![]() staple cartridge and surgical end effector for use with a surgical instrument
专利摘要:
SURGICAL FIELD CARTRIDGES WITH TISSUE STRINGS TO HANDLE DIVIDED TISSUE AND METHOD OF USING THE SAME. The present invention relates to surgical clip cartridges and methods for manipulating the split ends of divided tissue. In various forms, the staple cartridge has at least one base material temporarily supported thereon which is oriented to be stapled to a corresponding end of the divided fabric. At least one elongated cord is attached non-removably to each piece of base material. When the base material is stapled to the corresponding piece of divided fabric, the doctor can manipulate that piece of divided fabric by applying manipulation movements to the cord. Corresponding grooves or pockets can be established in the cartridge body to temporarily support the strings therein. 公开号:BR112013023739B1 申请号:R112013023739-2 申请日:2012-03-13 公开日:2020-12-08 发明作者:Jeffrey S. Swayze 申请人:Ethicon Endo-Surgery, Inc.; IPC主号:
专利说明:
BACKGROUND Technical field [0001] The present invention relates to surgical instruments and, in various modalities, surgical instruments for cutting and stapling and staple cartridges for them that are designed to cut and staple fabrics. Background [0002] Surgical staplers were used in the prior art to make a longitudinal incision in the tissue and simultaneously apply staple lines to opposite sides of the incision. Such instruments commonly include a pair of collaborating claw elements in which, if the instrument is intended for endoscopic or laparoscopic applications, they are able to pass through a cannula passage. One of the claw elements receives a staple cartridge that has at least two rows of staples laterally spaced. The other claw element defines an anvil that has aligned pockets formed by clamps, with rows of unformed clamps supported on the cartridge. [0003] In use, a doctor is able to close the clamp elements of the stapler on the fabric to position it before unloading the staples. When the doctor determines that the clamping elements are properly holding the tissue, the doctor can then unload the surgical stapler, thereby sectioning and stapling the tissue. Simultaneous sectioning and stapling avoids complications that may arise during the sequential execution of these actions with different surgical instruments that only section or staple, respectively, the tissue. [0004] A variety of surgical cutting and stapling instruments are known in the art that can be applied by means of laparoscopy and / or in conjunction with various "open" surgical procedures. Some surgical stapling and sectioning instruments are configured to support the replaceable cartridges that hold staples not formed there. Such devices commonly employ a retractable cutting element that remains with the stapling instrument and can be reused with multiple cartridges. After the clips are discharged into a cartridge, the cutting element is retracted and the used cartridge is removed to allow a new cartridge to be installed if desired. As the cutting element is guided distally through the cartridge, the unformed staples are discharged out of their respective pouches in the cartridge forming contact with the underside of the anvil. Examples of such devices are presented in US Patent No. 7,000,818, entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued on February 21, 2006, a description that is incorporated herein by reference, in its entirety . Other surgical cutting and stapling instruments employ what is commonly called a "disposable loading unit" or "UCD". Such devices support a staple cartridge and a new knife in the form of a "unit" that is configured to be operably attached to the surgical stapling instrument. The units are designed to be discarded after the clamps have been unloaded. Examples of these instruments are presented in U.S. Patent No. 5,865,361 entitled "Surgical Stapling Apparatus", issued on February 2, 1999, the complete description of which is incorporated herein by reference. [0005] In some circumstances, the layers of fabric may be relatively thin, may have a high fluid content, and / or may have a non-uniform thickness, which may cause staples to be formed incorrectly within the fabric. To alleviate this problem, a piece of "support" material was used to support the fabric, as the fabric is being fastened and stapled. Such a piece of reinforcement material is commonly releasably attached to at least one of the first and second claw elements before they are inserted into a surgical site. The piece of reinforcement material serves to distribute the compression force applied by the clips on the surface of the fabric area, in order to create a more uniform pressure distribution in the fabric. US patent publication No. US2009 / 0206143 A1, entitled "Surgical End Effector Having Buttress Retention Features", published on August 20, 2009, contains several reinforcements and reinforcement retention provisions and is hereby incorporated by reference in its entirety. . [0006] In many surgical procedures and, in particular, in many vascular surgical procedures, when the tissue is divided by the stapling and cutting instrument, the two tissue segments separate from the end effector that supports the staple cartridge. In some procedures that involve, for example, the intestine and / or the stomach, this may not be problematic. However, other types of tissue such as vases have a tendency to quickly retract towards their origin after they have been separated. For example, in a procedure such as a pulmonary lobotomy, in which the vessels are usually located inside a relatively confined chest cavity, when a vessel is removed, it can be very difficult to recover if the need arises. For example, if the seal or bandage is defective and there is bleeding, it is essential that the vessel be recomposed as soon as possible to subject the bleeding vessel to repair. [0007] Consequently, there is a need for surgical clip cartridge arrangements that address many of the challenges discussed above. [0008] The previously mentioned 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 [0009] In accordance with general aspects of at least one form, a surgical staple cartridge is provided that has a cartridge body that operably supports a plurality of surgical staples therein. A base material is temporarily supported on a portion of the cartridge body and is configured to be stapled to the fabric when the staples supported on the cartridge body are stapled to the fabric. The base material is configured to remain attached to the fabric when the cartridge body is removed from it. At least one elongated cord is non-removably coupled to the base material. [0010] According to other general aspects of at least one form, a surgical end effector is provided for use with a surgical instrument. In various embodiments, the surgical end effector comprises an elongated channel that is operably coupled to the surgical instrument. A staple cartridge that has a cartridge body is operably supported in the elongated groove. The cartridge body has a platform surface that is substantially divided into a first platform portion and a second platform portion through a longitudinal slot that extends between them. The cartridge body operably supports a first plurality of clips not formed there that correspond to the first platform portion. A second plurality of unformed clips correspond to the second platform portion. A tissue cutting element is operably supported on the cartridge body for axial advancement in the longitudinal slit by applying a cutting drive movement by the surgical instrument. An anvil is supported for moving paths towards, and away from, the platform surface in response to the opening and closing movements applied to it by the surgical instrument. A first base material is removably supported on the first platform portion and at least one first cord is non-removably attached thereto. A second base material is removably supported on the second platform portion and at least one second cord is non-removably attached thereto. [0011] According to yet other general aspects of at least one form, a method for manipulating the divided tissue is presented. In various forms, the method comprises dividing a piece of fabric into two separate fabric segments where each fabric segment has a separate end. The method further comprises stapling the separate ends of the first and second fabric segments and attaching at least one cord to at least one of the separate ends of the first and second fabric segments during the stapling action. The method further comprises manipulating the separate end having at least one cord attached to it by applying a manipulation movement to the cord. BRIEF DESCRIPTION OF THE DRAWINGS [0012] The aforementioned characteristics and other characteristics and advantages of this invention and the way of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of modalities of the invention, taken in conjunction with the drawings attached, in which: [0013] FIG. 1 is a side view of a shape of a surgical cutting and stapling instrument with which various cartridges and the end effector modalities of the present invention can be used; [0014] FIG. 2 is an exploded view of an embodiment of the end effector of the present invention; [0015] FIG. 2A is an exploded view of another embodiment of the end effector of the present invention; [0016] FIG. 2B is an exploded view of another embodiment of the end effector of the present invention; [0017] FIG. 3 is an exploded view of a portion of a staple cartridge embodiment of the present invention; [0018] FIG. 4 is a perspective view of a portion of the staple cartridge of FIG. 3; [0019] FIG. 5 is a partial plan view of an embodiment of the end effector holding a vessel between the anvil and the staple cartridge thereof; [0020] FIG. 6 is a perspective view of the divided and stapled vessel shown in FIG. 5; [0021] FIG. 7 is a perspective view of a surgical cutting and stapling instrument having a surgical staple cartridge embodiment of the present invention supported therein, which has been inserted into a trocar cannula; [0022] FIG. 8 is a view of the exploded unit of a portion of another staple cartridge embodiment of the present invention; [0023] FIG. 9 is a perspective view of a portion of the staple cartridge of FIG. 8; [0024] FIG. 10 is a view of the exploded unit of a portion of another staple cartridge embodiment of the present invention; [0025] FIG. 11 is a perspective view of a portion of the staple cartridge of FIG. 10; [0026] FIG. 12 is a view of the exploded unit of a portion of another staple cartridge embodiment of the present invention; [0027] FIG. 13 is a perspective view of a portion of the staple cartridge of FIG. 12; [0028] FIG. 14 is a view of the exploded unit of a portion of another staple cartridge embodiment of the present invention; [0029] FIG. 15 is a perspective view of a portion of the staple cartridge of FIG. 14; [0030] FIG. 16 is a view of the exploded unit of a portion of another staple cartridge embodiment of the present invention; and [0031] FIG. 17 is a perspective view of a portion of the staple cartridge of FIG. 16. DETAILED DESCRIPTION [0032] The Applicant for this application is also the owner of the US patent application entitled "Surgical Fastener Instruments", Legal Registration Number No. END6844USNP / 100529, which was filed on the same date as this application and which is incorporated herein by way of reference, in its entirety. [0033] Certain exemplary embodiments will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the devices and methods of the present invention presented. One or more examples of these modalities are illustrated in the attached drawings. Those of ordinary skill 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 solely by the embodiments. The characteristics illustrated or described in conjunction with an exemplary modality can be combined with the characteristics of other modalities. Such modifications and variations are designed to be included within the scope of the present invention. [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 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 features illustrated or described in conjunction with a modality can be combined, in whole or in part, with the structures of the attributes or features of one or more other modalities without limitation. Such modifications and variations are designed to be included within the scope of the present invention. [0035] The terms "proximal" and "distal" are used in the present invention with reference to the manipulation that a physician makes of the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located farthest from the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute. [0036] Various devices and exemplifying methods are provided for performing laparoscopic procedures and minimally invasive surgical procedures. However, those of ordinary skill in the art will readily recognize that the various methods and devices disclosed in the present invention can be used in a number of surgical procedures and applications including, for example, in connection with "open" surgical procedures. As this Detailed Description advances, those of ordinary skill in the art will additionally appreciate that the various instruments presented here can be inserted into a body in some way, such as through a natural orifice, through an incision or perforation formed in tissue, etc. The functional portions or portions of the end effector of the instruments can be inserted directly into a patient's body or can be inserted through an access device, such as a trocar that has a working channel through which the end effector and the elongated stem of a surgical instrument can be advanced. [0037] Returning to the Drawings in which equal numbers denote equal components across all the various views, FIG. 1 represents a modality of a surgical stapling and cutting instrument 10 that is capable of practicing several exclusive benefits of the present invention. Various forms of the surgical instrument 10 are disclosed in US Patent No. 7,753,904 entitled "Endoscopic Surgical Instrument With a Handle That Can Articulate With Respect to the Shaft", the complete description of which is incorporated herein by reference. As such, the details regarding the construction and operation of that device not necessary to understand the various modalities and forms of the present invention will not be specifically repeated here. The surgical instrument shown in FIG. 1 is a motor-driven or "motorized" instrument. As this Detailed Description advances, the person skilled in the art will recognize that the exclusive and innovative aspects of the present invention can also be effectively used in conjunction with surgical stapling and sectioning instruments that employ mechanical (non-motorized) systems to unload the clips. and sectioning the tissue without deviating from the character and scope of the present invention. [0038] As can be seen in FIG. 1, a form of a surgical instrument 10 comprises a handle 6 having an elongated tube unit 30 which is operably attached to it, which is configured to transmit actuating movements to an end effector 12 which is attached to a distal end portion of the elongated tube unit 30. End effector 12 includes a channel 22 that is coupled to support various forms of staple cartridges of the present invention, as will be discussed in more detail below. An anvil 24 is movably supported in relation to the channel 22 in response to the opening and closing movements applied to it by various portions of the elongated tube unit 30. [0039] The handle 6 includes a pistol grip 26 towards which a driver of the closing system 18 can be pivotedly pulled by the doctor to cause the anvils to clamp or close 24 towards the clamp channel 22 of the end effector 12. A discharge driver 20 is furthest from the center of the closing system 18. As shown in FIG. 2, the end effector 12 may include, in addition to the previously mentioned channel 22 and anvil 24, a knife and the sliding conductor element 32, a staple cartridge 50 that supports a plurality of unformed staples 90 there, a rod with helical thread 36 and a bearing 38 that is coupled to the structure of the groove 22. The anvil 24 can be pivotably connected to the groove 22 at an adjacent pivot point. In one embodiment, for example, the anvil 24 includes pivot pins projected laterally 25 at its proximal end that articulately engages in the openings of pivot 23 formed near the proximal end of the channel 22. When the actuator of the closing system 18 is actuated or that is, it is pulled by a user of the instrument 10, the rotating pins 25 of the anvil 24 can pivot inside the openings of the pivot 23 in the channel 22 around the point of the pivot inside the clamped or closed position. If the clamping of the end effector 12 is satisfactory, the operator can activate the discharge driver 20, which activates a motor / transmission (not shown) on the cable 6 that applies rotary movement to the helical thread rod 36 to make the element the knife / slider conductor 32 moves along the channel 22, thereby sectioning the tissue clamped inside the end effector 12 and leading the unformed clips 90 to form the contact with the underside of the anvil 24. As used here, the term "unload" with respect to the staples, refers to the actions involved in driving the unformed staples 90 out of their respective staple bags inside the staple cartridge and forming contact with a corresponding portion of the staple. anvil. As this Detailed Description advances, the reader will recognize, however, that the unique and innovative aspects of the present invention can be advantageously used in conjunction with a variety of other surgical staplers and surgical stapler instruments, including those surgical stapling units configured for be used with so-called disposable charge units, such as those devices featured in US patent application publication No. 2006/0011699 A1, entitled "Surgical Stapler With Universal Articulation and Tissue Pre-Clamp", description that is here incorporated by reference, in its entirety. Consequently, the scope of protection offered by the various modalities of the present invention should not be limited for use with a specific type of surgical stapling instrument. [0040] After the knife / slider conductor element 32 has been guided to the distal end of the staple cartridge 50, the physician releases the discharge driver 20 to allow the discharge driver 20 to return to an open position that will result in application of a retracting movement to the knife / slider conducting element 32 to cause it to move proximally to a starting position. Once the knife / slide guide element 32 has been moved to a start position outside the staple cartridge 50, the clinician can unlock the locking system driver 18 via a release button 30 on the handle to allow the actuator of the closing system 18 moves to the open position and in this way causes the anvil 24 to open in a pivotal way and release the divided and stapled fabric. [0041] In the embodiments shown in Figures 3 and 4, the staple cartridge 50 includes a cartridge body 51 that supports a plurality of non-formed staples 90 there. The cartridge body 51 has a centrally arranged slot 55 that divides the cartridge platform into a first platform portion 53 and a second platform portion 54. The slot 55 accommodates the knife / slider conducting element 32 while being driven longitudinally inside of the cartridge body 51. Various embodiments of the present invention include a first base material 60 which is removably or temporarily supported on, or attached to the first platform portion 53. Similarly, a second material 70 is supported in a removably or temporarily over, or attached to the second portion of platform 54. For example, the first and second base materials 60 and 70 can be removably attached to the respective first and second portion of platform 53 and 54 via adhesives (natural and manufactured), mechanically by deformation of the portions of the platform or by using biocompatible and / or absorbable closures. In various embodiments, the base materials 60 and 70 can be manufactured from a bioabsorbable mesh material. For example, base materials 60 and 70 can be manufactured with Vicryl suture (or other absorbable) or a collagen-based material. In other embodiments, the base materials 60 and 70 may comprise a "support" material made from, for example, bovine pericardium, GoreTex® material, etc. [0042] As can be seen in Figures 3 and 4, for example, several modalities of the base materials 60 and 70 each have at least one elongated cord attached to it. In particular, a first elongated cord 62 can extend completely around the first base material 60 and be attached to it by, for example, adhesives (natural and manufactured), mechanically by deformation portions of the platform, or by using biocompatible and / or absorbable closures. In other embodiments, the first elongated cord 62 is attached to a single portion of the first base material (for example, a corner, side, end, top or bottom surface) so that it extends therein. Similarly, a second elongated strand 72 is attached to the second base material 70 by the same materials and / or methods or the like. In the embodiment shown in Figures 3 and 4, the first and second elongated strands 62 and 72, respectively, can be supplied in various lengths. In one embodiment, for example, the first and second strands 62 and 72 can each have a length that is approximately at least twice the length "L" of the cartridge 50. See FIG. 2. However, the first and second strands 62 and 72 can each have shorter lengths or longer lengths, as will be discussed in more detail below. In still other embodiments, one of the elongated strands 62 or 72 is shorter than the other elongated strand 62 or 72. Although FIG. 2, illustrate the attachment of strands 62 and 72 to the distal ends of the first and second base materials 60 and 70, respectively, in other embodiments, the strands 62 and 72 can be attached to the proximal ends of the first and second base materials 60 and 70, respectively, or in other embodiments, a cord 62 or 72 can be attached to the distal end of its corresponding base material 60 and 70 and the other cord 62 or 72 can be attached to the proximal end of its corresponding base material. Refer to FIG. 2A for an example. In still other embodiments, the strands 62 and 72 can be attached to both ends of their corresponding base material 60 and 70, as shown in FIG. 2B. In still other modalities, a cord 62 and 72 can be attached to each corner of its respective base material 60 and 70. [0043] Figures 5 and 6 illustrate a use of the staple cartridge 50 to cut and staple a vase 80. As can be seen in FIG. 5, the end effector 12 is positioned in relation to the vessel 80 so that the portion of vessel 80 to be cut and stapled is received between the anvil 24 and the platform 52 of the staple cartridge 50. The anvil 24 is then closed ( pulling the locking system driver 18 and locking it in position). The discharge driver 20 can then be pressed to unload the clamps 90 and section the vessel inside two ends of the vessel 82 and 84. After unloading, the first base material 60 is sandwiched between the crowns of the clamps 90 and the first end of vessel 82. Similarly, the second base material 70 is sandwiched between the crowns of the clamps 90 and the second end of vessel 84. See FIG. 6. After the cutting and stapling actions have been completed and the anvil 24 is moved to an open position to release the ends of the split vessel 82 and 84 from end effector 12, end effector 12 can be removed from the site . In this modality, the cords 62 and 72 are not previously fixed to the cartridge body 51 and remain suspended from their respective first and second base materials 60 and 70. Thus, if the doctor needs to recover or identify the ends of the divided vessel 82 and 84, he can find the corresponding strands 62 and 72 and use a separate instrument (for example, a gripper, forceps, etc.) to bring the end of the vessel closer. Such an arrangement represents a vast improvement over previous cutting and stapling devices and methods, particularly when used when sectioning the fabric that may need to be further manipulated after stapling. [0044] As shown in FIG. 7, end effector 12 and elongated stem unit 30 can be sized to be inserted through a trocar unit 900 that has been inserted into the patient. Such trocar units are known in the art and, therefore, their construction and operation are not discussed in detail in the present invention. For example, U.S. Patent No. 6,017,356 to Frederick et al., Entitled "Method For Using a Trocar For Penetration and Skin Incision", a description which is incorporated herein by reference in its entirety, presents several trocar units. The reader will certainly recognize, however, that the various modalities of the present invention can be effectively applied with a variety of different trocars, cannula etc., arrangements without deviating from the character and scope of the present invention. Therefore, the various embodiments of the present invention and their equivalent structures should in no way be limited to use with the specific type of trocar described herein by way of example. [0045] When used in conjunction with a trocar, cannula etc., which offers an access passage inside the surgical site in the patient, the first and second strands 62 and 72, respectively, can be provided with a length that allows the strands 62 and 72 extend outside the trocar 900 to provide easy access to this. In such arrangements, for example, if a staple line is attached to a portion of tissue intended for excision, the cord could be used to pull that tissue towards the trocar cannula 902 to exit through it. Refer to FIG. 7. Such an exclusive and innovative arrangement can also be used when the trocar was removed, but the cord (s) extend out of the opening in the body cavity. In this way, the cord (s) can be used to manipulate stapled tissue from the outer layer of the body cavity even after the trocar has been removed. [0046] Figures 8 and 9 illustrate another embodiment of cartridge 150 that is substantially identical to cartridge 50 described above, except for the differences noted below. In this embodiment, for example, the cartridge 150 has a cartridge platform 152 which is divided into a first platform portion 153 and a second platform portion 154 through a slot 155. The first base material 60 is temporarily attached to, or supported in removably on the first platform portion 153 and the second base material 70 is temporarily attached to, or removably attached to, or supported on the second platform portion 154 in the various ways described above. In this embodiment, however, a first groove or pocket 156 that is adapted to temporarily receive at least a portion of the first cord 62 is located therein on the first platform portion 153. Similarly, a second groove or pocket 157 is formed in the second platform portion 154 to temporarily receive at least a portion of the second cord 72 therein. Refer to FIG. 9. The first groove or pouch 156 can be dimensioned in relation to the first cord 62 so that it can be pressed into it to be retained inside the groove 156 while the end effector 12 is introduced into the surgical site and then extracted for out of the first groove 156 after the first base material 60 has been attached to the tissue and the end effector 12 is removed from the surgical site. Similarly, the second groove or pocket 157 can be dimensioned in relation to the second cord 72 so that it can be pressed into it to be retained within the groove 157 while the end effector 12 is introduced into the surgical site and then is extracted out of the second groove 157 after the second base material 70 has been attached to the tissue and the end effector 12 is removed from the surgical site. In other embodiments, the first strand 62 may be temporarily retained within the first groove 156 by means of biocompatible adhesive, gel, etc., and the second cord 72 may be temporarily retained within the second groove 157 by means of biocompatible adhesive, gel, etc. [0047] Figures 10 and 11 illustrate another modality of cartridge 250 that is substantially identical to the cartridge 50 described above, except for the differences noted below. In this embodiment, for example, cartridge 250 has a cartridge platform 252 which is divided into a first platform portion 253 and a second platform portion 254 by an elongated slot 255. The first base material 60 is temporarily attached to, or fixed to removably to, or supported on, the first platform portion 253. Similarly, the second base material 70 is temporarily attached to, or removably attached to, or supported on the second platform portion 254 in the various ways described above. In this embodiment, however, a first groove, pocket, zone or region 257 which is adapted to temporarily receive at least a portion of the first cord 62 therein, is established in the tip portion of cartridge 256. Similarly, a second groove , pouch, zone or region 258 or pouch is formed at the tip portion of cartridge 256 to temporarily receive at least a portion of the second strand 72 therein. Refer to FIG. 11. The first groove or pouch 257 can be dimensioned in relation to the first cord 62 so that it can be pressed into it to be retained within the groove 257 while the end effector 12 is introduced into the surgical site and then extracted for out of the first groove 257 after the first base material 60 has been attached to the tissue and the end effector 12 is removed from the surgical site. Similarly, the second groove or pocket 258 can be dimensioned in relation to the second cord 72 so that it can be pressed into it to be retained within the groove 258 while the end effector is introduced into the surgical site and then extracted out of the second groove 258 after the second base material 70 has been attached to the tissue and the end effector 12 is removed from the surgical site. In other embodiments, the first strand 62 may be temporarily retained within the first groove 257 through the adhesive or friction and the second strand 72 may be temporarily retained within the second groove 258 by adhesive. [0048] Figures 12 and 13 illustrate another modality of cartridge 350 that is substantially identical to the cartridge 50 described above, except for the differences noted below. In this embodiment, for example, cartridge 350 has a cartridge body 351 that has a cartridge platform 352 which is divided into a first platform portion 353 and a second platform portion 354 by an elongated slot 355. The first base material 60 it is temporarily attached to, or removably attached to, or supported on the first platform portion 353. Similarly, the second base material 70 is temporarily attached to, or removably attached to, or supported on the second platform portion 354 in the various ways described above. In this embodiment, however, a first groove, pocket, zone or region 358 which is adapted to temporarily receive at least a portion of the first cord 62 is thereby established in the side portion 357 of the tip portion of the cartridge 356. Similarly , a second groove, pocket, zone or region 359 is formed on the side 357 of the tip portion of the cartridge 356 to temporarily receive at least a portion of the second cord 72 therein. Refer to FIG. 13. The first groove or pouch 358 can be dimensioned in relation to the first cord 62 so that it can be pressed into it to be retained within the groove 358 while the end effector 12 is introduced into the surgical site and then is extracted to out of the first groove 358 after the first base material 60 has been attached to the tissue and the end effector 12 is removed from the surgical site. Similarly, the second groove or pocket 359 can be dimensioned in relation to the second cord 72 so that it can be pressed into it to be retained within the second groove 359 while the end effector 12 is introduced into the surgical site and then it is extracted out of the second groove 359 after the second base material 70 has been attached to the tissue and the end effector 12 is removed from the surgical site. In other embodiments, the first strand 62 may be temporarily retained within the first groove 358 through the adhesive or friction and the second strand 72 may be temporarily held within the second groove 359 by adhesive or friction. [0049] Figures 14 and 15 illustrate another modality of cartridge 450 that is substantially identical to cartridge 50 described above, except for the differences noted below. In this embodiment, for example, cartridge 450 has a cartridge body 451 which has a cartridge platform 452 which is divided into a first platform portion 453 and a second platform portion 454 by an elongated slot 455. The first base material 60 it is temporarily attached to, or removably attached to, or supported on the first platform portion 453. Similarly, the second base material 70 is temporarily attached to, or removably attached to, or supported on the second platform portion 454 in the various ways described above. In this embodiment, however, a first groove, pocket, zone or region 457 which is adapted to temporarily receive at least a portion of the first cord 62 is thereby established on the side portion 456 of the tip portion of the cartridge 450. Similarly , a second groove, pocket, zone or region 458 is formed at the tip portion of the cartridge 456 to temporarily receive at least a portion of the second strand 72 therein. Refer to FIG. 15. The first groove or pocket 453 can be dimensioned in relation to the first cord 62 so that it can be pressed into it to be retained within the groove 457 while the end effector 12 is introduced into the surgical site and then is extracted to outside the first groove 457 after the first base material 60 has been attached to the tissue and the end effector 12 is removed from the surgical site. Similarly, the second groove or pocket 458 can be dimensioned in relation to the second cord 72 so that it can be pressed into it to be retained within the second groove 458 while the end effector 12 is introduced into the surgical site and then it is extracted out of the second groove 458 after the second base material 70 has been attached to the tissue and the end effector 12 is removed from the surgical site. In other embodiments, the first strand 62 may be temporarily retained within the first groove 457 through the adhesive or friction and the second strand 72 may be temporarily retained within the second groove 458 by adhesive or friction. [0050] Figures 16 and 17 illustrate another embodiment of cartridge 550 that is substantially identical to cartridge 50 described above, except for the differences noted below. In this embodiment, for example, cartridge 550 has a cartridge body 551 that has a cartridge platform 552 which is divided into a first portion of platform 553 and a second portion of platform 554 by an elongated slot 555. The first base material 60 is temporarily attached to, or removably attached to, or supported on the first platform portion 553. Similarly, the second base material 70 is temporarily attached to, or removably attached to, or supported on the second platform portion 554 in the various ways described above. In this embodiment, however, a first groove, pocket, zone or region (not shown) which is adapted to temporarily receive at least a portion of the first cord 62 is established therein in the first side portion 556 of the cartridge 550. Similarly, a second groove, pocket, zone or region 558 is formed in a second side portion 557 of the cartridge 550 to temporarily receive at least a portion of the second cord 72 therein. Refer to FIG. 17. The first groove or pouch can be dimensioned in relation to the first cord 62 so that it can be pressed into it to be retained within that groove while the end effector 12 is introduced into the surgical site and is then extracted out of the first groove after the first base material 60 has been attached to the tissue and the end effector 12 is removed from the surgical site. Similarly, the second groove or pocket 558 can be dimensioned in relation to the second cord 72 so that it can be pressed into it to be retained within the second groove 558 while the end effector 12 is introduced into the surgical site and then it is extracted out of the second groove 558 after the second base material 70 has been attached to the tissue and the end effector 12 is removed from the surgical site. In other embodiments, the first strand 62 may be temporarily retained within the first groove through the adhesive or friction and the second strand 72 may be temporarily held within the second groove 558 by adhesive. In this embodiment, a sufficient amount of clearance is established between the upright side walls 23 and 25 of the channel (FIG. 2) and the first and second side portions of the cartridge 550 to provide sufficient clearance for the first and second strands to be pushed out from their respective grooves in the cartridge 550 or otherwise separated from the sides of the cartridge 550 after the base materials 60 and 70 have been stapled to the separate tissue portions and the end effector 12 is removed from the surgical site. [0051] The modalities described above, each employs first and second base materials 60 and 70. However, for those orders where the ability to handle only a portion of the split / stapled fabric is desirable, only one base material can be used. employee. Accordingly, various embodiments of the present invention comprise at least one base material that is temporarily attached to, or otherwise removably supported on, the cartridge or other portion of the end effector 12 and to which the base material has at least one elongated cord attached to it. [0052] The devices described here can be designed to be discarded after single use, or they can be designed to 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 changing private 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 reconditioned device are all within the scope of this application. [0053] Preferably, the 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 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. [0054] 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 conflict with existing definitions, statements or other description material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein replaces any conflicting material incorporated herein by reference. Any material, or portion thereof, that is deemed to be incorporated by reference into 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. [0055] 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 technique to which this invention belongs.
权利要求:
Claims (8) [0001] 1. Surgical clamp cartridge (50, 150, 250, 350) comprising: a cartridge body (51) operably supporting a plurality of surgical clamps (90) within it, the cartridge body (51) comprising: a platform surface and first and second side sides; and a longitudinal slot (55) disposed therein dividing the platform surface within a first platform portion (53) and a second platform portion (54); a segment of first base material removably retained in the first platform portion (53), and a segment of second base material removably retained in the second platform portion (54), characterized by the fact that: the first material base has at least one first cord (62) fixed non-removably to it; and the second base material has at least one second cord (62) fixed non-removably to it. [0002] 2. Surgical staple cartridge (50, 150, 250, 350) according to claim 1, characterized in that the first base material and the second base material comprise a mesh material. [0003] 3. Surgical clamp cartridge (50, 150, 250, 350), according to claim 1, characterized in that the cartridge body (51) has a body length and in which at least one of the at least one of the elongated strands has a strand length that is at least as long as the body length. [0004] 4. Surgical clamp cartridge (50, 150, 250, 350), according to claim 1, characterized in that the first cord (62) is removably supported on a corresponding first portion of the cartridge body (51 ) and in which the second cord (62) is removably supported on a corresponding second portion of the cartridge body (51). [0005] 5. Surgical clamp cartridge (50, 150, 250, 350) according to claim 4, characterized in that each first cord (62) is removably supported within a corresponding first groove provided in the first portion of the portion of the cartridge body (51) and wherein the second cord (62) is removably supported within a corresponding second groove provided in the second portion of the cartridge body (51). [0006] 6. Surgical clamp cartridge (50, 150, 250, 350), according to claim 5, characterized by the fact that the first groove is provided in a first side portion of the cartridge body (51) and in which the second groove is provided in a second side side portion of the cartridge body (51). [0007] 7. Surgical staple cartridge (50, 150, 250, 350), according to claim 1, characterized in that portions of the first and second strands are removably supported in at least one groove is in a portion of the tip of the cartridge body portion (51). [0008] 8. Surgical end effector (12) for use with a surgical instrument (10), the surgical end effector (12) characterized by the fact that it comprises: an elongated channel operably coupled to the surgical instrument (10); a surgical staple cartridge (50, 150, 250, 350) as defined in claim 1, wherein the cartridge body (51) is operably supported in the elongated groove, the cartridge body (51) operably supporting a first plurality of unformed clips (90) therein corresponding to the first portion first platform portion (53) and a second plurality of unformed clips (90) corresponding to the second platform portion (54) a fabric cutting element is supported operably in the cartridge body (51) for axial advance in the longitudinal slot (55) longitudinally by applying a cutting drive movement of the same by the surgical instrument (10); an anvil supported for moving paths towards and away from the platform surface in response to the opening and closing movements applied to this by the surgical instrument (10).
类似技术:
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同族专利:
公开号 | 公开日 CA2828786C|2018-11-20| JP2014515639A|2014-07-03| JP6017466B2|2016-11-02| US20120234900A1|2012-09-20| CN103429171A|2013-12-04| RU2013145904A|2015-04-20| CA2828786A1|2012-09-20| AU2012230052B2|2016-05-19| EP2685908B1|2018-01-03| US8540131B2|2013-09-24| WO2012125628A1|2012-09-20| EP2685908A1|2014-01-22| BR112013023739A2|2016-12-13| CN103429171B|2016-04-06| AU2012230052A1|2013-09-12|
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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]| 2020-08-25| B09A| Decision: intention to grant [chapter 9.1 patent gazette]| 2020-12-08| 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 US13/048,608|2011-03-15| US13/048,608|US8540131B2|2011-03-15|2011-03-15|Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same| PCT/US2012/028914|WO2012125628A1|2011-03-15|2012-03-13|Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same| 相关专利
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