CN102940512B - Surgical Fastener Applicator - Google Patents

Abstract

The present disclosure relates to a surgical fastener applying apparatus for applying fasteners to body tissue. The device includes a cartridge receiving half-section defining an elongate channel member, an anvil half-section, and a clamping lever. The cartridge receiving half-section releasably receives a cartridge and a firing assembly. The clamping lever includes a protrusion on a side wall that is receivable in a bifurcated recess formed in a side wall of the cartridge receiving half-section to releasably retain the clamping lever in an undamped position and a clamped position. The apparatus includes a disposable firing assembly and a SULU.

Description

Surgical Fastener Applicator

This application claims priority to US Provisional Patent Application Serial No. 61/494,993, filed June 9, 2011, the entire contents of which are hereby incorporated by reference.

technical field

The present disclosure relates to surgical fastener applying devices, and more particularly, to surgical fastener applying devices having reusable components and disposable components.

Background technique

Surgical fastener applying devices are known in the art in which tissue is first grasped or clamped between opposing jaw structures and the tissue is then joined by surgical fasteners. In some of these devices, a knife is provided for cutting tissue that has been joined by the fastener. The fasteners are typically in the form of surgical staples, but other surgical fasteners, such as clips or two-piece polymer surgical fasteners, may also be utilized.

Surgical fastener applying devices typically include two elongated beam members for capturing or clamping tissue therebetween. Typically, one beam member carries a disposable staple cartridge assembly that houses a plurality of staples arranged in at least two rows, while the other beam member includes an anvil that defines a The surface of the staple legs that is shaped as the staples are ejected from the cartridge assembly. If a two-part fastener is used, the beam member, including the anvil, carries the mating part of the two-part fastener, such as a receiver. Typically, the staple forming process is effected by the interaction between one or more longitudinally moving cam members and a series of individual staple pushers. As the cam member travels longitudinally past the cartridge load beam member, each individual pusher member is biased upwardly to the rear span of the staples supported within the cartridge assembly to sequentially eject the staples from the cartridge. A knife may be positioned between the rows of staples to travel with the cam member to cut tissue between the rows of formed staples. One example of such a device is disclosed in US Patent No. 7,631,794, which is hereby incorporated by reference in its entirety.

Due to the risks associated with improper sterilization, surgical fastener applying devices are typically disposable after use. While the staple cartridge assembly can be replaced to perform multiple fastener application procedures on a single patient, the staple applying device is typically discarded after the procedure has been completed on the patient. This disposable requirement increases the costs associated with the surgical procedure. Although reusable fastener applying devices have been developed, such devices can be overly complex and prove difficult to sterilize.

There is a need in the art for a fastener applying device that includes reusable components, is not overly complex in construction, and is configured to facilitate proper sterilization after use in a surgical procedure.

Contents of the invention

The present disclosure relates to a surgical fastener applying device comprising an anvil half including a distal anvil portion and a proximal handle portion, and a cartridge receiving half defining a elongated channel members. The elongate channel member has a distal portion sized to releasably receive a staple cartridge and a proximal portion configured to support a firing assembly. The cartridge receiving half also includes a sidewall defining a bifurcated recess having a first recess portion and a second recess portion separated by a raised recess barrier. A clamping lever is attached to the cartridge receiving half and has a distal portion and a proximal portion including a handle portion. The clamping lever is operatively associated with the anvil half and the cartridge receiving half, and is movable from an unclamped position to a clamped position to releasably secure the anvil portion of the anvil half. into close proximity to the staple cartridge. The clamp lever also includes a side wall having a protrusion that is positionable within the first recess portion of the bifurcated recess to releasably retain the clamp lever in the released position, and the protrusion The portion may be positioned within the second recess portion of the bifurcated recess to releasably retain the clamping lever in the clamped position.

In one embodiment, the clamping lever is releasably mounted to the cartridge receiving half.

The device also includes a firing assembly configured to releasably fit within the proximal portion of the cartridge receiving half, and the firing assembly includes a firing lever and a cam lever fixedly mounted to the firing lever. The firing assembly can also include a stationary housing configured to be releasably supported within a proximal portion of the cartridge receiving half.

In one embodiment, the stationary housing comprises a U-shaped frame comprising a bottom wall and a pair of side walls, wherein each of the side walls has a proximal end containing a projection of a firing assembly, the firing assembly The assembly boss is positioned to be releasably received in a groove formed in the proximal end of the elongated channel member to releasably retain the stationary housing within the proximal portion of the elongated channel member. The firing assembly may also include a knife actuation lever configured to engage a knife supported within the single-use loading unit.

In one embodiment, the protrusion includes a flat side wall that abuts the raised recess barrier when the clamp lever is in the clamped position. The protrusion is deformable and the protrusion may pass the raised recess barrier when the clamp lever is moved between the unclamped position and the clamped position. The clamping lever may be pivotally mounted to the cartridge receiving half, wherein the clamping lever is pivoted to move the protrusion from the first recess portion of the bifurcated recess past the raised recess interval The stop enters the second recess portion of the bifurcated recess.

In one embodiment, the cartridge receiving half includes a pair of pivot members each having a planar surface. In one embodiment, the planar surface is positioned at the proximal surface of the pivot member.

In one embodiment, the clamping lever includes a pair of C-shaped grooves, the width of which is less than the diameter of the pivot member such that the pivot member needs to slide along a flat surface to the C-shaped grooves , so that the clamping lever is coupled to the cartridge receiving half. In one embodiment, the clamping lever is at a first angle relative to the cartridge receiving half such that the clamping lever is coupled to the cartridge receiving half and relative to the cartridge receiving half in the released position. at a second, smaller angle.

In one embodiment, the cartridge receiving half has a pair of U-shaped grooves to accommodate the lateral support members of the anvil half. The U-shaped groove and pivot member of the cartridge receiving half can be located distally of the bifurcation recess.

Description of drawings

Various embodiments of the surgical fastener applying apparatus of the present disclosure will now be described herein with reference to the accompanying drawings, in which:

1 is a side perspective view of one embodiment of the surgical fastener applying device of the present disclosure, viewed from the distal end, in a clamped position;

1A is a side perspective view of the surgical fastener applying device shown in FIG. 1 in a clamped position, viewed from the proximal end;

Figure 2 is a side perspective view of the surgical fastener applying device shown in Figure 1 in an open position;

2A is a side view of a portion of the cartridge receiving half and clamping lever during assembly of the clamping lever and cartridge receiving half;

2B is a side perspective view of the surgical fastener applying device shown in FIG. 1 in a closed, released position;

Figure 2C is an enlarged view of the detail representation area shown in Figure 2;

Figure 2D is a cross-sectional view taken along the section line 2D-2D of Figure 1A;

3 is an exploded side perspective view of the surgical fastener applying device shown in FIG. 1;

3A is a bottom side cross-sectional view of the clamping lever of the surgical fastener applying device shown in FIG. 1;

4 is a side perspective view of the cartridge containing half of the surgical fastener applying device, wherein a single use loading unit ("SULU") and firing assembly are supported within the cartridge containing half;

Figure 5 is an enlarged view of the detail representation area shown in Figure 4;

6 is a top perspective view of the cartridge receiving half of the surgical fastener applying device with the SULU and firing assembly supported therein;

Figure 7 is an enlarged view of the detail representation area shown in Figure 6;

Fig. 8 is a top perspective view of the front end of the emitting assembly of the surgical fastener applying device shown in Fig. 3;

Figure 9 is an enlarged view of the detail representation area shown in Figure 8;

Figure 9A is a top perspective view of a channel member with a launch assembly releasably housed therein;

Figure 9B is an enlarged view of the detail representation area shown in Figure 9A;

9C is a top perspective view of a central portion of a channel member;

Fig. 10 is a top perspective view of the rear end of the launch assembly shown in Fig. 8;

Figure 11 is an enlarged view of the detail representation area shown in Figure 10;

Figure 12 is an exploded side perspective view of the launch assembly shown in Figure 10;

12A is a perspective view of the cam lever of the firing assembly shown in FIG. 12 when viewed from below;

Fig. 12B is a perspective view of the firing lever of the firing assembly shown in Fig. 12 when viewed from below;

13 is a side perspective view of the SULU of the surgical fastener applying device shown in FIG. 1;

Figure 14 is an enlarged view of the detail representation area shown in Figure 13;

Figure 15 is a front perspective view of the SULU shown in Figure 13;

Figure 16 is an enlarged view of the detail representation area shown in Figure 15;

17 is an exploded side perspective view of the SULU shown in FIG. 15;

18 is a side cross-sectional view of the surgical fastener applying device shown in FIG. 1 in an open position;

Figure 19 is an enlarged view of the detail representation area shown in Figure 18;

Figure 20 is an enlarged view of the detail representation area shown in Figure 18;

21 is a perspective view of the proximal end of the surgical fastener applying device shown in FIG. 18 in an open position;

22 is a side view of the cartridge receiving half and clamping lever of the surgical fastener applying apparatus shown in FIG. 1 with the clamping lever in the released position;

Figure 23 is an enlarged view of the detail representation area shown in Figure 22;

24 is a side perspective view of the surgical fastener applying device shown in FIG. 1 in a clamped position;

25 is a side cross-sectional view of the surgical fastener applying device shown in FIG. 24 in a clamped position;

Figure 26 is an enlarged view of the detail representation area shown in Figure 25;

27 is a side view of the cartridge receiving half and clamping lever of the surgical fastener applying apparatus shown in FIG. 1 with the clamping lever in the clamped position;

Figure 27A is an enlarged view of the detail representation area shown in Figure 27;

Figure 28 is a cross-sectional view taken along section line 28-28 of Figure 26;

29 is a top view of the surgical fastener applying device shown in FIG. 1 as the firing assembly moves through the actuation stroke to eject the fastener from the device;

30 is a side cross-sectional view of the surgical fastener applying device shown in FIG. 29 with the firing assembly in the actuated position;

Figure 31 is an enlarged view of the detail representation area shown in Figure 30;

Figure 32 is an enlarged view of the detail representation area shown in Figure 30;

33 is a side cross-sectional view of the surgical fastener applying device shown in FIG. 1 after the device has been fired and moved to an open position; and

FIG. 34 is an enlarged view of the detailed representation area shown in FIG. 33 .

detailed description

Embodiments of surgical fastener applying devices according to the present disclosure will now be described in detail with reference to the drawings, wherein like reference numerals indicate elements of similar or identical structure. As used herein, by convention, the term "proximal" refers to the end of the device that is closer to the user, while the term "distal" refers to the end of the device that is further from the user.

1-34 illustrate an exemplary embodiment of a surgical fastener applying device of the present disclosure, generally identified as a surgical stapler 10 . Referring specifically to FIGS. 1-3 , a surgical stapler 10 includes an anvil half 12, a cartridge receiving half 14, a clamping lever 16, a single-use loading unit or cartridge 18 (hereinafter "SULU"), and Launch assembly 20. In one embodiment, the anvil block half 12, staple cartridge receiving half 14, and clamping lever 16 are constructed as reusable components whereby biocompatible materials suitable for sterilization and reuse are employed. Constructed, such as stainless steel. Instead, SULU 18 and launch assembly 20 are constructed to be disposable, and as such, can be constructed from any suitable biocompatible material having the necessary strength properties, such as plastic, metal, and combinations thereof. SULU 18 and firing assembly 20 can optionally be configured as an integral unit for loading into cartridge receiving half 14 as a single unit.

Referring to FIGS. 3-7 , the cartridge receiving half 14 defines an elongated channel member 22 defining a generally U-shaped channel 24 having a distal portion 24a and a proximal portion 24b, the distal portion 24a and the proximal portion 24b. Portion 24a is sized to releasably receive SULU 18 , while proximal portion 24b is sized to releasably receive launch assembly 20 . Firing assembly 20 includes a stationary housing 26 (see also FIG. 12 ), and stationary housing 26 has a proximal end that includes a flexible protrusion 28 that extends to a base formed in cartridge receiving half 14. The proximal end of the firing assembly 20 is releasably mounted within the proximal portion 24b of the channel member 22 . The distal end of firing assembly 20 defines an extension 64d positioned to engage a protrusion 65 formed on the inner wall of channel member 22 (see FIGS. Installed in the channel member 22. The convex portion 65 is positioned on top of the extension portion 64d as shown in FIG. 9B . The structure of launch assembly 20 will be discussed in further detail below. SULU 18 includes a pair of distal protrusions 32 ( FIG. 3 ) that are positioned in cutouts 34 formed at the distal end of channel member 22 to releasably secure SULU 18 in the channel. In the distal portion 24a of the member 22. During assembly, firing assembly 20 must be inserted into proximal portion 24b of channel member 22 prior to insertion of SULU 18 into distal portion 24a of channel member 22, as will be discussed below. To position the SULU 18 in the channel member 22 , the protrusion 32 on the SULU 18 is positioned within the cutout 34 while the SULU 18 is positioned above and at an angle to the channel member 22 . Thereafter, the SULU 18 can be rotated down into the distal portion 24a of the U-shaped channel 24 . This allows the drive components of the firing assembly 20 to be properly aligned with the components of the SULU 18 and, moreover, facilitates engagement of the firing assembly 20 with the knife 40 ( FIG. 17 ) supported within the SULU 18 . The proximal end of the SULU 18 includes outwardly extending serrated surfaces 42 ( FIG. 7 ) to facilitate gripping the proximal end of the SULU 18 for removal and/or replacement of the SULU 18 from the channel member 22 . The serrated gripping surface 42 does not drop completely within the distal portion 24a of the channel member 22 until the stapler 10 is moved to the clamped position, as will be discussed below.

Referring to FIGS. 8-12 , the firing assembly 20 includes a stationary housing 26 , a knife actuating lever 44 , a cam lever 46 , a guide block 48 , a firing lever 50 , a slider 52 and a pedal 54 . In one embodiment, the stationary housing 26 includes a U-shaped frame 60 including a bottom wall 62 and a pair of side walls 64 . The proximal end of each side wall 64 supports a respective flexible protrusion 28 . The protrusion 28 is capable of flexing inwardly into the groove 30 of the channel member 22 ( FIG. 21 ), thereby releasably fitting the firing assembly 20 within the proximal portion 24b of the channel member 22 ( FIG. 3 ) as discussed above. . The distal end of each side wall 64 defines a proximal step 64b, a sloped portion 64c, and a distal sloped portion (extension) 64d. As discussed above, extension 64d is positioned to engage protrusion 65 ( FIG. 9B ) formed on the inner wall of channel member 22 to retain the distal end of firing assembly 20 within channel member 22 . Each side wall 64 includes an extension 66 for slidingly retaining the slider 52 within the stationary housing 26 .

Guide block 48 includes a body defining three longitudinal slots 70a - c and a pair of outwardly extending protrusions 72 . In one embodiment, each protrusion 72 is generally cylindrical and includes a tapered portion 72a ( FIG. 9 ). Alternatively, other protrusion configurations are contemplated. Projection 72 is sized to be received within an opening 74 ( FIG. 12 ) formed in side wall 64 of stationary housing 26 to axially secure guide block 48 within the distal end of stationary housing 26 . The protrusion 72 allows some pivotal movement of the guide block 48 within the U-shaped frame 60 . As will be discussed in further detail below, guide block 48 pivots from a first position ( FIG. 19 ) in locking engagement with notches 49 and 51 of knife actuation bar 44 in response to movement of stapler 10 to the clamped position. to the second position disengaged from the notches 49 and 51 of the knife actuating lever 44 (Fig. 26). A torsion spring (not shown) is disposed about protrusion 72 to drive guide block 48 toward the first position. Each of the slots 70 a and 70 c is sized to slidably receive a corresponding side wall 114 of the cam lever 46 . Likewise, slot 70b is sized to slidably receive knife actuation rod 44 .

The slider 52 includes a hub 80 having a resilient finger 80 a configured to snap into a pivot hole 82 formed in the firing lever 50 . Firing lever 50 pivots about hub 80 when sled 52 is in the retracted position to facilitate actuation of firing assembly 20 from either side of stapler 10 . The pressure plate 54 is reciprocally received within a bore 84 formed in the slider 52 . The pressure plate 54 includes a split body portion 54 a configured to span the proximal end 102 of the knife actuation rod 44 . In one embodiment, the split body portion 54a includes a sloped distal surface 86 . A pin 88 extends upwardly from the pressure plate 54 through a hole 84 in the slider 52 . A biasing member 90 is positioned about the pin 88 between the split body portion 54 a and the slider 52 to drive the pressure plate 54 downwardly away from the slider 52 . In the retracted position of the slider 52 , the pressure plate 54 is received in a cutout 55 formed in the bottom wall 22 a of the channel member 22 .

The firing lever 50 includes a first finger engagement member 50a and a second finger engagement member 50b capable of selectively engaging either finger engagement member to move the firing lever 50 from either side of the stapler 10 throughout the firing journey. An arcuate recess 94 ( FIG. 12B ) is formed in the bottom surface of the firing lever 50 for slidably receiving the pin 88 of the pressure plate 54 to define the range of rotation over which the firing lever 50 can pivot about the hub 80 of the slider 52 . As used herein, the firing stroke is defined as the movement of the firing lever 50 from the fully retracted position ( FIG. 25 ) to the fully advanced position ( FIG. 30 ). A detent groove 94 a is formed at each end of the arcuate groove 94 . Detent groove 94 a is configured and dimensioned to receive the end of pin 88 of platen 54 to prevent pivotal movement of firing lever 50 about hub 80 during the firing stroke of surgical stapler 10 . More specifically, when the firing assembly 20 is actuated to advance the slider 52 distally within the stationary housing 26, the angled distal face 86 of the pressure plate 54 engages the channel member 22 and cams out of the notch 55 (FIG. 20) to drive upwardly. The pin 88 enters the detent groove 94a, thereby preventing pivotal movement of the firing lever 50 during the firing stroke movement of the firing lever 50 . Clearly, the pin 88 must be positioned below the detent recess 94a to allow the platen 54 to lift upwardly from the cutout 55, thereby allowing the firing lever 50 to move through the firing stroke. Thus, the firing lever 50 must first be pivoted to one side or the other of the firing assembly 20 before the firing lever 50 can move the firing stroke.

Knife actuation bar 44 includes a proximal end having a stepped portion 100 including a proximal first step 102 having a first height and a second step 104 having a second height that is greater than the first height. The distal end of the actuation rod 44 includes an upturned hook 106 and upper and lower notches 49 and 51 . Finger 108 projects upwardly from knife actuation bar 44 between first step 102 and second step 104 . As shown in FIG. 20 , fingers 108 are slidably received within grooves 110 formed in the underside of slider 52 . When the slider 52 is advanced distally within the stationary housing 26, the fingers 108 move within the groove 110 to move the slider 52 relative to the knife actuating rod 44 until the fingers 108 and the proximal end defining the groove 110 The wall 112 (Fig. 32) engages. Further distal movement of slider 52 will also effect distal movement of knife actuation rod 44 when fingers 108 engage wall 112 . As will be apparent below, this configuration allows staples to be ejected from SULU 18 prior to cutting tissue.

Referring to FIGS. 12 and 12A , the cam lever 46 includes a pair of side walls 114 and a bottom wall 116 . The proximal end 114a of each side wall 114 includes a raised wall portion 118 . Each raised wall portion 118 is configured to be fixedly received in a slot (not shown) formed in the underside of the slider 52 to securely mount the proximal end of the cam lever 46 to the slider 52 . Alternatively, slider 52 may be molded around the proximal end of knife actuation rod 44 . The distal end of each side wall 114 includes an angled cam surface 114b. Bottom wall 116 defines a distally extending elongated slot 123 ( FIG. 12A ) and a proximally extending longitudinal slot 121 extending from the distal end of cam rod 46 along most of the length of cam rod 46 . extend. Slot 121 is positioned to facilitate passage of pressure plate 54 through cutout 55 of channel member 22 when slider 52 is in the retracted position (see FIG. 20 ).

Sidewall 114 of cam lever 46 is slidably positioned in slots 70 a and 70 c of guide block 48 , and knife actuation rod 44 is slidably positioned in longitudinal slot 70 b of guide block 48 . Slider 52 moves distally within stationary housing 26 when firing assembly 20 is supported in channel member 22 and firing lever 50 is pivoted to one side of stationary housing 26 and pushed distally. As the slider 52 begins to move distally, the tapered surface 86 of the pressure plate 54 engages the distal edge of the channel member 22 defining the notch 55 to drive the pressure plate 54 upwardly out of the notch 55 and through the slot of the cam rod 46 121, and moves onto the inner surface of the stationary housing 26 of the launch assembly 20 (FIG. 20). At this point, the pin 88 of the pressure plate 54 moves into the detent groove 94a to prevent further pivotal movement of the firing lever 50 . If the firing lever 50 is not pivoted to such a position that the pin 88 is positioned below the detent groove 94a, the pressure plate 54 will be prevented from moving upwardly out of the notch 55 and the firing lever 50 will be prevented from moving the firing stroke. As firing lever 50 is moved distally, finger 108 moves within groove 110 to hold knife actuation lever 44 stationary while cam lever 46 is advanced distally. When finger 108 engages proximal wall 112 defining groove 110 , knife actuation rod 44 moves distally along with slide 52 and cam rod 46 . As will be discussed below, as the cam lever 46 and knife actuation lever 44 move distally within the stationary housing 26 and channel member 22 of the firing assembly 20, the angled cam surface 114b of the cam lever 46 moves through the SULU Pop off the fasteners. Simultaneously, the knife actuation rod 44 drives the blade 40 through the SULU 18 to dissect the tissue, albeit with a preset delay equal to the length of the groove 110 ( FIG. 20 ).

US Patent No. 7,631,794 (the "'794 patent") discloses a surgical fastener applying device that includes a firing assembly similar to that described above. The entire contents of the '794 patent are hereby incorporated by reference.

13 to 17 illustrate the SULU 18 . The SULU 18 includes a body 120, a plurality of staple pushers 122 (only one shown), a bottom cover 124, a knife 40 having an angled sharp leading edge or blade 40a, a plurality of staples 126 (only one shown) and a pivot Ground mounted safety lock 128. The proximal end of the body 120 includes flexible fingers 120 a that protrude slightly beyond the outer wall defining the body 120 . Fingers 120a frictionally engage the inner wall of channel member 22 ( FIG. 14 ) to retain the proximal end of SULU 18 within channel member 22 when SULU 18 is releasably positioned therein. It is known in the art that the body 120 has multiple rows of staple retaining slots 130 , such as 4 rows, 6 rows, etc., and that the linear grooved knife track 132 is centrally disposed in the body 120 . Surgical stapler 10 can be sized to accommodate or accommodate SULUs having different staple row lengths (eg, 60mm, 80mm, and 100mm). The knife 40 includes a downturned hook portion 40b positioned to engage the upturned hook portion 106 ( FIG. 12 ) of the knife actuation rod 44 when the SULU 18 is positioned within the channel member 22 .

In the illustrated embodiment, the body 120 includes two rows of staggered slots 130 formed on either side of a linear slotted tool track 132 . The rows of staggered slots 130 extend beyond the distal end of knife track 132 to facilitate staple forming beyond the distal end of blade 40 travel.

Staple pushers 122 may be configured to extend into one or more slots 130 . In one embodiment, a single pusher is associated with each slot 130 . Alternatively, as shown in FIG. 17 , each pusher 122 can be configured to extend into two adjacent slots 130 and to be positioned beneath a corresponding staple 126 retained in the slots 130 . It is known in the art that each pusher 122 includes a lower cam surface 122a positioned to engage one of the cam surfaces 114b ( FIG. 12 ) on the distal end of the cam lever 46 such that the cam lever Movement of 46 within the SULU 18 sequentially raises each respective pusher 122 within the respective one or more slots 130 to eject staples from the one or more slots 130 .

Bottom cover 124 partially surrounds channel 125 ( FIG. 18 ) formed in cartridge body 120 . A longitudinal ridge 134 ( FIG. 17 ) is formed on the upper surface of the bottom cover 124 and provides a bearing surface for a knife support member 136 mounted to the bottom edge of the knife 40 . Knives 40 may be attached to support member 136 by pins, welding, or other known fastening techniques. During the firing stroke, the knife 40 is guided along the knife track 132 as the firing lever 50 is advanced through the channel member 22 . A pair of slots 138 are defined between the sides of ridge 134 and the outer wall of cartridge body 120 . The longitudinal ridge 134 is positioned within the body 120 and is sized to be slidably received in the elongated slot 123 ( FIG. 12 a ) of the cam bar 46 , thereby enabling the cam bar 46 to slidably move about the longitudinal ridge 134 through the staple. Cartridge body 120 to eject staples 126 from SULU 18 .

Safety latch 128 is pivotally disposed on the upper proximal end of body 120 and pivots about pivot member 150 from a locked orientation ( FIG. 26 ) to an unlocked orientation ( FIG. 34 ). The pivot member 150 is received in an opening 154 in the body 120 . A biasing member, such as spring 152 , is positioned between the knife support member 136 and the safety lock 128 to drive the safety lock 128 toward the unlocked orientation. The safety lock 128 includes a proximal hook 156 positioned to receive an engagement member 158 formed on the knife 40 to maintain the safety lock 128 in the locked orientation when the knife 40 is in the retracted position ( FIG. 19 ). As the knife 40 moves toward the advanced position during the firing stroke, the engagement member 158 moves away from the proximal hook 156 to allow the safety latch 128 to pivot toward the unlocked position in response to urging of the spring 152 . It should be noted that when the anvil block half 12 and the staple cartridge receiving half 14 are in the clamped position, the safety lock 128 is prevented from pivoting to the unlocked position because the top surface 128a of the safety lock 128 is in contact with the anvil half 12. The inner surfaces engage to prevent pivoting of safety latch 128 . Safety latch 128 defines a slot 160 ( FIG. 16 ) sized to slidably receive knife 40 . In the retracted position of the knife 40, the leading edge 40a of the knife 40 is restrained within the slot 160 of the safety lock 128 to prevent accidental engagement and injury to medical personnel due to the leading edge 40a of the knife 40.

Referring again to FIGS. 2-3 , the anvil half 12 includes a proximal handle portion 12a and a distal anvil portion 12b. Anvil portion 12b includes a staple deforming portion 198 , which is known in the art to include a plurality of staple deforming grooves and faces the top surface of SULU 18 when SULU 18 is located in channel member 22 . It is also known in the art that staple deforming portion 198 includes a central longitudinal slot (not shown) for receiving knife 40 ( FIG. 17 ) as it moves through SULU 18 . The staple deforming portion 198 can be integrally formed with the anvil half 12 or, in the alternative, attached to the anvil half 12 by a fastening process, such as welding. A pair of positioning fingers 170 are positioned near the proximal end of staple deforming portion 198 of anvil portion 12b and engage slots in SULU 18 to properly align SULU 18 with staple deforming portion 198 .

The central portion of the anvil half 12 includes a pair of cylindrical lateral support members 172 . During assembly of the anvil half 12 and the cartridge receiving half 14, the lateral support member 172 is supported in a U-shaped groove 174 formed on a central portion 173 ( FIG. 28 ) of the cartridge receiving half 14 . The lateral support members 172 are also positioned to be received in cutouts 176 formed in spaced apart flange portions 178 of the clamping lever 16 when the clamping lever 16 is moved to the clamped position ( FIG. 1 ). The proximal handle portion 12a is ergonomically formed and includes a thumb engaging abutment 180 and a grip portion 182 . The proximal end of handle portion 12a includes downwardly extending fingers 184 (FIG. 21) that include a pair of opposing teardrop-shaped protrusions 186, discussed in further detail below. Alternatively, protrusion 186 may take various configurations.

Returning to FIG. 3 , the cartridge receiving half 14 includes a central portion 173 defining centrally spaced U-shaped grooves 174 positioned to support the lateral support members of the anvil half 12 172. The distal wall 173a of the central portion 173 defines a tissue stop. A pair of transverse cylindrical pivot members 187 are positioned below the recess 174 . Each pivot member defines a flat portion 187a (see also FIG. 2A ). The proximal end of the cartridge receiving half 14 also includes a pair of vertical support members 188 . Each vertical support member 188 includes an elongated vertical slot 188a having a circular bottom surface. The vertical slots 188a are dimensioned to accommodate the protrusions 186 formed on the fingers 184 ( FIG. 21 ) of the anvil half 12 when the anvil half 12 is supported on the staple cartridge receiving half 14 during assembly. . By positioning protrusion 186 within vertical slot 188a, anvil half-section 12 is pivotable relative to cartridge receiving half-section 14 between an open position and a closed position in a scissors-like motion. In one embodiment, protrusion 186 has a teardrop-shaped profile. At least one side wall of the cartridge receiving half 14 includes a bifurcated recess 189 (see FIG. 3 ), discussed in further detail below.

Clamping lever 16 includes a handle portion 190 having a grip portion 190a and a thumb engaging abutment portion 192 . As discussed above, a pair of spaced flange portions 178 are supported on the distal end of the clamp lever 16 . Each flange portion 178 defines a cutout 176 sized to receive a respective lateral support member 172 of the anvil half 12 when the stapler 10 is moved toward the clamped position ( FIG. 2B ). The distal end of the clamping lever 16 also defines a pair of distal C-shaped grooves 194 sized to receive the pivot member 187 of the cartridge receiving half 14 . Each groove 194 defines a slot having a width that is less than the diameter of the pivot member 187 . Because the width of the opening of each C-shaped groove 194 is smaller than the diameter of the pivot member 187, the pivot member 187 must Slide along the surface of the flat portion 187a of the pivot member 187 into the groove 194 in the direction of the arrow "x" of FIG. 2A. As such, clamping lever 16 must be positioned at an acute angle to cartridge receiving half 14 as shown in FIG. 2A so that clamping lever 16 is pivotally mounted about pivot member 187 of cartridge receiving half 14 . As shown, the acute angle is a greater angle relative to the cartridge receiving half than the angle of the clamping lever in the unclamped position relative to the cartridge receiving half. After the pivot member 187 is positioned in the C-shaped groove 194, the clamping lever 16 can be rotated counterclockwise as shown in FIG. 2A to the position shown in FIG. The bin houses the halves 14 .

As shown in FIG. 3A , the inner wall of the flange portion 178 of the clamp operating lever 16 includes a circular convex portion 201 having a flat side wall 201 a. As the clamping operating lever 16 rotates from the position shown in FIG. 2A to the position shown in FIG. 2B , the convex portion 201 moves forward and deforms under the action of the outer wall of the nail cartridge containing half 14 until the convex portion 201 moves to form In the first portion 189a of the bifurcated recess 189 in the sidewall of the cartridge receiving half 14 ( FIG. 2A ). A bifurcation recess 189 is formed proximally of U-shaped groove 174 and proximally of lateral support member 172 of cartridge receiving half 14 . By positioning the protrusion 201 in the first portion 189a of the recess 189, the clamping lever 16 is prevented from rotating such that the clamping lever 16 would separate from the staple cartridge receiving half 14 (FIG. 2A) and thus remain in the open position or loose position. open position (Figure 22). When the clamping lever 16 is moved to the clamping position, the deformable protrusion 201 passes the raised recess barrier 189c ( FIG. 5 ) and enters the second portion 189b of the bifurcated recess 189b to allow the clamping lever 16 Hold in clamped position (Fig. 27A). In this position, the flat sidewall 201a of the protrusion 201 abuts the recess barrier 189c. It should be noted that the first and second recess portions 189a, 189b are of different configuration, but may alternatively be of similar configuration. It should also be noted that the recess portions 189a, 189b may have a height or space that exceeds the diameter of the protrusion 201 to provide room for the protrusion to move within the portion 189a, 189b.

2 and 2C, after the clamping lever 16 has been loaded into the cartridge receiving half 14 and the SULU 18 and firing assembly 20 are loaded into the channel member 22, the anvil portion 12 can be assembled to the cartridge receiving half 14 . It should be noted that the SULU 18 and firing assembly 20 can be loaded into the channel member 22 either before or after the clamping lever 16 is loaded into the cartridge receiving half 14 . To couple anvil half 12 to cartridge receiving half 14 , protrusion 186 of finger 184 is positioned in vertical slot 188 a of vertical support member 188 of cartridge receiving half 14 . Thereafter, anvil half 12 is rotated toward cartridge receiving half 14 such that lateral support member 172 is positioned in U-shaped groove 174 .

To position surgical stapler 10 in the clamped position, clamp lever 16 is rotated counterclockwise from the position shown in FIG. 2B . As the clamping lever 16 is rotated, the lateral support member 172 is received in the cutout 176 of the flange portion 178 and cammed toward the cartridge receiving half 14 . In the clamped position shown in FIG. 1 , staple deforming portion 198 is positioned proximate to the top surface of SULU 18 .

Referring to FIGS. 3 , 12 , 19 and 26 , as discussed above, the guide block 48 is pivotally supported within the stationary housing 26 of the firing assembly 20 . Guide block 48 includes a distally extending nose 220 ( FIG. 12 ) that seats beneath SULU 18 when SULU 18 is supported in channel member 22 . The inner surface of guide block 48 includes locking surfaces 222 ( FIG. 19 ) that are received in notches 49 and 51 of knife actuation bar 44 when stapler 10 is in the released position. When the SULU 18 is positioned in the channel member 22, the SULU 18 is positioned over the nose 220 and does not drop completely into the channel member 22 prior to moving the clamp lever 16 to the clamped position, as discussed above. When the stapler 10 is moved to the clamped position, the positioning fingers 170 ( FIG. 3 ) of the anvil half engage the top surface of the body 120 of the SULU 18 to allow the SULU 18 to drop completely into the channel member 22 . Thereafter, the positioning fingers 170 engage the slots of the SULU 18 to properly position the SULU 18 relative to the anvil portion 12b. As the SULU 18 is fully dropped into the channel member 22 , the SULU 18 presses down on the nose 220 of the guide block 48 to pivot the guide block 48 about the protrusion 72 . As guide block 48 pivots, locking surface 222 moves out of notches 49 and 51 to unlock knife actuation lever 44 ( FIG. 26 ). This configuration prevents movement of the knife actuation bar 44 relative to the guide block 48 prior to clamping to ensure that the knife actuation bar 44 and SULU knife 40 remain properly positioned for operative engagement prior to use.

Referring to FIGS. 24-28 , when stapler 10 is in the clamped, non-firing position, slider 52 of firing assembly 20 is in a retracted position at the proximal end of channel member 22 and stationary housing 26 (see FIG. 25 ). In this position, the pressure plate 54 is positioned in the cutout 55 of the channel member 22 and the pin 88 of the pressure plate 54 is positioned in the arcuate groove 94 of the firing lever 50, below the detent groove 94a (see FIG. 12B ). In this way, the firing lever 50 can pivot to facilitate actuation of the stapler 10 from either side of the stapler 10 . Furthermore, in this position of the slider 52 , the finger 108 of the knife actuation bar 44 is positioned adjacent the distal wall of the groove 110 of the slider 52 . The protrusion 201 is positioned within the second portion 189b of the bifurcated recess 189 to maintain the clamping lever 16 in the clamped position. As noted above, the flat sidewall 201a of the protrusion 201 is positioned adjacent to the recess barrier 189c to prevent inadvertent removal of the protrusion 201 from the second portion 189b (FIG. 27A).

25 and 26, when the slider 52 is in the retracted position, the cam surface 114b (FIG. 9) of the knife 40 and cam lever 46 is positioned at the proximal end of the SULU 18, and the proximal hook 156 of the safety latch 128 is positioned To engage the engagement member 158 of the knife 40 to maintain the safety latch 128 in the locked orientation. Additionally, the downturned hook portion 40b of the knife 40 engages the upturned hook portion 106 of the knife actuation rod 44 to connect the firing assembly 20 to the knife 40 of the SULU 18 .

Referring to FIGS. 29 to 32 , when the firing lever 50 is advanced distally in the direction indicated by arrow “A” in FIG. A corresponding movement of the cam lever 46 and a delayed movement of the knife actuating lever 44 are effected. As discussed above, the delayed movement of the knife actuating rod 44 is equal to the length of the groove 110 of the slider 52 and is caused by the movement of the fingers 108 of the knife actuating rod 44 within the groove 110 of the slider 52 . When the finger 108 abuts the proximal wall 112 of the groove 110 , the knife actuation rod 44 and slider 52 begin to move together. As cam lever 46 moves distally through stationary housing 26 of firing assembly 20, cam surface 114b on side wall 114 of cam lever 46 is advanced through SULU 18 to sequentially engage pusher 122 (FIG. 17) to Staples 126 are ejected from slots 130 of body 120 . As a result, as the distal end of knife actuation rod 44 engages knife 40, knife 40 is advanced through SULU 18 after a preset delay to cut tissue between staple rows.

As shown in phantom in FIG. 32 , platen 54 rides over channel member 22 and moves along the interior surface of stationary housing 26 of firing assembly 20 as slider 52 moves distally within stationary housing 26 . At this point, the pin 88 of the pressure plate 54 moves into the detent groove 94a to prevent further pivotal movement of the firing lever 50 .

Referring to FIG. 32 , as the knife 40 is moved distally within the SULU 18 , the engagement member 158 of the knife 40 disengages from the proximal hook 156 of the safety latch 128 .

Referring to FIGS. 33 and 34 , when the firing lever 50 is returned to its most proximal position to retract the cam lever 46 and knife 40 , the clamping lever 16 is manually pivoted to align the protrusion 201 with the bifurcation recess 189 . The second portion 189b separates to move the clamp lever 16 to its released position to allow the stapler 10 to move to the open position. In the open position, anvil half 12 is spaced apart from cartridge receiving half 14, and spring 152 (FIG. 17) causes safety lock 128 to pivot about pivot member 150 in the direction indicated by arrow B in FIG. 34 to its unlocked position. , so that the safety latch 128 protrudes upwardly from the SULU 18 . In the unlocked position, safety lock 128 prevents movement of stapler 10 back to the clamped position. In order to reuse the stapler 10, the used SULU 18 must be replaced with a new one.

During a surgical procedure, the SULU 18 can be exchanged multiple times for multiple uses of the stapler 10 on a single patient. If an integral unit is provided, the SULU and launch assembly can be replaced multiple times. Since each SULU 18 is provided with a fresh knife 40, tissue tearing is minimized. After the surgical procedure, the used SULU 18 and launch assembly 20 can be removed from the channel member 22 and disposed of in a suitable manner. Thereafter, the clamping lever 16 can be removed from the cartridge receiving half 14 by rotating the clamping lever 16 to the position shown in FIG. 2A and disengaging the pivot member 187 from the C-shaped groove 194 . The anvil half 12, cartridge receiving half 14, and clamping lever 16 can now be sterilized, such as by autoclaving, and reused with a new SULU 18 and firing assembly 20 in the manner described above.

It should be understood that various modifications may be made to the embodiments of the surgical fastener applying apparatus of the present disclosure. Accordingly, the above description should not be taken as limiting, but only exemplifications of embodiments. Those skilled in the art can envision other modifications within the scope and spirit of this disclosure.

Claims (15)

1. a surgical fasteners bringing device, including:

Anvil block half portion, including distal anvil portion and proximal handle portion；

Cartridge half-section, defines elongated passageway component, and described elongated passageway component has extremity and a proximal portion, described far Sidepiece is sized to accommodate releasedly nail bin, and described proximal portion is configured to support emitting module, described cartridge Half portion also includes the sidewall limiting bifurcated recess, and described bifurcated recess has the first recess separated by protruding recess barrier portion Part and the second recess portions；

Clamp operation bar, is filled to described cartridge half-section, and described clamp operation bar has proximal portion and extremity and includes Handle portion,

Described clamp operation bar is operably associated with described anvil block half portion and described cartridge half-section, and can be from unclamping Position moves to clamped position, thus the anvil portion in described anvil block half portion is dressed up the described nail bin of next-door neighbour, wherein, institute releasedly Stating the sidewall that clamp operation bar also includes having the first protuberance, described first protuberance can be positioned at the first of described bifurcated recess In recess portions, so that described clamp operation bar is releasably held in released position, and described first protuberance can position In the second recess portions of described bifurcated recess, so that described clamp operation bar is releasably held in clamped position.

Surgical fasteners bringing device the most according to claim 1, wherein, described clamp operation bar is filled to nail releasedly Capacity receives half portion.

Surgical fasteners bringing device the most according to claim 1 and 2, it farther includes emitting module, described transmitting Assembly is configured to be contained in releasedly in the proximal portion of described cartridge half-section, and includes launching action bars and regularly Installing to the cam lever on described transmitting action bars, described emitting module also includes static housing and cutter actuator lever, described cutter Actuator lever is configured to engage with the cutter being supported in single use load units, and described static housing is configured to release It is supported on putting in the proximal portion of described cartridge half-section.

Surgical fasteners bringing device the most according to claim 3, wherein, described static housing includes U-frame frame, described U-frame frame includes diapire and pair of sidewalls, and each of which in sidewall has the near-end containing the second protuberance, and each is second convex Portion is all positioned as being contained in releasedly in the groove in the near-end being formed at described elongated passageway component, so that described static Shell is releasably held in the proximal portion of described elongated passageway component.

Surgical fasteners bringing device the most according to claim 1, wherein, described first protuberance includes smooth sidewall, When described clamp operation bar is in clamped position, described smooth sidewall adjoins with the recess barrier portion of described projection.

Surgical fasteners bringing device the most according to claim 1, wherein, described first protuberance is deformable, and When described clamp operation bar moves between released position and clamped position, described first protuberance is through the recess of described projection Barrier portion.

Surgical fasteners bringing device the most according to claim 1, wherein, described clamp operation bar is filled to institute pivotally State cartridge half-section, and described clamp operation bar is pivoted to make described first protuberance recessed from the first of described bifurcated recess Portion's componental movement enters the second recess portions of described bifurcated recess through the recess barrier portion of described projection.

Surgical fasteners bringing device the most according to claim 1, wherein, described cartridge half-section includes pair of pivot Component, each pivot member is respectively provided with flat surfaces.

Surgical fasteners bringing device the most according to claim 8, wherein, described clamp operation bar includes that a pair C-shaped is recessed Groove, the width of each C-shaped groove is respectively less than the diameter of described pivot member so that described pivot member needs along described smooth Surface slides in described C-shaped groove, so that described clamp operation bar is connected in described cartridge half-section.

Surgical fasteners bringing device the most according to claim 9, wherein, described clamp operation bar is relative to described nail Capacity is received half portion and is become the first angle so that described clamp operation bar is connected in described cartridge half-section, and relative to being in The cartridge half-section of released position becomes the second more low-angle.

11. surgical fasteners bringing devices according to claim 9, wherein, described flat surfaces is positioned in described pivot At the proximal face of shaft component.

12. surgical fasteners bringing devices according to claim 1, wherein, described cartridge half-section has pair of U-shaped Groove is to accommodate the lateral supports in described anvil block half portion, and described U-shaped groove is positioned in the distally of described bifurcated recess.

13. surgical fasteners bringing devices according to claim 1, wherein, described cartridge half-section includes a pair pivot Shaft component, described pivot member is positioned in the distally of described bifurcated recess.

14. surgical fasteners bringing devices according to claim 1, wherein, described first recess portions and the second recess Part is different structure.

15. surgical fasteners bringing devices according to claim 1, wherein, the first recess portions and the second recess portions Height exceed the diameter of described first protuberance.