apparatus and method for selectively coupling a reinforcement material to a staple cartridge for a s

专利摘要:
REINFORCEMENT OF THE SURGICAL CLAMP TO THE CARTRIDGE. The present invention relates to a surgical instrument that includes an end actuator and a staple cartridge that can be inserted into the end actuator. The staple cartridge includes a reinforcement material that is selectively attached to the staple cartridge. In some versions, the reinforcement material can be stapled to the staple cartridge by one or more fixing clips. Such fixing clips can be inserted into staple openings formed through an upper support of the staple cartridge. The clamps can include legs resiliently pulled to resist friction against removal. In some versions, the clamps can be dimensioned to form an interference fit in the clamp openings. Alternatively, the clamps can include splinters. A clamp actuator can be used to disengage the clamps. The clamp driver may include clamp-forming pockets to flex the clamp legs when disengaging the clamp.
公开号:BR112014008028B1
申请号:R112014008028-3
申请日:2012-10-02
公开日:2021-01-05
发明作者:Geoffrey C. Hueil；John V. Hunt；Venkataramanan Mandakolathur Vasudevan；Israel Nur；Gregory J. Fanuele
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, endocutter, claw, cutter, stapler, clamp applicator, access device, drug delivery device / gene therapy and device for applying energy 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 in 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 layers of fabric, and propel staples through fabric layers to firmly attach 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 on November 14, 1995; US Patent No. 5,597,107, entitled "Surgical Stapler Instrument", granted on January 28, 1997; US Patent No. 5,632,432, entitled "Surgical Instrument", issued on May 27, 1997; US Patent No. 5,673,840, entitled "Surgical Instrument", issued on 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 on 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 Ring 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 Surge 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; US patent No. 7,434,715, entitled "Surgical Stapling Instrument Having Multiple Opening Stroke Trigger Courses", issued on October 14, 2008; and in US Patent No. 7,721,930, entitled "Disposable Cartridge with Adhesive for Use with a Stapling Device", issued on 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 inventor (s) has manufactured or used the invention described in the attached claims. BRIEF DESCRIPTION OF THE DRAWINGS
[004] The attached drawings, which are incorporated into this descriptive report and which 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 the present invention.
[005] Figure 1A shows a perspective view of a surgical instrument of articulation with an end actuator in a non-articulated position;
[006] Figure 1B shows a perspective view of the surgical instrument in 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 to 1B;
[008] Figure 3A shows 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 perspective view of a clamp cartridge for the end actuator of Figure 2 that has a reinforcement material attached to it;
[0014] Figure 8A represents a side elevation view of the staple cartridge and the reinforcement material of Figure 7 in an untapped position;
[0015] Figure 8B represents a side elevation view of the staple cartridge and the reinforcement material of Figure 8A in a triggered position; and
[0016] Figure 9 represents a perspective view of an exemplary clamp trigger that has clamp-forming pockets.
[0017] The drawings are not intended to limit in any way, and it is envisaged that various modalities of the invention can be performed in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings, which form 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
[0018] 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 contemplated ways to carry 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. Exemplary surgical stapler
[0019] Figures 1 to 6 represent an exemplary surgical stapling and separation instrument 10 that is sized for insertion in a non-articulated state, as shown in Figure 1A, through the canal of the trocar cannula, to a surgical site. - genetic 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 and an end actuator 12 connected distally. When the articulation mechanism 11 and the 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, 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.
[0020] The 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 pivotally pressed by the doctor in order to cause clamping 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 moves 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 closing ring (33). The structure 34 is flexibly connected to the lower jaw (16) via the articulation mechanism 11, allowing articulation in a single plane. The frame 34 also supports, in a longitudinal and sliding way, a triggering member (not shown), which extends through the rod 23 and transmits a firing movement from the trigger 28 to the trigger bar 14. The firing trigger 28 is further 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, release button 30 is released to release tissue from end actuator 12.
[0021] Figures 2 to 5 represent the end actuator 12 which employs an electronic beam firing bar 14 to perform a variety of functions. As can be seen better in Figures 3A and 3B, the firing bar 14 includes a top pin transversely oriented 38, a cover of the firing bar 44, a middle pin transversely oriented 46 and a cutting edge in distal position 48 The upper pin 38 is located and is translatable inside an anvil pocket 40 of the anvil 18. The firing bar cover 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) that is formed along the lower jaw 16. The middle pin 46 engages in a sliding way to the top surface of the lower jaw 16, cooperating with the firing bar cover 44. Thus, firing 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 tissue for and avoiding the malformation of staples when an excessive amount of tissue is clamped.
[0022] Figure 2 shows the firing bar 14 positioned proximally and anvil 18 hinged in an open position, allowing an unused staple cartridge 37 to be removably installed in the lower jaw channel 16. As shown you can see better 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 better in Figure 2, a vertical slot 49 is formed through part of the staple cartridge 37. As can also be seen in Figure 2, three rows of staple openings 51 are formed through the upper platform 72 on one side of the vertical slot 49 , with another set of three rows of clamp openings 51 formed through the upper platform 72 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 drives Staple painters 43 are captured between the body of the cartridge 70 and the tray 74, with the wedge-shaped sliding support 41 located proximal to the clamp drivers 43. The wedge-shaped sliding support 41 is movable longitudinally inside the cartridge staples 37; whereas staple actuators 43 are movable vertically inside the staple cartridge 37. 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 driver 43, in order to propel the clamp 47 through an associated clamp opening 51. As can be seen better in Figures 3A and 3B and 5, the wedge-shaped sliding support 41 has sloping cam surfaces that push the clamp actuators 43 upward as the wedge-shaped sliding support 41 is propelled distally through the clamp cartridge 37.
[0023] 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 block propeller 80 is located at the distal end of the firing bar 14 and is configured to engage the wedge-shaped slide 41 so that the wedge-shaped slide 41 is pushed distally by the propeller block 80 according to the bar trigger 14 is advanced distally through a staple cartridge 37. During this firing, the cutting edge 48 of the trigger bar 14 enters the vertical slot 49 of the staple cartridge 37, separating the clamped tissue between the staple cartridge 37 and the anvil 18. As shown in Figures 3A to 3B, the middle pin 46 and the propeller block 80, together, drive the staple cartridge 37 into a slot 49 inside the staple cartridge 37, which takes the sliding bracket on wedge frame 41 to the upward contact of the cam with the clamp actuators 43, which, in turn, impel 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.
[0024] Figure 6 shows end actuator 12 driven by a single movement through fabric 90. The cutting edge 48 cuts through fabric 90, while staple actuators 43 drive three alternating rows of staples 47 through fabric 90 on each side 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, end actuator 12 is removed from the trocar after the first stroke is completed, the used staple cartridge 37 is replaced with a new staple cartridge, and 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 replacing the staple cartridge 37.
[0025] 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 staples 47, so that a staple 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 clamps. 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 tissue 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.
[0026] 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 7,367,485; US patent 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.
[0027] 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 the 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 here 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. Exemplary reinforcement material attached to the staple cartridge
[0028] In some exemplary versions, the staple cartridge 37 can be used in conjunction with a reinforcement material 100 as shown, for example, in Figures 7 to 9. It may be desirable to use reinforcement material 100 during cutting and / or stapling the fabric to help support and heal the cut area. In the present example, reinforcement material 100 comprises a coagulant which is intended to reinforce a surgical site when the surgical site is cut and stapled. For example, reinforcement material 100 may comprise fibrin and thrombin, but any suitable coagulant can be used as would be understood by the skilled person in view of the teachings of the present invention. In addition, reinforcement material 100 may comprise a hemostatic agent, any suitable glue material, acellular tissue (for example, allogeneic or xenogenic), collagen, gelatin, oxidized regenerated cellulose (ORC), woven synthetic materials and degradable non-woven fabrics such as polylactate, polyglycol, poly-cuproic acid, or any other suitable material, as would be understood by the skilled person in view of the teachings of the present invention. In some exemplary versions, reinforcement material 100 may comprise a fibrin block. In addition, reinforcement material 100 may comprise any combination of a variety of suitable materials.
[0029] Figure 7 represents the reinforcement material 100 placed on the upper support 70 and extending substantially along the length of the upper support 70. The reinforcement material 100 is a generally uniformly thick block coupled to the staple cartridge 37, but it will be understood that the reinforcement material 100 can be distributed in separate portions in the upper support 70. For example, strips of reinforcement material 100 can be used instead of a single block. Such strips can include longitudinal strips, side strips, diagonal strips, etc. Alternatively, greater or lesser amounts of reinforcement material 100 may be positioned at the distal and / or proximal end of the upper support 70, although this is purely optional. It should be understood that any suitable distribution of reinforcement material 100 along the upper support 70 can be used as would be understood by the person skilled in the art in view of the teachings of the present invention. The reinforcement material 100 of the present example comprises a semi-rigid and / or rigid structure so that, when decoupled from the staple cartridge 37 as will be described below, the reinforcement material 100 is capable of generally maintaining a flat and rectangular configuration.
[0030] The cartridge 37 of the present example has been modified so that one or more clip drivers 43, shown in Figures 8A-8B, do not have a clip 47 inserted therein. Instead, the clamps 110 are inserted through the reinforcement material 100 and into the clamp openings 51 that correspond to the clamp drivers 43 without a clamp 47. In the example shown in figure 7, six clamps 110 are inserted through the reinforcement material 100 and into the clip openings 51 to substantially secure the reinforcement material 100 to the upper support 70 of the staple cartridge 37. It should be understood that any number of fixing clips 110 can be used to couple reinforcement material 100 to the staple cartridge 37. The clamps 110 each comprise a pair of resilient legs 112 which are pulled out from the main portion of each clamp 110. Consequently , when the fixing clips 110 are inserted through the reinforcement material 100 and in the clip openings 51, resiliently pulled legs 112 are in a borderline position and selectively engage and the side walls of the staple openings 51 to resist friction against removal from inside the staple openings 51. When the staple cartridge 37 is used to implant staples 47 through the actuation of the wedge-shaped slide holder 41 shown in Figures 3A to 3B, the respective clamp actuators 43 located below the clamping clips 110 dislodge resiliently drawn legs 112 from the side walls of the clamp openings 51 so that the clamping clips 110 are uncoupled and directed out of their respective clip openings 51, as will be discussed in more detail below with respect to figures 8A-8B. As will be apparent to the person skilled in the art, the orientation of the clamps 110 in relation to the upper support 70 and the fabric is such that the clamps 110 do not pierce the fabric when the clamps 47 are installed from the cartridge of clamps 37. For example, the clamps 110 can simply remain attached to the reinforcement material 100, they can fall freely in the surgical site, they can be retained by an element in the anvil 18, etc.
[0031] Other configurations suitable for clamping clips 110 or other components selectively coupling and uncoupling from clamp openings 51 will be apparent to the person skilled in the art in view of the teachings of the present invention. For example, in some versions, the clamps 110 may comprise a wire that has a diameter that is larger than the diameter of the wire used for clamps 47. Consequently, the resiliently pulled legs 112 can also be selectively attached to the clamp openings 51 due to interference fit of the larger diameter wire into the clamp opening 51. In an additional version, the clamps 110 can include barbs 114 configured to enter the material of the clamp openings 51 to resist removal. Alternatively, rectangular insertable members (not shown) can be used instead of the clamping clips 110. Such insertable members can include barbs 114 to also resist removal. In addition, an adhesive can be included between the upper support 70 and the reinforcement material 100 to further secure, or alternatively, the reinforcement material 100 to the upper support 70.
[0032] Figure 8A represents the staple cartridge 37 having the reinforcement material 100 coupled to the upper support 70 by the fixing clamp 110. A plurality of staples 47 are also shown in a state not installed on top of the staple drivers - pos 43. Figure 8B represents the reinforcement material 100 installed with the clamps 47 and attached to the fabric 90. As shown in figure 8A, the clamps 47 are initially loaded into the clamp openings 51 of the clamp cartridge 37 and positioned over the clamp actuators 43 in an uninstalled state. In the example shown, a clip opening 51 does not receive a clip 47 therein. Instead, when the reinforcement material 100 is placed on the upper support 70, the clamp 110 is inserted and selectively clamped into the clamp opening 51. While a single clamp 110 is shown, it must be understand that more than one clamp 110 can be used. Just as an example, three clamps 110 can be used on the side of the clamp cartridge 37 to secure the reinforcement material 100 to it. As shown in figure 8A, the staple cartridge 37 having the reinforcement material 100 attached to it is in an uninstalled state and is ready to be used for stapling fabric.
[0033] When the fabric 90 has been positioned over the staple cartridge 37 to be stapled and cut, the user then activates the closing trigger 26 to secure the fabric 90 between the anvil 18 and the reinforcement material 100. The user then activates the firing trigger 28 to activate the firing bar 14 in a distal position through the staple cartridge 37. As described above, the cutting edge 48 of the firing bar 14 enters the vertical slot 49 of the staple cartridge 37, separating the fabric clamped between the staple cartridge 37 and the anvil 18. 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 leads the wedge-shaped sliding support 41 to the upward contact of the cam with the clamp actuators 43, which, in turn, impel the clamps 47 through the clamp openings 51, through the reinforcement material 100, through fabric 90 and to comfortable contact with the clamp-forming cavities 53 on the inner surface of the anvil 18. The wedge-shaped sliding bracket 41 also directs the respective clamp drivers 43 to the clamps 110, thus dislodging the resiliently pulled legs 112 and ejecting the clamps 110 from the clamp openings 51, as shown in figure 8B. Consequently, staples 47 staple fabric 90 and attach reinforcement material 100 to fabric 90 when installed from staple cartridge 37. It should be understood that in the present example, staple clips 110 are merely dislodged from the staple cartridge 37 and do not attach to fabric 90. In some versions, legs resiliently pulled 112 may comprise blunt ends.
[0034] Logically other configurations for the clamps 110 and / or for the clamp cartridge 37 will be apparent to one skilled in the art in view of the teachings of the present invention. For example, as shown in figure 9, an exemplary clamp clamp driver 150 may be included in clamp cartridge 37 in the respective clamp openings 51 where clamps 110 are to be inserted. The clamping driver 150 of the present example comprises a driver body 152 and clamp forming pockets 154 formed on the surface of the driving body 152. The clamp forming pockets 154 of the present example are configured to engage and flex resiliently pulled legs 112 to form curled staple legs. Consequently, when the reinforcement material 100, the clamps 47, and the clamps 110 are coupled to the fabric 90 within a body, the rolled resiliently pulled legs 112 can form a smooth surface so that another fabric cannot be caught in the resiliently drawn legs 112. Of course, other configurations for the staple cartridge 37 and / or reinforcement material 100 will be apparent to one skilled in the art in view of the teachings of the present invention. Just as an example, the staple cartridge 37 and / or reinforcement material 100 can be constructed in accordance with at least some of the teachings of US Patent Application Serial No. 13 / 233,664, entitled "Surgical Instrument and Buttress Material, "filed on September 15, 2011, the description of which is incorporated herein by reference.
[0035] Although certain configurations of exemplary surgical instruments have been described, several other ways in which surgical instruments can be configured will become apparent to elements skilled in the art in view of the teachings of the present invention. Just as an example, the surgical instruments mentioned here can be constructed in accordance with at least some of the 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 7,367,485; US patent 7,380,695; US patent No. 7,380,696; US patent No. 7,404,508; US patent No. 7,434,715; and US patent No. 7,721,930.
[0036] It is understood that any patent, publication, or other description material, in whole or in part, that is said to be incorporated into the present invention for reference purposes, is incorporated into the present invention only if the incorporated material does not conflict with existing definitions, statements, or other description material presented in this description. In this way, and as far as necessary, the description as explicitly determined here replaces any conflicting material incorporated here for reference. Any material, or portion thereof, that is considered 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 where no conflict will arise between the embedded material and the existing description material.
[0037] Modalities of the present invention have application in conventional open endoscopic and surgical instrumentation, as well as application in surgery aided by robotics. For example, those skilled in the art will recognize that various teachings of the present invention can be easily combined with various teachings from US Patent No. 6,783,524, entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," published on 31 August 2004, the description of which is incorporated by reference.
[0038] Modalities of the devices presented here 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, modalities of the devices presented here can be disassembled, any number of particular parts or parts of the devices can be selectively replaced or removed in any combination. With the cleaning and / or replacement of particular parts, modalities of the devices can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will 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 reconditioned device are all within the scope of this application.
[0039] Just as an example, the modalities described here can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a radiation field, which can penetrate the container, such as gamma radiation, X-rays or high-energy electrons. Radiation can kill bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until it is opened at the medical facility. 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.
[0040] Having shown and described various modalities of the present invention, other adaptations of the methods and systems described in the present invention can be made by means of suitable modifications by an element skilled in the art 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, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not necessary. Consequently, the scope of the present invention must be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of the structure and operation shown and described in the specification and drawings.

权利要求:
Claims (15)
[0001]
1. Apparatus, comprising: (a) a surgical instrument (10), in which the surgical instrument is operable to cut and staple a portion of tissue, in which the surgical instrument comprises a distal end, and in which the instrument surgical comprises an end actuator (12) at the distal end; and (b) a staple cartridge (37), wherein the staple cartridge is selectively insertable into the end actuator, the staple cartridge comprising: i. an upper support (72) having a plurality of clip openings (51), ii. a reinforcement material (100) in communication with the upper support, and iii. a clamp driver (150), characterized by the fact that the clamp driver (150) is in one of the plurality of clamp openings, in which the reinforcement material is selectively coupled to the clamp cartridge by one or more clamps (110), the clamp trigger (150) is operable to engage one or more clamps, and the clamp trigger is operable to disengage one or more clamps (110 ) from the staple cartridge.
[0002]
2. Apparatus according to claim 1, characterized by the fact that one or more fixing clips comprise a fixing clip (110), in which the fixing clip selectively couples the reinforcement material to the upper support .
[0003]
3. Apparatus according to claim 2, characterized by the fact that the upper support comprises a fixing clip opening, in which the fixing clip is inserted into the fixing clip opening.
[0004]
4. Apparatus according to claim 3, characterized by the fact that the fixing clip comprises a wire, where the wire has a diameter, where the opening of the fixing clip has a width, and where the wire diameter is equal to the width of the opening of the fixing clamp.
[0005]
Apparatus according to claim 3, characterized by the fact that the staple cartridge still comprises a plurality of staples and a plurality of staple drivers arranged therein, wherein the upper support comprises a plurality of staple openings (51), wherein each clamp of the plurality of clamps is in communication with a respective clamp driver of the plurality of clamp drivers.
[0006]
6. Apparatus according to claim 5, characterized by the fact that the opening of the fixing clamp is aligned longitudinally with one or more of the clamp openings.
[0007]
7. Apparatus according to claim 5, characterized by the fact that the plurality of clamp actuators are operable to direct the plurality of clamps through the reinforcement material.
[0008]
8. Apparatus, according to claim 3, characterized by the fact that the clamp actuator is in communication with the opening of the clamp.
[0009]
9. Apparatus, according to claim 8, characterized by the fact that the actuator of the clamp is vertically translatable in relation to the upper support.
[0010]
10. Apparatus according to claim 8, characterized by the fact that the clamp actuator comprises clamp-forming pockets (154).
[0011]
11. Apparatus according to claim 2, characterized by the fact that the fixing clip comprises a pair of legs resiliently pulled (112).
[0012]
12. Apparatus according to claim 11, characterized by the fact that the legs that are resiliently pulled are pulled out.
[0013]
13. Apparatus according to claim 11, characterized by the fact that the resiliently pulled legs comprise splinters (114).
[0014]
14. Apparatus, according to claim 1, characterized by the fact that the reinforcement material is selected from the group consisting of: a hemostatic agent; thrombin; or fibrin.
[0015]
15. Method for selectively coupling a reinforcement material to a staple cartridge for a surgical instrument using one or more clamps (110), wherein the surgical instrument comprises an end actuator (12) configured to receive the cartridge staple (37), where the end actuator is operable to cut a portion of fabric and staple a portion of tissue when the staple cartridge is inserted there, where the staple cartridge comprises an upper support ( 72) that has a plurality of clamp openings (51) and a clamping clip driver (150) in one of the plurality of clamp openings, the method characterized by the fact that it comprises the steps of: (a) placing the reinforcement material on at least a portion of the upper support; and (b) selectively coupling the reinforcement material to the staple cartridge by inserting one or more fixing clips (110) through the reinforcement material and in at least one staple opening (51) of the plurality of staple openings (51 ), so that the clamps are selectively detachable from the clamp cartridge (37) by actuation of the clamp driver (150).

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同族专利:

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公开号 | 公开日

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RU2621117C2|2017-05-31|

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CN103841902B|2016-12-14|

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RU2014117163A|2015-11-10|

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US8899464B2|2014-12-02|

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JP6208138B2|2017-10-04|

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JP2014533128A|2014-12-11|

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EP2765923A1|2014-08-20|

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EP2765923B1|2018-04-04|

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PL2765923T3|2018-09-28|

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BR112014008028A2|2017-04-11|

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US20130082086A1|2013-04-04|

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WO2013052435A1|2013-04-11|

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MX2014004084A|2014-09-22|

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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|

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2019-11-05| B06U| Preliminary requirement: requests with searches performed by other patent offices: suspension of the patent application procedure|

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2020-10-20| B09A| Decision: intention to grant|

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2021-01-05| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 02/10/2012, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US13/251,682|2011-10-03|

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US13/251,682|US8899464B2|2011-10-03|2011-10-03|Attachment of surgical staple buttress to cartridge|

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PCT/US2012/058388|WO2013052435A1|2011-10-03|2012-10-02|Attachment of surgical staple buttress to cartridge|

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