• 专利附录
  • 专利说明
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    • 专利摘要:
    SURGICAL CLAMPING HEAD SET WITH TRIGGER LOCK FOR A SURGICAL STAPLER. The present invention relates to a surgical stapling head which is provided, which may comprise a staple cartridge for holding one or more staples, a movable core relative to the staple cartridge, at least one staple driver extending from the core, and a compartment configured to contain the staple cartridge at least partially and to movably receive the core and the staple driver (s). The compartment may additionally comprise at least one retaining element that is configured to move from a first position to a second position when sufficient external force is applied to the retaining element, such as that provided by a surgical stapler rod during the insertion of the stapling head assembly into the rod. When the retaining element (s) is (are) in the second position, the staple driver (s) can be prevented from triggering staples in the staple cartridge thereby providing a trigger locking element to the stapling head assembly during insertion into at least a portion of (...).
    公开号:BR112013005685B1
    申请号:R112013005685-1
    申请日:2011-09-09
    公开日:2020-11-17
    发明作者:Aron O. Zingman
    申请人:Ethicon Endo-Surgery, Inc.；
    IPC主号:
    专利说明:

    BACKGROUND
    [0001] The modalities generally refer to surgical staplers, and, more particularly, to a circular stapler that includes a discontinuous staple height adjustment.
    [0002] In certain types of surgical procedures, the use of surgical staples has become the preferred method for joining tissues and, for this reason, specially configured surgical staplers have been developed for these applications. For example, intraluminal or circular staplers were developed for use in a surgical procedure known as anastomosis. Circular staplers useful for performing an anastomosis are shown, for example, in US Patent Nos. 5,104,025; 5,205,459; 5,285,945; and 5,309,927 and U.S. Patent Application Serial No. 12 / 408,905, which are each incorporated herein by reference in their respective totalities.
    [0003] A form of anastomosis comprises a surgical procedure in which the sections of the intestine are joined together after excision of a diseased portion. The procedure requires reconnecting the ends of the two tubular sections to each other to form a continuous tubular path. Previously, this surgical procedure was a laborious and time-consuming operation. The surgeon had to cut and precisely align the ends of the intestine, and maintain alignment by joining the ends with numerous stitches. The development of circular staplers greatly simplified the anastomosis procedure and also reduced the time required to perform an anastomosis.
    [0004] In general, a conventional circular stapler typically consists of an elongated rod that has a proximal drive mechanism and a distal stapling mechanism mounted on the rod. The distal stapling mechanism commonly consists of a fixed stapling cartridge that contains a plurality of staples configured in a concentric circular assembly. A round cutting face is mounted inside the cartridge concentrically to the clamps for axial displacement in it. Extending axially from the center of the cartridge is a movable changing rod, adapted to have a staple anvil attached to it in a removable manner. The anvil is configured to form the ends of the clamps as they are guided to it. The distance between a distal face of the staple cartridge and the staple anvil is controlled by an adjustment mechanism mounted on the proximal end of the staple rod to control the axial movement of the trocar. The tissues clamped between the staple cartridge and the staple anvil are simultaneously stapled and cut when the trigger mechanism is activated by the surgeon.
    [0005] In general, when performing a surgical operation for anastomotic stapling, two pieces of lumen or tubular tissue, for example, intestinal tissue, are fixed together by a ring of staples. The two pieces of tubular tissue can be attached end to end or a piece of tubular tissue can be attached laterally around an opening formed on the side of the other piece of tubular tissue. When performing the anastomosis with a stapling instrument, the two pieces of tubular tissue are attached together between the claw and the staple cartridge. A staple propellant is advanced to guide the staples into the tissue and form the staples against the anvil. In addition, the circular knife is advanced to cut the excess tissue trapped between the anvil and the clip holder. As a result, a section of ring-shaped tissue is separated from each lumen and remains on the anvil stem. The tubular tissue is joined by the circular ring of clamps and is released by advancing the anvil stem in a distal position to move the anvil away from the holder of the clamp. The stapling instrument is removed by pulling the anvil through the circular opening between the pieces of tubular tissue attached to the clamp ring.
    [0006] In addition, when performing a procedure in the lower colon using a circular stapler, the intestine is typically stapled using a conventional surgical stapler, with double rows of staples being placed on either side of the diseased intestine portion. to be removed. The target portion is simultaneously cut as the contiguous end is stapled. After removing the diseased portion, the surgeon typically inserts the anvil into the proximal end of the lumen, next to the stapling line. This is done by inserting the anvil head into an entrance door cut by the surgeon in the proximal lumen. In certain cases, the anvil can be positioned transanal, by placing the anvil head on the distal end of the stapler, and inserting the instrument through the rectum. The surgeon then ties the proximal end of the intestine to the anvil stem using a suture or other conventional lashing device. Then, the surgeon cuts the excess tissue adjacent to the tie and attaches the anvil to the stapler's trocar shaft. The surgeon then closes the gap between the anvil and the cartridge, thus pinching the proximal and distal ends of the intestine in the gap. Then, the surgeon activates the stapler, causing several rows of staples to be conducted through both ends of the intestine and formed, thus uniting the ends and forming a tubular path. Simultaneously, as the staples are guided and formed, the blade of the concentric circular knife is guided through the ends of the intestinal tissue, cutting the ends adjacent to the inner row of staples. The surgeon then removes the stapler from the intestine and the procedure is complete.
    [0007] During the surgical procedures described above, it is desirable to form staples properly within a range of staple heights so that they are retained in the tissue and prevent leakage and bleeding as well as to obtain "tissue to tissue" contact that promotes healing of the fabric. In general, by controlling the distance or gap between the anvil and the cartridge, better stapling and healing results can be obtained. Although some surgical staplers are equipped with a visual reading indicating the height of the staple, a surgeon may need to focus on many different items during surgery. In addition, once the anvil has been correctly positioned, it is necessary that the anvil does not move during firing, otherwise proper clamp formation could be adversely affected.
    [0008] The aforementioned discussion is only intended to illustrate the present field and should not be taken as a contradiction in the scope of implementation. SUMMARY
    [0009] In several modalities, a surgical stapling head set is provided. In at least one embodiment, the surgical stapling head assembly may comprise a staple cartridge to hold one or more surgical staples, a core movable relative to the staple cartridge, at least one staple driver to interconnect and drive the staples from the staple cartridge, and a compartment configured to contain at least partially the staple cartridge and to movably receive the core and at least one staple driver. In these modalities, the at least one clamp driver can extend from the core. In addition, in these embodiments, the compartment may additionally comprise at least one retaining element that is configured to move from a first position to a second position when sufficient external force is applied to the retaining element. In addition, in these embodiments, when the at least one retaining element is in the second position, the at least one staple driver is prevented from driving the staples of the staple cartridge.
    [00010] In several modalities, a surgical stapler is provided. In at least one embodiment, the surgical stapler may comprise a body, a stapling head assembly, a drive system, an anvil and an anvil adjustment assembly. In these embodiments, the body may comprise a cable portion and a stem portion extending from the cable portion. Additionally, in these embodiments, the stapling head assembly can be releasably coupled to the stem portion. In addition, in these embodiments, the stapling head assembly may comprise a staple cartridge to hold one or more surgical staples, a movable core relative to the staple cartridge, at least one staple driver to interconnect and drive the staples. staple cartridge, and a compartment configured to contain at least partially the staple cartridge and to movably receive the core and at least one staple driver. In addition, in these embodiments, the at least one clamp driver can extend from the core. In addition, in these embodiments, the compartment may additionally comprise at least one retaining element that is configured to move from a first position to a second position when sufficient external force is applied to the retaining element. In addition, in these embodiments, when the at least one retaining element is in the second position, the at least one staple driver is prevented from driving the staples of the staple cartridge. Additionally, in these modes, the drive system can be configured to apply drive movements to the clamp driver. Additionally, in these embodiments, the anvil can be held mobile in relation to the staple cartridge for axial movement towards and away from the staple cartridge. Also, in these embodiments, the anvil adjustment set can be configured to selectively adjust an axial position of the anvil with respect to the staple cartridge.
    [00011] In at least one embodiment, a surgical stapling head assembly is provided, which may comprise a staple cartridge to hold one or more surgical staples, a moving core relative to the staple cartridge, at least one trigger driver staples extending from the core and to interconnect and actuate the staple cartridge staples, a compartment configured to contain at least partially the staple cartridge and mobilely receive the core and at least one staple driver, and locking means to prevent the at least one staple driver from triggering staples from the staple cartridge. BRIEF DESCRIPTION OF THE FIGURES
    [00012] The innovative characteristics of the modalities described here are presented with particularity in the embodiments. The modalities, however, both with regard to the organization and the methods of operation can be better understood by reference to the description below, taken in conjunction with the attached drawings as follows.
    [00013] FIG. 1 is a perspective view of a non-limiting embodiment of a surgical stapler including a circular stapling head and an anvil in a first position.
    [00014] FIG. 2 is a perspective view of the surgical stapler of FIG. 1 with the anvil shown in a second position.
    [00015] FIG. 3 is an exploded view of the surgical stapler of FIG. 1.
    [00016] FIG. 4 is a perspective view of the surgical stapler of FIG. 1 with the stapler body shown in dotted lines to better illustrate the stapler components within the body.
    [00017] FIG. 5 is a cross-sectional view of the surgical stapler of FIG. 1.
    [00018] FIG. 6 is a rear perspective view of the anvil of the surgical stapler of FIG. 1.
    [00019] FIG. 7A is a front perspective view of a stapling head assembly of the surgical stapler of FIG. 1.
    [00020] FIG. 7B is a rear perspective view of a staple cartridge for the 7A staple head assembly; two staples are shown removed from the staple cavities in the cartridge.
    [00021] FIG. 7C is a front perspective view of a cutting element and the clip drivers of the staple head assembly of FIG. 7A.
    [00022] FIG. 8 is a side view of an anvil adjustment rod of the surgical stapler of FIG. 1.
    [00023] FIG. 9 is a perspective view of a portion of the anvil adjustment rod of FIG. 8.
    [00024] FIGS. 10A to 10C are a series of side views of a portion of the anvil adjustment rod of FIG. 8, each showing a progression of a thread surface when the stem is rotated around its longitudinal axis.
    [00025] FIGS. 11A to 11C are a series of side views of the anvil and the stapling head assembly of the surgical stapler of FIG. 1, each showing a height of discontinuous clamp formation that correlates with the positions of the rod shown in FIGS. 10A to 10C, respectively.
    [00026] FIG. 12 illustrates a non-limiting embodiment of a portion of an anvil adjustment rod including reference signals.
    [00027] FIG. 13 illustrates three reference signals from the adjustment rod portion of FIG. 12.
    [00028] FIG. 14 is a rear perspective view of a trigger of the surgical stapler of FIG. 1; the trigger includes a locking rod.
    [00029] FIG. 15 is a front perspective view of a portion of the surgical stapler of FIG. 3, showing the trigger and locking rod interconnected with the actuation strip and the adjustment rod, respectively.
    [00030] FIG. 16 is a perspective view of a non-limiting embodiment of a surgical stapler including a straight shank portion.
    [00031] FIG. 17 is a side view of an anvil adjustment rod of the surgical stapler of FIG. 16.
    [00032] FIG. 18 is a perspective view of an operating bar of the surgical stapler of FIG. 16.
    [00033] FIG. 19 is a perspective view of a non-limiting embodiment of a stapling head assembly with an assembly compartment shown in dotted lines to better illustrate the elements within the compartment.
    [00034] FIG. 20 is a side view of the staple head assembly of FIG. 19.
    [00035] FIG. 21 is a perspective view of a staple driver core of the staple head assembly of FIG. 19.
    [00036] FIG. 22 is a partial side view of the staple head assembly of FIG. 19 being initially inserted into a stapler body of FIG. 1 with a stapler body shown in dotted lines to better illustrate the portion of the staple head assembly positioned within the stapler body.
    [00037] FIG. 23 is a partial perspective view of the staple head assembly of FIG. 19 being further inserted into the body of the stapler of FIG. 1 with the stapler body and the staple head assembly compartment shown in dotted lines to better illustrate the various elements contained therein.
    [00038] FIG. 24 is a partial perspective view of the staple head assembly of FIG. 19 fully inserted into the stapler body of FIG. 1 with the stapler body shown in dotted lines to better illustrate the components contained therein.
    [00039] FIG. 25 is a perspective view of a non-limiting embodiment of a stapling head assembly that includes a cutting element with an assembly compartment shown in dotted lines to better illustrate the elements within the compartment.
    [00040] FIG. 26 is a side view of the staple head assembly of FIG. 25. DETAILED DESCRIPTION
    [00041] Certain modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the devices and methods presented in the present invention. One or more examples of three modalities are illustrated in the attached drawings. Those skilled 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 is defined only by the embodiments. The characteristics illustrated or described in relation to one modality can be combined with the characteristics of other modalities. In addition, when an order of steps in a process is indicated, these orders can be rearranged or the steps can be executed contemporaneously as desired unless it is illogical or if the order mentioned is explicitly necessary. These modifications and variations are intended to be included in the scope of the embodiments.
    [00042] In the following description, like reference characters designate corresponding or equal parts across multiple views. Also in the description below, it should be understood that terms such as "forward", "rear", "front", "rear", "right", "left", "upper", "lower", "up" , "down", "proximally", "distally", and the like are words used for convenience and should not be construed as limiting terms. The description below is intended to describe various modalities and is not intended to limit the embodiments.
    [00043] The various modalities in general refer to several surgical staplers configured for sealing tissue and, in at least one modality, also cutting the tissue. These surgical staplers can be configured to work through a natural orifice, such as the anus, mouth and / or vagina, or through an incision in a body wall. In addition, these surgical staplers can be designed as endoscopic tools, including laparoscopic tools. An exemplary type of surgical stapler can be found in co-pending application serial number 12 / 635.415, entitled CIRCULAR SURGICAL STAPLER WITH DISCRETE STAPLE HEIGHT ADJUSTMENT, and filed on December 10, 2009, hereby incorporated in full, by way of of reference.
    [00044] Now focusing on a non-limiting modality, as can be seen in FIGS. 1 to 4, a circular stapler 1 is provided which includes a tubular or circular body 10, a stapling head 30 operatively coupled to the body 10, an anvil 50, an anvil adjustment rod 70 supported by the body 10 and a trigger 90 coupled movably to the body 10. The anvil 50 can be held movably in relation to the stapling head assembly for selective passage towards or away from the stapling head 30. In addition, the anvil adjustment rod 70 can be supported by the body 10 to selectively adjust an anvil position in relation to the stapling head. Therefore, as will be explained in more detail below, the adjustment rod 70 can be operationally coupled to the anvil 50 to effect its movement. For example, the adjustment rod 70 can be rotated, via a button 79 of the adjustment rod, around its longitudinal axis, in a first direction of rotation, for example, clockwise "CW", to make that the rod 70 and the anvil 50 move or translate in the distal direction "DD", relative to the body 10, from a first position shown in FIG. 1 for a second position shown in FIG. 2. Similarly, the adjustment rod 70 can be rotated in a second rotational direction, for example, counterclockwise "CCW", to cause the rod 70 and anvil 50 to move or shift in one proximal direction "PD" with respect to body 10, from the second position shown in FIG. 2 to the first position shown in FIG. 1. It is understood that the anvil 50 can be positioned anywhere between or outside the positions shown in FIGS. 1 and 2, as permitted by the surgical stapler 1. In addition, in at least one embodiment, as explained in more detail below, the adjustment rod 70 can be configured to move the anvil 50 to at least a predetermined distance from the head and / or to provide tactile feedback to a user.
    [00045] When trigger 90 is activated, a drive system can be activated within body 10 so that clips 31 (see FIGS. 3 and 7B) can be ejected from the stapling head 30 into the forming contact of the anvil 50. Simultaneously, a cutting element 32 (see FIG. 7C), which is operationally supported within the head 30, acts by cutting the fabrics kept within the circumference of the stapled fabrics. Stapler 10 is then pulled through the fabric, leaving the stapled fabric in its place. In addition, trigger 90 may include a spring 91 which extends from lever 92 so that when lever 92 is tightened, or otherwise moved towards body 10 around hinge pin 93, lever 91 it is pulled back away from the body 10 and the knife 70 is automatically retracted by releasing lever 92.
    [00046] With reference to FIG. 3, the body 10 may include a cable portion 11 and a curved stem portion 12. Although the present embodiment illustrates a curved stem portion 12, the stem portion may also be straight or linear (see, for example, FIG 16, discussed below). The cable portion 11 can be adapted to receive the trigger 90 through a concave part fixation 13 which can also include holes 16 (see FIG. 3) with which to receive the hinge pin 93 which can also be received in the holes 96 of trigger 90. The cable portion 11 can further define an opening 14 at the top of the body 10 through which a portion of the trigger 90 can be positioned. For example, the meat surfaces 94 and a locking rod 95 can extend through opening 14. As will be explained in more detail below, the meat surfaces 94 can be configured to act on the drive system when the trigger 90 is moved with respect to the cable portion 11, and the locking rod 95 can prevent inadvertent firing of the cutting element 32 and / or the clamps 31 before the anvil 50 is in a suitable position so that the clamps can be formed between the anvil 50 and stapling head 30.
    [00047] With reference to FIGS. 3 and 4, the drive system may comprise a drive strip 80 that extends axially between the cam surface 94 of the trigger and the flaps 36 of the stapling head 30 within the rod portion of the body 12. The drive strip 80 may include proximal drive surfaces 81 and distal drive surfaces 82. Thus, actuation of the trigger can cause the meat surfaces 94 to rotate and push the proximal drive surfaces 81 so that drive band 80 moves in an axial direction towards the anvil 50 or away from it. The flaps 36 of the stapling head can be coupled within the distal drive surfaces 82 of the drive strip, which can take the form of indentations to reliably receive the flaps 36.
    [00048] With reference to FIGS. 4 and 7A to 7C, the stapling head 30 may include an assembly comprising a staple cartridge 33 for holding one or more staples 31, at least one staple driver 34 for interconnecting and driving the staples 31 from the cartridge 33, and a cutting element 32, for example, a knife, movably supported on the stapling head 30. In at least one embodiment, the clip drivers 34 and the cutting element 32 can be integrally connected and / or shaped. For example, the clip drivers 34 and the cutting element 33 can extend from a core 35, each of which can be formed from the same material. In any case, the actuation of the drive band 80 towards the staple cartridge 33 and / or the anvil 50 may cause the flaps 36 of the stapling head, which may extend from the core 35, and thus the cutting element 32 and the clip drivers 34, move towards the anvil 50. In addition, the stapling head 30 can also comprise a compartment 39 that is configured to contain the clip cartridge 33 and to receive movably the drivers of staples 34, the cutting element 32 and / or the core 35 through it. The compartment 39 can additionally include release buttons 37 which are configured to flex flexively and allow the stapling head 30 to be releasably attached to the rod portion of the body 12 in the corresponding holes 15 (see FIG. 3) formed therein . Consequently, with reference to FIG. 4, the stapling head 30 can be removed by pressing the buttons 37, and then rotating the head 30 so that the flaps 36 are released from the notches formed by the distal drive surfaces 82 of the drive band 80, and finally pull the head staple 30 away from body 10.
    [00049] Focusing now on adjusting anvil 50 and with reference to FIG. 3, in various embodiments and as noted above, the anvil 50 can be movably supported relative to the staple cartridge 33 so that the anvil can be moved axially towards the staple cartridge and away from it 33. In more detail , the surgical stapler 1 may comprise an anvil adjustment set to selectively adjust an axial position of the anvil 50 with respect to the staple cartridge 33. The anvil adjustment set may comprise an adjustment rod 70 and a trocar 73 coupled to the rod setting 70 to move with it. The adjustment rod 70 can comprise a proximal portion 70a and a distal portion 70b, which can be connected together to form the rod 70. Alternatively, the proximal and distal portions 70a, 70b can be unitary and integrally formed from the same piece of material ( see, for example, adjustment rod 170 shown in Figure 17 and discussed below). In addition, the adjustment rod 70 may further comprise an annular groove 71 located in the distal portion 70b which can be joined or otherwise freely connected to a proximal end of an anvil adjustment band 72. By freely connecting, it must it will be understood that the adjustment strip 72 may not rotate while the adjustment rod 70 rotates; however, the adjustment strip 72 can still be moved along with the stem 70. A distal end of the adjustment strip 72 can also be attached to the trocar 73. Consequently, the axial or translational movement of the adjustment rod 70 relative to the body 10 it can cause the trocar 73 to also move axially or translate in relation to the body 10.
    [00050] With reference to FIGS. 3 and 4, one or both of the adjustment bands of the anvil 72 and the drive band 80 may include flaps 83 and 84, respectively, which are angled or project in the other direction towards the body 10. Flaps 83 and 84 can assist in allowing the strips 72 and 80 to move through the curved rod portion of the body 12 while filling the space and maintaining a suitable axial position therein.
    [00051] Furthermore, with reference to FIGS. 3 and 6, as is known in the art, trocar 73 can be removably attached to anvil 50 by a blade or by spring clamps 55 coupled to the anvil and / or the trocar. In other words, the anvil can be removed from the trocar by pressing, traction or otherwise manipulating the spring-loaded clamps 55. Conversely, the trocar can be attached to the anvil by moving the trocar inside the anvil so that the clamps with spring 55 releasably attach the anvil to the trocar. In this way, the axial movement of the anvil adjustment rod 70 in relation to the body 10 can also move axially or translate the anvil 50 in relation to the body 10. In addition, the anvil may also include a housing 53 coupled to the body of the anvil 52 (see FIG. 3) and a washer 54 which is sheared when firing the cutting element 32, as discussed above. Washer 54 can be made of plastic and can serve as a cutting surface against which the fabric can be cut.
    [00052] Now with reference to FIGS. 3 to 5, the anvil adjustment rod 70 can be configured to be rotated, as explained above, so that the rod 70 translates in relation to the body 10. In more detail and in at least one embodiment, the anvil adjustment rod the anvil 70 may comprise a threaded surface 74 which functionally engages an engaging portion of the body 10, such as a threaded pin 75 attached to the body 10 through a hole in it. The thread surface 74 can be defined by a groove formed in the adjustment rod 70 which is dimensioned and configured to receive at least a portion of the pin 75 therein. The anvil adjustment rod 70 can be rotated around its longitudinal axis L (see FIG. 8) so that the threaded surface 74 contacts and moves over pin 75, thus causing the anvil adjustment rod 70 to move in relation to body 10. Although pin 75 is described in In this embodiment, any other suitable thread coupling portion or component, such as a protrusion, thread and the like, can be used to engage the thread surface in place of, or in addition to, pin 75. In any case, the rotation of the rod adjustment 70 around its longitudinal axis can cause the rod 70 and then the trocar 73 and the anvil 50 to also be axially translational in relation to the body 10 and / or the stapling head 30.
    [00053] As mentioned above, in various embodiments, the adjusting rod 70 can be configured to move the anvil 50 to at least a predetermined distance from the stapling head 30. In more detail, and focusing now on FIG. 8, which shows only the adjustment rod 70, the thread surface 74 of the adjustment rod may include at least an inclined portion and at least a contact portion. For example, the thread surface 74 may comprise a first, angled portion 74a and a second, contact portion or portions 74b. At least one delimiter, such as delimiter 76, can also separate the inclined portion 74a from the contact portion 74b. As will be discussed in more detail below, the inclined portion 74a may allow the adjustment rod to translate with respect to body 10 (see FIG. 4), the contact portion 74b may provide a predetermined distance to maintain the position of the anvil 50 to from the stapling head 30 (see FIG. 2), and the delimiter 76 can provide tactile feedback for a user to rotate the anvil adjustment rod 70 as well as a transition between the ramp and the contact portions. In addition, in at least one embodiment, the inclined portion 74a may be at least partially helical in shape.
    [00054] Continuing, the circle drawn in broken lines in FIG. 8 represents the approximate portion of the anvil adjustment rod 70 which is shown in FIGS. 9 and 10A to 10C. Focusing now on FIG. 9, the inclined portion 74a of the thread surface 74 can lead to at least one contact portion. As illustrated and in at least one embodiment, the thread surface 74 may further comprise three contact portions, the first contact portion 74b ', the second contact portion 74b "and the third contact portion 74b'". Rotating the anvil adjustment rod 70 around its longitudinal axis can cause the thread surface 74 to pass along pin 75 (see FIG. 5) so that the rod 70 translates in relation to the body 10 (again, see FIG. 5). In addition, as the rod 70 is rotated clockwise CW, for example, the thread surface 74 can move along pin 75 so that pin 75 contacts the angled portion and then the first contact portion 74b '. Then, when the stem 70 is rotated again in the CW clockwise direction, the pin can come in contact with the second contact portion 74b ". Consequently, the additional rotation of the stem 70 in the CW clockwise direction can move the pin to contact with the third contact portion 74b '". As will be explained in more detail below, each contact portion may have a different angular configuration compared to the inclined portion 74a.
    [00055] In addition, each contact portion 74b ', 74b "and 74b'" may be in a different longitudinal position along the anvil adjustment rod 70 to provide predetermined staple clamp heights. For example, with reference to FIG. 10A, the first contact portion 74b 'may be at a first distance L1 from a transverse protrusion 77 of the stem assembly. The second contact portion 74b "may be at a second distance L2 from a transverse projection 77 and the third contact portion 74b '" may be at a third distance L3 from a transverse projection 77. Any reference point or plane, including cross protrusion 77 can be used to establish the above distances. In any case, the first distance L1 can be greater than the second distance L2, which can be greater than the third distance L3, or L1> L2> L3. Alternatively, although not shown, the distances can be in other comparative orders, such as L1> L3> L2, L2> L1> L3, L2> L3> L1, L3> L2> L1, or L3> L1> L2. In addition, each of the contact distances L1, L2, and L3 can be uniform with respect to their respective contact portions 74b ', 74b ", and 74b'". In other words, with reference to FIG. 10B, for example, while the inclined portion of the thread surface 74a can tilt at an angle of inclination or helix α less than 90 degrees with respect to the longitudinal axis of the adjustment rod L, each contact portion (for example, 74b " in Figure 10B) can be substantially perpendicular to the longitudinal axis L, or define an angle θ which is approximately 90 degrees with respect to the axis L. Additionally, with reference to Figures 9 and 10A-10C, the contact portions 74b ' , 74b ", 74b '" can otherwise be steps that define distinct and predetermined clamp heights, as discussed below. When measuring the above-mentioned angles in relation to the longitudinal axis L, it should be understood that these measurements can be made in relation to to a plane that is tangential to a portion of the thread surface 74 and the intersection of the plane with the longitudinal axis L, which, for clarity purposes, is shown along the length of the anvil adjustment rod shown in Figures 10A to 10C. For example, with reference to FIG. 10B again, the helix angle α is defined between the tangential plane "TP", which is perpendicular to the plane of the page of FIG. 10B, and the longitudinal axis L.
    [00056] Focusing now on FIGS. 11A to 11C, the stapling head 30 and the anvil 50 are shown in various positions that correlate with the contact portions 74b ', 74b "and 74b'" of the threaded surface of the stem. For example, the staple staple forming heights D1, D2 and D3 can be defined between a staple forming surface 51 of anvil 50 and a staple ejection surface 38 of staple cartridge 33. The first height D1 may be larger than the second height D2, which can be greater than the third distance D3, or D1> D2> D3. Referring collectively to FIGS. 10A to 10C and 11A to 11C, each contact portion 74b ', 74b "and / or 74b'" can allow the anvil 50 to be maintained at the respective clamp formation height D1, D2 and / or D3 while the adjustment rod 70 is being rotated so that a contact portion moves along pin 75 (see FIG. 5). For example, each contact portion 74b ', 74b ", 74b'" can be designed to maintain the position of the anvil during a rod rotation period of about 60 degrees. In other words, an arc that runs along each surface of the contact portion can extend at an angle of approximately 60 degrees.
    [00057] With reference to FIGS. 9 and 10A to 10C, in various embodiments, at least one transition can separate each contact portion 74b ', 74b "and / or 74b'" to thereby allow the anvil adjustment rod 70 to be advanced to another position relative to the pin 75 (see FIG. 5). In at least one embodiment, the transition may comprise another inclined portion and / or a partial helical surface. However, in at least one other embodiment, the transition may also comprise at least one boundary. As can be seen in FIGS. 10A to 10C, a first boundary 76 'can separate an inclined portion of the thread surface 74a from the first contact portion 74b', a second boundary 76 "can separate the first contact portion 74b 'from the second contact portion 74b" and a third delimiter 76 "'can separate the second contact portion 74b" from the third contact portion 74b' ". As mentioned above, each delimiter 76 ', 76" and / or 76' "can provide tactile feedback to a user while the user rotates the anvil adjustment rod.
    [00058] In more detail, referring again to FIGS. 9 and 10A to 10C, each boundary 76 ', 76 "and / or 76'" may comprise a shoulder or protuberance on the thread surface. In other words, the thread surface 74 can define a surface topography that includes the inclined portion 74a and the contact portions 74b ', 74b "and 74b'", and each boundary 76 ', 76 "and / or 76'" can have an interruption in the surface topography, between the aforementioned portions, respectively. Also, with the exception of the 76 ', 76 "and / or 76'" delimiters, the surface topography on any portion of thread surface 74 can be smooth. For example, with reference to FIGS. 5, 9 and 10A to 10C, the inclined portion of the thread surface 74a may include a smooth topography so that the thread surface 74 can move relatively smoothly after pin 75 when the anvil adjustment rod 70 is rotated in relation to the body 10. However, when the pin 75 reaches the end of the inclined portion 74a, the surface topography can be interrupted by the first boundary 76 '. Consequently, when the thread surface 74 is advanced over the pin 75, the adjustment rod 70, which may be extending proximally from the body 10 smoothly when the rod 70 is being rotated, can jump, push or pull from a abrupt or discontinuous mode or otherwise provide tactile retrain information to a user when the first boundary 76 'comes into contact with pin 75, due to an interruption in the surface topography of the thread surface 74 in boundary 76'. The action of the first stop 76 'that passes over the pin 75 can provide a user by rotating the rod 70 with an indication that the first formation height of the discontinuous clamp D1 (see FIG. 11 A) has been reached since the pin 75 is now received in the first contact portion 74b '. The continuous rotation of the rod 70 during the contact period, which, as mentioned above, can be approximately 60 degrees, may not adjust the first formation height of the clamp D1. As a result, the user does not necessarily have to focus on the exact rotational position in which the anvil adjustment rod 70 is located, since the user knows that the first clamping height D1 will not be changed until the rod 70 is further rotated. to place another boundary in contact with pin 75. In addition, the user can rotate the anvil adjustment rod 70 back and forth so that pin 75 is relatively moved along the first contact portion 74b ', between the first delimiter 76 'and the second delimiter 76 ". When the delimiters protrude from the surface of the first contact portion 74b', the user, through the anvil adjustment rod 70, can feel when pin 75 comes into contact with the first or second delimiter 76 ', 76 "at the respective ends of the first contact portion 74b', thus providing confidence to the user that the first formation height of the D1 clamp has been reached.
    [00059] With reference to FIGS. 5, 9, and 10A to 10C, if the user wishes to change the clamp formation height from the first clamp formation height D1 to the second clamp formation height D2 (see FIGS. 11A to 11B), the user it can also rotate the anvil adjustment rod 70 so that the second boundary 76 "contacts the pin 75. When the pin 75 reaches the end of the first contact portion 74b ', the surface topography can be interrupted by second delimiter 76 ". Consequently, when the thread surface 74 advances over pin 75, the adjustment rod 70, which can be rotated smoothly while pin 75 is in contact with the first contact portion 74b ', can jump, push or pull an abrupt or discontinuous mode or otherwise provide a tactile feedback to a user, when the second boundary 76 "comes into contact with pin 75, due to the interruption in the surface topography of the thread surface 74 in boundary 76" ". The action of the second delimiter 76 "that passes over pin 75 can provide a user by rotating the rod 70 with an indication that the second height of formation of the discontinuous clamp D2 (see FIG. 11 A) has been reached since the pin 75 now is received in the second contact portion 74b ". The continuous rotation of the stem 70 during the contact period, which, as mentioned above, can be approximately 60 degrees, may not adjust the second formation height of the D2 clamp. Consequently, the user does not necessarily need to focus on the exact rotational position in which the anvil adjustment rod 70 is located, since the user knows that the second forming height of the D2 clamp will not be changed until the rod 70 is additionally rotated to bring one more stop in contact with pin 75. In addition, the user can rotate the anvil adjustment rod 70 backwards so that pin 75 is moved relatively along with the second contact portion 74b ", between the second delimiter 76 "and the third delimiter 76 '". When the delimiters protrude from the surface of the second contact portion 74b ", the user, through the anvil adjustment rod 70, can feel when pin 75 comes into contact with the second or third delimiter 76 ", 76" 'at the respective ends of the second contact portion 74b ", providing confidence to the user that the second formation height of the D2 clamp has been reached.
    [00060] Similarly, still referring to FIGS. 5, 9, and 10A to 10C, if the user wishes to change the clamp formation height from the second clamp formation height D2 to the third clamp formation height D3 (see FIGS. 11B to 11C), the user it can also rotate the anvil adjustment rod 70 so that the third boundary 76 '"contacts the pin 75. When the pin 75 reaches the end of the second contact portion 74b", the surface topography can be interrupted by the third delimiter 76 '". Consequently, when the thread surface 74 is advanced over pin 75, the adjustment rod 70, which can be rotated smoothly while pin 75 is in contact with the second contact portion 74b" , can jump, push or pull in an abrupt or discontinuous way or otherwise provide a tactile feedback to a user, when the third boundary 76 '"comes into contact with pin 75, due to the interruption in the surface topography of the thread 74 in the delimiter 76 "'. The action of the third delimiter 76 "'that passes over the pin 75 can provide a user by turning the rod 70 an indication that the third height of formation of the discontinuous clamp D3 (see FIG. 11C) has been reached since the pin 75 is now received in the third contact portion 74b '". The continuous rotation of the rod 70 during the contact period, which, as mentioned above, can be approximately 60 degrees, may not adjust the third forming height of the clamp D3. Consequently, the user does not necessarily need to focus on the exact rotational position in which the anvil adjustment rod 70 is located, since the user knows that the third forming height of the D3 clamp will not be changed until the rod 70 is further rotated. to place a stop 78 in contact with the pin 75, thus avoiding additional movement of the pin 75 in relation to the thread surface 74, towards the stop 78. The stop 78 can be a wall formed at the end of the third portion of the delimiter 74b '". In addition, the user can rotate the anvil adjustment rod 70 back and forth so that pin 75 is moved relative to the third contact portion 74b'", between the third boundary 76 '" and stop 78. As the stop and boundary 76 "'protrude from the surface of the third contact portion 74b", the user, through the anvil adjustment rod 70, can feel when pin 75 comes into contact with the third delimi tator 76 '"or stop 78 at the respective ends of the third contact portion 74b'", thus providing confidence to the user that the third formation height of the D3 clamp has been reached.
    [00061] In various modalities, with reference to FIGS. 9 and 15, for example, the thread surface 74 can be closed over the inclined portion 74a and opened over the contact portions 74b ', 74b ", 74b'". In other words, the inclined portion of the threaded surface may include proximal and distal walls whereas the contact portions of the threaded surface may include only proximal walls. In use, pin 75 can be pulled against the contact portions due to the fabric being fixed between the anvil 50 and the stapling head 30 when the anvil 50 is at a suitable staple forming height from the head 30, as discussed above (see FIGS. 11A to 11C).
    [00062] Although at least one embodiment described above shows the delimiters 76 ', 76 "and / or 76'" being formed as protrusions or protuberances on the thread surface 74, the delimiters may also take the form of indentations on the thread surface. In addition, the stoppers can also be on a separate part of the adjustment rod 70 so that they can be attached to it. In any case, the delimiters can provide tactile feedback to the user when the user rotates the rod 70. Furthermore, although a delimiter is shown separating the inclined portion 74a from the first contact portion 74b ', and so on, the thread surface may not include a contact portion or contact portions. In these embodiments, the thread surface may comprise multiple inclined portions separated, at desired intervals, by at least one delimiter. Consequently, a user can be informed, through tactile feedback, when an adequate staple forming height between the anvil 50 and the staple cartridge 33 (see, for example, FIG. 11A) has been obtained.
    [00063] In addition to tactile feedback, surgical stapler 1 can include visual reference signals to provide the user with an indication of when the aforementioned staple formation height (s) has been / has been reached ( s). For example, now with reference to FIGS. 12 to 13, the anvil adjustment rod 70 may include a reference sign 85 stamped or formed on the surface of the rod which, through a marking 86 on the body 10, provides an indication of when a discontinuous staple height has been reached, such as D1, D2, D3 (see FIGS. 11A to 110). In at least one embodiment, the respective staple forming heights can be 2.5 mm, 1.8 mm and 1.0 mm, and the reference signal 85 can indicate the same. In any case, the incorporation of visual reference signs, delimiters and / or contact portions, as discussed above, in the anvil adjustment rod 70 can eliminate the need for a clamp height indicator mechanism separate from the rod.
    [00064] Additionally, although at least one embodiment described above has illustrated the surface of the thread 74 as defined by a channel formed on the anvil adjustment rod 70, the surface of the thread can, in at least one embodiment, be alternatively defined by a thread protruding from the anvil adjustment rod 70. In these embodiments, pin 75 can be used or another thread coupling component can be used to engage the surface of the thread, such as a fork projected from inside the body 10.
    [00065] Furthermore, although the thread surface 74 discussed above is described as being a part of the anvil adjustment rod 70, it is understood that that thread surface could alternatively be a body part 10. In these embodiments, the portion coupling, such as a pin or other thread interconnect component, could be similarly attached to the adjustment rod 70 instead of the body 10. In any case, the rotation of the rod 70 can cause a thread surface to rotate in with respect to an engagement portion so that the rod 70 and, therefore, the anvil 50 translate in relation to the body 10 and / or stapling head 30.
    [00066] In various modalities, as mentioned above and with reference to FIG. 5, before the anvil 50 is at an adequate distance from the staple cartridge 33, the trigger 90 can cooperate with the adjustment rod 70 to prevent the trigger 90 from moving substantially towards the body 10 or otherwise causing the clip actuators 34 and / or cutting element 32 are activated, thus avoiding the unintentional firing of the surgical stapler 1. In other words, the actuator can include a lock. For example, in at least one embodiment and with reference to FIG. 8, the actuating rod 70 may comprise the first proximal portion 70a defining a first width W1, and the second distal portion 70b defining a second width W2. Additionally, with reference to FIG. 14, trigger 90 may comprise locking rod 95 extending from lever 92, rod 95 defining an aperture 97 having a size S. The locking rod may look like a fork with two teeth or a fork. In any case, the size S of the opening 97 may be smaller than the first width W1 of the proximal portion 70a, but the size S of the opening 97 can be greater than or equal to the second width W2 of the distal portion 70b, or W1> S> W2.
    [00067] Now with reference to FIG. 15, the locking rod 95 can be positioned through an opening in the body 14 so that the rod 95 is intended to engage both the proximal portion of the rod 70a and the distal portion of the rod 70b. If the locking rod 95 is positioned longitudinally over the proximal portion 70a, the trigger lever 92 can be prevented from moving substantially towards the body 10 due to interference between the locking rod 95 and the proximal portion of the rod 70a. In other words, because the width of the proximal portion W1 (see FIG. 8) is greater than the dimension S of the opening of the locking rod 97 (see FIG. 14), the trigger lever 92 can be prevented from causing the drive range 80 is activated, as described above, thus avoiding inadvertent triggering of clamps 31 and / or cutting element 32 (see FIG. 3). However, if the locking rod 95 is positioned longitudinally over the distal portion 70b, the trigger lever 92 can be allowed to move substantially towards the body 10 due to a lack of interference between the locking rod 95 and the distal portion of the rod 70b. In other words, because the width of the distal portion W2 (see FIG. 8) is less than or equal to the size S of the opening of the locking rod 97 (see FIG. 14), the trigger lever 92 can be allowed to move and cause the drive band 80 to be activated, as described above, thus triggering clamps 31 and / or the cutting element 32 (see FIG. 3). In these embodiments, the opening 97 can receive the distal portion of the rod 70b and allow the lever 92 to move towards the body 10 until the distal portion 70b reaches the end of the opening 97.
    [00068] Furthermore, with reference to FIG. 15, the distal portion of the shank 70b can be positioned along the anvil adjustment shank 70 so that the distal portion 70b correlates with a suitable clamp height. For example, the distal portion 70b may be positioned axially along the stem 70 so that the locking rod 95 is positioned longitudinally over the distal portion 70b when pin 75 is received in a contact portion, as the first contact portion. 74b '. Consequently, the locking rod 95 can only allow the clip driver 34 and / or cutting element 32 (see FIG. 3) to be triggered when a desired clip formation height is reached, without the need for a lever or mechanism locking mechanism separate from trigger 90. Furthermore, with reference to FIG. 14, locking rod 95 can be unitary and integrally formed from the same piece of material as spring for driver 91. However, in at least one embodiment, locking rod 95, spring for driver 91, and lever 92 can be unitary and integrally formed from the same piece of material.
    [00069] In several modalities, and as mentioned above, the surgical stapler can be straight instead of curved, as described above. Consequently, now with reference to FIG. 16, a surgical stapler 101 is shown. Surgical stapler 101 may include a body 110, a stapling head 130, an anvil 150, an anvil adjustment rod 170, and a trigger 190, similar to that described above. However, the stem portion 112 of the body 110 can be straight. In addition, stapling head 130 and anvil 150 can be linear and project axially away from body 110. It should be noted that, referring to surgical staplers 1 and 101 shown in FIGS. 1 and 16, respectively, because each stapling head 30, 130 can be removed from the body of the surgical stapler 10, 110 as discussed above, stapling heads 30,130 and anvils 50,150 can be interchangeable with each other, for example . In addition, other configurations of stapling heads and anvils can be employed in addition to the heads described above 30, 130 and anvils 50, 150.
    [00070] Also, now with reference to FIG. 17, the anvil adjustment rod 170 and trocar 173 can be unitary and integrally formed from the same piece of material. In this way, the distal portion of the stem 170b can protrude from the proximal portion 170a and be in a borderline position when using the trocar 173. Additionally, with reference to FIG. 18, a trigger bar 180 is shown. The trigger bar can allow the trigger 190 to move (see FIG. 16) to activate the trigger bar 180 towards the stapling head 130 to eject staples and / or activate an element cutting (not shown). Briefly, the actuation bar can be elongated and is generally tubular in shape and includes proximal actuation surfaces 181 and distal actuation surfaces 182. With reference to FIGS. 16 and 18, the proximal driving surfaces 181 can be configured to receive trigger movements of the trigger 190 and the distal driving surfaces 182 can be configured to engage clamp actuators and / or a cutting element (not shown) within the head Staple 130, as described above. In addition, the drive bar 180 can also include a passage 187 adapted to receive an adjustment rod of the anvil 170 (see FIG. 17) therethrough. In at least one embodiment, the stapler 101 may not include a cutting element and may function primarily for stapling or sealing, but does not perform tissue transection.
    [00071] It should be understood that the straight stapler 101 and the curved stapler 1, discussed above (see FIGS. 16 and 1, respectively) may contain significantly fewer components than similar current surgical staplers available on the market. For example, referring to the straight surgical stapler 101, and in particular the anvil adjustment rod, the combination of a button 179, with a screw cap or a screw surface 174, and a trocar 173 in an integral component, an anvil adjustment rod 170 reduces the number of pieces of a surgical stapler. The further reduction in the number of components can be achieved by combining an inclined portion 174a with a contact portion 174b on the thread surface 174. As discussed above, the inclined portion of the thread surface 174a can allow axial movement of the stem's initial stroke 170 in relation to body 110, and the contact portion (s) 174b can (m) establish at least one predetermined, discontinuous staple height between the anvil 150 and the stapling head 130. As As a whole, ignoring the anvil and stapling head components, the surgical stapler 101 can include only seven components compared to more than thirty in current devices. With reference to FIGS. 16 to 18, the seven components may include the body 110, the trigger 190, a hinge pin 193 pivotally coupling the trigger 190 to the body 110, a spring of the trigger 191 integrally formed with a locking rod 195, the locking rod adjustment of the anvil 170, a thread pin (not shown, see thread pin 75 seen in FIG. 3, for example) functionally interconnecting the thread surface of the stem 174, and the actuation bar 180. Additionally, the number of parts can be reduced even further. For example, hinge pin 193 can be eliminated by combining a hinge holder or flexible tab, for example, within trigger 190 itself. In addition, spring 191 and locking rod 195 can also be integrally formed with trigger 190. The thread pin (not shown) can also be eliminated by incorporating a protrusion that extends from an internal surface of the body 110 so that the thread protrusion can engage the surface of the thread 174. In any case, the aforementioned components of the surgical stapler 101 can provide functionality similar to those described above. This simplified stapler architecture that uses only a few manufacturing techniques can be widely applicable, and should be suitable for a multipurpose, sterilizable device that costs significantly less and requires less manufacturing time than similar surgical staplers currently available. Consequently, in at least one embodiment, a reusable stapler can be provided, which includes the aforementioned components, minus the anvil and stapling head parts. In addition, in at least one embodiment, the anvil and / or the stapling head, including a staple cartridge, can also be disposable.
    [00072] In at least one example experiment, the aforementioned decrease in the number of parts was accomplished by comparing each component to a list of parts criteria to see if that part was necessary. The only remaining ones were those mentioned above and necessary for assembly reasons, or because they had unique material properties or that moved in relation to other parts in the stapler.
    [00073] In various embodiments, a staple head assembly can be configured to include a locking element so that during insertion into a portion of a surgical stapler, the staple actuators are prevented or there is resistance to triggering or triggering accidental stapling from a staple cartridge. In more detail, now with reference to FIGS. 19 to 20, a staple head assembly 230 can generally be similar to the staple head 30 and / or 130 described above, so that the staple head assembly 230 can be used as a component of surgical stapler 1 and / or 101, for example. In other words, the stapling head assembly 230 can be inserted into the rod 12 or 112 as discussed above with respect to the stapling heads 30 and 130, respectively.
    [00074] Thus, in more detail, the stapling head assembly 230 may comprise a staple cartridge 233 for holding one or more surgical staples (not shown; however, see staples 31 in FIG. 7B, for example), a core 235 movable relative to the staple cartridge 233, at least one staple driver 234 extending from the core 235, and a compartment 239 configured to contain at least partially the staple cartridge 233 and to receive the core movably 235 and the staple actuators 234. As discussed above, the staple actuators 234 can interconnect and drive the staple cartridge staples.
    [00075] With reference to FIG. 21, in at least one embodiment, the clip drivers 234 and the core 235 can be connected and / or integrally formed. For example, staple actuators 234 can be functionally coupled to core 235, and each of which can be made of the same material, such as a plastic material, for example. If projecting from the core, there may be flaps 236 that can be configured to interconnect a drive range 80 or drive bar 180 (see FIGS. 4 and 18, respectively). In any case, as well as with the stapling head 30, discussed above, for example, the actuation of the actuation band 80 or actuator 180 can cause the core 235 and, in this way, the staple actuators 234 to fire triggering or ejecting thus the staples of the staple cartridge 233.
    [00076] As shown in FIG. 20, in at least one embodiment, the housing 239 may additionally comprise at least one retaining element 237 which is configured to deflect resiliently and / or flexibly and allow the stapling head 30 to be releasably attached to the stem portion of the body 12 in corresponding holes 15 (see FIG. 3) formed there, for example. Each retaining element 237 may additionally comprise a release button, as shown in FIGS. 19 and 20, for example. Consequently, when inserted into the stem portion 12 of the stapler body 10 (FIG. 3), the staple head assembly 230 (FIG. 19) can be removed by pressing the respective buttons on the retaining elements 237, and then rotating the head 30 so that the flaps 36 are released from the indentations formed by the distal drive surfaces 82 of the drive band 80, and finally pull the staple head assembly 230 away from the body 10.
    [00077] As discussed in more detail below, the retaining elements 237 can be configured to move from a first position to a second position when sufficient external force is applied to the retaining element, such as that provided by the stem portion 12 of a surgical stapler 1 (see FIG. 4) when inserting the stapling head assembly into the nail. The first position can be a non-depressed position and the second position can be a depressed position in which the retaining elements 237 may or may not be in contact with the core 235. When the retaining elements 237 are in the second position, the actuators of staples 234 can be prevented from driving or ejecting staples from staple cartridge 233, thereby providing a trigger locking element for staple head assembly 230 during insertion of it into at least a portion of a surgical stapler.
    [00078] In at least one embodiment, to provide additional locking capacity to the staple head assembly 230, the core 235 may additionally comprise a recess 240 dimensioned and configured to receive the retaining elements 237 when the retaining elements 237 are in second position. For example, with reference to FIG. 21, the recess 240 can be provided on the surface of the core 235 and the recess 240 can be defined between the two side walls 241 and 242, for example. In such embodiments, the core 235 and, subsequently, the clip drivers 234, can be prevented from moving in relation to the housing 239 (see FIG. 19) when the retaining elements 237 are lowered into the recess 240 due, at least in partly due to physical interference between the lowered retaining elements 237 and the side walls 241, 242, and / or due, at least in part, to friction between the lowered retaining elements 237 and the surface (s) of core 235.
    [00079] As noted above, in various embodiments, the retaining elements 237 can be resiliently deflectable. In other words, the retaining elements 237 can be configured to deflect resiliently so that after deflection caused by external forces, they can bounce back or otherwise return to their original positions. In more detail, the retaining elements 237 may each comprise a fixed cannon arm formed in the housing 239. In such embodiments, with reference to FIG. 19, the cantilevered retaining element can be curved around a longitudinal axis "L" defined by compartment 235 to correlate with the curvature of a tubular body 10 of a surgical stapler 1 (see FIG. 4), for example . In other words, the retaining elements 237 can be curved or radially wrapped around the cartridge compartment, as shown in FIG. 19. Alternatively, although not shown, the retaining elements may be linear or may extend in a direction that is parallel to the longitudinal axis L defined by housing 239.
    [00080] In at least one embodiment, the retaining elements 237 can be unitary and integrally formed with the housing 239 so that the housing 239 and the retaining elements 237 are formed and / or molded from the same piece of material. In such embodiments, compartment 239 can be produced from a plastic material, such as nylon, polycarbonate, polyether imide (PEI) or polyether ether ketone (PEEK), for example. In addition, in at least one embodiment, the core can be produced from a plastic material, such as nylon, polycarbonate, polyether imide (PEI) or polyether ether ketone (PEEK), for example.
    [00081] In at least one embodiment, the operation of the retaining elements 237 that interact with the core 235 and / or the recess 240 can be understood with reference to FIGS. 22 to 24. FIG. 22 illustrates a portion of the staple head assembly 230 being initially inserted into the stem portion 12 of the circular body of the stapler 10. The body 10 is shown in dashed lines to better illustrate the portion of the staple head assembly 230 that is positioned within the stapler body. As can be seen, the retaining elements 237, which may each include an inclined surface 243, are still in an undeflected first or first position just before the stem portion 12 makes contact with the inclined surface 243 of the retention 237. Additional displacement of the staple head assembly in the proximal direction "PD" can cause the stem portion 12 to come into contact and thus begin to deflect the retaining elements 237 inwardly towards the core 235. FIG . 23 illustrates the staple head assembly 230 being additionally inserted into the circular body of the stapler. As can be seen, the retaining elements 237 are being held in a depressed or second position by the inner walls of the circular body 10. In the depressed or second position, the retaining elements 237 can be received within the recess 240 ( see FIG. 21) to prevent core 235 from moving in a distal "DD" direction. In addition, the retaining elements 237 can be prevented from moving significantly in the distal direction DD by the side wall of the recess 241, for example. Moving the stapling head assembly further in the proximal direction PD (see FIG. 22) and then aligning the release buttons on the retaining elements 237 with the holes 15 on the body 10 can allow the retaining elements to return resiliently to a position non-depressed so that the retaining elements 237 not only hold the stapling head assembly 230 in the body of the circular stapler 10, but also release the recess 240 and / or the side walls 241, 242 to allow the core 235 and the staple actuators 234 are activated and trigger staples on staple cartridge 233 (see FIG. 19). For example, FIG. 24 illustrates the staple head assembly 230 fully inserted into the body of the circular stapler 10 with the retaining elements 237 in such a non-depressed position and located at least partially within holes 15. Additionally, as shown in FIG. 24, the flaps of the core 236 are received in notches of the driving range 80 to receive activation movements from them, similarly to what was discussed above with respect to the stapling head 30 (see FIG. 4), by example.
    [00082] Other styles of stapling head assemblies may include several elements discussed above. For example, in at least one embodiment and with reference to FIGS. 25 and 26, a staple head assembly 330 can generally be radially symmetrical about a longitudinal axis "L". However, in such embodiments, the staple head assembly 330 may be similar in other respects to the staple head assembly 230 and / or the staple head 30 described above, for example. For example, the staple head assembly 330 may comprise a staple cartridge 333 to hold one or more surgical staples, a core 335 movable relative to the staple cartridge 333, at least one staple driver 334 extending to from the core 335, and a compartment 339 configured to contain at least partially the staple cartridge 333 and movably receive the core 335 and at least one staple driver 334. The staple drivers 334 can be configured to interconnect and drive the staples of the staple cartridge 333. Additionally, the compartment may additionally comprise at least one retaining element 337 which is configured to move from a first position to a second position when sufficient external force is applied to the retaining element 337. In addition the retaining elements 337 are in the second position, the at least one staple driver can be prevented from driving the staples from the cartridge of staples. In at least one embodiment, the core may additionally comprise a recoil 340 sized and configured to receive the retaining elements 337 when the retaining elements 337 are in the second position. In addition, unlike stapling head assembly 230, assembly 330 may additionally comprise cutting element 332 functionally coupled to core 335. Consequently, when the retaining elements are in a depressed position so that core 335 is prevented from moving in relation to compartment 339, the cutting element 332 and / or the clip drivers 334 can be prevented from moving also in relation to the compartment 339, thus avoiding accidental firing of the cutting element 332 and / or the clips of the cartridge staples 333. Additionally, core 335 may include flaps 336 that project laterally from it to functionally interconnect a drive band or drive bar from a surgical stapler, as discussed above, with respect to staple head assemblies 30, 130, and / or 230. In yet other alternative modalities, the compartment can be configured to operably support one or more surgical staples. In such alternative embodiments, there is no separate staple cartridge necessary to operably support surgical staples. Instead, the compartment is configured to hold the clips so that upon contact with the clip drivers, the clips are directed out of the compartment.
    [00083] Although the modalities have been described, it will be evident, however, that several modifications, alterations and adaptations to these modalities can occur to those skilled in the art, from obtaining a part or all of the various modalities. For example, according to several modalities, a single component or step can be replaced by multiple components or steps, and multiple components or steps can be replaced by a single component or step, to perform a certain function or functions or achieve a certain objective . In addition, the various components described above can be produced from a variety of materials. For example, components can be produced from any combination of metal, plastic and / or biocompatible material. In addition, various components, such as the driver, the drive range and the anvil adjustment range, can be produced and curved or bent from a sheet metal. This request is therefore intended to cover all these modifications, alterations and adaptations, without departing from the scope and spirit of the achievements.
    [00084] 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 devices can be reconditioned for reuse after at least one use. Reconditioning may include a combination of steps to disassemble the device, followed by cleaning or replacing specific parts, and subsequent refitting. In particular, the devices can be disassembled, and any specific number of parts or parts of them can be selectively replaced or removed in any combination. By cleaning and / or replacing particular parts, the devices 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 note that the reconditioning of a device can use a variety of different 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.
    [00085] The devices described here can 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.
    [00086] Any patent, application, or other descriptive material, in whole or in part, that is cited as incorporated herein by reference, is incorporated only to the extent that the incorporated material does not conflict with existing definitions and statements, or with any other descriptive material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein replaces any conflicting material incorporated herein by way of reference. Any material, or portion thereof, that is deemed to be incorporated by reference in the present invention, but which conflicts with definitions, statements, or other description materials existing herein will be incorporated here only to the extent that no conflict appears between the embedded material and the existing description material.
    权利要求:
    Claims (11)
    [0001]
    1. Releasable surgical stapling head assembly (230, 330), comprising a compartment (239, 339) configured to hold one or more surgical staples in it, a core (235, 335) and at least one staple driver (234 , 334) received movably in the compartment (239, 339), with the at least one staple driver (234, 334) extending from the core (235, 335), the compartment (239, 339) having additionally at least one retaining element (237, 337) which is configured to releasably fix the stapling head assembly (230, 330) to a stem portion (12) of a surgical stapler (1). characterized by the fact that the at least one retaining element (237, 337) is still configured to move from a first position to a second position when sufficient external force is applied to the retaining element (237, 337) by the rod portion (12) of the surgical stapler (1) during insertion of the stapling head assembly (230, 330) into the stem portion (12), where the at least one retaining element (237, 337) is further configured to move from the second position to the first position when the external force is no longer applied to the retaining element (237, 337) by the rod portion (12) of the surgical stapler (1) after insertion of the stapling head assembly (230, 330 ) in the stem portion (12), and where when the at least one retaining element (237, 337) is in the second position, the at least one clamp driver (234, 334) is prevented from driving the compartment clamps (239, 339), thus providing a trigger lockout feature during t the insertion of the stapling head assembly (230, 330) in the stem portion (12).
    [0002]
    2. Surgical stapling head assembly (230, 330), according to claim 1, characterized by the fact that the core (235, 335) additionally comprises a recess (240, 340) dimensioned and configured to receive the at least one retaining element (237, 337) when the at least one retaining element (237, 337) is in the second position.
    [0003]
    3. Surgical stapling head assembly (230, 330) according to claim 1, characterized in that the retaining element (237, 337) is resiliently deflectable.
    [0004]
    4. Surgical stapling head assembly (230, 330) according to claim 3, characterized in that the retaining element (237, 337) comprises a fixed cantilevered arm.
    [0005]
    5. Surgical stapling head assembly (230, 330), according to claim 3, characterized by the fact that the cantilevered arm is curved around a longitudinal axis defined by the compartment (239, 339).
    [0006]
    6. Surgical stapling head assembly (230, 330) according to claim 3, characterized by the fact that the cantilevered arm extends in a direction that is parallel to a longitudinal axis defined by the compartment (239, 339 ).
    [0007]
    7. Surgical stapling head assembly (230, 330), according to claim 3, characterized by the fact that the retaining element (237, 337) is unitary and integrally formed with the compartment (239, 339).
    [0008]
    8. Surgical stapling head assembly (230, 330), according to claim 1, characterized by the fact that the one or more surgical staples are held in a staple cartridge (233, 333) supported in the compartment (239, 339).
    [0009]
    9. Surgical stapling head assembly (230, 330), according to claim 1, characterized by the fact that the core (235, 335) does not include a cutting element functionally coupled to it.
    [0010]
    10. Surgical stapling head assembly (330), according to claim 1, characterized by the fact that it also comprises a cutting element (332) functionally coupled to the core (335).
    [0011]
    11. Surgical stapler (1) characterized by the fact that it comprises: a body (10) comprising: a portion of cable (11); and rod portion (12) extending from the cable portion (11); a stapling head assembly (230, 330) as defined in any one of claims 1 to 10, releasably coupled to the stem portion (12); a drive system for applying movements to at least one staple driver (234, 334); an anvil held mobile in relation to the compartment (239, 339) for axial movement towards and away from the compartment (239, 339); and, an anvil adjustment set to selectively adjust an axial position of the anvil with respect to the housing (239, 339).
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    法律状态:
    2018-12-26| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-09-10| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-07-21| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2020-11-17| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 09/09/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US12/878,065|2010-09-09|
    US12/878,065|US8360296B2|2010-09-09|2010-09-09|Surgical stapling head assembly with firing lockout for a surgical stapler|
    PCT/US2011/050909|WO2012033960A2|2010-09-09|2011-09-09|Surgical stapling head assembly with firing lockout for a surgical stapler|
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