STAPLE CARTRIDGE FOR A SURGICAL INSTRUMENT
20220183686 · 2022-06-16
Inventors
Cpc classification
A61B18/1445
HUMAN NECESSITIES
A61B2017/07278
HUMAN NECESSITIES
International classification
Abstract
The present disclosure provides a staple cartridge for a surgical instrument, such as a tissue sealing instrument. The staple cartridge includes a housing and one or more staple assemblies within the housing. The staple assemblies each include one or more staple pushers and associated staples. The staple pushers and housing include coupling elements configured to cooperate with each other to retain the staple assemblies to the housing prior to use in surgery. The coupling elements, along with other components of the cartridge and instrument, result in a smaller staple cartridge relative to conventional devices, allowing for a more compact and maneuverable surgical instrument.
Claims
1. A surgical instrument comprising: an end effector comprising first and second jaws configured to move relative to each other from an open position to a closed position; and a staple cartridge coupled to one of the first or second jaws and comprising: a housing; and one or more staples assemblies each comprising a staple pusher and a staple, wherein the staple pusher has a coupling element sized to engage a portion of the housing such that the staple assemblies are retained to the housing.
2. The surgical instrument of claim 1, wherein the housing has a longitudinal axis with one or more openings spaced from each other substantially along the longitudinal axis and the coupling element comprises a projection sized to engage with at least one of the openings in the housing.
3. (canceled)
4. The surgical instrument of claim 2, wherein the projection comprises an outer inclined surface configured to extend through one of the openings in the housing, the outer inclined surface being sized to allow forced movement of the staple pusher in a single direction substantially perpendicular to the longitudinal axis.
5. The surgical instrument of claim 4, wherein the staple pusher is detachable from the staple cartridge upon said forced movement.
6. The surgical instrument of claim 1, wherein the housing comprises inner and outer wall sections each having a plurality of openings spaced from each other and extending along the longitudinal axis of the housing, the surgical instrument further comprising first and second rows of staple pushers adjacent each other within the housing, wherein each staple pusher has a projection sized to engage with one of the openings in the inner and outer wall sections of the housing to retain each row of staple pushers to the housing.
7. (canceled)
8. The surgical instrument of claim 1, wherein the housing comprises first and second longitudinal sections coupled to each other, each of the first and second longitudinal sections comprising a wall and a row of openings in the wall extending longitudinally along each section.
9. The surgical instrument of claim 8, wherein the first and second longitudinal sections each comprise a coupling member and wherein the coupling members of each section are configured to cooperate with each other to form an interference fit that couples the sections to each other.
10. The surgical instrument of claim 9 further comprising a drive member configured to translate distally through the end effector, the drive member including a central portion and first and second outer portions each having an inclined surface.
11. The surgical instrument of claim 10, wherein the first and second longitudinal sections cooperate to form a channel upon assembly of the first and second portions, the channel being sized to receive the central portion of the drive member.
12. The surgical instrument of claim 10, wherein the inclined surfaces of the outer portions of the drive member are configured to engage the staple pushers upon distal translation of the drive member through the channel of the staple cartridge and move the staples from a first position within an interior of the housing to a second position exterior to the housing.
13. The surgical instrument according to claim 12 further comprising an actuation mechanism in contact with the drive member and configured to translate the drive member distally through the end effector, wherein the actuator includes a control device of a robotic surgical system.
14. (canceled)
15. (canceled)
16. (canceled)
17. A surgical instrument comprising: an end effector comprising first and second jaws configured to move relative to each other from an open position to a closed position; a drive member configured to translate distally through the end effector; and a staple cartridge coupled to one of the first or second jaws and comprising: a housing having a longitudinal axis; and at least one staple assembly comprising a staple pusher and a staple, wherein the staple pusher comprises a coupling element configured to retain the staple pusher to the housing and to allow the drive member to force the staple pusher to move relative to the housing in a direction substantially perpendicular to the longitudinal axis.
18. The surgical instrument of claim 17, wherein the housing comprises an opening, wherein the coupling element is a projection extending from the staple pusher and configured to cooperate with the opening to retain the staple pusher to the housing.
19. The surgical instrument of claim 18, wherein the projection comprises an inclined outer surface configured to pass through the opening and to allow forced movement of the staple pusher in a single direction substantially perpendicular to the longitudinal axis of the housing, wherein the staple pusher is detachable from the staple cartridge upon such forced movement in the single direction.
20. (canceled)
21. The surgical instrument according to claim 17, further comprising: an actuation mechanism in contact with the drive member and configured to translate the drive member distally through the end effector; and an actuator operatively connected to the actuation mechanism, wherein the actuator includes a control device of a robotic surgical system.
22. (canceled)
23. A staple cartridge for a surgical instrument comprising: a housing having a longitudinal axis and one or more openings spaced from each other substantially along the longitudinal axis; and one or more staple assemblies each comprising a staple pusher and a staple, wherein each of the staple pushers comprises a projection configured to cooperate with one of the openings in the housing such that the staple assemblies are retained to the housing.
24. The staple cartridge of claim 23, wherein the projection comprises an outer inclined surface configured to extend through one of the openings in the housing.
25. The staple cartridge of claim 24, wherein the inclined surface of the projection is sized to substantially inhibit movement of the staple pusher relative to the outer wall of the housing and to allow forced movement of the staple pusher in a direction substantially parallel to the wall and substantially perpendicular to the longitudinal axis
26. The staple cartridge of claim 23, wherein the housing comprises inner and outer wall sections each having a plurality of openings spaced from each other substantially along the longitudinal axis.
27. The staple cartridge of claim 26 further comprising first and second rows of staple assemblies adjacent the respective inner and outer wall sections of the housing.
28-39. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0027] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several embodiments of the disclosure and together with the description serve to explain the principles of the disclosure.
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DETAILED DESCRIPTION
[0048] This description and the accompanying drawings illustrate exemplary embodiments and should not be taken as limiting, with the claims defining the scope of the present disclosure, including equivalents. Various mechanical, compositional, structural, and operational changes may be made without departing from the scope of this description and the claims, including equivalents. In some instances, wed-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Like numbers in two or more figures represent the same or similar elements. Furthermore, elements and their associated aspects that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment; the element may nevertheless be claimed as included in the second embodiment. Moreover; the depictions herein are for illustrative purposes only and do not necessarily reflect the actual shape, size, or dimensions of the system or illustrated components.
[0049] It is noted that, as used in this specification and the appended claims, the singular forms “a,” “an” and “the,” and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein; the term “include” and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.
[0050] While the following disclosure is presented with respect to a linear surgical stapler where staples are sequentially fired, it should be understood that the features of the presently described surgical instruments may be readily adapted for use in any type of surgical clamping, cutting, or sealing instruments, whether or not the surgical clamping and cutting instrument applies a fastener. For example, the presently described drive member and actuation mechanism may be employed in an electrosurgical instrument wherein the jaws include electrodes for applying energy to tissue to treat (e.g., cauterize, ablate, fuse, or cut) the tissue. The surgical clamping and cutting instrument may be a minimally invasive (e.g., laparoscopic) instrument or an instrument used for open surgery.
[0051] Additionally, the features of the presently described surgical stapling instruments may be readily adapted for use in surgical instruments that are activated using any technique within the purview of those skilled in the art, such as, for example, manually activated surgical instruments, powered surgical instruments (e.g., electro-mechanically powered instruments), robotic surgical instruments, and the like.
[0052]
[0053] In certain embodiments, handle assembly 102 may include input couplers (not shown) instead of, or in addition to, the stationary and movable handles. The input couplers provide a mechanical coupling between the drive tendons or cables of the instrument and motorized axes of the mechanical interface of a drive system. The input couplers may interface with, and be driven by, corresponding output couplers (not shown) of a telesurgical surgery system, such as the system disclosed in U.S Pub. No. 2014/0183244A1, the entire disclosure of which is incorporated by reference herein. The input couplers are drivingly coupled with one or more input members (not shown) that are disposed within the instrument shaft 106 and end effector 110. Suitable input couplers can be adapted to mate with various types of motor packs (not shown), such as the stapler-specific motor packs disclosed in U.S. Pat. No. 8,912,746, or the universal motor packs disclosed in U.S. Pat. No. 8,529,582, the disclosures of both of which are incorporated by reference herein in their entirety. Further details of known input couplers and surgical systems are described, for example, in U.S. Pat. Nos. 8,597,280, 7,048,745, and 10,016,244. Each of these patents is hereby incorporated by reference in its entirety.
[0054] Actuation mechanisms of surgical instrument 100 may employ drive cables that are used in conjunction with a system of motors and pulleys. Powered surgical systems, including robotic surgical systems that utilize drive cables connected to a system of motors and pulleys for various functions including opening and closing of jaws, as well as for movement and actuation of end effectors are well known. Further details of known drive cable surgical systems are described, for example, in U.S. Pat. Nos. 7,666,191 and 9,050,119 both of which are hereby incorporated by reference in their entireties. While described herein with respect to an instrument configured for use with a robotic surgical system, it should be understood that the wrist assemblies described herein may be incorporated into manually actuated instruments, electro-mechanical powered instruments, or instruments actuated in any other way.
[0055]
[0056] Referring now to
[0057] In certain embodiments, cartridge 122 also may include a shuttle 123 having an inclined distal surface 125 that, upon distal movement, sequentially acts on staple pushers 126, camming them upwardly, thereby moving staples 124 into deforming contact with anvil 115 (See
[0058]
[0059] Referring now to
[0060] In most conventional staple cartridge designs, the cartridge 122 would also include a sheet metal cover (not shown) surrounding at least a portion of cartridge 122. The cover serves to prevent the staple assemblies from falling out of cartridge 122 prior to use in surgery, e.g., during shipping, handling, etc. The cover, however, adds material thickness to the vertical height and horizontal width of the cartridge. In the present invention, cartridge 122 does not include this cover and, therefore, may be designed with taller staples and/or a smaller overall profile (e.g., diameter) than conventional staple cartridges. In an exemplary embodiment, staple cartridge 122 of the present invention preferably has a diameter less than 12 mm, more preferably about 8 mm. This smaller diameter cartridge allows for the design of a smaller and more compact surgical instrument, which provides the surgeon with more maneuverability during a surgical procedure. In addition, the smaller and more compact surgical instrument is less likely to contact and possibly damage collateral tissue in the surgical arena.
[0061] In one embodiment of the present invention, housing 202 of staple cartridge 122 includes a plurality of openings 214 spaced from each other and extending substantially in the direction of longitudinal axis 204. As shown more clearly in
[0062] The present invention allows the staple assemblies to be retained to housing 202 of staple cartridge 122 without the presence of a conventional sheet metal cover. However, it should be noted that the present invention is not limited to the embodiment described herein and other coupling mechanisms may be used to retain the staple assemblies to the cartridge prior to use. For example, staple pusher 126 and housing 206 may include other cooperating or coupling elements that retain pusher 126 to housing 206 while still allowing it to be driven in one direction by drive member 150, such as interference fits, snap-fit features, press-fit connectors, camming surfaces with various geometries and the like.
[0063] As shown in
[0064] Referring now to
[0065] In certain embodiments, jaws 111, 112 are attached to surgical instrument 100 via a suitable coupling device, such as a clevis 140. Clevis 140 includes upper and lower portions that cooperate when assembled to form a protrusion 145 configured to engage tabs 113 (see
[0066] Referring now to
[0067] As seen in
[0068] As shown in
[0069] Enlarged distal end 173 of drive cable 171 resides within an enlarged distal portion 159 of bore 158 in upper shoe 152 of drive member 150, such that a proximal face 157 of enlarged distal end 173 may apply a retraction force on upper shoe 152 when the drive cable 171 is pulled proximally, i.e., in the direction of arrow “B” in
[0070] Referring now to
[0071] During actuation of illustrative surgical instrument 100, drive rod 175 applies force to coil 120, thereby causing coil 120 to apply force to upper shoe 152 of drive member 150, translating it distally (i.e., in the direction of arrow “A” in
[0072] In use, in the open configuration, drive member 150 is positioned proximally of cam surface 114 formed on movable jaw 112. As drive member 150 translates in the distal direction, movable jaw 112 will rotate towards the closed position around pivot 117. Once drive member 150 has come into contact with cam surface 114 of movable jaw 112, lower portion 154 of drive member 150 rides underneath cam surface 114, drive member 150 pushes movable jaw 112, causing it to pivot towards the closed position. In the closed position. drive member 150 has translated distally past cam surface 114. In this position, tissue is clamped, and further advancement of the drive member will sever and staple tissue. Of course, it will be recognized by those skilled in the art that drive member 150 may be any structure capable of pushing at least one of a shuttle or a knife of a surgical stapling instrument with the necessary force to effectively sever or staple human tissue. Drive member 150 may be an I-beam, an E-beam, or any other type of drive member capable of performing similar functions. Drive member 150 is movably supported on the surgical stapling instrument 100 such that it may pass distally through a staple cartridge and upper fixed jaw 111 and lower jaw 112 when the surgical stapling instrument is fired (e.g., actuated).
[0073]
[0074] The Console includes a monitor 304 for displaying an image of a surgical site to the Surgeon, left and right manipulatable control devices 308 and 309, a foot pedal 305, and a processor 302. The control devices 308 and 309 may include any one or more of a variety of input devices such as joysticks, gloves, trigger-guns, hand-operated controllers, or the like. The processor 302 may be a dedicated computer that may be integrated into the Console or positioned next to it.
[0075] The Surgeon performs a minimally invasive surgical procedure by manipulating the control devices 308 and 309 (also referred to herein as “master manipulators”) so that the processor 302 causes their respectively associated robotic arm assemblies, 328 and 329, (also referred to herein as “slave manipulators”) to manipulate their respective removably coupled surgical instruments 338 and 339 (also referred to herein as “tools”) accordingly, while the Surgeon views the surgical site in 3-D on the Console monitor 304 as it is captured by a stereoscopic endoscope 340.
[0076] Each of the tools 338 and 339, as well as the endoscope 340, may be inserted through a cannula or other tool guide (not shown) into the Patient so as to extend down to the surgical site through a corresponding minimally invasive incision such as incision 366. Each of the robotic arms is conventionally formed of links, such as link 362, which are coupled together and manipulated through motor controlled or active joints, such as joint 363.
[0077] The number of surgical tools used at one time and consequently, the number of robotic arms being used in the system 300 will generally depend on the diagnostic or surgical procedure and the space constraints within the operating room, among other factors. If it is necessary to change one or more of the tools being used during a procedure, the Assistant may remove the tool no longer being used from its robotic arm, and replace it with another tool 331 from a Tray (“T”) in the operating room.
[0078] The monitor 304 may be positioned near the Surgeon's hands so that it will display a projected image that is oriented so that the Surgeon feels that he or she is actually looking directly down onto the operating site. To that end, images of the tools 338 and 339 may appear to be located substantially where the Surgeon's hands are located.
[0079] The processor 302 performs various functions in the system 300. One important function that it performs is to translate and transfer the mechanical motion of control devices 308 and 309 to their respective robotic arms 328 and 329 through control signals over bus 310 so that the Surgeon can effectively manipulate their respective tools 338 and 339. Another important function is to implement various control system processes as described herein.
[0080] Although described as a processor, it is to be appreciated that the processor 302 may be implemented in practice by any combination of hardware, software and firmware. Also, its functions as described herein may be performed by one unit, or divided up among different components, each of which may be implemented in turn by any combination of hardware, software and firmware. For additional details on robotic surgical systems, see, e.g., commonly owned U.S. Pat. No. 6,493,608 “Aspects of a Control System of a Minimally Invasive Surgical Apparatus,” and commonly owned U.S. Pat. No. 6,671,581 “Camera Referenced Control in a Minimally Invasive Surgical Apparatus,” which are hereby incorporated herein by reference in their entirety for all purposes.
[0081]
[0082] The setup joints 404 and 405 in this example are passive joints that allow manual positioning of the arm 400 when their brakes are released. For example, setup joint 404 allows link 402 to be manually rotated about axis 406, and setup joint 405 allows link 403 to be manually rotated about axis 407. Although only two links and two setup joints are shown in this example, more or less of each may be used as appropriate in this and other robotic arm assemblies in conjunction with the present invention. For example, although setup joints 404 and 405 are useful for horizontal positioning of the arm 400, additional setup joints may be included and useful for limited vertical and angular positioning of the arm 400. For major vertical positioning of the arm 400, however, the arm 400 may also be slidably moved along the vertical axis of the base 401 and locked in position.
[0083] The robotic arm assembly 400 also includes three active joints driven by motors. A yaw joint 410 allows arm section 430 to rotate around an axis 461, and a pitch joint 420 allows arm section 430 to rotate about an axis perpendicular to that of axis 461 and orthogonal to the plane of the drawing. The arm section 430 is configured so that sections 431 and 432 are always parallel to each other as the pitch joint 420 is rotated by its motor. As a consequence, the instrument 450 may be controllably moved by driving the yaw and pitch motors so as to pivot about the pivot point 462, which is generally located through manual positioning of the setup joints 404 and 405 so as to be at the point of incision into the patient. In addition, an insertion gear 445 may be coupled to a linear drive mechanism (not shown) to extend or retract the instrument 450 along its axis 463.
[0084] Although each of the yaw, pitch and insertion joints or gears, 410, 420 and 445, is controlled by an individual joint or gear controller, the three controllers are controlled by a common master/slave control system so that the robotic arm assembly 400 (also referred to herein as a “slave manipulator”) may be controlled through user (e.g., surgeon) manipulation of its associated master manipulator. A more complete description of illustrative robotic surgical systems for use with the present invention can be found in commonly-assigned U.S. Pat. Nos. 9,295,524, 9,339,344, 9,358,074, and 9,452,019, the complete disclosures of which are hereby incorporated by reference in their entirety for all purposes.
[0085] Hereby, all issued patents, published patent applications, and non-patent publications that are mentioned in this specification are herein incorporated by reference in their entirety for all purposes, to the same extent as if each individual issued patent, published patent application, or non-patent publication were specifically and individually indicated to be incorporated by reference.
[0086] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of presently disclosed embodiments. Thus the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.
[0087] Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. As well, one skilled in the art will appreciate further features and advantages of the present disclosure based on the above-described embodiments. Accordingly, the present disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
[0088] Other embodiments will be apparent to those skilled in the art from consideration of the specification and practice of the embodiment disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the embodiment being indicated by the following claims.