Surgical staple cartridge for supporting surgical buttress materials
Patent Information
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- COVIDIEN LP
- Filing Date
- 2024-12-18
- Publication Date
- 2026-07-31
Smart Images
Figure 0007898500000001 
Figure 0007898500000002 
Figure 0007898500000003
Abstract
Description
Technical Field
[0001] This application relates to surgical staplers, and more particularly to surgical staple cartridges configured to removably support a surgical buttress material.
Background Art
[0002] Surgical staplers are used by surgeons to continuously or simultaneously apply one or more rows of fasteners, such as staples, or two-piece fasteners, to body tissue for the purpose of collectively joining segments of body tissue and / or creating an anastomosis. Linear surgical staplers generally include a pair of jaws or finger-like structures between which the body tissue to be joined is disposed. When this linear surgical stapler is actuated or "fired," a firing bar moves longitudinally to contact a staple driving member within one of the jaws. The staple driving member pushes a surgical staple into an anvil of the opposing jaw that forms the staple through the body tissue. When removing or separating body tissue, a knife blade can be provided on one of the jaws of the device to cut the body tissue between the staple lines.
[0003] Surgical supports, such as meshes or buttress materials, can be used in combination with surgical staplers to bridge, repair, and / or reinforce tissue defects within a patient that occur, for example, within the body's abdominal wall, lumbar wall, diaphragm, or aponeurotic regions. This surgical buttress material reinforces the staple line and covers the tissue junction to reduce leakage prior to healing. This surgical buttress material can help promote proper staple formation while reducing any misalignment of the tissue and / or torsional / malformed conditions caused by abnormal or non-uniform tissue. This surgical buttress material can also provide support to weakened tissue or help address differences in tissue thickness.
[0004] [[ID=1,9]] Therefore, a new system and method that enables the easy and effective attachment of surgical buttress material to a surgical stapler, as well as the easy and effective removal of surgical buttress material from the surgical stapler, would be desirable. [Overview of the project] [Means for solving the problem]
[0005] According to embodiments of the present disclosure, an end effector for use with a surgical stapler comprises an anvil assembly and a staple cartridge assembly movable between an approaching position and an ajar position relative to the anvil assembly. The staple cartridge assembly defines a plurality of retaining slots and a cavity. The staple cartridge assembly includes a plurality of staples, a plurality of pushers, an operating sled, surgical buttress material, a binding suture, and a fixing button. The plurality of staples are disposed within each of the plurality of retaining slots. The plurality of pushers are configured to eject the plurality of staples through each of the plurality of retaining slots. The operating sled is configured to move along the length of the staple cartridge assembly so as to sequentially engage with the plurality of pushers to eject the plurality of staples through each of the plurality of retaining slots. The operating sled includes a first knife blade. The surgical buttress material is configured to be supported on the tissue-facing surface of the staple cartridge assembly. The binding suture includes both ends fixedly attached to the opposing sides of the staple cartridge assembly. The fixing button is configured to be received within a cavity in the staple cartridge assembly, and as a result, a portion of the binding thread is held within the cavity so as to be cut by the first knife blade of the working sled when the working sled moves distally.
[0006] In one embodiment, the staple cartridge assembly may further define opposing lateral grooves configured to secure and receive each end of the binding thread.
[0007] In another embodiment, the fixing button can define opposing circumferential grooves that coincide with each opposing lateral groove of the staple cartridge assembly.
[0008] In yet another embodiment, the locking button may define a notch configured to receive the first knife blade of the operating sled through the locking button.
[0009] In yet another embodiment, a portion of the binding thread can be arranged perpendicular to the central longitudinal axis defined by the staple cartridge assembly.
[0010] In yet another embodiment, the fixing button may include an engaging portion that defines a transverse groove configured to support a portion of the binding thread within the cavity.
[0011] In one embodiment, the staple cartridge assembly may include opposing lateral guides configured to receive surgical buttress material between the opposing lateral guides.
[0012] In another embodiment, the staple cartridge assembly may further define a central longitudinal slot that communicates with a cavity.
[0013] In one embodiment, the central longitudinal slot can extend through the cavity.
[0014] In another embodiment, the working sled may further include a second knife blade configured to extend through a central longitudinal slot to cut surgical buttress material and tissue in an overlapping relationship with the tissue-facing surface of the staple cartridge assembly.
[0015] In yet another embodiment, the surgical buttress material may have a distal portion that includes a notch that coincides with the distal portion of a central longitudinal slot.
[0016] In yet another embodiment, the cavity of the staple cartridge assembly can be defined in the distal portion of the staple cartridge assembly.
[0017] According to another embodiment of the present disclosure, an end effector for use with a surgical stapler comprises an anvil assembly and a staple cartridge assembly movable between an approaching position and an ajar position relative to the anvil assembly. The cartridge assembly defines a plurality of retaining slots and a lateral slot. The cartridge assembly includes a plurality of staples, a plurality of pushers, an operating sled, surgical buttress material, a binding suture, and a slider cam. The plurality of staples are disposed within each of the plurality of retaining slots. The plurality of pushers are configured to eject the plurality of staples through each of the plurality of retaining slots. The operating sled is configured to move along the length of the staple cartridge assembly to engage with the plurality of pushers to eject the plurality of staples through each of the plurality of retaining slots. The surgical buttress material is configured to be supported on the tissue-facing surface of the staple cartridge assembly. The binding suture includes both ends fixedly attached to the opposing sides of the staple cartridge assembly. The slider cam is configured to be slidably received within the lateral slot. The slider cam includes an engaging portion configured to engage with the working sled such that the axial displacement of the working sled causes lateral movement of the slider cam, which sequentially releases one end of the binding thread from the corresponding lateral groove of the staple cartridge assembly.
[0018] In one embodiment, the engaging portion may have an arched or tapered outer shape.
[0019] In another embodiment, the slider cam can further include a side portion having a plane configured to engage one of the two ends of the binding thread.
[0020] In yet another embodiment, the slider cam can include a body portion including a side portion and a finger flexibly extending distally from the body portion.
[0021] In still yet another embodiment, the side slot can include a first stop configured to engage a portion of the finger to limit the lateral displacement of the slider cam.
[0022] In still yet another embodiment, the finger can include a hook portion configured to engage the first stop of the side slot.
[0023] In one embodiment, the staple cartridge assembly can define a central longitudinal slot extending along the length of the staple cartridge assembly.
[0024] In another embodiment, the side slot of the staple cartridge assembly can further include a second stop configured to limit the lateral displacement of the slider cam toward the central longitudinal slot.
[0025] In one embodiment, the slider cam can be disposed laterally inwardly of both ends of the binding thread.
[0026] In another embodiment, the surgical buttress material can define opposing notches configured to align with respective opposing side grooves of the staple cartridge assembly.
[0027] In yet another embodiment, the staple cartridge assembly can include opposing side guides configured to receive the surgical buttress material therebetween.
[0028] In yet another further embodiment, the surgical buttress material can include stepped portions configured to engage respective opposing lateral guides.
[0029] In yet another further embodiment, the staple cartridge assembly can further include hook members extending from a surface facing the tissue.
[0030] In one embodiment, the surgical buttress material can define a notch.
[0031] In another embodiment, the hook members can be configured to be received through the notch of the surgical buttress material so as to secure the surgical buttress material to the staple cartridge assembly.
[0032] In yet another further embodiment, the actuating sled can also include a knife blade configured to extend through a central longitudinal slot so as to cut the surgical buttress material and the tissue in an overlapping relationship with a surface of the staple cartridge assembly facing the tissue.
[0033] In yet another further embodiment, both ends of the tie sutures can be frictionally fixed within respective opposing lateral grooves of the staple cartridge assembly.
[0034] According to yet another embodiment of the present disclosure, an end effector for use with a surgical stapler comprises an anvil assembly and a staple cartridge assembly movable between an approaching position and an ajar position relative to the anvil assembly. The cartridge assembly defines a plurality of retaining slots and a lifting slot. The cartridge assembly includes a plurality of staples, a plurality of pushers, an operating sled, surgical buttress material, a binding suture, and a lifting member. The plurality of staples are disposed within each of the plurality of retaining slots. The plurality of pushers are configured to eject the plurality of staples through each of the plurality of retaining slots. The operating sled is configured to move along the length of the staple cartridge assembly to engage with the plurality of pushers to eject the plurality of staples through each of the plurality of retaining slots. The surgical buttress material is configured to be supported on the tissue-facing surface of the staple cartridge assembly. The binding suture includes both ends fixedly attached to opposing sides of the staple cartridge assembly to detachably secure the surgical buttress material to the tissue-facing surface. The lifting member is configured to extend through a lifting slot for biasing the binding suture away from the surgical buttress material in order to release the surgical buttress material from the staple cartridge assembly.
[0035] In one embodiment, the lifting member can be coupled to one of a plurality of pushers.
[0036] In another embodiment, the lifting member can be coupled to the furthest pusher among a plurality of pushers.
[0037] In yet another embodiment, the staple cartridge assembly may define opposing lateral grooves configured to secure each end of the binding thread.
[0038] In yet another embodiment, one of the opposing lateral grooves may be adjacent to the lifting slot such that a portion of the binding thread extends across the lifting slot.
[0039] In one embodiment, the binding thread may be flexible.
[0040] In another embodiment, the staple cartridge assembly may include opposing lateral guides configured to receive surgical buttress material between the opposing lateral guides.
[0041] In yet another embodiment, the surgical buttress material can be defined with a notch.
[0042] In yet another embodiment, the staple cartridge assembly may include a hook member extending from the tissue-facing surface of the staple cartridge assembly. This hook member is configured to receive the surgical buttress material through a notch in the surgical buttress material to secure it to the staple cartridge assembly. For example, this application provides the following items. (Item 1) An end effector for use with a surgical stapler, Anvil assembly and, A staple cartridge assembly that is movable between an approaching position and a distanced position relative to the above anvil assembly, wherein the staple cartridge assembly comprises a staple cartridge assembly that defines a plurality of retaining slots and cavities, and the staple cartridge assembly Multiple staples are arranged within each of the above-mentioned multiple holding slots, Multiple pushers configured to eject the multiple staples through each of the multiple holding slots, An operating sled configured to move along the length of the staple cartridge assembly so as to sequentially engage with the pushers to eject the staples through each of the plurality of holding slots, wherein the operating sled includes a first knife blade, A surgical buttress material configured to be supported on the tissue-facing surface of the above staple cartridge assembly, A binding thread, including both ends, is fixedly attached to the opposing sides of the staple cartridge assembly described above. An end effector comprising: a fixing button configured to be received within the cavity of the staple cartridge assembly such that a portion of the binding thread is held within the cavity so as the working sled moves distally, it is cut by the first knife blade of the working sled. (Item 2) The end effector described above, wherein the staple cartridge assembly further defines opposing lateral grooves configured to fix and receive each of the above ends of the binding threads. (Item 3) An end effector according to any one of the above items, wherein the fixing button defines opposing circumferential grooves that coincide with the opposing lateral grooves of each of the above-mentioned staple cartridge assemblies. (Item 4) The end effector according to any one of the above items, wherein the locking button defines a notch, and the notch is configured to receive the first knife blade of the operating sled through the notch. (Item 5) An end effector according to any one of the above items, wherein the above portion of the binding thread is arranged to be perpendicular to the central longitudinal axis defined by the staple cartridge assembly. (Item 6) The end effector according to any one of the above items, wherein the fixing button includes an engaging portion that defines a transverse groove configured to support the above portion of the connecting thread within the cavity. (Item 7) The end effector according to any one of the above items, wherein the staple cartridge assembly includes opposing lateral guides, the opposing lateral guides are configured to receive the surgical buttress material between the opposing lateral guides. (Item 8) An end effector according to any one of the above items, wherein the staple cartridge assembly further defines a central longitudinal slot communicating with the cavity. (Item 9) An end effector according to any one of the above items, wherein the central longitudinal slot described above extends through the cavity described above. (Item 10) The end effector according to any one of the above items, further comprising a second knife blade configured to extend through the central longitudinal slot so as to cut through the surgical buttress material and tissue in an overlapping relationship with the tissue-facing surface of the staple cartridge assembly. (Item 11) An end effector according to any one of the above items, wherein the surgical buttress material has a distal portion including a notch that coincides with the distal portion of the central longitudinal slot. (Item 12) An end effector according to any one of the above items, wherein the cavity of the staple cartridge assembly is defined in the distal portion of the staple cartridge assembly. (Item 13) An end effector for use with a surgical stapler, Anvil assembly and, A staple cartridge assembly that is movable between an approaching position and a distanced position relative to the above anvil assembly, wherein the cartridge assembly comprises a staple cartridge assembly that defines a plurality of retaining slots and lateral slots, and the cartridge assembly is Multiple staples are arranged within each of the above-mentioned multiple holding slots, Multiple pushers configured to eject the multiple staples through each of the multiple holding slots, An operating sled configured to move along the length of the staple cartridge assembly to engage with the pushers to eject the staples through each of the above-mentioned multiple holding slots, A surgical buttress material configured to be supported on the tissue-facing surface of the above staple cartridge assembly, A binding thread, including both ends, is fixedly attached to the opposing sides of the staple cartridge assembly described above. An end effector comprising a slider cam configured to be slidably received within the lateral slot, wherein the slider cam includes an engaging portion configured to engage with the lateral sled such that an axial displacement of the working sled causes a lateral movement of the slider cam, which in turn releases one end of the binding thread from the corresponding lateral groove of the staple cartridge assembly. (Item 14) The end effector described in the above item, wherein the engagement portion has an outer shape that is arc-shaped or tapered. (Item 15) The end effector according to any one of the above items, further comprising a lateral portion having a plane configured to engage with one of the two ends of the connecting thread, wherein the slider cam further comprises a lateral portion having a plane configured to engage with one of the two ends of the connecting thread. (Item 16) The end effector according to any one of the above items, wherein the slider cam includes a main body portion including the lateral portion and a finger that flexibly extends distally from the main body portion. (Item 17) The end effector according to any one of the above items, wherein the lateral slot includes a first stop portion configured to engage with a portion of the finger to limit the lateral displacement of the slider cam. (Item 18) An end effector according to any one of the above items, comprising a hook portion configured such that the above-mentioned finger engages with the first stop portion of the above-mentioned lateral slot. (Item 19) An end effector according to any one of the above items, wherein the staple cartridge assembly defines a central longitudinal slot extending along the length of the staple cartridge assembly. (Item 20) The end effector according to any one of the above items, further comprising a second stop portion configured such that the lateral slot of the staple cartridge assembly is configured to restrict the lateral displacement of the slider cam toward the central longitudinal slot. (Item 21) The end effector according to any one of the above items, wherein the slider cam is disposed laterally inward at both ends of the connecting thread. (Item 22) The end effector according to any one of the above items, wherein the surgical buttress material defines opposing notches configured to coincide with the opposing lateral grooves of each of the staple cartridge assemblies. (Item 23) The end effector according to any one of the above items, wherein the staple cartridge assembly includes opposing lateral guides, the opposing lateral guides are configured to receive the surgical buttress material between the opposing lateral guides. (Item 24) An end effector according to any one of the above items, wherein the surgical buttress material includes a stepped portion configured to engage with each of the above opposing lateral guides. (Item 25) The end effector according to any one of the above items, wherein the staple cartridge assembly further includes a hook member extending from the surface facing the tissue. (Item 26) The above-mentioned surgical buttress material defines an end effector as described in any one of the above items. (Item 27) The end effector according to any one of the above items, wherein the hook member is configured to receive the surgical buttress material through a notch in the surgical buttress material for securing the surgical buttress material to the staple cartridge assembly. (Item 28) The end effector according to any one of the above items, comprising a knife blade configured to extend through the central longitudinal slot so as to cut through the surgical buttress material and tissue in an overlapping relationship with the tissue-facing surface of the staple cartridge assembly. (Item 29) The end effector according to any one of the above items, wherein both ends of the above-mentioned binding thread are fixed by friction within the opposing lateral grooves of the staple cartridge assembly. (Item 30) An end effector for use with a surgical stapler, Anvil assembly and, A staple cartridge assembly that is movable between an approaching position and a distanced position relative to the above anvil assembly, wherein the cartridge assembly comprises a staple cartridge assembly that defines a plurality of retaining slots and lifting slots, and the cartridge assembly Multiple staples are arranged within each of the above-mentioned multiple holding slots, Multiple pushers configured to eject the multiple staples through each of the multiple holding slots, An operating sled configured to move along the length of the staple cartridge assembly to engage with the pushers to eject the staples through each of the above-mentioned multiple holding slots, A surgical buttress material configured to be supported on the tissue-facing surface of the above staple cartridge assembly, A binding suture, including both ends fixed to the opposing sides of the staple cartridge assembly, is provided to detachably secure the above-mentioned surgical buttress material to the surface facing the tissue, An end effector comprising: a lifting member configured to extend through the lifting slot for biasing the binding suture away from the surgical buttress material in order to release the surgical buttress material from the staple cartridge assembly. (Item 31) The end effector described above, wherein the lifting member is coupled to one of the multiple pushers. (Item 32) An end effector according to any one of the above items, wherein the lifting member is coupled to the furthest pusher among the plurality of pushers. (Item 33) The end effector according to any one of the above items, wherein the staple cartridge assembly defines opposing lateral grooves configured to secure each end of the binding thread. (Item 34) The end effector according to any one of the above items, wherein one of the opposing lateral grooves is adjacent to the lifting slot such that a portion of the binding thread extends across the lifting slot. (Item 35) The above-mentioned binding thread is flexible, and the end effector is as described in any one of the above items. (Item 36) The end effector according to any one of the above items, wherein the staple cartridge assembly includes opposing lateral guides, the opposing lateral guides are configured to receive the surgical buttress material between the opposing lateral guides. (Item 37) The above-mentioned surgical buttress material defines an end effector as described in any one of the above items. (Item 38) The end effector according to any one of the above items, wherein the staple cartridge assembly includes a hook member extending from the tissue-facing surface of the staple cartridge assembly, the hook member being configured to receive the surgical buttress material through a notch in the surgical buttress material to secure it to the staple cartridge assembly. (Summary) The end effector for use with a surgical stapler includes a staple cartridge assembly that is movable relative to the anvil assembly. This staple cartridge assembly defines multiple retention slots and a cavity. This staple cartridge assembly includes multiple staples, multiple pushers, an operating sled, surgical buttress material, binding suture, and a locking button. The operating sled is configured to move along the length of the staple cartridge assembly so as to sequentially engage with the multiple pushers to eject the multiple staples through each of the multiple retention slots. The locking button is configured to be received within the cavity of the staple cartridge assembly, so as a result, a portion of the binding suture is held within the cavity so as to be cut by the knife blade of the operating sled as it advances distally. [Brief explanation of the drawing]
[0043] The above and other aspects, features, and advantages of this disclosure will become apparent in light of the following detailed description when read in conjunction with the accompanying drawings incorporated herein and forming part thereof.
[0044] [Figure 1] This is a perspective view of a surgical stapler having a surgical buttress material mounted on top, according to an embodiment of the present disclosure. [Figure 2] Figure 1 is a perspective view of the end effector of a surgical stapler. [Figure 3] Figure 1 is a disassembled and assembled perspective view of the tool portion of the end effector, with the components separated. [Figure 4]Figure 1 is a perspective view of the end effector staple cartridge assembly, illustrating a surgical buttress material detachably fixed to the top. [Figure 5] Figure 4 is a magnified view of the indicated detail area. [Figure 6] Figure 3 is a magnified view of the indicated detail area, illustrating the operational warp of the staple cartridge assembly in Figure 4. [Figure 7] Figure 3 is a magnified view of the indicated detail area, illustrating the fastening button of the staple cartridge assembly in Figure 4. [Figure 8] This is a cross-sectional view of the staple cartridge assembly shown in Figure 4, cut along the cutting line 8-8 in Figure 4. [Figure 9] Figure 8 is a magnified view of the indicated detail area, illustrating the placement of the fixing button along with the staple cartridge assembly in Figure 8. [Figure 10] Figure 8 is a magnified view of the indicated detail area, illustrating the placement of the fixing button along with the staple cartridge assembly in Figure 8. [Figure 11] This is a cross-sectional view of the staple cartridge assembly shown in Figure 5, cut along the cutting line 11-11 in Figure 5. [Figure 12] This is a cross-sectional view of the staple cartridge assembly shown in Figure 11, cut along the cutting line 12-12 in Figure 11, illustrating the cutting of the binding thread. [Figure 13] Figure 8 is a partial perspective view of the staple cartridge assembly, illustrating the cutting of the binding thread. [Figure 14] Figure 1 is a perspective view of tissue that has been stapled and cut using a surgical stapler. [Figure 15] A perspective view of a staple cartridge assembly for use with the surgical stapler shown in Figure 1, according to another embodiment of the present disclosure. [Figure 16] This is a magnified view of the indicated detail area in Figure 15. [Figure 17]Figure 15 is a perspective view of the staple cartridge assembly with surgical buttress material separated. [Figure 18] Figure 17 is a magnified view of the indicated detail area, illustrating the slider cam of the staple cartridge assembly in Figure 15. [Figure 19] This is a cross-sectional view of the staple cartridge assembly of Figure 15, cut along the cutting line 19-19 of Figure 15. [Figure 20] This is a magnified view of the indicated detail area in Figure 19. [Figure 21] This is a cross-sectional view of the surgical cartridge assembly of Figure 20, cut along the cutting line 21-21 in Figure 20. [Figure 22] Figure 19 is a partial cross-sectional view of a surgical cartridge assembly, illustrating a slider cam in a laterally displaced position. [Figure 23] This is a cross-sectional view of the surgical cartridge assembly shown in Figure 22, cut along the cutting line 23-23 in Figure 22. [Figure 24] Figure 15 is a partial perspective view of a surgical cartridge assembly, illustrating the cutting of the connecting sutures. [Figure 25] A perspective view of a staple cartridge assembly for use with the surgical stapler shown in Figure 1, according to yet another embodiment of the present disclosure. [Figure 26] This is a magnified view of the indicated detail area in Figure 25. [Figure 27] Figure 25 is a perspective view of the staple pusher and staples in the staple cartridge assembly. [Figure 28] Figure 25 is a partial top view of the staple cartridge assembly, illustrating the staple pusher shown in Figure 27, indicated by dashed lines. [Figure 29] This is a cross-sectional view of the staple cartridge assembly shown in Figure 28, cut along the cutting line 29-29 in Figure 28. [Figure 30] Figure 29 is a cross-sectional view of the staple cartridge assembly, illustrating the operation of the lifting member. [Figure 31] Figure 25 is a partial perspective view of the staple cartridge assembly, illustrating the operation of the lifting member. [Modes for carrying out the invention]
[0045] Embodiments of this disclosure are described in detail herein with reference to drawings in which similar reference numerals identify similar or identical elements. Throughout this description, the term “proximal” refers to a part of a structure or its components that is closer to the user, and the term “distal” refers to a part of a structure or its components that is further away from the user. Directional reference terms such as “up,” “down,” and “side” are used to facilitate the description of embodiments and are not intended to have a limiting effect on the final orientation of any structure or any part thereof. Known features or configurations are not described in detail below to avoid obscuring this disclosure by providing unnecessary detail.
[0046] Referring here to Figures 1 to 3, a typical surgical stapler 1 in the form of a linear surgical stapler is shown for use in fixing tissue with staples and applying surgical buttress material 100 to tissue. This surgical stapler 1 generally includes a handle assembly 10, an elongated tubular body portion 20 extending distally from the handle assembly 10, and an end effector 30 extending distally from the elongated tubular body portion 20. The end effector 30 comprises an anvil assembly 40 and a staple cartridge assembly 50. The end effector 30 may be permanently attached to the elongated tubular body portion 20 or detachably coupled, and thus may be replaceable with a new end effector 30. The anvil assembly 40 and / or staple cartridge assembly 50 may be pivotable relative to each other, and as a result, the anvil 40 and / or staple cartridge assembly 50 may be movable between an open position in which the anvil 40 and staple cartridge assembly 50 are spaced apart from each other and an approach position in which the anvil 40 and staple cartridge assembly 50 are substantially adjacent to each other. The handle assembly 10 includes, for example, an actuation button 12 configured to actuate an electric motor (not shown) operably associated with an actuation sled 66 for ejecting staples 58 out of the staple cartridge assembly 50, as well as an open button 14 and an approach button 16 configured to actuate electric motors (not shown) operably associated with the anvil 40 and / or staple cartridge assembly 50 to move the anvil 40 and / or staple cartridge assembly 50 between an open position and an approach position.
[0047] For a detailed description of the structure and function of exemplary surgical staplers, one can refer to U.S. Patents 8,256,656, 7,819,896, and 7,128,253, the entirety of each of which is incorporated herein by reference. It should be noted that the principles of this disclosure are equally applicable to surgical staplers having other configurations, such as those described in, for example, U.S. Patents 7,334,717, 5,964,394, and 5,915,616, the entirety of each of which is incorporated herein by reference. Therefore, it should be understood that a variety of surgical staplers may be available.
[0048] Referring to Figure 2, the anvil assembly 40 includes an anvil plate (not shown) having a central longitudinal slot formed internally, and a cover plate 44 fixed on the anvil plate, so that the cover plate 44 defines a surface 46 facing the top or outside of the anvil assembly 40. The anvil plate may include multiple staples that form pockets / cavities (not shown) defined inward or within the tissue-facing surface (not shown) of the anvil plate.
[0049] Referring to Figure 3, the staple cartridge assembly 50 includes a cartridge carrier 52 that defines an elongated support channel 51 configured and dimensionally designed to selectively receive a staple cartridge 54 internally. The cartridge carrier 52 also defines the lower or outward-facing surface 53 of the staple cartridge assembly 50. The staple cartridge 54 is removable and replaceable within the cartridge carrier 52. The staple cartridge 54 includes a body portion 54a and a cover 54b. The body portion 54a defines staple pockets or retaining slots 55 for receiving a number of fasteners or staples 58 and staple pushers 60 internally. The staples 58 are of a conventional type and include a backspan having a pair of legs extending from the backspan. The legs terminate at tissue-penetrating tips. The staple pushers 60 are positioned within their respective staple pockets 55 and positioned between the staples 58 and the path of the working sled 66. A central longitudinal slot 57 is defined along the length of the staple cartridge 54 to allow the first knife blade 61 of the working sled 66 to pass through it.
[0050] Referring to Figures 4 and 5, a cavity 65 (Figure 3) is defined adjacent to the distal portion of the central longitudinal slot 57. This cavity 65 is configured to receive a fixing button 70 for supporting a binding suture 17 that secures the surgical buttress material 100 onto the staple cartridge 54, as will be discussed below. The proximal 55a and distal 55b portions of the main body portion 54a of the staple cartridge 54 are configured to secure the respective binding sutures 17 to them, thereby detachably securing the surgical buttress material 100 to the tissue-facing surface 56 (Figure 3) of the main body portion 54. For this purpose, the proximal 55a of the main body portion 54a defines a lateral groove 69 configured to securely receive each end portion of the binding suture 17 internally. For example, the ends of the binding suture 17 can be secured to the lateral groove 69 by friction fitting or by the use of adhesive. Alternatively, the binding suture 17 can be welded to the lateral groove 69 using ultrasound. Furthermore, the proximal portion 55a of the main body portion 54a includes a pair of lateral guides 59 extending from the tissue-facing surface 56 (Figure 3). The surgical buttress material 100 is received between the lateral guides 59. In this way, together with the pair of lateral guides 59, the binding suture 17 fixes the surgical buttress material 100 to the proximal portion 55a of the main body portion 54a.
[0051] Referring further to Figures 4 and 5, the surgical buttress material 100 is further secured to the staple cartridge 54 by another binding suture 17 in the distal portion 55b of the main body portion 54b. While this disclosure discloses two binding sutures 17 for securing the respective proximal portions 102a and distal portions 102b of the surgical buttress material 100 to the main body portion 54b, it is considered that any number of binding sutures 17 can be used to provide the effect of securing the surgical buttress material 100 to the staple cartridge 54. The distal portion 55b of the main body portion 54b of the staple cartridge 54 defines opposing lateral grooves 69 (only one shown) configured to secure and receive the respective ends of the binding sutures 17. The distal end 102b of the surgical buttress material 100 is secured to the distal portion 55b of the staple cartridge 54 using the binding sutures 17 secured in the opposing lateral grooves 69.
[0052] Referring here to Figures 6 to 10, to enhance the ability to fasten and detach the surgical buttress material 100 to and from the staple cartridge 54, the fastening button 70 is positioned in a cavity 65 in the body portion 54a of the staple cartridge 54. The cavity 65 is defined within the distal portion 55b of the staple cartridge 54. In particular, the central longitudinal slot 57 extends through the cavity 65. The fastening button 70 includes a first finger 72 and a second finger 74 configured to bend relative to each other. The fastening button 70 includes an engagement portion 75 positioned between the first finger 72 and the second finger 74 for supporting a portion of the binding suture 17 at its upper part. The fastening button 70 defines opposing circumferential grooves 76a, 76b configured to receive the binding suture 17 internally. Furthermore, the locking button 70 defines a notch 73 extending through a first finger 72 and a second finger 74. This notch 73 is configured to receive the second knife blade 62 of the working sled 66 through those fingers. In such a configuration, as the working sled 66 moves forward, the second knife blade 62 of the working sled 66 extends through the notch 73 and cuts a portion of the binding thread 17 that extends across the notch 73. At least one of the first finger 72 and the second finger 74 of the locking button 70 further defines a notch 77 configured to engage with a stop 67 (Figure 9) extending inward into the cavity 65 of the staple cartridge 54. In this configuration, when the locking button 70 is pressed into the cavity 65 in the direction of arrow "L" (Figure 9), the stopper 67 engages with the notch 77, and the stopper 67 prevents the locking button 70 from being pulled back in the opposite direction of arrow "L", so that the locking button 70 remains inside the cavity 65 located within it.
[0053] Referring to Figure 11, both ends of the binding thread 17 are fixed to the respective lateral grooves 69 (Figure 5) of the distal portion 55b of the staple cartridge 54, and a portion of the binding thread 17 is held in place within the cavity 65 of the staple cartridge 54 by a fixing button 70. In such a configuration, a portion of the binding thread 17 is cut between the first finger 72 and the second finger 74, and extending across the notch 73 (Figure 6), by the second knife blade 62 of the working sled 66 that advances through the notch 73.
[0054] Returning to Figure 6 for a brief reference, the working sled 66 includes a cam wedge 68 configured to engage sequentially with the staple pusher 60 (Figure 3), a first knife blade 61 configured to be received through a central longitudinal slot 57 to cut tissue and surgical buttress material 100, and a second knife blade 62 configured to be received through a notch 73 (Figure 7) of the locking button 70. During operation of the surgical stapler 1, the working sled 66 translates through the staple cartridge 54, advancing the cam wedge 68 to sequentially contact the staple pusher 60, moving the staple pusher 60 vertically within the staple pocket 55 and ejecting the staples 58 out of the staple pocket 55 toward the tissue-facing surface of the anvil plate (not shown) of the anvil assembly 40. Furthermore, the second knife blade 62 is configured to cut the binding sutures 17 positioned relative to the locking button 70, as will be discussed below.
[0055] Referring to Figure 11, first, the staple cartridge 54 is loaded into the cartridge carrier 52 (Figure 3). The surgical buttress material 100 can be detachably attached to the staple cartridge 54 at any time before or after loading the staple cartridge 54 into the cartridge carrier 52. The surgical buttress material 100 is manufactured from biocompatible materials that are bioabsorbable or non-absorbable, natural or synthetic. It should be understood that the surgical buttress material 100 can be formed using any combination of natural, synthetic, bioabsorbable, and / or non-bioabsorbable materials. The surgical buttress material 100 may also be biodegradable (e.g., formed from bioabsorbable and bioreabsorbable materials), and as a result, the surgical buttress material 100 will decompose or break down (physically or chemically) under physiological conditions in the body, and its decomposition products will be excretable or absorbable by the body. The components or parts of the surgical buttress material 100 may be formed from the same or different materials. The entire surgical buttress material 100 may be formed from a single sheet of material (e.g., cut) or from multiple sheets of material, which may be manufactured from the same or different materials and attached to each other by means of welding, adhesive, binding sutures, etc.
[0056] In some embodiments, at least a portion of the surgical buttress material 100 is made from biodegradable materials selected from the following group, namely natural collagen-forming materials, intestinal glands, and synthetic resins, which include biodegradable materials derived from alkylene carbonates, trimethylene carbonates, cyclobutane carbonates, caprolactone, valerolactone, dioxanone, polyanhydrides, polyesters, polyacrylates, polymethyl methacrylate, polyurethanes, glycolic acid, lactic acid, glycolide, lactide, polyhydroxy butyrates, polyorthoesters, polyhydroxy alkanoates, their homopolymers, and their copolymers. In some embodiments, at least a portion of the surgical buttress material 100 is made from a non-biodegradable material selected from the following group, which are polyolefins, polyethylene, polydimethylsiloxane, polypropylene, polyethylene and polypropylene copolymers, polyethylene and polypropylene compoundings, ultra-high molecular weight polyethylene, polyamides, polyesters, polyethylene terephthalate, polytetrafluoroethylene, polyether esters, polybutaesters, polytetramethylene ether glycol, 1,4-butanediol, and polyurethane.
[0057] The surgical buttress material 100 may be porous, nonporous, or a combination thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and nonwoven structures) and / or foams (e.g., open-cell foams or closed-cell foams). Suitable nonporous structures include, for example, films. The surgical buttress material 100, or a portion thereof, may be a nonwoven fabric structure, mesh material, braided material, and / or a molded or extruded sheet formed by a melt-blown or melt-spun method. The surgical buttress material 100, or a portion thereof, may be a single porous layer or a nonporous layer, or may include multiple layers including any combination of porous and / or nonporous layers.
[0058] During use, the loaded surgical stapler 1 is introduced to the surgical site, for example, via a trocar or other access device. Tissue can be grasped between the anvil assembly 40 and the staple cartridge assembly 50 by pressing the closing button 16 on the handle assembly 10. Once the anvil 40 and staple cartridge assembly 50 are clamped over the tissue, the clinician presses the actuation button 12 to initiate the stapling process, thereby advancing the actuation sled 66. As the actuation sled 66 advances distally and biases the staple pusher 60 upward relative to the back span of the staple 58, the staple 58 is ejected from the staple pocket 55 and penetrates the surgical buttress material 100 and the captured tissue, thereby stapling the surgical buttress material 100 to the tissue. The tissue-penetrating tip of the staple 58 is bent in a pocket within the anvil assembly 40 that bends the tip of the staple, thereby securing the surgical buttress material 100, which is attached to the tissue-facing surface 56, to the tissue.
[0059] When the surgical stapler 1 is activated, the first knife blade 61, which is associated with the surgical stapler 1 and supported by the operating sled 66, enters the notch 104 of the surgical buttress material 100, and there it cuts the tissue between the rows of staples with bent tips, as well as the surgical buttress material 100 on the tissue. The resulting tissue is divided and stapled together with staples 58.
[0060] Referring to Figures 12 to 14, as the working sled 66 moves further forward, the first knife blade 61 cuts through the binding suture 17 that secures the surgical buttress material 100 to the proximal portion 55a of the staple cartridge 54. When the working sled 66 reaches the distal portion 55b of the staple cartridge 54, the second knife blade 62 of the working sled 66 extends through the notch 73 of the fixing button 70 and cuts a portion of the binding suture 17 extending through it, thereby cutting the binding suture 17 that secures the surgical buttress material 100 to the distal portion 55b of the staple cartridge 54. In this way, the surgical buttress material 100 is detachable from the staple cartridge 54 and divided into a first portion 132 and a second portion 134. At this time, the clinician can move the end effector 30 and / or the working sled 66 proximal to remove the surgical buttress material 100 stapled to the tissue from the end effector 30. In this way, the surgical buttress material 100 is stapled to the tissue, thereby sealing and reinforcing the staple line created by the staples.
[0061] Next, the used staple cartridge 54 is removed, and a new staple cartridge 54 and new surgical buttress material 100 can be loaded onto the staple carrier 52. Reloading of removable and replaceable staple cartridges is disclosed in U.S. Patent No. 9,016,539, which is incorporated herein by reference.
[0062] Referring to Figures 15-17, another embodiment of a staple cartridge for use with a surgical stapler (Figure 1) is shown as staple cartridge 154. The components of staple cartridge 154, which are substantially similar to those of staple cartridge 54 (Figure 3), are not described herein to avoid obscuring the disclosure with unnecessary detail. Staple cartridge 154 may be detachably attached to a cartridge carrier 52 (Figure 1), for example, by snap-fit or interlocking fit. Staple cartridge 154 is configured to detachably secure surgical buttress material 200 thereto. In particular, the proximal portion 154a of staple cartridge 154 includes opposing lateral guides 159 configured to receive surgical buttress material 200 between them, and a hook portion 190 configured to secure the proximal portion 202 of the surgical buttress material 200, as discussed below. Furthermore, the distal portion 154b of the staple cartridge 154 defines opposing lateral grooves 169 for securing each end portion of the binding suture 17 internally, and a slot 163 configured to receive a slider cam 170 internally, as will be described later, thereby allowing the surgical buttress material 200 to be removed from the staple cartridge 154.
[0063] The surgical buttress material 200 includes a proximal portion 202 which includes a stepped portion 206 configured to engage with the lateral guide 159 of the staple cartridge 154, and defines a cavity 209 configured to engage with and receive the hook portion 190 of the staple cartridge 154. The hook portion 190 may include a tapered portion 192 of the surgical buttress material 200 configured to enhance fixation with the staple cartridge 154. The distal portion 204 of the surgical buttress material 200 defines opposing lateral notches 205 configured to facilitate engagement with the binding suture 17. The distal portion 154b of the staple cartridge 154 defines lateral grooves 169 configured to secure each end portion of the binding suture 17. In addition, the distal portion 154b of the staple cartridge 154 further defines a slot 163 sized to receive a slider cam 170 which is slidably received inside.
[0064] Referring to Figures 19 and 20, the slider cam 170 is slidable laterally within the slot 163. Referring particularly to Figure 18, the slider cam 170 includes a body 171 having an engaging surface 172 configured to engage with a portion of a binding thread 17 fixed in a corresponding lateral groove 169 in order to detach the binding thread 17 from the corresponding lateral groove 169. The slider cam 170 further includes an inner portion 177 extending inward from the body 171, and a finger 174 extending distally from the body 171. The inner portion 177 has an arched or tapered surface 178 configured to engage with a portion of the working sled 166. The finger 174 is spaced apart from the body 171, and as a result, the finger 174 is configured to move toward and away from the body 171. In one embodiment, the finger 174 is biased to move away from the body 171, causing the slider cam 170 to move laterally outward, with the hook portion 174a of the finger 174 engaging with the outer stop portion 157a of the support member 151 (Figure 20) of the staple cartridge 154 to limit the lateral displacement of the slider cam 170. In this way, the slider cam 170 is movable laterally outward by a predetermined amount. For example, the slider cam 170 can be displaced laterally outward by a predetermined amount to displace the binding thread 17 out of the corresponding lateral groove 169 of the staple cartridge 154.
[0065] Referring here to Figures 20-22, the slider cam 170 is positioned toward the inside of the end portion of the binding thread 17 fixed in each lateral groove 169 (Figure 16) of the staple cartridge 154. Initially, the inner portion 177 (Figure 18) of the slider cam 170 is positioned to substantially coincide with the central longitudinal slot 157 (Figure 20). The finger 174 extends upward from the plane defined by the body 171 and the inner portion 177, and as a result, the finger 174 engages with the inner stop portion 157b to restrict displacement toward the central longitudinal slot 157. In such a configuration, the slider cam 170 is slidable between a first position in which the inner portion 177 substantially coincides with the central longitudinal slot 157 (Figure 20) and a second position in which the engaging surface 172 of the body 171 (Figure 18) is substantially coplanar with the lateral surface of the staple cartridge 154 (Figure 22).
[0066] Referring here to Figures 20 to 24, initially, the slider cam 170 is positioned toward the inside of the end portion of the binding suture 17 that secures the distal portion 204 (Figure 17) of the surgical buttress material 200 to the staple cartridge 154, thereby securing the end portion of the binding suture 17 within the respective lateral grooves 169 (Figure 16) of the staple cartridge 154. As the working sled 166 advances distally, the elongated engaging portion 179 of the working sled 166 engages with the arcuate or tapered surface 178 of the inner portion 177 (Figure 16) of the slider cam 170, and these surfaces sequentially move the slider cam 170 laterally outward in the direction of arrow "O" until the hook portion 174a of the finger 174 engages with the outer stop portion 157a. The lateral outward displacement of the slider cam 170 biases the corresponding end portion of the binding suture 17 outward from the corresponding lateral groove 169. In this way, one end of the binding suture 17 is released from the staple cartridge 154, thereby allowing the surgical buttress material 200 to be removed from the staple cartridge 154. The method and use of the staple cartridge 154 are substantially the same as the method and use of the staple cartridge 54 described above and are therefore not described herein.
[0067] Referring here to Figures 25–31, yet another embodiment of a staple cartridge for use with a surgical stapler (Figure 1) is shown as staple cartridge 254. The components of staple cartridge 254, which are substantially similar to those of staple cartridges 54 (Figure 3) and 154 (Figure 15), are not described herein in order to avoid obscuring the disclosure with unnecessary detail. Staple cartridge 254 may be detachably secured to a cartridge carrier 52 (Figure 1), for example, by snap-fit or interlock-fit. Staple cartridge 254 defines a staple-retaining slot 255 (Figure 31) for receiving a plurality of fasteners or staples 58 (Figure 3) and a staple pusher 60 (Figure 3) inside. A central longitudinal slot 257 (Figure 3) is defined along the substantial length of staple cartridge 254, facilitating the passage of the first knife blade 61 (Figure 6) of the working sled 66 through it. In particular, the proximal portion 255a and distal portion 255b of the staple cartridge 254 are configured to detachably secure the surgical buttress material 300 to the staple cartridge 254. The proximal portion 255a of the staple cartridge 254 includes a pair of lateral guides 259 extending from a tissue-facing surface 256. The surgical buttress material 300 is received between the lateral guides 259. Furthermore, the proximal portion 255a of the staple cartridge 254 includes a hook portion 290 with a tapered surface 292 configured to engage with a cavity 304 defined within the proximal portion 300a of the surgical buttress material 300.
[0068] The distal portion 255b of the staple cartridge 254 defines opposing lateral grooves 269 configured to receive the respective ends of binding sutures 17 for securing the surgical buttress material 300 to the staple cartridge 254. In addition, the distal portion 255b further defines a pair of opposing slots 271 configured to receive the respective lifting members 263 (Figure 27). In such a configuration, a portion of the surgical buttress material 300 is interposed between the opposing slots 271. The lifting members 263 may be disposed on the respective most distal pushers 260. In one embodiment, the lifting members 263 and the most distal pushers 260 may be formed as a single structure.
[0069] A portion of the surgical buttress material 300 is interposed between the slots 271, and as a result, each end of the binding suture 17 is fixed to the lateral groove 269, so that the binding suture 17 extends over the opposing slots 271. In such a configuration, the binding suture 17 fixes the surgical buttress material 300 to the distal portion 255b of the staple cartridge 254.
[0070] With reference to Figures 30 and 31, when the lifting member 263 extends outward from each slot 271, the lifting member 263 biases the binding suture 17 toward, for example, the anvil assembly 40 so that it moves away from the surgical buttress material 300, and as a result the surgical buttress material 300 can be released from the staple cartridge 254. In one embodiment, the binding suture 17 may be flexible.
[0071] During the operation of the surgical stapler 1, the working sled 66 translates through the staple cartridge 254, advancing the cam wedge 68 of the working sled 66 and sequentially contacting the staple pusher 260. This causes the staple pusher 60 to move vertically within the staple pocket 255 and biases the staples 58 toward the anvil assembly 40 from the staple pocket 255. Furthermore, the lifting members 263 extend outward from their respective slots 271 (Figure 26), releasing the surgical buttress material 300 from the staple cartridge 254. The method and use of the staple cartridge 254 are substantially the same as the method and use of the staple cartridges 54, 154 described above and are therefore not described herein.
[0072] While several embodiments of this disclosure are shown in the drawings, this disclosure is not intended to be limited to these embodiments, as it should be as broad as the art permitted and this specification should be read in the same manner. Therefore, it should be understood that this disclosure is not limited to the exact embodiments described, and various other changes and modifications can be made by those skilled in the art without departing from the scope or spirit of this disclosure. Furthermore, components and features shown and described in relation to a particular embodiment can be combined with components and features of other particular embodiments without departing from the scope of this disclosure, and such modifications and variations are also included within the scope of this disclosure. Therefore, the above description should be interpreted not as limiting, but merely as an example of preferred embodiments. Accordingly, the scope of the embodiments should be determined not by the examples given, but by the appended claims and their legal equivalents.
Claims
1. An end effector used with a surgical stapler, wherein the end effector is A staple cartridge assembly comprising an operating sled configured for axial displacement, wherein the staple cartridge assembly defines a lateral slot, and the staple cartridge assembly comprises a first stopper, A binding thread including a first end and a second end that are detachably fixed to each side of the staple cartridge assembly, Buttress assembly and Equipped with, The buttress assembly is A surgical buttress material configured to be supported on the tissue-facing surface of the staple cartridge assembly, A slider cam slidably received in the lateral slot of the staple cartridge assembly and Includes, The slider cam is configured to engage with the working sled, and when the working sled is advanced while engaged with the slider cam, the slider cam is displaced laterally, and then releases the first end of the binding thread from the corresponding side of the staple cartridge assembly. The aforementioned slider cam is A lateral portion having a plane configured to engage with the first end of the binding thread, The main body portion including the aforementioned lateral portion, A finger that flexibly extends distally from the main body portion, wherein the finger is configured to bend toward the main body portion and away from the main body portion, and Includes, The first stop portion of the staple cartridge assembly is an end effector that engages with a portion of the finger to restrict the lateral displacement of the slider cam.
2. The end effector according to claim 1, wherein the slider cam includes a curved surface configured to engage with the operating sled.
3. The end effector according to claim 1, wherein the finger includes a hook portion configured to engage with the first stop portion.
4. The end effector according to claim 1, wherein the slider cam is positioned between the first end of the binding thread and the second end of the binding thread.
5. The end effector according to claim 1, wherein the surgical buttress material defines a plurality of opposing notches for receiving the binding sutures, thereby enhancing the fixation of the surgical buttress material to the staple cartridge assembly.
6. An end effector used with a surgical stapler, wherein the end effector is A staple cartridge assembly comprising an operating sled configured for axial displacement, wherein the staple cartridge assembly defines a lateral slot, and the staple cartridge assembly defines a central longitudinal slot extending along the length of the staple cartridge assembly, A binding thread including a first end and a second end that are detachably fixed to each side of the staple cartridge assembly, Buttress assembly and Equipped with, The buttress assembly is A surgical buttress material configured to be supported on the tissue-facing surface of the staple cartridge assembly, A slider cam slidably received in the lateral slot of the staple cartridge assembly and Includes, The slider cam is configured to engage with the working sled, and when the working sled is advanced while engaged with the slider cam, the slider cam is displaced laterally, and then releases the first end of the binding thread from the corresponding side of the staple cartridge assembly. The lateral slot of the staple cartridge assembly further includes a first stopper configured to restrict the lateral displacement of the slider cam toward the central longitudinal slot, The aforementioned slider cam is A lateral portion having a plane configured to engage with the first end of the binding thread, The main body portion including the aforementioned lateral portion, A finger that flexibly extends distally from the main body portion, wherein the finger is configured to bend toward the main body portion and away from the main body portion, and Includes, The first stop portion of the staple cartridge assembly is an end effector that engages with a portion of the finger to restrict the lateral displacement of the slider cam.