Anvil support loading for surgical suturing apparatus

Abstract

A surgical stapling system includes an end effector and a support loading assembly. The end effector includes an anvil assembly. The support loading assembly includes an anvil support and an anvil support loader. The anvil support loader supports the anvil support and includes a support plate and a slide. The support plate includes a flexible locking arm. The carriage is coupled to the support plate by a flexible locking arm. The slide supports the anvil support and is configured to slide the anvil support onto the anvil assembly. The slide is configured to move relative to the support plate when the flexible lock arm is disconnected from the slide.

Description

[0001] This application claims priority to U.S. Provisional Patent Application 63 / 433,877, filed on Dec. 20, 2022, the entire content of which is incorporated herein by reference. Technical Field

[0002] This application relates to surgical stapling systems, and more particularly to systems, devices, and methods for loading a support member onto an anvil of a surgical stapling device. Background Art

[0003] Surgeons use surgical stapling devices to sequentially or simultaneously apply one or more rows of fasteners (e.g., staples or two-part fasteners) to body tissue for joining body tissue segments together. Such devices typically include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the surgical stapling device is actuated or "fired," a staple driver member in one of the jaws pushes surgical staples through the body tissue into an anvil in the opposite jaw, which forms the staples. If the body tissue is to be removed or separated, a blade can be provided in one of the jaws of the device to cut the body tissue between the rows of staples.

[0004] Surgical supports (e.g., meshes or support materials) can be used in combination with surgical stapling devices to bridge, repair, and / or reinforce tissue defects in a patient's body, such as those that occur in, for example, the abdominal wall, chest wall, diaphragm, or aponeurotic regions of the body. The support material will strengthen the rows of staples and cover the tissue junctions to reduce leakage prior to healing. The support material can help promote proper staple formation while reducing distortion / deformation caused by any misalignment and / or abnormalities or non-uniformities of the tissue. The support material can also provide support to weak tissue or help address differences in tissue thickness.

[0005] Accordingly, support materials provide clinical benefits. Nevertheless, improvements are desired, such as to reduce the complexity of manufacturing the support material and / or applying the support material to the surgical stapling device or to the tissue, or to expand the range of applications in which the support material can be used. Summary of the Invention

[0006] A simple and intuitive method for applying a support member material to an anvil assembly of a staple cartridge-based suturing system is needed. This disclosure details such a system for loading a support member material onto an anvil assembly, which is characterized in that the support member can be fully loaded and held on the anvil. Advantageously, the anvil support member loader of the support member loading assembly of this disclosure can act as a shipping cover for the support member, facilitating the transfer of the support member onto the anvil assembly, preventing the user from deploying the support member when the support member loading assembly is not fully loaded onto the anvil assembly, preventing the user from only partially loading the support member, and preventing the anvil support member loader from being reset.

[0007] According to one aspect, this disclosure relates to a support member loading assembly for an anvil assembly of a surgical suturing device. The support member loading assembly includes an anvil support member and an anvil support member loader. The anvil support member loader includes a support plate, a carriage, and a shroud. The support plate includes a flexible locking arm. The carriage is mounted to the support plate and is selectively movable relative to the support plate in response to movement of the flexible locking arm of the support plate relative to the carriage. The carriage supports the anvil support member and is configured to slide the anvil support member onto the anvil assembly when the carriage moves relative to the support plate. The shroud is mounted on the carriage and fixed to the support plate. The shroud includes support member fingers that engage the anvil support member and are movable relative to the shroud in response to the anvil assembly being inserted into engagement with the support member fingers, such that the anvil assembly can cause the flexible locking arm of the support plate to move relative to the carriage.

[0008] In various aspects, the carriage may include a visual indicator protrusion, and the shroud may be defined with a visual indicator slot that receives the visual indicator protrusion of the carriage. The visual indicator protrusion of the carriage may slide through the visual indicator slot of the shroud to indicate when the anvil support member is loaded onto the anvil assembly. The carriage may include an arch. The arch may support the visual indicator protrusion and may be defined with a recess that is configured to receive the flexible locking arm to selectively fix the flexible locking arm to the carriage. The anvil support member may be fixed to the visual indicator protrusion.

[0009] In various aspects, the support plate may be defined with an elongated locking notch, and the carriage may include a locking member that is slidably received within the elongated locking notch. The elongated locking notch may include a tapered surface that compresses the locking member. The elongated locking notch may include shoulder stops that prevent the locking member from sliding through the elongated locking notch when the anvil support member is loaded onto the anvil assembly.

[0010] In various aspects, the support plate can include arms having teeth configured to secure the support plate to the anvil assembly. The carriage can include cam bosses that engage the arms to disconnect the support plate from the anvil assembly as the carriage translates relative to the support plate.

[0011] In various aspects, the carriage can include forks coupled to the anvil support to secure the anvil support to the carriage.

[0012] According to another aspect, the present disclosure relates to a surgical suturing system. The surgical suturing system includes an end effector and a support member loading assembly, the end effector including an anvil assembly. The support member loading assembly includes an anvil support and an anvil support loader that supports the anvil support. The anvil support loader includes a support plate and a carriage. The support plate includes flexible locking arms. The carriage is coupled to the support plate by the flexible locking arms. The carriage supports the anvil support and is configured to slide the anvil support onto the anvil assembly. The carriage is configured to move relative to the support plate when the flexible locking arms are disconnected from the carriage.

[0013] In various aspects, the anvil support loader can further include a shroud secured to the support plate and configured to cover the anvil support. The shroud can include support fingers that engage the anvil support. The support fingers can move relative to the anvil support when the anvil assembly is inserted into the shroud.

[0014] In various aspects, the anvil assembly can include a spring clip configured to secure a proximal portion of the anvil support to the anvil assembly. The carriage can include a cam drive track that supports a cam drive shoulder. The cam drive shoulder can be configured to pivot the spring clip to enable the anvil support to extend between the spring clip of the anvil assembly and the anvil body of the anvil assembly.

[0015] In various aspects, the anvil body can extend to a distal end, and the anvil support can define an elongated end slot in a distal portion of the anvil support. The distal end of the anvil body can be received through the elongated end slot to secure the distal portion of the anvil support to the anvil assembly.

[0016] In various aspects, the support plate can further include inner arms having teeth on proximal portions of the inner arms. The anvil assembly can include wings that define windows. The teeth can be configured to be selectively pivotally received within the windows to selectively secure the support plate to the anvil assembly. The carriage can include cam bosses that axially translate into engagement with the inner arms as the carriage translates relative to the support plate to pivot the teeth out of the windows.

[0017] According to another aspect, the present disclosure relates to an anvil support loader. The anvil support loader includes a support plate, a shroud, and a carriage. The shroud is fixed to the support plate and includes a first indicator bump and a second indicator bump. The carriage is mounted to the support plate. The carriage is selectively movable relative to the support plate and the shroud to load a support onto the anvil. The carriage includes a pivotable arm member that is selectively attached to the anvil by teeth supported on an end of the pivotable arm member. The carriage includes a visual indicator projection that moves from the first indicator bump to the second indicator bump as the carriage moves relative to the support plate. The carriage includes a cam boss that pivots the teeth away from the anvil as the visual indicator projection slides from the first indicator bump to the second indicator bump.

[0018] Other features of the present disclosure will be understood from the following description. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The above and other aspects, features, and advantages of the present disclosure will be apparent when the following detailed description is considered in conjunction with the accompanying drawings, which are incorporated in and constitute a part of this specification, in which:

[0020] Figure 1 is a perspective view of a surgical suturing device of a surgical suturing system according to the principles of the present disclosure;

[0021] Figure 2A and Figure 2B is a perspective view of a support loading assembly of the surgical suturing system including the Figure 1 surgical suturing device;

[0022] Figure 3 is Figure 2A and Figure 2B a perspective view of the support loading assembly with the parts separated;

[0023] Figure 4 is Figure 2A and Figure 2B a bottom perspective view of the carriage of the support loading assembly;

[0024] Figure 5 is Figure 4 an enlarged view of the indicated detail area shown in

[0025] Figure 6 is Figure 3 an enlarged view of the indicated detail area shown in

[0026] Figure 7 is Figure 2A and Figure 2B a bottom perspective view of the shroud of the support loading assembly;

[0027] Figure 8 is Figure 2A an enlarged view of the indicated detail region shown in;

[0028] Figure 9 is Figure 2A and Figure 2B an enlarged perspective view of the support member loading assembly of, with the shroud and support plate of the support member loading assembly removed for clarity;

[0029] Figure 10 is Figure 2A an enlarged cross-sectional view taken along section line 10-10 shown in;

[0030] Figure 11 is Figure 2A an enlarged cross-sectional view taken along section line 11-11 shown in;

[0031] Figures 12 to 25 illustrates Figure 2A and Figure 2B the support member of the support member loading assembly securing the support member of the support member loading assembly to Figure 1 the anvil of a surgical suturing device; and

[0032] Figure 26 shows Figure 1 the Figure 2A and Figure 2B support member of the support member loading assembly of fixed to the anvil of a surgical suturing device. DETAILED DESCRIPTION

[0033] Aspects of the present disclosure will now be described in detail with reference to the accompanying drawings, in which like reference numerals represent like or identical elements. Throughout the description, the term "proximal" refers to the part of a structure or its component that is closer to the user, while the term "distal" refers to the part of a structure or its component that is farther from the user. Directional reference terms (such as "top", "bottom", "side", "upper", "lower", etc.) are used to simplify the description of aspects and are not intended to have any limiting effect on the ultimate orientation of the structure or any of its parts. Additionally, the term "endoscopic" is generally used to refer to endoscopic surgery, laparoscopic surgery, arthroscopic surgery, and / or any other surgery performed through small diameter incisions or trocars. Further, the term "clinician" is generally used to refer to medical personnel, including doctors, nurses, surgeons, and support staff.

[0034] In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure with unnecessary details.

[0035] Now referring to Figure 1 、 Figure 2A andFigure 2B , a surgical suture system according to the present disclosure includes a surgical suture device or stapler 10 and a support member loading assembly 100 for suturing tissue and applying one or more anvil and / or cartridge support members or surgical support members 200, 300 to the tissue. The surgical suture device 10 generally includes a handle assembly 12 and an elongate tubular body portion 14 extending distally from the handle assembly 12, which may be in the form of an adapter assembly selectively removable from the handle assembly 12. The elongate tubular body portion 14 may include a surgical loading unit 16 selectively attachable to the elongate tubular body portion 14. An end effector or jaw assembly 18 extends distally from the elongate tubular body portion 14 (e.g., the distal portion of the surgical loading unit 16). The jaw assembly 18 includes an anvil assembly 20 and a staple cartridge assembly 21. The jaw assembly 18 may be permanently attached to the elongate tubular body portion 14 or may be detachable relative to the elongate tubular body portion 14, and thus may be replaced with a new jaw assembly 18. The anvil assembly 20 and / or the staple cartridge assembly 21 are pivotable relative to the elongate tubular body portion 14 such that the anvil assembly 20 and / or the staple cartridge assembly 21 can move between an open position and a closed position (not shown), in the open position, the anvil assembly 20 and the staple cartridge assembly 21 are spaced apart from each other ( Figure 1 ), in the closed position, the anvil assembly 20 and the staple cartridge assembly 21 are substantially adjacent to each other.

[0036] The handle assembly 12 of the surgical suture device 10 includes any number of actuators 12a, 12b, 12c to facilitate the firing of the jaw assembly 18, the articulation and / or rotation of the jaw assembly 18 relative to the handle assembly 12, and / or the opening and / or closing of the anvil assembly 20 and / or the cartridge assembly 21 to clamp tissue therebetween. The jaw assembly 18 is configured to apply a staple row (not shown) to the tissue captured between the anvil assembly 20 and the staple cartridge assembly 21 upon firing.

[0037] For a detailed description of the structure and function of an exemplary surgical stapling device (which may include or modify one or more components of the exemplary surgical stapling device for use with the disclosed aspects), reference may be made to U.S. Patent Nos. 11,432,818; 8,256,656; 7,819,896; and / or 7,128,253, the entire contents of each of which are incorporated herein by reference. It should be understood that the principles of the present disclosure are equally applicable to surgical stapling devices having other configurations, such as those described in U.S. Patent Nos. 7,334,717; 5,964,394; and 5,915,616, the entire contents of each of which are incorporated herein by reference. Accordingly, it should be understood that various surgical stapling devices may be used with the surgical support and / or surgical support applicator or loader of the present disclosure, such as laparoscopic staplers, open staplers, lateral anastomosis staplers, and end-to-end anastomosis staplers having circular staple cartridges and anvil, as well as staple cartridge assemblies that accommodate surgical fasteners other than staples.

[0038] As Figure 1 , Figure 12 and Figure 26As seen, the anvil assembly 20 of the jaw assembly 18 of the surgical stapling device 10 includes an anvil body 20a having a proximal portion and a distal portion, the proximal portion including a tissue stop 20x configured to prevent tissue from shifting proximally, and the distal portion having a distal tip 20b. The tissue stop 20x has a pair of tissue stop wings 20c, 20d that extend outwardly and downwardly from opposite side surfaces of the anvil body 20a. Each wing 20c, 20d defines a pivot pin hole 20e in a proximal portion of the respective wing for supporting a pivot pin 30 and enabling pivotal movement between the anvil assembly 20 and the staple cartridge assembly 21. Each wing 20c, 20d further defines a window 20f in a distal portion of the respective wing to enable selective attachment of the support member loading assembly 100 to the anvil assembly 20. Each wing 20c, 20d further includes a distal cam drive edge 20g. The anvil assembly 20 further includes a first spring clip 22 and a second spring clip 24 that are flexibly mounted to the anvil body 20a and supported on opposite sides of a knife channel 26 defined through the anvil assembly 20. Proximal portions 22a, 24a of the first spring clip 22 and the second spring clip 24 are fixed to the anvil body 20a, between the wings 20c, 20d and proximal to anvil cavities 28 defined in the anvil body 20a for shaping staples (not shown) fired from the staple cartridge assembly 21. Each of the first spring clip 22 and the second spring clip 24 extends distally to outer bifurcated fingers 23a and inner bifurcated fingers 23b that are configured to flex away from the anvil body 20a when a pivoting force is applied to distal portions of the first spring clip 22 and the second spring clip 24, but bias back toward an un-flexed position adjacent to the anvil body 20a when the pivoting force is removed ( Figure 26 ). The inner bifurcated fingers 23b are disposed medial to the outer bifurcated fingers 23a and adjacent to the knife channel 26. The inner bifurcated fingers 23b include a proximal section 23p and a distal section 23d that angles away from the proximal section 23p and away from the anvil body 20a. The outer bifurcated fingers 23a include a proximal section 23pp and a distal section 23dd that angles toward the anvil body 20a (e.g., curves).

[0039] Reference Figures 3 to 5, the support member loading assembly 100 of the disclosed surgical suturing system includes an anvil support member 200 and an anvil support member loader 101 for loading the anvil support member 200 onto the surgical suturing device 10. Advantageously, the anvil support member loader 101 of the support member loading assembly 100 acts as a shipping cover for the anvil support member 200, facilitating the transfer of the anvil support member 200 to the anvil assembly 20, preventing the user from deploying the anvil support member 200 when the support member loading assembly 100 is not fully inserted onto the anvil assembly 20, preventing the user from only partially loading the anvil support member 200 onto the anvil assembly 20, and preventing the anvil support member loader 101 from being reset. In fact, the anvil support member loader 101 is a delivery system that helps eliminate or reduce user errors during the application of the anvil support member 200 to the anvil assembly 20.

[0040] The anvil support member 200 of the support member loading assembly 100 includes a support member body 202. The support member body 202 has a proximal portion 202a and a distal portion 202b. The proximal portion 202a of the support member body 202 includes spaced-apart extensions 204 (e.g., laterally spaced apart from each other). Each extension 204 defines a forked opening 204a passing through a ferrule 205 that is supported on the proximal ends of the spaced-apart extensions 204. The ferrule 205 may have a semi-circular profile. The proximal portion 202a of the support member body 202 further defines an elongate clamping groove 206 that extends transversely on the support member body 202 relative to the length of the support member body 202. The distal portion 202b of the support member body 202 includes a jaw engagement portion 208 that angles upwardly from the support member body 202 and defines an elongate end slot 208a passing through the jaw engagement portion. The elongate end slot 208a also extends transversely on the support member body 202 relative to the length of the support member body 202. The distal portion 202b further includes a tab 210 that extends distally from the jaw engagement portion 208. The tab 210 defines an indicator slot 210a that extends longitudinally along the tab 210. The tab 210 is connected to the jaw engagement portion 208 by a frangible portion 208b such that the tab 210 can be separated from the support member body 202.

[0041] The anvil support member loader 101 of the support member loading assembly 100 includes a shroud 102, a carriage 104, and a support plate 106.

[0042] Reference Figure 3 、 Figure 7 、 Figure 8 、 Figure 13 and Figure 25, the shroud 102 of the anvil support loader 101 includes an elongated body 102a having a curved or semi-circular cross-section. The elongated body 102a defines a central channel 102b extending along the length of the elongated body 102a. The elongated body 102a includes a support finger 102c that hangs from an intermediate portion of the elongated body 102a into the central channel 102b defined by the elongated body 102a. The elongated body 102a further defines an elongated finger opening 102d along an intermediate portion of the elongated body 102a. The support finger 102c has a proximal portion fixed to the elongated body 102a. The support finger 102c extends downwardly and distally from the elongated body 102a along the elongated finger opening 102d of the elongated body 102a to a free end 102e disposed in the central channel 102b. In fact, as Figure 10 seen in, the support finger 102c is inclined or angled relative to the elongated body 102a such that the free end 102e of the support finger 102c is configured to engage the top surface of the anvil support 200 to restrain the anvil support 200 between the shroud 102 of the anvil support loader 101 and the carriage 104 during shipping. The support finger 102c is flexible and configured to pivot from an initial position ( Figure 13 ) to a flexed position ( Figure 16 , as indicated by arrow "J") in response to an axial force from the distal end 20b of the anvil assembly 20 when the anvil assembly 20 moves (e.g., axially translates) into engagement with the support finger 102c (as indicated by arrow "X"). The elongated body 102a further defines a visual indicator slot 102f that extends longitudinally along a distal portion of the elongated body 102a. The elongated body 102a also includes a distal indicator bump 102g adjacent the distal end of the visual indicator slot 102f and a proximal indicator bump 102h adjacent the proximal end of the visual indicator slot 102f. The distal indicator bump 102g may have a surface colored a first color (e.g., red), and the proximal indicator bump 102h may have a surface colored a second color (e.g., green) such that the proximal indicator bump 102h and the distal indicator bump 102g can be used as position indicators of the carriage 104 relative to the shroud 102 and / or the position of the support loading state (e.g., the support 200 is loaded and / or not loaded onto the anvil assembly 20). The elongated body 102a further includes mounting hooks 102k that are spaced apart along both sides of the elongated body 102a for securing the shroud 102 to the support plate 106.

[0043] Now refer to Figures 3 to 5 、 Figure 8 、 Figure 9 、 Figure 13 、 Figure 16 、Figure 20 and Figure 22 , the carriage 104 of the anvil support loader 101 includes a carriage body 104a, which is shown as rectangular, but other shapes are conceivable. The carriage body 104a includes a proximal portion 104b and a distal portion 104c. The carriage body 104a includes a first wing 104d and a second wing 104e, which extend in opposite directions to opposite sides of the carriage body 104a. The side surfaces of the carriage body 104a extend between the top surface 104x and the bottom surface 104y of the carriage body 104a. Each of the first wing 104d and the second wing 104e has a plurality of spaced ribs 104b, which extend along the corresponding side surface of the carriage body 104a to assist the user in grasping the carriage body 104a. The carriage body 104a further includes an arch 104g, which extends above the top surface 104x of the carriage body 104a at the distal portion 104c of the carriage body 104a. As Figure 8 and Figure 25 seen, the arch 104g further includes a visual indicator projection 104h, which projects upward from the apex of the top surface of the arch 104g and is slidably received within the visual indicator slot 102f of the shield 102 (as indicated by the arrow "S"). The visual indicator projection 104h is also received within the indicator slot 210a of the tab 210 of the anvil support 200 (as Figure 9 seen), so that the tab 210 of the anvil support 200 can extend above the arch 104g to maintain the jaw engagement portion 208 and the elongated end slot 208a of the jaw engagement portion 208 with the distal portion of the anvil support 200 elevated above the support body 202, thereby facilitating the reception of the distal end 20b of the anvil body 20a through the elongated end slot 208a. The arch 104g is further defined with a tab recess 104p (see Figure 13 and Figure 16 ), which is located in the bottom surface of the arch 104g, adjacent to the apex of the arch 104g. The carriage body 104a is further defined with elongated sliding channels 104k, which are aligned with the intermediate mounting hook 1020k of the mounting hooks 102k of the shield 102 (see Figure 3 ), for slidably receiving the intermediate mounting hook 1020k of the shield 102 within the elongated sliding channels 104k of the carriage 104, so that the carriage 104 can slide relative to the shield assembly 102 and the support plate assembly 106, as Figure 20 and Figure 22 indicated by the arrow "A" in.

[0044] The bottom surface 104y of the carriage body 104a includes a locking member 104m that hangs from an intermediate portion of the bottom surface 104y. The locking member 104m is shown as having a chevron shape, but any suitable shape may be envisioned. The locking member 104m includes legs 1042m that are connected at a rounded end 1044m that points in the proximal direction. The legs 1042m are configured to flex inwardly toward each other when a compressive force is applied, as indicated by arrow "B" (see Figure 20 ), and are configured to return to their initial position (e.g., not flexed) when the compressive force is removed, as indicated by arrow "C" (see Figure 22 ). A guide member 104n having a T-shaped configuration (but any suitable shape may be envisioned) is proximal to the locking member 104m and hangs from the bottom surface 104y of the carriage body 104a adjacent to the proximal portion 104b of the carriage body 104a.

[0045] Also refer to Figure 3 、 Figure 5 、 Figure 9 、 Figure 21 and Figure 24 , the carriage body 104a of the carriage 104 further includes a head assembly 105 that extends proximally from the proximal portion 104b of the carriage body 104a. The head assembly 105 includes spaced-apart fork portions 105a that have noses 105b that are received through fork openings 204a in an extension 204 of an anvil support 200. As Figure 9 shown, the spaced-apart fork portions 105a further include abutment portions 105c that are distal to the noses 105b and that limit sliding movement of the extension 204 distally along the fork portions 105a to maintain the anvil support 200 extending along the anvil support loader 101. The head assembly 105 further includes cam bosses 105d that are adjacent to distal portions of the fork portions 105a and that hang from the bottom surface 104y of the carriage body 104a. The head assembly 105 further includes a cam drive track 105e that extends proximally from the carriage body 104a and that is disposed between the spaced-apart fork portions 105a. The cam drive track 105e includes cam drive shoulders 105f that are disposed on opposite sides of a proximal portion of the cam drive track 105e. The cam drive shoulders 105f are configured to cam along inner bifurcated fingers 23b of a first spring clip 22 and a second spring clip 24 such that when the carriage 104a slides proximally relative to the shroud 102, as indicated by arrow "A" (see Figure 21), causing the first spring clip 22 and the second spring clip 24 to deflect or pivot downwardly away from the anvil body 20a, as indicated by arrow "D". The cam drive shoulder 105f is also configured such that the first spring clip 22 and the second spring clip 24 can effect a proximal cam movement beyond the inner bifurcated fingers 23b of the first spring clip 22 and the second spring clip 24, as indicated by arrow "F" ( Figure 24 ), such that the first spring clip 22 and the second spring clip 24 can be biased or deflected back to their initial positions relative to the anvil body 20a, as indicated by arrow "G" (e.g., very close to the anvil body 20a), such that the outer bifurcated fingers 23a of the first spring clip 22 and the second spring clip 24 can be received within the elongated clip slots 206 of the anvil support 200 to secure the proximal portion of the anvil support 200 to the anvil body 20a.

[0046] Turning now to Figure 3 、 Figure 6 、 Figure 11 、 Figure 14 、 Figure 15 and Figure 19 , the support plate 106 of the anvil support loader 101 includes a proximal portion 106a and a distal portion 106b. As seen in Figure 14 and Figure 15 , the support plate 106 defines mounting recesses 106c which are defined and spaced along the side surface of the support plate 106 and which are aligned with and configured to engage the mounting hooks 102k of the shroud 102 such that the shroud 102 can snap fit onto the support plate 106 to fixedly secure the shroud 102 and the support plate 106 together. The support plate 106 further includes a flexible locking arm 106d which may have a curved configuration, is provided at the distal portion 106b and extends upwardly from the support plate 106. As seen in Figure 16 , the flexible locking arm 106d is configured to deflect or pivot downwardly in response to an axial force "I" applied by the distal end 20b of the anvil assembly 20 advancing distally into the flexible locking arm 106d, as indicated by arrow "H". The locking arm 106d further includes a locking tab 106e extending upwardly from the distal end of the locking arm 106d which is selectively receivable within a tab recess 104p of the carriage 104 to secure the carriage 104 to the support plate 106 and prevent longitudinal translation of the carriage 104 relative to the support plate 106, thereby preventing a user from deploying the anvil support 200 in the event that the anvil support loader 101 is not fully inserted onto the anvil assembly 20.

[0047] As seen in Figure 3As best seen in, the support plate 106 of the anvil support loader 101 further defines an elongated locking notch 106f in the middle portion of the support plate 106, and the elongated locking notch slidably supports the locking member 104m of the slide 104. The elongated locking notch 106f includes a distal portion 106g, a middle portion 106h, and a proximal portion 106i. In the distal portion 106g, the locking member 104m of the slide is configured to slide freely along the support plate 106. The middle portion 106h and the proximal portion 106i are separated by a shoulder stop 106k. In the middle portion 106h, the legs 1042m of the locking member 104m are compressed together by a tapered surface 106j (as indicated by arrow "B" and as seen in Figure 20 ), to push the locking member 104m into the proximal portion 106i, in which the legs 1042m are biased outwardly (as indicated by arrow "C"), such that the shoulder stop 106k prevents the locking member 104m from sliding back into the middle portion 106h or the distal portion 106g, as seen in Figure 22 . When the locking member 104m is prevented from sliding in the distal direction, the slide 104 cannot move relative to the support plate 106, thereby preventing the anvil support loader 101 from being reset.

[0048] Now referring to Figure 6 , the support plate 106 further defines a T-shaped slot 106m in the proximal portion of the support plate 106, and the T-shaped slot slidably supports the guide member 104n of the slide 104 to guide the slide 104 along the support plate 106. The proximal portion of the support plate 106 includes a central finger 106n, which extends proximally from the support plate 106 and the proximal portion of the T-shaped slot 106m extends into the central finger. The proximal portion of the support plate 106 further includes an outer arm 106p and an inner arm 106r, and these inner arms can move flexibly relative to the outer arm 106p and the central finger 106n. Each inner arm 106r has teeth 106t, which extend outwardly away from the central finger 106n and toward the corresponding outer arm 106p. Each inner arm 106r further includes an elbow 106q, which is configured to engage the cam boss 105d of the slide 104. The elbow 106q can have a curved configuration. The outer arm 106p further includes an anvil stop 106v, and these anvil stops limit the movement of the anvil assembly 20 relative to the support plate 106 (see Figure 15 ). The proximal portion of the support plate 106 also defines spaced-apart cam boss channels 106x, and these cam boss channels are configured to slidably receive the cam bosses 105d of the slide 104 when the slide 104 slides relative to the support plate 106.

[0049] Referring to Figure 14 , Figure 15 and Figure 19, to prevent the user from only partially loading the anvil support 200, the anvil assembly 20 and the anvil support loader 101 are moved closer (e.g., longitudinally translated as indicated by arrow "M") such that the distal cam drive edges 20g of the wings 20c, 20d of the anvil assembly 20 engage the teeth 106t of the support plate 106, causing the teeth 106t and the inner arm 106r to flex or pivot inwardly towards the central finger 106n (as indicated by arrow "N") such that when the anvil support loader 101 is longitudinally translated towards the anvil assembly 20, the teeth 106t can travel along the inner surfaces of the wings 20c, 20d until the teeth 106t are aligned with the windows 20f of the wings 20c, 20d to enable the teeth 106t to snap into the windows 20f, thereby locking the support plate 106 to the anvil assembly 20, as indicated by arrow "O". In this position, as Figure 15 seen in, the anvil stop 106v abuts against the distal ends of the wings 20c, 20d of the anvil assembly 20 and prevents further insertion of the anvil assembly 20 relative to the support plate 106.

[0050] To disengage the teeth 106t of the support plate 106 from the windows 20f of the anvil assembly 20, the slider 104 advances towards the anvil assembly 20 relative to the support plate 106 such that the cam boss 105d of the slider slides along the cam boss channel 106x of the support plate 106, as indicated by arrow "P" ( Figure 20 ). When the cam boss 105d and the slider 104 continue to slide in the proximal direction relative to the support plate 106, the anvil support 200 is fully loaded onto the anvil assembly 20 and the cam boss 105d engages the elbow 106q of the inner arm 106r to pivot the teeth 106t and the inner arm 106r out of the windows 20f of the anvil assembly 20, as Figure 22 indicated by arrow "Q" shown in. In this position, the visual indicator projection 104h will be set to be adjacent to the proximal indicator bump 102h (as Figure 25 seen in) to provide an indication to the clinician that the locking member 104m is locked within the proximal portion 106i of the elongated locking notch 106f to prevent movement of the slider 104 relative to the support plate 106 and that the anvil support 200 is fully loaded onto the anvil assembly 20. In particular, as Figure 26 seen in, when the anvil support 200 is fully loaded onto the anvil assembly 20, the distal end 20b of the anvil assembly 20 is fixed within the elongated end slot 208a at the distal portion 202b of the anvil support 200, and the proximal portion 202a of the anvil support 200 is fixed between the first clip 22 and the second clip 24 and the anvil body 20a. In the case where the teeth 106t pivot out of the windows 20f, the anvil support loader 101 can be separated from the anvil support 200 and the anvil assembly 20 by removing the anvil support loader 101 from the distal side.

[0051] The support of the present disclosure can be made of biocompatible materials, which are bioabsorbable or non-absorbable, natural materials or synthetic materials. It should be understood that any combination of natural materials, synthetic materials, bioabsorbable materials, and / or non-bioabsorbable materials can be used to form the surgical support. The support can be biodegradable (e.g., formed from bioabsorbable and bioresorbable materials), such that the support decomposes or degrades (physically or chemically) under physiological conditions in the body, and the degradation products can be excreted or absorbed by the body. The components or parts of the support can be formed of the same material or different materials.

[0052] In various aspects, at least a portion of the support is made of a biodegradable material selected from the group consisting of natural rubber materials, catgut, and synthetic resins, including synthetic resins derived from alkylene carbonates, trimethylene carbonate, tetramethylene carbonate, caprolactone, valerolactone, dioxanone, polyanhydrides, polyesters, polyacrylates, polymethyl methacrylate, polyurethanes, glycolic acid, lactic acid, glycolide, lactide, polyhydroxybutyrate, polyorthoesters, polyhydroxyalkanoates, their homopolymers, and their copolymers. In various aspects, at least a portion of the surgical support can be made of a non-biodegradable material selected from the group consisting of polyolefins, polyethylene, polydimethylsiloxane, polypropylene, copolymers of polyethylene and polypropylene, blends of polyethylene and polypropylene, ultra-high molecular weight polyethylene, polyamides, polyesters, polyethylene terephthalate, polytetrafluoroethylene, polyether esters, polybutyl esters, polytetramethylene ether glycol, 1,4-butanediol, and polyurethanes.

[0053] The support can be porous, non-porous, or a combination thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and / or foams (e.g., open-cell foams or closed-cell foams). Suitable non-porous structures include, for example, membranes. The support or a portion thereof can be a non-woven structure, a mesh material, a braided material, and / or a molded or extruded sheet formed by meltblowing or melt spinning methods. The support or a portion thereof can be a single porous or non-porous layer, or include multiple layers having any combination of porous layers and / or non-porous layers.

[0054] The support can be provided and / or sold as part of a support loader and / or loading unit. Alternatively, the support, the support loader, and / or the support loading assembly or unit can be provided and / or sold separately and assembled by the user. In various aspects, one or more supports, one or more support loaders, and / or loading assemblies are provided in a kit. In some aspects, the kit further includes one or more end effectors (and / or surgical loading units), and in certain aspects, the kit further includes a surgical stapler.

[0055] In any aspect disclosed herein, the support member can include brachytherapy materials or drugs, chemotherapy materials or drugs, other medical materials or drugs, or be used in conjunction with such materials or drugs. The support member can have pits, apertures, or other features for holding a brachytherapy seed in place with the support member, or the brachytherapy seed or material can be incorporated into one or more sutures that are threaded through, passed through, or otherwise attached to the support member. A coating having a brachytherapy material can be applied to the support member by spraying or dipping. Chemotherapy drugs or agents can be incorporated into the support member, coated on the support member, or otherwise applied as part of a suture or other feature attached to the support member.

[0056] It will be appreciated that known fixation techniques, such as welding, crimping, gluing, fastening, etc., can be used to effect the fixation of any component of the presently disclosed devices.

[0057] The various aspects disclosed herein can also be configured to work with robotic surgical systems, which are commonly referred to as "remote surgery". Such systems employ various robotic elements to assist the clinician and allow for the remote operation (or partial remote operation) of surgical instruments. Various robotic arms, gears, cams, pulleys, electric motors, and mechanical motors, etc. can be used for this purpose and can be designed to work with a robotic surgical system to assist the clinician during an operation or treatment. Such robotic systems can include remotely manipulable systems, automated flexible surgical systems, remotely flexible surgical systems, remotely articulated motion surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

[0058] The robotic surgical system can be used with one or more consoles located beside the operating room or at a remote location. In such a case, a team of clinicians can prepare the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein, while another clinician (or team of clinicians) remotely controls the instruments via the robotic surgical system. It will be appreciated that a highly skilled clinician can perform multiple procedures at multiple locations without leaving their remote console, which is both economically advantageous and productive for a single patient or a series of patients. For a detailed description of exemplary medical workstations and / or their components, reference can be made to U.S. Patent No. 8,828,023 and PCT Application Publication No. WO 2016 / 025132, the entire contents of each of which are incorporated herein by reference.

[0059] Those skilled in the art will understand that the structures and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary aspects, and the description, disclosure, and drawings should be understood only as examples of specific aspects. Accordingly, it should be understood that the present disclosure is not limited to the precise aspects described, and that various other changes and modifications can be made by those skilled in the art without departing from the scope or spirit of the present disclosure. Additionally, it is contemplated that, without departing from the scope of the present disclosure, the elements and features illustrated or described in connection with one exemplary aspect can be combined with the elements and features of another exemplary aspect, and such modifications and variations are also intended to be included within the scope of the present disclosure. Indeed, any combination of the currently disclosed elements and features is within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been specifically shown and described.

Claims

1. A support member loader assembly for an anvil assembly of a surgical suturing device, the support member loader assembly comprising: An anvil support member; And An anvil support member loader, the anvil support member loader comprising: A support plate, the support plate including a flexible locking arm; A carriage, the carriage being mounted to the support plate and being selectively movable relative to the support plate in response to movement of the flexible locking arm of the support plate relative to the carriage, the carriage supporting the anvil support member and being configured to slide the anvil support member onto the anvil assembly when the carriage moves relative to the support plate; and A shroud, the shroud being mounted on the carriage and fixed to the support plate, the shroud including a support finger that engages the anvil support member and is movable relative to the shroud in response to the anvil assembly being inserted into engagement with the support finger such that the anvil assembly can cause the flexible locking arm of the support plate to move relative to the carriage.

2. The support loading assembly according to claim 1, wherein, The carriage includes a visual indicator protrusion, and the shroud defines a visual indicator slot that receives the visual indicator protrusion of the carriage, wherein the visual indicator protrusion of the carriage slides through the visual indicator slot of the shroud to indicate when the anvil support member is loaded onto the anvil assembly.

3. The support loading assembly according to claim 2, wherein, The carriage includes an arch that supports the visual indicator protrusion and defines a recess that is configured to receive the flexible locking arm to selectively secure the flexible locking arm to the carriage.

4. The support member loading assembly according to claim 2, wherein, The anvil support member is fixed to the visual indicator protrusion.

5. The support member loading assembly according to claim 1, wherein, The support plate defines an elongate locking notch, and the carriage includes a locking member that is slidably received within the elongate locking notch.

6. The support loading assembly according to claim 5, wherein, The elongate locking notch includes a tapered surface that compresses the locking member.

7. The support loading assembly according to claim 5, wherein, The elongate locking notch includes a shoulder stop that prevents the locking member from sliding through the elongate locking notch when the anvil support member is loaded onto the anvil assembly.

8. The support loading assembly according to claim 1, wherein, The support plate includes an arm that has teeth that are configured to secure the support plate to the anvil assembly.

9. The support loading assembly according to claim 8, wherein, The carriage includes a cam boss that engages the arm to disconnect the support plate from the anvil assembly when the carriage translates relative to the support plate.

10. The support loading assembly according to claim 1, wherein, The carriage includes a fork that is coupled to the anvil support member to secure the anvil support member to the carriage.

11. A surgical suturing system, comprising: An end effector that includes an anvil assembly; And A support member loader assembly, the support member loader assembly comprising: An anvil support member; and An anvil support member loader that supports the anvil support member, the anvil support member loader comprising: A support plate, the support plate including a flexible locking arm; and A carriage, the carriage being coupled to the support plate by the flexible locking arm, the carriage supporting the anvil support and configured to slide the anvil support onto the anvil assembly, the carriage being configured to move relative to the support plate when the flexible locking arm is decoupled from the carriage.

12. The surgical suture system according to claim 11, wherein, The anvil support loader further includes a shroud, the shroud being fixed to the support plate and configured to cover the anvil support.

13. The surgical suture system according to claim 12, wherein, The shroud includes support fingers that engage the anvil support.

14. The surgical suture system according to claim 13, wherein, When the anvil assembly is inserted into the shroud, the support fingers are capable of moving relative to the anvil support.

15. The surgical suturing system according to claim 11, wherein, The anvil assembly includes a spring clip configured to secure a proximal portion of the anvil support to the anvil assembly.

16. The surgical suture system according to claim 15, wherein, The carriage includes a cam drive track that supports a cam drive shoulder configured to pivot the spring clip so that the anvil support can extend between the spring clip of the anvil assembly and the anvil body of the anvil assembly.

17. The surgical suture system according to claim 11, wherein, The anvil body extends to a distal end, and wherein the anvil support defines an elongated end slot in a distal portion of the anvil support, and the distal end of the anvil body can be received through the elongated end slot to secure the distal portion of the anvil support to the anvil assembly.

18. The surgical suture system according to claim 11, wherein, The support plate includes an inner arm having teeth on a proximal portion of the inner arm, and wherein the anvil assembly includes a wing defining a window, the teeth being configured to be selectively pivotally received within the window to selectively secure the support plate to the anvil assembly.

19. The surgical suture system according to claim 18, wherein, The carriage includes a cam boss that translates axially into engagement with the inner arm when the carriage translates relative to the support plate to pivot the teeth out of the window.

20. An anvil support loader, comprising: A support plate; A shroud fixed to the support plate and including a first indicator bump and a second indicator bump; And A carriage mounted to the support plate, the carriage being selectively movable relative to the support plate and the shroud to load a support onto an anvil, the carriage including a pivotable arm member selectively attached to the anvil by teeth supported on an end of the pivotable arm member, the carriage including a visual indicator projection that moves from the first indicator bump to the second indicator bump when the carriage moves relative to the support plate, the carriage including a cam boss that pivots the teeth away from the anvil when the visual indicator projection slides from the first indicator bump to the second indicator bump.

Images