Surgical Stapling Instrument for Integrated Linear and Purse-String Sutures
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Solution Overview
Problem
Existing minimally invasive surgical instruments face challenges in applying purse string sutures consistently and efficiently, particularly in bowel resection procedures, due to difficulties in manual placement and limited tissue cuff between the staple line and transection plane, leading to potential complications with circular staplers.
Innovation Solution
A surgical stapling instrument with elongate shaft and end effector featuring first and second jaws that apply both linear staples and a purse string suture simultaneously, allowing for increased tissue cuff and minimizing complications by securing the suture with staples, and incorporating a suture holding member to manage tension and compliance.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If purse string sutures are applied manually in minimally invasive surgery, then the surgical procedure can be performed, but the placement is difficult and time-consuming
Solution Approach 1:
The patent combines the application of linear staples and purse string sutures into a single integrated surgical instrument. The end effector simultaneously delivers both linear staples to the tissue and the purse string suture, eliminating the need for separate manual steps and reducing procedural time while maintaining ease of operation through automated delivery
Solution Approach 2:
The purse string suture is pre-loaded into the surgical instrument's end effector in a ready-to-deliver configuration. This preliminary preparation allows the suture to be applied immediately upon insertion into the tissue, eliminating the need for manual handling and tying during the procedure, thus increasing productivity while maintaining operational ease
2Reliability
If the tissue cuff between staple line and transection plane is increased, then complications with circular staplers are minimized, but the surgical instrument complexity increases
Solution Approach 1:
The surgical instrument divides the stapling function into distinct segments: linear staple delivery for creating the staple line and purse string suture delivery for creating the circumferential closure. This segmentation allows each component to be optimized independently, with the purse string mechanism specifically designed to create adequate tissue cuff while maintaining overall instrument manageability
Solution Approach 2:
The purse string suture acts as an intermediary element between the linear staple line and the final anastomosis. It creates a compliant hoop that maintains tissue cuff and prevents staple line crossing, thereby reducing complications without requiring complex instrument modifications
3Productivity
If a circular stapler is used for anastomosis, then the procedure can be completed, but staple line crossing and tissue cuff issues arise
Solution Approach 1:
The purse string suture is applied preliminarily to create a compliant hoop that prevents staple line crossing before the circular stapler is applied. This preliminary action counteracts the potential harmful effect of staple line crossing by establishing a protective barrier that maintains adequate tissue cuff and prevents harmful interactions between the linear and circular stapling systems
Data Source
AI summary
A surgical stapling instrument is configured to dissect tissue, apply a linear staple line along one side of the tissue dissection and apply a suture, such as a purse string suture, to the other side of the tissue dissection. The instrument comprises an elongate shaft, first and second jaws configured to open and close and a cutting element. The instrument includes a first row of staples in each of the first and second jaws having a suture extending therethrough and a second row of staples in the second jaw. A drive member is configured to translate distally through the end effector to dissect tissue with the cutting element, drive the second row of staples into the tissue on one side of the dissection and to apply the first row of staples and suture in combination to form a purse string suture on the other side of the tissue dissection.