CA1303933C - Stapler cartridge and anvilless surgical stapler - Google Patents
Stapler cartridge and anvilless surgical staplerInfo
- Publication number
- CA1303933C CA1303933C CA000576327A CA576327A CA1303933C CA 1303933 C CA1303933 C CA 1303933C CA 000576327 A CA000576327 A CA 000576327A CA 576327 A CA576327 A CA 576327A CA 1303933 C CA1303933 C CA 1303933C
- Authority
- CA
- Canada
- Prior art keywords
- staple
- housing
- legs
- opening
- set forth
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07228—Arrangement of the staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1125—Forceps, specially adapted for performing or assisting anastomosis
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
- Dental Preparations (AREA)
- Containers And Packaging Bodies Having A Special Means To Remove Contents (AREA)
- Coating Apparatus (AREA)
Abstract
ABSTRACT OF THE DISCLOSURE
An anvilless surgical stapler is disclosed which includes a pair of stapling assemblies which are mounted on the articulated handles of an applicator. Each stapling assembly includes a mounting block and a staple cartridge which is slidably mounted within the block. Further, each cartridge has a housing with a plurality of openings in which staples are slidably received along with a plurality of pushers. When the stapling assemblies are brought together, one or more ribs in the mounting blocks cause the pushers to fire the staples from the openings of the staple cartridge housings. A pair of deformable lips is also provided at the mouth of each opening for deforming the legs of each staple inwardly toward each other in order to embed the staple into tissue without penetrating into the tissue. The lips also permit passages of the deformed staples under the biasing force of the pushers.
An anvilless surgical stapler is disclosed which includes a pair of stapling assemblies which are mounted on the articulated handles of an applicator. Each stapling assembly includes a mounting block and a staple cartridge which is slidably mounted within the block. Further, each cartridge has a housing with a plurality of openings in which staples are slidably received along with a plurality of pushers. When the stapling assemblies are brought together, one or more ribs in the mounting blocks cause the pushers to fire the staples from the openings of the staple cartridge housings. A pair of deformable lips is also provided at the mouth of each opening for deforming the legs of each staple inwardly toward each other in order to embed the staple into tissue without penetrating into the tissue. The lips also permit passages of the deformed staples under the biasing force of the pushers.
Description
- ~ 3a~3~3 This invention relates to a staple cartridge and, more particularly, to an anvilless surgical stapler and a method of affixing a staple to tissue.
Heretofore, various types of stapling instruments have been known for affixing staples to body tissue.
Generally, the staples have been applied by using instruments having an anvil and an ejector mechanism for driving the legs of a staple through the tissue and against the anvil for deforming the legs into a "B"
shape or the like. In some cases, the stapling instruments have been used to apply a purse string to the tissue, for example, for an end to end anastomosis procedure.
Although various types of instruments have been known for driving the legs o~ a staple through tissue, there are times when it is not desirable or practical to drive the legs of a staple through the body tissue in order to affix a staple. For example, it is generally not practical to use a stapling instrument having an anvil for closing an incision in fascia tissue since there is usually limited space for access of an anvil.
Further, in cases where a purse string i5 to be applied to a tubular section of tissue, the stapling instruments haye been rather cumbersome and complex in order to provide an anvil against which the staples can be deformed in order to hold a purse string in place.
Accordingly, it is an--object of the invention to . ~ ~
~)3~33 provide a relatively simple surgical stapler for applying staples to body tissue without need for an anvil.
It is another object of the invention ~o provide a relatively simple stapling assembly for a surgical 5 stapler.
It is another object of the invention to provide means for affixing a staple to body tissue without complete piercing of the ~issue by the legs of the staples.
It is another object of the invention to provide lO a relatively simple instrument for applying a purse string to body tissue.
It is another o~ject of the invention to provide a staple which can be affixed to body tissue without complete piercing of the tissue.
Accordingly, one aspect of the invention provides a one-piece staple having a base of undulating shape and defining one of a recess and a projection and a pair of deformable legs extending from said base, each said leg extending angularly inwardly of said base towards the other 20 of said legs and having a sharp point at distal end. This one-piece staple can be affixed to tissue without complete piercing of the tissue. As indicated, each leg has a sharp point at a distal end for penetrating into ~ody tissue. The staple also preferably includes a pair of 25 rounded transition portions each of which extends between the base and one of the legs.
Another aspect of the invention provides a staple cartridge for tissue comprising a housing having a plurality of openings therein, a plurality of staplas, each 30 staple being slidably received in a respective opening of - said housing and including a base and a pair of legs extending from said base, a plurality of pushers, each said pusher being slidably received in a respective opening of said housing, first means in said housing for 35 simultaneously moving each pusher from a rest position thereof to an actuated position to expel said staples from said openings, and second means on said housing at a mouth of each opening for deforming the legs of each staple ~ .
3.303~33 - 2a inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
~ , : ' - ~L3t~ 9;13 The deforming means of the staple cartridge may be in the form of an inwardly directed pair of lips on the housing at each mouth to define an outlet of less width than the respective opening. In addition, each lip is made to be ~eformable under a biasing force of the first means in order to permit passage of a deformed staple thereby. Thus, as the staple is being expelled from an opening, the lips first serve to deform the legs of a staple inwardly toward each other so as to penetrate into and grip the tissue. 5econd, the lips are able to move apart to permit passage of the deformed staple under the biasing force.
The staple cartridge may also be constructed so that the housing includes a recess with extends transversely within a plane of the openings in order to receive a purse string therein for expelling within and with the deformed staples. ïn this regard, the staple cartridge is used t`o attach a purse string to body tissue.
The invention also provides a stapling assembly which is comprised of a mounting block having an internal recess for slidably mounting a staple cartridge therein as well as a centrally disposed rib within the recess for abutting a pusher in response to movement of the housing of a staple cartridge into the recess of the mounting block. This stapling assembly is constructed so that both the block and the cartridge are of elongated rectangular shape with the housing of the staple cartridge containing a plurality of staples. In addition, the mounting block may be provided with a single rib which extends longitudinally of the mountiny block in order to abut all of the pushers.
Alternatively, the mounting block may include two or more ribs for abutting respective sets of pushers.
The invention also provides an anvilless surgical .. ~,~ , ~3~39~3 stapler which is comprised of a pair of stapling assemblies as above and an applicator on which the stapling assem~lies are mounted . To this end, the applicator includes a pair of mounting plates disposed in opposed relation to each other with each plate having means for mounting a respective stapling assembly thereon. In addition, the applicator includes a pair of articulated handles connected to the mounting plates for moving the plates toward each other.
Each staple cartridge of a stapling assembly i5 also provided with a projection at each end for abutting an opposed staple cartridge so as to define a tissue-receiving gap between the cartridges. Thus, the surgical stapler can be initially brought into a clamped position about a tubular section of tissue before firing of the staples. In this respect, the applicator includes a releasable catch mechanism for holding the handles in this tissue-clamping position with the projections of the staple cartridges abutting respective cartridges.
The handles of the applicator are also movable fxom the tissue-clamping position into a staple firing position upon release of a safety machanism in order to move each cartridge into a respective housing while expelling the staples through the openings of the respective housings. After firing of the staples, the handles of the applicator can be moved apart so as to complete a stapling operation.
The projections on the staple cartridges may also be arranged to define a groove at each end of the cartridge in order to receive a purse string. In addition, each stapling assembly may be provided with a string retainer on the mounting block thereof for holding a loop of the purse string therein for assembly 3~ purposes.
The invention also provides a cartridge assembly which is comprised of a pair of stapling assemblies and ~ 303933 a holder which releasably holds the assemblies in somewhat spaced parallel relation. In this respect, the holder is formed of a base plate with a plurality of ribs on one side defining a pair of parallel grooves with each groove 5 receiving a respective retainer of a stapling assembly therein. In addition, means are provided for releasably engaging a respective retainer in a respective gro~ve. The holder is also provided with an outwardly extending tab for lifting of the plate from the stapling assemblies after lo mounting on an applicator.
The invention also provides a method of affixing a staple to tissue wherein a biasing force is applied on the base of a staple to push the legs of the staple into the tissue while simultaneously applying lateral forces 15 against the legs to deform each leg toward the other leg.
~he forces are applied to the staple with vectors in the same direction, i.e. without any opposed force as from an anvil. In this respect, the lateral forces can be applied while pushing the staple through an outlet of less width 20 than the staple.
Embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, wherein:
Fig. 1 illustrates a perspective view of an 25 anvilless surgical stapler;
Fig. 2 illustrates a partial view of a safety mechanism employed with the handles of the stapler of Fig.
l;
Fig. 3 illustrates a view of the safety mechanism 30 in a tissue-clamping position;
- Fig. 4 illustrates an enlarged exploded view of a cartridge assembly for mounting on an applicator;
Fig. 5 illustrates a view of a pair o stapling ~ jr;., ~3~)3933 assemblies after mounting on an applicator;
Fig. 6 illustrates a cross-sectional view of the mounted stapling assemblies;
Fig. 7 illustrates a cross~sectional view of the 5 surgical stapler assemblies in a tissue-clamping position;
Fig. 8 illustrates a cross-sectional view similar to Fig. 7 of the stapling assemblies in a fired position;
Fig. 9 illustrates a partial view of a stapling assembly in an initial deformation position;
10Fig. 10 illustrates a view similar to Fig. 9 during further deformation of a staple;
Fig. 11 illustrates a view similar to Figs. 9 and 10 of a deformed staple;
Fig. 12 illustrates a view similar to Figs. 9, 10 15 and 11 with a deformed staple expelled from a stapling assembly;
Fig. 13 illustrates a tubular section of tissue having a purse string applied thereto by the staple of Fig.
l; and 20Fig. 14 illustrates a modified staple.
Referring to Fig. 1, the anvilless surgical stapler 10 is used, for example for applying a pu~se string 11 to a tubular section of tissue 12. In this respect, the term "anvilless" means that there is no opposing anvil or 25 separate member to deform the legs of a staple. As indicated, the stapler 10 includes a pair of stapling assemblies 13 and an applicator 14 constructed in the manner of a ~orceps.
Re~erring to Figs. 5, 6 and 7, each stapling 30 assembly 13 includes a mounting block 15 and a staple .~
~L303~;~3 cartridge 16 slidably mounted in the mounting block 15.
As indicated in Fig. 5, each of the mounting block 15 and staple cartridge 16 is of elongated rectangular shape.
Referring to Fig. 7, the mounting block 15 includes an intexnal recess 17 for slidably receiving a staple cartridge 16 as well as a centrally disposed rib 18 within the recess 17. This rib 18 is fixedly secured to the remainder of the block 15. This rib 18 may extend longitudinally of the block 15 or a plurality of discrete ribs (not shown) may be used.
As indicated in Fig. 6, two pins P are provided in each block 15 to provide resistance and to hold the cartridge halves together. Each pin P passes through and is initially at the bottom of a groove G in the block 15 which widens in a direction away from the respective staple cartridge 16.
Referring to Figs. 6 and 7, each staple cartridge 16 includes a housing 19 having a plurality of longitudinally spaced apart openings 20 in each of which a staple 21 is slidably received. In addition, a plurality of pushers 22 are slidably mounted within the housing 19 with each pusher 22 being aligned with an opening 20 and a staple 21 therein as well as in alignment with a rib 18 for abutting thereagainst.
Referring to Fig. 9, each staple 21 i5 of one-piece construction having a base 23 of undulating shape to define a recess 24 and a pair of deformable legs 25 which extend from the base 23. As indicated, each leg 25 extends angularly inwardly of the base 23 towards the other leg 25 and has a sharp point 26 at the distal end.
Each staple 21 also includes a pair of rounded transition portions 27 each of which extends between the ~ase 23 and a leg 25. Further, each leg 25 is disposed on a rectilinear axis with the sharp point defined, for example by an included angle of 35. Tha staple 21 is , ~L303933 made of any suitable cross section, such as a circular cross-section as well as of any suitable material for the purposes intended such as stainless steel and absorbable materials.
Referring to Fig. 9, the housing 19 has a pair of opposed walls 28 defining each internal opening 20. In addition, each wall 28 is provided on the outside with a stiffener plate 28' and has a firct slot 29 extending longitudinally of the opening 20 in order to slidingly receive one side of a staple 21, that is, a rounded transition portion 27. In addition, a second slot 30 of greater width than the slot 29 extends coaxially of the slot 29 in order to slidably receive one side of a pusher 22.
As indicated in Fig. 9, the width of a staple 21 is greater than the width of a pusher 22. Further, the lower surface of each pusher 22 is provided with a surface complementary to the undulating base 23 of a staple 21 so as to have a projection (not shown) seated in the recess 24 of the staple 21. This arrangement serves to center the staple 21 within the opening 20 while also ensuring uniform motion of a staple 21 out of the opening 20.
The means for deforming the legs 25 of a staple 21 at the mouth of each opening 20 is constituted by a pair of inwardly directed lips 31. As indicated, each lip 31 is disposed at one end of the staple receiving slot 29 in a wall 28. Further, the lips 31 are spaced apart to define an outlet of less width than the opening 20 and less width than a staple 21. In this respect, the housing 19 is made of a material sufficient to permit deformation of the legs 25 of a staple 21 while at the same time being deformable to spread apart to permit passage of a deformed staple 21 under a biasing force on the respective pushers 11. Each lip 31 may also be of material resilient enough to permit the passage of a deformed staple while still capable of returning to its .
9~3 previous position and form. Such resiliency is required if successive staples are fired as, for example, in a skin stapler. Additionally, lips 31 may have an articulation means for achieving such resiliency.
As indicated in Fig. 9, the tip of each staple leg 25 is angled such that the heel (i.e. rear) of the angled tip slides within a slot 29 so that the sharp tip does not dig into the lip 31 during firing. In this respect, the slot 29 is curved within the lip 31.
Referring to Figs. 7 and 8, the ribs 18 constitute a means for moving the pushers 22 from a rest position in the respective housings 19, as indicated in Fig. 7, to an actuated position, as indicated in Fig. 8, adjacent the outlet of each opening 20. In this respect, a suitable means such as a bar may be connected to one or more pushers 22 in order to move the pushers simultaneously.
As indicated in Figs. 9 and 12, each housing 19 includes a recess 32 which extends along the housing 19 transversely of and across the respective openings 20 to receive a purse string 11.
Referring to Fig. 6, the openings 20 and respective staples 21 of each cartridge 16 are offset longitudinally of the openings 20 and staples 21 of the opposed cartridge 16. This allows the clamped tissue 12 to protrude into the openings 20 and also inhibits the staples 21 from penetrating both sides of the tissue 12.
Referring to Fig. 5, each stapling assembly 13 includes a retainer 33 which is mounted in fixed relation on a mounting block 15. As indicated, each retainer 33 defines an elongated space within which a loop of the string 11 may be retained.
As also indicated in Fig. 5, each cartridge 16 has a projection extending from each end of the housing 19 for abutting an opposed cartridge 16 in order to define a tissue-receiving gap as indicated in Fig. 6 between the cartridges 16. This gap is such as to avoid ~303~33 crushing of the tissue. Fur~her, each projection 34 can be provided with a recess 57 to receive a length of the purse string 11 therein.
The projections 34 also serve to transfer the forces necessary to fire the stapler. Alternatively, each staple cartridge may have a single projection at each end which is about half the width of a cartridge housing 19 so as to abut an aligned cartridge housing 19 while aligning with a similar projection of the opposed cartridge. In this case, the purse string would extend between the two projections at each end of the cartridges.
Referring to Fig. 1, the applicator 14 includes a pair of mounting plates 35 which are disposed in opposed relation to each other and a pair of articulated handles 36 which are connected to the mounting plates 35 for moving the plates 35 towards each other. As indicated, the handles 36 are pivotally connected to each other about a pivot pin 37. Also, each handle 36 includes a finger gripping portion 38 at a proximal end. A spring (not shown~ may also be provided to bias the handles 36 apart.
Referring to Fig. 4, each mounting plate 35 has means 39 for mounting a respective stapling assembly 13 thereon. As indicated, each means 39 includes a bracket 40 integral with a plate 35 from which a mounting leg 41 extends in spaced relation to the mounting plate 35. In addition, each stapling assembly 13 is provided with a sleeve-like connector 42 which releasably receives a mounting leg 41. A suitable detent 58 may be provided in the sleeve connector 42 to be releasably engaged in a groove 43 of the mounting leg 41.
In order to mount a stapling assembly 13 in place, the sleeve connector 42 is slid over the mounting leg 41 until the detent 58 catches in the groove 43 of the mounting leg 41.
Referring to Fig. 1, the applicator 10 includes a ~3()3~33 catch mechanism 44 which serves to approximate a predetermined clamping position of the applicator 10.
This mechanism 44 is disposed on the handles 36 at the proximal ends and is of generally known construction and need not be further described. In addition, a safety mechanism 45 is provided at the proximal end for stopping the handles 36 in a tissue-clamping position (as indicated in Fig. 6) with the projections 34 abutting a respective cartridge 16. As indicated in Figs. 1 and 2, the safety mechanism 45 is in the ~orm of a lever which is plvotally mounted about a pin 46 on the catch mechanism 44 and includes a lateral tab 47 which is sized to permit pivoting of the lever 45 by a thumb of a surgeon. As indicated in Fig. 3, when in the tissue-clamping position, the lever 45 abuts against an abutment surface 48 on the opposite handle 36 while the catch mechanism 44 holds the handles 36 in place.
Re~erring to Fig. 4, a holder 50 is provided to releasably hold a pair of stapling assemblies 13 in order to form a cartridge assembly. As indicated, the holder 50 is formed of a base plate 51 with a plurality of ribs 52 on one side forming a pair of parallel spaced apart grooves 53 for receiving a retainer of each stapling assembly 13. In addition, means are provided for releasably engaging each retainer 33 in a respective groove 53. For example, the means may be in the form of small projections 54 which fit into small spaces 55 between each retainer 33 and a mounting block 15 of a stapling assembly 13 (see Fig. 5). As indicated, the grooves 53 may be dis-continuous, that is the internal ribs 52 need not extend the length of the plate 51.
Alternatively, the holder 50 may grip the assemblies 13 at the ends rather than the sides as shown.
The holder 50 is also provided with an outwardly extending tab 56 at one end of the plate 51. This tab 56 serves to lift the plate 51 from the stapling assemblies 13 after mounting of the assemblies 13 on the b ,~
.
~3~13933 mounting plates 35 on the handles 36 of the applicator 14. Alternatively, instead of using a tab 56, a pair of finger engaging recesses may be provided on opposite ends of the plate 51, for example on the lower end of the plate 51 as viewed in Fig. 4.
In use, the stapler 10 may be provided with the stapling assemblies 13 in place. If not, a cartridge assembly as indicated in Fig. 4 may be brought to the mounting plates 35 with the handles 36 in an opened rest position. At this time, the stapling assemblies 13 can be slid onto the respective mounting legs 41 and snap-fitted in place as indicated in Fig. 5. Thereafter, the holder 50 can be removed, for example, by a slight tilting up of the plate 51 from the retainers 33.
Thereafter, the stapler 10 can be brought into position about a tubular section of tissue 12 as indicated in Fig. 1. Next, the handles 36 can be brought into a tissue-clamping position with the catch mechanism 44 engaged and the safety mechanism lever 45 in abutment with the surface 48 as indicated in Fig. 3.
At this time, the projections 34 of the staple cartridges 16 are in abutment with the tissue 12 in a collapsed condition as indicated in Figs. 6 and 7. At this point, the staples 21 have not been engaged by the pushers 22. Further, the stapler lO can be opened and re-positioned by moving the handles 36 apart in this position without projection of the staplers 21 from the cartridges 16.
Next, the safety mechanism 45 is released into the dotted line position of Fig. 3 and the handles 36 are brought further together in order to fire the staples 21 from the cartridges 16 as indicated in Fig. 8.
As indicated in Figs. 9 to 12, during firing, each staple 21 is deformed into a layer of tissue 12 without piercing through the tissue layer . Initially, as indicated in Fig. 9, the deformable legs 25 of the staple abut against the deformable lips 31 with the 130~3~33 sharp ends 26 projecting into the mouth of a respective opening 20. The layer of tissue 12 deforms about the lips 31 so as to enter slightly into the mouth of each opening 20 and may be slightly penetrated by the sharp tips of the staples 21.
As the handles 36 are brought together, the mounting blocks 15 of the staple assemblies 13 move toward each other as indicated in Fig. 8. However, the housings 19 of the respective staple cartridges 16 remain in place. That is, each mounting block ~5 moves relative to the stapled cartridge 16 therein. At this time, the rib 18 of each mounting block 15 abuts the pushers 22, or a bar common to the pushers 22~ so as to drive the pushers 22 towards the mouth of each opening 20 as indicated in Fig. 10.
Initially, as indicated in Fig. 10, each staple 21 is pushed under a biasing force applied to the base 23 while lateral forces are simultaneously applied against the legs 25 by the lips 31 so that the legs 25 begin to deform and move towards each other while penetrating into the layer of tissue 12.
As indicated in Fig. 11, near the end of each stroke of a pusher 22, the legs 25 of a staple have been substantially deformed so as to be in crossing relation to each other. In this position, the staples will not readily pull out from the layer of tissue 12. At the ~ame time, the string 11 which has been positioned in the longitudinal recess 32 of a cartridge housing 19 is pushed out of the reress 32 to one or the other side of the deformed staple 21.
As indicated in Fig. 11, the deformed staple 21 is of greater width than the mouth of the opening 20 so as to engage against the deformable lips 31.
Referring to Fig. 12, as the stroke of a pusher 22 is completed, the biasing force on the pusher 22 is sufficient to push the deformed staple 21 through the outlet of the mouth of the opening 20 past the lips 31 . . ~ .
. - : . ~'. - . ' ' :
- . ~ . . .
. - .
, -~3~3933 while deforming the lips 31 sufficiently to permit passage. The amount of deformation of the lips 31 is sufficient to permit passage of the deformed staple 21 while at the same time being insufficient to overly compress the layer of tissue 12.
Once the stapler has been fired, the purse string 11 is automatically pulled from the retainers 33 as the stapler 10 is removed from the area.
Of note, the staples 21 only penetrate the tissue 12 to a depth sufficient to remain embedded as the string 11 is drawn and the tissue 12 bunched together in a subsequent operation. In this respect, a purse string normally ties the end of an opening in the hollow tissue such as an intestine, stomach and the like~
After firing of the staples 21, the handles 36 can be held in place by the catch mechanism 44.
Alternatively, the catch mechanism 44 can be released so that the handles 36 are biased apart by the spring ~not shown) therebetween.
As indicated in Fig. 13, after removal of the stapler 10, the purse string 11 is held in place by the various staples which have been affixed to the tissue 12. Of note, depending upon the shi~ting of the string 11 to one side or the other within a staple 21, the string 11 may take a somewhat uneven path about the tissue 12.
Referring to Fig. 14, in order to centralize the string 11, the base 23 of each stapla 21 may be provided with a projection for reception in a suitable mating recess in the bottom surface of a pusher ~not shown).
In this case, as each staple is being expelled~ the purse strin~ 11 tends to be centered within each deformed staple 21'.
Various modifications may be made within the stapler. For example, the mounting arrangement of a staple cartridge on the applicator may be modified. For example, the mounting block of each cartridge may have a ~3 pair of tabs which can be slidably received in a mounting head on the end of a handle 36. Further, each staple may be made with a flat base and/or with legs that are angled toward each other and are sized so as not to cross each other when deformed depending on the use of the staple, for example, for closing an incision rather than for application of a purse string.
The invention thus provides a stapler which can be utilized for applying a purse string to body tissue.
However, the stapler may also be used as a skin or fascia stapler in which case use may be made of only one staple assembly. Where only one staple assembly is used, the staples may be fed and deformed singly. Also, the stapler may be constructed and adapted for use in eye surgery for the closing of incisions.
The invention also provides a method of affixing a staple to tissue wherein a biasing force is applied to the base of a staple to push the legs of the staple into the tissue while simultaneously applying lateral forces against the legs to deform each leg toward the other leg. Such forces are applied to the staple without any opposed force as from an opposed anvil.
- , .
., -
Heretofore, various types of stapling instruments have been known for affixing staples to body tissue.
Generally, the staples have been applied by using instruments having an anvil and an ejector mechanism for driving the legs of a staple through the tissue and against the anvil for deforming the legs into a "B"
shape or the like. In some cases, the stapling instruments have been used to apply a purse string to the tissue, for example, for an end to end anastomosis procedure.
Although various types of instruments have been known for driving the legs o~ a staple through tissue, there are times when it is not desirable or practical to drive the legs of a staple through the body tissue in order to affix a staple. For example, it is generally not practical to use a stapling instrument having an anvil for closing an incision in fascia tissue since there is usually limited space for access of an anvil.
Further, in cases where a purse string i5 to be applied to a tubular section of tissue, the stapling instruments haye been rather cumbersome and complex in order to provide an anvil against which the staples can be deformed in order to hold a purse string in place.
Accordingly, it is an--object of the invention to . ~ ~
~)3~33 provide a relatively simple surgical stapler for applying staples to body tissue without need for an anvil.
It is another object of the invention ~o provide a relatively simple stapling assembly for a surgical 5 stapler.
It is another object of the invention to provide means for affixing a staple to body tissue without complete piercing of the ~issue by the legs of the staples.
It is another object of the invention to provide lO a relatively simple instrument for applying a purse string to body tissue.
It is another o~ject of the invention to provide a staple which can be affixed to body tissue without complete piercing of the tissue.
Accordingly, one aspect of the invention provides a one-piece staple having a base of undulating shape and defining one of a recess and a projection and a pair of deformable legs extending from said base, each said leg extending angularly inwardly of said base towards the other 20 of said legs and having a sharp point at distal end. This one-piece staple can be affixed to tissue without complete piercing of the tissue. As indicated, each leg has a sharp point at a distal end for penetrating into ~ody tissue. The staple also preferably includes a pair of 25 rounded transition portions each of which extends between the base and one of the legs.
Another aspect of the invention provides a staple cartridge for tissue comprising a housing having a plurality of openings therein, a plurality of staplas, each 30 staple being slidably received in a respective opening of - said housing and including a base and a pair of legs extending from said base, a plurality of pushers, each said pusher being slidably received in a respective opening of said housing, first means in said housing for 35 simultaneously moving each pusher from a rest position thereof to an actuated position to expel said staples from said openings, and second means on said housing at a mouth of each opening for deforming the legs of each staple ~ .
3.303~33 - 2a inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
~ , : ' - ~L3t~ 9;13 The deforming means of the staple cartridge may be in the form of an inwardly directed pair of lips on the housing at each mouth to define an outlet of less width than the respective opening. In addition, each lip is made to be ~eformable under a biasing force of the first means in order to permit passage of a deformed staple thereby. Thus, as the staple is being expelled from an opening, the lips first serve to deform the legs of a staple inwardly toward each other so as to penetrate into and grip the tissue. 5econd, the lips are able to move apart to permit passage of the deformed staple under the biasing force.
The staple cartridge may also be constructed so that the housing includes a recess with extends transversely within a plane of the openings in order to receive a purse string therein for expelling within and with the deformed staples. ïn this regard, the staple cartridge is used t`o attach a purse string to body tissue.
The invention also provides a stapling assembly which is comprised of a mounting block having an internal recess for slidably mounting a staple cartridge therein as well as a centrally disposed rib within the recess for abutting a pusher in response to movement of the housing of a staple cartridge into the recess of the mounting block. This stapling assembly is constructed so that both the block and the cartridge are of elongated rectangular shape with the housing of the staple cartridge containing a plurality of staples. In addition, the mounting block may be provided with a single rib which extends longitudinally of the mountiny block in order to abut all of the pushers.
Alternatively, the mounting block may include two or more ribs for abutting respective sets of pushers.
The invention also provides an anvilless surgical .. ~,~ , ~3~39~3 stapler which is comprised of a pair of stapling assemblies as above and an applicator on which the stapling assem~lies are mounted . To this end, the applicator includes a pair of mounting plates disposed in opposed relation to each other with each plate having means for mounting a respective stapling assembly thereon. In addition, the applicator includes a pair of articulated handles connected to the mounting plates for moving the plates toward each other.
Each staple cartridge of a stapling assembly i5 also provided with a projection at each end for abutting an opposed staple cartridge so as to define a tissue-receiving gap between the cartridges. Thus, the surgical stapler can be initially brought into a clamped position about a tubular section of tissue before firing of the staples. In this respect, the applicator includes a releasable catch mechanism for holding the handles in this tissue-clamping position with the projections of the staple cartridges abutting respective cartridges.
The handles of the applicator are also movable fxom the tissue-clamping position into a staple firing position upon release of a safety machanism in order to move each cartridge into a respective housing while expelling the staples through the openings of the respective housings. After firing of the staples, the handles of the applicator can be moved apart so as to complete a stapling operation.
The projections on the staple cartridges may also be arranged to define a groove at each end of the cartridge in order to receive a purse string. In addition, each stapling assembly may be provided with a string retainer on the mounting block thereof for holding a loop of the purse string therein for assembly 3~ purposes.
The invention also provides a cartridge assembly which is comprised of a pair of stapling assemblies and ~ 303933 a holder which releasably holds the assemblies in somewhat spaced parallel relation. In this respect, the holder is formed of a base plate with a plurality of ribs on one side defining a pair of parallel grooves with each groove 5 receiving a respective retainer of a stapling assembly therein. In addition, means are provided for releasably engaging a respective retainer in a respective gro~ve. The holder is also provided with an outwardly extending tab for lifting of the plate from the stapling assemblies after lo mounting on an applicator.
The invention also provides a method of affixing a staple to tissue wherein a biasing force is applied on the base of a staple to push the legs of the staple into the tissue while simultaneously applying lateral forces 15 against the legs to deform each leg toward the other leg.
~he forces are applied to the staple with vectors in the same direction, i.e. without any opposed force as from an anvil. In this respect, the lateral forces can be applied while pushing the staple through an outlet of less width 20 than the staple.
Embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, wherein:
Fig. 1 illustrates a perspective view of an 25 anvilless surgical stapler;
Fig. 2 illustrates a partial view of a safety mechanism employed with the handles of the stapler of Fig.
l;
Fig. 3 illustrates a view of the safety mechanism 30 in a tissue-clamping position;
- Fig. 4 illustrates an enlarged exploded view of a cartridge assembly for mounting on an applicator;
Fig. 5 illustrates a view of a pair o stapling ~ jr;., ~3~)3933 assemblies after mounting on an applicator;
Fig. 6 illustrates a cross-sectional view of the mounted stapling assemblies;
Fig. 7 illustrates a cross~sectional view of the 5 surgical stapler assemblies in a tissue-clamping position;
Fig. 8 illustrates a cross-sectional view similar to Fig. 7 of the stapling assemblies in a fired position;
Fig. 9 illustrates a partial view of a stapling assembly in an initial deformation position;
10Fig. 10 illustrates a view similar to Fig. 9 during further deformation of a staple;
Fig. 11 illustrates a view similar to Figs. 9 and 10 of a deformed staple;
Fig. 12 illustrates a view similar to Figs. 9, 10 15 and 11 with a deformed staple expelled from a stapling assembly;
Fig. 13 illustrates a tubular section of tissue having a purse string applied thereto by the staple of Fig.
l; and 20Fig. 14 illustrates a modified staple.
Referring to Fig. 1, the anvilless surgical stapler 10 is used, for example for applying a pu~se string 11 to a tubular section of tissue 12. In this respect, the term "anvilless" means that there is no opposing anvil or 25 separate member to deform the legs of a staple. As indicated, the stapler 10 includes a pair of stapling assemblies 13 and an applicator 14 constructed in the manner of a ~orceps.
Re~erring to Figs. 5, 6 and 7, each stapling 30 assembly 13 includes a mounting block 15 and a staple .~
~L303~;~3 cartridge 16 slidably mounted in the mounting block 15.
As indicated in Fig. 5, each of the mounting block 15 and staple cartridge 16 is of elongated rectangular shape.
Referring to Fig. 7, the mounting block 15 includes an intexnal recess 17 for slidably receiving a staple cartridge 16 as well as a centrally disposed rib 18 within the recess 17. This rib 18 is fixedly secured to the remainder of the block 15. This rib 18 may extend longitudinally of the block 15 or a plurality of discrete ribs (not shown) may be used.
As indicated in Fig. 6, two pins P are provided in each block 15 to provide resistance and to hold the cartridge halves together. Each pin P passes through and is initially at the bottom of a groove G in the block 15 which widens in a direction away from the respective staple cartridge 16.
Referring to Figs. 6 and 7, each staple cartridge 16 includes a housing 19 having a plurality of longitudinally spaced apart openings 20 in each of which a staple 21 is slidably received. In addition, a plurality of pushers 22 are slidably mounted within the housing 19 with each pusher 22 being aligned with an opening 20 and a staple 21 therein as well as in alignment with a rib 18 for abutting thereagainst.
Referring to Fig. 9, each staple 21 i5 of one-piece construction having a base 23 of undulating shape to define a recess 24 and a pair of deformable legs 25 which extend from the base 23. As indicated, each leg 25 extends angularly inwardly of the base 23 towards the other leg 25 and has a sharp point 26 at the distal end.
Each staple 21 also includes a pair of rounded transition portions 27 each of which extends between the ~ase 23 and a leg 25. Further, each leg 25 is disposed on a rectilinear axis with the sharp point defined, for example by an included angle of 35. Tha staple 21 is , ~L303933 made of any suitable cross section, such as a circular cross-section as well as of any suitable material for the purposes intended such as stainless steel and absorbable materials.
Referring to Fig. 9, the housing 19 has a pair of opposed walls 28 defining each internal opening 20. In addition, each wall 28 is provided on the outside with a stiffener plate 28' and has a firct slot 29 extending longitudinally of the opening 20 in order to slidingly receive one side of a staple 21, that is, a rounded transition portion 27. In addition, a second slot 30 of greater width than the slot 29 extends coaxially of the slot 29 in order to slidably receive one side of a pusher 22.
As indicated in Fig. 9, the width of a staple 21 is greater than the width of a pusher 22. Further, the lower surface of each pusher 22 is provided with a surface complementary to the undulating base 23 of a staple 21 so as to have a projection (not shown) seated in the recess 24 of the staple 21. This arrangement serves to center the staple 21 within the opening 20 while also ensuring uniform motion of a staple 21 out of the opening 20.
The means for deforming the legs 25 of a staple 21 at the mouth of each opening 20 is constituted by a pair of inwardly directed lips 31. As indicated, each lip 31 is disposed at one end of the staple receiving slot 29 in a wall 28. Further, the lips 31 are spaced apart to define an outlet of less width than the opening 20 and less width than a staple 21. In this respect, the housing 19 is made of a material sufficient to permit deformation of the legs 25 of a staple 21 while at the same time being deformable to spread apart to permit passage of a deformed staple 21 under a biasing force on the respective pushers 11. Each lip 31 may also be of material resilient enough to permit the passage of a deformed staple while still capable of returning to its .
9~3 previous position and form. Such resiliency is required if successive staples are fired as, for example, in a skin stapler. Additionally, lips 31 may have an articulation means for achieving such resiliency.
As indicated in Fig. 9, the tip of each staple leg 25 is angled such that the heel (i.e. rear) of the angled tip slides within a slot 29 so that the sharp tip does not dig into the lip 31 during firing. In this respect, the slot 29 is curved within the lip 31.
Referring to Figs. 7 and 8, the ribs 18 constitute a means for moving the pushers 22 from a rest position in the respective housings 19, as indicated in Fig. 7, to an actuated position, as indicated in Fig. 8, adjacent the outlet of each opening 20. In this respect, a suitable means such as a bar may be connected to one or more pushers 22 in order to move the pushers simultaneously.
As indicated in Figs. 9 and 12, each housing 19 includes a recess 32 which extends along the housing 19 transversely of and across the respective openings 20 to receive a purse string 11.
Referring to Fig. 6, the openings 20 and respective staples 21 of each cartridge 16 are offset longitudinally of the openings 20 and staples 21 of the opposed cartridge 16. This allows the clamped tissue 12 to protrude into the openings 20 and also inhibits the staples 21 from penetrating both sides of the tissue 12.
Referring to Fig. 5, each stapling assembly 13 includes a retainer 33 which is mounted in fixed relation on a mounting block 15. As indicated, each retainer 33 defines an elongated space within which a loop of the string 11 may be retained.
As also indicated in Fig. 5, each cartridge 16 has a projection extending from each end of the housing 19 for abutting an opposed cartridge 16 in order to define a tissue-receiving gap as indicated in Fig. 6 between the cartridges 16. This gap is such as to avoid ~303~33 crushing of the tissue. Fur~her, each projection 34 can be provided with a recess 57 to receive a length of the purse string 11 therein.
The projections 34 also serve to transfer the forces necessary to fire the stapler. Alternatively, each staple cartridge may have a single projection at each end which is about half the width of a cartridge housing 19 so as to abut an aligned cartridge housing 19 while aligning with a similar projection of the opposed cartridge. In this case, the purse string would extend between the two projections at each end of the cartridges.
Referring to Fig. 1, the applicator 14 includes a pair of mounting plates 35 which are disposed in opposed relation to each other and a pair of articulated handles 36 which are connected to the mounting plates 35 for moving the plates 35 towards each other. As indicated, the handles 36 are pivotally connected to each other about a pivot pin 37. Also, each handle 36 includes a finger gripping portion 38 at a proximal end. A spring (not shown~ may also be provided to bias the handles 36 apart.
Referring to Fig. 4, each mounting plate 35 has means 39 for mounting a respective stapling assembly 13 thereon. As indicated, each means 39 includes a bracket 40 integral with a plate 35 from which a mounting leg 41 extends in spaced relation to the mounting plate 35. In addition, each stapling assembly 13 is provided with a sleeve-like connector 42 which releasably receives a mounting leg 41. A suitable detent 58 may be provided in the sleeve connector 42 to be releasably engaged in a groove 43 of the mounting leg 41.
In order to mount a stapling assembly 13 in place, the sleeve connector 42 is slid over the mounting leg 41 until the detent 58 catches in the groove 43 of the mounting leg 41.
Referring to Fig. 1, the applicator 10 includes a ~3()3~33 catch mechanism 44 which serves to approximate a predetermined clamping position of the applicator 10.
This mechanism 44 is disposed on the handles 36 at the proximal ends and is of generally known construction and need not be further described. In addition, a safety mechanism 45 is provided at the proximal end for stopping the handles 36 in a tissue-clamping position (as indicated in Fig. 6) with the projections 34 abutting a respective cartridge 16. As indicated in Figs. 1 and 2, the safety mechanism 45 is in the ~orm of a lever which is plvotally mounted about a pin 46 on the catch mechanism 44 and includes a lateral tab 47 which is sized to permit pivoting of the lever 45 by a thumb of a surgeon. As indicated in Fig. 3, when in the tissue-clamping position, the lever 45 abuts against an abutment surface 48 on the opposite handle 36 while the catch mechanism 44 holds the handles 36 in place.
Re~erring to Fig. 4, a holder 50 is provided to releasably hold a pair of stapling assemblies 13 in order to form a cartridge assembly. As indicated, the holder 50 is formed of a base plate 51 with a plurality of ribs 52 on one side forming a pair of parallel spaced apart grooves 53 for receiving a retainer of each stapling assembly 13. In addition, means are provided for releasably engaging each retainer 33 in a respective groove 53. For example, the means may be in the form of small projections 54 which fit into small spaces 55 between each retainer 33 and a mounting block 15 of a stapling assembly 13 (see Fig. 5). As indicated, the grooves 53 may be dis-continuous, that is the internal ribs 52 need not extend the length of the plate 51.
Alternatively, the holder 50 may grip the assemblies 13 at the ends rather than the sides as shown.
The holder 50 is also provided with an outwardly extending tab 56 at one end of the plate 51. This tab 56 serves to lift the plate 51 from the stapling assemblies 13 after mounting of the assemblies 13 on the b ,~
.
~3~13933 mounting plates 35 on the handles 36 of the applicator 14. Alternatively, instead of using a tab 56, a pair of finger engaging recesses may be provided on opposite ends of the plate 51, for example on the lower end of the plate 51 as viewed in Fig. 4.
In use, the stapler 10 may be provided with the stapling assemblies 13 in place. If not, a cartridge assembly as indicated in Fig. 4 may be brought to the mounting plates 35 with the handles 36 in an opened rest position. At this time, the stapling assemblies 13 can be slid onto the respective mounting legs 41 and snap-fitted in place as indicated in Fig. 5. Thereafter, the holder 50 can be removed, for example, by a slight tilting up of the plate 51 from the retainers 33.
Thereafter, the stapler 10 can be brought into position about a tubular section of tissue 12 as indicated in Fig. 1. Next, the handles 36 can be brought into a tissue-clamping position with the catch mechanism 44 engaged and the safety mechanism lever 45 in abutment with the surface 48 as indicated in Fig. 3.
At this time, the projections 34 of the staple cartridges 16 are in abutment with the tissue 12 in a collapsed condition as indicated in Figs. 6 and 7. At this point, the staples 21 have not been engaged by the pushers 22. Further, the stapler lO can be opened and re-positioned by moving the handles 36 apart in this position without projection of the staplers 21 from the cartridges 16.
Next, the safety mechanism 45 is released into the dotted line position of Fig. 3 and the handles 36 are brought further together in order to fire the staples 21 from the cartridges 16 as indicated in Fig. 8.
As indicated in Figs. 9 to 12, during firing, each staple 21 is deformed into a layer of tissue 12 without piercing through the tissue layer . Initially, as indicated in Fig. 9, the deformable legs 25 of the staple abut against the deformable lips 31 with the 130~3~33 sharp ends 26 projecting into the mouth of a respective opening 20. The layer of tissue 12 deforms about the lips 31 so as to enter slightly into the mouth of each opening 20 and may be slightly penetrated by the sharp tips of the staples 21.
As the handles 36 are brought together, the mounting blocks 15 of the staple assemblies 13 move toward each other as indicated in Fig. 8. However, the housings 19 of the respective staple cartridges 16 remain in place. That is, each mounting block ~5 moves relative to the stapled cartridge 16 therein. At this time, the rib 18 of each mounting block 15 abuts the pushers 22, or a bar common to the pushers 22~ so as to drive the pushers 22 towards the mouth of each opening 20 as indicated in Fig. 10.
Initially, as indicated in Fig. 10, each staple 21 is pushed under a biasing force applied to the base 23 while lateral forces are simultaneously applied against the legs 25 by the lips 31 so that the legs 25 begin to deform and move towards each other while penetrating into the layer of tissue 12.
As indicated in Fig. 11, near the end of each stroke of a pusher 22, the legs 25 of a staple have been substantially deformed so as to be in crossing relation to each other. In this position, the staples will not readily pull out from the layer of tissue 12. At the ~ame time, the string 11 which has been positioned in the longitudinal recess 32 of a cartridge housing 19 is pushed out of the reress 32 to one or the other side of the deformed staple 21.
As indicated in Fig. 11, the deformed staple 21 is of greater width than the mouth of the opening 20 so as to engage against the deformable lips 31.
Referring to Fig. 12, as the stroke of a pusher 22 is completed, the biasing force on the pusher 22 is sufficient to push the deformed staple 21 through the outlet of the mouth of the opening 20 past the lips 31 . . ~ .
. - : . ~'. - . ' ' :
- . ~ . . .
. - .
, -~3~3933 while deforming the lips 31 sufficiently to permit passage. The amount of deformation of the lips 31 is sufficient to permit passage of the deformed staple 21 while at the same time being insufficient to overly compress the layer of tissue 12.
Once the stapler has been fired, the purse string 11 is automatically pulled from the retainers 33 as the stapler 10 is removed from the area.
Of note, the staples 21 only penetrate the tissue 12 to a depth sufficient to remain embedded as the string 11 is drawn and the tissue 12 bunched together in a subsequent operation. In this respect, a purse string normally ties the end of an opening in the hollow tissue such as an intestine, stomach and the like~
After firing of the staples 21, the handles 36 can be held in place by the catch mechanism 44.
Alternatively, the catch mechanism 44 can be released so that the handles 36 are biased apart by the spring ~not shown) therebetween.
As indicated in Fig. 13, after removal of the stapler 10, the purse string 11 is held in place by the various staples which have been affixed to the tissue 12. Of note, depending upon the shi~ting of the string 11 to one side or the other within a staple 21, the string 11 may take a somewhat uneven path about the tissue 12.
Referring to Fig. 14, in order to centralize the string 11, the base 23 of each stapla 21 may be provided with a projection for reception in a suitable mating recess in the bottom surface of a pusher ~not shown).
In this case, as each staple is being expelled~ the purse strin~ 11 tends to be centered within each deformed staple 21'.
Various modifications may be made within the stapler. For example, the mounting arrangement of a staple cartridge on the applicator may be modified. For example, the mounting block of each cartridge may have a ~3 pair of tabs which can be slidably received in a mounting head on the end of a handle 36. Further, each staple may be made with a flat base and/or with legs that are angled toward each other and are sized so as not to cross each other when deformed depending on the use of the staple, for example, for closing an incision rather than for application of a purse string.
The invention thus provides a stapler which can be utilized for applying a purse string to body tissue.
However, the stapler may also be used as a skin or fascia stapler in which case use may be made of only one staple assembly. Where only one staple assembly is used, the staples may be fed and deformed singly. Also, the stapler may be constructed and adapted for use in eye surgery for the closing of incisions.
The invention also provides a method of affixing a staple to tissue wherein a biasing force is applied to the base of a staple to push the legs of the staple into the tissue while simultaneously applying lateral forces against the legs to deform each leg toward the other leg. Such forces are applied to the staple without any opposed force as from an opposed anvil.
- , .
., -
Claims (21)
1. A one-piece staple having a base of undulating shape and defining one of a recess and a projection and a pair of deformable legs extending from said base, each said leg extending angularly inwardly of said base towards the other of said legs and having a sharp point at distal end.
2. A one-piece staple as set forth in claim 1, which further includes a pair of rounded transition portions, each said portion extending between said base and one of said legs and wherein each leg is disposed on a rectangular axis.
3. A one-piece staple having a base, a pair of rounded transition portions extending from opposite ends of said base and a pair of deformable legs, each leg extending on a rectilinear axis from a respective transition portion towards the other of said legs with a sharp point at a distal end.
4. A one-piece staple as set forth in claim 3, wherein said base and said legs have a circular cross-section.
5. A staple cartridge comprising a housing having a pair of opposed walls defining an internal opening therebetween, each said wall having a first slot extending longitudinally of said opening to receive one side of a staple therein a second slot of greater width coaxially of said first slot and an inwardly directed lip at one end of said first slot to define an outlet of less width than said opening and a staple in said opening;
a pusher slidingly received in said second slot of each wall and extending across and between said walls for expelling a staple disposed in said slots of said walls through said outlet; and means for moving said pusher from a rest position in said housing to an actuated position adjacent said outlet.
a pusher slidingly received in said second slot of each wall and extending across and between said walls for expelling a staple disposed in said slots of said walls through said outlet; and means for moving said pusher from a rest position in said housing to an actuated position adjacent said outlet.
6. A staple cartridge as set forth in claim 5, wherein said housing has a plurality of said openings therein for receiving a plurality of staples and a plurality of pushers for expelling the staples, said means being connected to said pushers to move said pushers simultaneously.
7. A staple cartridge as set forth in claim 5, wherein each lip is of material sufficient to permit deformation of a staple therein under a biasing force of said means and said pusher.
8. A staple cartridge as set forth in claim 7, wherein each lip is deformable under a biasing force of said means to move away from the other lip to permit passage of a deformed staple thereby.
9. A staple cartridge as set forth in claim 5, 6 or 7, wherein said housing includes a recess for receiving a purse string therein, said recess extending transversely of and across said opening.
10. A staple cartridge for tissue comprising a housing having a plurality of openings therein;
a plurality of staples, each staple being slidably received in a respective opening of said housing and including a base and a pair of legs extending from said base;
a plurality of pushers, each said pusher being slidably received in a respective opening of said housing;
first means in said housing for simultaneously moving each pusher from a rest position thereof to an actuated position to expel said staples from said openings;
and second means on said housing at a mouth of each opening for deforming the legs of each staple inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
a plurality of staples, each staple being slidably received in a respective opening of said housing and including a base and a pair of legs extending from said base;
a plurality of pushers, each said pusher being slidably received in a respective opening of said housing;
first means in said housing for simultaneously moving each pusher from a rest position thereof to an actuated position to expel said staples from said openings;
and second means on said housing at a mouth of each opening for deforming the legs of each staple inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
11. A staple cartridge as set forth in claim 10, wherein said first means includes a pusher bar connected in common to said pushers.
12. A staple cartridge as set forth in claim 10, wherein said second means includes an inwardly directed pair of lips on said housing at each mouth to define an outlet of less width than said respective opening.
13. A staple cartridge as set forth in claim 12, wherein each lip is deformable under a biasing force of said first means to permit passage of a deformed staple thereby.
14. A staple cartridge as set forth in claim 10, 11, 12 or 13, wherein said housing includes a recess extending transversely within a plane of said openings to receive a purse string therein for expelling with and within the deformed staples.
15. A staple cartridge as set forth in claim 10, 11, 12 or 13, wherein each pusher has protuberance. and each staple has a recess in said base thereof receiving said protuberance.
16. An anvilless stapler comprising a cartridge having a plurality of openings, a plurality of staples slidably received in said openings and including a base and a pair of legs extending from said base and a plurality of pushers slidably received in said openings to abut a respective base of said staples;
first means for simultaneously moving each pusher from a rest position to an actuated position to expel said staples from said openings; and second means on said housing at a mouth of each opening for deforming said legs of each staple inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
first means for simultaneously moving each pusher from a rest position to an actuated position to expel said staples from said openings; and second means on said housing at a mouth of each opening for deforming said legs of each staple inwardly toward each other during movement of each staple through said mouth of each respective opening to penetrate into and engage with tissue therebetween.
17. An anvilless stapler as set forth in claim 16, wherein said second means includes an inwardly directed pair of lips on said housing at each mouth to define an outlet of less width than said respective opening.
18. An anvilless stapler as set forth in claim 17, wherein each lip is deformable under a biasing force of said first means to permit passage of a deformed staple thereby.
19. An anvilless stapler as set forth in claim 16, 17 or 18, wherein said housing includes a recess extending transversely within a plane of said openings to receive a purse string therein for expelling with and within the deformed staples.
20. A stapling assembly for an anvilless surgical stapler comprising a mounting block having an internal recess and a centrally disposed rib within said recess; and a staple cartridge slidably mounted within said recess of said block, said cartridge including a housing having at least one opening, a staple slidably received in said opening and including a base and a pair of legs, a pusher slidably received in said housing between and in alignment with said central rib and said staple, means at a mouth of said opening for deforming said legs of said staple inwardly towards each other during movement through said mouth in response to movement of said housing into said recess for mounting block.
21. A stapling assembly as set forth in claim 20, wherein each of said block and said cartridge is of elongated rectangular shape.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/092,076 US4821939A (en) | 1987-09-02 | 1987-09-02 | Staple cartridge and an anvilless surgical stapler |
US092,076 | 1987-09-02 |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1303933C true CA1303933C (en) | 1992-06-23 |
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ID=22231363
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000576327A Expired - Lifetime CA1303933C (en) | 1987-09-02 | 1988-09-01 | Stapler cartridge and anvilless surgical stapler |
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US (1) | US4821939A (en) |
EP (2) | EP0569049B1 (en) |
JP (1) | JP2599443B2 (en) |
AT (1) | ATE115381T1 (en) |
AU (2) | AU607800B2 (en) |
CA (1) | CA1303933C (en) |
DE (2) | DE3852446T2 (en) |
ES (2) | ES2064354T3 (en) |
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CA2060040A1 (en) | 1991-02-08 | 1992-08-10 | Miguel A. Velez | Surgical staple and endoscopic stapler |
US5217472A (en) * | 1991-05-07 | 1993-06-08 | United States Surgical Corporation | Surgical fastening device |
CA2079058A1 (en) * | 1991-10-18 | 1993-04-19 | Stanley H. Remiszewski | Surgical stapling apparatus |
US5356064A (en) * | 1991-10-18 | 1994-10-18 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5289963A (en) * | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5497933A (en) * | 1991-10-18 | 1996-03-12 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5188636A (en) * | 1992-05-07 | 1993-02-23 | Ethicon, Inc. | Purse string suture instrument |
US5242457A (en) * | 1992-05-08 | 1993-09-07 | Ethicon, Inc. | Surgical instrument and staples for applying purse string sutures |
US5484451A (en) * | 1992-05-08 | 1996-01-16 | Ethicon, Inc. | Endoscopic surgical instrument and staples for applying purse string sutures |
US5368599A (en) * | 1992-10-08 | 1994-11-29 | United States Surgical Corporation | Surgical fastening apparatus with suture array |
US5662662A (en) * | 1992-10-09 | 1997-09-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument and method |
US5626587A (en) * | 1992-10-09 | 1997-05-06 | Ethicon Endo-Surgery, Inc. | Method for operating a surgical instrument |
US5601224A (en) * | 1992-10-09 | 1997-02-11 | Ethicon, Inc. | Surgical instrument |
ES2109539T3 (en) * | 1993-04-20 | 1998-01-16 | United States Surgical Corp | SURGICAL STAPLER. |
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US2122815A (en) * | 1937-01-09 | 1938-07-05 | Hansen Mfg Co A L | Stapling machine |
US3315863A (en) * | 1965-07-06 | 1967-04-25 | United States Surgical Corp | Medical instrument |
DE2509105C3 (en) * | 1975-03-03 | 1978-11-16 | Vsesojuznyj Nautschno-Issledovatelskij I Ispytatelnyj Institut Medicinskoj Techniki, Moskau | Surgical sewing device for connecting two internal organs of the body with metal clips |
SU613754A1 (en) * | 1975-12-19 | 1978-07-05 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgery apparatus for tissue suturing |
US4241861A (en) * | 1977-12-20 | 1980-12-30 | Fleischer Harry N | Scissor-type surgical stapler |
US4232810A (en) * | 1978-10-10 | 1980-11-11 | Carlson Stapler And Shippers Supply, Inc. | String stapler |
SU886897A1 (en) * | 1978-12-25 | 1981-12-07 | Всесоюзный Научно-Исследовательский Институт Медицинской Техники | Surgical apparatus for applying side gastroenterostomy |
US4206863A (en) * | 1979-03-26 | 1980-06-10 | Savino Dominick J | Staple and anviless stapling apparatus therefor |
US4399810A (en) * | 1979-11-28 | 1983-08-23 | Samuels Peter B | Skin clip and applier |
US4375866A (en) * | 1981-01-22 | 1983-03-08 | Edward Weck & Company, Inc. | Skin clip applier |
GB2108418A (en) * | 1981-10-23 | 1983-05-18 | Vnii Ispytatel Med Tech | Device for applying anastomoses onto hollow organs |
DE3204532C2 (en) * | 1982-02-10 | 1983-12-08 | B. Braun Melsungen Ag, 3508 Melsungen | Surgical skin staple |
US4607638A (en) * | 1984-04-20 | 1986-08-26 | Design Standards Corporation | Surgical staples |
-
1987
- 1987-09-02 US US07/092,076 patent/US4821939A/en not_active Expired - Lifetime
-
1988
- 1988-08-25 AU AU21543/88A patent/AU607800B2/en not_active Ceased
- 1988-09-01 DE DE3852446T patent/DE3852446T2/en not_active Expired - Lifetime
- 1988-09-01 EP EP93110436A patent/EP0569049B1/en not_active Expired - Lifetime
- 1988-09-01 DE DE3855918T patent/DE3855918T2/en not_active Expired - Fee Related
- 1988-09-01 AT AT88308074T patent/ATE115381T1/en not_active IP Right Cessation
- 1988-09-01 ES ES88308074T patent/ES2064354T3/en not_active Expired - Lifetime
- 1988-09-01 CA CA000576327A patent/CA1303933C/en not_active Expired - Lifetime
- 1988-09-01 ES ES93110436T patent/ES2101903T3/en not_active Expired - Lifetime
- 1988-09-01 EP EP88308074A patent/EP0306298B1/en not_active Expired - Lifetime
- 1988-09-02 JP JP63220256A patent/JP2599443B2/en not_active Expired - Lifetime
-
1991
- 1991-01-02 AU AU68614/91A patent/AU622581B2/en not_active Ceased
Also Published As
Publication number | Publication date |
---|---|
AU607800B2 (en) | 1991-03-14 |
JP2599443B2 (en) | 1997-04-09 |
DE3855918T2 (en) | 1997-10-23 |
ES2064354T3 (en) | 1995-02-01 |
US4821939A (en) | 1989-04-18 |
AU6861491A (en) | 1991-03-14 |
JPH01113037A (en) | 1989-05-01 |
DE3855918D1 (en) | 1997-06-26 |
AU622581B2 (en) | 1992-04-09 |
DE3852446T2 (en) | 1995-05-18 |
ATE115381T1 (en) | 1994-12-15 |
DE3852446D1 (en) | 1995-01-26 |
AU2154388A (en) | 1989-03-02 |
EP0569049A1 (en) | 1993-11-10 |
EP0569049B1 (en) | 1997-05-21 |
EP0306298A2 (en) | 1989-03-08 |
EP0306298A3 (en) | 1989-08-30 |
ES2101903T3 (en) | 1997-07-16 |
EP0306298B1 (en) | 1994-12-14 |
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