staple cartridge

专利摘要:
CLAMP CARTRIDGE. The present invention relates to a staple cartridge (150) for use with a surgical stapling instrument (100), said staple cartridge (150) comprising a cutting element (160) positioned thereon. A staple cartridge (150) may comprise alignment characteristics (280) configured to align the cutting element (160) of the staple cartridge (150) with a distal end (201) of a drive rod (202) when the staples (150) is mounted on the surgical stapling instrument (100).
公开号:BR112012023435B1
申请号:R112012023435-8
申请日:2011-03-08
公开日:2021-01-05
发明作者:James J. Bedi
申请人:Ethicon Endo-Surgery, Inc.；
IPC主号:

专利说明:

Cross Reference On Related Order
[0001] This application is a continuation application in part under 35 USC §120 of US Patent Application Serial No. 12 / 234,149, entitled SURGICAL STAPLING INSTRUMENT WITH CUTTING MEMBER ARRANGEMENT, filed on September 19, 2008, the description of which complete is incorporated by reference. BACKGROUND I. Technical Field
[0002] The present invention relates to stapling instruments and, in various embodiments, to a surgical stapling instrument for producing one or more rows of staples. II. Background of the Related Art
[0003] In recent years, there has been an increasing tendency for surgeons to use stapling instruments to suture body tissues, such as, for example, lungs, esophagus, stomach, duodenum and / or other organs in the intestinal tract. The use of an appropriate stapling instrument can, in many cases, do a better job 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 manually loaded. 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 presented in US patent No. 3,499,591, entitled INSTRUMENT FOR PLACING LATERAL GASTROINTESTINAL ANASTOMOSES, which was granted on March 10, 1970, the description of which is incorporated herein by way of reference.
[0004] A stapling instrument may include a pair of elongated cooperating clamping elements, each clamping element being adapted to be inserted into an internal tubular body organ to be joined by anastomosis. In various embodiments, one of the claw elements can support a staple cartridge with at least two rows of staples spaced laterally, and the other claw element can support an anvil with staple-forming pockets aligned with the staple rows in the staple cartridge . In general, the stapling instrument may further include a drive bar and a knife blade which are slidable with respect to the clamping elements to sequentially eject staples from the staple cartridge through cam surfaces on the drive 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 spaced laterally rows of clamps deformed in the fabric trapped between the elements. claw. In typical stapling instruments, however, the anvil is not movable in relation to the staple cartridge since the claw elements have been assembled together 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 such stapling instruments are given in US Patent No. 4,429,695, entitled SURGICAL INSTRUMENTS, which was issued on February 7, 1984, the full description of which is incorporated herein by way of reference.
[0005] In various embodiments, a typical stapling instrument can include a first and second claw elements that can be secured by a latch, the latch being able to be moved between an open position, a partially closed position and a closed position. In the open and partially closed positions of the lock, however, the first and second clamping elements of a typical stapling instrument can be unintentionally separated from one another, thus requiring additional time to reassemble the clamping elements. In certain circumstances, the separation of the first and second claw elements can expose a knife blade. In various circumstances, in addition to the above, the stapling instrument may include a trigger button extending from a propeller bar that can be configured to be held by the surgeon and advanced distally to advance the propeller bar and knife blade inside staple cartridge. In certain circumstances, however, the actuator can be advanced with respect to a claw element even if the first and second claw elements have not been assembled. Once mounted, in at least one circumstance, the actuator button, as it can extend externally from the surgical instrument, may unintentionally contact the surrounding tissue with the surgical site and, as a result, the tissue may prevent advancing the actuator button. In these circumstances, a surgeon may have to force the actuator button beyond the tissue and / or reposition the stapling instrument, which can increase the time required to complete the surgery. An improvement is needed in what was previously mentioned. SUMMARY
[0006] In at least one form of the present invention, a surgical stapling instrument can include a first and a second claw element which can be pivotally connected to each other and held in position relative to each other by a lock. In various embodiments, the first and second claw elements may include a first and second clamping elements which may allow the first and second claw elements to be rotated with respect to each other to prevent, or at least inhibit, the first and second clamping elements. second claw elements are separated from each other. These modalities can be particularly useful in circumstances where the closure is in a partially closed position and the first and second claw elements are being manipulated to position the fabric with each other. In at least one of these embodiments, the first and second claw elements can be connected sufficiently together to avoid, or at least reduce, the possibility that the first and second claw elements are separated from each other in order to expose a cutting element . In at least one form of the present invention, a surgical stapling instrument can include a compartment that can extend at least partially over and / or around a cutting element. In various embodiments, the compartment can at least partially cover the cutting element when the first and second claw elements are separated from each other, thus allowing the cutting element to be moved relative to the first and second claw elements during use .
[0007] In various modalities, the surgical stapling instrument may additionally include a cutting element and / or sled of staples that can be advanced and / or retracted in relation to the first and second claw elements. In certain embodiments, the staple sled can be advanced by, and / or in conjunction with, the cutting element to implant the staples from a staple cartridge into one of the first and second claw elements. In at least one form of the present invention, a surgical stapling instrument may include a lock that can prevent, or at least inhibit, the staple cutting element and / or sled from being moved, or at least advanced, relative to the first ones and second claw elements before the closure has been closed. In at least one embodiment, the latch can be configured to engage the latch as the latch is moved from a fully open position to a fully closed position and to functionally disengage the latch from the cutting element and / or sled clamps. In at least one embodiment, one of the first and second claw elements may include an anvil that has at least one forming surface that can be configured to deform the clamps as they are being installed in the clamp cartridge. In at least one form of the present invention, an anvil can be movably adjustable relative to the staple cartridge to adjust the amount by which the staples will be deformed. In various modes, the anvil can be adjusted by a sliding adjustment plate and / or a rotating cam. BRIEF DESCRIPTION OF THE DRAWINGS
[0008] The characteristics mentioned above and other characteristics and advantages of this invention, and the way of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of modalities of the invention, taken in conjunction with the attached drawings, being that:
[0009] figure 1 is a perspective view of a surgical stapling instrument according to at least one embodiment of the present invention;
[00010] figure 2 is an exploded perspective view of the surgical stapling instrument of figure 1;
[00011] figure 3 is an exploded elevation view of the surgical stapling instrument of figure 1;
[00012] figure 4 is a partial cross-sectional view of the surgical stapling instrument in figure 1 illustrating the first and second portions being assembled together;
[00013] figure 5 is a partial cross-sectional view of the surgical stapling instrument in 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 portion;
[00014] figure 6 is a partial cross-sectional view of the surgical stapling instrument in figure 1 illustrating a lock rotated in the first portion, the lock being engaged with the second portion and the lock being rotated in a partially closed position;
[00015] 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;
[00016] figure 8 is a perspective view of a staple cartridge assembly of the surgical stapling instrument of figure 1;
[00017] figure 9 is an exploded view of the staple cartridge assembly of figure 8;
[00018] figure 10 is a cross-sectional view of the staple cartridge assembly in figure 8 along line 10-10 in figure 9;
[00019] figure 11 is an exploded view of a staple sled and the cutting element assembly of the staple cartridge assembly of figure 8;
[00020] figure 12 is a perspective view of the staple sled and the cutting element assembly of figure 11;
[00021] figure 13 is a perspective view of the surgical stapling instrument of figure 1 illustrating a staple discharge actuator moved distally along a first side of the surgical stapling instrument;
[00022] figure 14 is a perspective view of the surgical stapling instrument of figure 1 illustrating the staple unloading actuator of figure 13 moved distally along a second side of the surgical stapling instrument;
[00023] 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 coupled to a clamp discharge actuator ;
[00024] 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;
[00025] figure 17 is a perspective view of an anvil assembly of the surgical stapling instrument of figure 1;
[00026] figure 18 is an exploded perspective view of the anvil assembly of figure 17;
[00027] figure 19 is another exploded perspective view of the anvil assembly of figure 17;
[00028] figure 20 is an exploded cross-section elevation view of the anvil assembly of figure 17;
[00029] figure 21 is a cross-sectional view of the anvil assembly of figure 17 illustrating the anvil adjustment element in a first position;
[00030] figure 22 is a cross-sectional view of the anvil assembly of figure 17 illustrating the anvil adjustment element of figure 21 in a second position;
[00031] figure 23 is a cross-sectional view of the anvil assembly of figure 17 illustrating the anvil adjustment element of figure 21 in a third position;
[00032] figure 24 is a perspective view of a surgical stapling instrument according to at least one alternative embodiment of the present invention;
[00033] figure 25 is a cross-sectional view of the surgical stapling instrument in figure 24 along line 25-25 in figure 24;
[00034] figure 26 is a partial exploded view of the proximal end of the surgical stapling instrument of figure 24 including a detent mechanism for releasably retaining a rotating anvil adjustment element in position;
[00035] figure 27 is a perspective view of the surgical stapling instrument of figure 24 with some components removed and others shown in cross section;
[00036] 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;
[00037] figure 29 is a perspective view of the rotating anvil adjustment element of figure 28;
[00038] 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;
[00039] figure 31 is an end view in cross section of the surgical stapling instrument of figure 24 along line 31-31 in figure 24;
[00040] figure 32 is an end view of the surgical stapling instrument of figure 24 illustrating the rotating anvil adjustment element of figure 28 rotated from a first direction to a second orientation;
[00041] 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;
[00042] figure 34 is an end view of the surgical stapling instrument of figure 24 illustrating the rotating anvil adjustment element of figure 28 rotated from a second direction to a third orientation;
[00043] figure 35 is an end view in cross section of the surgical stapling instrument of figure 24 illustrating the anvil adjustment element in the third orientation of figure 34;
[00044] Figure 36 is a perspective view of an actuator for rotating the anvil adjustment element of figure 28;
[00045] figure 37 is a partial cross-sectional view of a surgical stapling instrument including a spring configured to induce the distal end of a first cable portion in the opposite direction to the distal end of a second cable portion when the stapling is in a partially closed configuration;
[00046] figure 38 is an exploded perspective view of the surgical stapling instrument of figure 1;
[00047] figure 39 is an exploded elevation view of the surgical stapling instrument in figure 1
[00048] figure 40 is a partial cross-sectional view of the surgical stapling instrument in figure 1 illustrating a fastener mounted pivotally to the first portion, the fastener being engaged with the second portion and the fastener being rotated in a partially closed position;
[00049] figure 41 is a perspective view of a staple cartridge assembly of the surgical stapling instrument of figure 1;
[00050] figure 42 is an exploded view of the staple cartridge assembly of figure 8;
[00051] figure 43 is a cross-sectional view of the staple cartridge assembly of figure 8;
[00052] figure 44 is an exploded view of a staple sleigh and the cutting element assembly of the staple cartridge assembly of figure 8;
[00053] figure 45 is a perspective view of the staple sled and the cutting element assembly of figure 44;
[00054] figure 46 is a detailed view of a distal end of a pusher bar to be functionally connected to a sled of clamps and cutting set of figure 44, the distal end of the pusher bar being illustrated in a proximal position in solid lines and a second position, distal, in dashed lines;
[00055] figure 47 is a partial bottom view of the staple cartridge assembly of figure 8; and
[00056] figure 48 is a cross-sectional view of a staple cartridge assembly according to an alternative embodiment.
[00057] The corresponding reference characters indicate the corresponding parts through the various views. The exemplifications described herein illustrate preferred embodiments of the invention, in one form, and such exemplifications should not be considered to limit the scope of the invention in any way. DETAILED DESCRIPTION
[00058] 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 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 modality can be combined with the aspects of other modalities. These modifications and variations are intended to be included in the scope of the present invention.
[00059] Full descriptions of the following non-provisional, commonly owned United States patent applications are hereby incorporated by reference:
[00060] United States Patent Application No. 12 / 234,149, entitled SURGICAL STAPLING INSTRUMENT WITH CUTTING MEMBER ARRANGEMENT, which was filed on September 19, 2008;
[00061] United States Patent Application No. 12 / 234,143, entitled SURGICAL STAPLER HAVING AN INTERMEDIATE CLOSING POSITION, which was filed on September 19, 2008;
[00062] United States Patent Application No. 12 / 234,133, entitled SURGICAL STAPLER WITH APPARATUS FOR ADJUSTING STAPLE HEIGHT, which was filed on September 19, 2008; and
[00063] United States Patent Application No. 12 / 234,113, entitled LOCKOUT ARRANGEMENT FOR A SURGICAL STAPLER, which was filed on September 19, 2008.
[00064] 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 can be configured to be held by a surgeon, for example, and can comprise a hand grip portion 106. In at least one embodiment, the first cable portion 102, referring to figures 2 and 3, can include a the first cap 108 attached to a first frame 110 and, similarly, the second cable portion 104 may include a second cap 112 attached to a second frame 114. Caps 108 and 112 can be ergonomically contoured, or otherwise suitably contoured , 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 into a surgical site. In various embodiments, cable covers 108 and 112 can be made from plastic and lightweight materials and / or any other suitable material, for example, while cable structures 110 and 114 can be made from stainless steel , titanium and / or any other suitable material, for example.
[00065] In various embodiments, with respect again to figures 1 to 3, the distal ends of the cable portions 102 and 104 may comprise an end effector 120 that can be configured to treat tissue within a surgical site, for example example. In at least such an 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 structure of the cable portion 110. In at least one embodiment, the staple cartridge channel 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 upwardly from walls opposite sides 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 or anvil element 130 extending from the second cable portion 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 gram instrument is 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.
[00066] As indicated above, again referring to figures 1 to 3, the staple cartridge channel 122 can be configured to support and / or retain a staple cartridge, such as staple cartridge 150, for example , inside the end effector 120, the staple cartridge being able to include one or more staples (not shown) removably stored there. In various embodiments, referring to figures 8 to 10, the staple cartridge 150 can include one or more staple cavities 151 that can be configured to store staples in any suitable arrangement, for example, in at least two longitudinal rows laterally spaced, for example. In at least one embodiment, referring to figures 9 and 10, the staple cartridge 150 can include the body 152 and a reservoir or retainer 154 of the staple cartridge, the body 152 and / or reservoir 154 of the staple cartridge it can be configured to define a channel, or trajectory, to receive a sled of staples and / or cutting element in a sliding way. In at least one embodiment, the reservoir 154 can include flexible arms 155, for example, which can be configured to engage the body of the staple cartridge 152 in a snap fit and / or snap fit arrangement. Referring to figures 10 to 12, the staple cartridge 150 may further include the staple sled assembly 160 which may include the staple sled portion 162 and, in addition, the cutting element 164. In various embodiments , the cutting element 164 can include cutting edge 165 and locking arm 166, for example, with locking arm 166 being configured to be snap-fit and / or snap-fit into opening 163 in staple sled 162 when the cutting element 164 is mounted on the staple sled portion 162. In various other embodiments, the staple sled portion 162 can be integrally molded to the cutting element 164.
[00067] In addition to the above, referring to figures 8 to 10, the body of the staple cartridge 152 may 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 sled assembly 160 and propeller bar assembly 200 (discussed below), slot 156 being configured to allow cutting element 164 to be moved between a first and second positions within the staple cartridge 150. In various embodiments, a slot 156 can be configured to allow the cutting element 164 to be moved between a proximal position (figure 10) and a distal position to incise the tissue positioned in the intermediate position of the cartridge of staples 150 and anvil 130, for example. With reference again to Figures 10 to 12, the staple sled portion 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 embodiments, with reference In Figure 9, the staple cartridge 150 can include the staple drivers 168 that can be lifted or slid upward into staple cavities 151 by the sled portion 162 so that the upward movement of the staple drivers 168 can eject or dispense the clamps at least partially positioned within the clamp cavities 151. While the clamp boosters 168 can, in fact, be lifted vertically upwards, the term upwards, and the like, may mean that the clamp boosters 168, for example, they are moved towards the top surface or deck 158 of the staple cartridge and / or towards the anvil 130, for example. In certain embodiments, as shown in Figure 9, each clamp booster 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 sled 162 and staple boosters 168. In various embodiments, a staple booster can be configured to dispense only one staple, while in certain embodiments, a staple booster can be configured to dispense two or more staples located in adjacent rows simultaneously, for example. Other devices are featured in US 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 here for reference.
[00068] In various embodiments, as described above, a surgical stapling instrument may include a staple sling cutter / set configured to cut 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 such an embodiment, a staple cartridge can include a staple sled positioned thereon and / or a surgical instrument can be configured to move a staple sled into a staple cartridge in order to staple tissue, for example, without dissecting it in another way. In certain other embodiments, a staple cartridge can include a sleigh of staples positioned therein when a surgical instrument can include a cutting element that can move in or in relation to the staple cartridge. In at least such an embodiment, the cutting element can be moved to contact the staple sled so that the cutting element and the staple sled can be moved together. Thereafter, the cutting element can be retracted sufficiently to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge that has a new staple sled. Such arrangements can be useful when a sleigh of staples becomes worn or deformed during use. Other modalities are envisaged, in which a staple cartridge can include a cutting element positioned therein when a surgical instrument can include a sleigh of staples that can move in or in relation to the staple cartridge. In at least such an embodiment, similar to that described above, the staple sled can be moved to contact the cutting element so that the cutting element and the staple sled can be moved together. Thereafter, the staple sled can be retracted sufficiently 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 wrapper or cover configured to prevent, or at least reduce the chance of, a surgeon or other doctor touching the cutting element positioned inside the staple cartridge while handles the staple cartridge, for example.
[00069] In various modalities, in addition to the above, the staple cartridge channel 122 and / or the staple cartridge 150, for example, may include one or more projections and / or recesses and cooperators, for example, which can be configured to removably retain 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 cable 102 it can be mounted on the second cable portion 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 cable portion 102 and the second cable portion 104 can include the proximal ends 103 and 105, respectively, which can be assembled together so that the first and second portions cable can be swiveled or pivotable to each other. In various embodiments, referring to figures 2 and 3, the first portion of cable 102 may include one or more pins, or projections, 111 extending therefrom, which can be configured to be received by sliding within a or more grooves, channels, or slots 115 in the second portion of cable 104. In certain embodiments, slots 115 can be defined in the second cable structure 114 and 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 cable portion 102 and the second cable portion 104, with reference to figure 4, the open ends of the slits 115 can be aligned with the projections 111 so that the second cable portion 104, for example, can be moved in relation to the first portion of cable 102 and the projections 111 can be slid into slots 115. In at least one embodiment, as shown in figures 2 and 3, the open ends of slits 115 can be located proximally to their closed ends. In at least such an embodiment, the proximal end 105 of the second cable portion 104 can be positioned distally with respect to the proximal end 103 of the first cable portion 102 so that the second cable portion 104 can be moved proximally to position the projections 111 within the slits 115. In several other circumstances, the first portion of cable 102 can be positioned proximally to the second portion of cable 104 and slide in a distal position to position the projections 111 within the slits 115.
[00070] In various embodiments, with reference to figure 5, the second cable portion 104 can be rotated towards the first cable portion 102 so that the anvil 130 can be placed in position in relation to the staple cartridge 150 and / or to the staple cartridge channel 122. In certain embodiments, the first cable portion 102 can be rotated towards the second cable portion 104 and / or the first and second cable portions can be rotated towards each other. In any case, the projections 111 and the slits 115, when engaged with each other, may comprise a pivot around which one or both of the first and second portions of the cable can be moved in relation to the other. In various embodiments, the second portion of handle 104 can be moved relative to the first portion of handle 102 so that the anvil 130 is placed in opposition close to the staple cartridge 150. In certain embodiments, with reference to figure 6, the second portion of cable 104 can be moved relative to the first cable portion 102 so that the lock projections 131 extending from the second cable portion 104 can be aligned with and / or inserted into the recesses 127 within the first cable portion 102 In various embodiments, with reference mainly to figures 2 and 3, the first portion of cable 102 may also include a locking mechanism 180 rotatable to it, which can be used to engage the locking projections 131 that extend to from the second cable portion 104 and secure the first and second cable portions together. Although not illustrated, other modalities are intended, in which a locking mechanism is pivotally mounted to the second cable portion and locking projections can extend from the first cable portion. In any case, in at least one embodiment, the locking mechanism 180 can be mounted on the first frame 110 by one or more pivot pins 182 which can be configured to define an axis around which the lock 180 can be rotated.
[00071] 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 elongated opposite side walls 185 that are separated by a distance sufficient to encompass the first portion of the structure 110. In at least one embodiment, the lid of the structure latch 186 can be made of plastic and lightweight materials and / or any other suitable material, for example, while the latch structure 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 contoured portion 187 that can be configured to assist a surgeon in handling the surgical instrument 100, in which, in at least one embodiment, the contoured portion 187 may 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 arms 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 attach the projections 131 inside the recesses 127, as shown in figure 7. In at least one embodiment, at least one of the locking arms 188 can be formed integrally with the structure of the lock 184. In certain embodiments, with reference to figure 6, at least one of the locking arms 188 may include a distal hook 189 which can be configured to wrap around at least a portion of the projections 131 in order to encompass or surround, or at least partially encompass and surround the projections 131. In at least one embodiment, the locking arms 188 may act as an upper central lock to maintain lock mechanism 180 in its locked or closed position.
[00072] In use, in various circumstances, the first portion of cable 102 or the second portion of cable 104 can be positioned on a first side of tissue within a surgical site and the other portion of 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. Subsequently, 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 for fixing 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), and a partially closed position, or intermediate (figure 6), and a closed position (figure 7). In at least such an embodiment, 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 locking 188 are engaged with the projections 131 so that, although the anvil 130 has been at least partially placed in opposition to the staple cartridge 150, a sufficient gap can remain between the anvil 130 and the staple cartridge 150 that can allow the effector of end 120 is repositioned in relation 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.
[00073] In several 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 a stapling instrument in the opposite direction of 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 each other. In certain embodiments, the spring can be configured to at least partially separate the first and second portions of the cable, so that there is a gap between the anvil and the staple cartridge, the gap may 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 separately from each other. Such an 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.
[00074] In various circumstances, as described above, the distal end of the first cable portion 102 can be moved relative to the distal end of the second cable portion 104, specifically when the locking mechanism 180 is not engaged, or is engaged only partially, with 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 portions of the cable can be configured to retain at least the proximal ends of the first and second portions of the cable cable 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 cable portion 102 comes off completely from the second cable portion 104. In certain embodiments, a first cable portion 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 coming off completely from the second cable portion. In at least one embodiment, the projections 111 may comprise the first lock portion and the slits 115 may comprise the second lock portion. Previous stapling instruments lacked these locking portions and, instead, relied on a single locking mechanism to hold the first and second portions of the cable together. In circumstances where 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 come off completely from each other, thus requiring, for example, that a surgeon to 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.
[00075] 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 the locking mechanism 180 is in its open position, as also described above, projections 111 can be inserted and / or removed from the slots 115. When the locking mechanism 180 is in its partially closed position, with reference to figure 6, the 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 such a mode, locking arms 188 and lock projections 131 can be configured to prevent, or at least inhibit that the second cable portion 104 is moved distally with respect to the first cable portion 102 and, as a result, prevent, or at least inhibit, that the projections 111 are disengaged from the slits 115. Correspondingly , the locking arms 188 and the lock projections 131 can be configured to prevent the first cable portion 102 from being moved proximally to the second cable portion 104. similar to the above, in various modalities, the locking arms 188 and the lock projections 131 can also be configured to prevent, or at least inhibit, that the projections 111 are removed from the slots 115 when the lock mechanism 180 is in the 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 such an 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 the locking mechanism 180 can be used to secure the first and second portions of the cable. 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 such an 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.
[00076] 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 embodiments, with reference to figure 3, the surgical stapling instrument 100 may further include a propeller bar assembly 200 that can be configured to advance and / or retract the staple sled assembly 160 within the staple cartridge 150, for example. example. In at least one embodiment, the drive bar assembly 200 may include the drive bar 202 and the clamp discharge actuator 204, the clamp discharge actuator 204 being configured to move the drive bar 202 and the sled assembly of staples 160 in the 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 sled 162 can include a groove, channel, or slot 161 that can be configured to receive, and can be functionally connected to a distal end 201 ( figure 3) of the drive rod 202. In certain embodiments, the staple sled assembly 160 can be functionally engaged with the drive rod 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 that 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 propeller rod 202 can be moved in a distal position before contacting and engaging the clamp sled assembly 160. In at least such an embodiment, the clamp sled assembly 160 may remain stationary until the propeller bar 202 get in touch with him. In any case, as described above, the actuator 204 can be functionally connected to the propeller bar 202 so that a thrust and / or traction 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 pivotably connected to a proximal end 203 of the propeller bar 202 so that the actuator 204 can be selectively rotated between at least the first and second positions.
[00077] In addition to the above, with reference to figures 1, 13 and 14, the actuator 204 can be movable between a first position on a first side 116 of the surgical stapling instrument 100 (figure 13), a second position on 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 cable positions 102 and 104. When the actuator 204 has been rotated to the position on the first or second sides 116, 117, actuator 204 can be moved in a distal position. In various circumstances, as a result, a surgeon can 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 distally along one side of the surgical instrument compared to the other. In various embodiments, referring to figures 2 and 3, the actuator 204 can include an arm 206 extending therefrom and the arm 206 can be pivotally mounted to the proximal end 203 of the propeller bar 202. In certain embodiments , again referring to 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, the first and second slots being slidably configured to receive at least a portion of the actuator 204. In at least one embodiment, the side walls of the first and second slits may delimit or at least help delimit the movement of the actuator 204 so that it can be moved along a predetermined path. With reference to figure 14, the second slot 118, for example, can be defined between the first cable portion 102 and the second cable portion 104 so that when the actuator 204 is moved distally along the second side 117, the arm 206 of the 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 the second portions of the cable. In various embodiments, with reference again to figures 13 and 14, the surgical instrument 100 may further include an intermediate slot 119 which can also be configured to allow the arm 206, and / or any other suitable portion of the actuator 204, to slide into it . In at least such an embodiment, 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 can be parallel, or at least substantially parallel to each other and / or be on the same plane, although other modalities are intended in which one or more of the slots are not are parallel to each other and / or are on a different plane. 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.
[00078] 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 sled assembly 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, generally referring to figure 5, the surgical stapling instrument 100 may further include the locking mechanism 220 which can be engaged with the actuator 204 and can remain engaged with the actuator 204 while the locking mechanism 180 is in a position completely open (figure 5) and / or a position at least substantially open. In various embodiments, the locking mechanism 220 may 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 such an 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, latch mechanism 220 can secure actuator 204 in position until the 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 the locking mechanism 220 and disengage lock 222 from actuator 204. In at least such a mode, referring to figures 5 to 7, the locking mechanism 180 may further include a cam 183 which can be configured to engage cam surface 223 with lock 222 when locking mechanism 180 is moved to its closed position and, as a result, sliding and / or moving away otherwise latch 222 of actuator 204. 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, a 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.
[00079] As described above, the locking mechanism 220 can be configured to prevent, or at least inhibit, that the drive bar 202 is moved in a distal position before the locking mechanism 180 is moved to a predetermined position, such as example, a closed position and / or a partially closed position. Advantageously, the locking mechanism 220 can also prevent, or at least inhibit, the advance of the clamp sled assembly 160 before the first cable portion 102 and the second cable portion 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 an adequate clamping force is applied to the fabric. In any case, when the locking mechanism 180 is returned to its fully open position, and / or to 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 contoured, chamfered and / or angled 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 a 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 distally, the stop 226 'can contact 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'. Similarly to the above, when the actuator 180 is removed from its closed position and the cam 183 is disengaged from the locking mechanism 220 ', the locking spring 224' can put lock 222 'in engagement with the actuator 204' again .
[00080] In various modalities, as described above, a discharge actuator can be used to move a propellant bar, a sled of clamps, and / or a cutting element between a first and second positions. As also described above, the propeller bar assembly 200, for example, can be used to move a staple sled assembly, such as the staple sled assembly 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 sled assembly 160 contained therein, the staple sled assembly 160 being positioned proximally, as shown in figure 10, when the staple cartridge is mounted or inserted into the staple cartridge channel 122. In at least such an embodiment, referring to figures 8 to 10, the staple cartridge 150 may include an additional compartment 170 that can be configured to cover at least a portion of the cutting element 164 when the staple sled assembly 160 is in its proximal 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 such an embodiment, at least an upper 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 portion cutting edge 165 may be exposed.
[00081] In various embodiments, as described above, the cutting element 165 can be at least partially positioned within 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 portion, 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 body of the staple cartridge 152, and a wall or upper portion 176 extending between the first wall 172 and the second wall 174. In certain embodiments, a compartment additionally 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 such an 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 sled assembly 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 distal edge 175 and / or proximal edge 177 of upper wall 176. In at least one embodiment, compartment 170 may include a rear wall 178 that can be configured to limit proximal movement of the cutting element 164 and / or any other portion of the staple sled assembly 160. In various embodiments, at least a portion of compartment 170, for example, may be integrally formed with the body of the staple cartridge 152. In at least such an embodiment, the 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. example. In certain embodiments, at least a portion of the compartment 170 can be mounted on the body of the staple cartridge 152 through a quick-fit arrangement, pressure-fit arrangement, and / or any other suitable manner.
[00082] In various embodiments, in addition to the above, the cutting element 164 can be defined by a flat or at least substantially flat body, which has a knife edge extending along at least one side of the body of the cutting element. cut. In at least such an embodiment, the first wall 172 and / or the second wall 174 can be configured and arranged so that they can include internal flat surfaces, or at least substantially flat 173 which are parallel or at least substantially parallel to the lateral surfaces of the element cutting element 164. In certain embodiments, the cutting element 164 can be received closely between the internal surfaces 173 of walls 172 and 174. In at least such an embodiment, the distance between walls 172 and 174 can be equal, or at least substantially equal to the width of the slot 156. In any case, a compartment can be configured so that at least a portion of the compartment extends over at least a portion of the slot 156, for example. In certain embodiments, compartment 170 may contain or completely surround a cutting element 164 and / or cutting surface 165. In at least one embodiment, although not shown, a compartment may include a separable and / or cuttable 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 such an 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 can include a thin portion, a reduced thickness portion, a cut mark and / or any other configuration to facilitate deformation and / or incision of the compartment wall. In certain embodiments, a cutting element can 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 tab, 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.
[00083] As described above, compartment 170 can be configured to cover, contain 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 assembled 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 such an embodiment, the new staple cartridge may include a new cutting element and / or set of staple sled positioned therein, although modalities are contemplated in which cutting element and / or set of previously used staple sled can be sufficiently removed from the spent staple cartridge and moved into the new staple cartridge to be reused. In embodiments in which a new cutting element and / or staple sled assembly is provided with a new staple cartridge, a sharp cutting edge, for example, can be used with each staple cartridge.
[00084] In various embodiments, although not illustrated, 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 may 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 such an embodiment, the cutting element can be positioned inside the proximal compartment when the staple cartridge is mounted on a surgical stapling instrument and, in certain embodiments, the cutting element can be moved into the distal compartment after having the tissue positioned inside the end effector was transected, 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 modalities 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.
[00085] In various embodiments, as discussed above, a staple cartridge 150 can be inserted into a staple cartridge channel 122. Referring now to Figure 38, a proximal end 213 of the staple cartridge 150 can be positioned within a proximal end 123 of the staple cartridge channel 122 while a distal end 211 of the staple cartridge 150 can be positioned within a distal end 121 of the staple cartridge channel 122. In at least one embodiment, the distal end 121 of the staple cartridge channel staple cartridge 122 may comprise one or more projections and / or one or more recesses which can be aligned correspondingly with one or more projections and / or one or more recesses at the distal end 211 of the staple cartridge 150, for example. In at least such an embodiment, each side wall 124 of the staple cartridge channel 122 may comprise a projection, or flap, 279 and a recess, or slot, 278, with each side of the staple cartridge 150 comprising, with reference to the 41, a projection 274 configured to be positioned within a recess 278 and, in addition, a recess 270 configured to receive a projection 279. In various embodiments, each recess 270 of the staple cartridge 150 may comprise opposite side walls 272 and 273 and a distal surface 271, the distal surface 271 being positioned against the projection 279 positioned therein when the staple cartridge 150 is positioned in the staple cartridge channel 122. In various circumstances, as discussed in more detail below, distal surfaces 271 of recesses 270 can serve as a interface surface from which various characteristics of the staple cartridge 150 can be predicted mined. In some circumstances, the distal end 211 of the staple cartridge 150 can be aligned with and / or inserted into the distal end 121 of the staple cartridge channel 122 before the proximal end 213 of the staple cartridge 150 is inserted into the proximal end 123 of the channel staple cartridge 122. For example, the distal end 211 of the staple cartridge channel 150 can be aligned with the staple cartridge channel 122 so that projections 279 are positioned within the recesses 270 and, consequently, the staple cartridge staples 150 can be moved from side to side, or rotated, towards staple cartridge channel 122 so that the proximal end 213 of staple cartridge 150 is inserted into end 123 of staple cartridge channel 122.
[00086] When the distal end 211 of the staple cartridge 150 is engaged with the distal end 121 of the staple cartridge channel 122, as described above, the projections 274 of the staple cartridge 150 can be inserted into the recesses 279 of the cartridge channel staples 122 hooking the projections 274 below the projections 278 of the staple cartridge channel 122. Under these circumstances, the cooperation of the projections 274 and 278 and recesses 270 and 279 can secure the distal end 211 of the staple cartridge 150 with the distal end of the cartridge staple 122, and in addition, align the staple cartridge 150 with the staple cartridge channel 122 so that staple cartridge 150 can be inserted between the side walls 124 of the staple cartridge channel 122. Once the distal end 211 of the staple cartridge 150 has been hooked into the staple cartridge channel 122, at least one of the hook cartridge 150 and the staple cartridge channel 122 can be rotated towards each other. In various circumstances, with reference again to figures 38 and 41, the staple cartridge 150 can be pivoted towards the staple cartridge channel 122 so that the alignment slots 280 in the staple cartridge channel 150 become aligned with the side flanges 128. In various embodiments, the staple cartridge 150 may comprise alignment slots 280 on opposite sides thereof which can each be configured to receive a side flange 128. In at least one embodiment, each alignment slot 280 can comprise side walls 283 and 284 and a base wall 281 extending between side walls 283 and 284. In addition to the above, a predetermined distance 289 can be measured between the distal relationship surfaces 271 of the recesses 270 to the base walls distal 281 from alignment slots 280. Referring now to Figures 39 and 41, the predetermined distance 288 between the distal end of the projections 279 and the end and distal side flanges 128 may be shorter than the distance 289 between the distal surfaces 271 of the recesses 270 and the base walls 281 of the alignment slots 280. Because the distance 288 is shorter than the distance 289, the staple cartridge 150 can be rotated to a position as described above so that flanges 128 can enter alignment slots 280. In various embodiments, alignment slots 280 can be dimensioned and configured so that side flanges 128 are received narrowly between side walls 283 and 284 so that there is little, if any, relative movement between side flanges 128 and side walls of alignment slots 280, for example.
[00087] In several alternative embodiments, in addition to the above, the proximal end 213 of the staple cartridge 150 can be inserted into the distal end 121 of the staple cartridge channel 122 and slid proximally between the side walls 124, so that the proximal end 213 of the staple cartridge channel 150 enters the proximal end 123 of the staple cartridge channel 122. During the alignment movement, the side flanges 128 can come into alignment with the slots 280 and, in addition, the projections 279 can enter recesses 270. In certain embodiments, the staple cartridge 150 can be either slid or rotated in the staple cartridge channel 122. In any case, in various embodiments, the staple cartridge 150 and the staple cartridge channel 122 can be configured so that the staple cartridge 150 can be removably attached within the staple cartridge channel 122. In at least one embodiment, now with reference Referring mainly to Figures 41 and 46, the staple cartridge 150 may comprise one or more retaining features that can be configured to releasably engage one or more retaining features in the staple cartridge channel 122. More particularly, at least one of such an embodiment, the staple cartridge 150 may comprise one or more retaining slots 190 which can be configured to engage one or more retaining keys 195 in the staple cartridge channel 122. In various embodiments, again with reference to figure 41 , each retention slot 190 may comprise a first portion, or inlet portion 191, that can be configured to receive a retention key 195 therein, and, in addition, a second portion 192 that can be configured to receive the retention key 195 after it has passed through the input portion 191. The input portion 191, in certain embodiments, can define a first width between a proximal side 193 and i on the distal side 194 of the retention slot 190 and, in addition, the second portion 192 can define a second width between the proximal side 193 and the distal side 194 which is wider than the first width of the inlet portion 191. In various embodiments , the first width of the entry portion 191 may be narrower than the width of the retention key 195 and the second width of the second portion 192 may be wider than the width of the retention key 195. In at least such an embodiment, a slot retainer 190 can be configured to engage a retainer key 195 in at least one of a pressure adjustment and / or a locking adjustment. In certain embodiments, at least one on the proximal side 193 and / or the distal side 194 can be configured to flex or tilt externally as the retaining key 195 is inserted into the retaining slot 190. At least as much modality, the proximal sides 193 can be moved proximally. In any case, with reference to figure 46, once the retention slot 190 has received the retention key 195, the proximal side 193 of the retention slot 190 can be positioned on a proximal side 196 of the retention key 195 and the distal side 194 of retention slot 190 can be positioned on a distal side 197 of retention key 195.
[00088] As highlighted above, the staple cartridge 150 can be mounted on the staple cartridge channel 122 by coupling the distal end 211 of the staple cartridge 150 and the distal end 121 of the staple cartridge channel 122 and then rotating the end proximal 213 of the staple cartridge 150 at the proximal end 123 of the staple cartridge channel 122. In at least such an embodiment, the retaining slots 190 can be configured to engage the retaining keys 195 as the staple cartridge 195 is rotated in its seated position within the staple cartridge channel 122. Now with reference to figure 39, a predetermined distance 199 between the distal relation surfaces 271 of the recesses 270 and the retaining slots 190 can be dimensioned and configured so that the slots retainer 190 are aligned with retainer keys 195 as the staple cartridge 150 is rotated to the position as described above. Correspondingly, in at least one embodiment, a distance between the distal ends of the projections 279 and retaining keys 195 may be such that it is equal, or at least substantially equal, to distance 199. In various circumstances, the distances mentioned above can be measured towards the center of the features comprising the slots 190 and retaining keys 195. For example, the distance 199 can be measured towards the center of the slot 190 in an intermediate way to the proximal and distal side walls thereof, for example . In various embodiments, the retaining slot 190 may additionally comprise insertion, chamfered, and / or radiated surfaces, which can be configured to guide, or direct, the retaining keys 195 in the retaining slots 190. In at least such an embodiment, these introduction surfaces may be wider than the first portions 191.
[00089] A staple cartridge 150 is rotated towards the staple cartridge 122, and a staple insert cutting and / or sled element positioned inside the staple cartridge 150 can be operably engaged with the drive bar 202. More particularly, now with reference to figures 43 to 45, the staple cartridge 150 can include a cutting element 160 which can be functionally coupled with the drive bar 202 so that, after the staple cartridge 150 settles into the channel staple cartridge 122, drive bar 202 and cutting element 160 can be advanced together as described above. In at least one embodiment, the cutting element 160 can comprise a slot 161 which can be configured to receive a distal pusher projection 294 (figure 39) at the distal end of the propeller bar 202. More particularly, now with reference to figure 47, the slot 161 of the cutting element 160 can be aligned with an access slot 290 at the bottom of the staple cartridge 150 so that, as the proximal end 213 of the staple cartridge 150 is seated at the proximal end 123 of the print cartridge channel clamps 122, the drive projection 294 of the drive bar 200 can extend through the access slot 290 in the slot 161 of the cutting element 160. In various embodiments, the slot 161 and the drive projection 294 can be sized and configured so that there is little, if any, relative movement between them. More particularly, now with reference to figures 44 and 45, the slot 161 may comprise a distal side wall 291 and a proximal side wall 292 with the pusher projection 294 being securely received between the side walls 291 and 292. In various embodiments , now with reference to figures 39 and 46, the drive bar 202 may additionally comprise a recess, or slot, 295 positioned proximally to the drive projection 294 and slot 295 can be configured to receive a proximal projection 293 (figure 43) extending from the cutting element 160. Similar to the above, the slot 295 can be defined by side walls that can be configured to intimately receive the proximal projection 293 so that there is little, if any, movement relative between them.
[00090] As described above, the slot 161 of the cutting element 160 can be positioned inside the staple cartridge 150 so that it is aligned with the pusher projection 294 of the propeller bar 202 when the staple cartridge 150 is seated inside the channel staple cartridge 122. Now with reference to Fig. 42, a predetermined distance 299 can be defined between the distal surfaces 271 of the recess 270 and the slot 161, the distance 299 being equal to, or at least substantially equal to, a predetermined distance 297 between the distal end of the projections 279 and the driving projection 294. In various circumstances, the cutting element 160 can be moved through a range of positions between the most proximal position, where it is positioned in compartment 170, and a more distal position, after it has been advanced through the cutting slot 156. In various modalities, the distance 299 can be measured in relation to the cutting element 16 0 when it is in its most proximal position. Similar to the above, the distances 297 and 299 can be measured to the center or midpoint of the booster projection 297 and slit 161, respectively. In various embodiments, the surgical instrument 100 may additionally comprise a locking mechanism that can be configured to secure the drive bar 202 in position while the cutting element 160 is engaged with the pusher projection 294. Similar to the above, in certain embodiments , a distance 298 can be defined between the distal end of the projections 279 and the recess 295 of the propeller bar 202, the distance 298 being equal to, or substantially equal to, the distance between the distal surface 271 of the recesses 270 and the projection 293 of the cutting element 160. In various embodiments, now mainly with reference to figures 43 and 46, the staple cartridge 150 can comprise a defined gap region between the proximal end 295 of the staple cartridge body 152 and the proximal end 294 of the staple cartridge reservoir 154, this gap region can be configured to receive the propeller bar 202 e / o u a portion of the staple cartridge channel 122 therein, for example. In any case, the propeller bar 202 can be advanced distally once it has been engaged with the cutting element 160, this movement being shown in figure 46 which illustrates the distal end 201 of the propeller bar 202 in a proximal position (illustrated with solid lines) and a second, distal position (illustrated in dashed lines), for example.
[00091] In various embodiments, as described above, the distal end 211 of the staple cartridge 150 can be engaged with the distal end 121 of the staple cartridge channel 122 and then pivoted towards the staple cartridge channel 122 so that the proximal end 213 of staple cartridge 150 can be seated at proximal end 123 of staple cartridge channel 122. This process may comprise engaging projections 274 of staple cartridge 150 below projections 276 of staple cartridge channel 122 and then, as described above, and rotate the staple cartridge 150 until alignment slots 280 are positioned adjacent to flanges 182. At this point, in various embodiments, the cutting element 160 may not be engaged with the drive bar 202, and furthermore , the retaining slots 190 may not be engaged with the retaining keys 195. As a result, the surgeon or clinician can adjust the position of the staple cartridge 150 within the ca staple cartridge end 122 before staple cartridge 150 is locked into position. Once the side flanges 182 have been positioned at least partially in the alignment slots 280, the proximal end 213 can be further rotated towards the staple cartridge channel 122. At this point, the cutting element 160 can enter into functional engagement with the propeller bar 202 and, in addition, the retaining slots 190 can engage the retaining keys 195. In various embodiments, the cutting element 160 can functionally engage the propeller bar 202 at the same time, or at least substantially to the same time, as the retaining slots engage the retaining keys 195. More particularly, in at least one embodiment, the pusher projection 294 of the propeller bar 202 can enter the slot 161 of the cutting element 160 at the same time as the retaining keys 195 enter, or snap into, the second portions 192 of slots 190. In at least such an embodiment, the cutting element 160 may not be advanced through the drive 202 until the staple cartridge 150 is press-closed, or seated, in place. In certain alternative embodiments, the cutting element 160 can be operably engaged with the drive bar 202 before the retaining keys 195 are fully seated within the retaining slots 190 when the proximal end 213 of the staple cartridge 150 is seated on the proximal end 123 of the staple cartridge channel 122. In various embodiments, the retaining slots 190 can be aligned with each other so that they engage the retaining keys 195 at the same time, or at least substantially at the same time. In at least such an embodiment, the retaining slots can be configured so that the retaining keys 195 enter the second portions 192 of the retaining slits 190 simultaneously. In at least one embodiment, the retaining slots 190 can be positioned along an axis that is transverse or perpendicular to a longitudinal axis defined by the cutting slot 156. In various embodiments, the retaining slits 190, and the axis defined between themselves, they can be positioned proximal to the cutting element 160, regardless of the position of the cutting element 160, including when the cutting element 160 is in its most proximal position, for example.
[00092] In various embodiments, the cutting slot 156 can define a first body portion 152a on a first side of it and a second body portion 152b on a second, or opposite side of it. Referring to Figures 41 and 43, the first body portion 152a can comprise a first plurality of clip cavities 151 and, in addition, the second body portion 152b can comprise a second plurality of clip cavities 151. In at least one In this embodiment, the first body portion 152a can comprise a more proximal staple cavity 151a that can be positioned proximally to the other staple cavities 151 in the first body portion 152a. In at least one embodiment, the entire staple cavity 151a can be positioned proximal to the base wall 281 of the alignment slot 280 in the first body portion 152a, while in other embodiments, at least a portion of the cavity clamp 151a can be positioned proximal to the base wall 281. As shown in Figure 43, the alignment slot 280 in the first body portion 152a is positioned laterally in relation to the most proximal clamp cavity 151a and, in addition , laterally in relation to the cutting slot 156. In addition to the above, the first body portion 152a can comprise a second, more proximal staple cavity 151c that can be positioned proximally to the other staple cavities 151 in the first portion of body 152a except for the most proximal staple cavity 151a. In at least one embodiment, the entire staple cavity 151c can be positioned proximal to the base wall 281 of the alignment slot 280 in the first body portion 152a, while in other embodiments, at least a portion of the cavity clamp 151c can be positioned proximal to the base wall 281. As shown in Figure 43, alignment slot 280 in the first body portion 152a is positioned at least partially laterally with respect to the second most proximal clamp cavity 151c . Still referring to figure 43, the first body portion 152a may comprise a retention slot 190 therein which can be positioned proximally to the staple cavities 151 therein, including the staple cavities 151a and 151c, for example .
[00093] Referring to Figure 41, in addition to the above, the second body portion 152b may comprise a more proximal staple cavity 151b which can be proximally positioned relative to the other staple cavities 151 in the second body portion 152b . In at least one embodiment, the entire staple cavity 151b can be positioned proximal to the base wall 281 of the alignment slot 280 in the second body portion 152b, while in other embodiments, at least a portion of the cavity clamp 151b can be positioned proximal to the base wall 281. As shown in Figure 41, the alignment slot 280 in the second body portion 152b is positioned laterally with respect to the most proximal clamp cavity 151b and the section 156. In addition to the above, the second body portion 152b may comprise a second, more proximal staple cavity 151d which may be proximally positioned relative to the other staple cavities 151 in the second body portion 152b except for the most proximal clamp 151b. In at least one embodiment, the entire staple cavity 151d can be positioned proximal to the base wall 281 of the alignment slot 280 in the second body portion 152b, while, in other embodiments, at least a portion of the staple cavity 151d can be positioned proximal to the base wall 281. As shown in Figure 41, the alignment slot 280 in the second body portion 152b is positioned at least partially laterally with respect to the second most proximal clamp cavity 151d. Still referring to figure 41, the second body portion 152b may comprise a retention slot 190 therein, which can be positioned proximally to the staple cavities 151 therein, including the staple cavities 151b and 151d, for example. example.
[00094] In various embodiments, in addition to the above, the body of the staple cartridge 152 can be comprised of plastic and can be formed using an injection molding process. Consequently, in various embodiments, the clip boosters 168 (figure 9) can be mounted in clip cavities 151 and the cutting element 160 can be positioned inside the cartridge body 152 so that the cutting element 164 is located inside the compartment 170, as described above. The staple cartridge reservoir 154 can then be mounted on the staple cartridge body 152. In various embodiments, with reference now to Figure 42, the distal end 277 of the staple cartridge reservoir 154 can be aligned with the proximal end 295 of the staple cartridge body 152, so that the staple cartridge body can be slid into the staple cartridge reservoir 154 between opposite walls 154a and 154b, for example. The body of the staple cartridge 152 and the reservoir 154 can be slid in relation to each other until the reservoir projections 276 are positioned within the recesses 270 and the projections 274 are positioned within the recesses of the reservoir 275. At the same time, the projections locking device 288 extending from the staple cartridge body 152 can be received into the locking openings 287 in the staple cartridge reservoir 154, so that reservoir 154 can be locked into the body of staple cartridge 152. In In various embodiments, the side walls 154a and 154b of reservoir 154 can flex or tilt externally as they pass over the lock projections 288 and then return elastically internally when the lock openings 287 are aligned with the lock projections 288. At this point , the arms 155 extending from the reservoir 154 can be aligned and positioned within the retaining slots 287 in the body of the cartu staple floor 152. In certain embodiments, now with reference to figure 47, the staple cartridge 150 may additionally comprise a retaining element, such as a retaining element 300, for example, which can be configured to selectively block slot 301 in the staple cartridge body 152, for example. In at least one embodiment, the retaining element 300 may comprise a pivoting arm 303 that can be rotated between a first position in which it extends beyond the slot 301 (illustrated in solid lines) and a second position in which it is positioned adjacent to slot 301 (shown in broken lines). In at least such an embodiment, an integral pivot pin 302 (figure 41) can extend from arm 303 into an opening in the body of staple cartridge 152, which can define an axis around which arm 303 can be rotated. In certain embodiments, the arm 303 may include a locking element 304 extending therefrom, which can be configured to be releasably engaged with a locking cavity 305 in the body of the staple cartridge 152 to hold the arm 303 at least one of your first and second positions, for example. In certain embodiments, positioning the arm 303 beyond the slot 301 can prevent, or at least inhibit, the cutting element 160, for example, from sliding out of the staple cartridge 150.
[00095] To facilitate the insertion and removal of staple cartridge 150 from staple cartridge channel 122, in various embodiments, staple cartridge 150 may comprise gripping portions positioned on opposite sides thereof, for example. In at least one embodiment, now with reference to figures 43 and 47, the body of the staple cartridge 152 may comprise side portions 285 positioned adjacent to the alignment slots 280 and the side portions 285 can be held and / or pushed by a doctor to seat the proximal end 213 of the staple cartridge 150 on the proximal end of the staple cartridge channel 122, for example. This force can be applied to the top surfaces, or in contact with the fabric, of the side portions 285 as the proximal end 213 of the staple cartridge 150 is rotated to the position as described above. In various embodiments, a lifting force can be applied to the side portions 285 to lift the proximal end 213 of the staple cartridge 150 out of the staple cartridge channel 122. In at least such an embodiment, with reference mainly to figure 47, each side portion 285 can comprise one or more steps, ridges, and / or elevations, such as elevations 287a and 287b, and / or 287c, for example, which can be configured to increase the physician's grip on the side portions 285. In several embodiments, elevations 287a and 287b, and / or 287c can be positioned at different heights in relation to each other. In any case, staple cartridge 150 can be removed from channel 122 by lifting the proximal end 213 of staple cartridge 150 out of channel 122 and then unhooking, or disengaging, distal end 211 of staple cartridge 150 from distal end 121 channel 122, for example. As the staple cartridge 150 is removed from channel 122, the slot 161 within the cutting element 160 can be moved away and disengaged from the pusher projection 294 of the propeller bar 202, for example.
[00096] In various circumstances, in addition to the above, the drive bar 202 and the cutting element 160 can be returned to their proximal positions before the staple cartridge 150 is removed from the staple cartridge channel 122. In this position, as discussed above, the cutting edge 165 can be positioned within compartment 170. In various embodiments, now with reference to figure 48, an alternative embodiment of a staple cartridge 150 'is shown without a compartment 170. In at least one of such an embodiment , the cutting edge 165 may at least partially extend above the deck surface 158 of the staple cartridge body 152 in its proximal position and / or any other distally advanced positions, for example
[00097] 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 a portion of compartment 170, when anvil 130 is taken closed in opposition to the staple cartridge 150, for example. In at least one embodiment, there may be sufficient clearance between housing 170 and 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.
[00098] As described above, the propeller bar assembly 200 can be moved in a distal position to move the staple sled assembly 160 within the staple cartridge assembly 150. In various embodiments, as also described above, wedge-like cam surfaces 167 of the staple sled 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 such an 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 further include a slot, channel, or groove 133 that can be configured to slide at least a portion of the staple sled 162, the cutting element 164 and / or the drive 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 several 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, mounted thereon, wherein the nose portion 139 can be configured to be snap-fit and / or quickly attached to the anvil channel 136, for example, so that the 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 insertion of the anvil 130 into a surgical site, for example. In some embodiments, with reference to figure 28, a nose portion, such as nose portion 139 ', can 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.
[00099] 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 sled 162 can determine the level of deformation of the staples. For example, if the distance between the anvil pockets 132 of the anvil 130 and top surfaces 135 on the staple sled 162 (figures 10 to 12) is relatively large, the staples will be deformed in a smaller amount compared to the distance between the anvil pockets 132 and sled surfaces 135 where the distance is relatively small. Correspondingly, if the distance between the anvil pockets 132 and the surfaces of the sled 135 is relatively small, the clamps will be more deformed compared to when the distance between the anvil pockets 132 and the surfaces of the sled 135 is relatively large. Often, the distance between the anvil pockets 132 and the surfaces of the sled 135 is called the height of clamp formation. Sometimes the height of clamp formation can be measured between the top or deck surface of the clamp cartridge and the clamp forming surfaces on the anvil. For the purposes of this application, however, any reference to a staple forming height, 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, for example, stapling instrument 100, may include means for adjusting the staple forming height.
[000100] In various 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 height of the staple formation. In at least one embodiment, referring to Figures 17 to 23, anvil 130 may include the anvil plate 134 which can be positioned movably and / or slidably within the anvil channel 136. In certain embodiments, the anvil 130 may further include one or more retaining pins or guides 140, 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 such In this embodiment, pins 140 and / or slots 141 can be configured to define a predetermined path along which the anvil plate 134 can be moved. With reference 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, the linear path being 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 and, in at least one embodiment, the pins 140 can be snapped into the openings 144. In any case, as described in the present invention, pins 140 can guide the anvil plate 134 as it is joined and / or moved away from the staple cartridge 150, for example.
[000101] In several modalities, in addition to the above, a surgical stapling instrument, such as 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 set 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 such an embodiment , referring 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 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 upwards towards the base 138 to the first positioning surface 145 contacting 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 such an 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 a 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 adjustment element 230 is in its first position, as described above, the second surface, or step, 232 of the adjustment element 230 can be positioned between the base 138 and the second positioning surface 146 on the anvil plate 134, and in addition, the third surface, or step, 233 can be positioned between the base 138 and the third positioning surface 147. With reference to figure 20, the adjusting element 230 may 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.
[000102] In certain embodiments, the first position of the adjusting element 230 can provide a relatively small, or short, clamp-forming height. In other embodiments, although not shown, the first position of an adjustment member can provide a relatively large intermediate clamp height and / or any other suitable height. In the event that the formation 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 clamping height is inadequate, a surgeon or other physician 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 allowable distance 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 staple forming height. Although the term "upwards" and the like may mean vertically upwards, the term is not limited to that; on the contrary, "up" can mean any direction towards the base of the anvil and / or in the opposite direction of a staple cartridge, for example. In any case, the adjustment 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 height of clamp formation. 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 to adjust the adjustment element 230. When the adjustment element 230 has been moved to its second position, with reference 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 back plate igorna 134 can be defined by a second distance 235.
[000103] 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 adjusting 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 relative movement level between the anvil plate 134 and the anvil channel 136. In 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 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 are contemplated. For example, an adjustment element can be movable 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 staple forming heights are contemplated. In addition, although the surfaces, or steps, 231, 232 and 233 of the adjustment element 230 are arranged in a decreasing order, other arrangements in which the surfaces, or steps, are arranged in an ascending 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. .
[000104] 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 adjusting 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 such an 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 such an embodiment, an anvil plate may include a positioning surface with the steps of an adjustment element being selectively used 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 the positioning surface 145, 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 may 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 may 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 forming clip. 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 such an 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 such an 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.
[000105] 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, surgical stapling instrument 100 may include actuator 250 which can be functionally attached to adjustment element 230 so that a force can be applied to actuator 250 and transmitted to the element adjustment 230. In certain embodiments, the actuator 250 may include handle portions, or cables, 252 that can be configured to be held by a surgeon, for example, in order to advance or retract the adjustment element 230 within the anvil 130 , as described above. In certain embodiments, the handle portions 252 may extend from the actuator body 251, 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 such an embodiment, with reference to figure 19, adjustment element 230 may include lock 254 extending therefrom, at least a portion of lock 254 may be received within opening 253 so as to secure the actuator body 251 to the adjusting 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 through least partially, to its uninflected position after feet 256 of legs 255 are pushed sufficiently through opening 253. In at least such an embodiment, feet 256 can prevent, or at least inhibit, that the body actuator 251 is detached from the adjustment element 230.
[000106] 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, 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, and in at least some embodiments, the body of the actuator 251 can include one or more channels, grooves, or recesses 257 that can configured to receive and / or retain a holding body 261 of the holding element 260. In at least one embodiment, the holding body 261 may 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 element 260 can additionally include detent legs 262 which can be configured to engage one or more recesses, openings, or grooves 101 (figures 2 to 7) in the first portion of the structure 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, the detent legs 262 being able to be engaged with the top surfaces 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 that can be configured to removably hold the actuator 250 in a first position distal, a second intermediate position, and a third proximal position, the first, second, and third positions of the actuator 250 respectively corresponding to the first, second, and third positions of the adjusting 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, the actuator 250 can be moved proximally to its second position so that the detent legs 162 are positioned within the recess 101b and the actuator 250 and the adjusting element 230 are retained in their second positions. Similarly, by applying sufficient force, actuator 250 can be moved proximally to its third position so that detent legs 162 are positioned within recess 101c and actuator 250 and adjustment 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 positions.
[000107] 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 adjustment element 230 and / or the actuator 250. In some embodiments, the adjustment 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 such an embodiment, the side walls 137 can be configured to control or limit the lateral or side movement of the adjustment element 230. In various embodiments, the holding legs 162 of the holding element 160 can comprise 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 element adjustment element 230 against or at least adjacent to the base 138 and the intermediate side walls 137. In certain embodiments, with reference to figure 19, the base 138 of the anvil 130 may also include a guide slot 149 that can be configured to receive at least a 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 such an embodiment, 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 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 230 is in your pri first position or more 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 more proximal position.
[000108] In various embodiments, in addition to the above, a holding element, similar to holding element 260, for example, can be used to separate the first cable portion 102 and the second cable portion 104 from one another. In at least one embodiment, with reference to figure 37, the surgical stapling instrument 100 'may include a holding element 260' configured to position the first portion of cable 102 and second portion of cable 104 so that there is a gap between the anvil 130 and the staple cartridge 150. Such a 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 mounted on the second portion of 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 modifying 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 101d 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 locking 188 can engage, and at least partially encircle, the lock projections 131. In this configuration, a surgeon can manipulate the instrument and, when satisfied with its 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 to 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 recesses 101a, 101b and 101c, respectively. In at least such an 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-surfaces -stage against which legs 262 'can be positioned when actuator 250 is in its pre-stage position.
[000109] 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 staples dispensed by a surgical stapling instrument. In various embodiments, although not shown, an adjustment element can be configured to positively move an anvil plate in the same direction and / or in the opposite direction of an opposite staple cartridge, for example. In at least such an embodiment, a surgical stapling instrument may include one or more traction elements, such as springs, for example, 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 move the anvil plate between the first and second positions in order to establish the first and second staple heights. In various embodiments, as a result of the above, an adjustment element can be configured to rotate a portion of an anvil into position. In at least such an embodiment, an adjustment member 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 move an anvil plate in the same direction and / or in the opposite direction of a staple cartridge, for example.
[000110] In addition to the above, as described in more detail below, an adjustment element can be rotated to adjust the clamp formation height. Referring to figures 24 to 36, the surgical instrument 100 'may include, similarly to the above, a first portion of cable 102', a second portion of cable 104 ', and a locking mechanism 180' that can be used to hold the fabric between the anvil 130 'and the staple cartridge 150'. With reference to figure 25, also similarly to the above, the locking mechanism 180 'can be pivotably coupled to the first portion 102' by one or more pivot pins 182 ', with the locking mechanism 180' including one or more locking arms 188 'that 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 move a cutting element and / or sled of staples into end effector 120 '. In at least such an embodiment, the propeller bar assembly 200 'may include a proximal end 203' and an actuator 204 ', with actuator 204' being pivotally mounted on 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 in relation 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.
[000111] In various embodiments, with reference to figure 27, the surgical instrument 100 'can include a rotary adjustment element 230' that can be selectively positioned in at least one first and second positions in order to provide different heel formation heights . In certain embodiments, the surgical instrument 100 'may 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, with reference 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 such an embodiment, with reference 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 actuator body 251' and the 230 'actuator. 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 quick-fit or 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 a portion of the actuator body 251 'to extend through them so that the handle portion 252 'can be mounted on actuator body 251' with at least a portion of cable portion 104 'positioned between them. In at least such an embodiment, the second cable portion 104 'may further include the recess 253' which can be configured so that at least a 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' can extends above the second cable portion 104, as shown in figure 30, so that the handle portion 252 'can be easily accessed by a surgeon.
[000112] 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, with reference to figure 28, a surgical stapling instrument may include an adjustment element rotatably positioned within an anvil, the adjustment element being configurable to limit the relative movement of a movable portion of the anvil . In at least such an 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', with the guide pins 140 'can be configured to allow anvil plate 134' to slide upward when anvil plate 134 'comes into contact with the tissue, as described above. Referring to figures 27, 30 and 31, the adjusting 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 height of staple formation of the staples. In at least such an embodiment, referring to figures 30 and 31, the adjusting element 230 'can 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 'of a relation surface 129' on the anvil 130 ', for example. Correspondingly, the forming surfaces 132 'can be positioned at 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' and the first diameter 241 'can define a maximum position of the upward movement of the anvil plate 134' within the anvil channel 136 '.
[000113] As indicated above, the adjusting element 230 'can be rotated in order to adjust the formation height of the clamps. In various embodiments, the adjustment 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 adjustment 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 such an 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 . Correspondingly, the forming surfaces 132 'can be positioned 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', the second diameter 242 'being able to 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 contoured surfaces. curved. 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.
[000114] In several 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 height of forming staple staple. In at least such an 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 . Correspondingly, the forming surfaces 132 'can be positioned at 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', the third diameter 243 'being able to 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 an at least partially arched contour, although other modalities are contemplated in which the third surfaces 233' can include flat or at least substantially flat contours. 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.
[000115] 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 adjustment element 230 'and / or the actuator 250' can be sufficiently retained so that, when the adjustment element 230 'is rotated, the adjustment element 230' can be rotated about an axis , such as axis 245 '(figure 27), for example. In at least one embodiment, with reference 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 retain at least one adjustment element portion 230 'and / or actuator 250'. In any case, as shown in figures 30 to 33, the second position or orientation of the adjusting element 230 'may allow the anvil plate 134' to slide a greater distance within the anvil channel 136 'compared to when the setting 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 mode, 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 into 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 such an embodiment, the first position of the adjustment element 230 ', and the actuator 250', can represent an intermediate position, the adjustment element 230 'being selectively moved to its second and third positions directly from your first position. In practice, the first position of the adjustment element 230 'can represent an intermediate height of the clamp, the second and third positions 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 'may include one or more signals thereon, which can be configured to inform the stapling formation heights, or at least the relative formation heights, that can be selected. For example, the second cable portion 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.
[000116] In various embodiments, in addition to the above, one or more of the first surfaces 231 ', second surfaces 232', and third surfaces 233 'may 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 perimeter 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 such an 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 formation heights for the staples dispensed by a surgical stapling instrument. In at least such an embodiment, an adjustment element can comprise a cam profile that can be defined along the length of the adjustment element, the longitudinal and / or rotational movement of which can be used to move the cam profile between at least the first and second positions.
[000117] In various embodiments, similarly to the above, the surgical instrument 100 'may also 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'. With reference 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 cable portion 104' so that the element holder 260 'can be held in position. In at least such an 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 in recess 265 '. As also illustrated in figure 26, each detent leg 262 'of detent member 260' may include one or more projections 264 'extending therefrom, which can be configured to engage actuator body 251' and secure releasably the actuator 250 'in position. In at least one embodiment, with reference 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 recess 269', the projection can be configured to hold actuator 250 'in its first position, for example, until sufficient force is applied to actuator 250' 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 a portion of the legs 262 'so that the legs 262' can move with respect to the 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 the actuator 250 'is in its second or third position, the leg 262' can jump forward, or distally, so that the projection 264 'can be secured within the 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 held 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.
[000118] The devices described here can be designed to be discarded after a single use, or they can be designed to be used 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, in 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 before 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 reconditioned device, are all within the scope of the present patent application.
[000119] 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, such as 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 on 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 at the medical facility.
[000120] 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 intended, therefore, that this application covers any variations, uses or adaptations of the invention with the use of 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 (15)
[0001]
1. Staple cartridge (150) for use with a surgical stapler, comprising: a movable element (160) comprising a cutting edge (165); a staple cartridge body (152), comprising: a tissue contact surface (158); a cutting slot (156) configured to receive the cutting edge (165); a first body portion (152a) positioned on a first side of the cutting edge (165); a second body portion (152a) positioned on a second side of the cutting edge (165); a plurality of first clip cavities (151) in said first body portion (152a); a plurality of second clip cavities (151) in said second body portion (152b); a first alignment slot (280) in said first body portion (152a) configured to receive a first alignment member (128) from the surgical stapler; a second alignment slot (280) in said second body portion (152b) configured to receive a second alignment member (128) from the surgical stapler; a first lateral gripping member (285) positioned laterally with respect to said first alignment slot (280); a second side gripping element (285) positioned laterally with respect to said second alignment slot (280); a distal end; and a proximal end (295a), comprising: a first proximal retention portion (190) positioned on said first side of said cutting slot (156), wherein said first proximal retention portion (190) is configured to engage releasably a portion of the surgical stapler; and a second proximal retention portion (190) positioned on said second side of said cutting slot (156), wherein said second proximal retention portion (190) is configured to releasably engage a portion of the surgical stapler; a plurality of first staples positioned within said plurality of first staple cavities (151); a plurality of second clamps positioned within said plurality of second clamp cavities (151); a plurality of first clamp drivers (168) positioned within said first clamp cavities (151); a plurality of second clamp boosters (168) positioned within said second clamp cavities (151); a retainer (154) attached to said staple cartridge body (152) configured to retain said first staple drivers (168) in said first staple cavities (151) and said second staple drivers (168) in said second ones staple cavities (151); characterized by the fact that it further comprises: a retaining element (300) configured to block a slot (301) at the proximal end (295a) of the staple cartridge body (152), the retaining element (300) comprising a pivoting arm (303) which can be rotated between a first position in which it extends through the slot (301) and a second position in which it is positioned in the adjacent slot (301), in which, in its first position, the retaining element (300 ) prevents the moving element (160) from sliding out of the staple cartridge (150).
[0002]
Staple cartridge according to claim 1, characterized in that said distal end comprises a reference surface (272), wherein said first alignment slot (280) comprises a first distal portion (281) , wherein said second alignment slot (280) comprises a second distal slot (281), and wherein said first distal portion (281) and said second distal portion (281) define a predetermined distance (289) in relation to said reference surface (271).
[0003]
Staple cartridge according to claim 1, characterized in that said distal end comprises a reference surface (271), and wherein said first proximal retention portion (190) and said second portion of proximal retention (190) defines a predetermined distance (199) in relation to said reference surface (271).
[0004]
Staple cartridge according to claim 1, characterized in that said first proximal retention portion (190) comprises a first retention slot configured to receive a first retention key (195) from the surgical stapler, and wherein said second proximal retention portion (190) comprises a second retention slot configured to receive a second retention key (195) from the surgical stapler.
[0005]
A staple cartridge according to claim 4, characterized in that said first retaining slot comprises: a first distal side (194); and a first proximal side (193) positioned opposite said first distal side (194), wherein said first proximal side (193) is configured to deviate proximally when said first retention slot is engaged with the first retention key ( 195), and wherein said second holding slot comprises: a second distal side (194); and a second proximal side (193) positioned opposite said second distal side (194), wherein said second proximal side (193) is configured to deviate proximally when said second retention slot is engaged with the second retention key ( 195).
[0006]
Staple cartridge according to claim 1, characterized in that said distal end comprises a reference surface (271), wherein said movable element (160) comprises a slot (161) configured to receive a propulsion member (202) of the surgical stapler, wherein said movable element (160) is movable between a proximal position and a distal position by the propulsion member (202), and wherein said slot (161) defines a predetermined distance (299) with respect to said reference surface (271) when said moving element (160) is in said proximal position.
[0007]
7. Staple cartridge according to claim 1, characterized in that said distal end comprises a projection (274) configured to hook under a distal projection (278) extending from a staple cartridge channel (122) of the surgical stapler.
[0008]
Staple cartridge according to claim 1, characterized in that said movable element (160) comprises: a slot (161) configured to receive a drive member (202) of the surgical stapler; and a projection (293) positioned proximally to said slot (161) configured to be positioned within a slot (295) in the drive member (202).
[0009]
Staple cartridge according to claim 1, characterized in that said plurality of first staple cavities (151) comprises a more proximal first staple cavity (151a), wherein said plurality of second staple cavities (151a) staples (151) comprises a second more proximal staple cavity (151a), wherein said first alignment slot (280) is positioned laterally with respect to said first most proximal staple cavity (151a) and said cutting slot ( 156), and wherein said second alignment slot (280) is positioned laterally with respect to said second most proximal staple cavity (151a) and said cutting slot (156).
[0010]
Staple cartridge according to claim 1, characterized in that said first alignment slot (280) comprises: a first side wall (283); a second side wall (284); and a first base wall (281) extending between said first side wall (283) and said second side wall (284), wherein said second alignment slot (280) comprises: a third side wall (283 ); a fourth side wall (284); and a second base wall (281) extending between said third side wall (283) and said fourth side wall (284), wherein said plurality of first staple cavities (151) comprises a first staple cavity more proximal (151a), wherein said plurality of second staple cavities (151) comprises a more proximal second staple cavity (151a), wherein said first more proximal staple cavity (151a) is positioned proximally to the said first base wall (281), and wherein said second most proximal staple cavity (151a) is positioned proximally to said second base wall (281).
[0011]
11. Staple cartridge according to claim 1, characterized in that said first side grip portion (285) comprises: a first tissue contact surface on a first side of said first side grip portion ( 285); and a first plurality of elevations (287a, 287b, 287c) on a second side of said first side grip portion (285), and wherein said second side grip portion (285) comprises: a second contact surface with the fabric on a first side of said second side grip portion (285); and a second plurality of elevations (287a, 287b, 287c) on a second side of said second side grip portion (285).
[0012]
Staple cartridge according to claim 4, characterized in that said first retaining slot and said second retaining slot are positioned along an axis, and wherein said axis is perpendicular to an axis longitudinal defined by said cutting slot (156).
[0013]
13. Staple cartridge according to claim 1, characterized in that said plurality of first staple cavities (151) comprises a more proximal first staple cavity (151a), wherein said plurality of second staple cavities (151a) staples (151) comprises a second, more proximal staple cavity (151a), wherein said first retaining portion (190) is positioned proximally to said first most proximal staple cavity (151a), and wherein said second retaining portion (190) is positioned proximally to said second most proximal staple cavity (151a).
[0014]
14. Staple cartridge according to claim 1, characterized in that an integral pivot pin (302) extends from the arm (303) to an opening in the staple cartridge body (152), in which the pin pivot defines an axis around which the arm (303) can be rotated.
[0015]
15. Staple cartridge according to claim 1, characterized in that the arm (303) includes a locking element (304) extending from it which is configured to release reliably with a locking cavity (305) on the staple cartridge body (152) in order to hold the arm (303) in at least one of its first and second positions.

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US20210186497A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising a seating cam|

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US20210186503A1|2019-12-19|2021-06-24|Ethicon Llc|Surgical instrument comprising a powered articulation system|

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US20210186502A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising a detachable tissue cutting knife|

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US20210186492A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising driver retention members|

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US20210186505A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising projections extending from a curved deck surface|

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US20210186506A1|2019-12-19|2021-06-24|Ethicon Llc|Stapling instrument comprising independent jaw closing and staple firing systems|

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US20210186498A1|2019-12-19|2021-06-24|Ethicon Llc|Surgical instrument comprising a rapid closure mechanism|

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US20210186500A1|2019-12-19|2021-06-24|Ethicon Llc|Surgical instrument comprising a nested firing member|

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US20210186504A1|2019-12-19|2021-06-24|Ethicon Llc|Motor driven surgical instrument|

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US20210186501A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising a deployable knife|

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US20210186499A1|2019-12-19|2021-06-24|Ethicon Llc|Staple cartridge comprising a latch lockout|

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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2019-07-30| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2019-12-17| B06G| Technical and formal requirements: other requirements [chapter 6.7 patent gazette]|

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2020-07-07| B07A| Application suspended after technical examination (opinion) [chapter 7.1 patent gazette]|

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2020-10-27| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-01-05| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 08/03/2011, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US12/725,993|US8540133B2|2008-09-19|2010-03-17|Staple cartridge|

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US12/725,993|2010-03-17|

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PCT/US2011/027504|WO2011115780A1|2010-03-17|2011-03-08|Staple cartidge|

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