or between the side walls 172 and 174 when the staple trend set 160 is in its proximal position . In certain embodiments, the cutting element 164 can be completely positioned under the upper wall 176 and / or completely positioned inside the compartment 170. In at least one embodiment, the cutting element 164 can be positioned under the upper wall 176 for the surface cutting edge 165 does not extend beyond the distal edge 175 and / or proximal edge 177 of the upper wall 176. In at least one embodiment, compartment 170 may include a rear wall 178 that can be configured to limit the proximal movement of the cutting element 164 and / or any other portion of the staple trend set 160. In various embodiments, at least one portion of compartment 170, for example, can be integrally formed with the body of staple cartridge 152. In at least one such embodiment, the first wall 172, the second wall 174, the top wall 176, and / or the rear wall 178 can be formed when the body of the staple cartridge 152 is injection molded, e.g. or example. In certain embodiments, at least a portion of the compartment 170 can be installed on the body of the staple cartridge 152 via a quick-fit arrangement, a snap-fit arrangement, and / or any other suitable manner.
[0095] In several embodiments, in addition to the above, the cutting element 164 can be defined by a piano body or at least substantially piano, which has a knife edge extending along at least one side of the body of the cutting element. cut. In at least one such embodiment, the first wall 172 and / or the second wall 174 can be configured and arranged so that they can include interior flat surfaces, or at least substantially flat 173 which are parallel or at least substantially parallel to the lateral surfaces of the cutting element 164. In certain embodiments, the cutting element 164 can be received narrowly between the interior surfaces 173 of walls 172 and 174. In at least one such mode, the distance between walls 172 and 174 can be equal, or at least less substantially equal to the width of the slot 156. In any case, a compartment can be configured so that at least one portion of the compartment extends over at least one portion of the slot 156, for example. In certain embodiments, compartment 170 can confer or completely surround a cutting element 164 and / or cutting surface 165. In at least one embodiment, although not illustrated, a compartment may include a separating and / or cutable portion that can be at least partially detached, separated and / or otherwise deformed in order to allow a cutting element to leave the compartment. In at least one such embodiment, the cutting surface of the fabric can be configured to contact the compartment to break and / or cut a wall of the compartment, for example. In various embodiments, the compartment wall may include a thin portion, a portion with reduced thickness, a cut mark and / or any other configuration to facilitate deformation and / or incision of the compartment wall. In certain embodiments, a cutting element may include one or more additional cutting surfaces and / or anvils, for example, which can be configured to deform and / or cut the compartment. In at least one embodiment, the compartment may include a movable and / or flexible portion, such as, for example, an articulated element and / or flexible flap, which can be configured to move and / or flex sufficiently to allow the cut pass. In any case, modalities are contemplated in which the cutting element can have any suitable configuration for cutting the fabric and the protective compartment can have any suitable configuration for enclosing or at least partially surrounding the cutting element. In addition, although a cutting element may comprise a sharp edge, as described above, other suitable cutting elements are contemplated, such as, for example, those that have sufficient electrical current to dissect tissue, for example.
[0096] As described above, compartment 170 can be configured to cover, check and / or surround a cutting element when it is in its proximal position. In various embodiments, the cutting element can be moved in a distal position to cut the fabric, for example, and then retracted proximally so as to position the cutting element again within compartment 170. In such modalities, the cutting element can be at least partially covered by compartment 170 when the staple cartridge is installed and removed from a surgical stapling instrument. In certain embodiments, a new or unused staple cartridge can be inserted into the staple cartridge channel to replace the at least partially used staple cartridge. In at least one such modality, the new staple cartridge may include a new cutting element and / or set of the staple trend positioned therein, although modalities are contemplated in which cutting element and / or set of the staple trend previously used it can be sufficiently removed from the worn staple cartridge and moved into the new staple cartridge to be reused. In embodiments in which a new cutting element and / or staple trend set is provided with a new staple cartridge, a sharp cutting edge, for example, can be used with each staple cartridge.
[0097] In various embodiments, although not shown, a staple cartridge can include two or more compartments configured to cover at least partially a cutting element when it is in two or more positions. In at least one embodiment, a staple cartridge can include a proximal compartment configured to cover at least partially the cutting element when it is in a proximal position, for example, and, in addition, a distal compartment configured to cover at least partially the cutting element when it is in a distal position, for example. In at least one such embodiment, the cutting element can be positioned inside the proximal compartment when the staple cartridge is installed in a surgical stapling instrument and, in certain embodiments, the cutting element can be moved into the distal compartment after he has transected the tissue positioned within the end effector, for example. In such embodiments, as a result, the cutting element can be at least partially positioned within the distal compartment when the staple cartridge is removed from the surgical stapler. Such embodiments can be particularly useful when a container, for example, is positioned between the proximal compartment and the distal compartment of the staple cartridge. In various embodiments, although not shown, a cutting element can be moved proximally from a distal position to a proximal position, and / or any other suitable position.
[0098] In various embodiments, in addition to the above, anvil 130 may include one or more openings, slits, or recesses 179 (figure 17) that can be configured to receive at least one portion of compartment 170 when anvil 130 it is placed in opposition to the staple cartridge 150, for example. In at least one embodiment, there may be sufficient clearance between the housing 170 and the recess 179 so that the anvil 130 and the staple cartridge 150 can be moved relative to each other without interference, or at least without substantial interference between them. In embodiments that have more than one cutting element compartment, as described above, an opposite anvil may have more than one corresponding opening to receive the compartments. In various embodiments, an anvil may include a movable cutting element and at least one compartment to cover, enclose and / or at least partially surround the cutting element. In certain embodiments, although not shown, both the anvil and the staple cartridge may comprise at least one movable cutting element and / or at least one compartment configured to cover, surround or at least partially encase the cutting elements when they are in a proximal position, for example.
[0099] As described above, the drive bar assembly 200 can be moved in a distal position in order to move the staple trend assembly 160 within the staple cartridge assembly 150. In various embodiments, as also described above, wedge-like cam surfaces 167 of the staple trend 162 can be engaged with the angled surfaces 169 on the staple drivers 168 to sequentially and / or simultaneously staple the staple cartridge 150 against the anvil 130 and shape the staples into any appropriate configuration, such as B-shaped configurations, for example. In at least one such embodiment, with reference to figure 17, the anvil 130 may include one or more staple forming surfaces, such as staple pockets 132, for example, which can be configured to deform the staples. In certain embodiments, the anvil 130 may also include a slot, channel, or groove 133 that can be configured to receive at least one portion of the staple trend 162, the cutting element 164 and / or the propeller bar 202, for example. example. In at least one embodiment, although not illustrated, an anvil may include an anvil plate that can be positioned securely and / or immovably within a defined anvil channel within the anvil. In various other embodiments, as illustrated in figures 18 and 19 and described in more detail below, anvil 130 may include an anvil plate 134 movably positioned within the anvil channel 136. In certain embodiments, the anvil channel 136 may include opposite side walls 137 and, in addition, a base 138 extending between side walls 137. In at least one embodiment, anvil 130 may further include a distal nose portion 139, for example, installed therein, wherein nose portion 139 can be configured to be snap-fit and / or quickly attached to the anvil channel 136, for example, so that nose portion 139 can be securely retained there. In certain embodiments, the nose portion 139 may consist of a soft and / or malleable material, such as, for example, rubber, and may comprise any suitable shape that can facilitate the insertion of the anvil 130 in a surgical site, for example. In some embodiments, with reference to figure 28, a nose portion, such as nose portion 139 'may be attached to an anvil by one or more fasteners 139a'. Similarly, with reference to figure 1, a staple cartridge channel and / or staple cartridge, such as staple cartridge 150, for example, may include a nose portion, such as, for example, nose portion 153 , which can facilitate the insertion of the staple cartridge 150 in a surgical site, for example.
[00100] As indicated above, staples can be dispensed from a staple cartridge and deformed against an anvil. In various circumstances, the distance between the staple forming surfaces on the anvil 130 and the staple trend 162 can determine the level of deformation of the staples. For example, if the distance between the anvil pockets 132 on the anvil 130 and the top surfaces 135 in the staple trend 162 (figures 10 to 12) is relatively large, the staples will be less deformed compared to when the distance between the pockets anvil 132 and the surfaces of trend 135 is relatively small. Correspondingly, if the distance between the anvil pockets 132 and the surfaces of the trend 135 is relatively small, the staples will be more deformed compared to when the distance between the anvil pockets 132 and the surfaces of the trend 135 is relatively large. Often, the distance between the anvil pockets 132 and the surfaces of the trend 135 is called the forming height of the staples. Sometimes the forming height of the staples can be measured between the top surface, or deck, of the staple cartridge and the staple forming surfaces on the anvil. For the purposes of this application, however, any reference to a height of clamp formation, or the like, may include one or both forms of measurement, where appropriate, and / or any other form of suitable measurement. In any case, as described in more detail below, a surgical stapling instrument, such as a stapling instrument 100, may include means for adjusting the staple forming height.
[00101] In several embodiments, in addition to the above, an anvil may include one or more forming surfaces that can be joined and / or moved away from a staple cartridge in order to adjust the forming height of the staples. In at least one embodiment, referring to figures 17 to 23, anvil 130 may include the anvil plate 134 which can be moved and / or slidable within the anvil channel 136. In certain embodiments, the anvil 130 may further include one or more retaining pins or guides 140, where the anvil plate 134 may include one or more retaining slots or guides 141 configured to receive slidingly at least a portion of the pins 140. In at least one In such an embodiment, pins 140 and / or slots 141 can be configured to define a predetermined path along which the anvil plate 134 can be moved. Referring to figure 18, pins 140 and slots 141 can be structured and arranged so that the anvil plate 134 can be moved along a linear or at least substantially linear path, where the linear path can be at least partially defined by axes 142 and 143, for example. Other modalities are contemplated in which an anvil plate can be moved along a non-linear path, for example, a curved and / or curvilinear path, for example. In certain embodiments, at least a portion of the pins 140 can be retained within the openings 144 in the side walls 137 where, in at least one embodiment, the pins 140 can be snapped into the openings 144. In any case, as described in the present invention, the pins 140 can guide the anvil plate 134 as it is joined and / or away from the staple cartridge 150, for example.
[00102] In various modalities, in addition to the above, a surgical stapling instrument, such as, for example, stapling instrument 100, may include one or more adjustment elements configured to position a portion of an anvil, such as a plate of the anvil. anvil 134, for example, in relation to other portions of an anvil assembly and / or an opposite staple cartridge. In certain embodiments, referring to figures 18 and 19, the stapling instrument 100 may include an anvil plate adjustment element 230 that can be configured to limit the movement range of the anvil plate 134. In at least one size With reference to figures 20 and 21, the adjustment element 230 can be positioned between the anvil plate 134 in a first position in which the first surface, or step, 231 of the adjustment element 230 is positioned between the base 138 of the anvil channel 136 and the first positioning surface 145 on the anvil plate 134. In this first position, the first step 231 can define the amount of relative movement possible, or allowed between the anvil plate 134 and the anvil channel 136. For example, when the anvil 130 is fixed against the fabric, as described above, the anvil plate 134 can come into contact with the fabric and slide upward towards the base 138 to the first positioning surface 145 come into contact with the first step 231. Once the surface 145 and step 231 are in contact, the adjusting element 230 can prevent or at least inhibit that the anvil plate 134 moves further towards the base 138. In at least one such embodiment, as a result, the adjusting element 230 can act as a stop so that the distance between the base 138 and the tissue contact surface 148 on the anvil plate 134 can be defined by a first distance 234. While base 138 is used as reference data in the present example, other portions of anvil 130 and / or an opposite staple cartridge, for example, could be used as reference data. When the adjusting element 230 is in its first position, as described above, the second surface, or step, 232 of the adjusting element 230 can be positioned between the base 138 and the second positioning surface 146 on the anvil plate 134, and furthermore, the third surface, or step, 233 can be positioned between the base 138 and the third positioning surface 147. Referring to figure 20, the adjusting element 230 can include two or more sets of steps, 231, 232 , and / or 233 and the anvil plate 134 may include two or more sets of positioning surfaces 145, 146, and / or 147. Although the first step 231 and the first positioning surface 145 are described above as being configured to control the position of the anvil plate 134, the second and third steps (232, 233) of the adjustment element 230 and the second and third positioning surfaces (146, 147) of the anvil plate 134, respectively, can also be configured to control the position of the anvil plate 134. However, for the sake of brevity, the present example will be described with respect to the first surface, or step 231, as being the surface that controls the position of the anvil plate 134, but the reader will understand that steps 232 and 233 can also control the position of the anvil plate 134.
[00103] In certain embodiments, the first position of the adjusting element 230 can provide a relatively small, or short, staple forming height. In other embodiments, although not shown, the first position of an adjustment element can provide a relatively large intermediate clamp forming height and / or any other suitable height. In the event that the forming height associated with the first position of the adjustment element is adequate, a surgeon may continue to use the surgical stapling instrument to staple and / or cut the tissue, as described above. However, in the event that the clamp formation height is inadequate, a surgeon or other doctor can move the adjustment element 230 so that the adjustment element 230 can allow the anvil plate 134 to slide upward for a distance different when the anvil plate 134 comes into contact with the fabric positioned between the anvil 130 and the staple cartridge 150. In at least one of these circumstances, the distance allowed for the anvil plate 134 to slide upwards can be greater, providing, thus, a higher forming height for the clamps. Correspondingly, in other circumstances, the adjustment element can be moved so that the anvil plate 134 can slide up a short distance when the anvil plate 134 comes into contact with the fabric, for example, thus providing , a shorter clamping height. Although the term "up", and the like, can mean vertically up, the term is not limited to that; on the contrary, "up" can mean any direction towards the base of the anvil and / or away from a staple cartridge, for example. In any case, the adjusting element 230 can be moved between its first position, shown in figure 21, and a second position, shown in figure 22, in order to increase the staple forming height. As indicated by the arrow "P" in figure 22, the adjustment element 230 can be slid proximally in order to move the adjustment element 230 between its first and second positions, although modalities in which an adjustment element can be slid in distal position and / or any other suitable direction in order to adjust the adjustment element 230. When the adjustment element 230 has been moved to its second position, referring to figure 22, a first surface, or step, 231 can be positioned between the base 138 and the second positioning surface 146 of the anvil plate 134. In this second position, the first step 231 can again define the level of relative movement allowed between the anvil plate 134 and the anvil channel 136. At least at least one embodiment, similarly to the above, the adjustment element 230 can act as a stop so that the distance between the base 138 and the fabric contact surface 148 on the bi plate gorna 134 can be defined by a second distance 235.
[00104] In addition to the above, the adjustment element 230 can be moved between its second position, shown in figure 22, and a third position, shown in figure 23, in order to increase the height of clamp formation again. As indicated by the arrow "P" in figure 23, the adjustment element 230 can be slid proximally in order to move the adjustment element 230 between its second and third positions. When the adjustment element 230 has been moved to its third position, with reference to figure 23, a first surface, or step 231, can be positioned between the base 138 and the third positioning surface 147. In this third position, the first step 231 can again define the level of relative movement between the anvil plate 134 and the anvil channel 136. In at least one embodiment, similarly to the above, the adjusting element 230 can act as a stop so that the distance between the base 138 and the tissue contact surface 148 on the anvil plate 134 can be defined by a third distance 236. Although the adjustment element 230 can be selectively moved between three positions, as described above, to provide three different heights of clamp forming, other embodiments comprising an adjustment element that can be moved between more than three positions to provide more than three different clamp forming heights when contemplated. For example, an adjustment element can be moved between four positions in order to provide four staple forming heights. Additional modalities comprising an adjustment element that can be moved between two positions to provide two clamp forming heights are contemplated. In addition, while the surfaces, or steps, 231, 232, and 233 of the adjusting element 230 are arranged in descending order, other arrangements in which the surfaces, or steps, are arranged in an increasing order are contemplated. Other provisions are contemplated in which the surfaces, or stages, are not necessarily arranged in ascending or descending order. Similarly, the positioning surfaces 145, 146, and 147 of the anvil plate 134 can be arranged in ascending order, descending order (figure 20), and / or any other suitable order. In addition, although the adjustment element 230 can be slid along an axis, other modalities are contemplated in which an adjustment element can be moved along any suitable path, such as, for example, curved and / or curvilinear paths. .
[00105] As described above, with reference to figure 21, the adjustment element 230 can comprise three surfaces, or steps, 231, 232, and 233, while the anvil plate 134 can comprise three corresponding adjustment surfaces 145, 146, and 147. When the adjustment element 230 is in its first position, for example, a first surface 231 can be positioned so as to be contiguous or adjacent to a first adjustment surface 145, the second surface 232 can be positioned so to be contiguous or adjacent to the second adjustment surface 146, and the third surface 233 can be positioned so as to be contiguous or adjacent to the third adjustment surface 147. An adjustment element 230 is slid in relation to the anvil plate 134 , as described above and referring to figures 22 and 23, the surfaces 231, 232, and 233 of the adjusting element 230 can be aligned sequentially with respect to the surfaces 145, 146, and 147 of the plate of the anvil 134. In at least one embodiment, an adjustment element may have a number of steps equal to the number of positioning surfaces on an anvil plate. Other modalities are contemplated, in which an adjustment element has more steps than the positioning surfaces on the anvil plate. In at least one such embodiment, an anvil plate may include a positioning surface on which the steps of an adjustment element can be used selectively to limit upward movement of the anvil plate, for example. In various embodiments, with reference generally to the adjusting element 230 and the anvil plate 134, an anvil plate may include a positioning surface, such as, for example, the positioning surface 145, in which steps 231, 232, and 233 of the adjusting element 230, for example, can be selectively positioned between the base 138 and the positioning surface 145. In such embodiments, the first step 231 can have a first thickness or height that can stop or limit the upward movement of the anvil plate 134 in order to define a first staple forming height, the second step 232 can have a second thickness or height that can stop or limit upward movement of the anvil plate 134 in order to define a second forming height and, in addition, the third step 233 can have a third thickness or height that can stop or limit the upward movement of the anvil plate 134 in order to define a third height of grain formation. ampo. In at least one embodiment, the thickness or height of steps 231, 232, and / or 233 can be measured between a rear surface 237 of the adjustment element 230 and a surface over the steps (231, 232, 233) that will come into contact with the anvil plate 134. In various embodiments, the difference in height, or thickness, between the first step 231 and the second step 232 can be the same, or at least substantially equal to the difference in height, or thickness, between the second step 232 and the third step 233. In at least one such embodiment, as a result, the heights of the step may increase at a linear rate, or at least at a substantially linear rate. In alternative modalities, the difference in height, or thickness, between the first and second stages may be different from the difference in height, or thickness, between the second and third stages. In at least one embodiment, the height, or thickness, of the first, second, and third stages may not increase or decrease at a linear rate; particularly, although not illustrated, the height, or thickness, of the steps can increase or decrease at a non-linear and / or geometric rate.
[00106] As described above, an adjustment element, such as, for example, adjustment element 230 can be movable between two or more positions. In various embodiments, a surgical stapling instrument may include an actuator configured to move the adjustment element. In at least one embodiment, referring to figures 17 to 20, the surgical stapling instrument 100 may include the actuator 250 that can be functionally attached to the adjusting element 230 so that a force can be applied to the actuator 250 and transmitted to the element adjustment device 230. In certain embodiments, actuator 250 may include handle portions, or cables, 252 that can be configured to be held by a surgeon, for example, to advance or retract adjustment element 230 within anvil 130 , as described above. In certain embodiments, the handle portions 252 may extend from the actuator body 251, wherein the actuator body 251 may include one or more openings, slits, or cavities 253 that can be configured to receive at least a portion of the adjustment element 230. In at least one such embodiment, with reference to figure 19, adjustment element 230 may include lock 254 extending from it, wherein at least a portion of lock 254 can be received within the opening 253 in order to secure the actuator body 251 to the adjustment element 230. In various embodiments, the lock 254 can include one or more resilient or flexible legs 255 that can be bent when inserted into opening 253, but return resiliently, or return at least partially, for its uninflected position after the legs 256 of the legs 255 are pushed sufficiently through the opening 253. In at least one such mode, the legs 256 can prevent, or at least inhibit, that the body actuator 251 is detached from the adjustment element 230.
[00107] In several modalities, in addition to the above, the surgical stapling instrument 100 can also include a detent mechanism that can be configured to hold, or release in a release way, the actuator 250 and / or the adjustment element 230 in position. In at least one embodiment, with reference to figure 19, the holding element 260 can be attached to the actuator 250 in which, in at least some embodiments, the body of the actuator 251 can include one or more channels, grooves, or recesses 257 that can be configured to receive and / or refer to a holding body 261 of the holding element 260. In at least one embodiment, the holding body 261 can include one or more openings 263 and / or any other suitable channels, slits, or grooves, which can be configured to receive one or more fasteners to secure the holding body 261 to actuator 251, for example. The detent member 260 may further include detent legs 262 that can be configured to engage one or more recesses, openings, or grooves 101 (figures 2-7) in the first portion of the frame 110, for example. More particularly, referring to figures 2 and 3, each side flange 128 can include one or more recesses 101 (101a, 101b, and 101c) defined therein, where the detent legs 262 can be placed in engagement with the top surfaces. of the side flanges 128 so that the detent legs 262 can be slid in and out of the recesses 101. In the illustrated embodiment, each side flange can include three recesses 101 which can be configured to removably hold the actuator 250 in a first position distal, a second intermediate position, and a third proximal position, where the first, second, and third positions of the actuator 250 can correspond respectively to the first, second, and third positions of the adjustment element 230 described above. For example, when the actuator 250 is in its first distal position, the holding legs 262 of the holding element 260 can be positioned within the recess 101a in order to removably hold the actuator 250 and the adjusting element 230 in their first positions. By applying sufficient force, actuator 250 can be moved proximally to its second position so that detent legs 162 are positioned within recess 101b and actuator 250 and adjusting element 230 are retained in their second positions. Similarly, by applying sufficient force, the actuator 250 can be moved proximally to its third position so that the detent legs 162 are positioned within the recess 101c and the actuator 250 and the adjusting element 230 are retained in their third positions. . In various embodiments, the holding legs 162 can be configured so that the actuator 250 can be placed back in its first and / or second position.
[00108] As described above, the adjusting element 230 can be moved along a predetermined path between two or more positions by the actuator 250. In various embodiments, the surgical stapling instrument 100, for example, can include one or more guides to control or limit the movement of the adjusting element 230 and / or the actuator 250. In some embodiments, the adjusting element 230 can be received narrowly between the side walls 137 of the anvil 130 so that the side walls 137 can orient the control element adjustment 230. In at least one such mode, the side walls 137 can be configured to control or limit the lateral or side-to-side movement of the adjustment element 230. In various embodiments, the holding legs 162 of the holding element 160 can understand resilient elements that can be configured to apply a changing force or upward pulling force on the adjustment element 230 in order to position the adjustment element 230 against or at least adjacent to base 138 and intermediate side walls 137. In certain embodiments, referring to figure 19, base 138 of anvil 130 may also include a guide slot 149 that can be configured to receive at least one portion of the adjustment element 230 and / or actuator 250 so that the guide slot 149 can limit the movement of the adjustment element 230 and the actuator 250. In at least one such mode, the lock 254 of the adjustment element 230 can be configured to extend through the guide slot 149 so that when lock 254 is inserted into opening 253 of actuator 250, as described above, the base 138 of the anvil 130 can be captured between the adjusting element 230 and the actuator 250. In certain embodiments, the guide slot 149 can be configured to limit the movement of the lock 254 so that the adjustment element 230 can be prevented, or at least inhibited, from being moved in the distal position when the adjustment element 2 30 is in its first or most distal position and / or, similarly, prevented or at least inhibited from being moved proximally when the adjusting element 230 is in its third position, or the most proximal position.
[00109] In several embodiments, in addition to the above, a holding element, similar to holding element 260, for example, can be used to separate the first portion of cable 102 and the second portion of cable 104 from each other. In at least one embodiment, referring to figure 37, the surgical stapling instrument 100 'may include a holding element 260' configured to position the first portion of the cable 102 and the second portion of the cable 104 so that there is a gap between the anvil 130 and the staple cartridge 150. This feature, as described above, can allow a surgeon to easily manipulate the surgical instrument without having to keep the first and second portions of the cable away from each other. In certain embodiments, the holding element 260 'can be sufficiently installed the second portion of the cable 104 so that the holding legs 262' extending from the holding element 260 'can come into contact with the flanges 128 and, when compressed, can apply a change force to the first and second portions of the cable. As seen in figure 37, the legs 262 'can come into contact with the surfaces 101 d on the flanges 128. In order to compress the holding legs 262', the locking mechanism 180 can be moved to a partially closed position so that the arms locking mechanism 188 can engage, and at least partially encircle, the locking projections 131. In this configuration, a surgeon can manipulate the instrument and, when satisfied with his position, can move locking mechanism 180 to a closed position and further compress holding legs 262 '. Similar to the above, the holding element 260 'can be fixed, or otherwise functionally engaged with the actuator 250 so that when the actuator 250 is moved between its first, second and third positions, as described above, the legs 262 'can engage the recesses 101a, 101b, and 101c, respectively. In at least one such embodiment, as a result, actuator 250 may have a pre-stage position in which actuator 250 is positioned distally with respect to its first position and, in addition, surfaces 101d may comprise pre-treated surfaces. stage against which the legs 262 'can be positioned when the actuator 250 is in its pre-stage position.
[00110] As described above, an adjustment element can be slid or moved between the first and second positions in order to adjust the formation height of the clips provided by a surgical stapling instrument. In various embodiments, although not shown, an adjustment element can be configured to positively displace an anvil plate towards and / or away from an opposite staple cartridge, for example. In at least one such modality, a surgical stapling instrument may include one or more traction elements, such as springs, for example,
[00111] In addition to the above, configured to position the anvil plate against the adjustment element so that when the adjustment element is moved between its first and second positions, the adjustment element can dislocate the anvil plate between the first and the second positions in order to establish the first and second heights of forming the clamp. In various embodiments, as a result of the above, an adjustment element can be configured to rotate a portion of an anvil to position. In at least one such embodiment, an adjustment element can be slid along an axis in order to positively displace an anvil plate. In other embodiments, a rotating adjustment element can be configured to positively displace an anvil plate towards and / or away from a staple cartridge, for example. [00111] In addition to the above, as described in more detail below, an adjustment element can be rotated to adjust the clamp forming height. Referring to figures 24 to 36, the surgical instrument 100 'may include, similarly to the above, a first portion of the cable 102', a second portion of the cable 104 ', and a locking mechanism 180' which can be used to hold the fabric between the anvil 130 'and the staple cartridge 150'. Referring to figure 25, also similarly to the above, the locking mechanism 180 'can be hingedly coupled to the first portion 102' by one or more pivb pins 182 ', where the locking mechanism 180' can include one or more more locking arms 188 'which can be configured to engage the second portion 104' and lock the first and second portions of the cable together. Also similarly to the above, referring to figures 25 and 27, the surgical instrument 100 'can also include the propeller bar assembly 200' that can be configured to dislocate a cutting element and / or sledge clamp into end effector 120 '. In at least one such embodiment, the drive bar assembly 200 'may include a proximal end 203' and an actuator 204 ', where actuator 204' can be rotatably installed at the proximal end 203 'and selectively positioned on the first and second sides of the 100 'stapling instrument. In various embodiments, the surgical stapling instrument 100 'can comprise elements that are the same or similar to those described with respect to the surgical stapling instrument 100 and can be operated in the same or similar way to the instrument 100 and, as a result, such details are not repeated on here.
[00112] In various modalities, referring to figure 27, the surgical instrument 100 'can include a rotary adjustment element 230' that can be selectively positioned in at least a first and a second position in order to provide different heights of formation clip. In certain embodiments, the surgical instrument 100 'can include an actuator 250' that can be functionally connected to the adjustment element 230 'so that the actuator 250' can move the adjustment element 230 'between at least its first and second positions. In at least one embodiment, referring to figure 28, the actuator 250 'may include the body of the actuator 251' and the handle or cable portion, 252 '. The actuator body 251 'can include an opening 258' that can be configured to receive a proximal end 238 'of the adjusting element 230' so that rotational movement, torque, and / or forces can be transmitted between actuator 250 'and the adjustment element 230 '. In at least one such embodiment, referring to figure 36, opening 258 'may comprise a non-circular profile and / or a profile that includes one or more flat guiding surfaces configured to transmit rotational movement between the actuator body 251' and the actuator 230 '. In certain embodiments, opening 258 'can be dimensioned and configured to receive closely the proximal end 238' of actuator 230 '. In at least one embodiment, the opening 258 'can be configured to receive the proximal end 238' in a snap-fit and / or snap-fit arrangement. In various embodiments, again with reference to Figure 28, the cable portion 104 'can include one or more slots 259' that can be configured to allow at least one portion of the actuator body 251 'to extend through them so that the because handle 252 'can be installed in the actuator body 251' with at least one portion of the cable portion 104 'positioned between them. In at least one such embodiment, the second portion of the cable 104 'may further include the recess 253' which can be configured so that at least one portion, or all, of the handle portion 252 'is positioned within the recess 253 '. In certain embodiments, the recess 253 'can be configured so that the handle portion 252' does not extend above the top surface of the second cable portion 104 'although, in other embodiments, an upper portion of the handle portion 252' may extends above the second portion of cable 104, as shown in Figure 30, so that handle portion 252 'can be easily accessed by a surgeon.
[00113] In various embodiments, as described above, an adjustment element can be rotated between at least the first and second positions to adjust the height of formation of the staples dispensed by a surgical stapler. In certain embodiments, referring to figure 28, a surgical stapling instrument may include an adjustment element rotatably positioned within an anvil, where the adjustment element can be configured to limit the relative movement of a movable portion of the anvil . In at least one such embodiment, the surgical stapling instrument 100 'may include an anvil plate 134' that can be slidably retained within the anvil channel 136 'by the retaining pins or guide 140', where the guide pins 140 'can be configured to allow the anvil plate 134' to slide upward when the anvil plate 134 'comes into contact with the fabric, as described above. Referring to figures 27, 30 and 31, the adjustment element 230 'can be positioned in a first position or orientation, so that it can limit the upward movement of the anvil plate 134' within the anvil channel 136 'and dictate the staple formation height of the staples. In at least one such embodiment, referring to figures 30 and 31, the adjusting element 230 'may include the first opposing surfaces 231' that can be positioned between the base 138 'of the anvil channel 136' and the positioning surface 145 'of the anvil plate 134' so that, when the positioning surface 145 'comes into contact with one of the first surfaces 231', the fabric contact surface 148 'of the anvil plate 134' can be positioned at a first distance 234 'from a relationship surface 129' on the anvil 130 ', for example. Correspondingly, the forming surfaces 132 'can be positioned apart a first distance from a staple cartridge so that, when the staples are dispensed by the staple cartridge, they can be deformed to a first staple height. In addition to the above, a first diameter 241 'can be defined between the first surfaces 231' where the first diameter 241 'can define a maximum position of the upward movement of the anvil plate 134' within the anvil channel 136 '.
[00114] As indicated above, the adjusting element 230 'can be rotated to adjust the forming height of the clamps. In various embodiments, the adjusting element 230 'can be rotated between its first position, or orientation (figures 30 and 31) and a second position, or orientation (figures 32 and 33). In at least one embodiment, referring to figures 32 and 33, the cable 252 'can be rotated in a direction indicated by the arrow "A", in order to move the adjusting element 230' between its first and second positions. Similar to the above, when the actuator 230 'is in its second position, or orientation, the actuator 230' can limit the upward movement of the anvil plate 134 'within the anvil channel 136' and dictate the forming height. of staple staples. In at least one such embodiment, referring to figures 32 and 33, the adjusting element 230 'can include the second opposing surfaces 232' that can be positioned between the base 138 'and the positioning surface 145' so that when the positioning surface 145 'comes into contact with one of the second surfaces 232', the tissue contact surface 148 'of the anvil plate 134' can be positioned at a second distance 235 'from a relationship surface 129', for example example. Correspondingly, the forming surfaces 132 'can be positioned apart at a second distance from a staple cartridge so that, when the staples are dispensed by the staple cartridge, they can be deformed to a second staple height. In various embodiments, similarly to the above, a second diameter 242 'can be defined between the second surfaces 232', where the second diameter 242 'can define the maximum upward movement position of the anvil plate 134' within the anvil channel 136 '. Although the first surfaces 231 'and the second surfaces 232' can be defined by flat or at least substantially flat surfaces, other embodiments are contemplated in which the first and second surfaces 231 'and 232' can include at least partially arched or contours curves. In any case, with reference to figure 27, the adjusting element 230 'may include one or more gap slots 240' that can be configured to provide a gap between the actuator 230 'and the retaining pins 140'. The gap slots 240 'can be configured to provide a gap between the actuator 230' and the retaining pins 140 'when the actuator 230' is in its first position, second position, and / or any other suitable position.
[00115] In various modalities, in addition to the above, the adjustment element 230 'can be rotated between its first position or orientation (figures 30 and 31) and a third position or orientation (figures 34 and 35). In at least one embodiment, referring to figures 34 and 35, the cable 252 'can be rotated in a direction indicated by the arrow "B", in order to move the adjustment element 230' between its first and third positions. Similar to the above, when the actuator 230 'is in its third position or orientation, the actuator 230' can limit the upward movement of the anvil plate 134 'within the anvil channel 136' and dictate the forming height of staple staple. In at least one such embodiment, referring to figures 34 and 35, the adjusting element 230 'can include the third opposing surfaces 233' that can be positioned between the base 138 'and the positioning surface 145' so that when the positioning surface 145 'comes into contact with one of the third surfaces 233', the tissue contact surface 148 'of the anvil plate 134' can be positioned at a third distance 236 'from a relationship surface 129', for example example. Correspondingly, the forming surfaces 132 'can be moved a third distance from a staple cartridge so that when the staples are dispensed by the staple cartridge, they can be deformed to a third staple height. In various embodiments, similarly to the above, a third diameter 243 'can be defined between the third surfaces 233', where the third diameter 243 'can define the maximum upward movement position of the anvil plate 134' within the anvil channel 136 '. Again referring to figures 34 and 35, the third surfaces 233 'can be defined by a contour at least partially arched, although other modalities are contemplated in which the third surfaces 233' can include contours pianos or at least substantially pianos. In at least one embodiment, the adjusting element 230 'can be configured so that the greatest distance or diameter between the third arched surfaces 233' can be used to define the third clamp height.
[00116] As described above, referring to figures 30 and 31, the adjustment element 230 'can be positioned in a first position or orientation, to establish a first forming height for the staples dispensed by the surgical stapling instrument 100' . As also described above, referring to figures 32 and 33, the actuator 250 'can be used to move the adjusting element 230' to its second position or orientation, to establish a second forming height for the clamps. To do this, in at least one embodiment, a force can be applied to the cable 252 ', which can cause the cable 252' and the adjustment element 230 'attached to it, to rotate in a direction indicated by the arrow "A ". In at least one embodiment, the adjusting element 230 'and / or the actuator 250' can be sufficiently retained so that, when the adjusting element 230 'is rotated, the adjusting element 230' can be rotated about an axis , such as axis 245 '(figure 27), for example. In at least one embodiment, referring to figure 25, the proximal end 203 'of the propeller bar assembly 200' may include one or more grooves, channels, or recesses 205 'that can be configured to receive and / or refer to at least one portion of the adjustment element 230 'and / or the actuator 250'. In any case, as shown in figures 30 to 33, the second position or orientation of the adjustment element 230 'may allow the anvil plate 134' to slide a greater distance within the anvil channel 136 'compared to when the adjustment element 230 'is in its first position. In at least one embodiment, as a result, the second staple forming height may be greater than the first staple forming height. As also described above, referring to figures 34 and 35, the actuator 250 'can be used to move the adjusting element 230' to its third position or orientation, to establish a third forming height for the clamps. To do this, in at least one embodiment, a force can be applied to the cable 252 ', which can cause the cable 252' and the adjustment element 230 'attached to it, to rotate in a direction indicated by the arrow "B ". As shown in figures 30, 31, 34 and 35, the third position or orientation of the adjustment element 230 'may allow the anvil plate 134' to slide a shorter distance within the anvil channel 136 'compared to when the adjustment element 230 'is in its first position In at least one embodiment, as a result, the first and second staple forming heights can be greater than the third staple forming height. In at least one such embodiment, the first position of the adjustment element 230 ', and the actuator 250', may represent an intermediate position, in which the adjustment element 230 'can be selectively moved to its second and third positions directly from from your first position. In practice, the first position of the adjustment element 230 'can represent an intermediate height of the clamp, where the second and third positions of the clamp of the adjustment element 230' can represent higher and lower clamp heights, respectively. In certain embodiments, with reference to figure 24, the surgical stapling instrument 100 'can include one or more signals thereon, which can be configured to inform the staple forming heights, or at least the relative forming heights, that can be selected. For example, the second portion of cable 104 'may include a first signal 245' which may indicate an intermediate height or first height of the clamp, a second signal 246 'which may indicate a higher height, or a second height of the clamp and, in addition in addition, a third signal 247 'which may indicate a shorter height, or third height of the clamp.
[00117] In various modalities, in addition to the above, one or more of the first surfaces 231 ', second surfaces 232', and third surfaces 233 'can comprise or define, or at least partially understand or define, a perimeter or circumference of the adjustment element 230 '. As discussed above, due to the first, second and third diameters (241 ', 242' and 243 ') defined by the first, second, and third surfaces (231', 232 ', and 233'), respectively, the perimeter or circumference of the adjustment element 230 'may be non-circular. However, in certain embodiments, the penimeter or circumference of the adjustment element 230 'may be symmetrical, substantially symmetrical, and / or non-symmetrical. In various embodiments, in addition to the above, an adjustment element may comprise a cam positioned of rotating mold between the base 138 'of the anvil 130' and the adjustment surface 145 'of the anvil plate 134', for example. In at least one such embodiment, one or more of the first surfaces 231 ', second surfaces 232' and third surfaces 233 ', for example, can comprise or define a cam profile which, similarly to the above, can be configured to positively position the anvil plate 134 'and / or provide a stop against which the anvil plate 134' can be positioned. In any case, although not illustrated, several modalities are contemplated, in which an adjustment element can be slid and rotated in order to establish two or more staple forming heights for the staples dispensed by a surgical stapling instrument. In at least one such embodiment, an adjustment element may comprise a cam profile that can be defined along the length of the adjustment element, in which the longitudinal and / or rotational movement can be used to move the cam profile between at least minus the first and second positions.
[00118] In various embodiments, similarly to the above, the surgical instrument 100 'may further include a detent mechanism configured to hold, or at least releasably hold, the actuator 250' in position. In at least one embodiment, referring to figures 25 and 26, the surgical instrument 100 'may further include the holding element 260' comprising the holding body 261 'and one or more holding legs 262'. Referring to figure 26, the holding body 261 'can include one or more grooves, recesses, or channels 263' that can be configured to receive at least a portion of the proximal end 105 'of the second portion of the cable 104' so that the element holder 260 'can be held in position. In at least one such embodiment, the proximal end 105 'may further include one or more grooves, channels, or recesses 265' that can be configured to receive closely the holding element 260 '. In certain embodiments, at least a portion of the holding body 261 ', such as channel 263', for example, can be retained by snap fit, quick fit and / or suitably retained otherwise in the recess 265 '. As also illustrated in figure 26, each detent leg 262 'of detent member 260' can include one or more projections 264 'extending therefrom, which can be configured to engage actuator body 251' and secure releasably actuator 250 'in position. In at least one embodiment, referring to figure 36, the actuator body 251 'may include one or more recesses, or holes, 269' that can be configured to receive a projection 264 '. When a projection 264 'is positioned within the recess 269', the projection can be configured to hold the actuator 250 'in its first position, for example, until a sufficient force is applied to the actuator 250' in order to cause the projection 264 'is moved out of recess 269'. More particularly, the force applied to the actuator 250 'can be transmitted to the projection 264' and, due to the cooperating surfaces between the projection 264 'and the recess 269', the holding leg 262 'associated with the projection 264' can be flexed and moved proximally to allow the actuator body 251 'to be moved relative to it. In order to favor such proximal movement, with reference to figure 25, the recess 265 'can include elongated portions 266' which can each be configured to receive at least one portion of the legs 262 'so that the legs 262' can move with respect to cable portion 104 '. As the actuator 250 'is moved in its second or third position, the body of the actuator 251' can come into contact with a projection 264 'extending from another leg 262' and deflect leg 262 'proximally so that when actuator 250 'is in its second or third position, leg 262' can spring forward, or distally, so that projection 264 'can be secured within recess 269'. In at least one embodiment, in addition to the above, the interaction between the projections 264 'and the side walls of the recess 269' can be such that the actuator 250 'can be safely maintained in one of its first, second, and third positions, for example, but still allows the actuator 250 'to be moved by applying sufficient force. In such embodiments, the holding element 260 'can prevent, or at least inhibit, that the actuator 250' and, consequently, the adjusting element 230 'are accidentally displaced.
[00119] As discussed above and shown in figure 2, each side flange 128 of the first portion of cable 102 may include a notch or recess 127, for example, which can be configured to receive one or more lock projections 131, for example, extending from anvil 130, and / or any other suitable portion of the second portion of cable 104. As also discussed above, with reference mainly to figures 2 and 3, the first portion of cable 102 may further include a locking mechanism 180 swiveled to it, which can be used to engage the lock projections 131 extending from the second portion of cable 104 and secure the first and second portions of cable 102, 104 together. The locking mechanism 180 may further include one or more locking arms 188 extending therefrom, which can be configured to engage one or more locking projections 131 and pulling and / or securing the projections 131 within the recesses 127 , as shown in figure 7. With reference to figure 6, at least one of the locking arms 188 can include a distal hook 189 that can be configured to wrap around at least a portion of the projections 131 so as to encompass or surround, or at least partially encompass and surround the projections 131. In at least one embodiment, the locking arms 188 can act as an upper central lock to hold lock mechanism 180 in its locked or closed position.
[00120] In various modalities, now with reference to figure 38, each projection 131 may comprise a slot or groove 190 positioned between the side wall 191 and an enlarged end or head, 192 of the projection 131, in which slot 190 can be configured to receive at least a portion of the locking arm 188. More particularly, in at least one embodiment, the slot 190 may be wider than the width of the locking arm 188 so that, when the locking arm 188 is engaged with the projection 131, locking arm 188 can enter slot 190. In some circumstances, the width of each slot 190 may be slightly greater than the width of a locking arm 188 so that the locking arm is received narrowly within slot 190 In various circumstances, the slot 190, the side wall 191 and the head 192 of the projection 131 can be dimensioned and configured so as to avoid or at least limit the relative lateral movement, i.e. the movement away from or towards the sides of the anvil 130, between the locking arm 188 and the projection 131. In addition to the above, however, the locking arms 188 can slide longitudinally into the grooves 190 while the locking arms 188 move the projections 131 into the recesses 127 in the first portion 102. Due to this relative sliding movement between the locking arms 188 and the projections 131, frictional forces that can resist the movement of the locking arms 188 can be generated between them. In various circumstances, the magnitude of these frictional forces can be significant when the normal or perpendicular forces between the locking arms 188 and the lateral walls of the groove 190 are large. In many circumstances, as a result, the operator of the surgical instrument will have to overcome these frictional forces when operating the locking mechanism 180.
[00121] In several alternative modalities, now with reference to Figures 39 and 40, a surgical instrument can comprise one or more locking projections that have a rotating bearing that can reduce the magnitude of the frictional forces between the locking arms of a mechanism locking and locking projections. In at least one embodiment, an anvil 330, which can be substantially similar to anvil 130 in many respects, may comprise a lock projection 331 extending from each of its sides, where each lock projection 331 can comprise a swivel bearing 393. In use, the locking arms 188 of the locking mechanism 180, for example, can come in contact with the swivel bearings 393 in order to position the locking projections 331 in the recesses 127. In various circumstances, the arms locking means 188 can slide through the surface or outer diameter of bearings 393; however, as bearings 393 can rotate with respect to locking arms 188, the magnitude of the frictional forces between locking arms 188 and projections 331 may be less than the magnitude of the frictional forces between locking holes 188 and the projections 131. Due to these smaller frictional forces, a smaller closing force or fastening may be necessary to activate the locking mechanism 180, for example.
[00122] In various embodiments, with reference mainly to figure 41, each swivel bearing 393 may comprise a circular or round outer diameter 394 and, in addition, a circular or round bearing opening 395 extending therefrom. In certain embodiments, each projection 331 may further comprise a stem portion 396 extending from the side wall 391 and an enlarged end, or head, 392 extending from stem portion 396, wherein, as illustrated in Fig. 31, the stem portion 396 can extend through the bearing opening 395 of the swivel bearing 393. In various embodiments, the stem portion 396 may comprise a circular or round outer diameter, which can be received narrowly within the bearing opening. 395 so that there is little relative radial movement between them, should it occur. The diameter of the bearing opening 395, however, can be sufficiently larger than the outer diameter of the stem portion 396, so that the bearing 393 can rotate the stem portion 396 relative to an axis 399 in relation to it. the swivel bearing 393 can be retained over the stem portion 396 by the enlarged head 392. More particularly, in at least one embodiment, the enlarged head 392 can be larger than, or can define a diameter greater than, the diameter of the bearing opening 395 so that a swivel bearing 393 cannot slide off the end of the stem portion 396. In certain embodiments, the side wall 391 and the head 392 can define a gap between them and, in addition, bearing 393 it can comprise a width, in which the distance of the gap can be greater than the width of the bearing 393. In at least one embodiment, the distance of the gap can be slightly greater than the width of the bearing 393 so that the bearing 393 do not tilt, or tilt at least substantially, with respect to axis 399, for example.
[00123] As discussed above, the locking holes 188 of the locking mechanism 180 can be configured to engage the bearings 393 and position the bearings 393 within the recesses 127. In several alternative modalities, with respect mainly to figure 40, a The surgical instrument may comprise a locking mechanism 380 which may comprise the first and second locking holes 388 extending from it on opposite sides of the anvil 331 and the staple cartridge channel 324. In use, similarly to set forth above, locking holes 388 may contact bearings 393 in order to move bearings 393 into recesses 327 in the staple cartridge channel 324 and move the anvil 331 toward the staple cartridge channel 324. This movement is illustrated with imaginary lines in figure 41. In various ways, each locking hole 388 can define, at least partially, a groove, or slot 397, in q Each slot 397 can be configured to receive a bearing 393. In at least one embodiment, a slot 397 can comprise a first guiding surface, or side wall, 398a which can be positioned against bearing 393 and, depending on a closing force and applied to the locking mechanism 380, the locking pin 388 can apply a closing force to the bearing 393. In these circumstances, the bearing 393 can enter further into the slot 397 according to the locking mechanism 380 and rotated to its closed position. In various circumstances, slot 397 may additionally comprise a second guiding surface, or side wall, 398b which can be positioned against the other side and / or the opposite side of bearing 393 so that an opening force can be applied to bearing 393 through the locking arm 388. As the locking mechanism 380 is moved to its open position, the bearing 393 can come out of the slot 397. In any case, the first guiding surface 398a and the second guiding surface 398b can define a width between them, which may be larger than the outer diameter of bearing 393 so that bearing 393 can move within slot 397. In some embodiments, the gap width may be slightly larger than the outer diameter of bearing 393. In at least one embodiment, at least because the first targeting surface 398a and the second targeting surface 398b can be parallel, or at least subs tially parallel to each other. In at least one such embodiment, at least portions of the first targeting surface 398a can be positioned opposite the second targeting surface 398b.
[00124] As described above, a surgical stapling instrument can be configured to deform one or more surgical staples between a first configuration, not dispensed, and a second configuration, dispensed. In various modalities, now with reference to figure 39, a surgical clamp, such as clamp 400, for example, can comprise a base 402, a first leg, or deformable element, 404 extending from base 402 and, in addition , a second leg, or deformable element, 406 extending from the base 402. In certain embodiments, the base 402, the first leg 404 and the second leg 406 may consist of a continuous wire, in which at least one In this embodiment, the first leg 404 and the second leg 406 can each be tilted in a direction that is perpendicular to the base 402 before the clamp 400 is inserted and deformed by a surgical stapler. More particularly, the clip 400 can be manufactured so that the base 402 is oriented along a base line 401 and so that the legs 404 and 406 are oriented along lines 409 and 411, respectively, which are perpendicular, or at least substantially perpendicular, the baseline 401. In various embodiments, the first leg 404 can be positioned at a first end of the base 402 and the second leg 406 can be positioned at a second end of the base 402, wherein, in at least one embodiment, an average line 403 can be defined, which extends through a midpoint of the base 402 and extends in a direction perpendicular to the base line 401. The clamp 400 can be configured so that the base 402, the first leg 404, and the second leg 406 are located, or are or at least substantially located, on the same piano, or on a common piano, when the clamp 400 is in its first configuration or configuration not dispensed with. In such embodiments, the base line 401, along which base 402 is oriented, and perpendicular lines 409 and 411, along which legs 404 and 406 are oriented, can be located on the same piano.
[00125] In several modalities, in addition to the above, the continue wire comprising base 402, first leg 404, and second leg 406 may consist of titanium and / or stainless steel, for example. In at least one embodiment, the first leg 404 can comprise a first end 405 and the second leg 406 can comprise a second end 407, wherein the ends 405 and 407 can each comprise a sharp or beveled tip, which can be configured to pierce bone and / or tissue. In use, staple 400 can be deformed by a surgical stapler in order to capture tissue, for example, within staple 400. In various embodiments, staple 400 can be dispensed from a staple cartridge so that the ends 405 and 407 of the legs of clamp 404 and 406, respectively, come into contact with an anvil positioned opposite the clamp 400. In these circumstances, a first compression force F1 can be applied to the first leg 404 and a second compression force F2 can be applied. the second leg 406 is applied while the base 402 is supported by at least a portion of the staple cartridge. As described in more detail below, the anvil may comprise a staple pocket which can apply the first compression force F1 to the first leg 404, so that the end 405 of the leg of the staple 404 is moved towards the base 402. Similarly , the clip pocket can apply the second compression force F2 to the second leg of the clip 406 so that the end 407 of the leg of the clip 404 is also moved towards the base 402. In addition to the above, as also discussed in more detail below, now with reference to figures 50 to 52, the staple pocket can tilt the first leg of the staple 404 to a first side of the base 402 and the second leg of the staple 406 to a second side, or opposite side, of the base 402.
[00126] In various embodiments, with reference to figures 49 and 50, the first leg 404 of the clamp 400 can be tilted so that the end 405 of the first leg 404 is moved towards the base 402 and towards the second leg 406 when the first leg 404 is deformed by the first compression force F1. In at least one embodiment, the end 405 can be moved from a first side 410 of the middle line 403, as shown in figure 49, to a second side 412 of the middle line 403, as shown in figure 50. Similarly, the second leg 406 of clip 400 can be tilted so that the end 407 of the second leg 406 is moved towards the base 402 and towards the first leg 404 when the second leg 406 is deformed by the second compression force F2. In at least one embodiment, the end 407 can be moved from a second side 412 of the middle line 403, as shown in figure 49, to a first side 410 of the middle line 403, as shown in figure 50. In the dispensed, or deformed configuration , of the clamp 400, as shown in figure 50, the ends 405 and 407 of the legs of the clamp 404 and 406 can extend beyond the midline 403 to form an angle between them. More particularly, the end 405 of the first leg 404, when it is in its deformed configuration, can extend along, or in relation to, a first axis 414 and, similarly, the end 407 of the second leg 406, when in their deformed configuration may extend along, or in relation to, a second axis 416 so that the first axis 414 and the second axis 416 define an angle 417 between them. In some embodiments, the angle 417 can be approximately 90 degrees, for example. In certain embodiments, the angle 417 can be in a range between approximately 0.1 degree and approximately 89 degrees, for example. In various embodiments, the angle 417 can be greater than 90 degrees, while in at least one embodiment, the angle 417 can be greater than approximately 90 degrees, but less than 180 degrees, for example.
[00127] In several modalities, in addition to the above, the first axis 414 and the second axis 416 can, in various modalities, be oriented, or crossed, at a transverse angle in relation to the other, that is, at least when the clamp 400 is viewed from the side view or in elevation of figure 50. More particularly, it is evident from the analysis of figure 52 that, although axes 414 and 416 extend in transversal directions when viewed from the side (figure 50), axes 414 and 416 cannot, in at least one mode, actually cross with each other. In such embodiments, when viewing clip 400 from above or from below (figure 52), for example, axes 414 and 416 may extend in parallel, or at least substantially parallel, directions. In addition, in various embodiments, the reader will note that the first axis 414 and the second axis 416 are not perpendicular to the baseline 401. In other words, the end 405 of the first leg of the clamp 404 and the end 407 of the second leg of the clamp 406 is not pointing directly down toward base 402 and baseline 401. In at least one such embodiment, the first axis 414 and the second axis 416 may extend at an acute angle with respect to the base line 401 , for example.
[00128] As described above, a surgical instrument can be configured to deform the clamp 400 of figure 49, for example, between a non-deformed shape (figure 49) and a deformed shape (figure 50). In various embodiments, as also described above, the surgical instrument may comprise an anvil having a staple pocket configured to receive and deform at least a portion of the staple. In certain embodiments, now with reference to figure 42, an anvil may comprise a contact surface with the fabric 501 and a plurality of staple pockets 500 formed therein, where each staple pocket 500 can be configured to deform a staple 400. In various embodiments, each clip pocket 500 may comprise a longitudinal axis 599 (figure 43) and, in addition, a first forming container 502 and a second forming container 504 positioned in relation to the longitudinal axis 599. In use, the first forming container 502 can be configured to receive the first staple leg 404 of staple 400 and the second forming container 504 can be configured to receive second staple leg 406. More particularly, in at least one embodiment, the staple pocket 500 can be positioned in relation to staple 400 so that when staple 400 is ejected from a staple cartridge, for example, the end 405 of the first leg 404 can enter in the first forming container 502 and the end 407 of the second leg 406 can enter the second forming container 504. In addition to the above, the end 405 of the first leg of the clamp 404 can contact the base 506 of the first forming container 502 so that the first compression force F1 can be applied to the first leg 404 and, similarly, the end 407 of the second leg of the clip 406 can contact the base 508 of the second forming container 504 so that the second force of compression F2 can be applied to the second leg 406.
[00129] In several embodiments, in addition to the above, the first forming container 502 can comprise an inner portion 510 and an outer portion 512, wherein, when the end 405 of the first leg of the clamp 404 enters the first forming container 502 , the end 405 can enter the outer portion 512. Upon entering the outer portion 512 of the forming container 502, the end 405 can contact the base 506 and, due to the concave curve of the base 506, the end 405 can be directed inwardly towards the inner portion 510. More particularly, now with reference to figures 46 to 48, the base 506 can be curved towards the contact surface with the fabric 501 so that, at the moment when the leg of the staple 404 enters in contact with the base 506, the end 405 can be directed downwards, that is, away from the surface of contact with the fabric 501, and inwards along the concave curved surface towards an inflection point 595. In varies In these embodiments, the inflection point 595 may represent the point at which the concave surface of the base 506 will begin to deflect the end 405 of the first leg 404 upwards towards the surface of contact with the fabric 501. In various embodiments, the radius of curvature, r, of the concave surface may be constant, or at least substantially constant, in the longitudinal direction along its length, as shown in figures 47 and 48. In certain embodiments, the radius of curvature r of the concave surface of the base 506 may be consistent over the entire width of the base 506 between a first inner side wall 516 and a first outer side wall 517. In any case, according to the end 405 of the first leg 404 and advanced towards the inner portion 510 of the forming container 502, the end 405 can come into contact with a transition beam 514 positioned between the base 506 and the first inner side wall 516. In such embodiments, the transition beam 514 can be co-located nfigured to direct the end 405 against the first inner side wall 516.
[00130] As shown in figure 43, in addition to the above, the first interior side wall 516 can be oriented at an angle with respect to the longitudinal axis 599 of the staple pocket. In certain embodiments, the first interior side wall 516 can be oriented at an acute angle, such as 10 degrees, for example, with respect to the longitudinal axis 599. In various embodiments, the first interior side wall 516 and the longitudinal axis 599 cannot be neither perpendicular nor parallel to each other. In any case, the first interior side wall 516 can extend through the axis 599 so that a first portion of the first interior side wall 516 is positioned on a first side 515 of the axis 599 and a second portion of the first interior side wall 516 is positioned on a second side 517 of the axis 599. In various embodiments, as a result, the first inner side wall 516 can extend between the first outer portion 512 and the first inner portion 510. When the end 405 of the first leg 404 comes into contact with the first inner side wall 516, as described above, the end 405 can be directed along with the first inner side wall 516 and away from the longitudinal axis 599 so that the leg of the clamp 404 is flexed away from the common piano of the clamp 400 facing the first side 515 of the axis 599. According to the end 405 of the first leg 404 and directed together with, or and flexed by, the first side wall interior 516, as described above, the leg of the clip 404 can also be directed or flexed by the base 506. In other words, the first side wall 516 and the first base 506 can cooperate to deform the first leg of the clip 404 so that the end 405 is redirected towards base 402 and simultaneously to a first side of base 402, as described above. At some point during insertion of the first leg of clamp 404 into the first forming container 502, the end 405 of the first leg of clamp 404 may emerge from the first inner portion 510 of the first forming container 502 and, depending on the leg of clamp 404 and additionally deformed by the clip pocket 500, the end 405 can be directed along the first axis 414 (figure 50) as described above.
[00131] In several embodiments, in addition to the above, the first inner side wall 516 may extend along the inner side of the first base 506, in which, in at least one embodiment, the first forming container 502 may additionally comprise a first external side wall 517 extending along an opposite side of the first base 506. In certain embodiments, similarly to the above, the first forming container 502 may additionally comprise a transiption radius 519 positioned between the base 506 and external side wall 517. In at least one embodiment, now with reference to Figure 43, the external side wall 517 can extend in a direction parallel, or at least substantially parallel, to the longitudinal axis 599 of the staple pocket. As also shown in figure 43, the first inner side wall 516 and the first outer side wall 517 can extend in directions that are transversally to each other. In at least one embodiment, the inner side wall 516 can extend at an acute angle, such as, for example, approximately 15 degrees with respect to the outer side wall 517. In various embodiments, as a result, the outer portion 512 of the first container of shape 502 may be wider than the inner portion 510. In at least one such embodiment, the width of the outer portion 512 and the inner portion 510 may narrow between a first width and a second width.
[00132] In various embodiments, again referring to figure 43, the outer portion 512 of the first forming container 502 may comprise a first outer wall 513 that can extend in a direction that is perpendicular to the first outer wall 517 and / or to the longitudinal axis 599 and can define the outermost portion of the forming container 502. In at least one embodiment, in addition to the above, the width of the first outer wall 513 can be such that the outer portion 512 can capture the end 405 of the first leg 404 and guide it into the inner portion 510 of the container 502, as described above. In at least one such embodiment, the first outer wall 513 may be at least twice as wide as the diameter of the first leg 404. In certain embodiments, the first forming container 502 may additionally comprise a channeling surface 528 surrounding the the first inner portion 510 and the first outer portion 512, which can be configured to orient the leg of the clamp 404 into and / or out of the forming container 502. In various embodiments, the inner portion 510 may additionally comprise an inner wall 511 which can define the deepest portion of the forming container 502. Similar to the above, the inner wall 511 can also define the narrowest portion of the forming container 502. In at least one embodiment, the width of the inner wall 511 can be equal, or at least substantially equal, to the diameter of the first leg 404, so that the inner wall 511 can control where the end 405 emerges from the staple forming container 502.
[00133] In various embodiments, in addition to the above, the second forming container 504 may comprise an inner portion 520 and an outer portion 522, wherein, when the end 407 of the second leg of the clamp 406 enters the second forming container 504 , the end 407 can enter the external portion 522. Upon entering the external portion 522 of the forming container 504, the end 407 can contact the base 508 and, due to the concave curve of the base 508, the end 407 can be directed inward towards internal portion 520. More particularly, in a similar manner as described above, the base 508 can be curved towards the surface of contact with the fabric 501 so that, at the moment the leg of the staple 406 comes into contact with the base 508, the end 407 can be directed downward, that is, away from the surface of contact with the fabric 501, and inward along the concave surface curved towards an inflection point 596. In several ways However, the inflection point 596 may represent the point at which the concave surface of the base 508 begins to deflect the end 407 of the second leg 406 upwards towards the surface of contact with the fabric 501. In various embodiments, the radius of curvature , r, of the concave surface may be constant, or at least substantially constant, in the longitudinal direction along its length, similarly to the base 506 of the first forming container 502, as shown in figures 47 and 48. In any case, according to the end 407 of the second leg 406 and advanced to the internal portion 520 of the forming container 504, the end 407 can come into contact with a transition radius 524 positioned between the base 508 and the second inner side wall 526. In such embodiments , the transition radius 524 can be configured to direct the end 407 against the second inner side wall 526.
[00134] As shown in figure 43, in addition to the above, the second inner side wall 526 can be oriented at an angle with respect to the longitudinal axis 599 of the staple pocket. In certain embodiments, the second inner side wall 526 can be oriented at an acute angle, such as 10 degrees, for example, with respect to the longitudinal axis 599. In various embodiments, the second inner side wall 526 and the longitudinal axis 599 cannot be neither perpendicular nor parallel to each other. In any case, the second inner side wall 526 can extend through the axis 599 so that a first portion of the second inner side wall 526 is positioned on a first side 515 of the axis 599 and a second portion of the second inner side wall 526 is positioned on a second side 517 of the axis 599. In various embodiments, as a result, the second inner side wall 526 can extend between the second outer portion 522 and the second inner portion 520. When the end 407 of the second leg 406 comes into contact with the inner side wall 526, as described above, the end 407 can be directed along with the inner side wall 526 so that the leg of the staple 406 is flexed away from the common piano of the staple 400 facing the first side 517 of the shaft 599 As the end 407 of the second leg 406 is directed along with, or is flexed by, the inner side wall 526, as described above, the leg of the clamp 406 can also be is directed and flexed by the base 508. In other words, the second inner side wall 526 and the second base 508 can cooperate to deform the second leg of the clamp 406 so that the end 407 is redirected towards the base 402 and simultaneously towards a second side, or opposite side, of the base 402, as described above. At some point during the insertion of the second leg of the clamp 406 into the second forming container 504, the end 407 of the second leg of the clamp 406 can emerge from the second inner portion 520 of the second training container 504 and, depending on the leg of the clamp 406 and further deformed by the clip pocket 500, the end 407 can be directed along the second axis 416 (figure 50) as described above.
[00135] In several embodiments, in addition to the above, the second inner side wall 526 may extend along the inner side of the second base 508, in which, in at least one embodiment, the second forming container 504 may additionally comprise a second external side wall 527 extending along an opposite side of the second base 508. In certain embodiments, similarly to the above, the second forming container 504 may additionally comprise a transition radius 529 positioned between the base 508 and the outer side wall 527. In at least one embodiment, now with reference to figure 43, the outer side wall 527 may extend in a direction parallel, or at least substantially parallel, to the longitudinal axis 599 of the staple pocket. As also shown in Figure 43, the second inner side wall 526 and the second outer side wall 527 can extend in directions that are transversally to each other. In at least one embodiment, the inner side wall 526 may extend at an acute angle, such as, for example, approximately 15 degrees with respect to the outer side wall 527. In various embodiments, as a result, the outer portion 522 of the second container forming length 504 may be wider than the inner portion 520. In at least one such embodiment, the width of the outer portion 522 and the inner portion 520 may narrow between a first width and a second width.
[00136] In various embodiments, again referring to figure 43, the outer portion 522 of the second forming container 504 may comprise a second outer wall 523 which may extend in a direction that is perpendicular to the second outer wall 527 and / or to the longitudinal axis 599 and can define the outermost portion of the forming container 504. In at least one embodiment, in addition to the above, the width of the second outer wall 523 can be such that the outer portion 522 can capture the end 407 of the second leg 406 and guide it into the inner portion 520 of the container 504, as described above. In at least one such embodiment, the second outer wall 523 may be at least twice as wide as the diameter of the second leg 406. In certain embodiments, the second forming container 504 may additionally comprise a channeling surface 529 surrounding the second portion inner 520 and the second outer portion 522, which can be configured to orient the leg of the clamp 406 into and / or out of the forming container 504. In various embodiments, the inner portion 520 may additionally comprise an inner wall 521 that can define the deepest portion of the forming container 504. Similar to the above, the inner wall 521 can also define the narrowest portion of the forming container 504. In at least one embodiment, the width of the inner wall 521 can be equal , or at least substantially equal, to the diameter of the second leg 406, so that the inner wall 521 can control the place where the end 407 emerges from the staple forming container 504.
[00137] As discussed above, with reference again to figures 43 to 45, the first forming container 502 may comprise a first inner side wall 516 and a second forming container 504 may comprise a second interior side wall 526. As illustrated in the figure 43, the first inner portion 510 of the forming container 502 can be positioned in close proximity, or in close relationship, with the second inner portion 520 of the forming container 504 so that the first inner side wall 516 can be positioned next to the second inner side wall 526. In at least one embodiment, the first inner portion 510, or at least a substantial portion thereof, can be displaced relative to the longitudinal axis 599 of the staple pocket in the first direction 515 while the second inner portion 520 , or at least a substantial portion thereof, can be displaced relative to the longitudinal axis 599 in the second direction 517. In several embodiments, the clip pocket 500 may comprise a wall 530 positioned between the first inner portion 510 and the second inner portion 520, wherein the first side of the wall 530 may comprise the first inner side wall 516 and wherein a second side of the wall 530 may comprise the second inner side wall 526. In at least one embodiment, the first inner side wall 516 may be parallel, or at least substantially parallel, the second inner side wall 526. More particularly, in at least one embodiment, the the first interior side wall 516 can define a first piano and the second interior side wall 526 can define a second piano, wherein the first piano and the second piano can be parallel, or at least substantially parallel, to each other. In various embodiments, with reference again to Figures 44 and 45, the first inner side wall 516 can be perpendicular, or at least substantially perpendicular, the fabric contact surface 501 and, similarly, the second inner side wall 526 can be perpendicular, or at least substantially perpendicular, the tissue contact surface 501.
[00138] In various embodiments, in addition to the above, the first inner side wall 516 may comprise a first vertical portion 516a which is perpendicular, or at least substantially perpendicular, to the surface of contact with the fabric 501. In at least one embodiment, the first vertical portion 516a may extend through or cross the longitudinal axis 599. In various embodiments, the first vertical portion 516a may extend over all or just a portion of the first interior side wall 516. Similarly, the second interior side wall 526 may comprise a second vertical portion 526a which is perpendicular, or at least substantially perpendicular, the tissue contact surface 501. In at least one embodiment, such a second vertical portion 526a may extend through or cross the longitudinal axis 599. In various embodiments, the second vertical portion 526a may extend over all or just a portion of the second inner side wall 526. During the dispensing of the clamp 400, in addition to the above, the end 405 of the first leg 404 may be in contact with the first vertical portion 516a of the first interior side wall 516, simultaneously, the end 407 of the second leg 406 is in contact with the second vertical portion 526a of the second interior side wall 526. Under these circumstances, the first vertical portion 516a and the second vertical portion 526a may comprise a vertical cavity. More particularly, the vertical portions 516a and 526a can cooperate to control, deflect, and tilt the legs of the clamp 404 and 406 in opposite directions, i.e., towards the sides of an ordinary piano, as described above, when the legs 404 and 406 come into contact with the inner side walls 516 and 526 of the forming containers 502 and 504, respectively. For example, again with reference to figure 52, the first vertical portion 516a can be configured to deflect and tilt the leg of the clamp 404 to a first side of the base 402 and the second vertical portion 526a can be configured to deflect and tilt the leg of the clamp. clamp 406 for a second side, or opposite side, of the base 402.
[00139] In several modalities, in addition to the above, the vertical cavity comprising the vertical portions 516a and 526a can extend along the entire length of the first and second internal lateral walls 516 and 526, while, in other modalities, the cavity The vertical cavity can extend over only a portion of the side walls 516 and 526. In at least one embodiment, the vertical cavity can be approximately 0.127 cm (0.05 inches) in length, i.e., the overlap of the first vertical surface 516a and the second vertical surface 526a can be approximately 0.127 cm (0.05 inches), for example, along the lengths of the inner surfaces 516 and 526. In various embodiments, the length of the vertical cavity can be between approximately 0.076 cm (0 , 03 inches) and approximately 0.254 cm (0.10 inches), for example. In certain embodiments, the length of the vertical cavity may be approximately twice the radius of curvature (r) of the curved surface of the base 506, for example. In various embodiments, the length of the vertical cavity can be approximately equal to the radius of curvature (r) of the base 506, for example. In at least one embodiment, the length of the vertical cavity can be between approximately 0.5 * r and approximately 2 * r, for example. In various embodiments, in addition to the above, the vertical cavity may extend beyond the longitudinal axis 599 of the staple pocket 500 so that, in at least one embodiment, at least a portion of the vertical cavity can be positioned on a first side and / or a second side of the 599 axis. In certain embodiments, the vertical cavity may extend through the central portions of the first and second forming containers 502 and 504.
[00140] In various embodiments, the first interior side wall 516 may additionally comprise a first inclined portion which, in at least one embodiment, can be oriented at an acute angle with respect to the surface of contact with the fabric 501. In at least one In such an embodiment, the first inclined portion may be positioned outwardly with respect to the first vertical portion 516a. In certain embodiments, the first inner side wall 516 may comprise an inclined portion positioned towards the external portion 512 which may progressively become more perpendicular towards the inner portion 510 of the first forming container 502 until the inclined portion passes into the first by vertical 516a. In various embodiments, the second inner side wall 526 may additionally comprise a second inclined portion which, in at least one embodiment, can be oriented at an acute angle with respect to the tissue contact surface 501. In at least one such embodiment, the second inclined portion can be positioned outwardly with respect to the second vertical portion 526a. In certain embodiments, the second inner side wall 526 may comprise an inclined portion positioned towards the external portion 522 which may become progressively more perpendicular towards the internal portion 520 of the second forming container 504 until the inclined portion passes into the second by vertical 526a.
[00141] In various modalities, now with reference to figure 52A, the clip pocket 500 can be configured to deform the first leg of the clip 404 so that the first end 405 is deflected a first distance X1 from the base line 401. Similarly, the second leg of the clamp 406 can be deformed so that the second end 407 is deflected a second distance X2 from the base line 401. In certain embodiments, the distance X1 and the distance X2 can be equal, or at least least substantially the same. In several other modalities, the distances X1 and X2 can be different. In at least one such embodiment, the first leg 404 can be deformed so that the first end 405 is positioned closer to the base 402 than the second end 407, for example. In such embodiments, the first axis 414 of the deformed clamp leg 404 and the second axis 416 of the deformed clamp leg 406 may not be parallel. More particularly, in at least one embodiment, the first axis 414 can extend to a first angle with respect to the baseline 401 and the second axis 416 can extend to a second angle with respect to the baseline 401 in which the second angle is different from the first angle. In various embodiments, the first leg 404 and the second leg 406 can extend beyond the midline 403 at different angles. In certain other embodiments, the first leg 404 and the second leg 406 may extend at different angles with respect to the baseline 401 although one or both legs 404 and 406 may not extend beyond the midline 403.
[00142] In various modalities, in addition to the above, a surgical stapler may comprise a staple pocket that can be configured to deform a staple leg from staple 400 so that it is located inside, or substantially inside, a standard piano with base 402 and, furthermore, deform the other leg of the staple of the staple 400 to one side of the base 402, as described above. In at least one embodiment, the first leg 404 can be deformed so as to extend beyond the midline 403 in a direction that is coplanar, or at least substantially coplanar, with the base 402 and, in addition, the second leg 406 can be deformed so as to extend beyond the midline 403 in a direction that is transversal to the piano. In other words, in at least one embodiment, axis 414 and baseline 401 of clip 400 can be coplanar, or at least almost coplanar, with each other, while the second axis 416 can extend in a direction that follows through of a piano. In certain embodiments, at least one of the first leg 404 and the second leg 406 may not extend beyond the midline 403.
[00143] In various embodiments, in addition to the above, the clip pocket 500 can be configured to deform the legs of the clip 404 and 406 of the clip 400 simultaneously, or at least substantially simultaneously. In at least one embodiment, the base 506 of the first forming container 502 can contact the end 405 of the first leg of the clamp 404 at the same time, or at least substantially at the same time, as the base 508 of the second forming container 504 contacts the end 407 of the second leg of the clamp 406. In certain other embodiments, a clamp pocket can be configured to deform the legs of the clamp 404 and 406 sequentially. In at least one such embodiment, a first forming container can be brought into contact with the first leg of the clamp 404 before a second forming container is brought into contact with the second leg of the clamp 406, for example. In various alternative embodiments, although not shown, a surgical clamp can comprise more than two legs of the clamp, such as, for example, three legs of the clamp or four legs of the clamp, and a pocket of the clamp can comprise a corresponding amount of training containers clamp to deform the clamp legs.
[00144] In various embodiments, in addition to the above, the wire comprising surgical clip 400 may comprise a circular, or at least substantially circular, cross-section. In various other embodiments, now with reference to figures 53 to 56, a surgical clamp, such as clamp 600, for example, can comprise a non-circular cross-section. In at least one embodiment, the clamp 600 may comprise a base 602, a first leg 604 and a second leg 606, wherein the base 602 and legs 604 and 606 may consist of a continuous wire. In various embodiments, the continuous thread may comprise a rectangular cross section, for example. In at least one embodiment, referring to figure 56, the rectangular cross section can comprise a base (b) and a height (h), where the base (b) can be defined in relation to a lateral central axis (x) , and in which the height (h) can be defined in relation to a central longitudinal axis (y). In various circumstances, the rectangular cross section can be defined as having two elements of inertia, that is, a first moment of inertia (lx) defined with respect to the axis (x) and a second moment of inertia (ly) defined with respect to the (y) axis. In at least one circumstance, the first moment of inertia (lx) can be calculated as (b * hA3) / 12 while the second moment of inertia (ly) can be calculated as (h * bA3) / 12. Although the clamp 600 comprises a rectangular, or at least substantially rectangular, cross-section, any other suitable non-circular cross-section can be used, for example, oblate, elliptical and / or trapezoidal cross-sections.
[00145] As illustrated in figure 56, the base (b) of surgical clamp 600 is greater than the height (h) and, in view of the above, the moment of inertia (ly) of the rectangular cross-section is greater than the moment of inertia (lx). In various embodiments, as a result, the ratio of the moment of inertia, i.e., ly / lx, of the rectangular cross section can be greater than 1.0. In certain embodiments, the ratio of the moment of inertia can be between approximately 2.0 and approximately 2.7, for example. In certain other embodiments, the ratio of the moment of inertia can be between approximately 1.1 and approximately 3.0, for example. As a result of this, leg 604 has a greater tendency to bend over axis (x) than over axis (y) when a force, such as the compression load F1, for example, is applied to leg 604. In this case, excluding all other considerations, the leg 604, in such modalities, is more likely to bend inside a common piano defined by clamp 600 when it is in its non-deformed state than to bend to one side of the base of the staple 602. In various modalities, however, a surgical stapler comprising an anvil and a staple pocket according to the modalities described here, such as staple pocket 500, for example, can be used to make legs 604 and 606 of the clamp 600 will bend out of your ordinary piano when deformed. In such embodiments, this lateral deflection can occur despite the fact that the moment of inertia ly, which resists this deformation, is greater than the moment of inertia lx. As shown in figure 55, the first leg 604 of the clamp 600 can be deformed so as to bend with respect to both the (x) and (y) axes of its cross section and, as a result, the first leg of the clamp 604 it can be twisted or deformed so that the end 605 of the first leg of the clamp 604 is positioned on a first side of the base 602. Similarly, the second leg 606 can be deformed so as to bend with respect to both axes (x ) and (y) of its cross section and, as a result, the second leg of the clamp 606 can be twisted or deformed so that the end 607 of the second leg of the clamp 606 is positioned on a second side of the base 602.
[00146] In various modalities, now with reference to figure 57, a surgical clamp, such as surgical clamp 700, for example, can comprise a base 702 and, in addition, a first leg 704, and a second leg 706 extending from base 702. In certain embodiments, similarly to the above, base 702, first leg 704, and second leg 706 may be located, or at least substantially located, on a standard piano when clamp 700 is in a non-deformed configuration, or not dispensed, that is, a configuration before being deformed by an anvil of a surgical stapler, for example. In the deformed or dispensed configuration of the clamp 700, as shown in Figure 57, the first leg 704 can be deformed so that the end 705 points to the base 702 and the second leg 706. More particularly, in at least one embodiment, the end 705 can be located along, or with respect to, a first axis 714 which is oriented at an angle with respect to the middle line 703. Similarly, the second leg 706 can be deformed so that the end 707 points towards the base 702 and for the first leg 704. More particularly, in at least one embodiment, the end 707 may be located along, or with respect to, a second axis 716 which is oriented at an angle with respect to the midline 703. In In various embodiments, the ends 705 and 707 of the legs 704 and 706 may not cross the middle line 703. In certain embodiments, similar to the above, the 705 end of the first leg 704 may be deformed so as to extend to a first The side of the base 702 and the end 707 of the second leg 706 can be deformed so as to extend to a second side, or opposite side, of the base 702 so that the legs 704 and 706 are not completely positioned on the same piano as the base 702 in its deformed configuration, for example.
[00147] In various embodiments, a surgical clamp, such as clamp 800 (figure 58), for example, can comprise a base 802, a first leg 804, and a second leg 806, in which clamp 800 can comprise a substantially configuration U-shaped in its non-deformed configuration, or not dispensed. In at least one such embodiment, the legs 804 and 806 can extend in a perpendicular direction, or at least substantially perpendicular, with respect to the base 802. In various circumstances, the clamp 800 can be deformed in a B-shaped configuration, as shown in figure 58. In at least one such embodiment, the first leg 804 can be curved downwards towards the base 802 so that the axis 814 extending through the end 805 is perpendicular, or at least substantially perpendicular, the line base 801. Similarly, the second leg 806 can be curved downwardly towards base 802 so that the axis 816 extending through end 807 is perpendicular, or at least substantially perpendicular, to baseline 801. In at least one such circumstance, the legs 804 and 806 can be curved so that the axes 814 and 816 are parallel, or at least substantially parallel, to each other. In various modalities, again with reference to figure 58, the legs of the clamp 804 and 806 can be deformed so as not to cross the central line 803. The legs of the clamp 804 and 806 can be deformed so as to remain on the same piano, or at least substantially on the same piano as the 802 base.
[00148] Several examples described below are provided, which incorporate one or more aspects of the various modalities described above. Such examples are exemplary and various aspects of the various modalities described in this application can be combined into a single embodiment. In each of the examples described below, the surgical clamp may comprise a base that defines a base line, a first leg and a second leg extending from the base, and a midline between the first leg and the second leg . Example 1
[00149] A surgical clamp can be deformed so that:
Example 2
[00150] A surgical clamp can be deformed so that:
Example 3
[00151] A surgical clamp can be deformed so that:
Example 4
[00152] A surgical clamp can be deformed so that:
Example 5
[00153] A surgical clamp can be deformed so that:
Example 6
[00154] A surgical clamp can be deformed so that:
Example 7
[00155] A surgical clamp can be deformed so that:
Example 8
[00156] A surgical clamp can be deformed so that:
Example 9
[00157] A surgical clamp can be deformed so that:

[00158] Several of the deformed staples described above comprise one or more staple legs that cross the midline of the staple base. In various embodiments, as a result, the deformed clip legs may overlap, at least partially. More particularly, the deformed clip legs, when viewed from the side, can cooperate to traverse the base of the clip from one end to the other without leaving gaps between them. Such modalities can be particularly useful, especially when used to staple vascular tissue. More specifically, the overlapping legs of the clamp can compress the blood vessels within the tissue regardless of where the blood vessels extend through the clamp. Staples that have gaps between the legs, or legs that do not extend the entire length of the staple base when deformed, may not be able to adequately compress all blood vessels in the tissue and, as a result, one or more vessels blood can leak.
[00159] In several modalities, in addition to the above, a surgical instrument can be configured to dispense a plurality of staples 400 in the manner described above and illustrated in figures 50 to 52. In at least one such mode, the surgical stapler can dispense with staples 400 in a sequential manner along a staple path and / or in a simultaneous manner, for example. In certain embodiments, a surgical instrument can be configured to dispense a plurality of staples 600 in the manner described above and illustrated in figure 55. In at least one such embodiment, similar to the above, the surgical stapler can dispense with staples 600 of a sequential shape along a staple path and / or in a simultaneous manner, for example. In several modalities, in addition to the above, a surgical instrument can be configured to dispense a plurality of staples 700 in the manner described above and illustrated in figure 57. In at least one such embodiment, the surgical stapler can dispense staples 700 in a manner sequentially along a staple path and / or in a simultaneous manner, for example.
[00160] In several modalities, in addition to the above, a surgical clamp can consist of titanic, such as titanium wire, for example. In certain embodiments, a surgical clamp may consist of an alloy comprising titanium, aluminum, and / or vanadium, for example. In at least one embodiment, the surgical clamp may consist of surgical stainless steel and / or an alloy comprising cobalt and chromium, for example. In any case, the surgical clamp can consist of metal, such as titanium, and an outer surface of metal oxide, such as titanium oxide, for example. In various embodiments, the outer surface of metal oxide can be coated with a material. In certain embodiments, the coating material may consist of polytetrafluoroethylene (PTFE), such as Teflon®, and / or tetrafluoroethylene (TFE), such as ethylene-tetrafluoroethylene (ETFE), perfluroralcoxyethylene-tetrafluoroethylene (PFA), and / or fluorinated ethylene FEP), for example. Certain coatings may comprise silicon. In various embodiments, such coating materials can prevent, or at least inhibit, further oxidation of the metal. In certain embodiments, the lining materials may provide one or more slippery surfaces against which the anvil, or staple pockets, may come into contact with the staples in order to reduce the frictional force between them. In many circumstances, lower frictional forces between the clamps and the clamp pockets can reduce the force required to deform the clamps.
[00161] The devices described here can be designed to be discarded after a single use, or they can be designed for use multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, and any number of particular parts or parts of the device can be selectively replaced or removed, in any combination. When cleaning and / or replacing particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that the reconditioning of a device can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting refurbished device, are all within the scope of the present patent application.
[00162] Preferably, the present invention described here will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, like a plastic or TYVEK bag. The container and the instrument are then placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation kills bacteria in the instrument and the container. The sterile instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened in the medical facility.
[00163] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the description. It is therefore intended that this application will cover any variations, uses or adaptations of the invention using its general principles. In addition, this application is intended to cover such changes to the present description, in accordance with known or customary practice in the technique to which this invention belongs.

权利要求:
Claims (9)
[0001]
1. Surgical stapler comprising: an anvil set comprising: a tissue contact surface (501); a plurality of staple pockets (500) formed on the fabric contact surface (501), each staple pocket (500) comprising: a staple pocket longitudinal axis (599), a first forming container (502) comprising: a first internal portion (510); a first external portion (512); and a first inner side wall (516) extending between the first outer portion (512) and the first inner portion (510), wherein the first inner side wall (516); and a second forming container (504) comprising: a second internal portion (520); a second external portion (522), in which the first internal portion (510) is positioned relative to the second internal portion (520), in which the first internal portion (510) and the second internal portion (520) are positioned displaced on the longitudinal axis of the staple pocket (599), where the first external portion (512) and the second external portion (522) are positioned on opposite sides of the first internal portion (510) and the second internal portion (520), and a second inner side wall (526) extending between the second outer portion (522) and the second inner portion (520), wherein the first vertical portion (516a) and the second vertical portion (526a) extend across the longitudinal axis of the staple pocket (599), and wherein the first vertical portion (516a) and the second vertical portion (526a) form a vertical cavity for contacting the first and second staple legs (404,406) of a staple (400) to deform the first clamp leg (404) from a clamp (400) to a first side of the longitudinal axis of the staple pocket (599) and to deform the second staple leg (406) of a staple (400) to a second side of the longitudinal axis of the staple pocket (599), characterized by the fact that the first inner side wall (516) and the second inner side wall (526) comprise, respectively, a first vertical portion (516a) and the second vertical portion (526a) which are perpendicular to the fabric contact surface (501); wherein the side walls (516, 526) of the first forming container (502) and the second forming container (504) are, respectively, perpendicular to the fabric contact surface (501); the first inner portion (510) and the second inner portion (520) of the forming containers (502, 504) are positioned offset in opposite directions from each other with respect to the longitudinal axis of the staple pocket (599); and the first interior side wall (516) and the second interior side wall (526) are oriented at an acute angle with respect to the longitudinal axis of the staple pocket (599).
[0002]
2. Surgical stapler according to claim 1, characterized in that the first inner side wall (516) still comprises a first angle portion which is oriented at an acute angle in relation to the tissue contact surface (501) , wherein the first angled portion is positioned outwardly relative to the first vertical portion (516a), wherein the second inner side wall (526) still comprises a second angled portion that is oriented at an acute angle to the surface of fabric contact (501), and wherein the second angled portion is positioned outwardly relative to the second vertical portion (526a).
[0003]
3. Surgical stapler according to claim 1 or 2, characterized in that the first inner portion (510) and the second inner portion (520) are separated by a wall, the wall being defined by the first side wall interior (516) and the second interior side wall (526).
[0004]
Surgical stapler according to any one of claims 1 to 3, characterized in that the first inner portion (510) is defined by a first width and the first outer portion (512) is defined by a second width, and wherein the second width is wider than the first width.
[0005]
Surgical stapler according to any one of claims 1 to 4, characterized in that the first forming container (502) still comprises a first outer side wall (517), wherein the second forming container (504) it further comprises a second outer sidewall (527), wherein the first inner sidewall (516) and the first outer sidewall (517) are oriented at an acute angle with respect to each other, and the second inner sidewall (526) and the second outer side wall (527) are oriented at an acute angle with respect to each other.
[0006]
Surgical stapler according to claim 5, characterized in that the first forming container (502) comprises a first elongated base (506), wherein the first elongated base (506) is concave curved along of the staple pocket longitudinal axis (599), wherein the second forming container (504) comprises a second elongated base (508), and the second elongated base (508) is concave curved along the longitudinal axis clip pocket (599).
[0007]
Surgical stapler according to claim 6, characterized in that the first elongated base (506) is defined by a radius of curvature (r), and the first vertical portion (516a) is defined by a length between 0.5 * r and 2.0 * r.
[0008]
Surgical stapler according to any one of claims 1 to 7, characterized in that the first inner side wall (516) is parallel to the second inner side wall (526).
[0009]
Surgical stapler according to any one of claims 1 to 8, characterized by the fact that it still comprises a staple (400) partially coated with one of polytetrafluoro ethylene and silicon.

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法律状态:
2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-07-16| B06T| Formal requirements before examination [chapter 6.20 patent gazette]|

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2019-12-03| B07A| Application suspended after technical examination (opinion) [chapter 7.1 patent gazette]|

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2020-03-24| B06A| Patent application procedure suspended [chapter 6.1 patent gazette]|

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2020-07-07| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2020-11-24| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 10 (DEZ) ANOS CONTADOS A PARTIR DE 24/11/2020, OBSERVADAS AS CONDICOES LEGAIS. |

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2021-06-22| B16C| Correction of notification of the grant [chapter 16.3 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 04/10/2010, OBSERVADAS AS CONDICOES LEGAIS. PATENTE CONCEDIDA CONFORME ADI 5.529/DF, QUE DETERMINA A ALTERACAO DO PRAZO DE CONCESSAO |

优先权:

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申请号 | 申请日 | 专利标题

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US25037709P| true| 2009-10-09|2009-10-09|

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US61/250,377|2009-10-09|

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US12/622,113|2009-11-19|

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US12/622,113|US8141762B2|2009-10-09|2009-11-19|Surgical stapler comprising a staple pocket|

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PCT/US2010/051288|WO2011044026A2|2009-10-09|2010-10-04|Surgical stapler comprising a staple pocket|

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