fabric stapling device

专利摘要:
RESOURCE TO RETIRE THE TISSUE STAPLER SAFETY KEY. The present invention relates to a surgical instrument including an anvil selectively attachable to a stapling head assembly and an operable trigger for firing staples into the compressed tissue between the anvil and the stapling head assembly. In some versions, a locking element may engage a safety feature to prevent the anvil from acting on the stapling head assembly. For example, a flap can engage a slot in an actuator, a screen door latch can provide frictional resistance or engage teeth in the actuator, a door can engage in engagement with one or more recesses, oriented teeth can engage with teeth in the actuator , the locking element can include a ratchet assembly to engage the actuator and / or a push button can act in a recess while disengaging the locking element. Alternatively, in some versions, the trigger actuation set can be disengaged before firing. An anvil position indicator can restrict the engagement of the trigger actuation set.
公开号:BR112014014682B1
申请号:R112014014682-9
申请日:2012-12-11
公开日:2021-01-26
发明作者:Carl J. Shurtleff；Johnny H. Iii Alexander；Christopher C. Miller；Edward G. Chekan；John F. Cummings；Adam R. Dunki-Jacobs；Barry T. Jamison；Joseph E. Young；Cortney E. Henderson
申请人:Ethicon Endo-Surgery, Inc.；
IPC主号:

专利说明:

BACKGROUND
[001] In some situations, a surgeon may want to position a surgical instrument through a patient's orifice and use the instrument to adjust, position, attach and / or otherwise interact with tissue within the patient. For example, in some surgical procedures, portions of the gastrointestinal tract may be cut and removed to remove unwanted tissue or for other reasons. As soon as the desired tissue is removed, the remaining portions will need to be joined. Such a tool to perform these anastomotic procedures is a circular stapler that is inserted through a hole in the patient.
[002] Examples of such circular surgical staplers are described in US Patent No. 5,205,459, entitled "Surgical Anastomosis Stapling Instrument", issued on April 27, 1993; US patent No. 5,271,544, entitled "Surgical Anastomosis Stapling Instrument", issued December 21, 1993; US patent No. 5,275,322, entitled "Surgical Anastomosis Stapling Instrument", issued January 4, 1994; US Patent No. 5,285,945, entitled "Surgical Anastomosis Stapling Instrument", issued February 15, 1994; US patent No. 5,292,053, entitled "Surgical Anastomosis Stapling Instrument", issued March 8, 1994; US Patent No. 5,333,773, entitled "Surgical Anastomosis Stapling Instrument", issued August 2, 1994; US patent No. 5,350,104, entitled "Surgical Anastomosis Stapling Instrument", issued September 27, 1994; and US Patent No. 5,533,661, entitled "Surgical Anastomosis Stapling Instrument", issued July 9, 1996. The description of each of the aforementioned US patents is incorporated by reference into the present invention. 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.
[003] Other exemplary surgical staplers, merely additional, are presented in US Patent No. 4,805,823, entitled "Pocket Configuration for Internal Organ Staplers", granted 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 Shot System", 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; US patent No. 7,434,715, entitled "Surgical Stapling Instrument Having Multiple Shooting Courses with Aperture Lock", 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 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.
[004] 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
[005] Although the specification concludes with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which the same numbers reference points identify the same elements and where:
[006] Figure 1 describes a side elevation view of an exemplary circular stapling surgical instrument;
[007] Figure 2A depicts an enlarged longitudinal cross-sectional view of an exemplary stapling head assembly of the instrument of Figure 1 showing an example anvil in an open position;
[008] Figure 2B depicts an enlarged longitudinal cross-sectional view of the stapling head assembly of Figure 2A showing the anvil in a closed position;
[009] Figure 2C depicts an enlarged longitudinal cross-sectional view of the stapling head assembly of Figure 2A showing an exemplary clamp driver and blade in a triggered position;
[0010] Figure 3 depicts an enlarged partial cross-sectional view of an example clamp formed against the anvil;
[0011] Figure 4A depicts an enlarged side elevation view of a trigger cable assembly exemplifying the surgical instrument of Figure 1 with a portion of the structure removed, showing a trigger in an unstrung position and a locking feature in a locked position. ;
[0012] Figure 4B depicts an enlarged side elevation view of the driver cable assembly of Figure 4A, showing the driver in a triggered position and the locking feature in an unlocked position;
[0013] Figure 5 describes an enlarged partial perspective view of a set of the exemplary indicator of the surgical instrument of Figure 1 showing an indicator window and indicator lever;
[0014] Figure 6 describes a diagrammatic view of the indicator window of Figure 5 showing an exemplary indicator bar and corresponding exemplary clip representations;
[0015] Figure 7A depicts a partial lateral cross-sectional view of an exemplary spring-loaded brake and a locking feature shown in a locked position;
[0016] Figure 7B depicts a partial lateral cross-sectional view of the spring-loaded brake and locking feature of Figure 7A shown in a firing position;
[0017] Figure 8A depicts a partial side cross-sectional view of an exemplary screen door latch and lock feature shown in a locked position;
[0018] Figure 8B depicts a partial side cross-sectional view of the screen door latch and the locking feature of Figure 8A shown in a firing position;
[0019] Figure 9A depicts a partial lateral cross-sectional view of an exemplary locking feature that has a brake shown in a locked position;
[0020] Figure 9B depicts a partial lateral cross-sectional view of the locking feature of Figure 9A shown in a firing position;
[0021] Figure 10A depicts a partial side cross-sectional view of a trap door and locking feature shown in a locked position;
[0022] Figure 10B depicts a partial lateral cross-sectional view of the trap door and locking feature of Figure 10A shown in a firing position;
[0023] Figure 11A depicts a partial lateral cross-sectional view of an exemplary oriented locking feature shown in a locked position;
[0024] Figure 11B depicts a partial lateral cross-sectional view of the oriented locking feature of Figure 11A shown in a firing position;
[0025] Figure 12A depicts a partial lateral cross-sectional view of a toothed trocar actuator and locking feature shown in a locked position;
[0026] Figure 12B depicts a partial lateral cross-sectional view of the toothed trocar actuator and locking feature of Figure 12A shown in a firing position;
[0027] Figure 13A depicts a partial lateral cross-sectional view of a notched trocar actuator and locking feature shown in a locked position;
[0028] Figure 13B depicts a partial lateral cross-sectional view of the notched trocar actuator and locking feature of Figure 13A shown in a firing position;
[0029] Figure 14A depicts a partial lateral cross-sectional view taken along the center of the instrument showing an exemplary two-piece trigger actuation set and locking feature in a locked position;
[0030] Figure 14B depicts a partial side cross-sectional view of the two-piece trigger actuation assembly and locking feature of Figure 14A shown in a firing position;
[0031] Figure 15 describes a partial perspective view of a trigger actuator of the trigger actuation assembly in two parts of figures 14A-14B showing a toothed element and a reset button;
[0032] Figure 16 describes a schematic side view of the actuator of the actuator, toothed element and reset button of Figure 15, showing the actuator of the actuator engaged to the reset button;
[0033] Figure 17A depicts a partial lateral cross-sectional view of a two-piece trigger actuator set and an exemplary indicator showing a trigger carrier disengaged from a trigger;
[0034] Figure 17B depicts a partial lateral cross-sectional view of the trigger actuation assembly of Figure 17A showing the trigger carrier engaged with the trigger.
[0035] The drawings are not intended to be limiting in any way, and it is contemplated that various modalities of technology can be executed in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings incorporated and forming a part of the specification illustrate various aspects of the present technology, and together with the description they serve to explain the principles of the technology; it is understood, however, that this technology is not limited precisely to the provisions shown. DETAILED DESCRIPTION
[0036] The following description of some examples of the technology should not be used to limit its scope. Other examples, elements, aspects, modalities and advantages of the technology will become evident to those skilled in the art with the following description, which is by means of illustrations, one of the best ways contemplated for the realization of the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without departing from the technology. Consequently, drawings and descriptions should be considered as illustrative rather than restrictive. I. Overview of the exemplary circular stapling surgical instrument
[0037] Figures 1-6 describe an exemplary circular stapling surgical instrument (10) that has a stapling head assembly (20), a stem assembly (60) and a driver cable assembly (70), each of which will be described in detail below. The stem assembly (60) extends distally from the driver cable assembly (70) and the staple head assembly (20) is coupled to a distal end of the stem assembly (60). In summary, the driver cable assembly (70) is intended to actuate a staple driver (24) from the staple head assembly (20) to direct a plurality of staples (66) out of the staple head assembly (20 ). The clips (66) are curved to form complete clips by an anvil (40) which is attached to the distal end of the instrument (10). Consequently, the fabric (2), shown in Figures 2A-2C, can be stapled using the instrument (10).
[0038] In the present example, the instrument (10) comprises a closing system and a triggering system. The closing system comprises a trocar (38), a trocar actuator (39) and a rotary knob (98). An anvil (40) can be coupled to a distal end of the trocar (38). The rotary knob (98) has the purpose of longitudinally translating the trocar (38) in relation to the stapling head assembly (20), thus translating the anvil (40) when the anvil (40) is coupled to the trocar (38), to secure the fabric between the anvil (40) and the stapling head assembly (20). The firing system comprises a trigger (74), a trigger actuation set (84), a trigger actuator (64) and a clamp trigger (24). The staple driver (24) includes a knife (36) configured to break the tissue when the staple driver (24) is activated longitudinally. In addition, the clamps (66) are positioned distally to a plurality of clamp driver (30) clip insertion elements (30) so that the clamp driver (24) also inserts the clamps (66) into distal position when the clamp driver (24) is activated longitudinally. This way, when the trigger (74) is activated and the trigger actuation set (84) activates the clamp actuator (24) through the actuator actuator (64), the knife (36) and the elements (30) of substantially simultaneously break the fabric (2) and insert the clips (66) in a distal position in relation to the staple head assembly (20) in the fabric. The components and functionalities of the closing system and firing system will now be described in more detail. A. Exemplary anvil
[0039] As shown in Figures 1-2C, the anvil (40) is selectively attachable to the instrument (10) to provide a surface against which the clamps (66) can be curved to staple the material contained between the set of stapling head (20) and the anvil (40). The anvil (40) of the present example is selectively coupled to a trocar or pointed rod (38) that extends distally in relation to the stapling head assembly (20). With reference to Figures 2A-2C, the anvil (40) can be selectively coupled through the coupling of a proximal rod (42) of the anvil (40) to a distal tip of the trocar (38). The anvil (40) comprises a generally circular anvil head (48) and a proximal stem (42) that extends proximally from the anvil head (48). In the example shown, the proximal rod (42) comprises a tubular element (44) having resiliently inclined retaining clips (46) to selectively couple the anvil (40) to the trocar (38), although this is merely optional, and should it will be understood that other retention features for coupling the anvil (40) to the trocar (38) can also be used. For example, C clips, claws, threads, pins, stickers, etc. they can be used to couple the anvil (40) to the trocar (38). In addition, although the anvil (40) is described as selectively attachable to the trocar (38), in some versions the proximal stem (42) may include a one-way coupling feature so that the anvil (40) does not can be removed from the trocar (38) as soon as the anvil (40) is attached. For example, the one-way features include barbs, single-use pressure fittings, tweezers, rings, flaps, strips, etc. Of course, still other configurations for coupling the anvil (40) to the trocar (38) will be apparent to the person skilled in the art in view of the teachings of the present invention. For example, the trocar (38) may instead be a hollow stem and the proximal stem (42) may comprise a sharp stem that can be inserted into the hollow stem.
[0040] The anvil head (48) of the present example comprises a plurality of staple forming pockets (52) formed on a proximal face (50) of the anvil head (48). Consequently, when the anvil (40) is in the closed position and the staples (66) are directed out of the staple head assembly (20) into the staple forming pockets (52), as shown in Figure 2C, the legs (68) of the clips (66) are folded to form the complete clips. It should be understood that the staple-forming pockets (52) are purely optional and may be omitted in some versions.
[0041] With the anvil (40) as a separate component, it should be understood that the anvil (40) can be inserted and attached to a portion of fabric (2) before being attached to the stapling head assembly (20) . As an example only, the anvil (40) can be inserted and attached to a first tubular portion of tissue (2) while the instrument (10) is inserted and attached to a second tubular portion of tissue (2). For example, the first tubular tissue portion (2) can be sutured to or around a portion of the anvil (40), and the second tubular tissue portion (2) can be sutured to or around the trocar (38) .
[0042] As shown in Figure 2A, the anvil (40) is then coupled to the trocar (38). The trocar (38) of the present example is shown in a more distal activated position. Such an extended position for the trocar (38) can provide a larger area to which the tissue (2) can be attached before fixing the anvil (40). In addition, the extended trocar position (38) can also provide easier attachment of the anvil (40) to the trocar (38). The trocar (38) additionally includes a tapered distal tip. Such a tip may be able to perforate the tissue and / or assist in the insertion of the anvil (40) into the trocar (38), although the tapered distal tip is merely optional. For example, in other versions, the trocar (38) may have a blunt tip. In addition, or as an alternative, the trocar (38) may include a magnetic portion (not shown) that can attract an anvil (40) towards the trocar (38). Of course, additional configurations and arrangements for the anvil (40) and trocar (38) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0043] When the anvil (40) is coupled to the trocar (38), the distance between a proximal face of the anvil (40) and a distal face of the stapling head assembly (20) defines a gap distance d. The trocar (38) of the present example can be moved longitudinally in relation to the stapling head assembly (20) through an adjustment button (98) located at a proximal end of the driver cable assembly (70), as will be described in more detail below. Consequently, when the anvil (40) is coupled to the trocar (38), the rotation of the adjustment knob (98) increases or decreases the gap d by activating the anvil (40) in relation to the stapling head assembly (20) . For example, as shown sequentially in Figures 2A-2B, the anvil (40) is shown to be activated proximally to the driver cable assembly (70) from an initial open position to a closed position, thus reducing the distance span the distance between the two portions of fabric (2) to be joined. Once the span distance d falls within a predetermined range, the stapling head assembly (20) can be fired, as shown in Figure 2C, to staple and break the fabric (2) between the anvil (40) and the stapling head assembly (20). The staple head assembly (20) is intended to staple and break the fabric (2) by a user by turning a trigger (74) of the trigger cable assembly (70), as will be described in more detail below.
[0044] As noted above, the span distance d corresponds to the distance between the anvil (40) and the stapling head assembly (20). When the instrument (10) is inserted into a patient, this gap distance d may not be easily visible. Consequently, a movable indicator bar (110), shown in Figures 5-6, is provided to be visible through an indicator window (120) positioned opposite the trigger (74). The indicator bar (110) is intended to move in response to the rotation of the adjustment knob (98) so that the position of the indicator bar (110) is representative of the span distance d. As shown in Figure 6, the indicator window (120) further comprises a scale (130) that indicates that the anvil span is within a desired operating range (for example, a green colored region or "green zone") and a corresponding clip compression representation at each end of the scale (130). As an example only, as shown in Figure 6, a first clip image (132) describes a large clip height while a second clip image (134) describes a small clip height. Consequently, a user can view the position of the coupled anvil (40) in relation to the stapling head assembly (20) through the indicator bar (110) and the scale (130). The user can then adjust the position of the anvil (40) using the adjustment knob (98) accordingly.
[0045] Returning to Figures 2A-2C, a user sutures a portion of tissue (2) around the tubular element (44) so that the anvil head (48) is located within a portion of the tissue (2) a be bugged. When the fabric (2) is attached to the anvil (40), the retaining clips (46) and a portion of tubular element (44) emerges from the fabric (2) so that the user can couple the anvil (40) to the trocar (38). With the fabric (2) attached to the trocar (38) and / or another portion of the stapling head assembly (20), the user fixes the anvil (40) to the trocar (38) and activates the anvil (40) in a way proximal towards the stapling head assembly (20) to reduce the gap distance d. As soon as the instrument (10) is within the operating range, the user then staples the ends of the fabric (2), thus forming a tubular portion of tissue substantially contiguous (2).
[0046] The anvil (40) can additionally be constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention. B. Exemplifying staple head assembly
[0047] The stapling head assembly (20) of the present example is coupled to a distal end of the stem assembly (60) and comprises a tubular compartment (22) that houses a sliding clip driver (24) and a plurality of staples (66) contained within the staple pockets (32). The clips (66) and the staple pockets (32) are arranged in a circular matrix around the tubular compartment (22). In the present example, the staples (66) and the staple pockets (32) are arranged in a pair of concentric annular rows of staples (66) and the staple pockets (32). The purpose of the clamp driver (24) is to act longitudinally within the tubular compartment (22) in response to the rotation of the trigger (74) of the driver cable assembly (70). As shown in Figures 2A-2C, the clip driver (24) comprises an enlarged cylindrical element having a trocar opening (26), a central recess (28) and a plurality of elements (30) arranged circumferentially around the central recess (28) and extends in a distal position in relation to the stem set (60). Each element (30) is configured to contact and engage a corresponding clamp (66) of the plurality of clamps (66) within the clamp pockets (32). Consequently, when the clamp driver (24) is activated in a distal position in relation to the driver cable assembly (70), each element (30) directs a corresponding clamp (66) out of its clamp pocket (32) through a clamp opening (34) formed at a distal end of a tubular compartment (22). As each element (30) extends from the staple driver (24), the plurality of staples (66) is directed out of the staple head assembly (20) at substantially the same time. When the anvil (40) is in the closed position, the clamps (66) are directed into the clamp forming pockets (52) to flex the legs (68) of the clamps (66), thus stapling the material between the anvil (40) and the stapling head assembly (20). Figure 3 describes a merely exemplary clamp (66) directed by an element (30) to a clamp-forming pocket (32) of the anvil (40) to flex the legs (68).
[0048] The staple driver (24) additionally includes a cylindrical knife (36) that is coaxial to the opening of the trocar (26) and inserted from the staple pockets (32). In the present example, the cylindrical knife (36) is arranged inside the central recess (28) to translate distally with the clamp driver (24). When the anvil (40) is attached to the trocar (38), as described above, the anvil head (48) provides a surface against which the cylindrical knife (36) cuts the material contained between the anvil (40) and the set stapling head (20). In some versions, the anvil head (48) may include a recess (not shown) for the cylindrical knife (36) to assist in cutting the material (for example, by providing a cooperative shear edge). In addition, or as an alternative, the anvil head (48) can include one or more opposing cylindrical knives (not shown) moving from the cylindrical knife (36) so that a scissor-like cutting action can be provided. Other configurations will be apparent to the person skilled in the art in view of the teachings of the present invention. The stapling head assembly (20) is thus operable for both staple and cut fabric (2) substantially simultaneously in response to actuation by the driver cable assembly (70).
[0049] Of course, the stapling head assembly (20) can be additionally constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0050] As noted earlier, the clamp driver (24) includes a trocar opening (26). The trocar opening (26) is configured to allow the trocar (38) to slide longitudinally with respect to the stapling head assembly (20) and / or stem assembly (60). As shown in Figures 2A-2C, the trocar (38) is coupled to a trocar actuator (39) so that the trocar (38) can be activated longitudinally by rotating the rotary knob (98), as will be described in more detail. details below in reference to the driver cable assembly (70). In the present example, the trocar actuator (39) comprises a relatively rigid stem coupled to the trocar (38), although this is purely optional. In some versions, the actuator (39) can comprise a longitudinally rigid material while allowing lateral flexion so that instrument portions (10) can be selectively bent or curved during use; or instrument (10) may include a predefined flexed stem assembly (60). A purely exemplary material is nitinol. When the anvil (40) is coupled to the trocar (38), the trocar (38) and the anvil (40) are translatable through the actuator (39) to adjust the gap d between the anvil (40) and the set of stapling head (20). Other additional configurations for the actuator (39) longitudinally acting the trocar (38) will be apparent to the person skilled in the art in view of the teachings of the present invention. C. Exemplary stem set
[0051] The stapling head assembly (20) and the trocar (38) are positioned at a distal end of the stem assembly (60), as shown in Figures 2A-2C. The stem assembly (60) of the present example comprises an external tubular element (62) and an actuator of the driver (64). The outer tubular element (62) is coupled to the tubular compartment (22) of the staple head assembly (20) and to a frame (72) of the driver cable assembly (70), thus providing a mechanical base for the actuating components there. The proximal end of the actuator actuator (64) is coupled to a trigger actuation assembly (84) of the actuator cable assembly (70), described below. The distal end of the actuator actuator (64) is coupled to the clamp actuator (24) so that the rotation of the trigger (74) longitudinally activates the clamp actuator (24). As shown in Figures 2A-2C, the actuator actuator (64) comprises a tubular element that has an open longitudinal axis so that the actuator (39) coupled to the trocar (38) can act longitudinally and in relation to the actuator actuator ( 64). Of course, it should be understood that other components can be arranged within the actuator of the actuator (64) as will be apparent to those skilled in the art in view of the teachings of the present invention.
[0052] The stem assembly (60) can be additionally constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention. D. Exemplary trigger cable assembly
[0053] Now with reference to figures 4A-5, the driver cable assembly (70) comprises a structure (72), a trigger (74), a locking feature (82), a trigger actuation set (84) and a set of actuation of the trocar (90). The trigger (74) of the present example is pivotally mounted to the frame (72) and is coupled to the trigger actuation assembly (84) so that the rotation of the trigger (74) from an un triggered position (shown in Figure 4A) to a triggered position (shown in Figure 4B) activates the actuator actuator (64) described above. A spring (78) is coupled to the frame (72) and the trigger (74) to tilt the trigger (74) towards the non-triggered position. The locking feature (82) is a pivoting element that is coupled to the frame (72). In a first locked position, the locking feature (82) is rotated up and away from the frame (72) so that the locking feature (82) engages the trigger (74) and mechanically resists trigger action (74) by a user. In a second unlocked position, like the one shown in Figures 1 and 4B, the locking feature (82) is turned down so that the trigger (74) can be activated by the user. Consequently, with the locking feature (82) in the second position, the trigger (74) can engage a trigger actuation set (84) to trigger the instrument (10).
[0054] As shown in Figures 4A-4B, the trigger actuation assembly (84) of the present example comprises a sliding trigger conveyor (86) coupled to a proximal end of the actuator actuator (64). The conveyor (86) includes a set of tabs (88) at a proximal end of the conveyor (86) for securing and engaging a pair of trigger arms (76) extending from the trigger (74). Consequently, when the trigger (74) is turned, the conveyor (86) is activated longitudinally and transfers the longitudinal movement to the actuator of the actuator (64). In the example shown, the conveyor (86) is fixedly coupled to the proximal end of the actuator of the actuator (64), although this is purely optional. In fact, in a purely exemplary alternative, the conveyor (86) can simply adjoin the actuator actuator (64) while a distal spring (not shown) tilts the actuator actuator (64) proximally to the cable assembly driver (70).
[0055] The trigger actuation set (84) can be additionally constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0056] The structure (72) also houses a trocar actuation set (90) configured to act the trocar (38) longitudinally in response to the rotation of the adjustment knob (98). As best shown in Figures 4A-5, the trocar actuation set (90) of the present example comprises the adjustment knob (98), a grooved rod (94) and a sleeve (92). The grooved rod (94) of the present example is located at a distal end of the trocar actuator (39), although it should be understood that the grooved rod (94) and the trocar actuator (39) can alternatively be separate components that engage up to transmit longitudinal movement. The adjustment knob (98) is rotationally supported on the proximal end of the structure (72) and its purpose is to rotate the sleeve (92) which is engaged with the grooved rod (94) through an internal flap (not shown). The grooved rod (94) of the present example comprises a continuous groove (96) formed on the outer surface of the grooved rod (94). Consequently, when the adjustment knob (98) is turned, the inner flap passes inside the groove (96) and the grooved rod (94) is longitudinally activated in relation to the sleeve (92). As the grooved rod (94) is located at the distal end of the trocar actuator (39), turning the adjustment knob (98) in a first direction advances the trocar actuator (39) in a distal position in relation to the driver cable assembly (70). Consequently, the gap distance d between the anvil (40) and the stapling head assembly (20) is increased. By turning the adjusting knob (98) in the opposite direction, the trocar actuator (39) is activated proximally to the driver cable assembly (70) to reduce the gap d between the anvil (40) and the stapling head assembly (20). In this way, the trocar actuation set (90) is intended to actuate the trocar (38) in response to the rotation of the adjustment knob (98). Of course, other configurations for the trocar actuation set (90) will be apparent to the person skilled in the art in view of the teachings of the present invention.
The groove (96) of the present example comprises a plurality of different portions (96A, 96B, 96C) that have different intervals or number of different grooves per axial distance. The groove present (96) is divided into a distal portion (96A), a middle portion (96B) and a proximal portion (96C). As shown in Figure 5, the distal portion (96A) comprises a narrow gap or a high number of grooves at a small axial distance from the grooved rod (94) so that a large number of rotations of the adjustment knob (98) is required to cross a small axial distance. The middle portion (96B) comprises a section with comparably wider gap or few grooves per axial distance so that relatively few rotations are required to traverse a long axial distance. As a result, the span distance d can be quickly reduced by relatively few rotations of the adjustment knob (98). The proximal portion (96C) of the present example is substantially similar to the distal portion (96A) and comprises a gap or a high number of grooves over a small axial distance from the grooved rod (94) so that a large number of rotations are required for cross the small axial distance. The proximal portion (96C) of the present example is positioned inside the sleeve (92) when the anvil (40) is substantially close to the stapling head assembly (20) so that the indicator bar (110) moves within the indicator window (120) along the scale (130) to indicate that the anvil span is within a desired operating range, as will be described in detail below. Consequently, when the tab is within the proximal portion (96C) of the groove (96), each rotation of the adjustment knob (98) can reduce the gap distance d by a small amount to provide fine tuning.
[0058] The trocar actuation set (90) can be additionally constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0059] In the example shown in Figures 4A-4B, a U-shaped clip (100) is attached to an intermediate portion of the trocar actuator (39) located distally to the grooved rod (94). The U-shaped clip (100) engages with a portion of the frame (72) to substantially prevent the trocar actuator (39) from rotating around its axis when the adjustment knob (98) is turned. The U-shaped clip (100) additionally includes an elongated slot (102) on each of its opposite sides to receive a connecting element, such as a screw, pin, pin, clip, etc., to selectively adjust the longitudinal position the elongated slot (102) of the U-shaped clip (100) in relation to the trocar actuator (39) for the purposes of calibrating the indicator bar (110) in relation to the scale (130).
[0060] As shown in Figure 5, the driver cable assembly (70) additionally includes an indicator bracket (140) configured to engage and rotate an indicator (104). The indicator bracket (140) of the present example is slidable with respect to the frame (72) along a pair of slits formed in the frame (72). The indicator bracket (140) comprises a rectangular plate (144), an indicator arm (146) and an angled flange (142). The angled flange (142) is formed at the proximal end of the rectangular plate (144) and includes an opening (not shown) for sliding mounting on the trocar actuator (39) and / or grooved rod (94). A spiral spring (150) is interposed between the flange (142) and a protrusion (152) to tilt the flange (142) against the U-shaped clip (100). Consequently, when the U-shaped clip (100) acts distally with the trocar actuator (39) and / or the grooved rod (94), the spiral spring (150) impels the indicator bracket (140) to follow distally with the U-shaped clip (100). In addition, the U-shaped clip (100) propels the indicator bracket (140) proximally to the protrusion (152) when the trocar actuator (39) and / or the grooved rod (94) translates proximally , thereby compressing the spiral spring (150). Of course, it must be understood that in some versions the indicator bracket (140) can be attached to the trocar actuator (39) and / or grooved rod (94).
[0061] In the present example, a portion of the locking feature (82) adjoins a surface (141) of the indicator bracket (140) when the indicator bracket (140) is in a longitudinal position that does not correspond to when the gap of the anvil is within a desired operating range (for example, a green colored region or "green zone"). When the anvil span is within a desired operating range (for example, a green colored region or "green zone"), the indicator bracket (140) narrows to provide a pair of spans (145) on each side an indicator arm (146) that allows the locking feature (82) to rotate, thereby releasing the trigger (74). Consequently, the locking feature (82) and the indicator bracket (140) can substantially prevent a user from releasing and operating the trigger (74) until the anvil (40) is in a predetermined operating range. Of course, it must be understood that the blocking feature (82) can be omitted entirely in some versions.
[0062] This operating range can be visually communicated to the user through an indicator bar (110) of an indicator (104) shown against a scale (130), briefly described above. At one distal end of the indicator bracket (140) is an indicator arm (146) protruding distally and ending in a finger (148) that protrudes laterally to control the movement of the indicator (104). The index arm (146) and the finger (148), best shown in Figure 5, are configured to engage a tab (106) of the indicator (104) so that the indicator (104) is rotated when the indicator bracket (140 ) is activated longitudinally. In the present example, the indicator (104) is pivotally coupled to the structure (72) at a first end of the indicator (104), although this is purely optional and another pivot points to the indicator (104) will be apparent to the person versed in the technique in view of the teachings of the present invention. An indicator bar (110) is positioned at the second end of the indicator (104) so that the indicator bar (110) moves in response to the actuation of the indicator bracket (140). Consequently, as discussed above, the indicator bar (110) is displayed through an indicator window (120) against a scale (130) (shown in Figure 6) to show the relative span distance d between the anvil (40) and the stapling head assembly (20).
[0063] Of course, the indicator bracket (140), the indicator (104) and / or the driver cable assembly (70) can additionally be constructed in accordance with at least some of the teachings of US Patent No. 5,205,459; US patent No. 5,271,544; US patent No. 5,275,322; US patent No. 5,285,945; US patent No. 5,292,053; US patent No. 5,333,773; US patent No. 5,350,104; US Patent No. 5,533,661, the disclosures of which are hereby incorporated by reference; and / or according to other configurations as will be apparent to the person skilled in the art in view of the teachings of the present invention. II. Exemplary trocar actuator locking sets
[0064] In some cases, it may be useful for a user to lock the trocar actuator (39) in position as soon as the locking feature (82) is disengaged. For example, some users may inadvertently twist the adjustment knob (98) when pulling the trigger (74). Twisting the adjustment knob (98) can result in the anvil (40) activating proximally or distally from a desired position in relation to the staple head assembly (20). Consequently, the size of the staple may become too small or too large or, in some cases, the anvil (40) can be activated so that incomplete stapling of staples (66) occurs (that is, the anvil (40) does not is more in the "green zone"). Consequently, securing the trocar actuator (39) from the actuation proximally or distally as soon as the locking feature (82) is disengaged can reduce the likelihood of such occurrences. A. Exemplary spring-loaded brake
[0065] Figures 7A-7B describe a set of trigger cable (200) for surgical instrument (10), described above, having a frame (202), a trigger (210) pivotally mounted to the frame (202) and a trocar actuator (220) that extends longitudinally through the frame (202). In the present example, the trocar actuator (220) is coupled to an anvil (not shown), such as anvil (40), at a distal end. A proximal end of the trocar actuator (220) is in communication with an adjustment button (not shown), such as the adjustment button (98), to actuate the trocar actuator (220) proximally and / or distally in relation to to the driver cable assembly (200). Consequently, when the anvil is attached to the distal end of the trocar actuator (220) and the adjustment knob is turned, the trocar actuator (220) increases or decreases the distance between the anvil and a stapling head assembly (not shown) ). The trigger (210) is intended to direct the clips (not shown) out of the staple head assembly and into the fabric. The frame (202), the trigger (210), the trocar actuator (220) and / or the driver cable assembly (200) can additionally be constructed in accordance with at least some of the teachings of the frame (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0066] In the example shown, a locking feature (230) is also pivotally coupled to the frame (202) and is configured to rotate between a first position shown in Figure 7A, in which the locking feature (230) is engaged with trigger (210) to substantially prevent the trigger (210) from firing and a second position shown in Figure 7B, in which the locking feature (230) is disengaged from the trigger (210). The locking feature (230) can be constructed and / or function at least partially according to the locking feature (82) described above. As shown, the locking feature (230) includes a cam surface (232) that interacts with a spring-loaded brake (240). In some versions, the cam surface (232) may comprise a friction material, such as rubber, which engages the brake (240) to resist the longitudinal movement of the brake (240) in relation to the cam surface (232). The brake (240) comprises a plate (242) and an engaging feature (244) extending from the plate (242). As shown in Figure 7A, a pair of springs (246) are arranged between the plate (242) and the protrusions (204) of the frame (202) to tilt the brake (240) towards the cam surface (242). It is clear that the springs (246) are merely optional and can be omitted. In some versions, the locking feature (230) may include a retaining element (not shown) configured to selectively attach the locking feature (230) to the frame (202) so that the locking feature (230) does not be turned back to the first position by means of the inclination provided by the springs (246). In addition, or as an alternative, the brake (240) can be coupled to the trocar actuator (220) and the plate (242) can extend longitudinally so that the locking feature (230) engages the brake (240) in any longitudinal position. The engagement feature (244) of the present example comprises a square flap extending from the plate (242) and is configured to selectively enter a notch or recess (222) formed in the trocar actuator (220). Of course, the coupling feature (244) can include other dimensioned flaps, gear teeth, ratchet features and / or any other feature as will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0067] The recess (222) has a longitudinal length that corresponds to the longitudinal path of the trocar actuator (220) when activated within the "green zone" described above. Consequently, when the engagement feature (244) is inserted into the recess (222), the trocar actuator (220) can be activated within the "green zone", but the engagement feature (244) is contiguous to the end (224 ) of the recess (222) when any limit of the "green zone" is reached. Of course, the recess (222) can include a shorter or longer length.
[0068] Figure 7A shows the locking feature (230) in the locked position so that the trigger (210) cannot be operated by the user. As soon as the user has turned the adjustment knob to actuate the anvil (and therefore also the trocar actuator (220)) in the "green zone", the coupling feature (244) is positioned adjacent to at least a portion of the recess ( 222). When the locking feature (230) is rotated to the second position, shown in Figure 7B, the cam surface (232) engages the brake (240) to insert the engaging feature (244) into the recess (222). As noted above, the user can then act on the trocar actuator (220), but only within the "green zone". If the user attempts to move the trocar actuator (220) out of the "green zone" while the locking feature (230) is disengaged, the engaging feature (244) is prevented by either end (224) of the recess (222) . In some versions, the recess (222) can be dimensioned so that the trocar actuator (220) cannot be longitudinally activated once the locking feature (230) is disengaged. In addition, or as an alternative, a plurality of small recesses (222) can be arranged along the length of the trocar actuator (220) to provide a plurality of locking positions for the engagement feature (244). With the trocar actuator (220) attached to the frame (202) via the brake (240), the user can then trigger the instrument to staple the tissue. Of course, other configurations for the brake (240) and / or the locking feature (230) will be apparent to the person skilled in the art in view of the teachings of the present invention. B. Sample screen door latch
[0069] Figures 8A-8B describe a set of trigger cable (300) exemplifying the surgical instrument (10), described above, having a frame (302), a trigger (310) pivotally mounted on the frame (302) and a trocar actuator (320) that extends longitudinally through the frame (302). In the present example, a trocar actuator (320) is coupled to an anvil (not shown), such as an anvil (40), at a distal end. A proximal end of the trocar actuator (320) communicates with an adjustment button (not shown), such as an adjustment button (98), to actuate the trocar actuator (320) proximally and / or distally from the driver cable assembly (300). Consequently, when the anvil is attached to the distal end of the trocar actuator (320) and the adjustment knob is turned, the trocar actuator (320) increases or decreases the distance between the anvil and a staple head assembly (not shown) ). The trigger (310) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (302), the trigger (310), the trocar actuator (320) and / or the driver cable assembly (300) can additionally be constructed in accordance with at least some of the teachings of the frame (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0070] In the example shown, a locking feature (330) is also pivotally coupled to the frame (302) and is configured to rotate between a first position shown in Figure 8A, in which the locking feature (330) is engaged with the trigger (310) to substantially prevent the trigger (310) from being fired and a second position shown in Figure 8B, in which the locking feature (330) is disengaged from the trigger (310). The locking feature (330) can be constructed and / or function at least partially according to the locking feature (82) described above. As shown, the locking feature (330) includes a cam surface (332) that interacts with a screen door latch (340). The screen door latch (340) is pivotally coupled to the frame (302) at a first end (342). A second end (344) of the screen door latch (340) is attached to a spring (350) which is also attached to a portion of the frame (302). The spring (350) of the present example is a compression spring configured to tilt the second end (344) on the cam surface (332). In some versions, the locking feature (330) may include a retaining element (not shown) configured to securely attach the locking feature (330) to the frame (302) so that the locking feature (330) does not be turned back to the first position by means of the inclination provided by the spring (350). Of course, it should be understood that the spring (350) can be omitted and the latch on the screen door (340) can be connected or otherwise coupled to the locking feature (340).
[0071] In the present example, the latch on the screen door (340) also includes an opening (346) formed through it and comprises an edge (348) configured to engage one or more teeth (322) formed in an external portion of the trocar actuator (320). In some versions, the rim (348) may include a friction material, such as rubber, configured to frictionally resist the movement of the trocar actuator (320). In the present example, the trocar actuator (320) extends and is longitudinally activable in relation to the opening system (346). As shown, a plurality of teeth (322) is formed on the outside of the trocar actuator (320), although it should be understood that a plurality of notches can be formed on the trocar actuator (320) and / or a single tooth or notch can be formed. be provided for the edge (348) to lock. Of course, additional configurations of the screen door lock (340) and / or trocar actuator (320) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0072] Figure 8A shows the locking feature (330) in the locked position so that the trigger (310) is inoperable by the user. In this position, the user can turn the adjustment knob to actuate the anvil (and therefore also the trocar actuator (320)) to the "green zone". With the screen door latch (340) shown in a first position with the edge (348) engaged with the teeth (322), the trocar actuator (320) can move longitudinally through the opening (346) in response one rotation of the adjustment knob. Consequently, the user can adjust the position of the anvil in relation to the staple head assembly. When the locking feature (330) is rotated to the second position, shown in Figure 8B, the cam surface (332) engages and rotates the screen door latch (340) to its second position. When the screen door latch (340) is turned to the second position, the edge (348) engages with the teeth (322) and the screen door latch (340) substantially prevents the trocar actuator (320) from being longitudinally activated. In this way, if a user inadvertently exerts a rotational force on the adjustment knob, the screen door latch (340) maintains the position of the trocar actuator (320) and the anvil in relation to the stapling head assembly. With the trocar actuator (320) attached to the frame (302) via the screen door latch (340), the user can then fire the instrument to staple the tissue. Still other configurations for the screen door lock (340) and / or the locking feature (330) will be apparent to the person skilled in the art in view of the teachings of the present invention. C. Exemplary brake blocking feature
[0073] Figures 9A-9B describe a set of trigger cable (400) exemplifying the surgical instrument (10), described above, which has a frame (402), a trigger (410) pivotally mounted to the frame (402 ) and a trocar actuator (420) that extends longitudinally through the frame (402). In the present example, the trocar actuator (420) is coupled to an anvil (not shown), such as anvil (40), at a distal end. A proximal end of the trocar actuator (420) is in communication with an adjustment button (not shown), as an adjustment button (98), to actuate the trocar actuator (420) proximally and / or distally in relation to the driver cable assembly (400). Consequently, when the anvil is attached to the distal end of the trocar actuator (420) and the adjustment knob is turned, the trocar actuator (420) increases or decreases the distance between the anvil and a stapling head assembly (not shown) ). The trigger (410) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (402), the trigger (410), the trocar actuator (420) and / or the driver cable assembly (400) can additionally be constructed in accordance with at least some of the teachings of the structure (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0074] In the example shown, a locking feature (430) is also pivotally coupled to the frame (402) and is configured to rotate between a first position shown in Figure 9A, where the locking feature (430) is engaged with the trigger (410) to substantially prevent the trigger (410) from being fired, and a second position shown in Figure 9B, in which the locking feature (430) is disengaged from the trigger (410). The locking feature (430) can be constructed and / or function at least partially according to the locking feature (82) described above. The locking feature (430) additionally includes a cam surface (432) that engages with a portion of the trocar actuator (420) to substantially prevent the trocar actuator (420) from activating longitudinally. As shown, the cam surface (432) enters a recess (422) formed in the trocar actuator (420), although this is purely optional. In some cases, the cam surface (432) can directly engage an external surface of the trocar actuator (420). Returning to the present example, the recess (422) is positioned so that the locking feature (430) is pivoted from the locked position only when the trocar actuator (420) and the anvil are in a position that corresponds to the "zone" green". When the locking feature (430) is rotated, a friction material, such as rubber, from the cam surface (432) engages with a surface of the trocar actuator (420) to frictionally resist the movement of the trocar actuator (420 ). In some versions, the locking feature (430) may include a retaining element (not shown) configured to selectively attach the locking feature (420) to the frame (402) so that the locking feature (430) does not return to the first position if the trocar actuator is moved.
[0075] Figure 9A shows the locking feature (430) in the locked position so that the trigger (410) cannot be operated by the user. As soon as the user has turned the adjustment knob to actuate the anvil (and therefore also the trocar actuator (420)) in the "green zone", at least a portion of the recess (422) is aligned with the locking feature (430) . When the locking feature (430) is rotated to the second position, shown in Figure 9B, the cam surface (432) engages the recess (422) to frictionally resist the movement of the trocar actuator (420). In this way, if a user inadvertently applies a rotational force on the adjustment knob, the cam surface (432) frictionally maintains the position of the trocar actuator (420) and the anvil in relation to the stapling head assembly. With the trocar actuator (420) attached to the frame (402) through the cam surface (432), the user can then fire the instrument to staple the tissue. Still other configurations for the trocar actuator (420) and / or the locking feature (430) will be apparent to the person skilled in the art in view of the teachings of the present invention. D. Exemplary trapdoor set
[0076] Figures 10A-10B describe a set of trigger cable (500) exemplifying the surgical instrument (10), described above, which has a frame (502), a trigger (510) pivotally mounted to the frame (502 ) and a trocar actuator (520) extending longitudinally through the frame (502). In the present example, the trocar actuator (520) is coupled to an anvil (not shown), such as the anvil (40), at a distal end. A proximal end of the trocar actuator (520) is in communication with an adjustment button (not shown), such as the adjustment button (98), to actuate the trocar actuator (520) proximally and / or distally in relation to to the driver cable assembly (500). Consequently, when the anvil is attached to the distal end of the trocar actuator (520) and the adjustment knob is turned, the trocar actuator (520) increases or decreases the distance between the anvil and a stapling head assembly (not shown) ). The trigger (510) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (502), the trigger (510), the trocar actuator (520) and / or the driver cable assembly (500) can additionally be constructed in accordance with at least some of the teachings of the structure (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0077] In the example shown, a locking feature (530) is also pivotally coupled to the frame (502) and is configured to rotate between a first position shown in Figure 10A, in which the locking feature (530) is engaged with the trigger (510) to substantially prevent the trigger (510) from being fired, and a second position shown in Figure 10B, in which the locking feature (530) is disengaged from the trigger (510). The locking feature (530) can be constructed and / or function at least partially according to the locking feature (82) described above. The locking feature (530) of this example includes a cam surface (532) configured to engage and actuate a door (540) in relation to the frame (502). In some versions, the cam surface (532) can be positioned at 90 degrees to the main portion of the locking feature (530) so that the cam surface (532) does not engage the door (540) until the locking feature lock (530) be rotated 90 degrees with respect to the frame (502), although this is purely optional. The door (540) comprises a flat plate that has an opening (542) through which the trocar actuator (520) extends. As shown in Figures 10A-10B, the door (540) includes an upper portion (544) and a lower portion (546) on opposite sides of the opening (542). When the door (540) is not activated by the locking feature (530), the upper portion (544) adjoins a portion of the trocar actuator (520) and the lower portion (546) is disengaged from one or more recesses (522) formed in the trocar actuator (520), as will be discussed in more detail below. In the present example, a spring (548) is coupled to the upper portion (544) and the frame (502) for tilting the door (540) to the non-activated position shown in Figure 10A. The lower portion (546) is sized to enter one or more recesses (522) when the door (540) is activated by the cam surface (532) of the locking feature (530). Of course, other constructions for the door (540) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0078] The trocar actuator (520) comprises a plurality of side recesses (522) formed in the trocar actuator (520). Just as an example, the recesses (522) are formed in the trocar actuator (520) so that the recesses (522) are adjacent to the lower portion (546) when the trocar actuator (520) and the anvil are in " green area". Consequently, the recesses (522) form a plurality of distinct positions where the lower portion (546) can selectively lock the trocar actuator (520) when the door (540) is activated by the locking feature (530).
[0079] Figure 10A shows the locking feature (530) in the locked position so that the trigger (510) is inoperable by the user. As soon as the user turns the adjustment knob to actuate the anvil (and therefore also the trocar actuator (520)) in the "green zone", one or more of the plurality of recesses (522) are positioned adjacent to the lower portion (546) of the door (540). When the locking feature (530) is rotated to the second position, shown in Figure 10B, the cam surface (532) activates the door (540) to push the lower portion (546) into one of the plurality of recesses (522). Thus, if a user inadvertently applies rotational force to the adjustment knob, the door (540) and the lower portion (546) maintain the position of the trocar actuator (520) and the anvil in relation to the stapling head assembly. With the trocar actuator (520) attached to the frame (502) through the door (540), the user can then fire the instrument to staple the tissue. Other constructions for the trocar actuator (520) and / or port (540) will be apparent to the person skilled in the art in view of the teachings of the present invention. E. Exemplary oriented blocking feature
[0080] Figures 11A-11B describe a set of trigger cable (600) exemplifying the surgical instrument (10), described above, having a frame (602), a trigger (610) pivotally mounted to the frame (602) and a trocar actuator (620) that extends longitudinally through the frame (602). In the present example, the trocar actuator (620) is coupled to an anvil (not shown), such as the anvil (40), at a distal end. A proximal end of the trocar actuator (620) communicates with an adjustment button (not shown), such as an adjustment button (98), to actuate the trocar actuator (620) proximally and / or distally in relation to the driver cable assembly (600). Consequently, when the anvil is attached to the distal end of the trocar actuator (620) and the adjustment knob is turned, the trocar actuator (620) increases or decreases the distance between the anvil and a stapling head assembly (not shown) ). The trigger (610) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (602), the trigger (610), the trocar actuator (620) and / or the driver cable assembly (600) can additionally be constructed in accordance with at least some of the teachings of the structure (72), trigger ( 74), trocar actuator (39) and / or driver cable set (70) described above.
[0081] In the example shown, a locking feature (630) is also pivotally coupled to the frame (602) and is configured to rotate between a first position shown in Figure 11A, in which the locking feature (630) is engaged with the trigger (610) to substantially prevent the trigger (610) from being fired and a second position shown in Figure 11B, in which the locking feature (630) is disengaged from the trigger (610). The locking feature (630) can be constructed and / or function at least partially according to the locking feature (82) described above. The locking feature (630) additionally includes an engagement head (632) having one or more locking elements (634), as oriented teeth, configured to engage one or more complementary elements (622) in the trocar actuator (620). The complementary elements (622) are formed by two trocar actuators (620) so that the complementary elements (622) interlock with the locking elements (634) only when the trocar actuator (620) and the anvil are in the "green zone ". Consequently, the complementary elements (622) form a plurality of distinct positions where the locking elements (634) can selectively lock the trocar actuator (620). Of course, the complementary elements (622) can extend along the entire longitudinal length of the trocar actuator (620) or any other portion thereof. As an example only, the locking elements (634) comprise three oriented teeth which engage with a plurality of complementary oriented teeth in the trocar actuator (620). Other gear elements (622, 634) will be apparent to the person skilled in the art in view of the teachings of the present invention. In some versions, the locking elements (634) of the coupling head (632) can be positioned 90 degrees with respect to the main portion of the locking feature (630) so that the locking elements (634) do not engage the actuator. trocar (620) until the locking feature (630) is rotated 90 degrees relative to the frame (602), although this is purely optional. Still further configurations for the locking feature (630) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0082] Figure 11A shows the locking feature (630) in the locked position so that the trigger (610) cannot be operated by the user. As soon as the user turns the adjustment knob to actuate the anvil (and therefore also the trocar actuator (620)) in the "green zone", one or more of the complementary elements (622) are positioned adjacent to the coupling head (632) locking feature (630). When the locking feature (630) is rotated to the second position, shown in Figure 11B, the locking elements (634) of the coupling head (632) engage with the complementary elements (622). The locking elements (634) and the complementary elements (622) can be dimensioned so that the minimum distal movement of the trocar actuator (620) occurs when the locking elements (634) engage with the complementary elements (622). In addition, or as an alternative, the locking elements (634) may comprise the resilient ratchet-shaped teeth that compress against the coupling head (632) when engaging with the complementary elements (622). The locking element gear (634) with complementary elements (622) substantially restricts the longitudinal movement of the trocar actuator (620). In this way, if a user inadvertently applies a rotational force to the adjustment knob, the locking elements (634) maintain the position of the trocar actuator (620) and the anvil in relation to the stapling head assembly. With the trocar actuator (620) attached to the frame (602) through the elements (622, 634), the user can then fire the instrument to staple the tissue. Additional configurations for trocar actuator (620) and / or complementary elements (622) will be apparent to the person skilled in the art in view of the teachings of the present invention. F. Exemplary toothed trocar actuator set
[0083] Figures 12A-12B describe a set of trigger cable (700) exemplifying the surgical instrument (10), described above, which has a frame (702), a trigger (710) pivotally mounted to the frame (702 ) and a trocar actuator (720) extending longitudinally through the frame (702). In the present example, the trocar actuator (720) is coupled to an anvil (not shown), such as the anvil (40), at a distal end. A proximal end of the trocar actuator (720) is in communication with an adjustment button (not shown), as an adjustment button (98), to actuate the trocar actuator (720) proximally and / or distally in relation to the driver cable assembly (700). Consequently, when the anvil is attached to the distal end of the trocar actuator (720) and the adjustment knob is turned, the trocar actuator (720) increases or decreases the distance between the anvil and a stapling head assembly (not shown) ). The trigger (710) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (702), the trigger (710), the trocar actuator (720) and / or the driver cable assembly (700) can additionally be constructed in accordance with at least some of the teachings of the structure (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0084] In the example shown, a locking feature (730) is also pivotally coupled to the frame (702) and is configured to rotate between a first position shown in Figure 12A, where the locking feature (730) is engaged with the trigger (710) to substantially prevent the trigger (710) from being fired, and a second position shown in Figure 12B, in which the locking feature (730) is disengaged from the trigger (710). The locking feature (730) can be constructed and / or function at least partially according to the locking feature (82) described above. The locking feature (730) additionally includes a catch rod (732) extending from a lever (734) of the locking feature (730). In the present example, the catch rod (732) extends perpendicularly from the lever (734), although this is merely optional. In some versions, the catch rod (732) can extend from the lever (734) at other angles.
[0085] The capture rod (732) is configured to engage and be contiguous to one or more ratchet teeth (722) formed in the trocar actuator (720). In the present example, the ratchet teeth (722) are triangular teeth extending from one side of the trocar actuator (720), although this is merely optional. In some versions, the ratchet teeth (722) may comprise helical teeth (722) that revolve around the trocar actuator (720) to allow the catch rod (732) to engage the teeth (722) even if the actuator trocar (720) is rotated. In an alternative version, the ratchet teeth (722) can be annular protrusions spaced on an external surface of the trocar actuator (720). In addition, as shown in the present example, the ratchet teeth (722) are formed in a portion of the trocar actuator (720) that substantially aligns with the locking feature (730), although this is purely optional. Of course, still other constructions for the ratchet teeth (722) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0086] Figure 12A shows the locking feature (730) in the locked position so that the trigger (710) cannot be operated by the user. As soon as the user turns the adjustment knob to actuate the anvil (and therefore also the trocar actuator (720)) in the "green zone", the ratchet teeth (722) are substantially aligned with the locking feature (730). When the locking feature (730) is rotated to the second position, shown in Figure 12B, the catch rod (732) engages one or more ratchet teeth (722) to prevent the trocar actuator (720) from the distal performance in relation to the structure (702). Of course, the ratchet teeth (722) allow for a trocar actuator (720) to act proximally in relation to the structure (702). In this way, the user can further reduce the gap between the anvil and the stapling head assembly, but not increase the gap. With the trocar actuator (720) attached to the frame (702) via the capture rod (732), the user can then fire the instrument to staple the tissue. Of course, other configurations for the trocar actuator (720) and / or the capture rod (732) will be apparent to the person skilled in the art in view of the teachings of the present invention. For example, in addition, or as an alternative, the catch rod (732) can comprise an enlarged end that inserts or presses into a corresponding resilient element formed in the trocar actuator (720). In this version, the resilient element can be configured to be a one-way element for the capture rod (732) to lock on the trocar actuator (720). G. Exemplary notched trocar actuator set
[0087] Figures 13A-13B describe a set of trigger cable (800) exemplifying the surgical instrument (10), described above, which has a frame (802), a trigger (810) pivotally mounted to the frame (802 ) and a trocar actuator (820) that extends longitudinally through the frame (802). In the present example, the trocar actuator (820) is coupled to an anvil (not shown), such as an anvil (40), at a distal end. A proximal end of the trocar actuator (820) is in communication with an adjustment button (not shown), as an adjustment button (98), to actuate the trocar actuator (820) proximally and / or distally in relation to the driver cable assembly (800). Consequently, when the anvil is attached to the distal end of the trocar actuator (820) and the adjustment knob is turned, the trocar actuator (820) increases or decreases the distance between the anvil and a staple head assembly (not shown) ). The trigger (810) is intended to direct the staples (not shown) out of the staple head assembly and onto the fabric. The frame (802), the trigger (810), the trocar actuator (820) and / or the driver cable assembly (800) can additionally be constructed in accordance with at least some of the teachings of the structure (72), the trigger (74), the trocar actuator (39) and / or the driver cable assembly (70) described above.
[0088] In the example shown, a locking feature (830) is also pivotally coupled to the structure (802) through a pivot point (838) and is configured to rotate between a first position shown in Figure 13A, where a first end (832) of the locking feature (830) is engaged with the trigger (810) to substantially prevent the trigger (810) from being fired and a second position shown in Figure 13B, wherein the first end (832) of the feature lock (830) is disengaged from the trigger (810). The locking feature (830) can be constructed and / or works at least partially according to the locking feature (82) described above. The locking feature (830) is additionally pivotally connected to a button assembly (840) at a second end (834) via a pin (836). In the present example, the button assembly (840) comprises a button (842) and a stem (844) coupled to the button (842). In some versions, the rod (844) is fixedly coupled to the button (842); In others, the rod (844) is pivotally coupled to the button (842). The stem (844) is offset in relation to the vertical plane along which the central axis of the trocar actuator (820) extends, so that the stem (844) extends downwards and adjacent to the trocar actuator ( 820). The button (842) is aligned with the vertical plane along which the central axis of the trocar actuator (820) extends. The button (842) extends along an axis that is perpendicular to the central axis of the trocar actuator (820), through an opening (804) formed in the structure (802). As shown in the sequence shown in the Figures. 13A-13B, when the button assembly (840) is activated inwardly, the rod (844) rotates to the second end (834) of the locking feature (830) around the pivot point (838) to disengage the first end (832) of the trigger (810).
[0089] The trocar actuator (820) includes a recess (822) configured to receive a portion of the button (842) in it. In the present example, the recess (822) has a longitudinal length that corresponds to the longitudinal path of the trocar actuator (820) when activated within the "green zone" described above. Consequently, when the button (842) is depressed in the recess (822), the trocar actuator (820) is activated within the "green zone", but the button (842) is in contiguity at the end (824) of the recess (822) ) when any "green zone" limit is reached. Of course, the recess (822) can include a shorter or longer length. When the trocar actuator (820) is not within the "green zone", the button (842) is contiguous to the outer surface of the trocar actuator (820), thus preventing the locking feature (830) from disengaging the trigger (810).
[0090] Figure 13A shows the locking feature (830) and the button assembly (840) in the locked position so that the trigger (810) cannot be operated by the user. As soon as the user has turned the adjustment knob to actuate the anvil (and therefore also the trocar actuator (820)) in the "green zone", the knob (842) is positioned in front of at least a portion of the recess (822) . When the button (842) is pressed by the user in the recess (822), the stem (844) rotates the locking feature (830) to the second position, shown in Figure 13B. As noted above, the user can then act on the trocar actuator (820), but only within the "green zone". If the user tries to move the trocar actuator (820) out of the "green zone", the button (842) prevents the movement of the trocar actuator (820) from being contiguous to either end (824) of the recess (822). With the trocar actuator (820) substantially restricted to movement within the "green zone", the user can then fire the instrument to staple the tissue. Still other constructions for the button assembly (840) and / or the locking feature (830) will be apparent to the person skilled in the art in view of the teachings of the present invention. For example, in some versions, a user can manually or directly rotate the locking feature (830) around the pivot point (838) to remove the button (842) in the recess (822). III. Exemplary release sets for the two-piece trigger actuation set
[0091] In some cases, it may be useful for a user to just engage the trigger actuation set (84) when the user is about to fire the instrument (10). For example, the trigger actuation assembly (84) can be engaged in response to disengagement of the locking feature (82) and / or positioning of the indicator (104) within the "green zone". To accomplish this, For example, one or both, the trigger conveyor (86) and / or actuator actuator (64), can be misaligned or otherwise disengaged to prevent firing when the locking feature (82) is engaged and / or the position indicator (104) is outside the "green zone". Consequently, several sets for disengaging and / or re-engaging the trigger actuation assembly (84) for firing will now be described in greater detail. A. Two-piece trigger actuator set activated by locking feature
[0092] Figures 14A-16 describe a set of trigger cable (900) exemplifying for surgical instrument (10), described above, which has a frame (902), a trigger (910) pivotally mounted to the frame (902) and a trigger actuation set (920). A pair of toothed elements (960), as will be discussed in more detail below, has been omitted in Figures 14A-14B for clarity. In the present example, the trigger actuation assembly (920) comprises a trigger carrier element (922) that is operable to engage and actuate a resilient actuator actuator (930). A distal end of the actuator actuator (930) is coupled to a staple actuator (not shown), such as the staple actuator (24), to direct the staples out of a staple head assembly (not shown), as the staple head assembly (20). With brief reference to Figure 15, a proximal end (932) of the actuator actuator (930) includes a pair of ratchet teeth (934) that extend outwardly from the actuator actuator (930) and are configured to engage a corresponding toothed element (960), as will be described in more detail below. As shown in Figures 14A-16, the actuator of the actuator (930) comprises a resilient element inclined away from engagement with the trigger carrier element (922). In the present example, the actuator of the actuator (930) tilts away from the trigger (910), although this is purely optional. As an example only, the actuator of the actuator (930) comprises a deformable plastic or metallic component that is substantially longitudinally rigid, but laterally foldable. A spring (938) is coupled to the actuator actuator (930) and impels the actuator actuator proximally to the structure (902). In some versions, a proximal end of the actuator actuator (930) may include a recess or other guide features (not shown) configured to receive and guide the trigger conveyor element (922) in engagement with the actuator actuator. The actuator actuator (930) can additionally be constructed in accordance with at least some of the teachings of the actuator actuator (64) described above and / or otherwise, as will be apparent to the skilled person in view of the teachings of the present invention .
[0093] As noted above, the trigger conveyor element (922) engages the actuator actuator (930), when the actuator actuator (930) is aligned and aims to actuate the actuator actuator longitudinally (930). As shown in Figures 14A-14B and 16, the trigger carrier element (922) is engaged and activated by the trigger (910). When the actuator actuator (930) is not longitudinally aligned with the trigger conveyor element (922), the turning of the trigger (910) activates the trigger conveyor element (922), but the actuator actuator (930) is not directed distally by the trigger carrier element (922). The trigger carrier element (922) can be additionally constructed in accordance with at least some of the teachings of the trigger carrier (86) described above and / or in other forms, as will be apparent to one skilled in the art in view of the teachings of the present invention.
[0094] With reference to Figures 14A-14B, the actuator of the actuator (930) of the present example is tilted through an opening (942) permeable formed by an anvil indicator (940). For the sake of example, the anvil indicator (940) comprises a plate having a longitudinal slot (942) through which the actuator of the actuator (930) extends. As shown in Figure 14A, when the anvil indicator (940) is not within the "green zone", the anvil indicator (940) prevents the actuator actuator (930) from bending in longitudinal alignment with the trigger carrier element (922). As shown in Figure 14B, when the anvil indicator (940) indicates that the anvil span, described above, is within the "green zone", the anvil indicator (940) and the slot (942) have been activated proximally to allow the actuator of the driver (930) to be curved in longitudinal alignment with the trigger carrier element (922). In an alternative version, the actuator of the actuator (930) may comprise a forked end through which the anvil indicator (940) extends and a proximal plate prevents the actuator of the actuator (930) from bending in alignment with the conveyor element the trigger (922). The anvil indicator (940) can be additionally constructed in accordance with at least some of the teachings of the indicator bracket (140) described above. Of course, additional provisions for the anvil indicator (940) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0095] A release (950) is pivotally mounted to the structure (902) and its purpose is to flex the actuator actuator (930) in longitudinal alignment with the trigger carrier element (922). The release (950) is pivoting from a first position, shown in Figure 14A to a second position, shown in Figure 14B. In the first position, the release (950) is substantially prevented from rotation by the anvil indicator (940) interfering with the actuator of the actuator (930). When the anvil indicator (940) is activated to allow the actuator of the actuator (930) to pass through the slit (942), the release (950) is pivoted to the second position, thus pushing the actuator actuator (930) to longitudinal alignment with the trigger carrier element (922). A spring-loaded latch (952) releasably locks the release (950) in the second position to keep the actuator actuator (930) in alignment with the trigger conveyor element (922) prior to trigger operation (910).
[0096] As will be apparent to the person skilled in the art in view of the teachings of the present invention, disengagement of the trigger carrier element (922) from the actuator actuator (930) and interference by the anvil indicator (940) substantially avoids that the actuator actuator (930) extends the clamps and / or knives from a staple head assembly, such as the staple head assembly (20) described above, while the anvil is outside the "zone" green". In addition, when the release (950) is pivoted in the second position shown in Figure 14B, the release (950) substantially prevents the anvil indicator (940) (and therefore an anvil coupled both directly and indirectly to the anvil indicator (940) )) move out of the "green zone".
[0097] Figures 15-16 describe a pair of toothed elements (960) having a plurality of teeth (962) that are configured to provide a ratchet effect as the actuator of the actuator (930) is directed distally through of the trigger carrier element (922). In the present example, the toothed elements (960) extend inwardly from the structure (902), although this is merely optional and, in some cases, the toothed elements (960) may be separate components. A pair of spans (968) is formed between the bottom surfaces (966) of the toothed elements (960) and a portion of the structure (902) so that the ratchet teeth (934) can be moved longitudinally through it. Consequently, as will be described below, when the actuator of the actuator (930) completes a complete firing sequence, the ratchet teeth (934) pass beyond the most distal teeth (962) of the toothed elements (960) and fall into the gaps ( 968) due to the resilient tilt of the actuator actuator (930). The spring (938) impels the actuator of the actuator (930) proximally to translate the teeth in ratchet (934) proximally through the gaps (968).
[0098] A pair of holders or notches (972) of a reset button (970) prevents the ratchet teeth (934) from moving proximally back to the starting position shown in Figure 14A. In the present example, the reset button (970) comprises a flexible or deformable material, such as rubber or silicone, coupled to the frame (902) and having notches (972) for receiving ratchet teeth (934) in it. The reset button (970) is intended to secure the ratchet teeth (934) until a user presses the reset button (970) to release the ratchet teeth (934), thus returning the instrument to the initial position shown in Figure 14A . In some versions, the lock (952) can be mechanically coupled to a feature (not shown) that is operable to press or bounce on the reset button (970) when the lock (952) is released. Alternatively, the reset button (970) can be attached to the lock (952) so that the lock (952) is released when the reset button (970) is pressed. Consequently, in such versions, the lock (952) and the reset button (970) return, simultaneously or substantially simultaneously, to their initial positions. Other configurations for toothed elements (960) and / or reset button (970) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[0099] Returning to Figure 14A, the trigger (910), the trigger carrier element (922), the actuator of the trigger (930), the anvil indicator (940) and the release (950) are shown in a starting position . As noted above, in this position, the actuator of the actuator (930) is tilted away from longitudinal alignment with the trigger carrier element (922) and is prevented from aligning through the interference of a portion of the anvil indicator (940). In this position, if the user tries to fire the device by turning the trigger (910), the trigger conveyor element (922) simply moves inside the instrument and does not engage the actuator actuator (930). In addition, or as an alternative to the set described above, a locking feature (not shown), such as the locking feature (82) described above and / or any of the other locking features described herein, can be incorporated into the instrument to substantially avoid triggering (910) before the anvil is positioned in the "green zone". As soon as the user has positioned the anvil so that the anvil gap is within the "green zone", the slot (942) is positioned so that the actuator actuator (930) can pass through it. When the user wishes to fire the instrument, the user rotates the release (950) to allow a rebound on the actuator actuator (930) in longitudinal alignment with the trigger carrier element (922) as shown in Figure 14B. The lock (952) secures the release (950) so that the actuator of the actuator (930) remains longitudinally aligned with the trigger carrier element (922) even if the user is no longer holding the release (950) in place. With the actuator actuator (930) longitudinally aligned with the trigger conveyor element (922), it must be understood that the anvil indicator (940) can be additionally activated proximally, but cannot be activated in a distal position due to the interference from the actuator actuator (930) and / or the release (950). Consequently, this can prevent the instrument from inadvertently moving out of the "green zone".
[00100] To fire the instrument, the user turns the trigger (910) to engage and drive the actuator actuator (930) in a distal position with respect to the frame (902) and compresses the spring (938). As the actuator actuator (930) is activated longitudinally, the downward tilt of the actuator actuator (930) (as shown in Figures 14A and 15) engages the ratchet teeth (934) with the teeth (962) of the elements teeth (960) arranged on each side of the actuator of the actuator (930). As will be apparent to the person skilled in the art in view of the teachings of the present invention, the actuator of the actuator (930) is thus substantially prevented from translating proximally by engaging the teeth in ratchet (934) with the teeth (962) ( for example, if the user releases the trigger (910) before completing a complete firing stroke). Such a ratchet effect can help to ensure that the instrument is fully triggered before the actuator of the actuator (930) returns to the initial position. As soon as the ratchet teeth (934) extend beyond the most distal teeth (962), which corresponds to a complete firing of the instrument, the resilient tilt of the actuator actuator (930) drives the ratchet teeth (934) into the gaps (968) and the proximal inclination of the spring (938) impels the actuator of the actuator (930) proximally in relation to the structure (902). As the ratchet teeth (934) and actuator actuator (930) translate proximally, the ratchet teeth (934) engage in the notches (972) of the reset button (970) shown in Figure 16. At present For example, the user then releases the lock (952) to reset the release (950) to the home position. The user presses the reset button (970) to push the ratchet teeth (934) out of the notches (972) and the spring (938) pushes the actuator actuator (930) back to the starting position shown in Figure 14A . In versions where the lock (952) and the reset button (970) are operable at the same time, the user release of the lock (952) or the reset button (970) can also release the reset button (970) or the closure (952) simultaneously or substantially simultaneously. When the actuator of the actuator (930) returns to the starting position, the trigger conveyor element (922) is disengaged again from the actuator of the actuator (930) to allow only a single shot of the instrument at a time. The user can then insert new staples and / or a new staple cartridge to trigger the instrument again.
[00101] Although some configuration examples for the driver cable set (900) having a two-piece trigger actuation set (920) have been described, other configurations will be apparent to the technically skilled in view of the teachings of the present invention. B. Two-piece trigger actuation set activated by the exemplary movement indicator
[00102] An exemplary alternative driver cable set (1000) for surgical instrument (10), described above, is shown in Figures 17A-17B. The driver cable set (1000) comprises a frame (1002), a trigger (1010) pivotally mounted to the frame (1002) and a trigger actuation set (1020). In the present example, the trigger actuation assembly (1020) comprises a trigger carrier element (1022) operable to engage and actuate an actuator actuator (1030). A distal end of the actuator actuator (1030) is coupled to a staple actuator (not shown), such as a staple actuator (24), to direct the staples out of a staple head assembly (not shown), such as the stapling head assembly (20). A proximal end of the actuator actuator (1030) is coupled or otherwise engaged with the trigger carrier element (1022). The actuator actuator (1030) can additionally be built according to at least some of the teachings of the actuator actuator (24) described above.
[00103] As shown in Figure 17A, the trigger carrier element (1022) includes a pair of pivoting pins (1024) that extend outwardly from opposite sides of the trigger carrier element (1022). The pins (1024) extend in the longitudinal channels (1004) formed in the structure (1002). In this way, the pins (1024) allow the rotation around the pins (1024) within the channels (1004) and the longitudinal actuation along the channels (1004). The trigger carrier element (1022) also includes a pair of side elements (1026) and a rear element (1027) configured to capture and secure one end (1012) of the trigger (1010). Consequently, as seen in Figure 17B, the side elements (1026) and the rear element (1027) couple the end (1012) of the trigger (1010) so that the trigger carrier element (1022) is longitudinally activated by the trigger (1010) ). A flap (1028) extends from a side element (1026) and is intended to keep the trigger carrier element (1022) in a first position, shown in Figure 17A. Of course, other configurations and / or coupling assemblies for the trigger carrier element (1022) and the trigger (1010) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[00104] An indicator (1040) is pivotally coupled to the structure (1002) and is intended to indicate the position of an anvil (not shown) in relation to a stapling head assembly (not shown) through an indicator window (1006) of the structure (1002). The indicator window (1006) includes a "green zone" region (1008) that indicates when the anvil is in a position that corresponds to the instrument's preferred operating range. In the present example, the indicator (1040) is pivotally connected to an actuator (1042) that activates longitudinally to mechanically connect the connection indicator (1040) to the positional movement of the anvil in relation to the stapling head assembly. The actuator (1042) and / or the indicator (1040) can be constructed and / or assembled according to at least some of the teachings of the indicator (104) and / or the indicator bracket (140) described above. The indicator (1040) of the present example comprises a V-shaped element having a main portion (1044) with an indicator bar (1046) extending perpendicularly from a first end (1048). Thus, when a user views the indicator window (1006), the indicator bar (1046) provides a visual indicator of the anvil's position in relation to the desired operating range or "green zone". Of course, it should be understood that the indicator bar (1046) is merely an exemplifying component that visually identifies when the instrument is in the "green zone". Other features, such as markings on the actuator (1042), can be used to indicate whether the instrument is in the "green zone" as will be apparent to the person skilled in the art in view of the teachings of the present invention.
[00105] A release bracket (1052) extends upward and distal to the main portion (1044) from a second end (1050) of the main portion (1044), although this is purely optional. For example, the release bracket (1052) can alternatively be connected to the actuator (1042) and / or the actuator of the actuator (1030). As an example only, a cam surface can be provided on the actuator (1042) and / or on the actuator actuator (1030) to engage and / or disengage the trigger conveyor element (1022) and rotate the main portion (1044) . Alternatively, a window or gap can be provided through the actuator (1042) and / or the actuator of the actuator (1030) in which a support element (not shown) that raises the trigger conveyor element (1022) (similar to the bracket) release (1052)) and enter the window or go when the actuator (1042) and / or the actuator of the actuator (1030) are in a predetermined position for firing. Of course, other resources that correspond to the "green zone" can be connected or otherwise coupled to the actuator (1042) and / or to the actuator of the actuator (1030) to engage and / or disengage the trigger conveyor element (1022) as it will be apparent to the person skilled in the art in view of the teachings of the present invention.
[00106] As shown in Figure 17A, one end of the release bracket (1052) engages or otherwise supports the tab (1028) of the trigger carrier element (1022) when the indicator (1040) is in an initial position outside the "green area". As an example only, a snap-fit feature can selectively couple the release bracket (1052) to the flap (1028) so that the flap (1028) does not inadvertently disengage from the release bracket (1052). Of course, other settings for the indicator (1040) will be apparent to the person skilled in the art in light of the teachings of the present invention. For example, in some versions, the release bracket (1052) can be pivotally connected to the trigger carrier element (1022). In another configuration, the release bracket (1052) may include a shoulder feature for releasing the trigger carrier (1022) when the indicator (1040) is in the "green zone" and activates the trigger carrier (1022) upwards when the indicator (1040) is moved out of the "green zone". In some versions, the shoulder feature may be provided on the actuator (1042) with a shoulder for the trigger carrier element (1022) out of engagement with the end (1012) of the trigger (1010) when the actuator (1042) is not in "green area". In addition, or as an alternative, a spring (not shown) can be provided to tilt the trigger carrier element (1022) toward the position shown in Figure 17A and the actuator cam (1042) feature rotates the carrier carrier trigger (1022) for engagement with the end (1012). In another version, a spring can be provided to tilt the trigger carrier element (1022) towards the engaged position shown in Figure 17B. In such a version, windows or other openings in the actuator (1042) are provided to allow passage of the trigger carrier element (1022) or other resources through them only when the actuator (1042) is in the "green zone". Thus, when the actuator (1042) is not within the "green zone", a portion of the actuator (1042) inhibits the trigger carrier element (1022) from engaging with the trigger (1010). When the actuator (1042) is moved out of the "green zone", the surfaces protruding from the windows or openings disengage the trigger carrier element (1022) from the trigger (1010). Of course, other disengagement features will be apparent to the person skilled in the art in view of the teachings of the present invention.
[00107] Returning to Figure 17A, the trigger carrier element (1022) is shown in an initial position angled upwards and in the opposite direction of the engagement with the end (1012) of the trigger (1010). The release bracket (1052) is engaged with or otherwise supports the flap (1028) to hold the trigger carrier element (1022) in this initial position. Also as shown, the indicator bar (1046) of the indicator (1040) is outside the "green zone" region (1008) in this position. If a user attempts to fire the instrument by rotating the trigger (1010), the end (1012) merely rotates inside the device and does not engage the trigger carrier (1022). As the anvil is positioned within the "green zone" and the indicator (1040) rotates through the actuator (1042), the indicator bar (1046) moves to the "green zone" region (1008), shown in Figure 17B. The release bracket (1052) is positioned so that the release bracket (1052) disengages or no longer supports the tab (1028) of the trigger carrier element (1022). The trigger carrier element (1022) then rotates around the pins (1024) and falls on the end (1012) of the trigger (1010) by gravity. Of course, a spring (not shown) can also be provided to push the trigger carrier element (1022) over the end (1012), although this is purely optional. With the trigger carrier element (1022) coupled to the trigger (1010), the user can then fire the instrument. The trigger (1010) longitudinally activates the trigger carrier element (1022) along the channels (1004) to direct the actuator actuator (1030) in a distal position to fire the clips into the fabric. Additional configurations for the driver cable assembly (1000), the trigger carrier element (1022) and / or the indicator (1040) will be apparent to the person skilled in the art in view of the teachings of the present invention.
[00108] 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. Therefore, the teachings, the expressions, the modalities, the examples, etc. described above 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 appended claims.
[00109] It is understood that any patent, publication, or other description material, in whole or in part, which is said to be incorporated into the present invention for reference purposes, is incorporated into the present invention only if the incorporated material does not enter in conflict with existing definitions, statements, or other description material presented in this description. Accordingly, and as far as necessary, the description as explicitly stated herein replaces any conflicting material incorporated herein by way of reference. Any material, or portion thereof, that is deemed to be incorporated by reference in the present invention, but which conflicts with definitions, statements, or other description materials existing herein will be incorporated here only to the extent that no conflict will appear between the embedded material and the existing description material.
[00110] 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 August 31, 2004, the description of which is incorporated herein by way of reference.
[00111] 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 pouch. 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. The radiation can exterminate 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.
[00112] 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, in 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 refurbished device are all within the scope of the present application.
[00113] Having shown and described various modalities of the present invention, further 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 should 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 (3)
[0001]
1. Apparatus for stapling fabric, which comprises: (a) a structure (500); (b) a trigger (510) pivotally mounted to the structure; (c) an actuator (520) that extends longitudinally within the structure and is operable to act longitudinally on it; (d) a locking element (530) pivotally mounted to the structure, where the locking element is pivoting from a first position, in which the locking element is engaged with the trigger (510), to a second position, in which the locking element is disengaged from the trigger; and (e) a safety feature associated with the locking element (530) and the actuator (520), in which the safety feature is intended to restrict the longitudinal actuation of the actuator; characterized by the fact that the safety feature comprises an actionable door (540), in which the door comprises an opening (542) through which the actuator extends, in which the actuator comprises one or more recesses (522), in which a portion of the door engages in one or more recesses of the actuator when the locking element is rotated to the second position.
[0002]
2. Apparatus according to claim 1, characterized by the fact that the door (540) is coupled to a spring (548), in which the spring tilts the door so that the portion of the door is disengaged from one or more recesses (522).
[0003]
3. Apparatus according to claim 1, characterized by the fact that it still comprises: (a) a stapling head assembly (20) coupled to a distal end of the structure (120), in which the trigger (74) has for the purpose of activating the stapling head assembly; and (b) an anvil (40) selectively attachable to a distal end of the actuator; in which the actuator aims to act longitudinally the anvil in relation to the stapling head assembly.

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同族专利:

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公开号 | 公开日

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EP3031406A2|2016-06-15|

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EP3222224A1|2017-09-27|

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CN103987330A|2014-08-13|

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EP3222224B1|2021-12-15|

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EP2790592A1|2014-10-22|

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PL2790592T3|2016-03-31|

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US20130153630A1|2013-06-20|

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MX2014007194A|2014-08-21|

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MX345796B|2017-02-16|

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JP2017099988A|2017-06-08|

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JP6345824B2|2018-06-20|

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JP6227548B2|2017-11-08|

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US10631867B2|2020-04-28|

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CN103987330B|2016-12-07|

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RU2014129025A|2016-02-10|

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WO2013090221A1|2013-06-20|

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JP2015503949A|2015-02-05|

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US20170215883A1|2017-08-03|

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EP3031406B1|2020-11-04|

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EP3031406A3|2016-10-05|

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RU2618953C2|2017-05-11|

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US9603599B2|2017-03-28|

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BR112014014682A2|2017-06-13|

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法律状态:
2018-12-04| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-11-19| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-11-24| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-01-26| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 11/12/2012, 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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US13/328,344|US9603599B2|2011-12-16|2011-12-16|Feature to reengage safety switch of tissue stapler|

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US13/328,344|2011-12-16|

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PCT/US2012/068859|WO2013090221A1|2011-12-16|2012-12-11|Feature to reengage safety switch of tissue stapler|

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