巴西专利BR112014006308B1 surgical instrument apparatus with filled clamp

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专利摘要:
SURGICAL INSTRUMENT WITH FILLED CLAMP. The present invention relates to an apparatus that comprises a surgical instrument that has a proximal end and a distal end. The proximal end may comprise a cable. The distal end may comprise a cutter and a stapler. The device may additionally comprise staples for use with the stapler. The clamp may comprise an internal channel that extends over at least a portion of the length of the clamp. The apparatus may additionally comprise an agent contained in the internal channel, which can be used to coagulate a surgical site where the surgical instrument is used. The agent can facilitate the coagulation of fluids at the surgical site when the clamps are anchored to the surgical site.
公开号:BR112014006308B1
申请号:R112014006308-7
申请日:2012-09-10
公开日:2021-02-02
发明作者:Brett E. Swensgard；Dean B. Bruewer；Cory G. Kimball；Katherine J. Schmid；William A. Daunch
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

BACKGROUND
[001] In some contexts, endoscopic surgical instruments may be preferred over devices for traditional open surgery, since a smaller incision can reduce recovery time and complications in the postoperative period. Consequently, some endoscopic surgical instruments may be suitable for placing a distal end actuator in a desired surgical site through the trocar cannula. These distal end actuators can hold the tissue in various ways to achieve a diagnostic or therapeutic effect (for example, cutter, claw, cutter, stapler, clamp applicator, access device, drug delivery / gene therapy device and device for energy application using ultrasound, RF, laser, etc.). Endoscopic surgical instruments can comprise a rod between the end actuator and a cable portion, which is handled by the physician. This rod can allow insertion to the desired depth and rotation around the longitudinal axis of the rod itself, thus facilitating the positioning of the end actuator on the patient. The positioning of an end actuator can also be facilitated by the inclusion of one or more articulated joints or features, allowing the end actuator to be selectively articulated or even offset in relation to the longitudinal axis of the stem.
[002] Examples of endoscopic surgical instruments include surgical staplers. Some of these staplers can be operated to staple layers of fabric, cut through stapled fabric layers, and urge staples through fabric layers to securely join separate layers of fabric near the separate ends of the fabric layers. Merely exemplary surgical staplers are presented in US Patent No. 4,805,823, entitled "Pocket Configuration for Internal Organ Staplers", issued on February 21, 1989; US Patent No. 5,415,334, entitled "Surgical Stapler and Staple Cartridge", issued May 16, 1995; US Patent No. 5,465,895, entitled "Surgical Stapler Instrument", issued November 14, 1995; US Patent No. 5,597,107, entitled "Surgical Stapler Instrument", issued January 28, 1997; US Patent No. 5,632,432, entitled "Surgical Instrument", issued May 27, 1997; US Patent No. 5,673,840, entitled "Surgical Instrument", issued October 7, 1997; US Patent No. 5,704,534, entitled "Articulation Assembly for Surgical Instruments", issued on January 6, 1998; US Patent No. 5,814,055, entitled "Surgical Clamping Mechanism", issued September 29, 1998; US Patent No. 6,978,921, entitled "Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism", issued December 27, 2005; US Patent No. 7,000,818, entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued February 21, 2006; US Patent No. 7,143,923, entitled "Surgical Stapling Instrument Having a Firing Lockout for an Unclosed Anvil", issued December 5, 2006; US Patent No. 7,303,108, entitled "Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack", issued on December 4, 2007; US Patent No. 7,367,485, entitled "Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission", published on May 6, 2008; US Patent No. 7,380,695, entitled "Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of Firing", issued on June 3, 2008; US Patent No. 7,380,696, entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism", issued on June 3, 2008; US Patent No. 7,404,508, entitled "Surgical Stapling and Cutting Device", issued July 29, 2008; in US patent No. 7,434,715, entitled "Surgical Stapling Instrument Having Multiple Shooting Courses with Aperture Lock", granted on October 14, 2008; and in US Patent No. 7,721,930, entitled "Disposable Cartridge with Adhesive for Use with a Stapling Device", issued May 25, 2010. The description of each of the aforementioned US patents is incorporated into the present invention by reference. Although the aforementioned surgical staplers are described as used in endoscopic procedures, it should be understood that these surgical staplers can also be used in open procedures and / or other non-endoscopic procedures.
[003] Although various types of surgical stapling instruments and associated components have been manufactured and used, it is believed that no one before the inventors has manufactured or used the invention described in the embodiments. BRIEF DESCRIPTION OF THE DRAWINGS
[004] The attached drawings, which are incorporated into this specification and form part of it, illustrate modalities of the invention and, together with the general description provided above and the detailed description of the modalities provided below, serve to explain the principles of present invention.
[005] Figure 1A represents a perspective view of a surgical instrument of articulation with an end actuator in a non-articulated position;
[006] Figure 1B represents a perspective view of the surgical instrument of Figure 1A with an end actuator in an articulated position;
[007] Figure 2 represents a perspective view of the open end actuator of the surgical instrument of Figures 1A and 1B;
[008] Figure 3A represents a side cross-sectional view of the end actuator of Figure 2, taken along line 3-3 of Figure 2, with the firing bar in a proximal position;
[009] Figure 3B represents a side cross-sectional view of the end actuator of Figure 2, taken along line 3-3 of Figure 2, but showing the firing bar in the distal position;
[0010] Figure 4 represents a cross-sectional view from the end of the end actuator of Figure 2, taken along line 4-4 of Figure 2;
[0011] Figure 5 represents an exploded perspective view of the end actuator of Figure 2;
[0012] Figure 6 shows a perspective view of the end actuator of Figure 2, positioned on the fabric and being actuated once on the fabric;
[0013] Figure 7 represents a front elevation view of an exemplary version of a clamp;
[0014] Figure 8 represents a perspective view of an alternative exemplary version of a clamp;
[0015] Figure 9 represents a cross-sectional view along line A-A of the clamp shown in Figure 8;
[0016] Figure 10 represents a cross-sectional view of yet another exemplary alternative version of a clamp that has a C-shaped cross section;
[0017] Figure 11 represents a front perspective view of yet another alternative exemplary version of a clamp that has a plurality of holes.
[0018] The drawings are not intended to limit in any way, and it is envisaged that various modalities of the invention may be carried out in a variety of other ways, including those not necessarily represented in the drawings. The accompanying drawings incorporated and forming a part of the specification illustrate various aspects of the present invention, and together with the description serve to explain the principles of the invention; it is understood, however, that this invention is not limited to the provisions shown. DETAILED DESCRIPTION
[0019] The following description of specific examples of the invention should not be used to limit the scope of the present invention. Other examples, characteristics, aspects, modalities and advantages of the invention will become evident to those skilled in the art from the following description, which uses illustrations, one of the best ways contemplated for carrying out the invention. As will be understood, the invention can have other different and obvious aspects, all without departing from the invention. Consequently, drawings and descriptions should be considered as illustrative rather than restrictive. I. Exemplary surgical stapler
[0020] Figures 1 to 6 represent an exemplary surgical stapling and cutting instrument 10 that is dimensioned for insertion in a non-articulated state, as shown in Figure 1A, through the canal of the trocar cannula, to a surgical site in a patient undergoing a surgical procedure The surgical stapling and separation instrument 10 includes a portion of cable 20 connected to an implement portion 22, the latter further comprising a stem 23 that ends distally in a hinge mechanism 11 connected distally to the end actuator 12. When the articulation mechanism 11 and the distal end actuator 12 are inserted through the canal of the trocar cannula, the articulation mechanism 11 can be articulated remotely, as shown in Figure 1B, by the articulation control 13. Thus , the end actuator 12 can reach behind an organ or approach a tissue at a desired angle or for other reasons. It should be understood that terms such as "proximal" and "distal" are used in the present invention with reference to the cable portion 20 of the instrument 10 manipulated by the physician. In this way, the end actuator 12 is distal with respect to the most proximal portion of cable 20. It will also be recognized that, for convenience and clarity, spatial terms such as "vertical" and "horizontal" are used in the present invention in connection with the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
[0021] end actuator 12 of the present example includes a lower jaw 16 and an articulated anvil 18. The handle portion 20 includes a pistol grip 24, against which a closing trigger 26 is pivoted by the physician in order to causing pinching or closing of the anvil 18 against the lower jaw 16 of the end actuator 12. This closing of the anvil 18 is achieved by means of an external closing sleeve 32, which travels longitudinally in relation to the cable portion 20 in response to the articulated actuation of the closing trigger 26 against the pistol grip 24. A distal closing ring 33 of the closing sleeve 32 is supported indirectly by the structure 34 of the implement portion 22. In the articulation mechanism 11, a proximal closing tube 35 of the closing sleeve 32 communicates with the distal portion closing ring 33. The frame 34 is flexibly connected to the lower jaw 16 via the articulation mechanism tion 11, allowing articulation in a single plane. The structure 34 also supports, in a longitudinal and sliding way, a non-shown firing member, which extends through the rod 23 and transmits a firing movement from the firing trigger 28 to the firing bar 14. The firing trigger 28 it is farthest from the closing trigger 26, being pressed jointly by the doctor to staple and separate the tissue clamped on the end actuator 12, as will be described in more detail below. Then, the release button 30 is released to release the tissue from the end actuator 12.
[0022] Figures 2 to 5 represent the end actuator 12 that employs an electronic beam firing bar 14 to perform a variety of functions As best seen in Figures 3A and 3B, the firing bar 14 includes an upper pin transversely oriented 38, a firing bar cover 44, a transversely oriented middle pin 46 and a cutting edge in distal position 48. The upper pin 38 is located and translatable inside an anvil pocket 40 of the anvil 18. The cover the firing bar 44 slidably engages the lower surface of the lower jaw 16, causing the firing bar 14 to extend along the groove in the channel 45 shown in Figure 3B which is formed along the lower jaw 16. The middle pin 46 slidably engages the top surface of the lower jaw16, cooperating with the trigger bar cover 44. Thus, the trigger bar 14 positively spaces the end actuator 12 during firing, avoiding mechanical tightening that can occur between the anvil 18 and the lower jaw 16 with a minimum amount of clamped tissue and avoiding the malformation of clamps when an excessive amount of tissue is clamped.
[0023] Figure 2 shows the firing bar 14 positioned proximally and the anvil 18 hinged in an open position, allowing a cartridge of staples 37 not to be installed in the channel of the lower jaw 16 in a removable way As best can be observed in Figures 4 and 5, the staple cartridge 37 in this example includes the cartridge body 70, which contains an upper platform 72, and is coupled to a lower cartridge tray 74. As can be seen best in Figure 2, a vertical slot 49 is formed through part of the staple cartridge 37. Also, as can be seen better in Figure 2, three lines of staple openings 51 are formed through the upper platform 70 on one side of the vertical slot 49, with another set of three lines of staple openings 51 formed through the upper platform 70 on the other side of the vertical slot 49. Returning to Figures 3 to 5, a wedge-shaped sliding support 41 and a plurality of grain drivers ampo 43 are captured between the body of the cartridge 70 and the tray 74, with the wedge-shaped sliding bracket 41 proximal to the clamp actuators 43. The wedge-shaped sliding bracket 41 is movable longitudinally inside the staple cartridge 37; whereas the staple actuators 43 are movable vertically inside the staple cartridge 37. The staples 47 are also positioned inside the cartridge body 70, above the corresponding staple actuators 43. In particular, each staple 47 is propelled vertically inside the cartridge body 70 by a clamp actuator 43, in order to impel the clamp 47 through an associated clamp opening 51. As can best be seen in Figures 3A and 3B and 5, the wedge-shaped sliding support 41 has angled cam surfaces that push the clamp actuators 43 upward as the wedge-shaped sliding support 41 is propelled distally through the clamp cartridge 37.
[0024] With the end actuator 12 closed, as shown in Figure 3A, the firing bar 14 is advanced engaged with the anvil 18, through the entrance of the upper pin 38 in a longitudinal slot of the anvil 42. A propeller block 80 is located at the distal end of the firing bar 14 and is configured to engage the wedge-shaped sliding bracket 41 so that the wedge-shaped sliding bracket 41 is pushed distally by the propeller block 80 as the firing bar 14 is advanced distally through a staple cartridge 37. During this firing, the cutting edge 48 of the firing bar 14 enters the vertical slot 49 of the staple cartridge 37, separating the pinched fabric between the staple cartridge 37 and the anvil 18. As shown in Figures 3A and 3B, the middle pin 46 and the propeller block 80, together, activate the staple cartridge 37 by entering a firing slot inside the staple cartridge 37, which takes the sliding support in shape wedge 41 to the upward contact of the cams with the clamp actuators 43, which in turn pushes the clamps 47 through the clamp openings 51 and to the forming contact with the clamp-forming cavities 53 on the inner surface of the anvil 18 Figure 3B represents the firing bar 14 completely translated distally after the separation and stapling of the fabric are completed.
[0025] Figure 6 represents the end actuator 12 driven by a single movement through the fabric 90. As shown, the cutting edge 48 cut through the fabric 90, while the clip drivers 43 pushed three alternating rows of clips 47 through the fabric 90 on both sides of the cutting line produced by the cutting edge 48. The clamps 47 are all oriented substantially parallel to the cutting line in this example, although it should be understood that the clamps 47 can be positioned in any suitable orientations. In the present example, the end actuator 12 is removed from the trocar after the first stroke is completed, the staple cartridge sent 37 is replaced with a new staple cartridge, and the end actuator 12 is again inserted through the trocar to reach the stapling site for additional cutting and stapling. This process can be repeated until the desired number of cuts and staples 47 has been applied. Anvil 18 may need to be closed to facilitate insertion and removal through the trocar; and the anvil 18 may need to be opened to facilitate replacement of the staple cartridge 37.
[0026] It should be understood that the cutting edge 48 can separate fabrics substantially at the same time that the clamps 47 are pushed through the fabric during each stroke of actuation. In the present example, the cutting edge 48 closely follows the insertion of the clips 47, so that a clip 47 is pushed through the fabric just before the cutting edge 48 passes through the same region of the fabric, although it should be understood that this order can be reversed, or that the cutting edge 48 can be directly synchronized with the adjacent clips. Although Figure 6 shows the end actuator 12 being driven in two layers 92, 94 of fabric 90, it should be understood that end actuator 12 can be driven through a single layer of fabric 90 or more than two layers 92, 94 of fabric. It should also be understood that the formation and positioning of staples 47 adjacent to the cut line produced by the cutting edge 48 can substantially join the fabric at the cut line, thereby reducing or preventing bleeding and / or leakage of other body fluids in the cut-line. Various suitable configurations and procedures in which the instrument 10 can be used will be apparent to those skilled in the art in view of the teachings contained herein.
[0027] It should be understood that instrument 10 can be configured and is operable in accordance with any other teachings of US Patent No. 4,805,823; US patent No. 5,415,334; US patent No. 5,465,895; US patent No. 5,597,107; US patent No. 5,632,432; US patent No. 5,673,840; US patent No. 5,704,534; US patent No. 5,814,055; US patent No. 6,978,921; US patent No. 7,000,818; US patent No. 7,143,923; US patent No. 7,303,108; US patent No. 7,367,485; US patent No. 7,380,695; US patent No. 7,380,696; US patent No. 7,404,508; US patent No. 7,434,715; and / or US patent No. 7,721,930. As noted above, the descriptions of each of these patents are incorporated by reference to the present invention. Additional exemplary modifications that can be made to instrument 10 will be described in more detail below. Several suitable ways in which the teachings below can be incorporated into instrument 10 will be apparent to those skilled in the art. Similarly, various ways in which the teachings below can be combined with various teachings of the patents cited herein will be apparent to those skilled in the art. It should also be understood that the teachings below are not limited to the instrument 10 or the devices taught in the patents cited here. The teachings below can be readily applied to several other types of instruments, including instruments that would not be classified with surgical staplers. Various other suitable devices and configurations in which the teachings below can be applied will be apparent to those skilled in the art in view of the teachings contained herein. II. Exemplary filled staples
[0028] In the exemplary version shown in Figures 1 to 6, it will be understood that the clamps 47 may comprise surgical clamps, as illustrated, for example, in Figures 3A-4. for further illustration, Figure 7 shows an enlarged view of a clamp 200 for use with the surgical cutting and stapling instrument 10 as shown in Figures 1 to 6. Clamp 200 comprises a crown 202, legs 204 and teeth 206. In some exemplary versions, the clamp 200 can be constructed from a wire that has a circular or substantially round cross section. In other versions, the clamp 200 may be constructed from a wire or ribbon of material having a substantially flat or rectangular cross section. It will be understood that other variations of clip shapes and sizes 200 can be used as would be apparent to an element skilled in the art, in view of the teachings of the present invention.
[0029] It will be understood that it may be desirable for clamp 200 to assist or facilitate the clotting of blood or other fluids at the surgical site. In some other purely exemplary versions, it may be desirable to have clamp 200 assisting healing of the surgical site by providing a therapeutic agent for the surgical site. For example, Figure 8 shows an example clamp 300 for use with surgical cutting and stapling 10. Clamp 300 comprises a crown 302, legs 304 and teeth 306. Clamp 300 additionally comprises an inner groove 308. As shown in the version example, the inner channel 308 extends throughout the inner part of the clamp 300 of the teeth 306, through the legs 304, and through the crown 302. In some exemplary versions, the inner channel 308 can extend only for a portion of the clamp 300. For example, inner channel 308 can extend only through crown 302. In other exemplary versions, inner channel 308 can extend only through legs 304. Other lengths suitable for inner channel 308 can be used as would be apparent to the person skilled in the art, in view of the teachings of the present invention. In the exemplary version, teeth 306 have a pointed shape, but any shape suitable for teeth 306 can be used as would be apparent for an element skilled in the art, in view of the teachings of the present invention. For example, teeth 306 may comprise a rectangular surface or other blunt shape.
[0030] In the illustrated version, the inner channel 308 contains an agent 310. Agent 310, in the exemplary version comprises a mixture of thrombin powder and operable fibrin to aid in coagulation around the area of the clamp 300, when the clamp 300 is inserted in the surgical site. While the exemplary version comprises thrombin and fibrin, it will be understood that any suitable coagulant can be used as would be apparent for an element skilled in the art, in view of the teachings of the present invention. In addition, in some versions, other therapeutic agents can be used in addition to a coagulant. For example, agent 310 may comprise an operable material to assist in healing the surgical site. Merely exemplifying therapeutic agents may include antibiotics, hemostatic agents, adhesives, sealants, cancer drugs, radioactive materials, and / or any other suitable agents, as would be apparent to an element skilled in the art, in view of the teachings of the present invention. In exemplary versions, agent 310 may comprise a mixture of a curing agent, as well as a coagulant or any other suitable materials, as would be apparent to an element skilled in the art, in view of the teachings of the present invention. In some other exemplary versions, it will be understood that agent 310 can be placed in inner channel 308 or clamp 300, while a distinct therapeutic agent, such as any of those discussed here, can be applied to the outer surface of clamp 300, instead of just be applied to the inner channel 308.
[0031] In the illustrated version, agent 310 comprises a powder mixture as stated earlier. The powder mixture of agent 310 is operable to be sufficiently packaged inside the inner channel 308 such that the agent 310 does not fall out of the inner channel 308. Once the clamp 300 is inserted into the surgical site, the mixture in powder can be activated by mixing with blood and / or other fluids at the surgical site, thus initiating the clotting process. As the agent 310 near the exposed portion of the inner channel comes into contact with bodily fluids, more and more powder material in the inner channel 308 absorbs the fluid from the surgical site. Powdered material combined with fluid forms a thicker fluid, in which a portion of the thicker fluid flows out of the inner channel 308. As a result, agent 310 is able to spread to other portions of the surgical site except those directly adjacent to clamp 300. It will be understood that the clotting of blood and other fluids from the surgical site as a result of coming into contact with agent 310, can result in additional stability of the clamps 300 inserted into the surgical site. it will also be understood that, once the clamp 300 is inserted into the surgical site, the operation of the surgical cutting and stapling instrument 10 results in legs 304 of the clamp 300 folding inward. As a result, this deformation of a portion of the clamp 300 can assist clamp 300 in expelling agent 310 from clamp 300. While the present exemplary agent 310 is in a powdered state, agent 310 can be in a freeze-dried form in which agent 310 was injected into channel 308, then freeze-dried after agent 310 was positioned inside inner channel 308. In other exemplary versions, any fluid state suitable for agent 310 can be used as it would be apparent to an element skilled in the art, in view of the teachings of the present invention. Figure 9 shows a cross section of the clamp 300 having a generally rectangular cross section, showing the agent 310 packaged in the inner channel 308 before use.
[0032] In some versions, agent 310 may comprise a gel or other liquid agent 310 which generally remains within the inner channel 308, until the clamp 300 is inserted into the surgical site. For example, it will be appreciated that a liquid or gel, used as agent 310, can remain inside the inner channel 308, due to the liquid tension being operable to keep agent 310 inside the inner channel 308. Once the clamp 300 is inserted in the surgical site, agent 310 can come into contact with fluids and / or tissues, which essentially interrupt the surface tension of agent 310, thus allowing agent 310 to interact with the surgical site.
[0033] It should also be understood that instead of having an exposed inner channel 308 extending around the clip 300, the clip 300 can define a hollow cylindrical cross section in such a way that the inner channel 308 can only be exposed in place surgery on teeth 306. Such a clamp configuration 300 can be constructed by means of the inner channel 308 within a long wire, which can then be cut and bent to form clamps 300. Other methods of forming clamps suitable for the inner channel 300 they can be used as would be apparent to the person skilled in the art, in view of the teachings of the present invention. As a result, agent 310 contained within the inner channel 308 is released to the surgical site, through teeth 306 to provide a slower release of agent 310. Any appropriate configuration for inner channel 308 can be used as would be apparent to the skilled in the art, in view of the teachings of the present invention. It will also be understood that the internal channel 308 within the clamp 300 can be operable to act as a capillary in such a way that, once inserted in the surgical site, the clamp 300 can have agent 310 removed from the clamp 300.
[0034] In Figure 10, an exemplary version of clamp 400 has a C-shaped cross section, instead of a rectangular cross section. In some exemplary versions, clamp 400 can be formed using an elongated wire. The elongated wire may have a groove formed therein along the length of the clamp 400, which forms the internal groove 408. In some exemplary versions, the clamp 400 can be formed using a rolled-up piece of material that can be filled with the agent 410. For example, the staple forming material 400 can be arranged in a flattened manner. Then, a suitable amount of agent 410 can be placed on the material, where the material can then be rolled up. A portion of material can be cut and then folded to form clamp 400. As a result, the process can provide a circular cross section as shown in the Figure. 10. However, a similar process can be used to form the clamps 400, having any suitable cross section, as would be apparent to the person skilled in the art, in view of the teachings of the present invention. In addition, any other suitable method for forming staple 400 can be used as would be apparent to one skilled in the art, in view of the teachings of the present invention.
[0035] Figure 11 shows an alternative exemplary version of a clamp 500 that has an internal channel 508 that contains an agent 510 In the exemplary version, the clamp 500 additionally comprises a plurality of holes 512, distributed across the surface of the clamp 500. The holes 512 can be spread evenly as shown in the present example, or in other exemplary versions, holes 512 can be more highly concentrated in one particular area than in another. In addition, although the present example shows holes 512 that are generally circular in shape, it will be appreciated that any size or shape of holes 512 can be used as would be apparent to the person skilled in the art, in view of the teachings of the present invention. It will be understood that once the clamp 500 is applied to a surgical site, holes 512 can facilitate the release of agent 510 to the surgical site, by agent 510 being released into the site through holes 512 or when exiting directly from the internal channel 508 It will also be understood that holes 512 can be operable to provide support for tissue growth, after staple 500 is inserted into a surgical site. It will be understood that other suitable functionalities may result and are considered as a result of holes 512 in the clamp 500.
[0036] It will be understood that staples 300, 400, 500, as described herein, can be configured so that they are loadable and otherwise compatible with a conventional staple cartridge 37, without having to provide special accommodations for staples 300 , 400, 500. In addition, when agent 310, 410, 510 is injected into staples 300, 400, 500, staples 300, 400, 500 are still sized to fit into conventional staple cartridges 37. It will be understood, however , that the clamps 300, 400, 500 can be constructed to be of any size and suitable configuration, as would be evident to a person skilled in the art, taking into account the teachings contained herein, even if such sizes or configurations exceed the sizes of conventional staple cartridges 37.
[0037] It must be understood that any one or more of the teachings, expressions, modalities, examples, etc. described here can be combined with any one or more of the other teachings, expressions, modalities, examples, etc. that are described here. The teachings, expressions, modalities, examples, etc. described below should not be seen in isolation from each other. Various suitable ways in which the teachings of the present invention can be combined will be readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included in the scope of the embodiments.
[0038] Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in medical treatments and procedures assisted by robotics.
[0039] Versions of what has been described above can be designed to be discarded after a single use, or they can be designed for use multiple times. The versions can, in either or both cases, 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, some versions of the device can be disassembled, in any number of particular parts or parts of the device can be selectively replaced or removed in any combination. With the cleaning and / or replacement of particular parts, some versions of the device can be reassembled for subsequent use in a reconditioning facility, or by a user immediately before a surgical procedure. Those skilled in the art will understand that the reconditioning of a device can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting refurbished device are all within the scope of the present application.
[0040] Just as an example, the versions described here can be sterilized before and / or after a procedure. In a sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the device can then be placed in a radiation field, such as gamma radiation, X-rays or high-energy electrons, which can penetrate the container. Radiation can exterminate bacteria on the device and the container. The sterile device can then be stored in a sterile container for later use. The device can also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.
[0041] In view of the presentation and description of several versions in the present disclosure, additional adaptations of the methods and systems described in this document can be made through appropriate modifications made by an element versed in the technique, without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to the elements versed in the technique. For example, the examples, versions, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative only and are not mandatory. Consequently, the scope of the present invention must be considered in accordance with the terms of the embodiments and it is understood that it is not limited to the details of the structure and operation shown and described in the specification and in the drawings.

权利要求:
Claims (12)
[0001]
1. Apparatus, comprising: (a) a surgical instrument (10) comprising a proximal end and a distal end, wherein the proximal end of the surgical instrument (10) comprises a handle (20), wherein the distal end of the instrument surgical (10) comprises a cutter and a stapler (12); (b) a staple (300, 400, 500) in communication with the stapler (12), in which the stapler (12) of the surgical instrument (10) is configured to release the staple (300, 400, 500) to a location surgical; and (c) an agent (310, 410, 510); characterized by the fact that the clamp (300, 400, 500) comprises an exposed internal channel (308, 408, 508) that extends along the entire length of the clamp (300, 400, 500), in which the internal channel (308, 408, 508) exposed retains the agent (310, 410, 510) and is further configured to release at least a portion of the agent (310, 410, 510).
[0002]
2. Apparatus according to claim 1, characterized by the fact that the agent (310, 410, 510) comprises fibrin and thrombin.
[0003]
Apparatus according to claim 1, characterized by the fact that the agent (310, 410, 510) comprises a powder form.
[0004]
4. Apparatus according to claim 1, characterized by the fact that the clamp (300, 400, 500) has a rectangular cross section.
[0005]
5. Apparatus according to claim 1, characterized by the fact that the clamp (300, 400, 500) has a C-shaped cross section.
[0006]
Apparatus according to claim 1, characterized in that the agent (310, 410, 510) comprises a gel form.
[0007]
Apparatus according to claim 1, characterized by the fact that it additionally comprises an adjunct therapeutic agent, in which the adjunct therapeutic agent is contained within the inner channel (308, 408, 508) mixed with the agent (310, 410 , 510).
[0008]
8. Apparatus according to claim 1, characterized in that the clamp (300, 500) comprises a crown (302), a leg portion (304), and a pair of teeth (306), in which each tooth has a blunt shape.
[0009]
9. Apparatus according to claim 1, characterized by the fact that the clamp (300, 500) comprises a crown (302), a leg portion (304), and a pair of teeth (306), in which each tooth has a pointed shape.
[0010]
Apparatus according to claim 1, characterized by the fact that the clamp (300, 400, 500) comprises a therapeutic coating applied to the outer surface of the clamp (300, 400, 500).
[0011]
11. Apparatus according to claim 1, characterized by the fact that the agent (310, 410, 510) is configured to activate when combined with a liquid, in which the agent (310, 410, 510) is configured to assist clotting when the agent (310, 410, 510) is activated.
[0012]
12. Apparatus according to claim 1, characterized by the fact that the clamp (300, 400, 500) is operable to be deformed when the clamp (300, 400, 500) is released to a surgical site, where the deformation of the clamp (300, 400, 500) pushes out at least a portion of the agent (310, 410, 510).

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同族专利:

公开号 | 公开日

MX2014003173A|2014-09-22|

RU2014114835A|2015-10-20|

JP2014533121A|2014-12-11|

EP2755568A1|2014-07-23|

CN103987328A|2014-08-13|

CN103987328B|2017-04-26|

BR112014006308A2|2017-04-11|

WO2013039823A1|2013-03-21|

EP2755568B1|2020-12-09|

MX343432B|2016-11-03|

RU2621119C2|2017-05-31|

JP2017170184A|2017-09-28|

US20130068815A1|2013-03-21|

JP6411584B2|2018-10-24|

US9125649B2|2015-09-08|

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法律状态:
2018-12-11| B06F| Objections, documents and/or translations needed after an examination request according art. 34 industrial property law|

2019-10-29| B06U| Preliminary requirement: requests with searches performed by other patent offices: suspension of the patent application procedure|

2020-11-24| B09A| Decision: intention to grant|

2021-02-02| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 10/09/2012, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

申请号 | 申请日 | 专利标题

US13/233,646|2011-09-15|

US13/233,646|US9125649B2|2011-09-15|2011-09-15|Surgical instrument with filled staple|

PCT/US2012/054410|WO2013039823A1|2011-09-15|2012-09-10|Surgical instrument with filled staple|

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