• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    CLAMP CARTRIDGE. The present invention relates to a staple cartridge which may comprise a plurality of staples positioned within a cartridge body, wherein the cartridge body may comprise a fabric contact deck and a plurality of ridges extending to from the fabric contact deck. The ridges can be configured to prevent or reduce the possibility of the fabric moving in relation to the staple cartridge during use. The staple cartridge can additionally comprise a plurality of staple cavities, wherein each staple cavity can comprise an opening in the deck that is at least partially surrounded by a ridge. The ridges can comprise a uniform height or a height that varies along their length. The height can vary with respect to a proximal end and a distal end of the cartridge body and / or between the center and the side of the cartridge body.
    公开号:BR112013007613B1
    申请号:R112013007613-5
    申请日:2011-09-23
    公开日:2021-02-09
    发明作者:Thomas W. Huitema；Douglas J. Siebenaler
    申请人:Ethicon Endo-Surgery Inc.；
    IPC主号:
    专利说明:

    i. Technical Field
    [001] The present invention relates to stapling instruments and, in various modalities, to a surgical stapling instrument to produce one or more rows of staples. Background of the Related Art
    [002] A stapling instrument can include a pair of elongated cooperating clamping elements, each clamping element being adapted to be inserted into a patient and positioned in relation to the tissue that will be stapled and / or cut. In various embodiments, one of the claw elements can hold a staple cartridge with at least two rows of staples spaced laterally and contained therein, and the other claw element can hold an anvil with staple-forming pockets aligned with the rows of staples in the staple cartridge. In general, the stapling instrument may additionally include a propeller bar and a knife blade which are slidable with respect to the claw element to sequentially eject the staple cartridge clips through cam surfaces on the drive bar and / or surfaces of cam over a wedge rail that is pushed by the propellant bar. In at least one embodiment, the cam surfaces can be configured to activate a plurality of cartridge-loaded clamp actuators and associated with the clamps in order to push the clamps against the anvil and form spaced sideways rows of deformed clamps on the attached tissue between the claw elements. In at least one embodiment, the knife blade can follow the cam surfaces and cut the fabric along a line between the staple rows. Examples of such stapling instruments are provided in US Patent No. 7,794,475, entitled "SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME", the entire description of which is incorporated herein, by way of title of reference.
    [003] The aforementioned discussion is only intended to illustrate various aspects of the related technique in the field of the invention at the moment, and should not be taken as a denial of the scope of the claims. SUMMARY
    [004] In at least one form, a staple cartridge can comprise a plurality of staples and a cartridge body. The cartridge body may comprise a deck of contact with the fabric, a plurality of staple cavities, each staple cavity comprising an opening in the deck, and a staple being positioned in each staple cavity. The cartridge body may further comprise a plurality of ridges extending from the fabric contact deck, each opening being at least partially surrounded by a ridge.
    [005] In at least one form, a staple cartridge can comprise a plurality of staples and a cartridge body. The cartridge body may comprise a medium portion, a side portion, a fabric contact deck, a plurality of staple cavities, with a staple being positioned in each staple cavity, and a plurality of ridges extending to from the contact deck with fabric, each crest extending between the middle portion and the lateral portion of the cartridge body.
    [006] In at least one form, a staple cartridge can comprise a plurality of staples and a cartridge body. The cartridge body may comprise a proximal end, a distal end, a fabric contact deck, a plurality of staple cavities, a staple being positioned in each staple cavity, and a plurality of ridges extending to from the contact deck with tissue, each crest comprising a height that varies between a proximal height and a distal height, and the proximal height is closer to the proximal end than the distal height.
    [007] The previously mentioned discussion should not be considered as a contradiction of the scope of the claim. BRIEF DESCRIPTION OF THE DRAWINGS
    [008] Several characteristics of the modalities described here are demonstrated with particularity in the appended claims. The various modalities, however, with regard to both the organization and the methods of operation, together with their advantages, can be better understood according to the description presented below taken in conjunction with the attached drawings, as shown.
    [009] Figure 1 is an elevation view of a surgical stapling instrument.
    [0010] Figure 2 is a cross-sectional view of an end actuator of the surgical stapling instrument in figure 1 along line 2-2 in figure 1.
    [0011] Figure 3 is a perspective and cross-sectional view of the end actuator of figure 1.
    [0012] Figure 4 is a cross-sectional view of the end actuator of figure 1, which illustrates the clamps contained therein in an unstressed configuration.
    [0013] Figure 5 is a diagram that illustrates the clamps in Figure 4 in a triggered configuration.
    [0014] Figure 6 is a diagram illustrating the end actuator of figure 1 being used to staple and cut through the fabric.
    [0015] Figure 7 is a perspective view of a staple cartridge according to at least one embodiment comprising a plurality of ridges extending from a cartridge body.
    [0016] Figure 8 is a detail view of the staple cartridge in figure 7.
    [0017] Figure 8A is a cross-sectional view of the staple cartridge in figure 7.
    [0018] Figure 9 is a view in detail that illustrates staples positioned inside the staple cavities defined in the staple cartridge of figure 7.
    [0019] Figure 10 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of transverse ridges extending from a cartridge body.
    [0020] Figure 11 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of transverse ridges extending from a cartridge body.
    [0021] Figure 12 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of ridges that surround the proximal and distal ends of the staple cavity openings defined in a cartridge body .
    [0022] Figure 13 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of ridges that surround the proximal and distal ends of the staple cavity openings defined in a cartridge body .
    [0023] Figure 14 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of toothed ridges extending from a cartridge body.
    [0024] Figure 15 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of toothed ridges extending from a cartridge body.
    [0025] Figure 15A is a perspective view of a pyramidal tooth according to at least one modality.
    [0026] Figure 15B is a perspective view of a fronto-tooth according to at least one modality.
    [0027] Figure 15C is a perspective view of a triangular tooth according to at least one modality.
    [0028] Figure 16 is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of ridges that entirely surround the openings of the staple cavities defined in a cartridge body.
    [0029] Figure 16A is a partial perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of ridges that completely surround the openings of the staple cavities defined in a cartridge body.
    [0030] Figure 17 is a perspective view of a staple cartridge according to at least one alternative embodiment comprising a plurality of longitudinal ridges extending from a cartridge body.
    [0031] Figure 18 is a detail view of the staple cartridge in figure 17.
    [0032] The corresponding reference characters indicate the corresponding parts through the various views. The exemplifications described herein illustrate various 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
    [0033] Numerous specific details are presented to provide a complete understanding of the structure as a whole, function, manufacture and use of the modalities as described in the specification and illustrated in the attached drawings. It will be understood by those skilled in the art, however, that the modalities can be practiced without these specific details. In other instances, operations, components, and well-known elements have been described in detail so as not to obscure the modalities described in the specification. Those skilled in the art will understand that the modalities described and illustrated in the present invention are non-limiting examples and, therefore, it can be understood that the specific structural and functional details presented in the present invention can be representative and illustrative. Variations and changes can be made to this, without departing from the scope of the claims.
    [0034] The reference from the beginning to the end of the specification of "various modalities", "some modalities", "a modality", or "the modality", or similar, means that an attribute, structure, or characteristic described together with the modality is included in at least one modality. Therefore, the appearance of the phrases "in various modalities", "in some modalities," "in one modality," or "in the modality", or similar, in places from beginning to end of the specification are not necessarily all referring to the same modality. In addition, the particular attributes, structures, or characteristics can be combined in any suitable way in one or more modalities. Therefore, the particular attributes, structures, or characteristics illustrated or described in conjunction with a modality can be combined, in whole or in part, with the structures of the attributes, or characteristics of one or more other modalities without limitation. In addition, it should be considered that for accuracy and clarity, spatial terms such as "vertical", "horizontal", "up" and "down", for example, can be used in the present invention with respect to the illustrated modalities. However, these terms are used to assist the reader and are not intended to be limiting and absolute.
    [0035] Returning to figure 1, a stapling and cutting surgical instrument 10 can include a portion of cable 12 that can be manipulated in order to position an implement portion 14 in a surgical location. In various embodiments, the implement portion 14 can include an end actuator 16 attached to an elongated stem 18. In various circumstances, the implement portion 14 can be sized and configured to be inserted through a trocar cannula (not shown) ) into the surgical site to perform an endoscopic or laparoscopic procedure, for example. The end actuator 16 may comprise an upper jaw, or anvil 20 and a lower jaw 22, the anvil 20 being able to be moved between an open position and a closed position when the closing trigger 24 of the cable portion 12 is moved, or pressed in the direction of the pistol grip 26 of the cable portion 12. In various embodiments, the pressure of the closing trigger 24 can advance an outer closing cylindrical socket 28 of the elongated rod 18 while the outer closing cylindrical socket 28 can contact anvil 20 and pivot anvil 20 to its closed position. In certain circumstances, the surgeon can rotate the implement portion 14 on its longitudinal axis by twisting the rod rotation knob 30. In any event, when the end actuator 16 has been inserted into an inflated body cavity, for example, the closing trigger 24 can be released, thus allowing the anvil 20 to be pulled open by a spring (not shown) and positioned in relation to the intended tissue. In various embodiments, the closing trigger 24 can be locked in its pressed condition and, in at least one embodiment, the cable portion 12 may additionally comprise a lock release actuator 44 that can be pressed to unlock the closing trigger 24 When the bi-gorn 20 and the lower jaw 22 have been properly positioned in relation to the tissue in a surgical location, the closing trigger 24 can be pressed again to close the anvil 20 and compress the tissue against the cartridge of clamps 42 attached to the lower jaw 22.
    [0036] When the anvil 20 has been closed, a trigger trigger 32 can be extracted, or pressed, towards the closing trigger 24 and the pistol grip 26 in order to apply a force or trigger movement to one of element trigger and advance the trigger element from an un triggered position. In various embodiments, the firing element may comprise a proximal fastening discharge rod 34 which is attached to a distal firing bar 36. In at least one of these modalities, the fastening discharge rod 34 and / or the firing 36 can be supported within a frame 38 on a rod 18 which can extend between the cable portion 12 and the end actuator 16. As a result of the firing motion applied to the firing element, the firing bar 36 can be distally advanced inside an elongated staple cartridge channel 40 of the lower jaw 22 and a staple cartridge 42 positioned inside the cartridge channel 40. In various embodiments, with reference to figure 2, the firing bar 36 it can comprise a fixing portion 48 that is fixed to an electronic beam 50 that can translate within the end actuator 16. The electronic beam 50 can comprise a vertical portion 52 that can pass through a phen of the longitudinal and narrow anvil 58 extending across a fabric contact surface 60 on the anvil 20, a narrow vertical slot 62 in the staple cartridge 42, and a slot in the longitudinal and narrow channel 64 in the elongated staple channel 40 when the electronic beam 50 is advanced distally. Now with reference to figures 2 and 3, the anvil slot 58 can extend upward and into the anvil 20 and can comprise an end that opens into a laterally expanded longitudinal channel 66, dimensioned and configured to receive an upper pin 54 extending laterally from vertical portion 52. Similarly, the slot of channel 64 can extend downwardly and into channel 40 and can comprise an end that opens into a laterally expanded longitudinal channel 68, dimensioned and configured to receive one or more lower feet 70 extending laterally from the vertical portion 52.
    [0037] In various embodiments, in addition to the above, the electronic beam 50 may additionally comprise one or more middle pins 72 which can extend laterally from the vertical portion 52 and which can be configured to slide along a top surface of a lower tray 74 of the staple cartridge 42. In certain embodiments, the middle pins 72 can be configured to seat the staple cartridge 42, or to ensure that the staple cartridge 42 remains seated, in channel 40. A longitudinal firing recess 75 formed in the staple cartridge 42 above the lower tray 74 is sized to allow the middle pins 72 to translate through the staple cartridge 42. In various embodiments, the electronic beam 50 can additionally comprise a distal drive surface 76 that can be configured to move through the vertical slot 62 in the staple cartridge 42 and guide a wedge rail 78 distally through the staple cartridge 42. In certain embodiments, the wedge rail 78 can be integrally formed within the electronic beam 50 while, in other embodiments, the wedge rail 78 can reside in the staple cartridge 42 and can be contacted via the drive surface 76 to the as the electronic beam 50 is advanced distally. The vertical portion 52 of the electronic beam 50 may further comprise a cutting surface 80 that extends along a distal edge above the distal drive surface 76 and below the upper pin 54 that separates the fixed fabric 46 as the fabric 46 is being tapped. Now with reference to figure 4, the wedge rail 78 can be configured to couple one or more staple actuators 82 and drive the staple actuators 82 upwards towards the anvil 20. In various embodiments, the staples, such as the staples 83 , for example, can be seated on and / or otherwise supported by the clamp actuators 82 so that, as the clamp actuators 82 are lifted upwards, the clamps 83 can also be lifted upwards. In at least one of these embodiments, staples 83 may also be at least partially positioned inside the cavities, or pockets, of staple 84 in a staple cartridge body 85 of staple cartridge 42, as, as staples 83 are lifted upwards, staples 83 can come into contact with anvil 20 and can be ejected from the staple cavities 84. In at least one embodiment, again with reference to figure 4, the lower tray 74 can be fixed to the body of the cartridge 85 to secure the clip drivers 82 and the clips 83 inside the clip cartridge 42 until the clips 83 are installed there, as described above.
    [0038] In use, now with reference to figures 5 and 6, the anvil 20 can be positioned on one side of the fabric 46 and the lower jaw 22 can be positioned on the opposite side of the fabric 46, so that when the anvil 20 is closed on the fabric, the fabric contact surface 60 of the anvil 20 and the fabric contact deck 90 of the staple cartridge 42 can compress the fabric 46 between an uncompressed thickness 91 and a compressed thickness 92. In order to staple and cut through the fabric 46, as described above, the wedge rail 78 can be advanced distally inside the staple cartridge 42, in order to raise the staple actuators 82 towards the anvil 20 and deform the staples 83. In various ways , each clamp driver 82 may comprise one or more slots defined therein that can be configured to receive and releasably hold the bases 87 of the clamps 83 in position. In at least one of these embodiments, each clamp 83 may comprise one or more legs of the clamps 88 extending from the base 87, the legs of the clamps 88 extending upwards and into the cavities of the clamps 84. In various embodiments, the leg tips of the clamps 88 can be lowered with respect to the deck, or fabric contact surface, 90 of the cartridge body 85 when the clamps 83 are in their untapped position. As the clamps 83 are being lifted upwards by the actuators 82, the legs of the clamps 88 can emerge from the clamp cavities 84, penetrate the fabric 46 and come into contact with the anvil that forms the pockets 89 positioned in front of the staple cavities 84. The anvil forming the pockets 89 can be configured to deform the staples 83 to any suitable shape, such as the B shape shown in figure 5, for example. As the clamps 83 are installed, now with reference to figure 6, the cutting edge 80 can cut through the fabric 46 into stapled portions 94.
    [0039] As described above, the clamping elements of an end actuator can be configured to apply a compressive pressure, or force, to the fabric being stapled. In many circumstances, however, the fabric can be slippery, for example, and at least a portion of the fabric can slide in relation to the claw elements. In certain circumstances, the fabric may slide off the distal end of the end actuator in a longitudinal direction and / or slide off the sides of the end actuator in a direction that is transverse to the longitudinal direction. In some circumstances, portions of the tissue may seep out of the distal end of the end actuator and / or the sides of the end actuator when the tissue is compressed. In various embodiments presented in the present invention, a staple cartridge can comprise one or more tissue retention features that can be configured to prevent or at least reduce the possibility of the tissue positioned inside the end actuator from moving in relation to the end actuator.
    [0040] In various embodiments, now with reference to figures 7 and 8, a staple cartridge, such as a staple cartridge 142, for example, may comprise a cartridge body 185 and a plurality of staples, such as staples 187 (figure 9), for example, positioned inside the cartridge body 185. The cartridge body 185 can comprise a proximal end 141 and a distal end 143, with the proximal end 141 being configured to be inserted at a proximal end. of a staple cartridge channel and a distal end 143 can be configured to be inserted into a distal end of the staple cartridge channel. In at least one embodiment, the cartridge body 185 may comprise a plurality of staple cavities 184 that can each be configured to receive a staple 187 there. In certain alternative embodiments, although not shown, a staple cavity may comprise more than one staple positioned there. In any event, the staple cavities 184 can be arranged in a plurality of rows within the cartridge body 185. More particularly, in at least one embodiment, the staple cavities 184 can be arranged in three rows of staples, for example , on a first side 145 of the cartridge body 185 and three rows of clips, for example, on a second side 147 of the cartridge body 185. In at least one of these embodiments, the first side 145 and the second side 147 of the body of the cartridge 185 can be separated by a knife slot 162 which can be configured to receive a sliding cutting element there. In several other embodiments, a cartridge may comprise any other suitable number of staple rows, such as two rows of staples or four rows of staples, for example, on each side of the knife slot 162. Referring to Figure 9, in various embodiments , the staple cartridge 142 may further comprise a plurality of staple actuators 182 configured to hold the staples 187 and / or eject the staples 187 from the staple cavities 184. In certain embodiments, each staple cavity 184 may comprise an open end, or opening 110 on deck 190 of cartridge body 185 through which clips 187 can be ejected.
    [0041] In various embodiments, with reference primarily to figure 8, the staple cavities 184 can be arranged so as to be longitudinally misaligned with respect to each other. For example, staple pockets 184 on the first side 145 of the cartridge body 185, for example, can be arranged in an innermost row of staple pockets 184, an intermediate row of staple pockets 184 and an outermost row of pockets of staples 184, the staple cavities 184 in a row may not be aligned transversely with the staple cavities 184 in one or both of the other rows. In at least one embodiment, each staple cavity 184 may comprise a proximal end 111 and a distal end 112, the proximal end 111 of each staple cavity 184 being positioned closer to the proximal end 141 of the cartridge body 185 of the than the distal end 112. Similarly, the distal end 112 of each cavity 184 can be positioned closer to the distal end 143 of the cartridge body 185 than the proximal end 111. In various embodiments, the innermost row of cavities of staples 184 can be positioned so that the distal ends 112 of the staple cavities 184 within the innermost row are positioned distally with respect to the distal ends 112 of the staple cavities 184 in the middle row of staple cavities 184. similarly, the outermost row of staple cavities 184 can be positioned so that the distal ends 112 of the c staple acvies 184 within the outermost row are positioned distally with respect to the distal ends 112 of the staple cavities in the middle row of staple cavities 184. For example, the most distal staple cavity 184 in the innermost row can be positioned distally with respect to the most distal staple cavity 184 in the middle row, and similarly, the most distal staple cavity 184 in the outermost row can be positioned distally with respect to the most distal staple cavity 184 in the middle row. In certain embodiments, the staple cavities 184 of the innermost row and the staple cavities 184 of the outermost row can be aligned transversely with each other so that, one, the distal ends 112 of the innermost staple cavities 184 are aligned with the distal ends 112 of the staple cavities 184 and, two, the proximal ends 111 of the innermost staple cavities 184 are aligned with the proximal ends 111 of the outermost staple cavities 184. In various embodiments, each staple cavity 184, and their openings 110, may have the same, or at least approximately the same, configuration and, in at least one embodiment, the staple cavities 184 may be spaced equidistantly, or at least substantially equidistant, from one another in a row of staples.
    [0042] In various embodiments, again with reference to figures 7 and 8, the cartridge body 185 of the staple cartridge 142 can additionally comprise one or more ridges, such as the ridges 113, 114 and 115, for example, which can be configured to contact and compress the intended fabrics. More particularly, now with reference to figure 8A, the anvil 120 of an end actuator can be closed in order to compress the fabric T against the staple cartridge 142 and, in such circumstances, the fabric contact deck 190 and the ridges 113, 114 and 115 extending from there can couple to the tissue. As the anvil 120 is closed, in certain circumstances, the anvil 120 can push the fabric towards the staple cartridge 142, so that the fabric first contacts the ridges 113, 114 and 115 and then comes in in contact with the cartridge deck 190. In other circumstances, the staple cartridge 142 can be positioned against the fabric so that the ridges 113, 114 and 115 come into contact with the fabric before the fabric is contacted by the deck. of cartridge 190. In any event, the ridges 113, 114 and 115, when in contact with the fabric, can prevent, or at least limit, the relative movement between the fabric and the staple cartridge 142. In certain embodiments, the ridges 113, 114 and 115 can extend upwards from a flat, or at least substantially flat, cartridge deck 190 and can define one or more pockets or channels, for example, which can be configured to receive a portion of fabric in them and, as a result, inhibit re movement of the tissue in the longitudinal direction and / or in the transverse direction of the end actuator, specifically when the tissue is at least partially compressed between the anvil 120 and the ridges 113, 114 and 115. In various modalities, as the ridges 113, 114 and 115 extend above the cartridge deck 190, the fabric positioned intermediate to the anvil 120 and the ridges 113, 114 and 115 can be compressed before the fabric positioned intermediate to the anvil 120 and the deck cartridge 190 to be compressed. In some of such circumstances, as a result, the fabric positioned between the anvil 120 and the ridges 113, 114 and 115 can be pre-compressed, that is, at least partially compressed before other portions of the fabric positioned between the anvil 120 and the cartridge deck 190 to be compressed. Due to this pre-compression, in various circumstances, portions of the tissue can be controlled or prevented from slipping out of the end actuator before the tissue is fully compressed as described in more detail below.
    [0043] In various embodiments, again with reference to figures 7 and 8, the ridges 113 extending from the cartridge deck 190 may extend around the proximal ends 111 of the openings in the staple cavities 110. Similarly, the ridges 114 extending from the cartridge deck 190 can extend around the distal ends 112 of the openings in the staple cavities 110. These proximal ridges 113 and distal ridges 114, in various embodiments, can be configured to couple the fabric positioned above and / or around the staple cavities 184 and keeping these portions of tissue in position as the tissue is being compressed and / or stapled. In other words, keeping the fabric positioned above and / or around staple cavities 184 can provide localized control over the portions of the fabric that will be stapled and, as a result, prevent, or at least limit, the relative movement between those portions of fabric and staple cartridge 142. In various embodiments, ridges 113 and 114 can be positioned around openings 110 of all staple cavities 184 or just some of the staple cavities 184. In at least one embodiment, a cartridge body may comprise the ridges 113 and 114 surrounding only the staple cavities 184 in the outermost rows of the first and second sides 145 and 147. In such embodiments, the ridges surrounding the outermost rows of the staple cavities 184 may be sufficient to block the lateral movement of the tissue inside the end actuator. In certain embodiments, a cartridge body can only comprise the proximal ridges 113 which surround the proximal ends 111 of the most proximal clip cavities 184 and / or the distal ridges 114 which surround the distal ends 112 of the most distal clip cavities 184. In in such embodiments, the ridges surrounding the most proximal and distal staple cavities 184 may be sufficient to block the longitudinal movement of the tissue within the end actuator.
    [0044] In various embodiments, in addition to the above, each proximal crest 113 may comprise an arcuate or curved profile, for example, which surrounds a proximal end 111 of an opening 110. The arcuate profile of each proximal crest 113 can be defined by a radius of curvature or by more than a radius of curvature. Similarly, each distal ridge 114 can comprise an arcuate or curved profile, for example, which surrounds a distal end 112 of an opening 110. The arcuate profile of each distal ridge 114 can be defined by a radius of curvature or by more than a radius of curvature. In certain embodiments, in addition to the above, each crest 113 and 114 can form a pocket that can receive a portion of tissue that is being compressed and prevents that portion of tissue from moving longitudinally and / or transversely in relation to the staples 142. In various embodiments, the staple cartridge 142 may additionally comprise intermediate ridges 115 which may extend between and / or connect adjacent ridges 113 and 114 in adjacent rows of staple cavities 184. In at least one such embodiment, one or more ridges 113, 114 and 115 can cooperatively form an undulating ridge that extends through the first side 145 or the second side 147 of the cartridge body 185, and in at least one embodiment, the undulating ridge can extend between a central portion and a lateral portion of the cartridge body 142. In various embodiments, each undulating crest can comprise a plurality of undulating portions that wrap around it the distal and proximal ends of the staple cavities 184, for example. In various embodiments, each crest 113, 114 and 115 may comprise a defined height from the cartridge deck 190, and in certain embodiments, the height of each crest 113, 114 and 115 may be uniform, or at least substantially uniform, through their length. In at least one embodiment, each crest 113, 114 and 115 may have the same, or at least substantially the same, height.
    [0045] In various embodiments, as described above, the staple cavities defined in a staple cartridge body may comprise a staple positioned therein and the entire staple may be positioned below the top surface, or the contact surface with the deck of the cartridge when the clamp is in its non-triggered position. In certain other embodiments, at least a portion of the clamp, such as the tips of the clamps' legs, for example, may extend above the top surface, or the fabric contact surface, of the cartridge deck when the clamps are in their position. not triggered position. In some embodiments, the tips of the staples can protrude from the deck and can bump into the tissue as the staple cartridge is inserted into a surgical location. In at least one embodiment, now with reference to figure 9, the ridges 113 and 114, for example, which extend above the fabric contact cartridge deck 190, can at least partially encircle and protect the legs of the clamps 183 of the staples 187 when they extend above the cartridge deck 190 in their non-triggered position. Although the ridges 113 and 114 may not extend fully around each opening 110, in various embodiments, the proximal crest 113 can sufficiently encircle one end of the clamp legs and the distal crest 114 can sufficiently encircle the other end of the legs of the clamps. staples so that the tips of the staple legs do not come into contact with the fabric before they are compressed against the staple cartridge 142 and / or the staples 187 are ejected from the staple cartridge 142. In at least one embodiment, the ends of the legs of the clamps can be positioned below the top surfaces 116 of the ridges 113 and 114. In certain embodiments, the tips of the legs of the clamps can be located in a common plane with the top surfaces 116 of the ridges 113 and 114. In several modalities, as a result of the protection provided by the ridges 113 and 114, for example, clamps that have a higher clamp height can be used without the clamp tips protruding remove staple cartridge 142 in its non-triggered position. In certain embodiments, again with reference to figure 9, the ridges 113 and 114 can extend or increase the length by which the legs of the clamps 183 of the clamps 187 can be controlled and / or supported. In at least one such embodiment, each crest 113 and 114 may extend or increase the length in which the legs of the clamps 183 are supported on three sides thereof. Such modalities can prevent, or at least reduce, the possibility that the legs of the 183 clips will become trapped when they are inserted through dense tissue, such as the bronchial tissue, for example.
    [0046] In various embodiments, again with reference to figure 4, the cartridge body 85 can comprise cavities 84, a slot 62, and channels 86, for example, defined therein and which can reduce the resistance of the cartridge body 85. In various circumstances, specifically when the cartridge body 85 is compressed by the anvil 20, for example, the cartridge body 85 can deflect as a result of the load applied to it. In at least one such embodiment, the portions of the cartridge deck 90 extending over channels 86, for example, may be specifically thin and may be specifically subject to deflection and / or rupture. In certain modalities, again with reference to figures 7 and 8, the ridges 113, 114 and / or 115 can be configured to strengthen and / or stiffen the body of the carcass 185. In at least one of these modalities, the ridges 113 and 114, for example, may extend around the openings 110 to strengthen and / or stiffen the portions of the cartridge body 185 that surround the staple cavities 184. In certain embodiments, the ridges 115, for example, may extend extend transversely over the channels 86, or the like, defined inside the cartridge body 185 so that the ridges 115 can strengthen and / or stiffen the cartridge body 185 surrounding the channels 86. In several other embodiments, the body of the cartridge cartridge 185 may comprise any number and configuration of suitable ridges extending therefrom to achieve the advantages described herein.
    [0047] In various embodiments, a body of the staple cartridge 185 may consist of plastic materials, metallic materials and / or ceramic materials, for example. Some of such materials may comprise liquid crystal polymers, such as Vectra, for example, thermoplastic polymers, such as polycarbonate, alkylbenzene sulfonate (ABS), Noryl, polyamides (nylon), polyethersulfones, polyetherimides, such as Ultem, for example , and / or polymer mixtures of two or more of the aforementioned thermoplastic polymers, for example, in which, in various embodiments, the cartridge body 185 may be formed by an injection molding process, for example. Some of such materials may comprise thermosetting polymers, such as thermosetting polyesters, for example, investment molded stainless steels, such as 17-4 PH, for example, and / or metal injection molded stainless steels, such as 17-4 PH, for example. In at least one of these embodiments, the ridges 113, 114 and / or 115 can be integrally formed with the cartridge deck 190 of the cartridge body 185. In certain embodiments, the ridges 113, 114 and / or 115 can be formed attached to cartridge deck 190 by at least one adhesive, for example.
    [0048] In various embodiments, now with reference to figure 12, a staple cartridge, such as staple cartridge 342, for example, may comprise a cartridge body 385, a plurality of staple cavities 384 defined in the body of the cartridge 385 and a staple positioned in each of the staple cavities 384. In certain embodiments, the cartridge body 385 may additionally comprise a first side 345 comprising a first group of staple cavities 384, a second side 347 comprising a second group of staple cavities 384 and a cartridge deck 390. In various embodiments, the cartridge body 385 can additionally comprise a plurality of ridges 315 extending from the cartridge deck 390 that can be positioned in the middle and adjacent to the cavities of staples 384 in a row of staple cavities 384. In at least one embodiment, each crest 315 may comprise a cross-sectional or X-shaped configuration, for example it. In at least one such embodiment, for example, each crest 315 may comprise a V-shaped portion 313 that can at least partially surround a proximal end 311 of an opening in the clamp cavity 310 and, in addition, a shaped portion of V 314 which can at least partially surround a distal end 312 of another opening of the staple cavity 310. In certain embodiments, only the outermost rows of the staple cavities 384 in the cartridge body 385 can be at least partially surrounded by ridges 315 In certain other embodiments, now with reference to figure 13, a staple cartridge body 385 'may comprise the ridges 315 that at least partially surround the opening 310 of each staple cavity 384 in the cartridge body. In any event, in various modalities, each crest 315 can be configured to compress and control the fabric positioned against the staple cartridge 342, as described above, and / or surround the legs of the staple staples that extend above deck 390 .
    [0049] In various embodiments, now with reference to figure 16, a staple cartridge, such as staple cartridge 542, for example, may comprise a cartridge body 585, a plurality of staple cavities 584 defined in the cartridge body 585 and a staple positioned in each of the staple cavities 584. In certain embodiments, the cartridge body 585 may additionally comprise a first side 545 comprising a first group of staple cavities 584, a second side 547 comprising a second group of staple cavities 584 and a cartridge deck 590. In various embodiments, the cartridge body 585 can additionally comprise a plurality of ridges 515 extending from the cartridge deck 590, each ridge 515 being able to completely surround or cover an opening of the clip cavity 510. As shown in figure 16, some openings of the cavities 510 in the cartridge body 585 may not be surrounded by a ridge 515; whereas, in various alternative embodiments, now with reference to figure 16A, each opening of cavity 510 in a cartridge body 585 'can be surrounded by a ridge 515. Various embodiments are contemplated where a cartridge body comprises a first group of cavities of staples 584 that are surrounded by a ridge 515 and a second group of staple cavities 584 that are not surrounded by a ridge 515, with staples having a higher staple height can be positioned in the first group of staple cavities 584 and the staples having a shorter staple height can be positioned in the second group of staple cavities 584 so that neither the tallest staples nor the shortest staples protrude from the staple cartridge 542. In at least one such modalities, for example, the cartridge body can be configured to use the highest staples in a row of 584 staple wells and the shortest staples in one another row of staple wells 584. In certain embodiments, the ridges 515 can surround all of the staple wells 584 in the outermost rows of the staple wells 584 in the cartridge body, so that the taller staples can be used in the higher rows outer clamps and the shortest clamps can be used in the innermost rows and / or in the intermediate rows of the 584 clamp cavities, for example.
    [0050] In various embodiments, now with reference to figure 14, a staple cartridge, such as staple cartridge 442, for example, may comprise a cartridge body 485, a plurality of staple cavities 484 defined in the cartridge body 485 and a staple positioned in each of the staple cavities 484. In certain embodiments, the cartridge body 485 may additionally comprise a first side 445 comprising a first group of staple cavities 484, a second side 447 comprising a second group of staple cavities 484 and a cartridge deck 490. In various embodiments, the cartridge body 445 may additionally comprise a plurality of ridges 415 extending from the cartridge deck 490, with each ridge 415 comprising a plurality, or a set of teeth. In use, an anvil can be used to position the tissue against the teeth, so that the tissue conforms to the contour of the teeth. In various embodiments, each crest 415 may comprise a plurality of pyramid-shaped or diamond-shaped teeth, for example, at least partially surrounding one or more openings of the staple cavities 410, with the teeth in at least one embodiment. pyramidal shape can point upwards from the 490 cartridge deck. In at least one embodiment, each pyramidal tooth can comprise four triangular sides that can converge to form an acute point. In certain embodiments, with reference to figure 15A, the pyramidal teeth of the ridges 415 can be truncated, the top of each tooth being able to comprise a flat top surface surrounded by sloping sides. Although four-sided pyramidal teeth can be used, now with reference to figure 15C, other pyramidal shapes that have less than four sides or more than four sides, such as three sides, for example, are contemplated. In various embodiments, one or more ridges 415 may comprise a plurality of cone-shaped teeth, each cone-shaped tooth may comprise a circular, or at least substantially circular, base that tapers upward to form a sharp point . In certain embodiments, now with reference to figure 15B, the cone-shaped teeth can be truncated, the top of each tooth being able to comprise a flat top surface surrounded by an annular side. In various embodiments, again with reference to figure 14, the teeth of the ridges 415 may extend along the side sides of the openings in the staple cavities 410 and / or between the adjacent openings in the staple cavities 410. In at least one embodiment, the teeth may extend around the proximal ends 411 and / or the distal ends 412 of the openings in the staple cavities 410. In certain embodiments, the teeth in the ridges 415 may only encircle some of the staple cavities 484, whereas in certain other embodiments, with reference to figure 15, the teeth of the ridges 415 can cover the whole, or at least the substantial totality, of the cartridge deck 490, for example.
    [0051] In various embodiments, now with reference to figure 10, a staple cartridge, such as staple cartridge 242, for example, may comprise a cartridge body 285, a plurality of staple cavities 284 defined in the cartridge body 285 and a staple positioned in each of the staple cavities 284. In certain embodiments, the cartridge body 285 may additionally comprise a first side 245 comprising a first group of staple cavities 284, a second side 247 comprising a second group of staple cavities 284 and a cartridge deck 290. In various embodiments, the cartridge body 285 may additionally comprise a plurality of ridges, or protuberances, 215 extending from the cartridge deck 290. In at least one such embodiments, each crest 215 may extend transversely between a central or middle portion of the cartridge body 245 positioned adjacent to the knife slot 262 and a lateral portion of the carton body ucho 245. More particularly, with reference specifically to the first side 245 of the cartridge body 285, each ridge 215 may comprise a first end 213 positioned adjacent to the knife slot 262 and a second end 214 positioned adjacent to the first side 261 of the cartridge body 285. Similarly, now with reference to the second side 247 of the cartridge body 285, each ridge 215 may comprise a first end 213 positioned adjacent to the knife slot 262 and a second end 214 positioned adjacent to the second side 263 of the cartridge body 285. In at least one of these embodiments, each crest 215 may comprise a height measured from deck 290, and in at least one of these embodiments, the height of each crest 215 may vary over the length thereof. In certain embodiments, the second end 214 may be higher than the first end 213 and the height of each crest 215 may narrow between the second end 214 and the first end 213. In certain alternative embodiments, although not shown, the first end 213 the ridge 215 may be higher than the second end 214. In at least one embodiment, the height of each ridge 215 may narrow linearly, or at least substantially linearly, between ends 213 and 214. In at least one of In such embodiments, the height of each crest 215 can narrow between a maximum height at the second end 214 to no height at the first end 213. In certain embodiments, the height of each crest 215 can vary geometrically between ends 213 and 214. In certain alternative embodiments, now with reference to figure 11, each ridge 215 'may comprise a uniform height across its length.
    [0052] As described above, the inner ends 213 of the ridges 215 may be shorter than the outer ends 214 of the ridges 215. In various circumstances, as a result, the inner ends 213 may apply less pressure to the fabric fixed between an anvil and the staple cartridge 242 compared to outer ends 214. In various embodiments, as described above, each crest 215 may extend transversely across cartridge deck 290. In certain embodiments, each crest 215 may extend along an axis of the ridge that cuts through a longitudinal axis 299 of the cartridge body 285. In at least one of these embodiments, the ridge axes can be perpendicular, or at least substantially perpendicular, to the longitudinal axis 299. In various embodiments, the staple cavities 284 can be arranged in a plurality of rows, each row of staple cavities 284 being defined along a longitudinal axis end that can be parallel, or at least substantially parallel, to the longitudinal axis 299. In at least one embodiment, the axes of the crest of the ridges 215 may extend in a direction that cuts through the longitudinal axes of the clamp cavities 284. In at least one of these modalities, the crest axes of the ridges 215 may extend in a direction that is perpendicular, or at least substantially perpendicular, to the longitudinal axes of the clamp cavities 284. In various embodiments, again with reference to figure 10, each Ridge 215 may comprise a ridge 209 and, in addition, inclined surfaces 208 extending between ridge 209 and cartridge deck 290. In certain embodiments, each inclined surface 208 may comprise one or more flat surfaces, curved surfaces, concave and / or convex surfaces, for example. In various embodiments, each crest 215 may extend along a path that extends through one or more openings 210 of the staple cavities 284. In at least one of such embodiments, such openings 210 may extend upwardly through the ridges 215 As the ridges 215 extend across the cartridge deck 290, the ridges 215, similar to the ridges 115, can increase the strength and / or hardness of the cartridge body 285.
    [0053] In various embodiments, now with reference to figures 17 and 18, a staple cartridge, such as staple cartridge 642, for example, can comprise a cartridge body 685, a plurality of staple cavities 684 defined in the body of the cartridge 685 and a staple positioned in each of the staple cavities 684. In certain embodiments, the cartridge body 685 may additionally comprise a first side 645 comprising a first group of staple cavities 684, a second side 647 comprising a second group of staple cavities 684 and a cartridge deck 690. In various embodiments, the cartridge body 685 may additionally comprise a plurality of ridges, or protuberances, 615 extending from the cartridge deck 690. In at least one of such modalities, each crest 615 may extend in a longitudinal direction, each crest 615 may comprise a distal end 613 and a proximal end 614, the end being The distal end 613 of the ridge 615 can be positioned closer to the distal end 643 of the cartridge body 685, and the proximal end 614 of the ridge 615 can be positioned closer to the proximal end 641. In at least one of these modalities each ridge 615 may comprise a height measured from deck 690, with the height of each ridge 615 in at least one of these embodiments varying along the length of the ridge. In certain embodiments, the proximal end 614 may be higher than the distal end 613 and the height of each crest 615 may narrow between the proximal end 614 and the distal end 613. In certain alternative embodiments, although not shown, the distal end 613 the ridge 615 may be higher than the proximal end 614. In at least one embodiment, the height of each ridge 615 may narrow linearly, or at least substantially linearly, between ends 613 and 614. In at least one of these modalities, the height of each crest 615 can narrow between a maximum height at the proximal end 614 to no height at the distal end 613. In certain embodiments, the height of each crest 615 can vary geometrically between the ends 613 and 614. In certain alternative embodiments, each ridge 615 can comprise a uniform height across its length.
    [0054] As described above, the distal ends 613 of the ridges 615 may be shorter than the proximal ends 614 of the ridges 615. In various circumstances, as a result, the distal ends 613 may apply less pressure to the tissue fixed between an anvil and the staple cartridge 642 compared to proximal ends 614. In various embodiments, as described above, each crest 615 can be extended longitudinally through cartridge deck 690. In certain embodiments, each crest 615 can extend along the axis of the crest which is parallel, or at least substantially parallel, to a longitudinal axis 699 of the cartridge body 685. In various embodiments, the staple cavities 684 can be arranged in a plurality of rows, each row of staple cavities 684 being able to be defined along a longitudinal axis that can be parallel, or at least substantially parallel, to the axes of the ridges of the 615 ridges. In one embodiment, again with reference to Fig. 18, each ridge 615 may comprise a ramped surface which may comprise one or more flat surfaces, curved surfaces, concave surfaces, and / or convex surfaces, for example. In at least one such embodiment, the bottom of the ramped surface may be distally present, which can facilitate the sliding of the fabric by the staple cartridge 642 when the fabric is positioned on the end actuator. In various embodiments, each crest 615 may extend along a path that extends through one or more openings 610 of the staple cavities 684. In at least one of such embodiments, such openings 610 may extend upwardly through the ridges 615 As the ridges 615 extend transversely across the cartridge deck 690, the ridges 615 can increase the strength and / or hardness of the 685 cartridge body.
    [0055] In several modalities, in addition to the above, a surgical clamp can consist of titanium, such as titanium wire, for example. In certain embodiments, a surgical clamp may consist of an alloy comprising titanium, aluminum, and / or vanadium, for example. In at least one embodiment, the surgical clamp may consist of surgical stainless steel and / or an alloy comprising cobalt and chromium, for example. In any case, the surgical clamp can consist of metal, such as titanium, and an external surface of metal oxide, such as titanium oxide, for example. In various embodiments, the outer surface of metal oxide can be coated with a material. In certain embodiments, the coating material may consist of polytetrafluoroethylene (PTFE), such as Teflon®, and / or tetrafluoroethylene (TFE) such as ethylene-tetrafluoroethylene (ETFE), perfluroralcoxyethylene-tetrafluoroethylene (PFA), and / or ethylene propylene fluorinated (FEP), for example. Certain coatings may comprise silicon. In various embodiments, such coating materials can prevent, or at least inhibit, further oxidation of the metal. In certain embodiments, the lining materials may provide one or more slippery surfaces against which the anvil, or staple pockets, may come into contact with the staples in order to reduce the frictional force between them. In many circumstances, lower frictional forces between the clamps and the clamp pockets can reduce the force required to deform the clamps.
    [0056] Although several modalities of the devices have been described here in connection with certain modalities presented, many modifications and variations of these modalities can be implemented. Also, where materials are developed for certain components, other materials can be used. In addition, according to various modalities, a single component can be replaced by multiple components and multiple components can be replaced by a single component, to perform one or more specific functions. The aforementioned description and the following claims are intended to cover all such modifications and variations.
    [0057] 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.
    [0058] 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 pouch. 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.
    [0059] 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 will cover 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.
    [0060] Any patent, publication or other description material, in whole or in part, which is said to be incorporated into the present invention as a reference, is incorporated into the present invention only to the extent that the incorporated materials do not come into effect. conflict with existing definitions, statements or other description material presented in this description. Accordingly, and as far as 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 will appear between the embedded material and the existing description material.
    权利要求:
    Claims (7)
    [0001]
    1. Staple cartridge (142,342,542), comprising: a plurality of staples (187); and a cartridge body (185,385,585) comprising: a fabric contact deck (190,390,590); a plurality of staple cavities (184,384,584), wherein each staple cavity comprises an opening (110,310,510) in the deck, and in which a staple is positioned in each staple cavity; and a plurality of ridges (113-115,315,515) extending from the fabric contact deck (190,390,590), each opening (110,310,510) comprising a proximal end (111,311,511) and a distal end (112,312,512) and characterized by the fact that each of the distal and proximal ends is surrounded by a respective crest.
    [0002]
    Staple cartridge according to claim 1, characterized in that each opening (510) is entirely surrounded by a respective crest (515).
    [0003]
    Staple cartridge according to claim 1, characterized by the fact that it still comprises a plurality of staple actuators (182) configured to eject the staples (187) from the staple cavities (184,384,584), in which each staple is supported by a clamp actuator, in which each clamp comprises at least one tip and in which the tips of the clamps are positioned above the fabric contact deck (190,390,590).
    [0004]
    Staple cartridge according to claim 3, characterized in that each crest comprises a top surface (116), and in which the tips are positioned below the top surfaces.
    [0005]
    Staple cartridge according to claim 1, characterized in that the plurality of staple cavities (184) comprises a first row of staple cavities that houses a first row of staples and a second row of staple cavities which houses a second row of staples, and in which the ridges (113-115) that surround the proximal and distal ends of the openings (110) of the first row of staple cavities are connected to the ridges that surround the distal and proximal ends of the openings of the second row of staple cavities.
    [0006]
    6. Staple cartridge according to claim 1, characterized in that the plurality of staple cavities (184) comprises a row of staple cavities that house a row of staples, and in which the ridges (315) are positioned in an intermediate way to the staple wells in the row of staple wells.
    [0007]
    7. Staple cartridge according to claim 6, characterized in that each crest (315) comprises an X-shaped configuration.
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    同族专利:
    公开号 | 公开日
    US10898191B2|2021-01-26|
    US20190105042A1|2019-04-11|
    RU2013119673A|2014-11-10|
    AU2011314209B2|2014-02-13|
    RU2579738C2|2016-04-10|
    CN103140180B|2015-08-26|
    CA2811950A1|2012-04-19|
    EP2621360A1|2013-08-07|
    US9131940B2|2015-09-15|
    EP2621360B1|2019-10-23|
    EP3689262A1|2020-08-05|
    BR112013007613A2|2016-08-09|
    US8733613B2|2014-05-27|
    US20150265276A1|2015-09-24|
    US10130363B2|2018-11-20|
    JP2013540519A|2013-11-07|
    US20130161375A1|2013-06-27|
    US20210204942A1|2021-07-08|
    AU2011314209A1|2013-02-21|
    CA2811950C|2018-12-18|
    US20120074198A1|2012-03-29|
    CN103140180A|2013-06-05|
    WO2012050798A1|2012-04-19|
    JP5902176B2|2016-04-13|
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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]|
    2020-08-18| B07A| Technical examination (opinion): publication of technical examination (opinion) [chapter 7.1 patent gazette]|
    2020-12-08| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-02-09| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 23/09/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US12/893,461|2010-09-29|
    US12/893,461|US8733613B2|2010-09-29|2010-09-29|Staple cartridge|
    PCT/US2011/053040|WO2012050798A1|2010-09-29|2011-09-23|Staple cartridge|
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