APPLIANCE FOR FABRIC STAPLING

专利摘要:
fabric stapler anvil element to prevent premature opening of the claw. The present invention relates to a surgical instrument including a handle assembly having a trigger (74) for the purpose of firing a staple driver (24) for staple tissue. the instrument includes a pointed shaft (38) that can attach to an anvil (40). an anvil sensing element is included to determine when the anvil is coupled to the shank. in some versions, the anvil sensing element comprises a translatable rod (140, 230) inhibiting disengagement of a locking element (82, 212). in other versions, an anvil sensing tube (622, 722) is disposed around the pointed shaft and interferes with trigger actuation in a first position. a recess (624) in the tube allows the trigger to actuate when the anvil sensing tube is in the second position. alternatively, a resilient tab (310) is coupled to the sharpened rod and resists actuation of the staple driver. a trigger lock assembly (1300) may include a spring-loaded button (1352) that "pops" when a push rod is actuated, thereby releasing a pivotal locking element.
公开号:BR112014016658B1
申请号:R112014016658-7
申请日:2012-12-17
公开日:2021-06-29
发明作者:Chester O. Baxter, Iii；John V. Hunt；Venkataramanan Mandakolathur Vasudevan；Kevin D. Felder；Jerome R. Morgan；Carl J. Shurtleff；Christopher C. Miller；John F. Cummings；Cortney E. Henderson；Joseph P. Schowalter；Johnny H. Alexander, Iii；Barry T. Jamison；Kent P. Baker；Patrick J. Swindon；Patrick A. Weizman；Cory G. Kimball；Edward G. Chekan；Joseph E. Young；Adam R. Dunkijacobs；Julia F. Serber
申请人:Ethicon Endo-Surgery, Inc.；
IPC主号:

专利说明:

BACKGROUND
[001] In some scenarios, a surgeon may want to position a surgical instrument through a patient's orifice and use the instrument to adjust, position, fix, 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 eliminate unwanted tissue or for other reasons. Once the desired tissue is removed, the remaining portions will need to be re-attached together. One of the tools for performing these anastomotic procedures is a circular stapler that is inserted through a patient's orifice.
[002] Examples of such surgical circular staplers are described in US Patent No. 5,205,459 entitled "Surgical Anastomosis Stapling Instrument," issued 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 above-cited US patents is incorporated by reference into the present invention. Some of these staplers can be operated to staple fabric layers, cut through stapled fabric layers, and push the staples through fabric layers to securely join the separate fabric layers near the separated ends of the fabric layers.
Merely additional exemplary surgical staplers are disclosed in US Patent No. 4,805,823 entitled "Pocket Configuration for Internal Organ Staplers", issued February 21, 1989; U.S. Patent No. 5,415,334 entitled "Surgical Stapler and Staple Cartridge", issued May 16, 1995; U.S. 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 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; U.S. Patent No. 7,000,818 entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued February 21, 2006; U.S. 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 December 4, 2007; US Patent No. 7,367,485 entitled "Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission", issued May 6, 2008; US Patent No. 7,380,695 entitled "Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of Firing", granted June 3, 2008; US Patent No. 7,380,696 entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism", granted June 3, 2008; US Patent No. 7,404,508 entitled "Surgical Stapling and Cutting Device", issued July 29, 2008; U.S. Patent No. 7,434,715 entitled "Surgical Stapling Instrument Having Multiple Strokes of Firing with Aperture Lock", granted on October 14, 2008; and 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 above-cited US patents is incorporated herein by reference. Although the aforementioned surgical staplers are described as being 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 prior to the inventor(s) has manufactured or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS
[005] Although the specification ends 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 references identify the same elements and where:
[006] Figure 1 represents a side elevation view of an exemplary circular stapling surgical instrument;
[007] Figure 2A represents an enlarged longitudinal cross-sectional view of an exemplary stapling head assembly of the instrument of Figure 1 showing an exemplary anvil in an open position;
[008] Figure 2B represents an enlarged longitudinal cross-sectional view of the stapling head assembly of Figure 2A showing the anvil in a closed position;
[009] Figure 2C represents an enlarged longitudinal cross-sectional view of the staple head assembly of Figure 2A showing an exemplary staple driver and a blade in a fired position;
[0010] Figure 3 is an enlarged partial cross-sectional view of an exemplary clamp formed against the anvil;
[0011] Figure 4A represents an enlarged side elevation view of an actuator cable assembly exemplifying the surgical instrument of Figure 1 with a portion of the body removed, showing a trigger in an unfired position and a locking element in a locked position ;
[0012] Figure 4B represents an enlarged side elevation view of the actuator cable assembly of Figure 4A, showing the trigger in a fired position and the locking element in an unlocked position;
[0013] Figure 5 is an enlarged partial perspective view of an exemplary indicator assembly of the surgical instrument of Figure 1 showing an indicator window and indicator lever;
[0014] Figure 6 is a diagrammatic view of the indicator window of Figure 5 showing an exemplary indicator bar and corresponding exemplary clip representations;
[0015] Figure 7 is a partial side cross-sectional view of a surgical instrument having an exemplary trocar with an anvil presence rod;
[0016] Figure 8 is an enlarged partial cross-sectional view of an exemplary anvil detection assembly having a resiliently pulled tab, an exemplary staple driver, a trocar, and an anvil;
[0017] Figure 9A is a partial cross-sectional view of an alternative anvil detection assembly having a pair of spring-loaded clips, shown in an extended position;
[0018] Figure 9B is a partial cross-sectional view of the incus detection assembly of Figure 9A showing the trocar and spring clips in the retracted position without an anvil attached;
[0019] Figure 9C is a partial cross-sectional view of the anvil detection assembly shown in the retracted position with the anvil attached;
[0020] Figure 10A is an enlarged view in partial longitudinal cross-section of an anvil sensing assembly having a pair of resiliently tensioned locking elements with magnetic portions;
[0021] Figure 10B is an enlarged view in partial longitudinal cross-section of the incus detection assembly of Figure 10A showing a complementary incus coupled to the trocar and aligned with the magnetic portions;
[0022] Figure 11 is a side cross-sectional view of an exemplary surgical instrument having an exemplary anvil sensing assembly with an anvil sensing tube;
[0023] Figure 12 is an enlarged partial perspective view of the distal end of the anvil sensing assembly of Figure 11;
[0024] Figure 13 is an enlarged partial perspective view of another exemplary anvil detection assembly having an alternative exemplary anvil presence tube with a container;
[0025] Figure 14 is an enlarged partial cross-sectional view of yet another exemplary anvil detection assembly showing an exemplary alternative anvil with a split collet shank and a pair of tabs;
[0026] Figure 15 is an enlarged partial cross-sectional view of an additional exemplary anvil detection assembly showing a trocar with spring loaded pins;
[0027] Figure 16A is a rear cross-sectional view of an exemplary surgical instrument showing an exemplary locking knob assembly with a knob shown in a first position;
[0028] Figure 16B represents a posterior cross-sectional view of the surgical instrument of Figure 16A showing the button swung into a second position;
[0029] Figure 16C represents a posterior cross-sectional view of the surgical instrument of Figure 16A showing the button actuated to a third position;
[0030] Figure 17 is a side elevation view of the surgical instrument of Figure 16A with a portion of the body removed;
[0031] Figure 18A is a posterior cross-sectional view of an exemplary surgical instrument with an alternative exemplary locking knob assembly with a knob shown in a first position;
[0032] Figure 18B represents a posterior cross-sectional view of the surgical instrument of Figure 18A showing the button swiveled to a second position;
[0033] Figure 18C represents a posterior cross-sectional view of the surgical instrument of Figure 18A showing the knob rotated to a third position;
[0034] Figure 19A is a partial perspective view of yet another exemplary locking knob assembly with a knob shown in a first position and an anvil pin inserted therethrough;
[0035] Figure 19B is a partial perspective view of the locking knob assembly of Figure 19A showing the anvil pin removed;
[0036] Figure 19C is a partial perspective view of the locking button assembly of Figure 19A showing the button actuated to a second position;
[0037] Figure 19D is a partial perspective view of the locking knob assembly of Figure 19A showing the knob rotated to a third position;
[0038] Figure 19E is a partial perspective view of the locking button assembly of Figure 19A showing the button actuated to a fourth position;
[0039] Figure 19F represents a partial perspective view of the locking button assembly of Figure 19A showing the trigger bar actuated in relation to the button in the fourth position;
[0040] Figure 20A is a side cross-sectional view of an exemplary surgical instrument that has an alternative locking knob assembly shown in a first position;
[0041] Figure 20B represents the alternative locking knob assembly of Figure 20A shown in a second position;
[0042] Figure 20C represents the alternative locking knob assembly of Figure 20A showing a proximal end element rotating a pivot element;
[0043] Figure 21A is a schematic view of an exemplary interlock safety assembly shown in a locked position;
[0044] Figure 21B represents a schematic view of the interlock safety assembly of Figure 21A shown in an unlocked position;
[0045] Figure 22 is an enlarged partial perspective view of the interlock safety assembly of Figure 21A showing an exemplary anvil shank in the locked position; and
[0046] Figure 23 is an enlarged partial perspective view of the interlock safety assembly of Figure 21A showing an exemplary safety lever in the locked position.
[0047] The drawings are not intended to be limiting in any way, and it is contemplated that various modalities of the technology may be carried out in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings incorporated and forming a part of the descriptive report illustrate various aspects of the present technology, and together with the description 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
[0048] 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 through illustrations, one of the best ways contemplated for carrying out 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, the drawings and descriptions are to be regarded as illustrative in nature and not restrictive. Overview of the exemplary circular stapling surgical instrument
[0049] Figures 1 to 6 show an exemplary circular surgical stapling instrument 10 having a stapling head assembly 20, a rod assembly 60, and an actuator handle assembly 70, each of which will be described in more detail. below. Stem assembly 60 extends distally from actuator cable assembly 70 and clamping head assembly 20 is coupled to a distal end of stem assembly 60. In summary, actuator cable assembly 70 is for purpose actuate a staple driver 24 of the staple head assembly 20 to drive a plurality of staples 66 away from the staple head assembly 20. The staples 66 are angled to form complete staples by an anvil 40 that is secured to the distal end of the instrument 10. Consequently, tissue 2, shown in Figures 2A-2C, can be stapled using instrument 10.
[0050] In the present example, the instrument 10 comprises a closure system and a fastener discharge system. The closure 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 is intended to longitudinally translate the trocar 38 with respect to the staple head assembly 20, thus translating anvil 40 when anvil 40 is coupled to trocar 38, to grip tissue between anvil 40 and staple head assembly 20. The fastener discharge system comprises a trigger 74, a trigger actuator assembly 84, a trigger actuator 64, and a staple trigger 24. The staple trigger 24 includes a knife 36 configured to cut tissue when the staple trigger 24 is actuated longitudinally. In addition, staples 66 are positioned distal to a plurality of staple drive elements 30 of staple driver 24 so that staple driver 24 also drives staples 66 distally when staple driver 24 is actuated. longitudinally. In this way, when trigger 74 is actuated and trigger actuation assembly 84 actuates staple driver 24 through trigger actuator 64, knife 36 and members 30 cut tissue 2 substantially simultaneously and actuate staples 66 distal to the staple head assembly 20 into the tissue. The components and functionalities of the closure system and fastener discharge system will now be described in more detail. Exemplary anvil
[0051] 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 flexed to staple the material contained between the clamping head assembly 20 and the anvil 40 The anvil 40 of the present example is selectively attachable to a trocar or sharpened rod 38 that extends distally to the clamping head assembly 20. Referring to Figures 2A-2C, the anvil 40 is selectively attachable through the attachment. from a proximal shaft 42 of the incus 40 to a distal tip of the trocar 38. The incus 40 comprises a generally circular anvil head 48 and a proximal shaft 42 extending proximally from the head of the incus 48. In the example shown, the shaft The proximal 42 comprises a tubular member 44 having resiliently tensioned retaining clips 46 to selectively couple the anvil 40 to the trocar 38, although this is merely and optional, and it should be understood that other retaining elements for engaging anvil 40 to trocar 38 may also be used. For example, C-clips, claws, threads, pins, stickers, etc. may be employed to couple the incus 40 to the trocar 38. Furthermore, while the incus 40 is described as selectively attachable to the trocar 38, in some versions, the proximal shaft 42 may include a unidirectional coupling element so that the anvil (40) ) cannot be removed from trocar 38 when incus 40 is attached. Merely exemplary unidirectional elements include barbs, unidirectional snap buttons, tweezers, collars, flaps, bands, etc. Of course still other configurations for coupling anvil 40 to trocar 38 will be apparent to one of skill in the art in view of the teachings of the present invention. For example, trocar 38 may be a hollow rod and proximal rod 42 may comprise a sharpened rod that can be inserted into the hollow rod.
[0052] The anvil head 48 of the present example comprises a plurality of clip-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 clips 66 are actuated to outside the staple head assembly 20 to the staple forming pockets 52, as shown in Figure 2C, the legs 68 of the staples 66 are bent to form full staples. It should be understood that the staple forming pockets 52 are merely optional and may be omitted in some versions.
[0053] With the anvil 40 as a separate component, it should be understood that the anvil 40 can be inserted and secured in a portion of tissue 2 prior to being coupled to the stapling head assembly 20. By way of example only, anvil 40 can be inserted and secured to a first tubular tissue portion 2 while the instrument 10 is inserted and secured to a second tubular tissue portion 2. For example, the first tubular tissue portion 2 may be sutured to or around of a portion of the incus 40, and the second tubular tissue portion 2 may be sutured to or around the trocar 38.
[0054] As shown in Figure 2A, the incus 40 is then coupled to the trocar 38. The trocar 38 of the present example is shown in a more actuated distal position. This extended position for the trocar 38 can provide a larger area with which tissue 2 can be attached prior to attachment of the incus 40. In addition, the extended position of the trocar 38 can also provide easier attachment of the incus 40 to the trocar 38. Trocar 38 also includes a tapered distal tip. This tip may be capable of piercing tissue and/or assisting in the insertion of the incus 40 over the trocar 38, although the tapered distal tip is merely optional. For example, in other versions, trocar 38 may have a blunt tip. Additionally, or in the alternative, the trocar 38 may include a magnetic portion (not shown) that can attract the incus 40 toward the trocar 38. Logically, still further configurations and arrangements for the incus 40 and the trocar 38 will be apparent to one skilled in the art in view of the teachings of the present invention.
[0055] 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 clamping head assembly 20 defines a span distance d. The trocar 38 of the present example is translatable longitudinally with respect to the clamping head assembly 20 via an adjustment knob 98 located at a proximal end of the actuator handle assembly 70, as will be described in more detail below. Consequently, when the anvil 40 is coupled to the trocar 38, rotation of the adjustment knob 98 extends or reduces the span distance d by moving the anvil 40 relative to the clamping head assembly 20. For example, as shown sequentially in the Figures 2A-2B, the anvil 40 is shown moving proximally with respect to the actuator cable assembly 70 from an initial open position to a closed position, thus reducing the span distance between the two portions of tissue 2 to be joined. When the span distance d is brought within a predetermined range, the stapling head assembly 20 can be fired, as shown in Figure 2C, to staple and cut the fabric 2 between the anvil 40 and the stapling head assembly. 20. The staple head assembly 20 is intended to staple and cut the fabric 2 by a user who rotates a trigger 74 of the actuator cable assembly 70, as will be described in more detail below.
[0056] As noted above, the span distance d corresponds to the distance between the anvil 40 and the stapling head assembly 20. When instrument 10 is inserted into a patient, this span distance d may not be easily viewable. Accordingly, a movable indicator bar 110, shown in Figures 5 to 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 rotation of the trigger knob. adjust 98 so that the position of indicator bar 110 is representative of the span distance d. As shown in Figure 6, the indicator window 120 further comprises a scale 130 indicating that the anvil span is within a desired operating range (e.g., a green colored region or "green zone") and a representation of the corresponding clip compression at each end of the scale 130. By way of example only, as shown in Figure 6, a first clip image 132 represents a large clip height while a second clip image 134 represents a small clip height. Consequently, a user can view the position of the coupled anvil 40 relative to the clamping head assembly 20 through the indicator bar 110 and the scale 130. The user can then adjust the positioning of the anvil 40 through the adjustment knob 98 accordingly. .
Referring again to Figures 2A-2C, a user sutures a portion of tissue 2 around tubular member 44 so that the head of anvil 48 is located within a portion of tissue 2 to be stapled. When tissue 2 is secured to anvil 40, retaining tabs 46 and a portion of tubular member 44 protrude from tissue 2 so that the user can attach anvil 40 to trocar 38. When tissue 2 is attached to trocar 38 and/ or another portion of the clamping head assembly 20, the user attaches the anvil 40 to the trocar 38 and actuates the anvil 40 proximally toward the clamping head assembly 20 to reduce the span distance d. Once the instrument 10 is within the operating range, the user then staples the ends of fabric 2 together, thus forming a substantially contiguous tubular portion of fabric 2.
The anvil 40 may be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. B. Exemplary Stapling Head Assembly
[0059] clamping head assembly 20 of the present example is coupled to a distal end of the rod assembly 60 and comprises a tubular housing 22 housing a sliding staple driver 24 and a plurality of staples 66 contained within staple pockets 32 The staples 66 and staple pockets 32 are arranged in a circular arrangement around the tubular housing 22. In the present example, the staples 66 and staple pockets 32 are disposed in a pair of concentric annular rows of staples 66 and pockets of staples 32. The staple driver 24 is intended to actuate longitudinally within the tubular housing 22 in response to rotation of the trigger 74 of the actuator cable assembly 70. As shown in Figures 2A-2C, the staple driver 24 comprises a cylindrical element flare which has a trocar opening 26, a central recess 28, and a plurality of members 30 circumferentially disposed around the central recess. 28 and extending distally to stem assembly 60. Each member 30 is configured to contact and engage a corresponding clip 66 of the plurality of clips 66 within clip pockets 32. Consequently, when the clip driver 24 is actuated distally to the actuator cable assembly 70, each member 30 drives a corresponding clip 66 out of its clip pocket 32 through a clip opening 34 formed at a distal end of the tubular housing 22. As each member 30 extends from the staple driver 24, the plurality of staples 66 are driven out of the staple head assembly 20 at substantially the same time. When the anvil 40 is in the closed position, the staples 66 are placed in the staple forming pockets 52 to flex the legs 68 of the staples 66, thereby staple the material located between the anvil 40 and the staple head assembly 20. Figure 3 depicts a merely exemplary staple 66 driven by a member 30 for a staple forming pocket 32 of the anvil 40 to flex the legs 68.
[0060] staple driver 24 further includes a cylindrical knife 36 that is coaxial to trocar opening 26 and inserted from staple pockets 32. In the present example, cylindrical knife 36 is disposed within central recess 28 for translating distally with the staple driver 24. When the anvil 40 is secured to the trocar 38, as described above, the head of the anvil 48 provides a surface against which the cylindrical knife 36 cuts the material contained between the anvil 40 and the assembly. of stapling head 20. In some versions, the anvil head 48 may include a recess (not shown) for the cylindrical knife 36 to help cut the material (e.g., by providing a cooperative shear edge). Additionally, or alternatively, the anvil head 48 may include one or more opposing cylindrical knives (not shown) spaced apart from the cylindrical knife 36 so that a scissors-like cutting action can be provided. Still other configurations will be apparent to one skilled in the art in view of the teachings of the present invention. The staple head assembly 20 is thus intended to staple and cut the fabric 2 substantially simultaneously in response to actuation by the actuator cable assembly 70.
[0061] Logically, the clamping head assembly 20 can be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
[0062] As noted earlier, the staple driver 24 includes an opening for the trocar 26. The opening for the trocar 26 is configured to allow the trocar 38 to slide longitudinally with respect to the clamping head assembly 20 and/or the clamping assembly. rod 60. As shown in Figures 2A to 2C, the trocar 38 is coupled to a trocar actuator 39 so that the trocar 38 can be actuated longitudinally by rotating the rotary knob 98, as will be described in more detail below with reference to the actuator cable assembly 70. In the present example, the trocar actuator 39 comprises an elongated and relatively rigid rod coupled to the trocar 38, although this is merely optional. In some versions, actuator 39 can comprise a longitudinally rigid material while allowing lateral flexion so that portions of instrument 10 can be selectively flexed or curved during use; or instrument 10 may include a previously prepared bent rod assembly 60. A merely 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 span distance d between the anvil 40 and the clamping head assembly 20. Still additional configurations for the actuator 39 to actuate trocar 38 longitudinally will be apparent to one skilled in the art in view of the teachings of the present invention. C. Exemplary rod assembly
[0063] Stapling head assembly 20 and trocar 38 are positioned at a distal end of stem assembly 60, as shown in Figures 2A to 2C. The rod assembly 60 of the present example comprises an outer tubular member 62 and an actuator of the actuator 64. The outer tubular member 62 is coupled to the tubular housing 22 of the clamping head assembly 20 and to a body 72 of the actuator cable assembly 70 , thus providing a mechanical basis for the actuating components. The proximal end of the actuator actuator 64 is coupled to a trigger actuator assembly 84 of the actuator cable assembly 70, described below. The distal end of the actuator of the actuator 64 is coupled to the actuator of staples 24 so that rotation of the trigger 74 longitudinally actuates the trigger of staples 24. As shown in Figures 2A to 2C, the actuator of the trigger 64 comprises a tubular member having an open longitudinal axis so that the actuator 39 coupled to the trocar 38 can act longitudinally within and relative to the actuator of the actuator 64. Of course, it should be understood that other components may be disposed within the actuator of the actuator 64 as will be apparent to a skilled in the art in view of the teachings of the present invention.
[0064] rod assembly 60 may be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. D. Exemplary actuator cable assembly
[0065] Now referring to Figures 4A-5, the actuator handle assembly 70 comprises a body 72, a trigger 74, a locking member 82, a trigger actuation assembly 84, and a trocar actuation assembly 90. The trigger 74 of the present example is pivotally mounted to the body 72 and is coupled to the trigger 84 actuation assembly so that the trigger 74 rotates from an unfired position (shown in Fig. 4A) to a fired position (shown in Fig. 4B ) actuates the actuator of the actuator 64 described above. A spring 78 is coupled to body 72 and trigger 74 to pull trigger 74 toward an unfired position. The locking element 82 is a pivoting element that is coupled to the body 72. In a first locked position, the locking element 82 is pivoted up and away from the body 72 so that the locking element 82 engages the trigger 74 and mechanically resist trigger 74 actuation by a user. In a second unlocked position, such as that shown in Figures 1 and 4B, the locking element 82 is rotated downward so that the trigger 74 can be actuated by the user. Accordingly, with the locking member 82 in the second position, the trigger 74 can engage a trigger 84 actuation assembly to trigger the instrument 10.
[0066] As shown in Figures 4A through 4B, the trigger actuation assembly 84 of the present example comprises a slide actuator carriage 86 engaged with a proximal end of the trigger actuator 64. The carriage 86 includes a set of tabs 88 at one end proximal to the carriage 86 to retain and engage a pair of actuator arms 76 extending from the trigger 74. Consequently, when the trigger 74 is rotated, the carriage 86 is longitudinally actuated and transfers longitudinal movement to the actuator of the actuator 64. In the example shown, carriage 86 is fixedly coupled to the proximal end of the actuator of actuator 64, although this is merely optional. Indeed, in a merely exemplary alternative, carriage 86 may simply be in a position abutting actuator actuator 64 while a distal spring (not shown) pulls actuator actuator 64 proximally with respect to actuator cable assembly 70.
[0067] Trigger actuation assembly 84 can be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
[0068] Structure 72 also houses a trocar actuation assembly 90 configured to actuate trocar 38 longitudinally in response to rotation of adjustment knob 98. As best shown in Figures 4A-5, the trocar actuation assembly 90 of the present The example comprises the adjustment knob 98, a grooved rod 94, and a sleeve 92. The grooved rod 94 of the present example is situated at a distal end of the trocar actuator 39, although it should be understood that the grooved rod 94 is the actuator. Trocar 39 may alternatively be separate components that engage to transmit longitudinal movement. The adjustment knob 98 is pivotally supported by the proximal end of the body 72 and is intended to rotate the sleeve 92 which is engaged with the grooved rod 94 through an inner tab (not shown). The grooved rod 94 of the present example comprises a continuous groove 96 formed in the outer surface of the grooved rod 94. Consequently, when the adjustment knob 98 is rotated, the inner tab passes into the groove 96 and the grooved rod 94 is actuated longitudinally with respect to the sleeve 92. Since the grooved rod 94 is situated at the distal end of the trocar actuator 39, rotation of the adjustment knob 98 in a first direction advances the trocar actuator 39 distally to the actuator handle assembly 70. Consequently, the span distance d between the anvil 40 and the clamping head assembly 20 is increased. Upon rotation of the adjustment knob 98 in the opposite direction, the trocar actuator 39 is actuated proximally to the actuator cable assembly 70 to reduce the span distance d between the anvil 40 and the clamping head assembly 20. In this way , the trocar actuation assembly 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 assembly 90 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention .
[0069] The groove 96 of the present example comprises a plurality of different portions 96A, 96B, 96C having a different range or number of grooves per axial distance. The present groove 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 thin gap or a high number of grooves along a short axial distance from the grooved rod 94 so that a large number of rotations of the adjustment knob 98 are required to cross the short axial distance. The middle portion 96B comprises a section with comparably greater gap or with fewer grooves per axial distance so that relatively less rotations are needed to traverse a long axial distance. Consequently, 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 thin gap or a high number of grooves along a short axial distance from the grooved rod 94 so that a large number of rotations are needed to traverse the short axial distance. Proximal portion 96C of the present example is positioned within sleeve 92 when anvil 40 is substantially close to staple head assembly 20 so that indicator bar 110 moves within indicator window 120 along scale 130 to indicate that the anvil span is within a desired operating range as will be described in more 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 span distance d by a small amount to provide a fine adjustment.
[0070] Trocar actuation assembly 90 may be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention.
[0071] In the example shown in Figures 4A to 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 body 72 to substantially prevent the actuator of the trocar 39 from rotating about its axis when the adjustment knob 98 is rotated. The U-shaped tab 100 further includes an elongated slot 102 on each of its opposite sides for receiving a connecting element, such as a screw, clamp, pin, clip, etc., to selectively adjust the longitudinal position of the slot. elongated 102 of the U-shaped loop 100 with respect to the actuator of the trocar 39 for the purpose of calibrating the indicator bar 110 with respect to the scale 130.
[0072] As shown in Figure 5, the actuator cable assembly 70 further includes an indicator support 140 configured to engage and rotate an indicator 104. The indicator support 140 of the present example is slidable relative to the body 72 along of a pair of slits formed in the body 72. The indicator holder 140 comprises a rectangular plate 144, an indicator arm 146, and an inclined flange 142. The inclined flange 142 is formed at the proximal end of the rectangular plate 144 and includes an opening (not shown) for sliding support over trocar actuator 39 and/or grooved rod 94. A coil spring 150 is interposed between flange 142 and protrusion 152 to pull flange 142 against U-shaped clamp 100. Consequently, when the U-shaped cleat 100 acts distally with the trocar actuator 39 and/or grooved rod 94, the spiral spring 150 urges the indicator holder 140 to move distally with the U-shaped cleat 10 0. In addition, the U-shaped loop 100 drives the indicator holder 140 proximally to the protrusion 152 as the trocar actuator 39 and/or the grooved rod 94 translate proximally, thus compressing the coil spring 150. Of course, it should be understood that in some versions, indicator holder 140 can be fixedly attached to trocar actuator 39 and/or grooved rod 94.
[0073] In the present example, a portion of the locking element 82 abuts 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 anvil span is within a desired operating range (for example, a region colored green or "green zone"). When the anvil span is within a desired operating range (eg, a green colored region or "green zone"), the indicator bracket 140 narrows to provide a pair of spans 145 on each side of an arm of the indicator 146 which allows the locking element 82 to rotate, thereby releasing the trigger 74. Consequently, the locking element 82 and the bracket of the indicator 140 can substantially prevent a user from releasing or operating the trigger 74 until the anvil 40 is in a range of predetermined operation. Logically, it should be understood that the locking element 82 may be omitted entirely in some versions.
[0074] This operating track may be visually communicated to the user via an indicator bar 110 of an indicator 104 shown against a scale 130, described briefly above. At the distal end of the indicator bracket 140 is a distally projecting index arm 146 that terminates in a laterally projecting pawl 148 to control movement of the indicator 104. The indicator arm 146 and pawl 148, best shown in the figure 5, are configured to engage a tab 106 of indicator 104 so that indicator 104 is rotated when indicator bracket 140 is actuated longitudinally. In the present example, indicator 104 is pivotally coupled to body 72 at a first end of indicator 104, although this is merely optional and other pivot points for indicator 104 will be apparent to one skilled in the art in view of the teachings of the present invention. An indicator bar 110 is positioned over the second end of indicator 104 such that indicator bar 110 moves in response to actuation of indicator bracket 140. Consequently, as discussed above, indicator bar 110 is presented through an indicator window. 120 against a scale 130 (shown in Figure 6) to show the span distance d between the anvil 40 and the clamping head assembly 20.
[0075] Logically, the bracket of the indicator 140, the indicator 104, and/or the actuator cable assembly 70 can be further 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; U.S. Patent No. 5,533,661, the disclosures of which are incorporated herein by reference; and/or in other embodiments, as will be apparent to one skilled in the art in view of the teachings of the present invention. Detection of anvil, indicators, and exemplifying locking elements
[0076] In some cases, it may be desirable for a user to detect when the incus 40 is sufficiently coupled to the trocar 38. This detection can confirm that the incus 40 is properly coupled to the trocar 38 such that the incus 40 does not move distally in with respect to the staple driver 24 when the instrument 10 is triggered. Indicator for this detection may be provided through a sensory indicator assembly (eg, visual, auditory, tactile, etc.) and/or through a trigger lock assembly to prevent trigger 74 from being actuated by the user. Consequently, a user may be able to determine whether the anvil 40 is properly secured, or fully seated on the trocar 38, before firing the instrument 10 or, in some cases, the instrument 10 will prevent the user from firing until the anvil 40 is properly fixed. Consequently, various anvil detection sets, indicator sets, and trigger lock sets will now be described. Exemplary anvil presence rod
[0077] Figure 7 represents a surgical instrument 200 that includes an exemplary anvil presence rod 230 incorporated into an exemplary trocar 220. In the present example, the surgical instrument 200 comprises a body 202, a trigger 204, a locking element 210 , an adjustment knob 216, a trocar 220, and an anvil presence rod 230. The body 202, the trigger 204, the locking element 210, the adjustment knob 216, and the trocar 220, may be constructed substantially of according to the body 72, trigger 74, locking element 82, adjustment knob 98 and trocar 38 described above. The surgical instrument 200 may be further constructed substantially in accordance with the surgical instrument 10 described above, or 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; and/or US Patent No. 5,533,661, the disclosures of which are incorporated herein by reference.
[0078] In the present example, the trocar 220 includes a central rod tube 222 configured to slidingly receive therein the anvil presence rod 230. The anvil presence rod 230 comprises a longitudinally rigid rod element that is slidable within. of the rod tube 222 of the trocar 220 and extends into an opening 218 formed through the adjustment knob 216. As shown in Figure 7, the anvil presence rod 230 is positioned in a non-activated position. The incus presence rod 230 is slid proximally to the trocar 220 when an anvil, such as the incus 40 shown in Figures 1 to 6, is inserted into the trocar 220, thereby moving the incus presence rod 230 proximally to an actuated position. . This proximal movement of the anvil presence rod 230 can be used to mechanically interact or release components of instrument 200 to indicate when the anvil is properly seated on trocar 220.
[0079] In the present example, the anvil presence rod 230 includes a proximal end 232 that extends outwardly through an aperture 218 formed in the adjustment knob 216 when an anvil presence rod 230 is slid proximally to the trocar. 220. This proximal end 232 may include one or more regions and/or markings 234 to visually indicate the position of the anvil presence rod 230. By way of example only, these markings 234 may include a plurality of colors (e.g., red , yellow, green) and/or symbols (e.g., numbers, letters, etc.) to indicate the longitudinal position of the anvil presence rod 230. In the example shown, the markings 234 comprise three regions 234A, 234B, 234C corresponding to the colors red 234A, yellow 234B, and green 234C. The user can use the markings 234 to detect whether the anvil presence rod 230 has been actuated sufficiently to indicate that the incus is properly seated over the trocar 220. For example, the green marking portion 234C may correspond to when the anvil has been sufficiently coupled to the trocar 220 so that the incus will not disengage when firing the instrument 200. The yellow marking portion 234B of the present example may be provided to indicate to the user that the incus presence rod 230 has been actuated proximally to the trocar 220, but incus was not fully seated over trocar 220. In an alternative, only a single marking, such as green portion 234C, can be provided to indicate the position corresponding to when the incus has been sufficiently attached to trocar 220. Of course, it should It will be understood that the markings 234 and/or the extension of the proximal end 232 out of the opening 218 of the adjustment knob 216 are merely optional equipment.
[0080] In addition, the anvil presence rod 230 of the present example is pulled distally by a spiral spring 240 that is disposed within a portion of the trocar 220. Consequently, when no object is acting the anvil presence rod 230 proximally to the trocar 220, the coil spring 240 urges the distal end of the anvil presence rod 230 out of the distal end of the rod tube 222. If a user attempts to attach the incus to the trocar 220 and the anvil is not properly seated on the trocar 220, the distal traction provided by the coil spring 240 ejects the incus from the trocar 220. In this way, the incus presence rod 230 can physically and visually provide an indication to the user that the incus is not properly seated on the trocar 220. To provide distal traction to the incus presence rod 230, the coil spring 240 is coupled to a portion of the incus presence rod 230 t as well as being adjacent to a flap, being fixedly coupled at one end, and/or otherwise. In some versions, the proximal end 232 of the anvil presence rod 230 may not extend through the opening 218 of the adjustment knob 216, but rather abuts the coil spring 240 to provide distal traction. A distal flap or flared portion 236, shown in Figure 7, prevents the anvil presence rod 230 from ejecting distally from the trocar 220 from the distal traction provided by the coil spring 240, although this too is merely optional.
[0081] Although a visual indicator may be provided by proximal end 232 and/or markings 234, in some versions an element may be desired which substantially prevents trigger 204 from being actuated by the user until the anvil is properly seated on. the trocar 220. In the present example, the locking member 210 comprises a pivoting member having a leg 212 that abuts a bulge 238 of the anvil presence rod 230 when the anvil presence rod 230 is in the non-activated position. shown in Figure 7. Lump 238 extends outwardly through a slit 224 formed in trocar 220 such that bulge 238 is slid longitudinally along slit 224 when anvil presence rod 230 is actuated proximally to the trocar. 220. The longitudinal length of the protrusion 238 in this example corresponds to the longitudinal distance traversed by the anvil presence rod. to 230 to indicate that the anvil is properly attached to the trocar 220. Consequently, when the anvil is properly attached, the protrusion 238 is no longer adjoined to the leg 212 of the locking element 210. The user then rotates the locking element 210 to unlocking and permitting operation of trigger 204 to trigger instrument 200. The combination of protrusion 238 and locking element 210 can substantially prevent the user from triggering instrument 10 when the anvil is not properly coupled to trocar 220. In some versions , leg 212 may be integrally formed with or otherwise attached to trigger 204. In some such versions, locking element 210 may be omitted. Logically, other arrangements for preventing the locking member 210 from rotating prior to actuation of the anvil presence rod 230 to the actuated position will be apparent to one of skill in the art in view of the teachings of the present invention. B. Exemplary resiliently tensioned anvil detection elements
[0082] Figure 8 depicts an alternative anvil detection assembly 300 that can be incorporated into a surgical instrument, such as the surgical instruments 10, 200 described above. In the example shown, the anvil sensing assembly 300 comprises a hinged flap 310 extending outwardly from a trocar 302. The trocar 302 may be constructed in accordance with at least some of the trocar teachings 38, 220 described above. As shown in the present example, a spring 312 pulls tab 310 outward from trocar 302, although this is merely optional. For example, in an alternative, spring 312 can be omitted and tab 310 can be integrally formed with trocar 302 so that tab 310 is a resiliently tensioned tab. Furthermore, although a single tab 310 is illustrated, it should be understood that a plurality of tabs 310 may be positioned over the trocar 302. When tab 310 is extended away from the trocar 302, the tab 310 of the present example mechanically interferes with a staple driver 308 to substantially prevent the staple driver 308 from acting distally to the trocar 302. Accordingly, a user can be prevented from firing the staple driver 308 by operating a trigger, such as the trigger 74 described above. , until tab 310 is pressed against or into trocar 302.
[0083] In the example shown, an anvil 340 comprises an anvil head 342 and a hollow shaft 344. Anvil 340 may be further constructed in accordance with at least some of the teachings of anvil 40 described above. The hollow rod 344 comprises a cylindrical tube configured to slide over the trocar 302 and selectively couple the anvil 340 to the trocar 302. In the example shown, the hollow rod 344 includes detents 346 that engage indentations 304 of the trocar 302 to selectively secure the anvil 340 to the trocar 302. Of course, other coupling assemblies for selectively coupling anvil 340 to trocar 302 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention. When the hollow rod 344 is slid over the trocar 302, the hollow rod 344 compresses the tab 310 against the trocar 302, thus allowing the staple driver 308 to act distally to the trocar 302 and/or the anvil 340 when the user operates. the instrument. In the example shown, the length of the hollow rod 344 is such that the hollow rod 344 only engages the tab 310 when the anvil 340 is fully seated on the trocar 302. The present assembly can thus prevent a user from firing the device to unless the anvil 340 is properly coupled to the trocar 302. Of course, still additional configurations for the anvil 340, flap 310, and/or trocar 302 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[0084] Furthermore, alternatively, the tab 310 can be mechanically associated with a locking element on the actuator cable assembly. By way of example only, tab 310 may comprise a cam surface for the purpose of actuating a rod, such as anvil presence rod 230 described above, when tab 310 is pressed against trocar 302. The rod of this example may include a protrusion, such as protrusion 238, that selectively interferes with the release of a locking member depending on the longitudinal position of the rod. Additionally, or alternatively, the rod may include a proximal end, such as proximal end 232, that projects from the proximal end of the surgical instrument to provide visual feedback to the user. Logically, tab 310 may be mechanically associated with other locking elements and/or visual indicators as will be apparent to one skilled in the art in view of the teachings of the present invention. In another alternative, tab 310 may be positioned so that trocar 302 cannot be actuated proximally to staple driver 308 from an extended position via the adjustment knob. For example, tab 310 may be positioned to be in a position adjacent to staple driver 308 while trocar 302 is in the extended position. Consequently, if the user attempts to actuate trocar 302 proximally through the adjustment knob, tab 310 resists proximal actuation and provides tactile feedback that tab 310 has not been depressed by attachment of rod 344 of anvil 340. If trocar 302 has not is proximally actuable due to interference from tab 310 then, in an instrument such as instrument 10, a user cannot rotate locking member 82 to release trigger 74 due to the position of the indicator bracket 140, as discussed above. In this way, when tab 310 is extended, a user can be substantially prevented from triggering the instrument. Of course, still additional configurations and assemblies incorporating tab 310 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[0085] Figures 9A-9C show an alternative anvil sensing assembly 400 comprising a trocar 410 having a pair of spring clips 420. In the example shown, the spring clips 420 are contained within a formed slit 412. in the trocar 410. As shown in Figure 9A, the spring clamps 420 are pulled outward from the trocar 410 so that the proximal ends 422 extend laterally from the trocar 410. For example only, the spring clamps 420 are coupled to trocar 410 at a pivot point 424 and a spring (not shown) is interposed between the spring clamps 420 to pull each of these away from each other. Additionally, or alternatively, spring clips 420 may comprise resiliently tensioned elements that are tensioned away from pivot point 424. In the example shown in Figure 9A, when spring clips 420 are extended laterally, trocar 410 is impeded acting proximally because the proximal ends 422 engage an opening for the trocar 416. Consequently, if an anvil 440 (shown in Figure 9C) is not coupled to the trocar 410 then the trocar 410 is prevented from acting proximally with respect to an actuator. clamps 430. If a user wishes to actuate the trocar 410 proximally to the staple driver 430 without the anvil 440 attached, the user must press the spring clamps 420 together to allow retraction.
[0086] As shown in figure 9B, when an anvil 440 (shown in figure 9C) is not coupled to trocar 410 and trocar 410 is retracted proximally to staple driver 430, spring clips 420 engage notches 432 formed in driver of clips 430. As will be apparent to one of skill in the art in view of the teachings of the present invention, spring clips 420 inserted into notches 432 substantially prevent clip driver 430 from acting distally with respect to trocar 410. 440 is not attached to the trocar 410 then the spring clips 420 provide a locking mechanism to prevent the instrument from firing. Finally, as shown in Figure 9C, when the anvil 440 is coupled to the trocar 410, an anvil shaft 442 swings the spring clips 420 inward so that the proximal ends 422 do not engage the notches 432. Consequently, the clip driver 430 may be actuated distally to trocar 410 to trigger the instrument. Still additional configurations for the anvil detection assembly 400 and/or the spring clips 420 will be apparent to one skilled in the art in view of the teachings of the present invention. C. Exemplary Magnetic Anvil Detection Assembly
[0087] Figures 10A-10B depict an alternative anvil detection assembly 500 that may be incorporated into a surgical instrument, such as the surgical instrument 10 described above. Referring initially to Figure 10A, a trocar 510 and staple driver 520 extend distally from an actuator cable assembly (not shown). Trocar 510 and staple driver 520 can be constructed in accordance with at least some of the teachings of trocar 38 and staple driver 24 described herein. A pair of resilient members 530 also extend distally from the actuator handle assembly and are pulled away from the trocar 510. The proximal ends (not shown) of the resilient members (530) are coupled to a portion of the assembly. actuator cable to mechanically support resilient members 530. For example, resilient members 530 may be integrally formed with the body of the actuator cable assembly or mechanically coupled through a connecting element such as a screw, pin, adhesive, etc. In some versions, the proximal ends of the resilient members 530 can be coupled to the trocar 510. In another version, the proximal ends of the resilient members 530 can be coupled to the staple driver 520. Of course, still additional configurations for engaging the resilient members 530 at their proximal ends will be apparent to one skilled in the art in view of the teachings of the present invention.
[0088] The resilient members 530 each comprise an elongated member having a locking arm 532 and a magnet 534. The magnet 534 may be a ferrous magnet, a neodymium magnet, a cobalt samarium magnet, or any another suitable magnet 534 as will be apparent to one skilled in the art in view of the teachings of the present invention. Each locking arm 532 extends outside the longitudinal axis of a corresponding resilient member 530. In the example shown, each locking arm 532 is perpendicular to the longitudinal axis of the corresponding resilient member 530 so that each locking arm 532 is configured to interfere mechanically with the distal actuation of the staple driver 520 relative to the resilient member 530 and/or the trocar 510. Consequently, when the resilient arms 530 are in a locked position, such as that shown in Figure 10A, the staple driver 520 is substantially prevented from acting distally by the locking arms 532. While only one pair of resilient members 530 is shown, it should be understood that any number of resilient members 530 can be used to restrict the distal actuation of the staple driver 520. For example, 1 , 2, 3, 4, 5, or 6 resilient members 530 may be disposed around trocar 510 and configured to interfere. laugh with the distal actuation of the 520 staple driver.
[0089] Figure 10B depicts a complementary anvil 540 to the anvil 500 detection assembly. The anvil 540 comprises an anvil head 542 and a shank 544. The anvil 540 may be further constructed in accordance with at least some of the teachings of 40 anvil described here. Stem 544 of the present example is configured to selectively couple anvil 540 to trocar 510. By way of example only, stem 544 may comprise detents (546) configured to engage with indentations 512 (shown in Figure 10A) of trocar 510 for engaging selectively the anvil 540 to the trocar 510. The rod 544 further comprises a magnetic portion 548 positioned along the longitudinal length of the rod 544. The magnetic portion 548 may comprise a single annular magnet fitted to the rod 544 or a plurality of magnets disposed therein. of rod 544. Additionally, or alternatively, magnetic portion 548 may not be fitted within rod 544 but may be coupled to the outer or inner surface of rod 544. In addition, magnetic portion 548 may comprise one or more ferrous magnets, neodymium magnets, samarium-cobalt magnets, and/or any other suitable magnet, as will be apparent to one skilled in the art in view of the teachings of the present invention. then. In the present example, magnetic portion 548 is positioned longitudinally to align with magnets 534 of resilient arms 530 only when anvil 540 is fully seated on trocar 510.
[0090] As shown in Figure 10B, when the anvil 540 is fully seated, the magnetic portion 548 attracts the magnets 534 so that the resilient arms 530 flex inwardly towards the rod 544 and/or the trocar 510. locking arms 532 no longer mechanically interfere with the staple driver 520, thus allowing the staple driver 520 to act longitudinally to allow the user to trigger the instrument. In a merely exemplary alternative, resilient arms 530 may omit magnets 534 and may instead be constructed of a ferrous material so that magnetic portion 548 attracts resilient arms 530 inwardly. In this configuration, the spring constant for the resilient arms 530 can be configured so that the locking arms 532 no longer impede distal movement of the staple driver 520 only when the anvil 540 is fully seated on the trocar 510. for example, when the anvil 540 is attached to the trocar 510, the resilient arms 530 begin to flex inward due to the magnetic portion 548 that magnetically attracts the material. Only when the anvil 540 is fully seated on the trocar 510 does the attraction force of the magnetic portion 548 on the resilient arms 530 displace the resilient arms 530 so that the locking arms 532 no longer impede the longitudinal actuation of the staple driver 520. in some versions, resilient arms 530 may comprise magnets 534 while magnetic portion 548 of rod 544 is omitted. Logically, still additional configurations for the anvil detection assembly 500 will be apparent to one skilled in the art in view of the teachings of the present invention. D. Exemplary Outer Stem Anvil Sensing Element
[0091] Figures 11 to 12 represent yet another anvil sensing assembly 620 for a surgical instrument 600 comprising an anvil sensing tube 622 slidably disposed around a trocar 602. As shown in Figure 11, the anvil sensing tube 622 sensing anvil 620 extends proximally into an actuator handle assembly 610. The actuator handle assembly 610 of the present example includes a trigger 614 pivotal with respect to a body 612. Trigger 614 includes an extending arm or member 616 outward from a pivot point of trigger 614 so that arm 616 is rotated with trigger 614. In some versions, a pair of arms 616 may be provided, such as trigger arms 76 described above. Alternatively, or additionally, arm 616 may be a separate separate element from trigger arms 76. Instrument 600, trocar 602, and/or actuator cable assembly 610 may be further constructed in accordance with at least some of the teachings for instrument 10, trocar 38, and/or actuator cable assembly 70 described above.
[0092] Anvil sensing tube 622 of the present example comprises a tubular member disposed coaxially around trocar 602, although it should be understood that this is merely optional. In some versions, the anvil sensing tube 622 may comprise a longitudinal bar extending along one side of the trocar 602 or the anvil sensing tube 622 may include a U-shaped element partially surrounding a portion of the trocar 602 Still additional configurations for the anvil detection tube 622 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention. The anvil sensing tube 622 shown in Fig. 11 includes a notch 624 formed in a proximal portion of the anvil sensing tube 622. Consequently, when the anvil sensing tube 622 is in an unactuated position, such as that shown in Fig. 11, notch 624 is not aligned with arm 616. Instead, arm 616 abuts a portion of the sensing tube of anvil 622 so that trigger 614 cannot be pivoted with respect to body 612. When the sensing tube of the anvil 622 is actuated proximally to the trocar 602 to an actuated position, as will be discussed in more detail below, the notch 624 is aligned with the arm 616 so that the trigger 614 is pivotal relative to the body 612 A spring 628 is coupled to a proximal end of the anvil sensing tube 622 to pull the anvil sensing tube 622 distally with respect to the actuator cable assembly 610.
[0093] In the present example, the longitudinal position of notch 624 is situated so that arm 616 aligns with notch 624 only when an anvil 630 is fully seated on trocar 602 and trocar 602 is actuated proximally into the " green zone" described above. The "green zone" indicates that the anvil span, or distance between the anvil head (not shown) and staple driver 604, is within a desired operating range. If incus 630 is not fully seated on trocar 602 then spring 628 ejects incus 630 from trocar 602, as will be discussed in more detail below. If the anvil 630 is fully seated on the trocar 602 and the notch 624 and arm 616 are aligned, the user can operate the trigger (614) to trigger the instrument 600. Of course, the notch 624 may have other longitudinal positions on the tube. anvil detection 622. Still further configurations for the anvil detection tube 622 and/or actuator cable assembly 610 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[0094] Referring now to Figure 12, the anvil sensing tube 622 is shown disposed between the trocar 602 and the staple driver 604. The anvil sensing tube 622 includes a coupling surface 628 at a distal end 626 that is configured to engage an annular boss 640 of an anvil 630. The anvil 630 of the present example comprises an anvil head (not shown), a shank 634, an annular bulge 640 formed on the shank 634, and a coupling element (not shown ). Anvil 630 can be further constructed in accordance with at least some of the teachings of anvil 40 described herein. When the anvil 630 is pushed over the trocar 602, the annular protrusion 640 engages with the coupling surface 628 to actuate the sensing tube of the anvil 622 proximally with respect to a trocar 602 and/or staple driver 604. The coupling element of the anvil 630 selectively couples the anvil 630 to the trocar 602. By way of example only, the coupling element may include detents (not shown) formed on the rod 634 that engage with indentations 603 of the trocar 602. In the present example, the anvil 630 is is fully seated in trocar 602 (i.e., selectively coupled together by the coupling element) then spring 628 does not eject anvil 630. If anvil 630 is not fully seated on trocar 602 (i.e., coupling element does not engage and attaching anvil 630 to trocar 602) then spring 628 ejects anvil 630. Although ejection of anvil 630 of the present example occurs when anvil 630 is initially engaged. As for trocar 602, it should be understood that, in other versions, ejection of incus 630 may occur when trocar 602 is actuated proximally via the adjustment knob. In this alternative version, annular protrusion 640 engages mating surface 628 when trocar 602 is actuated proximally via the rotary knob. Logically, still additional configurations for the anvil 630 and/or the anvil detection tube 622 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[0095] In the present example, notch 624 does not align with arm 616 until trocar 602 and incus 630 are actuated proximally to the "green zone" described above. In this version, trigger 614 is "locked in" until anvil 630 is fully seated and positioned in the "green zone." In other versions, notch 624 may align with arm 616 of trigger 614 when anvil 630 is initially fully seated over trocar 602. In this version, the user may partially rotate trigger 614 to determine that anvil 630 is fully seated over trocar 602 before actuating trocar 602 and incus 630 proximally via the rotary knob. Consequently, the user can be provided with a form of tactile feedback indicating that the incus 630 is fully seated over the trocar 602. Of course, still additional configurations for the incus sensing tube 622 and/or the annular protuberance 640 will be apparent to one skilled in the art in view of the teachings of the present invention.
[0096] For example, in the example shown in Figure 13, an alternative anvil sensing tube 722 is shown having a container 724 configured to receive and guide the annular protrusion 640 of the anvil 630 for engagement with the mating surface 728 of the tube. anvil detection tube 722. The anvil detection tube 722 may be further constructed in accordance with the anvil detection tube 622 described above. Accordingly, when annular rod 640 engages with mating surface 728, anvil sensing tube 722 is configured to allow a trigger such as trigger 614 to be operated to trigger the instrument. Although the example shown includes annular boss 640, in other versions, container 724 can be configured to mate with a stem 634 that omits annular boss 640.
[0097] Figure 14 represents an alternative anvil 800 that can be used to engage the anvil sensing tubes 622, 722. The anvil 800 comprises an anvil head (not shown), a shank 802, and a pair of pegs 810 extending outwardly from rod 802. Rod 802 of the present example comprises a slotted clamp configured to engage over, and selectively engage with, an enlarged portion 822 of a trocar 820. In some versions, rod 802 may comprise a magnetic member 804 for being magnetically guided towards the trocar 820. Additionally, or alternatively, the trocar 820 and/or the flared portion 822 may comprise a magnetic member 824 for guiding the rod 802 over the trocar 820. The pegs 810 are configured to engage mating surfaces 628, 728 in substantially similar fashion to annular protrusion 640. then 628, 728, anvil 800 and trocar 820 can be actuated proximally via an adjustment knob so that the anvil sensing tube 622, 722 engages and/or disengages a locking element such as arm 616 and 624 slot described above. In some versions, mating surfaces 628, 728 may include a recessed portion (not shown) so that pegs 810 press fit within the recessed portion to selectively secure anvil 800 to anvil sensing tubes 622, 722.
[0098] In a still further version, Figure 15 depicts an alternate trocar 850 having spring loaded pins 852 pulled outward against an anvil sensing tube 860. The anvil sensing tube 860 of the present example may be constructed of in accordance with at least some of the teachings for the anvil sensing tubes 622, 722 described above. The anvil 870 of the present example includes a rod 872 that has a pair of apertures 874 into which pins 860 launch when the rod 872 is pushed over the trocar 850. Consequently, when the anvil 870 is inserted into the trocar 850, the rod 872 engages anvil sensing tube 860 and pushes anvil sensing tube 860 proximally to trocar 850. When rod 872 has actuated anvil sensing tube 860 proximally a predetermined distance, pins 852 launch to openings 874, thereby securing rod 872 to trocar 850.
Logically, still additional configurations for anvils 630, 800, 870, anvil sensing tubes 622, 722, and/or trocars 602, 820, 850 will be apparent to one of skill in the art in view of the teachings of the present invention. E. Exemplary locking elements
[00100] Although the aforementioned examples have demonstrated various anvil detection sets, it may be preferred that the aforementioned sets engage one or more locking elements to release trigger 74 to trigger instrument 10. For example, in some versions, it may be preferred that the anvil sensing elements release a locking button which must be pressed or pressed by the user to release the trigger 74, thus preventing instrument 10 from being fired until the anvil 40 is properly coupled to the trocar 38 and the locking is operated by the user. Alternatively, it may be preferred that the anvil sensing assembly releases an indicator and releases the locking element 82 so that the indicator visually indicates that the anvil 40 is fully seated on the trocar 38 and that the locking element can be disengaged to operate trigger 74. Accordingly, it should be understood that the following examples may be combined with one or more of the aforementioned anvil detection sets and/or with any other anvil detection set, as will be apparent to a person skilled in the art. technique in view of the teachings of the present invention. Exemplary lock button assembly having a three-position button
[00101] Figures 16A-17 show an exemplary surgical instrument 900 having an exemplary locking knob assembly 950. Referring initially to Figure 16A, the locking knob assembly 950 comprises an extending anvil sensing rod 960 longitudinally into the actuator handle assembly 930 to engage a button 970. The anvil sensing rod 960 includes a proximal end 962 having an obliquely inclined cam surface 964 configured to engage the knob 970. The anvil sensing rod 960 can be further constructed in accordance with the teachings for anvil detection tube 622 described herein, although it should be understood that any of the aforementioned anvil detection assemblies can be used in addition to or alternatively to anvil detection rod 960. The actuator cable assembly 930 of the present example includes a body 938 that has a first side hole 940 (shows shown in dashed line in Figure 17), a second side hole 942, a first channel 944 (shown in dashed line in Figure 17), a second channel 946, and a vertical slot 948. Button 970 comprises an inner member 972, a intermediate element 974, intermediate shaft 976, and outer element 978. In the present example, first side hole 940 is sized to allow intermediate element 974 of button 970 to pass through it. Second side hole 942 is sized to allow outer member 978 to pass therethrough, but is sized to not allow intermediate member 974 to pass therethrough. First channel 944 is configured to allow inner member 972 to act vertically along first channel 944. Second channel 946 is configured to allow intermediate shaft 976 to act vertically along second channel 946. Finally, vertical slot 948 is configured to allow intermediate element 974 to act vertically. Of course, still additional configurations for button 970 and/or body 938 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[00102] Referring to Figures 16A and 17, button 970 is initially positioned such that inner member 972 mechanically interferes with the actuation of trigger 932. In the example shown, button 970 is positioned such that a protrusion 934 that extends from trigger 932 abuts an inner member 972 to prevent a user from rotating trigger 932. As shown in Figure 16A, intermediate member 974 is within the first side hole 940 and outer member 978 is within the second side hole 942, thus forming a substantially level outer surface of body 938. When anvil sensing rod 960 is actuated proximally by attaching an anvil, such as anvil 40, cam surface 964 engages inner member 972 to swing knob 970 outward as shown in figure 16B. When knob 970 is swung outward, outer member 978 extends out of second side hole 942, intermediate shaft 976 substantially aligns with second channel 946, intermediate member 974 enters vertical slot 948, and inner member 972 substantially aligns with first channel 944. As shown in Fig. 16B, outer member 978 provides visual indication (through body projection 938) that the anvil sensing rod 960 has been actuated proximally to the actuator cable assembly. 930 and that the incus is completely seated on the trocar. In this position, inner member 972 still mechanically interferes with the actuation of trigger 932. In the present example, button 970 is actuated outwardly to the position shown in Figure 16B by anvil sensing rod 960 when the anvil is initially coupled to the trocar . When the anvil is attached, the user can reduce the anvil gap by means of an adjustment knob, such as the adjustment knob 98 described above. When the device is within the desired operating range, or "green zone," the user can actuate the button 970 down through the outer slider 978 along the outer surface of the body 938. In the present example, the intermediate shaft 976 slides within the second channel 946, the intermediate element 974 slides into the vertical slot 948, and the inner element 972 slides along the first channel 944. Consequently, as shown in Figure 16C, the inner element 972 is actuated to a position such that the protrusion 934 of trigger 932 is no longer obstructed by inner element 972. The user can then trigger instrument 900. Although the aforementioned example has been described with reference to a vertical locking knob assembly 950 it should be understood that others orientations for assembly 950 can be used, such as longitudinal and/or any other angle. In addition, although the aforementioned example has been described with reference to linear motion to describe the actuation of the locking knob assembly 950, it should be understood that other orientations for actuating the outer member 978 may be used, including rotation.
[00103] In some versions, the knob 970 is oscillated through the sensing rod of the incus 960 when the incus and trocar are actuated proximally via the adjustment knob. Additionally, or alternatively, a locking element, such as the locking element 82 described above, may be provided to lock the trigger 932 unless the anvil and trocar are within the "green zone", thus providing an assembly secondary locking. In a still further configuration, inner element 972 can be configured so that when knob 970 is swung out through the sensing rod of anvil 960, inner element 972 no longer interferes with protrusion 934 of trigger 932. , channels 944, 946, vertical slot 948, intermediate element 974 and/or intermediate shaft 976 can be omitted. Still further, a spring (not shown) may be interposed between intermediate element 974 and/or inner element 972 and a portion of body 938 to pull button 970 inwardly so that button 970 is not actuated out unless the anvil sensing rod 960 to swing knob 970 against spring pull. The user may then trigger instrument 900. Of course, still additional configurations for surgical instrument 900 and/or lock button assembly 950 will be apparent to one skilled in the art in view of the teachings of the present invention.
[00104] By way of example only, Figures 18A-18C show an exemplary surgical instrument 1000 that has an exemplary locking knob assembly 1050. Referring initially to Figure 18A, the locking knob assembly 1050 comprises a sensing rod of anvil 1060 which extends longitudinally into actuator cable assembly 1030 to engage a button 1070. Sensing rod of anvil 1060 includes a proximal end 1062 having an obliquely inclined cam surface 1064 configured to engage button 1070. Anvil sensing rod 1060 can be further constructed in accordance with the teachings for anvil sensing tube 622 described herein, although it should be understood that any of the aforementioned anvil sensing assemblies may be used in addition to or alternatively to the shank. detection of anvil 1060. The actuator cable assembly 1030 of the present example includes a body 1038 which has a in a hole 1040. The button 1070 comprises an inner element 1072, a paddle element 1074 in the inner element 1072, and an outer element 1076. In the present example, the hole 1040 is sized to allow the outer element 1076 of the button 1070 to pass through. the same. Logically, additional configurations for button 1070 and/or body 1038 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[00105] Referring to Figure 18A, button 1070 is initially positioned so that paddle element 1074 mechanically interferes with the actuation of a trigger 1032. In the example shown, a protrusion 1034 extending from trigger 1032 is at adjoining a paddle element 1074 to prevent a user from turning the trigger 1032, although other elements may be provided to prevent the user from turning the trigger 1032. As shown in Figure 18A, the outer element 1076 is within the hole 1040 of the body. 1038, so that the outer member 1076 is substantially flush with the outer surface of the body 1038. When the anvil sensing rod 1060 is actuated proximally through the attachment of an anvil, such as the anvil 40, the cam surface 1064 engages the member. internal 1072 to swing the 1070 knob out to the second position as shown in figure 18B. When knob 1070 is swiveled outward, outer member 1076 extends out of hole 1040. Outer member 1076 thus provides a visual indication (through the projection of body 1038) that the sensing rod of anvil 1060 has been actuated proximally. with respect to the actuator cable assembly 1030 and that the anvil is fully seated on the trocar. When the anvil is attached, the user can reduce the anvil gap by means of an adjustment knob, such as the adjustment knob 98 described above. Blade element 1074 continues to prevent trigger 1032 from actuating at this stage. When the anvil gap is within the desired operating range, or "green zone," the user rotates knob 1070 through outer element 1076 to a third position. As shown in Figure 18C, in a merely exemplary version, the user rotates knob 1070 so that paddle element 1074 is oriented approximately 180 degrees relative to the initial position shown in Figure 18A. Consequently, paddle element 1074 is rotated to a position such that protrusion 1034 of trigger 1032 is no longer obstructed by paddle element 1074. The user may then fire instrument 900.
[00106] Figures 19A-19F show yet another exemplary surgical instrument 1100 having an exemplary locking knob assembly 1150. Referring initially to Figure 19A, locking knob assembly 1150 comprises an anvil sensing pin 1160 coupled to an anvil sensing rod (not shown) extending longitudinally to an actuator handle assembly for engaging a button 1170. In the present example, the button 1170 comprises an inner portion 1172, an intermediate portion 1176, and an outer portion 1178. spring 1180 is associated with inner portion 1172 and pulls knob 1170 laterally with respect to body 1138 (the cutaway portion of which is shown in Figures 19A and 19C, but is omitted in Figure 19B and 19D-F for clarity). In the present example, the outer portion 1178 of the button 1170 is initially positioned within an opening 1139 in the body 1138 and is substantially flush with the exterior of the body 1138 in the first position. The inner portion 1172 of the button 1170 includes a hole 1174 that is configured to receive the detection pin of the anvil 1160. Of course, it should be understood that the hole 1174 may be formed in an intermediate portion 1176 and/or outer portion 1178, or, in some versions, omitted entirely. The intermediate portion 1176 of the present example comprises a rectangular element defined by a first dimension d1 and a second dimension d2 so that d2 is less than d1. The middle portion 1176 will be described in more detail below. The inner portion 1172 and the outer portion 1178 are shown as cylindrical elements having diameters that are substantially equal to a first dimension d1, although this is merely optional and the inner portion 1172 and/or the outer portion 1178 may have other shapes and/ or configurations, as will be apparent to one skilled in the art in view of the teachings of the present invention.
[00107] surgical instrument 1100 also includes a staple firing rod 1140 having a stepped opening 1142 formed therethrough and configured to receive the button 1170. The staple firing rod 1140 is coupled to a trigger (not shown) and is intended to actuate a staple driver (not shown) of the instrument 1100. In the present example, the stepped opening 1142 comprises a first portion 1144 and a second portion 1146 with a step 1148. The first portion 1144 is sized to be substantially equal to the first dimension d1 so that the intermediate portion 1176 of the button 1170 can act laterally through the first portion 1144. The second portion 1146 is located proximally to the first portion 1144 and is reduced in size by the step 1148. The second portion 1146 is sized to be substantially equal to the second dimension d2 of the intermediate portion 1176 so that the staple firing rod 1140 can act longitudinally. secondly with respect to intermediate portion 1176 when knob 1170 is rotated to a third position, shown in Figures 19D-19F and described in more detail below.
[00108] As shown in Figure 19A, initially, the anvil detection pin 1160 is inserted through hole 1174 of the inner portion 1172. In some versions, the anvil detection pin 1160 may only be partially inserted into hole 1174 and/ or hole 1174 does not extend through inner portion 1172 of knob 1170. In this first position, the anvil detection pin 1160 prevents spring 1180 from pulling knob 1170 laterally to project outer portion 1178 out of body 1138 through the opening 1139. Furthermore, the intermediate portion 1176 is initially positioned such that the intermediate element 1176 is positioned within the first portion 1144 of the stepped opening 1142 and is oriented with the first dimension d1 perpendicular to the vertical plane along which the axis center of clamp firing rod 1140 extends. As shown in Figure 19A, intermediate portion 1176 interferes with the distal actuation of staple firing rod 1140 because step 1148 is adjacent to intermediate portion 1176.
[00109] When an anvil, such as the anvil 40 described above, is fully seated, the anvil sensing pin 1160 is retracted distally relative to the knob 1170 to disengage from orifice 1174, as shown in Figure 19B. Spring 1180 biases knob 1170 laterally with respect to body 1138 (shown in Figure 19A) so that outer portion 1178 projects through opening 1139 to a second position shown in Figure 19C. Furthermore, with button 1170 in the second position, inner portion 1172 is positioned within first portion 1144 of step opening 1142 so that staple firing rod 1140 cannot be actuated longitudinally with respect to button 1170. versions, spring 1180 can be omitted and button 1170 can be manually actuated to the second position.
[00110] With the outer portion 1178 protruding from the body 1138 and thus exposed for grip, the user rotates the knob 1170 to a third position, for example, by rotating knob 1170 90 degrees, so that the intermediate portion 1176 is oriented with the second dimension d2 perpendicular to the vertical plane along which the central axis of the staple firing rod 1140 extends, as shown in Figure 19D. In this position, the inner portion 1172 is still positioned within the first portion 1144 of the step opening 1142 so that the staple firing rod 1140 cannot be actuated longitudinally with respect to the button 1170. The user then actuates the button 1170 inwardly of body 1138 so that intermediate portion 1176 is aligned within step opening 1142, as shown in Figure 19E. As shown, with the intermediate portion 1176 rotated to have the second dimension d2 perpendicular to the vertical plane along which the central axis of the staple firing rod 1140 extends, the staple firing rod 1140 can then be actuated longitudinally. with respect to button 1170 since step 1148 and intermediate portion 1176 are no longer in a boundary position and engage each other. Consequently, the user can then trigger instrument 1100. Logically other configurations and orientations will be apparent to one skilled in the art in view of the teachings of the present invention. Exemplary lock button assembly having a button for the palm of the hand
[00111] Figure 20A-20C represents an exemplary alternative surgical instrument 1200 that has an exemplary locking knob assembly 1250. Referring initially to Figure 20A, the surgical instrument 1200 of the present example comprises a stapling head assembly (not shown ), a stem assembly 1220, and an actuator cable assembly 1230. The stem assembly 1220 extends distally from the actuator cable assembly 1230 and the clamping head assembly is coupled to a distal end of the assembly. rod 1220. In summary, actuator cable assembly 1230 includes a trigger 1232 which is intended to actuate a staple driver not shown of the staple head assembly to drive a plurality of staples (not shown) out of the head assembly. clipping. The staples are angled to form complete staples by an anvil (not shown), such as anvil 40, which is attached to a trocar that extends outward from the distal end of instrument 1200. Consequently, tissue can be stapled using instrument 1200. The clamping head assembly, the stem assembly (1220), and the actuator cable assembly 1230 can be further constructed in accordance with the clamping head assembly 20, the stem assembly 60, and the actuator cable assembly 70 described above.
[00112] In the example shown, the locking knob assembly 1250 of the present example comprises an anvil sensing rod 1260, a palm knob 1270, and a pivot element 1280. Figure 20A depicts the sensing rod of the anvil 1260, palm button 1270, and pivot element 1280 in a locked home position. In this position, pivot element 1280 is configured to mechanically interfere with the pivoting of a locking element 1234 so that trigger 1232 cannot be actuated. By way of example only, pivot element 1280 mechanically interferes with locking element 1234 through an arm 1286 that extends outwardly from a distal end 1284 of pivot element 1280. Locking element 1234 may be constructed substantially of according to the locking element 82 described herein. The palm button 1270 in the present example is substantially flush with the exterior of the instrument 1200, although this is merely optional and the palm button 1270 may be inserted or projected with respect to the exterior of the instrument 1200. anvil detection 1260 includes a proximal end element 1262 configured to engage the palm button 1270 and the pivot element 1280. In the home position shown in Figure 20A, the proximal end element 1262 is disengaged from the palm button. hand 1270 and pivot element 1280. By way of example only, proximal end element 1262 may be located distally from palm button 1270 and pivot element 1280 so that a space is formed between the palm button. 1270 and pivot element 1280. Consequently, even if a user attempts to actuate palm button 1280 inward toward pivot element 1280 in this initial locked position, the The palm stud 1270 does not engage the pivot element 1280. Thus, the pivot element 1280 and arm 1286 remain in a position to mechanically interfere with the locking element 1234. In some versions, the pivot element 1280 may include a spring (not shown) to pull arm 1282 to interfere with locking element 1234.
[00113] In the present example, the proximal end element 1262 includes a cam surface 1264, a button surface 1266, and a lever arm 1268. As shown in Figure 20B, the cam surface 1264 is intended to engage and oscillate the palm knob 1270 out when the incus sensing rod 1260 is actuated proximally to the actuator handle assembly 1230, such as by attaching an anvil and adjusting the anvil and trocar to the "green zone." Palm button 1270 can then provide a visual indicator that the anvil is properly attached and the device is within operating range. When the palm button 1270 is swiveled outward, at least part of the palm button 1270 is adjacent to the surface of the button 1266 so that the palm button 1270 can engage the surface of the button 1266 when the button for 1270 palm is pushed inwards. In addition, lever arm 1268 of proximal end element 1262 is aligned with proximal end 1282 of pivot element 1280. Anvil sensing rod 1260 may be further constructed in accordance with the teachings for anvil sensing tube 622 described herein, although it should be understood that any of the aforementioned anvil detection kits can be used in addition to or alternatively to the anvil detection rod 1260.
[00114] When the palm button 1270 and the proximal end element 1262 are aligned, as shown in Figure 20B, the user presses the palm button 1270 inwards, thereby engaging the lever arm 1268 with the end. proximal 1282 of pivot element 1280. Consequently, when lever arm 1268 rotates pivot element 1280 around pivot 1281 by a predetermined amount, shown in Figure 20C, arm 1286 no longer mechanically interferes with locking element 1234. user can then rotate locking element 1234 to unlock trigger 1232 to trigger instrument 1200. Although a merely exemplary configuration for a 1250 locking assembly having a 1270 palm button has been described, still additional configurations will be apparent to one skilled in the art in view of the teachings of the present invention. For example, in some versions, proximal end member 1262 omits cam surface 1264 and palm knob 1270 does not oscillate outwardly relative to the exterior of instrument 1200. Exemplary lock button assembly that has an interlock assembly
[00115] Figures 21A-23 show yet another exemplary locking knob assembly 1300 comprising a spring loaded push rod 1310, a spring loaded pin 1320, and a pivotal locking element 1340. Figure 21A represents the rod spring loaded press stud 1310, spring loaded pin 1320, and pivotal locking member 1340 shown in a home or locked position and contained within a body 1350 of an exemplary surgical instrument, such as instrument 10 described above. In the present example, body 1350 includes a small hole 1352 sized to allow an outer portion 1338 of pin 1320 to extend therethrough. In some versions, hole 1352 may be sized to allow outer portion 1338 to extend therethrough, but comprises a smaller diameter than intermediate portion 1332, thus allowing only outer portion 1338 to protrude through it. Of course, it should be understood that orifice 1352 is merely optional and may be omitted in some versions. Body 1350 can be further constructed in accordance with at least some of the teachings for body 72 described above.
[00116] With respect first to the spring-loaded pressure rod 1310, the pressure rod 1310 comprises an elongated rod extending longitudinally within a surgical instrument. A spring 1312 engages a proximal end of push rod 1310 to provide distal traction. By way of example only, push rod 1310 can be configured to be actuated proximally when an incus such as incus 40 is coupled to a trocar, such as trocar 38, and both the incus and trocar are actuated to the range of operation or "green zone" described above. Referring to Figure 22 briefly, push rod 1310 includes a side hole 1314 and a longitudinal slot 1316 formed through push rod 1310. In the present example, side hole 1314 is sized to allow for an intermediate portion 1332 of pin 1320 pass through side hole 1314. Longitudinal slot 1316 is sized to allow an intermediate shaft 1334 of pin 1320 to slide along longitudinal slot 1316. As shown in Figure 22, pin 1320 and push rod 1310 are shown in position. initial or locked with push rod 1310 actuated distally through spring 1312, thereby laterally restraining pin 1320 with shaft 1334 within slot 1316. Additionally, or alternatively, push rod 1310 may be constructed in accordance with the teachings to the anvil detection tube 622 described herein, although it should be understood that any of the anvil detection kits previously mentioned. Shapes may be incorporated into the present locking knob assembly 1300. Still other configurations for push rod 1310 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[00117] Figure 21A also represents pin 1320 coupled to a spring 1322 so that pin 1320 is pulled laterally towards hole 1352. Pin 1320 comprises an inner portion 1324, an inner shaft 1328, an intermediate portion 1332, an intermediate shaft 1334, and an outer portion 1338. In the present example, the intermediate portion 1332 and the outer portion 1338 are substantially equal sized while the inner portion 1324 includes an enlarged portion 1326. Of course, it should be understood that this it is merely optional. In some versions, inner portion 1324, intermediate portion 1332, and outer portion 1338 are all sized substantially equal. In other versions, inner portion 1324, intermediate portion 1332, and outer portion 1338 comprise different sizes and/or shapes. Consequently, the lateral actuation of pin 1320 can be controlled by having different sizes and/or shapes for inner portion 1324, intermediate portion 1332, and outer portion 1338. Inner shaft 1328 couples inner portion 1324 to intermediate portion 1332 and is substantially smaller than inner portion 1324 and/or intermediate portion 1332. In the present example, shaft 1328 is configured to allow locking element 1340 to be rotated while shaft 1328 passes into an arcuate slot 1349, described in more detail below . Intermediate shaft 1334 couples intermediate portion 1332 to outer portion 1338 and is substantially smaller than intermediate portion 1332 and/or outer portion 1338. In the present example, shaft 1334 is configured to allow push rod 1310 to be actuated proximally to axis 1334, while axis 1334 passes within longitudinal slot 1316, described above.
[00118] The locking element 1340 of the present example comprises an arm 1342, a pivot element 1344, and a main body 1346. The arm 1342 is configured to be in a position adjacent to a trigger (not shown) in substantially similar fashion to the element. locking system 82 described above. Pivot element 1344 is configured to engage a portion of body 1350, as a recess, to allow locking element 1340 to be rotated relative to body 1350. Main body 1346 comprises a sector, or pie-shaped component, having a hole 1348 and an arcuate slot 1349. Hole 1348 is sized to allow the passage of the intermediate portion 1332 of the pin 1320 through the hole 1348, but does not allow the enlarged portion 1326 of the inner portion 1324 to pass therethrough. The arcuate slot 1349 is configured to allow the inner shaft 1328 to be slidably received within the arcuate slot 1349. Consequently, when the inner shaft 1328 is within the hole 1348, as shown in Figure 21B, the locking member 1340 can be rotated. so that arcuate slot 1349 slides over inner shaft 1328. Consequently, when locking element 1340 is rotated, arm 1342 no longer prevents trigger actuation, thus allowing the user to trigger the instrument. When the locking element 1340 is in the first or locked position, shown in Figures 21A and 23, the locking element 1340 prevents the trigger from actuating and the locking element 1340 is prevented from rotating through interference provided by the presence of the intermediate portion 1332 of pin 1320 into hole 1348. Of course, still additional configurations for locking element 1340 will be apparent to one of ordinary skill in the art in view of the teachings of the present invention.
[00119] With respect now to the sequence shown in Figures 21A-21B, initially, the spring-loaded push rod 1310, the spring-loaded pin 1320, and the pivotal locking element 1340 are in an initial or locked position. In this position, arm 1346 of locking element 1340 inhibits the reactivation actuation, locking element 1340 is prevented from rotating because of the presence of intermediate portion 1332 within hole 1348, and pin 1320 is prevented from acting laterally through the spring 1322 because the intermediate portion 1332 abuts the push rod 1310 and is not aligned with the side hole 1314. In the example shown, the outer portion 1338 is within the hole 1352 and is flush with the outside of the body 1350. affixing an anvil, such as anvil 40, to a trocar, such as trocar 38, the incus can engage a distal end of push rod 1310 and begin to actuate push rod 1310 proximally against the traction provided by spring 1312. with some of the aforementioned examples, spring 1312 can provide sufficient distal force for the incus to be ejected from the trocar if the incus is not fully seated. . When the incus is attached to the trocar, the longitudinal slit 1316 begins to slide proximally to the intermediate axis 1334 to move the lateral hole 1314 into close alignment with the intermediate portion 1332. When the incus and trocar are positioned within the operating range or "green zone," side hole 1314 and middle portion 1332 line up. Spring 1322 drives the pin laterally, thus pushing intermediate portion 1332 into side hole 1314 and aligns inner shaft 1328 with arcuate slot 1349 of locking element 1340, as shown in Figure 21B. Enlarged portion 1326 abuts locking member 1340 to prevent spring 1322 from ejecting pin 1320 too far or out of the device. With the inner shaft 1328 and arcuate slot 1349 aligned, the user can rotate the locking element 1340 around the pivot element 1344, thus releasing the trigger and allowing the user to trigger the instrument. In some versions, a rotational spring (not shown) can be coupled to the locking element 1340 to automatically rotate the locking element 1340, although this is merely optional. In the present example, spring 1322 also extends outer portion 1338 of pin 1320 out of hole 1352. The protrusion of outer portion 1338 through hole 1352 can be used as a visual indicator by the user that the instrument is within range of operation so that the locking element 1340 can be rotated to release the trigger. Of course, in some versions, outer portion 1338 and/or orifice 1352 may be omitted. Still additional configurations for the lock button assembly 1300 will be apparent to one skilled in the art in view of the teachings of the present invention.
[00120] It should be understood that any one or more of the teachings, expressions, modalities, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, modalities, examples, etc. which are described here. The teachings described above, expressions, modalities, examples, etc. they should not, therefore, be seen in isolation from one another. Various suitable ways in which the teachings of the present invention may 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 within the scope of the appended claims.
[00121] It is understood that any patent, publication, or other descriptive material, in whole or in part, which is said to be incorporated into the present invention by way of reference, is incorporated into the present invention only if the incorporated material does not enter in conflict with existing definitions, statements, or other descriptive material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, which is hereby incorporated by reference into the present invention, but which conflicts with existing definitions, statements, or other descriptive materials set forth herein will be incorporated herein only to the extent that no conflict. will appear between the embodied material and the existing descriptive material.
[00122] Modalities of the present invention have application in conventional open surgical and endoscopic instrumentation, as well as application in robotic-assisted surgery. For example, those skilled in the art will recognize that the various teachings of the present invention can be easily combined with the various teachings of US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," issued August 31, 2004, the description of which is incorporated herein by reference.
[00123] By way of example only, the modalities described here can be processed prior to surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a radiation field, which can penetrate the container, such as gamma radiation, X-rays or high energy electrons. The radiation can kill bacteria in the instrument and container. The sterilized 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 may also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide, or water vapor.
[00124] Modalities of the devices presented here can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, embodiments of the devices presented herein can be disassembled, in any number of particular pieces or parts of the devices can be selectively replaced or removed in any combination. With cleaning and/or replacement of particular parts, device modalities can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will understand that reconditioning a device can utilize 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 this order.
[00125] Having shown and described various embodiments 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 a person 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 those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and not necessary. Accordingly, the scope of the present invention is to be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of structure and operation shown and described in the specification and drawings.

权利要求:
Claims (10)
[0001]
1. Apparatus for tissue stapling (1200), characterized in that it comprises: (a) an actuator cable assembly (1230) comprising: i. a trigger (1232) pivotally mounted to a body; and ii. an adjustment knob (1270) rotatably mounted to the body, the adjustment knob (1270) defining an opening; and (b) a staple head assembly comprising: i. a staple trigger, ii. a sharpened rod, wherein a position of the sharpened rod is adjustable by the adjustment knob (1270) at least in the presence of a seated anvil, and iii. an anvil sensing element (1260), wherein the anvil sensing element (1260) comprises an anvil presence rod (230) wherein the anvil presence rod (230) extends into the aperture of the knob. fit (1270); wherein the trigger (1232) is intended to actuate the staple trigger in a distal position relative to the actuator cable assembly (1230); and wherein the anvil sensing element (1260) is intended to prevent the trigger (1232) from rotating in the absence of a seated anvil.
[0002]
2. Apparatus according to claim 1, characterized in that the actuator cable assembly (1230) further comprises a locking element (1234), wherein the locking element (1234) is movable from a first position to a second position, wherein the locking element (1234) in the first position engages the trigger (1232) to prevent pivoting of the trigger (1232), wherein the locking element (1234) in the second position allows pivoting of the trigger (1232 ), wherein the anvil presence rod (230) is intended to prevent the locking element (1234) from rotating from the first position to the second position.
[0003]
3. Apparatus according to claim 2, characterized in that the anvil presence rod (230) comprises a translatable element having a bulge.
[0004]
4. Apparatus according to claim 3, characterized in that the anvil presence rod (230) is pulled in a distal position in relation to the actuator cable assembly (1230).
[0005]
5. Apparatus according to claim 4, characterized in that the attachment of an anvil to the pointed rod triggers the anvil presence rod (230) proximally.
[0006]
6. Apparatus according to claim 1, characterized in that the anvil sensing element (1260) comprises an anvil sensing tube (622).
[0007]
7. Apparatus according to claim 6, characterized in that the anvil sensing tube (622) is arranged coaxially around the pointed shaft.
[0008]
8. Apparatus according to claim 6, characterized in that the trigger (1232) comprises a trigger arm (1282) (1232), wherein the trigger arm (1282) adjoins the sensing tube of the anvil (622) when the anvil sensing tube (622) is in a first position.
[0009]
9. Apparatus according to claim 8, characterized in that the anvil sensing tube (622) comprises a recess, wherein the recess is sized to allow the trigger arm (1282) to rotate through it when the Anvil sensing tube (622) is in a second position.
[0010]
Apparatus according to claim 6, characterized in that the anvil sensing tube (622) comprises a distal container configured to receive an anvil shaft.

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JP2015506223A|2015-03-02|

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CN104039244A|2014-09-10|

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BR112014016658A2|2017-06-13|

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RU2014132163A|2016-02-27|

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RU2619382C2|2017-05-15|

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EP3895630A1|2021-10-20|

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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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2021-01-05| B06A| Patent application procedure suspended [chapter 6.1 patent gazette]|

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2021-04-20| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-06-01| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2021-06-29| 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 17/12/2012, 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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US13/344,061|US9186148B2|2012-01-05|2012-01-05|Tissue stapler anvil feature to prevent premature jaw opening|

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US13/344,061|2012-01-05|

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PCT/US2012/069990|WO2013103505A2|2012-01-05|2012-12-17|Tissue stapler anvil feature to prevent premature jaw opening|

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