A surgical stapler group and a surgical instrument

Abstract

A surgical stapler group (3) and a surgical instrument (1), in particular for a laparoscopic stapler (U), having an anvil (4) and a staple box (5) which are reciprocally movable with respect to a hinge axis (H); said anvil (4) and staple box (5) extend along a longitudinal axis (X) between a proximal end (e1), which is by said hinge axis (H), and a distal end (e2); said surgical stapler group (3) having a crimp area (A), where one or more staples (V) are applied, in use, to an organic tissue (T) disposed between the anvil (4) and the staple box (5), and a window (W) configured to house, in use, an organic tissue (T) without applying staples; wherein said window (W) is interposed along the longitudinal axis (X) between the rotation system and the crimp area (A).

Description

[0001] "A SURGICAL STAPLER GROUP AND A SURGICAL INSTRUMENT"

[0002] Cross-Reference To Related Applications

[0003] This Patent Appl ication claims priority from Italian Patent Application No . 102023000012549 filed on June 19 , 2023 , the entire disclosure of which is incorporated herein by reference .

[0004] Technical Field

[0005] The present invention patent application relates to a surgical stapler group and a surgical instrument , in particular an accessory for a surgical instrument generally known as a laparoscopic stapler . In greater detail , the present invention relates to a surgical stapler group and a laparoscopic surgical instrument for bariatric surgery .

[0006] Prior Art

[0007] Bariatric surgery includes all those surgical interventions aimed at reducing or removing, at least partially, the stomach in order to reduce the weight of people suf fering from obesity .

[0008] Bariatric surgery interventions are generally performed laparoscopically . Known surgical techniques include : SLEEVE GASTRECTOMY, GASTRIC BYPASS, and GASTRIC BANDING. Apart from gastric banding, the known surgical techniques require extensive gastric resections and gastro-intestinal anastomoses . This is made possible by surgical instruments , in particular accessories for a laparoscopic stapler, generally known as staplers .

[0009] Well-known laparoscopic staplers have a substantially scissor-like structure with two opposing arms , which are guided in a known way in order to be operated remotely by a laparoscopic stapler . Typically, one of the two arms includes a blade , which cuts through the tissues as the arms are brought together so that they press against each other .

[0010] Laparoscopic staplers of the type described above further comprise cartridges configured to apply staples at the same time as the cut and along both sides of the blade . Therefore , a laparoscopic stapler of the type described above is configured to perform a tissue section line and, at the same time , apply layers of staples to the sides of the section line to suture the cut edges .

[0011] By way of example , Figure 1 schematically shows a person' s abdomen indicating the positions (numbered with Roman numerals from I to V) of the incisions that are normally made during a bariatric surgery intervention . Typically, the stapler is introduced into the abdomen via incision I , near the navel . Once inside the abdomen, the stapler is guided to the stomach .

[0012] By way of example , Figures 2 and 3 schematically illustrate a surgical technique known as the SLEEVE GASTRECTOMY, which involves making a section line such that a portion of the stomach is removed . This intervention is further complicated by the need to remove a portion of the stomach from the patient .

[0013] Again, by way of example , Figure 4 shows an additional surgical technique known as the MAGENSTRASSE / MILL GASTROPLASTY . This technique involves the creation of a slot , or an opening, at the level of the gastric antrum approximately 5- 6 cm from the pylorus . This slot is necessary to allow a stapler blade to pass through the stomach completely . Once the blade has been inserted through the slot , the resection is made in one or two di f ferent directions . In particular, proceeding with the section towards the angle of His , the MAGENSTRASSE is completely isolated from the gastric body . This intervention is known as MAGENSTRASSE . In addition to the above , by making a further section extending the section line up to 3 cm from the pylorus , the mill is reduced, no longer antral but prepyloric, an intervention known as the LONG MAGENSTRASSE GASTROPLASTY ( as shown in Figure 3 ) . This method also involves pyloric finger fracture , ef fectively turning the intervention into a true gastric bypass . The method shown in Figure 4 , although it does not involve the resection of part of the stomach, nevertheless entails an operating risk comparable to that of the SLEEVE GASTRECTOMY due to the extensive section edges .

[0014] Surgical techniques using known staplers of the type described above have the disadvantage of having to cause very extensive section edges or perform the complete removal of a portion of the stomach .

[0015] Disadvantageously, the extensive section lines ( for example , those performed according to the operating methods shown in Figures 1 to 3 ) expose the patient to the risk of fistulas and haemorrhage . In addition, gastric tube dilation, which is responsible for the inef fectiveness of the surgery, with weight regain, may occur in the patient . The method is also burdened by a very high percentage of gastroesophageal reflux disease , which is almost impossible to treat surgically .

[0016] Therefore , non-negligible morbidity and mortality rates are associated with the above surgical techniques , especially when referred to the reasons for the intervention, which are often l inked to conditions that statistically may reduce li fe expectancy but are not disabling or a direct cause of possible short-term death .

[0017] The question therefore arises as to whether it is appropriate to subj ect patients to surgical practices which statistically involve real risks of severe complications and death, with a high cost to health that can outweigh the benefits of the surgery itsel f .

[0018] Description of the Invention

[0019] The obj ect of the present invention is to provide a surgical instrument which allows a new bariatric surgery technique to be performed without involving the resection and / or dissection of the stomach .

[0020] According to the present invention, a surgical instrument is provided as recited in the appended claims .

[0021] Brief Description of the Drawings

[0022] The invention wi ll now be described with reference to the accompanying drawings , which illustrate non-limiting embodiments thereof , in which :

[0023] - Figure 1 schematically shows a person ' s abdomen and some details of the stomach and stomach wall ;

[0024] - Figures 2 to 4 schematically show bariatric surgery techniques according to the prior art ;

[0025] - Figure 5 is a schematic view of a surgical instrument according to the present invention, in use ;

[0026] - Figures 6 to 9 are schematic views of examples of bariatric surgery techniques achievable with a surgical instrument according to the present invention;

[0027] - Figure 10A is a schematic view of a laparoscopic stapler comprising a surgical instrument according to the present invention;

[0028] - Figure 10B is an exploded view of a surgical stapler group according to the present invention;

[0029] - Figure I OC shows the surgical stapler group in Figure 10B in an operating configuration;

[0030] - Figure 11 is a schematic view of the surgical stapler group in Figure 10B in a further operating configuration;

[0031] - Figure 12 shows a variant of a surgical stapler group according to the present invention; and

[0032] - Figures 13 and 14 show a variant of a surgical stapler group according to the present invention in respective di f ferent operating configurations .

[0033] Preferred Embodiment of the Invention

[0034] Figure 1 schematically shows the abdomen of a patient P indicating the positions (numbered with Roman numerals from I to V) of the incisions that are normally made during a bariatric surgery intervention . With reference to the magni fication in Figure 1 , it is also evident that the wall T of the stomach S is a thick tissue comprising three layers of muscle tissue , indicated by Tl , T2 and T3 , and a mucosa M rich in glands G .

[0035] Figures 2 to 4 show some well-known surgical techniques , which disadvantageously involve the dissection or resection, indicated by J, of at least part of the stomach S and are made with well-known surgical instruments K .

[0036] In Figure 5 , the numeral 1 schematically indicates a surgical instrument according to the present invention, in use . Hereinafter, the surgical instrument 1 is identi fied as a stapler . Figures 6 to 9 schematically show examples of bariatric surgery techniques that can be performed with the stapler 1 . As wil l be explained in greater detail below, the stapler 1 is configured to carry out new bariatric surgery techniques , which avoid performing a dissection or resection J of the stomach S . In other words , the stapler 1 according to the present invention lacks a cutting blade and, as a result , does not dissect the tissue T . According to variants , not shown, the stapler 1 may be used for other surgical techniques involving organs and / or tissues other than those of the stomach .

[0037] The stapler 1 is a laparoscopy instrument that can be attached to an insertion shaft C of a laparoscopic stapler U by means of a rotation system 2 which has one or more hinges H allowing the rotation of the stapler 1 . The rotation system 2 can be a component of the insertion shaft C or it can be part of the stapler 1 itsel f . The rotation system 2 is well known and shown schematically, and comprises a plurality of hinge axes Hl , H2 , H3 , which allow the surgical stapler group 3 and the insertion shaft C to be mutually articulated . The hinge axes Hl , H2 , H3 indicated in Figure 10 are purely exemplary and non-limiting; the configuration, arrangement and number of hinges H may be di f ferent from what is shown .

[0038] Advantageously, the stapler 1 comprises a surgical stapler group 3 configured to apply, in use , a plurality of staples V to a ti ssue T ( in the examples shown in Figures 5 to 9 the wall T of the stomach S ) to obtain a suture line L .

[0039] The surgical stapler group 3 can be made up of a plurality of components assembled together or be made in one piece .

[0040] According to the example shown, the surgical stapler group 3 extends along a longitudinal axis X and has a proximal end el adj acent to the rotation system 2 , and a distal end e2 that protrudes outwards . The proximal end el may be either fixed and made in one piece with the rotation system 2 or releasably connected to the rotation system 2 .

[0041] An XYZ reference system is used hereinafter ( Figure 10A) . Hereinafter , terms such as upper, lower, right , left , top, bottom, and the like are used with reference to this XYZ system .

[0042] Advantageously, the surgical stapler group 3 has a crimp area A and a window W .

[0043] Staples V are applied in the crimp area A to form a suture line L .

[0044] The tissue T is not altered in the area of the window W, in other words , the tissue T is not modi fied in the area of the window W .

[0045] The window W is interposed along the longitudinal axis X between the rotation system 2 and the crimp area A.

[0046] Advantageously, the window W has an extension such as to contain ( even partially i f folded and pressed against itsel f ) a portion of the stomach S , particularly at the greater curvature b, so that , when using the stapler 1 , a passage opening d is left free between a proximal end e3 of the suture line L and the greater curvature b of the stomach S . The extension of the passage opening d is such as to allow the passage of substances F ( such as gastric j uice , bolus , fluids , or the like ) , as will be better explained hereinafter . As an indication, the proximal end e3 is located approximately 2 / 3 from the greater curvature b . The window W has an extension xl along the longitudinal axis X, hereinafter referred to as the length xl, greater than 5 cm. Preferably, the length xl is comprised between 5 and 15 cm.

[0047] The window W has an extension yl along the axis Y (perpendicular to the axes X and Z) , hereinafter referred to as the height yl, of less than 3 cm. Preferably, the height yl is comprised between 0.5 cm and 3 cm.

[0048] The window W has an extension zl along the axis Z (perpendicular to the axes X and Y) , hereinafter referred to as the width zl, of approximately 1 cm. The width zl can be variable and be comprised, for example, between 1 cm and 3 cm.

[0049] Advantageously, the crimp area A has an extension along the axis X, hereinafter referred to as the length x2, which is adequate to the suture line L to be performed. For example, if a suture line L extending from the proximal end e3 to the angle of His q of the stomach S is to be made (Figure 6) , the length x2 is greater than 3 cm (for example, to perform sutures on the duodenum) , the length x2 is preferably greater than, can be between 10 and 20 cm, in greater detail is between 15 and 17 cm.

[0050] To perform other types of suture lines L, the length x2 may be less than 10 cm.

[0051] According to the example shown, the surgical stapler group 3 comprises two arms 4 and 5, hereinafter identified as the anvil 4 and the staple box 5, respectively.

[0052] Advantageously, the anvil 4 is a single-use (i.e., disposable) component and is configured to be hooked to and unhooked from a respective support 6. According to the example shown, the support 6 is connected to the rotation system 2. The anvil 4 may be fixed to the support 6 by means of a form-fit and / or interference coupling. According to a variant, not shown, the anvil 4 may be fixed directly to, or be made in one piece with, the rotation system 2. Advantageously, the staple box 5 is a single-use ( i . e . , disposable ) component and is configured to be hooked to and unhooked from a staple box holder 7 which, in turn, is connected to the rotation system 2 . The staple box 5 may be fixed to the staple box holder 7 by means of a form- fit and / or interference coupling . The staple box 5 is configured to house , in a known way and as shown schematically, a plurality of staples V varying in both type and number of rows . The staple box holder 7 is well known and shown schematically . The staple box holder 7 comprises , in a known way, not shown, a slider and a mechanism which are configured, in use , to push the staples V of the staple box 5 against the anvil 4 , when the staple box holder 7 is pressed against the anvil 4 , in order to staple the tissue T ( in particular the wall T of the stomach) and form a suture line L ( Figures 6 to 9 ) .

[0053] As shown in Figure 10 , in use , the anvil 4 and the staple box 5 extend along the longitudinal axis X and are opposite each other . The anvil 4 and the staple box 5 are reciprocally movable so that they can be selectively positioned in a plurality of di f ferent configurations . In particular, the anvil 4 and the staple box 5 may be arranged, for example : in an open configuration Pl ( Figure 5 ) ; a closed configuration P2 ( Figures 10A and 10C ) ; and a suturing configuration P3 ( Figure 11 ) .

[0054] When the surgical stapler group 3 is in the open configuration Pl , the window W is accessible longitudinally through the distal end e2 of the surgical stapler group 3 between the anvil 4 and the staple box 5 . In other words , when the surgical stapler group 3 is in the open configuration Pl , a tissue T can be slid along the axis X between the anvil 4 and the staple box 5 until it reaches the window W .

[0055] When the surgical stapler group 3 is in the closed configuration P2 , the anvil 4 and the staple box 5 are in contact with each other, as will be explained in greater detail below .

[0056] Advantageously, the surgical stapler group 3 is shaped so as to create the window W . In particular, the window W is made near the proximal end el of the surgical stapler group 3 . The window W i s delimited partly by the anvil 4 and partly by the staple box 5 , so that it can be opened and closed towards the distal end e2 , depending on the reciprocal position taken between the anvil 4 and the staple box 5 .

[0057] According to the example shown in Figures 10A, 10B, 10C and 11 , the anvi l 4 is a thin body extending mainly along the longitudinal axis X . The anvil 4 has a height ( extension along the axis Y) that is signi ficantly less than its length and width ( extension along the axis Z ) . According to the example shown, the anvil 4 is made of bent sheet metal ; according to some non-shown variants , it can be made of any material and with di f ferent technologies ( e . g . , plastic moulding) . In particular, the anvil 4 has an attachment 10 which is configured to be form- fit and / or interference coupled to the respective support 6 of the rotation system 2 . According to a variant , not shown, the anvil does not have the attachment but is made in one piece with the rotation system 2 .

[0058] The anvil 4 has a housing portion 11 , a bending portion 12 , and a tip 14 . The bending portion 12 is interposed along the longitudinal axis X between the housing portion 11 and the tip 12 . The anvil 4 is delimited by an upper surface 15 , a lower surface 16 , and a lateral surface 17 . The upper surface 15 and the lower surface 16 are the larger lateral surfaces of the anvil 4 .

[0059] The extension of the housing portion 11 along the axis X is equal to or greater than the length xl of the window W . The extension of the bending portion 12 along the axis X is equal to or greater than the length x2 of the crimp area A.

[0060] Similarly, the staple box 5 extends mainly along the longitudinal axis X . The staple box 5 has an attachment 20 which is configured to be form- fit and / or interference coupled to the respective staple box holder 7 . For example , in a known manner , the staple box 5 is configured to form a translational coupling of the guide-slide type with the staple box holder 7 . The staple box 5 is configured to house , in a known way and as shown schematically, a plurality of staples V which interact in a known way with the staple box holder 7 .

[0061] The staple box 5 , in turn, has a housing portion 21 , a bending portion 22 , and a tip 23 . The bending portion 22 is interposed along the longitudinal axis X between the housing portion 11 and the tip 12 . In greater detail , the staples V are arranged along the bending portion 22 of the staple box 5 . The staples V are of the traditional type and have a U shape with the concavity facing the anvil 4 . The staple box 5 has an upper surface 25 facing, in use , the lower surface 16 of the anvil 4 . The number of rows and the type of staples V vary in a known way and as shown schematically .

[0062] According to the sketch shown in Figure 11 , the bending portion 12 of the anvil 11 and the bending portion 22 of the staple box 5 def ine the crimp area A. In other words , the tissue T , which during use is arranged between the bending portion 12 and the bending portion 22 is sutured with the staples V . The crimp area A is interposed between the window W and the attachment 10 of the anvil 4 and the attachment 20 of the staple box 5 .

[0063] According to the sketch shown in Figure 11 , the housing portion 11 and the housing portion 21 of the staple box 5 form the sides of the window W .

[0064] In particular, the anvil 4 is shaped so as to have , at the housing portion 11 , a housing 14 facing, in use , the staple box 5 . The staple box 5 is shaped so as to have , at the housing portion 21 , a housing 24 facing, in use , the anvil 4 . According to the example shown in Figures 10A, 10B, I OC and 11 , the lower surface 16 of the anvil 4 is substantially U-shaped at the housing 14 , with the concavity facing the staple box 5 . Similarly, the upper surface 25 of the staple box 5 is substantially U-shaped, with the concavity facing the anvil 4 . The depth, i . e . the extension along the axis Y, of both the housing 14 and the housing 24 may be variable .

[0065] Advantageously, the shape and si ze of both the housing 14 and the housing 24 are variable .

[0066] Figure 12 shows an alternative embodiment of the anvil 4 in which the lower surface 16 of the anvil 4 has a curved shape at the hous ing 14 ( in the example , an arc-of-a-circle shape ) .

[0067] According to the example shown in Figures 10A to 12 , the anvil 4 is made in one piece . According to a variant , not shown, the anvil 4 is made up o f a plurality of components assembled together . For example , according to a variant , not shown, the housing portion 11 and the bending portion 12 may be two separate components fixed to each other in a releasable or non-releasable manner . In this way, advantageously, di fferent types of housing portions 11 and bending portions 12 can be combined in a modular way to obtain respective di f ferent final configurations of the anvil 4 . Advantageously, this allows the housing portion 11 and / or the bending portion 12 to be selected according to patient-speci fic parameters , and thus an ideal anvil 4 to be obtained for performing the relevant intervention .

[0068] According to the example shown in Figures 10A to 12 , the staple box 5 i s made in one piece . According to a variant , not shown, the staple box 5 is made up of a plurality of components assembled together . For example , according to a variant , not shown, the housing portion 21 and the bending portion 22 may be two separate components fixed to each other in a releasable or non-releasable manner . In this way, advantageously, di fferent types of housing portions 21 and bending portions 22 can be combined in a modular way to obtain respective di f ferent final configurations of the staple box 5 . Advantageously, this allows the housing portion 21 and / or the bending portion 22 to be selected according to patient-speci fic parameters , and thus an ideal staple box 5 to be obtained for performing the relevant intervention . The combination of the components of the staple box 5 i s selected to optimi ze the operation in cooperation with the anvil 4 , and vice versa .

[0069] In Figures 13 and 14 , the numeral 3 ' schematically shows a variant of the surgical stapler group 3 . The elements in common with the surgical stapler group 3 maintain the same numbering and are not repeated for the sake of brevity . In particular, the surgical stapler group 3 ' comprises an anvil 4 ' and a staple box 5 ' , which have a variable extension along the longitudinal axis X at the window X .

[0070] In the schematic example shown, the anvil 4 ' compri ses two parts 18 and 19 which are reciprocally movable along the axis X . The parts 18 and 19 can be fixed to each other in a certain position by means of fasteners ( known and not shown) . In this way, the length of the housing portion 11 and / or the bending portion 12 can be regulated as required . Similarly, the staple box 5 ' comprises two parts 26 and 27 which are reciprocally movable along the axis X . The parts 26 and 27 can be fixed to each other in a certain position by means of fasteners ( known and not shown) . In this way, the length of the housing portion 21 and / or the bending portion 22 can be regulated as required . In the schematic examples shown in Figures 13 and 14 , the reciprocally movable parts 18 and 19 of the housing portion 11 and the reciprocally movable parts 26 and 27 of the bending portion 12 interpenetrate at the window W . According to a variant , not shown, both the reciprocally movable parts 18 and 19 of the housing portion 11 and the reciprocally movable parts 26 and 27 of the bending portion 12 can be selected from a group consisting of solutions which differ from each other in terms of: shape, size, and interpenetration position.

[0071] Figures 13 and 14 show two respective different operating configurations of a surgical stapler group 3' . Figure 13 shows the surgical stapler group 3' in the retracted configuration, and Figure 14 shows the surgical stapler group 3' in the extended configuration. Figures 13 and 14 show an example of a surgical stapler group 3' which enables the variation in the extension of the length xl of the window W.

[0072] According to some variants, not shown, the surgical stapler group 3' can be modified in the number, position and size of the parts that make up the anvil; in this way, the length xl of the window W and / or the length x2 of the bending portion 22 can be adjusted.

[0073] According to a variant, not shown, the anvil and the staple box may have a different shape from the one shown, for example they may be curved. In this case, the above also applies mutatis mutandis to this variant wherein, instead of a straight longitudinal axis X, there is a curved longitudinal axis.

[0074] In use, incisions are made in a known way in the patient's abdomen to give access to the surgical instruments.

[0075] The surgical stapler group 3 is installed onto an insertion shaft C of a laparoscopic stapler U in order to be guided in a known manner.

[0076] Then, the surgical stapler group 3 is pushed into the abdomen until it reaches the greater curvature b of the stomach S.

[0077] The surgical stapler group 3 is arranged into the open configuration Pl and pushed upwards so that the tissue T of the stomach S is introduced between the anvil 4 and the staple box 5. The surgical stapler group 3 is pushed until the tissue T of the stomach S arrives against a shoulder part of the surgical stapler group 3, for example, against the housing portion 11 of the anvil 4 and / or the housing portion 21 of the staple box 5 . The surgical stapler group 3 can be pushed upwards some more to obtain a build-up of tissue T within the window W .

[0078] When the desired positioning of both the window W and the crimp area A is achieved, the surgical stapler group 3 is tightened into the suturing configuration P3 . At this stage , the tissue T located inside the window W remains unchanged, while the staple box 5 applies the staples V ( as known and schematically shown) to the tissue T arranged between the anvil and the staple box within the crimp area A. In this way, advantageously, a single action results in both a desired suture line L and a passage opening d extending between the proximal end e3 , that corresponds to the area of insertion of the first staple V, and the greater curvature b of the stomach S .

[0079] The staple box 5 and / or the entire surgical stapler group 3 can be replaced to create an additional suture line L' . In this case , the surgical stapler group 3 is positioned to obtain an additional suture line L' with a pre-determined inclination and length . The surgical stapler groups 3 may di f fer from each other in the extension of the length xl of the window W and / or the extension of the length x2 of the crimp area A depending on the type of suture to be achieved .

[0080] Advantageously, in case of using an anvil 4 as shown in Figure 12 , it is possible to obtain a particularly compact surgical stapler group 3 that can easily fit between the organs of the patient P .

[0081] Advantageously, in case of using a surgical stapler group 3 ' , it is possible to adj ust the reciprocal position of the parts 18 , 19 of the anvil 4 ' and the parts 26 and 27 of the staple box 5 ' in order to achieve a desired length xl of the window W and / or a desired length x2 of the crimp area A. In this way, the surgical stapler group 3 ' can be adapted to patient-speci fic requirements , and the type of intervention can be customi zed, as much as possible , to the patient ' s physicality .

[0082] Advantageously, the surgical stapler group 3 , 3 ' of the type described above allows a new bariatric surgery technique to be performed, which allows long segments of the bowel to be accommodated in the window W, ensuring that the suture line L is only placed in the distal segment of the stomach S . For example , the suture line L shown in Figure 6 extending from the proximal end e3 to the angle of His q of the stomach S . This surgical technique avoids performing a dissection or resection of the stomach S , however, allowing at the same time a substantial reduction of the stomach S . In particular, Figure 6 schemati zes a surgical technique that can be implemented with a surgical stapler group 3 , 3 ' according to the present invention and which is essentially a replacement technique for the SLEEVE GASTROPLASTY . With this technique , the stomach S is divided into two parts with dimensions similar to those obtained with the SLEEVE GASTROPLASTY . The passage opening d obtained due to the presence of the window W of the surgical stapler group 3 , 3 ' is a secretory pathway for the excluded stomach portion .

[0083] Figures 7 and 8 show further possible surgical techniques which can be implemented with a surgical stapler group 3 , 3 ' according to the present invention wherein a first suture line L is made in the manner described above for the example shown in Figure 6 and, in addition, a second suture line L2 is made , optionally a third suture line L3 ( Figure 8 ) , which are extended towards the pylorus and the greater curvature b of the stomach S , respectively .

[0084] Figure 9 shows a further variant , in which the suture line L was created by a curved surgical stapler group 3 , 3 ' .

[0085] Advantageously, the surgical stapler group 3 according to the present invention lacks blades or equivalent instruments suitable for dissecting organic tissues . Therefore , advantageously, the pos sibility of dissecting or resecting the tissue T, particularly the wall of the stomach S, is completely abolished.

[0086] Therefore, a surgical stapler group 3, 3' of the type described above allows for significantly safer surgical treatments for the patient P; in fact, the risks of potential postoperative complications and, in particular, the risks of death are completely eliminated. This, of course, leads to a reduction in health, social and legal costs.

[0087] Advantageously, the surgical stapler group 3, 3' of the type described above is easy to use; in fact, once the length xl of the window W and / or the length x2 of the crimp area A have been set, it is sufficient to arrange the surgical stapler group 3, 3' in the desired position and actuate, as customary, the reciprocal movement between the anvil 4, 4' and the staple box 5, 5' in order to apply a suture line L.

[0088] Advantageously, the surgical stapler group 3, 3' can be regulated according to patient-specific parameters. Indeed, the fact that the anvil 4, 4' and / or the staple box 5, 5' can be made up of several parts (11, 12; 18, 19; 21, 22; 26, 27) allows the parts to be modularly combined or reciprocally positioned according to patient-specific parameters in order to obtain a surgical stapler group 3, 3' that is ideal for the operation to be performed.

[0089] Therefore, the surgical stapler group 3, 3' of the type described above is particularly safe and significantly reduces the operating times, simplifying the currently known bariatric surgery procedures.

Claims

C L A I M S1. A surgical stapler group (3) , in particular for a laparoscopic stapler; said stapler group (3) comprising an anvil (4) and a staple box (5) which are reciprocally movable, in use, with respect to a support element (C) ; said anvil (4) and staple box (5) extend along a longitudinal axis (X) between a proximal end (el) , which is by said support element (C) , and a distal end (e2) ; said surgical stapler group (3) being characterized by having a crimp area (A) , where one or more staples (V) are applied, in use, to an organic tissue (T) disposed between the anvil (4) and the staple box (5) , and a window (W) configured to house, in use, an organic tissue (T) without applying staples; wherein said window (W) is interposed along said longitudinal axis (X) between the proximal end (el) and the crimp area (A) .

2. A surgical stapler group (3) according to claim 1 characterized by being without blades so as not to cut, in use, said organic tissue (T) .

3. A surgical stapler group (3) according to claim 1 or 2; wherein said anvil (4) and said staple box (5) are substantially two arms of a stapler; said anvil (4) and said staple box (5) are reciprocally rotatable around a hinge axis (Hl ) .

4. A surgical stapler group (3) according to any of the preceding claims, wherein said anvil (4) has a first housing portion (11) and a first bending portion (12) ; said first housing portion (11) is interposed along the longitudinal axis (X) between the first bending portion (12) and the proximal end (el) ; wherein said staple box (5) has a second housing portion (21) and a second bending portion (22) ; the second housing portion (21) is interposed along the longitudinal axis (X) between the second bending portion (22) and the proximal end (el) .

5. A surgical stapler group (3) according to any of the preceding claims, wherein said window (W) has an extensionalong said longitudinal axis (X) of at least 5 cm.

6. A surgical stapler group (3) according to any of the preceding claims, wherein said window (W) has an extension along a second axis (Y) , in particular an axis perpendicular to the longitudinal axis (X) , of less than 3 cm.

7. A surgical stapler group (3) according to any of the preceding claims, wherein said crimp area (A) has an extension along the longitudinal axis (X) of at least 3 cm.

8. A surgical stapler group (3) according to any of the preceding claims, wherein the staple box (5) is configured to house a plurality of staples (V) aligned with each other along the longitudinal axis (X) and by said crimp area (A) .

9. A surgical stapler group (3) according to any of the preceding claims, wherein said anvil (4) and said staple box are adjustable in length along the longitudinal axis (X) , so that the extension of the window (W) and / or the extension of the crimp area (A) along the longitudinal axis (X) can be modified and selectively regulated in function of patientspecific parameters.

10. A surgical stapler group (3) according to any of the preceding claims, wherein the anvil (4) comprises a plurality of assembled components (11, 12; 18, 19) ; and / or the staple box (5) comprises a plurality of assembled components (21, 22; 26, 27) .

11. A surgical instrument, in particular for a laparoscopic stapler, comprising a stapler group (3) according to any of the preceding claims and comprising a rotation system (2) , which is configured to be handled by a laparoscopic stapler (U) ; wherein said anvil (4) and said staple box (5) are made in one piece with said rotation system (2) or are, directly or indirectly, connected to said rotation system (2) .

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