 SURGICAL INSTRUMENT
专利摘要:
removable surgical staple cartridges the present invention relates to surgical staple and channel cartridge assemblies for attachment to an instrument for surgical cutting and stapling. an integrated surgical fastener cartridge assembly is described which comprises: an elongated channel configured for removable fixation to a distal portion of the structure of a surgical instrument, said elongated channel having a fixing portion comprising: - a wedge portion configured for a wedge coupling with the distal portion of the structure; e- a locking element for reliably retaining said wedge-shaped portion in a wedge engagement with the distal portion of the structure, and said integrated surgical clamp cartridge additionally comprising a cartridge body supported on the said elongated channel and operationally supporting a plurality of fabric fasteners therein. 公开号:BR112013023738B1 申请号:R112013023738-4 申请日:2012-03-13 公开日:2021-04-27 发明作者:Clarie E. Ellerhorst；Jeffrey S. Swayze；Karen K. Isaacs；Robert P. Kruth；Patrick J. Swindon 申请人:Ethicon Endo-Surgery, Inc； IPC主号:
专利说明:
Background Technical field [0001] The present invention relates to instruments for surgical cutting and stapling and, in various modalities, to disposable surgical staple cartridges. Background [0002] Endoscopic surgical instruments are often preferred over traditional open surgery devices, as a smaller incision tends to reduce recovery time and complications in the postoperative period. Generally, these endoscopic surgical instruments include an "end effector", a cable assembly and an elongated stem that extends between the end actuator and the cable assembly. The end actuator is the portion of the instrument configured to interact with the tissue in various ways, in order to obtain a desired diagnosis or therapeutic effect (for example, endoscopic scalpel, claw, cutter, staplers, clip applicator, access device , device for application of drug / gene therapy, and energy device with the use of ultrasound, radiofrequency, laser, etc.). [0003] Two major design approaches have been used in the past by several medical component manufacturers to reduce the overall cost of endoscopic surgical instruments, such as endoscopic scalpels. While both attempts have been successful in addressing at least some of the user's needs, neither attempt has fully addressed all of those needs. [0004] For example, the first design approach involved the use of disposable endoscopic scalpel devices for each shot. These endoscopic scalpel end actuators were manufactured from relatively weak components that could be fired only once, before a new end actuator was needed, since the components of the end actuator were markedly deformed after each shot. This type of end actuator employed an "i-profile" feature on the scalpel, to prevent the anvil from being deflected in the opposite direction to the cartridge, during firing. Since the i-profile is supported on a relatively weak anvil component, the i-profile deforms the portion of the anvil located directly under the i-profile feature. This combination of factors allows the shape of the clamp to be improved, while decreasing the forces required to drive the device, as the i-profile is only pulling the material from the anvil down to the correct position in relation to the cartridge, where it is needed to form a clamp at any time. [0005] Although this approach optimizes the shape of the staple and reduces the force required to cut the fabric and apply the staples, it has a number of disadvantages. First, having the surgeon dispose of an entire set of anvil, groove and cartridge after each shot adds a high degree of manufacturing expense. Second, the device often does not firmly hold the target tissue, due to a combination of the relatively weak components of the end actuator and the way the anvil is actually attached to the tissue. The third problem is that the relatively weak components of the end actuator can only be reliably used to fire against moderate tissue thickness, and the components will not work on very thick tissue. [0006] The second main design approach used in the past was to produce much stronger end actuator components, which could be used for multiple shots. In this approach, only the cartridge assembly is replaced after each shot. As the components of the end actuator have to withstand multiple firing loads, they are purposely designed so that they do not deform after each firing. This design concept employs a different set of features on the scalpel, to keep the anvil positioned in relation to the cartridge during the application of the clamps, in order to optimize the shape of the clamps. The combination of the more rigid end actuator components with a different clamping mechanism allows this type of device to safely apply high clamping loads, so that the surgeon can easily manipulate the desired tissue. The stiffer components also allow the end actuator to be used safely over relatively thick tissue samples. [0007] A disadvantage of this approach, however, is that the features on the scalpel that prevent the anvil from bending in the opposite direction to the cartridge must now pull a very stiff anvil component down towards the cartridge. The scalpel is, therefore, trying to pull down, towards the cartridge, an entire bar that is as long as the entire stapling line, instead of pulling down only the anvil in a localized region, as in the previous device. This approach therefore generally needs to generate higher implantation forces due to the increased drag loads from the anvil on the scalpel. [0008] US patent publication No. 2007/0175950 A1, entitled "Disposable Staple Cartridge Having an Anvil With Tissue Locator For Use With Surgical Cutting and Fastening Instrument and Modular End Effector System Therefor", the description of which is incorporated herein in its the entirety, by way of reference, describes various disposable cartridge arrangements employing a disposable anvil component. This provision effectively addresses a variety of deficiencies discussed above, but it also includes an additional expense for an anvil component. In addition, all the aforementioned arrangements require a separate support channel to support the staple cartridge thereon. These support components add cost to the surgical instrument. [0009] Consequently, there is a need for surgical staple cartridges that effectively address many of the limitations described above. [00010] The aforementioned discussion is only intended to illustrate some of the disadvantages present in the field of the invention at the moment, and should not be taken as a denial of the scope of the claims. summary [00011] According to the general aspects of at least one shape, a cartridge assembly with an integrated surgical clamp is described, comprising an elongated groove that is configured for removable attachment to a distal portion of the structure of a surgical instrument. In at least one shape, the elongated channel has a fixing portion comprising a wedge-shaped portion that is configured for wedge engagement with the distal portion of the structure. The fixing portion additionally comprises a locking element for releasably retaining the wedge-shaped portion, in a wedge engagement with the distal portion of the structure. The integrated surgical clamp cartridge additionally comprises a cartridge body that is supported on the elongated channel and operationally supports, inside, a plurality of tissue clamps. [00012] In accordance with other general aspects of at least one form, a cartridge of surgical staples for use with instruments for surgical stapling that has a distal portion of the structure and an anvil movably supported on it is described. In at least one form, the surgical staple cartridge comprises an elongated groove that has a proximal end portion for removable attachment to the distal portion of the structure. The proximal end portion of the elongated channel has at least one angled portion that is shaped for wedge engagement with a corresponding surface shaped complementarily over the distal portion of the structure. A selectively movable locking element is configured for releasable engagement with one of the distal portion of the structure and the elongated channel so that, when the locking element is in an engaged position, at least an angled portion of the elongated channel is forced proximally at a wedge engagement with the corresponding surface of complementary shape with the distal portion of the structure to releasably fix the elongated channel to the distal portion of the structure. A staple cartridge is operationally supported inside the elongated channel, and operationally supports a plurality of staples inside it. [00013] In accordance with yet other general aspects of at least one form, a surgical instrument is described which comprises a distal portion of the structure and an integrated surgical staple cartridge assembly. In at least one form, the integrated surgical staple cartridge assembly comprises an elongated groove having a proximal end portion for removable attachment to the distal portion of the structure. The proximal end portion of the elongated channel has at least one angled portion that is shaped for wedge engagement with a corresponding surface shaped complementarily over the distal portion of the structure. A staple cartridge is operationally supported inside the elongated channel, and operationally supports a plurality of surgical staples inside it. The surgical instrument additionally comprises a selectively movable locking element which is configured for releasable engagement with one of the distal portion of the structure and the elongated channel so that, when the locking element is in an engaged position, at least one portion in angle of the elongated channel is forced proximally in a wedge engagement with the corresponding surface of complementary shape with the distal portion of the structure to releasably fix the elongated channel to the distal portion of the structure. Brief Description of Drawings [00014] The aforementioned characteristics and other characteristics and advantages of this invention, and the manner of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of the modalities of the invention, taken in conjunction with the attached drawings, in which: Figure 1 is a side elevation view of a form of surgical instrument supporting a non-limiting modality of cartridge and channel integrated in a form of the present invention; Figure 2 is an exploded assembly view of a non-limiting modality of integrated cartridge and channel and a portion of a surgical instrument configured for use with it; Figure 2A is another exploded assembly view of the integrated cartridge and channel mode of Figure 2, with the cartridge installed in the elongated channel; Figure 3 is a perspective assembly view of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 4 is another perspective assembly view of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 5 is an enlarged perspective assembly view of a portion of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 6 is an enlarged perspective and cross-sectional view of a portion of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 7 is an enlarged perspective and cross-sectional view of a portion of an integrated cartridge and channel modality attached to a portion of a surgical instrument; Figure 8 is a perspective view of another embodiment of an integrated cartridge and channel fixed to a portion of a surgical instrument; Figure 9 is a perspective assembly view of another embodiment of an integrated cartridge and channel and a portion of a surgical instrument; Figure 10 is an enlarged perspective and cross-sectional view of a portion of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 11 is another enlarged perspective and cross-sectional view of a portion of an integrated cartridge and channel modality attached to a portion of a surgical instrument; Figure 12 is an exploded view of an integrated cartridge and channel modality and a portion of a surgical instrument; Figure 13 is a cross-sectional view of a portion of the locking ring and the integrated cartridge and channel mode, taken along line 13-13 in Figure 9; and Figure 14 is a perspective and cross-sectional view of a portion of the locking ring and the integrated cartridge and channel modality, taken along line 14-14 in Figure 9. Detailed Description [00015] Certain exemplary modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the instruments and methods described here. One or more examples of these modalities are illustrated in the attached drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are exemplary non-limiting modalities, and that the scope of the various modalities of the present invention is defined only by the claims. The 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 characteristics 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. These modifications and variations are intended to be included in the scope of the various modalities described in the present invention, and their respective equivalents. [00016] The terms "proximal" and "distal" are used in the present invention with reference to a physician's manipulation of the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located farthest from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up", "down", "right" and "left" can be used in the present invention with respect to drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute. [00017] Various instruments and exemplifying methods for performing laparoscopic and minimally invasive surgical procedures are described. However, the person skilled in the art will readily understand that the various methods and instruments described herein can be used in numerous surgical procedures and applications including, for example, in conjunction with "open" surgical procedures. As the present Detailed Description continues, those skilled in the art will additionally appreciate that the various instruments described here can be inserted into a body in any way, such as through a natural orifice, through an incision or perforation formed in the tissues, etc. The functional portions or end actuator portions of the instruments can be inserted directly into a patient's body, or they can be inserted through an access device, such as a trocar that has a working channel through which the actuator can be advanced. end and the elongated stem of a surgical instrument. [00018] Returning to the Drawings, in which similar numbers denote similar components in all the various views, Figure 1 represents a modality of a surgical cutting and stapling instrument 10, which is capable of practicing several exclusive benefits of at least one form of present invention. Several portions of the instrument 10 can be identical to portions of the devices described in US patent No. 7,670,334, which is incorporated herein by reference, and / or in US patent No. 7,000,818, entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems ", the description of which is incorporated herein in its entirety, by way of reference. [00019] As shown in Figure 1, in a non-limiting manner, the surgical instrument 10 generally includes a portion of cable 20 that is connected to an implement portion 12, the latter additionally comprising a stem assembly 14 ending distally in an end actuator 100. In at least one non-limiting embodiment, end actuator 100 generally comprises a pair of "jaws" 102 and 104 that are configured to clamp and staple fabrics. As will be discussed in more detail below, one "jaw" comprises an integrated cartridge and groove assembly 120 and the other jaw comprises a movable anvil 200. The handle portion 20 includes a pistol grip 24 towards which a closing trigger 26 is pulled in an articulated manner by the doctor, to cause clamping, or closing, of the anvil 200 towards the integrated cartridge and groove assembly 120. A firing trigger 28 is further away from the center of the closing trigger 26, being pulled in a way articulated by the doctor to cause stapling and cutting of the tissue clamped on the end actuator 100. [00020] As is known, the closing trigger 26 is activated first. When satisfied with the positioning of the end actuator 100, the physician can return the closing trigger 26 to its completely closed and locked position, adjacent to the pistol grip 24. Then, the trigger trigger 28 is actuated. The trigger trigger 28 returns by spring action when the doctor removes the pressure. A release button 30, when pressed at the proximal end of the cable portion 20, releases any locked closing trigger 26. [00021] As will be discussed in more detail below, the integrated cartridge and groove assembly 120 is removably coupled to a structure 50 that protrudes from the cable portion 20. The structure 50 is enclosed within a set of movable closing tube 40 which is configured to form an operational interface with the closing trigger 26 at one end, and with the anvil 200 at the other end. When the closing tube 32 is moved proximally over the frame 50 by the closing trigger 26, the anvil 200 opens, pivoting to move away from the integrated cartridge and groove assembly 120. As the present Detailed Description continues, the Those skilled in the art will recognize that the various embodiments of the integrated cartridge and groove assembly 120 of the present invention can be employed with a variety of known surgical instruments designed to cut and staple tissue. Thus, the protection granted to the various modalities of the present invention described here, as well as their respective equivalents, should not be limited to the specific provision of the surgical instrument described here. For example, various modalities of the present invention can be correctly employed with surgical instruments having articulating end actuators or non-articulating end actuators, instruments that have mechanized closing and firing capabilities, instruments that have manual closing and firing capabilities, instruments that are connected to robots or other automated control equipment, etc. [00022] Turning to Figure 2, a form of an integrated cartridge and channel assembly 120 of the present invention is shown, for attachment to the distal end portion 51 of the structure 50. In various embodiments, the integrated cartridge and channel assembly 120 comprises a molded cartridge body 122, which is formed from, and supported on, an elongated channel 123. The cartridge body 22 can be configured to snap into channel 123, or can be attached by other means to it . The clamp cartridge body 122 operationally supports a plurality of clamps 124 which are operatively supported on corresponding clamp actuators 126, which are supported within the respective upwardly opened clamp openings 128 formed in the cartridge body 122. [00023] The instrument 10 additionally includes a firing bar 80 which is configured to travel longitudinally through the stem assembly 14 and through a firing slot 54 in the structure 50. The firing bar 80 has an end portion distal 82 which has a sharp cutting edge 84 formed thereon for cutting fabrics. Various firing bar configurations are known and can be adapted for use in conjunction with the integrated cartridge and groove assembly 120, without departing from the spirit and scope of the present invention. [00024] In operation, the distal end portion 82 of the firing bar 80 drives the integrated cartridge and groove assembly 120 as the firing bar 80 is driven distally through it. A wedge sliding piece 90 is guided distally by the distal end portion 82 of the firing bar 80. The wedge sliding piece 90 moves the clamp actuators 126 upward to force the clamps 124 out and in a deforming contact with the closed anvil 200, while the cutting edge 84 of the distal end portion 82 of the firing bar 80 cuts through the pinched fabric. The firing bar 80 is movably supported within the stem assembly 14 so as to pass through the integrated cartridge and groove assembly 120 when the instrument 10 is triggered (for example, actuated). [00025] As can be seen in Figure 2, the anvil 200 rests movably on the distal end portion 52 of the structure 50. A pair of openings 55 can be arranged on the distal end portion 52 to receive pins movably pivots or pins 202 on the anvil 200, allowing the anvil 200 to revolve from an open position to a closed position in relation to the integrated cartridge and groove assembly 120 in response to the opening and closing movements received from the closing tube assembly 40 In various non-limiting embodiments, the distal end 41 of the closing tube assembly 40 includes a horseshoe opening 42 and a flap 43 for engaging an opening flap 204 over anvil 200. As is known, when the tube assembly closing actuator 40 of the end actuator is advanced distally over the frame 50 of the end actuator, the horseshoe opening 42 applies a closing movement to the flap 204, to move the anvil 200 towards the integrated cartridge assembly and groove 120. When the closing tube assembly 40 of the end actuator is retracted in the proximal direction, the flap 43 engages with the flap 204 to move the anvil 200 in the opposite direction to the cartridge assembly and integrated channel 120 and up to an open position. In various non-limiting embodiments, a spring clip 205 is mounted on the distal portion 52 of the frame 50 of the end actuator, as a lock to the firing bar 80, in a known manner. It should be understood that various modalities may include other types of blocking, or none at all. [00026] In various non-limiting modalities, the elongated channel 123 has a fixation portion 130 which has at least one wedge-shaped fixation portion 132. In the modalities shown in figures 2 to 8, two portions are employed wedge-shaped clamping 132. The wedge-shaped clamping portions 132 are configured to wedge into angled engagement surfaces with complementary shape 56 formed on the distal end 51 of the frame 50 when the clamping portion 130 is moved proximally for engagement with the distal end 51 of the frame 50. [00027] As can be seen in Figures 4 to 8, the elongated channel 123 additionally includes a locking element 140 for releasably retaining the wedge-shaped fastening portions 132 in a wedge engagement with the engaging surfaces at an angle 56 on the structure 50. In various non-limiting embodiments, the locking element 140 comprises at least one locking tab 144 which is formed on a spring arm 146 which projects proximally from the elongated channel 123. In several modes not limiters, the locking tab 144 is configured to extend to a locking engagement with a locking opening 57 at the distal end 51 of the frame 50, as shown in Figure 7. The locking tab 144 has a locking surface 148 for engaging with the edge of the locking opening 57. In various non-limiting embodiments, the locking surface 148 can be provided with a slight angle so that when the locking surface engages with the edge of the locking opening te 57, the locking surface forces the elongated channel 123 in the proximal direction "DP". In other embodiments, the locking surface 148 is substantially perpendicular to the bottom of the elongated channel 123. To allow the locking tab 114 to be pulled out of the locking opening 57, a clearance hole 46 is arranged through the closing tube assembly 40 , which is registered with the locking opening 57. To disconnect the integrated cartridge assembly 120 from the frame 50, the doctor simply applies a changing force (force "F" in Figure 7) to the locking tab 144, through the holes 46 and 57, to force the locking tab 144 out of its engagement with the locking opening 57. In other non-limiting embodiments, the locking tab is arranged over the distal end 51 of the structure, and the locking opening is arranged in the elongated channel 123 . [00028] Figures 8 to 14 illustrate another embodiment of end actuator 100 ', in accordance with various non-limiting embodiments of the present invention. As can be seen in these figures, the end actuator 100 'includes an integrated cartridge and groove assembly 320 that has a cartridge body 322 that rests on an elongated groove 323 that is configured for removable attachment to the distal end 51' of the frame 50 '. In various embodiments, the integrated cartridge and groove assembly 320 comprises a molded cartridge body 322 which rests on the elongated groove. The cartridge body 322 can be configured to snap into channel 323, or can be attached by other means to it. The clamp cartridge body 322 operationally supports a plurality of clamps 124 which are supported on corresponding clamp drivers, which are supported within the respective upwardly opened clamp openings 328 formed in the cartridge body, as discussed above. It should be understood that the integrated cartridge and groove assembly 320 is substantially identical, in terms of construction and operation, to the integrated cartridge and groove assembly 120 described above, except for the differences discussed below. [00029] In various non-limiting embodiments, the elongated channel 323 has a fixation portion 430 that has at least one wedge-shaped fixation portion 432 and a proximally protruding fixation segment 450. In the modalities shown in Figures 12 to 14, two wedge-shaped fixing portions 432 are used. The wedge-shaped fixing portions 432 are configured to wedge into angled engagement surfaces with complementary shape 56 ', formed on the distal end 51 'of the frame 50' when the attachment portion is moved proximally to an engagement with the distal end 51 'of the frame 50'. The structure 50 'is similar, in terms of construction and operation, to the integrated structure 50 described above, except for the differences discussed below. The angled engagement surfaces 56 'are formed on lugs 440 extending distally, formed on the distal end 51' of the structure 50 '. Each lock 440 has a rotary pin orifice 442 for receiving a corresponding anvil rotating pin 202. In various non-limiting embodiments, the closing tube assembly 40 ', which is operated in the same manner as the closing tube assembly 40 described above, is configured to be in a boundary position with a closing protrusion 203 formed on the anvil 200 as the closing tube set 40 'is conducted in the distal direction "DD". As the closing tube assembly 40 'is guided distally and adjoins the closing projection 203, the anvil 200 is pivoted to the closed position towards the integrated cartridge and groove assembly 320. In various embodiments, a spring (not shown) is attached to a proximal portion of the anvil or is otherwise employed so that as the closing tube assembly 40 'is moved in the proximal direction "DP", the spring forces the anvil 200 into an open position ( shown in Figure 9). [00030] As can be seen in Figures 9 to 12, the end effector 100 'additionally includes a locking element 460 for releasably retaining the wedge-shaped fixing portions 432 in a wedge engagement with the surfaces of angled coupling 56 'over the frame 50'. In various non-limiting embodiments, the locking element 460 comprises a locking ring 462 which is pivotally supported on the distal end 51 'of the frame 50'. The locking ring 462 has a pair of diametrically opposing locking tabs 464, formed on the inner surface 463 thereof. As can be seen in figure 12, each locking tab 464 has a proximally oriented tapered end 466 formed thereon. The locking tabs 464 are received within a radial groove 446 formed at the distal end 51 'of the frame 50' to pivot the locking ring 44 on the frame 50 '. [00031] To fix the integrated cartridge and groove assembly 320 to the structure 50 ', the clamping segment 450 is inserted between the latches 440 until the wedge-shaped clamping portions 432 engage with the clamping surfaces at an angle 56' corresponding to the 50 'structure. See figure 11. When in this position, the radial groove 446 at the distal end 51 'of the frame 50' aligns radially with a retaining groove 452 on the clamping segment 450. To fix the integrated cartridge and groove assembly 320 to the frame 50 ', the doctor simply rotates the locking ring 462 either clockwise ("CW") or counterclockwise ("CCW"), to place one of the locking tabs 464 in a locking latch within the retaining groove 452 in the fastening segment 450. As the tapered end 466 interacts with the proximal wall of the retention groove 452, the elongated channel 323 is proximally forced so that the wedge-shaped fixing portions 432 engage wedge to the fixing surfaces in corresponding 56 'angles in the structure 50', to connect the elongated channel 323 to the structure 50 '. It should be understood that when a locking tab 462 is received within the retaining groove 452, the other locking tab 462 is retained within the radial groove 446 at the distal end 51 'of the frame 50'. [00032] Various embodiments of the integrated cartridge and groove assembly of the present invention can be easily attached to, and separated from, the surgical instrument, without the need to use any additional tools or instruments. The devices described here can be designed to be discarded after a single use, or they can be designed for use multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, and any number of particular parts or parts of the device can be selectively exchanged or removed, in any combination. After cleaning and / or exchanging 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 or replacement, and reassembly. The use of such techniques, and the resulting refurbished device are all within the scope of the present application. [00033] Preferably, the inventions 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 the field of radiation 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. [00034] Any patent, publication or other description material, in whole or in part, which is said to be incorporated into the present invention for reference purposes, 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 described 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. [00035] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the description. It is therefore intended that this application will cover any variations, uses or adaptations of the invention using its general principles. In addition, this application is intended to cover such changes to the present description, as is known or customary practice in the art to which this invention belongs.
权利要求:
Claims (4) [0001] 1. Surgical instrument (10), comprising: a distal portion of structure (51, 52, 51 ’); an integrated surgical staple cartridge assembly (120, 320), comprising: an elongated groove (123, 323) that has a proximal end portion (130, 430) for removable attachment to the distal portion of the structure (51, 52, 51 '); and a staple cartridge (122, 322) operationally supported inside the elongated channel (123, 323) and operationally supporting a plurality of surgical staples (124), and the surgical instrument (10) still comprises a locking element (140 , 460) selectively mobile for releasable engagement with one of the distal portion of the structure (51, 52, 51 ') and the elongated channel (123, 323); characterized by the fact that the proximal end portion (130, 430) of the elongated channel (123, 323) has at least one wedge-shaped portion (132, 323) formed for wedge engagement with a corresponding complementary shaped surface ( 56, 56 ') on the distal portion of the structure (51, 52, 51'); and since the locking element (140, 460) is in an engaged position, at least a wedge-shaped portion (132, 323) of the elongated channel (123, 323) is forced proximally in a wedge engagement with the surface corresponding complementary shape (56, 56 ') on the distal portion of the structure (51, 52, 51'), and the elongated channel (123, 323) is releasably attached to the distal portion of the structure (51, 52, 51 '). [0002] 2. Surgical instrument (10), according to claim 1, characterized by the fact that it still comprises an anvil (200) movably supported on the distal portion of the structure (51, 52, 51 ’). [0003] 3. Surgical instrument (10), according to claim 2, characterized by the fact that it still comprises a closing element (32, 40, 40 ') supported on the distal portion of the structure (51, 52, 51') to selectively apply closing and opening movements to the anvil (200). [0004] 4. Surgical instrument (10), according to claim 3, characterized by the fact that it still comprises a cutting element (82, 84) movably supported inside the distal portion of the structure (51, 52, 51 ') and that it is selectively advanceable through an elongated slot (54) in the staple cartridge (122, 322).
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公开号 | 公开日 CN103429172A|2013-12-04| EP2685909B1|2019-11-20| CN103429172B|2016-03-30| RU2599869C2|2016-10-20| US20120234896A1|2012-09-20| CA2829926A1|2012-09-20| RU2013145916A|2015-04-20| JP6125438B2|2017-05-10| EP2685909A1|2014-01-22| WO2012125633A1|2012-09-20| US8800841B2|2014-08-12| AU2012230057B2|2017-03-16| AU2012230057A1|2013-09-12| BR112013023738A2|2016-12-13| CA2829926C|2019-05-14| JP2014515640A|2014-07-03|
引用文献:
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stapling device with floating staple cartridge| US10806452B2|2017-08-24|2020-10-20|Covidien Lp|Loading unit for a surgical stapling instrument| USD907647S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface| US10743872B2|2017-09-29|2020-08-18|Ethicon Llc|System and methods for controlling a display of a surgical instrument| US10796471B2|2017-09-29|2020-10-06|Ethicon Llc|Systems and methods of displaying a knife position for a surgical instrument| USD917500S1|2017-09-29|2021-04-27|Ethicon Llc|Display screen or portion thereof with graphical user interface| US10765429B2|2017-09-29|2020-09-08|Ethicon Llc|Systems and methods for providing alerts according to the operational state of a surgical instrument| USD907648S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface| US10729501B2|2017-09-29|2020-08-04|Ethicon Llc|Systems and methods for language selection of a surgical instrument| US11134944B2|2017-10-30|2021-10-05|Cilag Gmbh International|Surgical stapler knife motion controls| US11090075B2|2017-10-30|2021-08-17|Cilag Gmbh International|Articulation features for surgical end effector| US10779903B2|2017-10-31|2020-09-22|Ethicon Llc|Positive shaft rotation lock activated by jaw closure| US10842490B2|2017-10-31|2020-11-24|Ethicon Llc|Cartridge body design with force reduction based on firing completion| US10925603B2|2017-11-14|2021-02-23|Covidien Lp|Reload with articulation stabilization system| US10863987B2|2017-11-16|2020-12-15|Covidien Lp|Surgical instrument with imaging device| US10863988B2|2017-11-29|2020-12-15|Intuitive Surgical Operations, Inc.|Surgical instrument with lockout mechanism| US10966718B2|2017-12-15|2021-04-06|Ethicon Llc|Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments| US10743874B2|2017-12-15|2020-08-18|Ethicon Llc|Sealed adapters for use with electromechanical surgical instruments| US11071543B2|2017-12-15|2021-07-27|Cilag Gmbh International|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges| US10869666B2|2017-12-15|2020-12-22|Ethicon Llc|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument| US10779825B2|2017-12-15|2020-09-22|Ethicon Llc|Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments| US10779826B2|2017-12-15|2020-09-22|Ethicon Llc|Methods of operating surgical end effectors| US10743875B2|2017-12-15|2020-08-18|Ethicon Llc|Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member| US11033267B2|2017-12-15|2021-06-15|Ethicon Llc|Systems and methods of controlling a clamping member firing rate of a surgical instrument| US11197670B2|2017-12-15|2021-12-14|Cilag Gmbh International|Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed| US11006955B2|2017-12-15|2021-05-18|Ethicon Llc|End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments| US10828033B2|2017-12-15|2020-11-10|Ethicon Llc|Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto| US10687813B2|2017-12-15|2020-06-23|Ethicon Llc|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments| USD910847S1|2017-12-19|2021-02-16|Ethicon Llc|Surgical instrument assembly| US10729509B2|2017-12-19|2020-08-04|Ethicon Llc|Surgical instrument comprising closure and firing locking mechanism| US11020112B2|2017-12-19|2021-06-01|Ethicon Llc|Surgical tools configured for interchangeable use with different controller interfaces| US10716565B2|2017-12-19|2020-07-21|Ethicon Llc|Surgical instruments with dual articulation drivers| US11045270B2|2017-12-19|2021-06-29|Cilag Gmbh International|Robotic attachment comprising exterior drive actuator| US10835330B2|2017-12-19|2020-11-17|Ethicon Llc|Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly| US10743868B2|2017-12-21|2020-08-18|Ethicon Llc|Surgical instrument comprising a pivotable distal head| US11129680B2|2017-12-21|2021-09-28|Cilag Gmbh International|Surgical instrument comprising a projector| US11076853B2|2017-12-21|2021-08-03|Cilag Gmbh International|Systems and methods of displaying a knife position during transection for a surgical instrument| US10945732B2|2018-01-17|2021-03-16|Covidien Lp|Surgical stapler with self-returning assembly| US11134946B2|2018-02-27|2021-10-05|Bolder Surgical, Llc|Staple cartridge and methods for surgical staplers| JP2021513906A|2018-02-27|2021-06-03|アプライド メディカル リソーシーズ コーポレイション|Surgical stapler with electric handle| 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assemblies with a gap locking member| US11147551B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems| US11147553B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems| US11172929B2|2019-03-25|2021-11-16|Cilag Gmbh International|Articulation drive arrangements for surgical systems| US11241228B2|2019-04-05|2022-02-08|Covidien Lp|Surgical instrument including an adapter assembly and an articulating surgical loading unit| US11253254B2|2019-04-30|2022-02-22|Cilag Gmbh International|Shaft rotation actuator on a surgical instrument| US11224497B2|2019-06-28|2022-01-18|Cilag Gmbh International|Surgical systems with multiple RFID tags| US11051807B2|2019-06-28|2021-07-06|Cilag Gmbh International|Packaging assembly including a particulate trap| US11219455B2|2019-06-28|2022-01-11|Cilag Gmbh International|Surgical instrument including a lockout key| US11241235B2|2019-06-28|2022-02-08|Cilag Gmbh International|Method of using multiple RFID chips with a surgical assembly| US11259803B2|2019-06-28|2022-03-01|Cilag Gmbh International|Surgical stapling system having an information encryption protocol| US11246678B2|2019-06-28|2022-02-15|Cilag Gmbh International|Surgical stapling system having a frangible RFID tag| US11224424B2|2019-08-02|2022-01-18|Covidien Lp|Linear stapling device with vertically movable knife| US11123068B2|2019-11-08|2021-09-21|Covidien Lp|Surgical staple cartridge| US11109862B2|2019-12-12|2021-09-07|Covidien Lp|Surgical stapling device with flexible shaft| US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout| US11246593B2|2020-03-06|2022-02-15|Covidien Lp|Staple cartridge| US11191537B1|2020-05-12|2021-12-07|Covidien Lp|Stapling device with continuously parallel jaws| US11191538B1|2020-06-08|2021-12-07|Covidien Lp|Surgical stapling device with parallel jaw closure| US11266402B2|2020-07-30|2022-03-08|Covidien Lp|Sensing curved tip for surgical stapling instruments| CN112741658B|2020-12-14|2022-01-07|苏州法兰克曼医疗器械有限公司|Cutting anastomat driven by one-time percussion of cutting knife|
法律状态:
2018-12-18| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]| 2019-10-08| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]| 2020-09-24| B07A| Technical examination (opinion): publication of technical examination (opinion) [chapter 7.1 patent gazette]| 2021-02-23| B09A| Decision: intention to grant [chapter 9.1 patent gazette]| 2021-04-27| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 13/03/2012, OBSERVADAS AS CONDICOES LEGAIS. |
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申请号 | 申请日 | 专利标题 US13/048,598|US8800841B2|2011-03-15|2011-03-15|Surgical staple cartridges| US13/048,598|2011-03-15| PCT/US2012/028921|WO2012125633A1|2011-03-15|2012-03-13|Removable surgical staple cartridges| 相关专利
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