SURGICAL STAPLER

Abstract

The stapler of the invention is a surgical stapler/cutter that allows latero-lateral intestinal anastomosis, for both open surgery and laparoscopic surgery, at a distance from the openings used to insert the instrument. The stapler is based on the conventional structure of this type of stapler, and one of the fundamental features thereof is that an interspace (12) that determines a space for inserting the free ends (13, 13′) of the tissues (8, 8′) to be joined, is determined between an articulation shaft (3) of the two jaws (4, 5) of the stapler and the front end at which are disposed forms (6) and vertically movable teeth (9) on which staples (7) are disposed. This prevents the staples for the anastomosis and those for the removal of the pathological area from crossing when the area to be removed is cut. The invention also provides for the inclusion, in the described inter-space (12), of an Infrared Data Association (IrDA) device for testing blood flow that transmits a signal to a luminous signalling device which is visible to the user and which allows the degree of tissue vascularisation to be assessed.

Claims

1. Surgical stapler, applicable to open or laparoscopic surgeries, being of the type of those constituted from a device as scissors, or tilting closure, involving two arms (1-2) of roasting and pressing, articulated on one axis (3) and topped in jaw paths (4-5), so that in one of these jaws (5) a series of conformations is established internally (6) intended to plastically deform staples (7) arranged on the complementary jaw (4), staples (7) initially set up in “U”, which are arranged on vertically scrollable grinding teeth (9) by the effect of a cam (10) in which a push bar (11) is finished horizontally within the jaw (4), where is characterised by the joint axis (3) of the two jaws (4-5) and the initial end at which the conformations are available (6) and the vertically scrollable grinding teeth (9) on which the staples are available (7), a spacing (12) is defined between the axis and the principle of the stapling of anastomosis, to preserve the part of the intestine within that space, from which the anastomosis itself is performed.

2. Surgical stapler, according to claim 1, wherein it has an IrDA type blood flow-making device, located in the cavity (12), with an emitter (17) and a receiver (18), connected to a luminous signaling device (19) located on an external arm (1) in the user's view.

3. Surgical stapler, according to claim 1, whereas it includes means of cutting to communicate the two handles to anastomose between the staple lines, materialized in a tilting blade (14) with respect to a axis of rotation (15), which is axially scrollable in a longitudinal groove of the jaw (4), against the tension of a spring, counting this tilting blade (14) with a striking roller (16) intended to come into contact with cam (10) of the thrust arm (11) during axial displacement within the jaw (4), causing its emergency and shear displacement.

4. Surgical stapler, according to claim 1, where the lower jaw (4) is subsequently extended in long arm (1′) in whose bosom the thrust bar (11) that is finished on the cam (10) in the form of a inclined plane and which causes the sequential stapling of the tissues is axially displaced, with the particularity that the rod is finished at its other end in a trigger mechanism (27), implanted on the corresponding manually operated and controlled handle of the mechanism, with the particularity that the upper jaw (5) or pressed, is articulated with respect to the assembly formed by the arm (1′) and the lower jaw (4), through a axis of rotation (3), jaw that is required towards its opening position by effect of a spring associated with its shaft (3) of tilting, so that, said upper jaw (5) includes in correspondence with its anterior and upper limb, a cavity (29) that is facing the upper edge of the aforementioned laparoscopic arm (1′), in which manually, by means of a wheel (32), geared with the rod (30), moves it through a guide (31) whose end is insertable into the cavity (29), forcing to swing to the upper jaw (5).

Description

DESCRIPTION OF DRAWINGS

[0023] To complement the description to be made below and in order to help a better understanding of the characteristics of the invention, in accordance with a preferred example of practical realization of the invention, is accompanied as an integral part of that description, a set of plans in which the following has been represented for illustrative and non-limiting purposes:

[0024] FIG. 1 Shows a side elevation and section view of a surgical stapler performed according to the object of the invention, in an initial phase of approximation to the tissues to be joined, in which it can be observed as in it is left a space or camera before which the tip of the tissues access, in order that the limb is not affected by the staples or jaws, with a view to subsequently making a stapling line on that area in another direction without overlapping staples.

[0025] FIG. 2.—Shows a view similar to that of the figure above, but in which the jaws of the stapler appear properly closed.

[0026] FIG. 3.—Displays a view similar to that in FIG. 2, but in which the push bar in cam functions of the stapler appears in an intermediate working position.

[0027] FIG. 4.—Shows a detail of the bond between the fabrics after both stapling lines have been made in different directions, and it can be observed that at the free end of the fabrics to be joined do not overlap the staples of one alignment with those of another.

[0028] FIGS. 5 and 6.—Show two expanded details of FIGS. 2 and 3 at the level of the stapler's jaws, so that they can more clearly observe their internal structure.

[0029] FIG. 7.—Shows a sequence of the anastomosis process with the traditional system

[0030] FIG. 8.—Shows a sequence of the anastomosis process with the process of the invention.

[0031] FIGS. 9 and 10.—Show views similar to FIGS. 1 and 2 but corresponding to a variant of realization of the invention in which the stapler includes means of remote operation, for example, for laparoscopic surgeries.

[0032] FIGS. 11 and 12.—Finally, show two expanded details of FIGS. 9 and 10 at the level of the drive media of the upper jaw of the stapler.

PREFERENTIAL REALIZATION OF THE INVENTION

[0033] In view of the figures outlined, it can be observed how the stapler of the invention is constituted, as is conventional, applicable to open or laparoscopic surgeries, being of the type of those that are constituted from a device as scissors, or tilting closure in the case of laparoscopy, in which two arms (1-2) of roasting and pressing, articulated on one axis (3) and topped in jaw paths (4-5), so that in one of these jaws (5) a series of conformations (6) are established internally intended to plastically deform the staples (7) that are arranged on the jaw (4) causing them to curve inward once the tissues are crossed (8-8′) to be joined, for which, staples (7), initially set in “U”, are available on vertically scrollable grinding teeth (9) by the effect of a cam (10) in the form of a sloping plane in which a push bar (11) horizontally scrollable in the sine of the jaw (4) is finished, so that the displacement of the push bar (11) causes the sequential stapling of the tissues (8-8′), as shown in FIGS. 5 and 6.

[0034] Well, from this structuring, the stapler of the invention focuses its characteristics on the fact that between the axis of articulation (3) of the two jaws (4-5) and the initial end at which the aforementioned conformations (6) and grinding wheel are available vertically scrollable (9) on which staples are available (7), a camera (12) is defined as determinant of a space wide enough to allow the free ends (13-13′) of the fabrics to be joined (8-8′), a magnitude and a length greater than the width of the staples (7), in order to define a space between the free end of the staples and the start of the stapling line sufficient to allow to carry out with the same utensil a second line of stapling, perpendicular to it or where appropriate in another direction, without the first staple (7′) applied in this second stapling line (see FIG. 4) overlapping with the first of the staples (7) implanted in the first manoeuvre.

[0035] In FIG. 7 you can see the sequences of the pre-invention process, which are:

A) the part of the intestine is shown to anastomar, with the tumors (20) to be removed, and the holes (21) made to introduce the surgical stapler.
B) The first stapling (22) performed is displayed.
C) The second cross stapling is shown (23)
D) Cutting line shown (24)
E) The segment already sectioned with an extended detail (25) showing the overlap of the staples (26) is displayed.

[0036] FIG. 8 shows the sequences of the process proposed by the invention, which is characterized by having a sufficient space so that the cross stapling does not overlap the first stapling:

A) the part of the intestine is shown to anastomar, with the tumors (20′) to be removed, and the holes (21′) made to introduce the surgical stapler.
B) The first stapling (22′) performed is displayed.
C) The second cross stapling (23′)
D) Cutting line is displayed (24′)
E) The segment already sectioned with an extended detail (25′) is shown showing the non-overlapping of staples (26′).

[0037] As previously said, this prevents the crossing of staples in the sutures, thus avoiding possible anastomotic leaks.

[0038] As for the cutting media provided for in the stapler, these consist of a tilting blade (14), which, in an inoperative situation, will remain hidden the jaw (4), tilting with respect to a turning axis (15), which is axially scrollable in a longitudinal groove of the jaw, not represented in the figures, against the tension of a spring, counting this tilting blade (14) with a brass (16) intended to come into contact with the ramp or cam (10) of the thrust arm (11) during its axial displacement in the sinus of the jaw (4), which causes its initial tilting until it emerges in a cutting arrangement, position in which it will remain angularly unchanged, moving in conjunction with the cam (10) along the longitudinal groove in which its axis plays (15), thus obtaining safer means of cutting.

[0039] The surgical stapler, to ensure proper tissue irrigation, has in the chamber (12) an IrDA-type blood flow-checking device, with emitters (17) and infrared receptors (18) of infrared rays, of appropriate frequency, so that once faced by passing the rays the tissue (13-13′), sends the data to a signaller (19) for example green/red, located in the part of the stapler that is best visualized by the surgeon, in this way the correct position for subsequent sewn is ensured, so it could represent a useful solution that prevents local ischemias in this type of anastomosis, which can be one of the most important causes of failure of intervention by anastomotic leaks.

[0040] This new distal point rapper-cutter device is also applicable to latero-side anastomosis as the only bypass technique, which, represents an advantage, since anastomosis is performed remotely from the holes for the introduction of the mechanical device, and allows the closure of them without continuity with respect to anastomosis.

[0041] Thus, the object of the present invention is to avoid the lack of irrigation of anastomosis, especially by crossing the staples between the latero-lateral anastomosis and that of the section of the surgical piece that is removed.

[0042] According to a variant of practical realization of the invention, the one shown in FIGS. 9 to 12, when the device is intended to be used in laparoscopic surgeries, the lower jaw (4) is subsequently prolonged in a long arm (1′) in whose bosom is axially displaced the already commented push bar that is finished on the aforementioned cam in the form of a sloping plane and which causes the sequential stapling of the tissues, all similar to as described in the first variation of realization, with the particularity that that bar is finished at its other end in a trigger thrust mechanism (27), implanted on the corresponding handle (28), which allows manual and controlled operation of that mechanism.

[0043] As for the means of actuating the upper jaw (5) or pressing, it shall be articulated with respect to the assembly formed by the arm (1′) and the lower jaw (4), through a axis of rotation (3), also defining a chamber (12), as well as the same stapling, cutting and sensor means described for the first example of realization, with the particularity that in order to operate that jaw it is intended that it is required to be required towards its opening position by effect of a spring associated with its axis (3) of tilting, so that, that upper jaw (5) includes in correspondence with its anterior and upper limb, a cavity (29) that is facing the upper edge of that arm (1′) laparoscopic, so that, in correspondence with that upper area of the arm, a rod (30) is axially and manually scrollable, through a guide (31) and that by virtue of such means of guidance it causes the rod to remain parallel to the laparoscopic arm (1′), to cause it, when the end of the rod (30) is inserted into the cavity (29), initially inclined, the rod (30) force the upper jaw (5) to move angularly, coinciding the position of maximum insertion of the rod (30) into the cavity (29) with the total closing position of one jaw against another. A wheel (32) geared with the rod (30), when operated, moves the rod (30) towards the cavity (29). Another wheel (33) regulates the left and right positioning of the stapler when necessary. As previously said, the other characteristics of this stapler do not vary from those described for the variation in the realization of FIGS. 1 to 6.