US20110087276A1 - Method for forming a staple - Google Patents
Method for forming a staple Download PDFInfo
- Publication number
- US20110087276A1 US20110087276A1 US12/622,130 US62213009A US2011087276A1 US 20110087276 A1 US20110087276 A1 US 20110087276A1 US 62213009 A US62213009 A US 62213009A US 2011087276 A1 US2011087276 A1 US 2011087276A1
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- United States
- Prior art keywords
- staple
- leg
- staple leg
- base
- anvil
- 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.)
- Abandoned
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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- 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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0686—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
-
- 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
- A61B17/07207—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 the staples being applied sequentially
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
-
- 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
- A61B2017/07285—Stapler heads characterised by its cutter
Definitions
- the present invention relates to stapling instruments and, in various embodiments, to a surgical stapling instrument for producing one or more rows of staples.
- a stapling instrument can include a pair of cooperating elongate jaw members, wherein each jaw member can be adapted to be inserted into an internal, tubular body organ to be anastomosed.
- one of the jaw members can support a staple cartridge with at least two laterally spaced rows of staples, and the other jaw member can support an anvil with staple-forming pockets aligned with the rows of staples in the staple cartridge.
- the stapling instrument can further include a pusher bar and knife blade which are slidable relative to the jaw members to sequentially eject staples from the staple cartridge via camming surfaces on the pusher bar.
- the camming surfaces can be configured to activate a plurality of staple drivers carried by the cartridge and associated with the individual staples to push the staples against the anvil and form laterally spaced rows of deformed staples in the tissue gripped between the jaw members.
- the anvil is unmovable relative to the staple cartridge once the jaw members have been assembled together and the formed height of the staples cannot be adjusted.
- the knife blade can trail the pusher bar and cut the tissue along a line between the staple rows. Examples of such stapling instruments are disclosed in U.S. Pat. No. 4,429,695, entitled SURGICAL INSTRUMENTS, which issued on Feb. 7, 1984, the entire disclosure of which is hereby incorporated by reference herein.
- a surgical stapler can comprise a first handle portion comprising a staple cartridge channel configured to receive a staple cartridge and a second handle portion comprising an anvil.
- the stapler further comprises a rotatable latch and a latch projection, wherein the latch is rotatably coupled to one of the first handle portion and the second handle portion and wherein the latch projection extends from the other of the first handle portion and the second handle portion.
- the latch is configured to engage the latch projection to move the first handle portion and the second handle portion toward one another.
- the latch projection comprises a rotatable bearing wherein the latch is configured to contact the rotatable bearing when the latch engages the latch projection.
- a surgical stapler can comprise an anvil having a plurality of staple pockets formed in a tissue contacting surface.
- Each staple pocket can comprise a longitudinal axis, a first forming cup, and a second forming cup.
- the first forming cup can comprise a first interior sidewall comprising a first vertical portion which is substantially perpendicular to the tissue contacting surface.
- the second forming cup can comprise a second interior sidewall comprising a second vertical portion which is substantially perpendicular to the tissue contacting surface.
- first vertical portion and the second vertical portion can extend through the longitudinal axis, wherein the first interior sidewall and the second interior sidewall can comprise a trap for deforming a first staple leg of a staple to a first side of the longitudinal axis and for deforming a second staple leg of the staple to a second side of the longitudinal axis.
- a method for deforming a staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed, the method comprising positioning the first staple leg within a first cup of a staple pocket, the first cup comprising a first inner surface, applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and the second staple leg, contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward a first side of the base, and deforming the first staple leg such that the end of the first staple leg crosses a mid-line of the staple defined between the first staple leg and the second staple leg.
- FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment of the present invention
- FIG. 2 is an exploded perspective view of the surgical stapling instrument of FIG. 1 ;
- FIG. 3 is an exploded elevational view of the surgical stapling instrument of FIG. 1 ;
- FIG. 4 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1 illustrating first and second portions being assembled together;
- FIG. 5 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1 illustrating the proximal end of the first portion of FIG. 4 being locked to the proximal end of the second portion of FIG. 4 and illustrating the second portion being rotated toward the first portion;
- FIG. 6 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1 illustrating a latch rotatably mounted to the first portion, wherein the latch is engaged with the second portion and wherein the latch has been rotated into a partially-closed position;
- FIG. 7 is a partial cross-sectional view of the surgical stapling instrument of FIG. 1 illustrating the latch of FIG. 6 in a closed position;
- FIG. 8 is a perspective view of a staple cartridge assembly of the surgical stapling instrument of FIG. 1 ;
- FIG. 9 is an exploded view of the staple cartridge assembly of FIG. 8 ;
- FIG. 10 is a cross-sectional view of the staple cartridge assembly of FIG. 8 taken along line 10 - 10 in FIG. 9 ;
- FIG. 11 is an exploded view of a staple sled and cutting member assembly of the staple cartridge assembly of FIG. 8 ;
- FIG. 14 is a perspective view of the surgical stapling instrument of FIG. 1 illustrating the firing actuator of FIG. 13 moved distally along a second side of the surgical stapling instrument;
- FIG. 15 is a cross-sectional view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention illustrating a latch in a partially-closed position and a locking mechanism engaged with a firing actuator;
- FIG. 16 is a cross-sectional view of the surgical stapling instrument of FIG. 15 wherein the latch has been moved into a closed position and has disengaged the locking mechanism from the firing actuator;
- FIG. 17 is a perspective view of an anvil assembly of the surgical stapling instrument of FIG. 1 ;
- FIG. 18 is an exploded perspective view of the anvil assembly of FIG. 17 ;
- FIG. 19 is another exploded perspective view of the anvil assembly of FIG. 17 ;
- FIG. 20 is an exploded cross-sectional elevational view of the anvil assembly of FIG. 17 ;
- FIG. 21 is a cross-sectional assembly view of the anvil assembly of FIG. 17 illustrating an anvil adjustment member in a first position
- FIG. 22 is a cross-sectional assembly view of the anvil assembly of FIG. 17 illustrating the anvil adjustment member of FIG. 21 in a second position;
- FIG. 23 is a cross-sectional assembly view of the anvil assembly of FIG. 17 illustrating the anvil adjustment member of FIG. 21 in a third position;
- FIG. 24 is a perspective view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention.
- FIG. 25 is a cross-sectional view of the surgical stapling instrument of FIG. 24 taken along line 25 - 25 in FIG. 24 ;
- FIG. 26 is a partial exploded view of the proximal end of the surgical stapling instrument of FIG. 24 including a detent mechanism for releasably holding a rotatable anvil adjustment member in position;
- FIG. 27 is a perspective view of the surgical stapling instrument of FIG. 24 with some components removed and others shown in cross-section;
- FIG. 28 is an exploded view of portions of the surgical stapling instrument of FIG. 24 illustrating a rotatable anvil adjustment member in a first orientation
- FIG. 29 is a perspective view of the rotatable anvil adjustment member of FIG. 28 ;
- FIG. 30 is an end view of the surgical stapling instrument of FIG. 24 with some components removed and others shown in dashed lines illustrating the rotatable anvil adjustment member in the first orientation of FIG. 28 ;
- FIG. 34 is an end view of the surgical stapling instrument of FIG. 24 illustrating the rotatable anvil adjustment member of FIG. 28 rotated in a second direction into a third orientation;
- FIG. 38 is a similar perspective view of the surgical stapling instrument of FIG. 1 to that of FIG. 17 ;
- FIG. 39 is a detail view of a latch projection extending from an anvil of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention.
- FIG. 40 is a diagram illustrating the latch projection of FIG. 39 and a latch configured to engage the latch projection and move the latch projection into a latch recess;
- FIG. 42 is a perspective view of a staple pocket in accordance with at least one embodiment of the present invention.
- FIG. 43 is a top view of the staple pocket of FIG. 42 ;
- FIG. 44 is a cross-sectional view of the staple pocket of FIG. 42 taken along line 44 - 44 in FIG. 43 ;
- FIG. 45 is a cross-sectional view of the staple pocket of FIG. 42 taken along line 45 - 45 in FIG. 43 ;
- FIG. 46 is another top view of the staple pocket of FIG. 42 ;
- FIG. 47 is a cross-sectional view of the staple pocket of FIG. 42 taken along line 47 - 47 in FIG. 46 ;
- FIG. 48 is a cross-sectional view of the staple pocket of FIG. 42 taken along line 48 - 48 in FIG. 46 ;
- FIG. 50 is an elevational view of the surgical staple of FIG. 49 in a deformed shape in accordance with at least one embodiment of the present invention.
- FIG. 52 is a plan view of the surgical staple of FIG. 49 in the deformed shape of FIG. 50 ;
- FIG. 52A is another plan view of the surgical staple of FIG. 49 in the deformed shape of FIG. 50 ;
- FIG. 53 is an elevational view of a surgical staple in an undeformed shape
- FIG. 54 is a bottom view of the surgical staple of FIG. 53 in an undeformed shape
- FIG. 55 is a bottom view of the surgical staple of FIG. 53 in a deformed shape in accordance with at least one embodiment of the present invention.
- FIG. 56 is a partial cross-sectional view of the surgical staple of FIG. 53 ;
- FIG. 57 is an elevational view of a surgical staple in a deformed shape in accordance with at least one embodiment of the present invention.
- FIG. 58 is an elevational view of a surgical staple in a deformed shape.
- a surgical stapling instrument can comprise a first handle portion 102 and a second handle portion 104 .
- first handle portion 102 and second handle portion 104 can be configured to be grasped by a surgeon, for example, and can comprise hand grip portion 106 .
- first handle portion 102 referring to FIGS. 2 and 3 , can include a first cover 108 attached to a first frame 110 and, similarly, second handle portion 104 can include a second cover 112 attached to a second frame 114 .
- Covers 108 and 112 can be ergonomically contoured, or otherwise suitably contoured, to assist a surgeon in manipulating stapling instrument 100 within a surgical site.
- handle covers 108 and 112 can include enlarged protrusions 109 and 113 , respectively, which can facilitate the insertion of stapling instrument 100 into a surgical site.
- handle covers 108 and 112 can be made of plastic, lightweight materials, and/or any other suitable material, for example, while handle frames 110 and 114 can be made of stainless steel, titanium, and/or any other suitable material, for example.
- each side flange 128 of can include a notch, or recess, 127 , for example, which can be configured to receive one or more latch projections 131 , for example, extending from anvil 130 , and/or any other suitable portion of second handle portion 104 , as described in greater detail further below.
- staple cartridge channel 122 can be configured to support and/or retain a staple cartridge, such as staple cartridge 150 , for example, within end-effector 120 , wherein the staple cartridge can include one or more staples (not illustrated) removably stored therein.
- staple cartridge 150 can include one or more staple cavities 151 which can be configured to store staples in any suitable arrangement, such as in at least two laterally-spaced longitudinal rows, for example. In at least one embodiment, referring to FIGS.
- staple cartridge 150 can include staple cartridge body 152 and pan 154 , wherein staple cartridge body 152 and/or pan 154 can be configured to define a channel, or path, for slidably receiving a staple sled and/or cutting member therein.
- pan 154 can include flexible arms 155 , for example, which can be configured to engage staple cartridge body 152 in a snap-fit and/or press-fit arrangement.
- staple cartridge 150 can further include staple sled assembly 160 which can include staple sled portion 162 and, in addition, cutting member 164 .
- cutting member 164 can include cutting edge 165 and lock arm 166 , for example, wherein lock arm 166 can be configured to be press-fit and/or snap-fit into aperture 163 in staple sled 162 when cutting member 164 is assembled to staple sled portion 162 .
- staple sled portion 162 can be integrally molded to cutting member 164 .
- a surgical stapling instrument can include a cutting member/staple sled assembly configured to incise tissue and deploy staples from a staple cartridge.
- a surgical stapling instrument may not require, or include, a cutting member.
- a staple cartridge can include a staple sled positioned therein and/or a surgical instrument can be configured to move a staple sled into a staple cartridge in order to staple tissue, for example, without otherwise dissecting it.
- a staple cartridge can include a staple sled positioned therein where a surgical instrument can include a cutting member movable into, or relative to, the staple cartridge.
- the cutting member can be advanced into contact with the staple sled such that the cutting member and staple sled can be advanced together. Thereafter, the cutting member can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge having a new staple sled.
- a staple cartridge can include a cutting member positioned therein where a surgical instrument can include a staple sled movable into, or relative to, the staple cartridge.
- the staple sled can be advanced into contact with the cutting member such that the cutting member and staple sled can be advanced together.
- the staple sled can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge having a new cutting member.
- the staple cartridge can include a protective housing or cover configured to prevent, or at least reduce the possibility of, a surgeon or other clinician from touching the cutting member positioned within the staple cartridge while handling the staple cartridge, for example.
- staple cartridge channel 122 and/or staple cartridge 150 can include one or more co-operating projections and/or recesses, for example, which can be configured to removably retain staple cartridge 150 within staple cartridge channel 122 .
- first handle portion 102 can be assembled to the second handle portion 104 .
- the staple cartridge may be inserted into the staple cartridge channel after the first and second handle portions have been assembled together. In either event, referring to FIGS.
- first handle portion 102 and second handle portion 104 can include proximal ends 103 and 105 , respectively, which can be assembled together such that the first and second handle portions can be rotatably or pivotably coupled to one another.
- first handle portion 102 can include one or more pins, or projections, 111 extending therefrom which can be configured to be slidably received within one or more grooves, channels, or slots 115 in second handle portion 104 .
- slots 115 can be defined in second handle frame 114 and projections 111 can extend from a proximal end post 107 extending from first handle frame 110 , for example.
- first handle portion 102 and second handle portion 104 In order to assemble first handle portion 102 and second handle portion 104 , referring to FIG. 4 , the open ends of slots 115 can be aligned with projections 111 such that second handle portion 104 , for example, can be translated relative to first handle portion 102 and projections 111 can be slid within slots 115 .
- the open ends of slots 115 can be located proximally with respect to their closed ends.
- proximal end 105 of second handle portion 104 can be positioned distally with respect to proximal end 103 of first handle portion 102 such that second handle portion 104 can be moved proximally in order to position projections 111 within slots 115 .
- first handle portion 102 can be positioned proximally with respect to second handle portion 104 and slid distally in order to position projections 111 within slots 115 .
- second handle portion 104 can be rotated toward first handle portion 102 such that anvil 130 can be moved into position relative to staple cartridge 150 and/or staple cartridge channel 122 .
- first handle portion 102 can be rotated toward second handle portion 104 and/or the first and second handle portions can be rotated toward each other.
- projections 111 and slots 115 when engaged with one another, can comprise a pivot about which one or both of the first and second handle portions can be moved relative to each other.
- second handle portion 104 can be moved relative to first handle portion 102 such that anvil 130 is moved into close opposition to staple cartridge 150 .
- first handle portion 102 can further include latching mechanism 180 rotatably mounted thereto which can be utilized to engage latch projections 131 extending from second handle portion 104 and secure the first and second handle portions together.
- latching mechanism 180 can be mounted to first frame 110 by one or more pivot pins 182 which can be configured to define an axis about which latch 180 can be rotated.
- At least one of latch arms 188 can be integrally-formed with latch frame 184 .
- at least one of latch arms 188 can include a distal hook 189 which can be configured to wrap around at least a portion of projections 131 so as to encompass or surround, or at least partially encompass or surround, projections 131 .
- latch arms 188 can act as an over-center latch to maintain latching mechanism 180 in its latched, or closed, position.
- one of the first handle portion 102 and the second handle portion 104 can be positioned on a first side of tissue within a surgical site and the other handle portion can be rotated into position on the opposite side of the tissue.
- staple cartridge 150 can be positioned on one side of the tissue and anvil 130 can be positioned on the other side of the tissue.
- latching mechanism 180 can be actuated such that it can be moved between an open position and a closed position in order to latch second handle portion 104 to first handle portion 102 and apply a clamping force to the tissue positioned between staple cartridge 150 and anvil 130 .
- latching mechanism 180 can be moved between an open position ( FIG.
- latching mechanism 180 can be configured to be moved between an open position, a partially-closed position, and a closed position.
- latching mechanism 180 When latching mechanism 180 is in its open position, as also outlined above, projections 111 can be inserted into and/or removed from slots 115 .
- latch arms 188 When latching mechanism 180 is in its partially-closed position, referring to FIG. 6 , latch arms 188 can be configured to engage latch projections 131 such that projections 111 cannot be removed from slots 115 .
- latch projections 131 can extend from second handle portion 104 at a location which is intermediate its proximal and distal ends.
- projections 111 and slots 115 can be configured to hold the first and second handle portions together at their proximal ends while latching mechanism 180 can be utilized to hold the first and second handle portions together at an intermediate location.
- the first and second handle portions cannot be disengaged from one another unless latching mechanism 180 is moved into its fully open position.
- projections 111 and slots 115 cannot be disengaged from one another when latching mechanism 180 is in a closed and/or partially-closed position.
- surgical stapling instrument 100 can further include pusher bar assembly 200 which can be configured to advance and/or retract staple sled assembly 160 within staple cartridge 150 , for example.
- pusher bar assembly 200 can include pusher bar 202 and firing actuator 204 , wherein firing actuator 204 can be configured to move pusher bar 202 and staple sled assembly 160 distally to deploy staples from staple cartridge 150 and deform the staples against anvil 130 as described above.
- firing actuator 204 can be configured to move pusher bar 202 and staple sled assembly 160 distally to deploy staples from staple cartridge 150 and deform the staples against anvil 130 as described above.
- pusher bar 202 can be advanced distally before contacting and engaging staple sled assembly 160 .
- the staple sled assembly 160 can remain stationary until contacted by pusher bar 202 .
- actuator 204 can be operably connected to pusher bar 202 such that a pushing and/or pulling force can be applied to actuator 204 and transmitted to pusher bar 202 .
- actuator 204 can be pivotably connected to a proximal end 203 of pusher bar 202 such that actuator 204 can be selectively rotated between at least first and second positions.
- actuator 204 can include arm 206 extending therefrom where arm 206 can be pivotably mounted to proximal end 203 of pusher bar 202 .
- surgical instrument 100 can include a first slot (not illustrated) extending along first side 116 and a second slot 118 extending along second side 117 , wherein the first and second slots can be configured to slidably receive at least a portion of actuator 204 .
- the sidewalls of the first and second slots can confine, or at least assist in confining, the movement of actuator 204 such that it can be moved along a predetermined path.
- second slot 118 can be defined between first handle portion 102 and second handle portion 104 such that, when actuator 204 is moved distally along second side 117 , arm 206 of actuator 204 can be slid intermediate the first and second handle portions.
- the first slot can also be defined intermediate the first and second handle portions.
- surgical instrument 100 can further include intermediate slot 119 which can also be configured to allow arm 206 , and/or any other suitable portion of actuator 204 , to slide therein.
- intermediate slot 119 can connect the first and second slots such that, when actuator 204 is positioned in its intermediate position, actuator 204 can be moved into either one of its first and second positions.
- the first slot, second slot 117 , and intermediate slot 119 can be parallel, or at least substantially parallel, to one another and/or lie in the same plane, although other embodiments are envisioned in which one or more of the slots is not parallel to the others and/or lies in a different plane.
- first and second sides of the illustrated embodiment are located on opposite sides of surgical instrument 100
- first and second slots for example, are located on adjacent sides and/or sides which are not directly opposite to each other.
- other embodiments are envisioned in which the sides of a stapling instrument are not readily discernable, such as instruments having round and/or arcuate portions.
- surgical stapling instrument 100 can further include a locking mechanism which can prevent, or at least inhibit, actuator 204 and, correspondingly, staple sled assembly 160 , from being advanced prematurely.
- the locking mechanism can be configured to prevent, or at least inhibit, actuator 204 from being advanced distally prior to latching mechanism 180 being moved into a closed, or an at least partially-closed, position.
- surgical stapling instrument 100 can further including locking mechanism 220 which can be engaged with actuator 204 and can remain engaged with actuator 204 while latching mechanism 180 is in a fully open position ( FIG. 5 ) and/or an at least substantially-open position.
- locking mechanism 220 can include lock 222 which can be biased into engagement with actuator 204 by a biasing force applied thereto by lock spring 224 , for example.
- actuator 204 can include one or more grooves, channels, or slots (not illustrated) which can be configured to receive at least a portion of lock 222 .
- locking mechanism 220 can hold actuator 204 in position until latching mechanism 180 is moved into its fully closed position ( FIG. 7 ) and/or an at least substantially closed position.
- latching mechanism 180 can be configured to engage locking mechanism 220 and disengage lock 222 from actuator 204 .
- latching mechanism 180 can further include cam 183 which can be configured to engage cam surface 223 on lock 222 when latching mechanism 180 is moved into its closed position and, as a result, slide, and/or otherwise move, lock 222 away from actuator 204 .
- cam 183 can comprise a wall, rib, and/or ridge extending from latch cover 186 and/or latch frame 184 .
- actuator 204 can be moved from its intermediate position, illustrated in FIG. 1 , into one of its first and second positions, as illustrated in FIGS. 13 and 14 .
- locking mechanism 220 can be configured to prevent, or at least inhibit, drive bar 202 from being advanced distally prior to latching mechanism 180 being moved into a predetermined position, such as, for example, a closed position and/or partially-closed position.
- locking mechanism 220 may also prevent, or at least inhibit, staple sled assembly 160 from being advanced prior to the first handle portion 102 and the second handle portion 104 being assembled together.
- locking mechanism 220 can prevent tissue positioned intermediate anvil 130 and staple cartridge 150 from being cut and/or stapled prior to anvil 130 and staple cartridge 150 being properly positioned relative to the tissue.
- locking mechanism 220 can prevent staples from being deployed into the tissue prior to an appropriate clamping force being applied to the tissue.
- locking mechanism 220 ′ can include a lock 222 ′ comprising a cam surface 223 ′ and, in addition, a stop 226 ′ which can limit the relative movement of lock 222 ′.
- cam 183 can be configured to contact cam surface 223 ′ and, owing to the contoured, beveled, and/or angled surface of cam surface 223 ′, cam 183 can be configured to drive lock 222 ′ distally as illustrated in FIG. 16 .
- Lock 222 ′ can be driven distally such that pin 228 ′, which extends from lock 222 ′, can be moved between a first position ( FIG. 15 ) in which it is positioned within aperture 229 ′ in actuator 204 ′ and a second position ( FIG. 16 ) in which pin 228 ′ has been sufficiently removed from aperture 229 ′.
- stop 226 ′ can be configured such that, as lock 222 ′ is driven distally, stop 226 ′ can come into contact with cam 183 once lock 222 ′ has been sufficiently displaced. In such embodiments, stop 226 ′ can be configured to control the second, or displaced, position of lock 222 ′. Similar to the above, as actuator 180 is moved out of its closed position and cam 183 is disengaged from locking mechanism 220 ′, lock spring 224 ′ can move lock 222 ′ into engagement with actuator 204 ′ once again.
- a firing actuator can be utilized to move a pusher bar, staple sled, and/or cutting member between first and second positions.
- pusher bar assembly 200 can be utilized to move a staple sled assembly, such as staple sled assembly 160 , for example, between a proximal position ( FIG. 10 ) and a distal position.
- a staple cartridge such as staple cartridge 150
- staple cartridge 150 can include a staple sled assembly 160 contained therein, wherein staple sled assembly 160 can be positioned in a distal position, as illustrated in FIG. 10 , when the staple cartridge is assembled to or inserted into staple cartridge channel 122 .
- staple cartridge 150 can include further housing 170 which can be configured to cover at least a portion of cutting member 164 when staple sled assembly 160 is in its distal position, for example.
- housing 170 can be configured to protect a surgeon, for example, when handling the staple cartridge, when inserting the staple cartridge into the surgical stapler, and/or assembling two or more portions of the surgical stapler together, for example.
- at least an upper portion of cutting edge 165 can extend above deck, or top surface, 158 of staple cartridge 150 and, absent a protective housing, such as housing 170 , for example, the upper portion of cutting edge 165 may be exposed.
- housing 170 can include a first wall, or portion, 172 extending from a first portion 157 of staple cartridge body 152 , a second wall, or portion, 174 extending from a second portion 159 of staple cartridge body 152 , and a top wall, or portion, 176 extending between first wall 172 and second wall 174 .
- a housing may comprise only one support wall, or support portion, extending from a staple cartridge body and, in addition, a top wall, or top portion, extending therefrom.
- a housing may comprise one or more side walls, or portions, and no top wall.
- the side walls of the housing can be configured such that they extend above the top of the cutting member, or at least extend above a cutting edge of the cutting member, for example.
- at least a portion of cutting member 164 can be positioned underneath top wall 176 and/or between side walls 172 and 174 when staple sled assembly 160 is in its proximal position.
- cutting member 164 can be entirely positioned underneath top wall 176 , and/or entirely positioned within housing 170 . In at least one embodiment, cutting member 164 can be positioned underneath top wall 176 such that cutting surface 165 does not extend beyond the distal edge 175 and/or the proximal edge 177 of top wall 176 . In at least one embodiment, housing 170 can include a rear wall 178 which can be configured to limit the proximal movement of cutting member 164 and/or any other portion of staple sled assembly 160 . In various embodiments, at least a portion of housing 170 , for example, can be integrally-formed with staple cartridge body 152 .
- first wall 172 , second wall 174 , top wall 176 , and/or rear wall 178 can be formed when staple cartridge body 152 is injection molded, for example.
- at least a portion of housing 170 can be assembled to staple cartridge body 152 via a snap-fit arrangement, press-fit arrangement, and/or any other suitable manner.
- cutting member 164 can be defined by a planar, or an at least substantially planar, body having a knife edge extending along at least one side of the cutting member body.
- first wall 172 and/or second wall 174 can be configured and arranged such that they can include planar, or at least substantially planar, interior surfaces 173 which are parallel, or at least substantially parallel, to the side surfaces of cutting member 164 .
- cutting member 164 can be closely received between the interior surfaces 173 of walls 172 and 174 .
- the distance between walls 172 and 174 may be the same as, or at least substantially the same as, the width of slot 156 .
- a housing can be configured such that at least a portion of the housing extends over at least a portion of slot 156 , for example.
- housing 170 can completely enclose or surround a cutting member 164 and/or cutting surface 165 .
- a housing can include a break-away and/or incisable portion which can be at least partially detached, separated, and/or otherwise deformed in order to permit a cutting member to exit the housing.
- the tissue cutting surface can be configured to contact the housing to break and/or incise a housing wall, for example.
- the housing wall can include a thin portion, a reduced-thickness portion, score mark, and/or any other configuration to facilitate the deformation and/or incision of the housing wall.
- a cutting member can include one or more additional cutting surfaces and/or anvils, for example, which can be configured to deform and/or incise the housing.
- the housing can include a movable and/or flexible portion, such as a hinged member and/or flexible flap, for example, which can be configured to sufficiently move and/or flex to allow the cutting member to pass thereby.
- the cutting member can have any suitable configuration for incising tissue and the protective housing can have any suitable configuration for at least partially enclosing or surrounding the cutting member.
- a cutting member can comprise a sharpened edge as described above, other suitable cutting members are envisioned, such as those supplied with an electrical current sufficient to dissect tissue, for example.
- housing 170 can be configured to at least partially cover, enclose, and/or surround a cutting member when it is in its proximal position.
- the cutting member can be advanced distally to incise tissue, for example, and then retracted proximally in order to position the cutting member within housing 170 once again.
- the cutting member can be at least partially covered by housing 170 when the staple cartridge is assembled to and removed from a surgical stapling instrument.
- a new, or unspent, staple cartridge can be inserted into the staple cartridge channel to replace the at least partially spent staple cartridge.
- the new staple cartridge can include a new cutting member and/or staple sled assembly positioned therein, although embodiments are envisioned in which the previously-used cutting member and/or staple sled assembly can be sufficiently withdrawn from the spent staple cartridge and advanced into the new staple cartridge in order to be reused once again.
- a sharp cutting edge for example, can be utilized with each staple cartridge.
- a staple cartridge can include two or more housings configured to at least partially cover a cutting member when it is in two or more positions.
- a staple cartridge can include a proximal housing configured to at least partially cover the cutting member when it is in a proximal position, for example, and, in addition, a distal housing configured to at least partially cover the cutting member when it is in a distal position, for example.
- the cutting member can be positioned within the proximal housing when the staple cartridge is assembled to a surgical stapling instrument and, in certain embodiments, the cutting member can be advanced into the distal housing after it has transected tissue positioned within the end-effector, for example.
- the cutting member can be at least partially positioned within the distal housing when the staple cartridge is removed from the surgical stapler.
- Such embodiments may be particularly useful when a vessel, for example, is positioned intermediate the proximal housing and the distal housing of the staple cartridge.
- a cutting member can be moved proximally from a distal position to a proximal position, and/or any other suitable position.
- anvil 130 can include one or more apertures, slots, or recesses 179 ( FIG. 17 ) which can be configured to receive at least a portion of housing 170 when anvil 130 is brought into close opposition to staple cartridge 150 , for example.
- sufficient clearance can be present between housing 170 and recess 179 such that anvil 130 and staple cartridge 150 can be moved relative to each other without interference, or at least substantial interference, therebetween.
- an opposing anvil can have more than one corresponding aperture for receiving the housings.
- an anvil can include a movable cutting member and at least one housing for at least partially covering, enclosing, and/or surrounding the cutting member.
- both an anvil and a staple cartridge can comprise at least one movable cutting member and/or at least one housing configured to at least partially cover, surround, or enclose the cutting members when they are in a proximal position, for example.
- pusher bar assembly 200 can be advanced distally in order to move staple sled assembly 160 within staple cartridge assembly 150 .
- the wedge-like cam surfaces 167 of staple sled 162 can be moved into engagement with the sloped surfaces 169 on staple drivers 168 to sequentially, and/or simultaneously, drive staples from staple cartridge 150 against anvil 130 and form the staples into any suitable configuration, such as B-shaped configurations, for example.
- anvil 130 can include one or more staple forming surfaces, such as staple pockets 132 , for example, which can be configured to deform the staples.
- anvil 130 can further include a slot, channel, or groove 133 which can be configured to slidably receive at least a portion of staple sled 162 , cutting member 164 , and/or pusher bar 202 , for example.
- an anvil can include an anvil plate which can be securely and/or immovably positioned within an anvil channel defined within the anvil.
- anvil 130 can include an anvil plate 134 movably positioned within anvil channel 136 .
- anvil channel 136 can include opposite side walls 137 and, in addition, a base 138 extending between side walls 137 .
- anvil 130 can further include a distal nose portion 139 , for example, assembled thereto wherein nose portion 139 can be configured to be press-fit and/or snap-fit into anvil channel 136 , for example, such that nose portion 139 can be securely retained therein.
- nose portion 139 can be comprised of a soft and/or pliable material, such as rubber, for example, and can comprise any suitable shape which can facilitate the insertion of anvil 130 into a surgical site, for example.
- a nose portion, such as nose portion 139 ′ can be retained to an anvil by one or more fasteners 139 a ′.
- a staple cartridge channel and/or staple cartridge, such as staple cartridge 150 can include a nose portion, such as nose portion 153 , for example, which can facilitate the insertion of staple cartridge 150 into a surgical site, for example
- staples can be deployed from a staple cartridge and deformed against an anvil.
- the distance between the staple forming surfaces on anvil 130 and staple sled 162 can determine the amount in which the staples are deformed. For example, if the distance between anvil pockets 132 on anvil 130 and top surfaces 135 on staple sled 162 ( FIGS. 10-12 ) is relatively large, the staples will be deformed a lesser amount as compared to when the distance between anvil pockets 132 and sled surfaces 135 is relatively small.
- the staples will be deformed a greater amount as compared to when the distance between anvil pockets 132 and sled surfaces 135 is relatively large.
- the distance between anvil pockets 132 and sled surfaces 135 is referred to as the forming height of the staples.
- the forming height of the staples can be measured between the top surface, or deck, of the staple cartridge and the staple forming surfaces on the anvil.
- any reference to a staple forming height, or the like can include one or both manners of measurement, where appropriate, and/or any other suitable manner of measurement.
- a surgical stapling instrument such as stapling instrument 100 , for example, can include means for adjusting the staple forming height.
- an anvil can include one or more forming surfaces which can be moved toward and/or away from a staple cartridge in order to set the forming height of the staples.
- anvil 130 can include anvil plate 134 which can be movably and/or slidably positioned within anvil channel 136 .
- anvil 130 can further include one or more retention, or guide, pins 140 , wherein anvil plate 134 can include one or more retention, or guide, slots 141 configured to slidably receive at least a portion of pins 140 .
- pins 140 and/or slots 141 can be configured to define a predetermined path along which anvil plate 134 can be moved.
- pins 140 and slots 141 can be structured and arranged such that anvil plate 134 can be moved along a linear, or at least substantially linear, path, wherein the linear path can be at least partially defined by axes 142 and 143 , for example.
- Other embodiments are envisioned in which an anvil plate can be moved along a non-linear path, such as a curved and/or curvi-linear path, for example.
- pins 140 can be retained within apertures 144 in side walls 137 wherein, in at least one embodiment, pins 140 can be press-fit within apertures 144 . In any event, as described herein, pins 140 can guide anvil plate 134 as it is moved toward and/or away from staple cartridge 150 , for example.
- a surgical stapling instrument such as stapling instrument 100
- stapling instrument 100 can include anvil plate adjustment member 230 which can be configured to limit the range of motion of anvil plate 134 . In at least one such embodiment, referring to FIGS.
- adjusting member 230 can be positioned intermediate anvil plate 134 in a first position in which first surface, or step, 231 of adjusting member 230 is positioned intermediate base 138 of anvil channel 136 and first positioning surface 145 on anvil plate 134 .
- first step 231 can define the amount of relative movement possible, or permitted, between anvil plate 134 and anvil channel 136 .
- anvil plate 134 can contact the tissue and slide upwardly toward base 138 until first positioning surface 145 contacts first step 231 .
- adjusting member 230 can prevent, or at least inhibit, anvil plate 134 from moving further toward base 138 .
- adjusting member 230 can act as a stop such that the distance between base 138 and tissue-contacting surface 148 on anvil plate 134 can be defined by a first distance 234 .
- base 138 is used as a reference datum in the present example, other portions of anvil 130 and/or an opposing staple cartridge, for example, could be used as reference datums.
- second surface, or step, 232 of adjusting member 230 can be positioned intermediate base 138 and second positioning surface 146 on anvil plate 134
- third surface, or step, 233 can be positioned intermediate base 138 and third positioning surface 147 . Referring to FIG.
- adjustment member 230 can include two or more sets of steps, 231 , 232 , and/or 233 and anvil plate 134 can include two or more sets of positioning surfaces 145 , 146 , and/or 147 . While first step 231 and first positioning surface 145 are described above as being configured to control the position of anvil plate 134 , the second and third steps ( 232 , 233 ) of adjustment member 230 and the second and third positioning surfaces ( 146 , 147 ) of anvil plate 134 , respectively, can also be configured to control the position of anvil plate 134 .
- step 231 the surface which controls the position of anvil plate 134
- steps 232 and 233 can control the position of anvil plate 134 as well.
- the first position of adjustment member 230 can provide for a relatively small, or short, staple forming height. In other embodiments, although not illustrated, the first position of an adjustment member can provide for an intermediate, a relatively large, and/or any other suitable staple forming height. In the event that the forming height associated with the first position of the adjustment member is suitable, a surgeon can proceed to use the surgical stapling instrument to staple and/or incise tissue as described above. In the event, however, that the staple forming height is unsuitable, a surgeon, or other clinician, can move adjustment member 230 such that adjustment member 230 can permit anvil plate 134 to slide upwardly a different distance when anvil plate 134 contacts tissue positioned intermediate anvil 130 and staple cartridge 150 .
- the distance in which anvil plate 134 is permitted to slide upwardly can be larger, thereby providing a larger forming height for the staples.
- the adjustment member can be moved such that anvil plate 134 can slide upwardly a shorter distance when anvil plate 134 contacts the tissue, for example, thereby providing a shorter staple forming height.
- upward can mean vertically upward, the term is not so limited; rather, “upward” can mean any direction which is toward the base of the anvil and/or away from a staple cartridge, for example.
- adjustment member 230 can be moved between its first position, illustrated in FIG. 21 , and a second position, illustrated in FIG.
- adjustment member 230 can be slid proximally in order to move adjustment member 230 between its first and second positions, although embodiments are envisioned where an adjustment member can be slid distally and/or any other suitable direction in order to adjust adjustment member 230 .
- first surface, or step, 231 can be positioned intermediate base 138 and second positioning surface 146 of anvil plate 134 . In such a second position, first step 231 can once again define the amount of relative movement permitted between anvil plate 134 and anvil channel 136 .
- adjusting member 230 can act as a stop such that the distance between base 138 and tissue-contacting surface 148 on anvil plate 134 can be defined by a second distance 235 .
- adjustment member 230 can be moved between its second position, illustrated in FIG. 22 , and a third position, illustrated in FIG. 23 , in order to once again increase the staple forming height. As indicated by arrow “P” in FIG. 23 , adjustment member 230 can be slid proximally in order to move adjustment member 230 between its second and third positions.
- first surface, or step, 231 can be positioned intermediate base 138 and third positioning surface 147 . In such a third position, first step 231 can once again define the amount of relative movement between anvil plate 134 and anvil channel 136 .
- adjusting member 230 can act as a stop such that the distance between base 138 and tissue-contacting surface 148 on anvil plate 134 can be defined by a third distance 236 . While adjustment member 230 can be selectively moved between three positions as described above to provide three different staple forming heights, other embodiments are envisioned which comprise an adjustment member which can be moved between more than three positions to provide more than three different staple forming heights. For example, an adjustment member can be movable between four positions in order to provide four staple forming heights. Further embodiments are envisioned which comprise an adjustment member which can be moved between two positions to provide two staple forming heights.
- adjustment member 230 can be slid along an axis, other embodiments are envisioned where an adjustment member can be moved along any suitable path such as curved and/or curvi-linear paths, for example.
- adjustment member 230 can comprise three surfaces, or steps, 231 , 232 , and 233 while anvil plate 134 can comprise three corresponding adjustment surfaces 145 , 146 , and 147 .
- first surface 231 can be positioned such that it abuts or is adjacent to first adjustment surface 145
- second surface 232 can be positioned such that it abuts or is adjacent to second adjustment surface 146
- third surface 233 can be positioned such that it abuts or is adjacent to third adjustment surface 147 .
- adjustment member 230 is slid relative to anvil plate 134 , as described above and referring to FIGS.
- an anvil plate may include one positioning surface, such as positioning surface 145 , for example, where steps 231 , 232 , and 233 of adjustment member 230 , for example, can be selectively positioned intermediate base 138 and positioning surface 145 .
- first step 231 can have a first thickness or height which can stop, or limit, the upward movement of anvil plate 134 so as to define a first staple forming height
- second step 232 can have a second thickness or height which can stop, or limit, the upward movement of anvil plate 134 so as to define a second staple forming height
- third step 233 can have a third thickness or height which can stop, or limit, the upward movement of anvil plate 134 so as to define a third staple forming height.
- the thickness or height of steps 231 , 232 , and/or 233 can be measured between a back surface 237 of adjustment member 230 and a surface on the steps ( 231 , 232 , 233 ) which will contact anvil plate 134 .
- the difference in height, or thickness, between first step 231 and second step 232 can be the same, or at least substantially the same, as the difference in height, or thickness, between second step 232 and third step 233 .
- the step heights can increase at a linear rate, or an at least substantially linear rate.
- the difference in height, or thickness, between the first and second steps can be different than the difference in height, or thickness, between the second and the third steps.
- the first, second, and third steps may not increase or decrease in height, or thickness, at a linear rate; rather, although not illustrated, the steps may increase or decrease in height, or thickness, in a non-linear and/or geometric rate.
- an adjustment member such as adjustment member 230
- a surgical stapling instrument can include an actuator configured to move the adjustment member.
- surgical stapling instrument 100 can include actuator 250 which can be operably attached to adjustment member 230 such that a force can be applied to actuator 250 and transmitted to adjustment member 230 .
- actuator 250 can include grasping portions, or handles, 252 which can be configured to be grasped by a surgeon, for example, in order to advance or retract adjustment member 230 within anvil 130 as described above.
- grasping portions 252 can extend from actuator body 251 , wherein actuator body 251 can include one or more apertures, slots, or cavities 253 which can be configured to receive at least a portion of adjustment member 230 .
- adjustment member 230 can include lock 254 extending therefrom, wherein at least a portion of lock 254 can be received within aperture 253 so as to retain actuator body 251 to adjustment member 230 .
- lock 254 can include one or more resilient, or flexible, legs 255 which can be deflected when they are inserted into aperture 253 but resiliently return, or at least partially return, to their unflexed position after feet 256 of legs 255 are sufficiently pushed through aperture 253 .
- feet 256 can prevent, or at least inhibit, actuator body 251 from being detached from adjustment member 230 .
- detent body 261 can include one or more apertures 263 , and/or any other suitable channels, slots, or grooves, which can be configured to receive one or more fasteners for securing detent body 261 to actuator 251 , for example.
- Detent member 260 can further include detent legs 262 which can be configured to engage one or more recesses, apertures, or grooves 101 ( FIGS. 2-7 ) in first frame portion 110 , for example. More particularly, referring to FIGS.
- each side flange 128 can include one or more recesses 101 ( 101 a , 101 b , and 101 c ) defined therein wherein detent legs 262 can be biased into engagement with the top surfaces of side flanges 128 such that detent legs 262 can be slid into, and slid out of, recesses 101 .
- each side flange can include three recesses 101 which can be configured to removably hold actuator 250 in a first, distal position, a second, intermediate position, and a third, proximal position, wherein the first, second, and third positions of actuator 250 can respectively correspond with the first, second, and third positions of adjustment member 230 described above.
- detent legs 262 of detent member 260 can be positioned within recess 101 a so as to removably retain actuator 250 and adjustment member 230 in their first positions.
- actuator 250 can be moved proximally into its second position such that detent legs 162 are positioned within recess 101 b and actuator 250 and adjustment member 230 are retained in their second positions.
- actuator 250 can be moved proximally into its third position such that detent legs 162 are positioned within recess 101 c and actuator 250 and adjustment member 230 are retained in their third positions.
- detent legs 162 can be configured such that actuator 250 can be returned to its first and/or second positions.
- adjustment member 230 can be moved along a pre-determined path between two or more positions by actuator 250 .
- surgical stapling instrument 100 can include one or more guides for controlling or limiting the movement of adjustment member 230 and/or actuator 250 .
- adjustment member 230 can be closely received between side walls 137 of anvil 130 such that side walls 137 can guide adjustment member 230 .
- side walls 137 can be configured to control or limit the lateral or side-to-side movement of adjustment member 230 .
- detent legs 162 of detent member 160 can comprise resilient members which can be configured to apply an upward biasing or pulling force on adjustment member 230 so as to position adjustment member 230 against, or at least adjacent to, base 138 and intermediate side walls 137 .
- base 138 of anvil 130 can further include guide slot 149 which can be configured to receive at least a portion of adjustment member 230 and/or actuator 250 therein such that guide slot 149 can limit the movement of adjustment member 230 and actuator 250 .
- lock 254 of adjustment member 230 can be configured to extend through guide slot 149 such that, when lock 254 is inserted into aperture 253 of actuator 250 as described above, base 138 of anvil 130 can be captured intermediate adjustment member 230 and actuator 250 .
- guide slot 149 can be configured to limit the movement of lock 254 such that adjustment member 230 can be prevented, or at least inhibited, from being moved distally when adjustment member 230 is in its first, or distal-most, position and/or, similarly, prevented, or at least inhibited, from being moved proximally when adjustment member 230 is in its third, or proximal-most, position.
- a detent member similar to detent member 260 , for example, can be utilized to bias first handle portion 102 and second handle portion 104 away from one another.
- surgical stapling instrument 100 ′ can include a detent member 260 ′ configured to position first handle portion 102 and second handle portion 104 such that a gap exists between anvil 130 and staple cartridge 150 .
- a detent member 260 ′ configured to position first handle portion 102 and second handle portion 104 such that a gap exists between anvil 130 and staple cartridge 150 .
- detent member 260 ′ can be sufficiently mounted to second handle portion 104 such that detent legs 262 ′ extending from detent member 260 ′ can contact flanges 128 and, when compressed, apply a biasing force to the first and second handle portions. As seen in FIG. 37 , legs 262 ′ can contact surfaces 101 d on flanges 128 . In order to compress detent legs 262 ′, latch mechanism 180 can be moved into a partially-closed position such that latch arms 188 can engage, and at least partially surround, latch projections 131 . In this configuration, a surgeon can manipulate the instrument and, when satisfied with its position, move latch mechanism 180 into a closed position and further compress detent legs 262 ′.
- detent member 260 ′ can be affixed, or otherwise operably engaged with, actuator 250 such that, when actuator 250 is moved between its first, second, and third positions as described above, legs 262 ′ can engage recesses 101 a , 101 b , and 101 c , respectively.
- actuator 250 can have a pre-staged position in which actuator 250 is positioned distally with respect to its first position and, in addition, surfaces 101 d can comprise pre-stage surfaces against which legs 262 ′ can be positioned when actuator 250 is in its pre-staged position.
- an adjustment member can be slid, or translated, between first and second positions so as to adjust the forming height of staples deployed by a surgical stapling instrument.
- an adjustment member can be configured to positively displace an anvil plate toward and/or away from an opposing staple cartridge, for example.
- a surgical stapling instrument can include one or more biasing members, such as springs, for example, configured to position the anvil plate against the adjustment member such that, when the adjustment member is moved between its first and second positions, the adjustment member can displace the anvil plate between first and second positions in order to set first and second staple forming heights.
- an adjustment member can be configured to cam a portion of an anvil into position.
- an adjustment member can be slid along an axis in order to positively displace an anvil plate.
- a rotatable adjustment member can be configured to positively displace an anvil plate toward and/or away from a staple cartridge, for example.
- surgical instrument 100 ′ can include, similar to the above, a first handle portion 102 ′, a second handle portion 104 ′, and a latching mechanism 180 ′ which can be utilized to clamp tissue intermediate anvil 130 ′ and staple cartridge 150 ′.
- latching mechanism 180 ′ can be pivotably coupled to first portion 102 ′ by one or more pivot pins 182 ′, wherein latching mechanism 180 ′ can include one or more latch arms 188 ′ which can be configured to engage second portion 104 ′ and latch the first and second handle portions together.
- surgical instrument 100 ′ can further include pusher bar assembly 200 ′ which can be configured to advance a cutting member and/or staple sled within end-effector 120 ′.
- pusher bar assembly 200 ′ can include a proximal end 203 ′ and an actuator 204 ′, wherein actuator 204 ′ can be rotatably mounted to proximal end 203 ′ and selectively positioned on first and second sides of stapling instrument 100 ′.
- surgical stapling instrument 100 ′ can comprise the same, or similar, features to those described in connection with surgical stapling instrument 100 and can be operated in the same manner, or a similar manner, as instrument 100 and, as a result, such details are not repeated herein.
- surgical instrument 100 ′ can include a rotatable adjustment member 230 ′ which can be selectively positioned in at least first and second positions so as to provide different staple forming heights.
- surgical instrument 100 ′ can include an actuator 250 ′ which can be operably connected to adjustment member 230 ′ such that actuator 250 ′ can move adjustment member 230 ′ between at least its first and second positions.
- actuator 250 ′ can include actuator body 251 ′ and grasping portion, or handle, 252 ′.
- Actuator body 251 ′ can include an aperture 258 ′ which can be configured to receive a proximal end 238 ′ of adjustment member 230 ′ such that rotational motion, torque, and/or forces can be transmitted between actuator 250 ′ and adjustment member 230 ′.
- aperture 258 ′ can comprise a non-circular profile and/or a profile which includes one or more flat drive surfaces configured to transmit rotational motion between actuator body 251 ′ and actuator 230 ′.
- aperture 258 ′ can be sized and configured to closely receive proximal end 238 ′ of actuator 230 ′.
- aperture 258 ′ can be configured to receive proximal end 238 ′ in a press-fit and/or snap-fit arrangement.
- handle portion 104 ′ can include one or more slots 259 ′ which can be configured to permit at least a portion of actuator body 251 ′ to extend therethrough such that grasping portion 252 ′ can be assembled to actuator body 251 ′ with at least a portion of handle portion 104 ′ positioned therebetween.
- second handle portion 104 ′ can further include recess 253 ′ which can be configured such that at least a portion, if not all, of grasping portion 252 ′ is positioned within recess 253 ′.
- recess 253 ′ can be configured such that grasping portion 252 ′ does not extend above the top surface of second handle portion 104 ′ although, in other embodiments, an upper portion of grasping portion 252 ′ can extend above second handle portion 104 , as illustrated in FIG. 30 , such that grasping portion 252 ′ can be easily accessed by a surgeon.
- an adjustment member can be rotatable between at least first and second positions in order to adjust the forming height of staples deployed by a surgical stapler.
- a surgical stapling instrument can include an adjustment member rotatably positioned within an anvil wherein the adjustment member can be configured to limit the relative movement of a movable anvil portion.
- surgical stapling instrument 100 ′ can include an anvil plate 134 ′ which can be slidably retained within anvil channel 136 ′ by retention, or guide, pins 140 ′, wherein guide pins 140 ′ can be configured to allow anvil plate 134 ′ to slide upwardly when anvil plate 134 ′ comes into contact with tissue as described above.
- adjustment member 230 ′ can be positionable in a first position, or orientation, such that it can limit the upward movement of anvil plate 134 ′ within anvil channel 136 ′ and dictate the staple forming height of the staples.
- FIGS. 27 , 30 , and 31 adjustment member 230 ′ can be positionable in a first position, or orientation, such that it can limit the upward movement of anvil plate 134 ′ within anvil channel 136 ′ and dictate the staple forming height of the staples.
- adjustment member 230 ′ can include opposing first surfaces 231 ′ which can be positioned intermediate base 138 ′ of anvil channel 136 ′ and positioning surface 145 ′ of anvil plate 134 ′ such that, when positioning surface 145 ′ contacts one of first surfaces 231 ′, tissue-contacting surface 148 ′ of anvil plate 134 ′ can be positioned a first distance 234 ′ away from a datum surface 129 ′ on anvil 130 ′, for example.
- forming surfaces 132 ′ can be positioned a first distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a first staple height.
- a first diameter 241 ′ can be defined between first surfaces 231 ′ wherein the first diameter 241 ′ can define the maximum upward position of anvil plate 134 ′ within anvil channel 136 ′.
- adjustment member 230 ′ can be rotated in order to adjust the forming height of the staples.
- adjustment member 230 ′ can be rotated between its first position, or orientation, ( FIGS. 30 and 31 ) and a second position, or orientation ( FIGS. 32 and 33 ).
- handle 252 ′ can be rotated in a direction indicated by arrow “A” in order to move adjustment member 230 ′ between its first and second positions.
- actuator 230 ′ when actuator 230 ′ is in its second position, or orientation, actuator 230 ′ can limit the upward movement of anvil plate 134 ′ within anvil channel 136 ′ and dictate the staple forming height of the staples.
- adjustment member 230 ′ can include opposing second surfaces 232 ′ which can be positioned intermediate base 138 ′ and positioning surface 145 ′ such that, when positioning surface 145 ′ contacts one of second surfaces 232 ′, tissue-contacting surface 148 ′ of anvil plate 134 ′ can be positioned a second distance 235 ′ away from datum surface 129 ′, for example.
- forming surfaces 132 ′ can be positioned a second distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a second staple height.
- a second diameter 242 ′ can be defined between second surfaces 232 ′, wherein second diameter 242 ′ can define the maximum upward position of anvil plate 134 ′ within anvil channel 136 ′.
- first surfaces 231 ′ and second surfaces 232 ′ can be defined by flat, or at least substantially flat, surfaces, other embodiments are envisioned in which the first and second surfaces 231 ′ and 232 ′ can include at least partially arcuate, or curved, contours.
- adjustment member 230 ′ may include one or more clearance slots 240 ′ which can be configured to provide clearance between actuator 230 ′ and retention pins 140 ′. Clearance slots 240 ′ can be configured to provide clearance between actuator 230 ′ and retention pins 140 ′ when actuator 230 ′ is in its first position, second position, and/or any other suitable position.
- adjustment member 230 ′ can be rotated between its first position, or orientation, ( FIGS. 30 and 31 ) and a third position, or orientation ( FIGS. 34 and 35 ).
- handle 252 ′ can be rotated in a direction indicated by arrow “B” in order to move adjustment member 230 ′ between its first and third positions.
- actuator 230 ′ when actuator 230 ′ is in its third position, or orientation, actuator 230 ′ can limit the upward movement of anvil plate 134 ′ within anvil channel 136 ′ and dictate the staple forming height of the staples.
- adjustment member 230 ′ can include opposing third surfaces 233 ′ which can be positioned intermediate base 138 ′ and positioning surface 145 ′ such that, when positioning surface 145 ′ contacts one of third surfaces 233 ′, tissue-contacting surface 148 ′ of anvil plate 134 ′ can be positioned a third distance 236 ′ away from datum surface 129 ′, for example.
- forming surfaces 132 ′ can be positioned a third distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a third staple height.
- a third diameter 243 ′ can be defined between third surfaces 233 ′, wherein third diameter 243 ′ can define the maximum upward position of anvil plate 134 ′ within anvil channel 136 ′.
- third surfaces 233 ′ can be defined by an at least partially arcuate contour, although other embodiments are envisioned in which third surfaces 233 ′ can include flat, or at least substantially flat, contours.
- adjustment member 230 ′ can be configured such that the largest distance, or diameter, between the arcuate third surfaces 233 ′ can be utilized to define the third staple height.
- adjustment member 230 ′ can be positioned in a first position, or orientation, to set a first forming height for the staples deployed by surgical stapling instrument 100 ′.
- actuator 250 ′ can be utilized to move adjustment member 230 ′ into its second position, or orientation, to set a second forming height for the staples.
- a force can be applied to handle 252 ′ which can cause handle 252 ′, and adjustment member 230 ′ attached thereto, to rotate in a direction indicated by arrow “A”.
- adjustment member 230 ′ and/or actuator 250 ′ can be sufficiently retained such that, when adjustment member 230 ′ is rotated, adjustment member 230 ′ can be rotated about an axis, such as axis 245 ′ ( FIG. 27 ), for example.
- the proximal end 203 ′ of pusher bar assembly 200 ′ can include one or more grooves, channels, or recesses 205 ′ which can be configured to receive and/or retain at least a portion of adjustment member 230 ′ and/or actuator 250 ′ therein. In any event, as illustrated in FIGS.
- the second position, or orientation, of adjustment member 230 ′ can allow anvil plate 134 ′ to slide a larger distance within anvil channel 136 ′ as compared to when adjustment member 230 ′ is in its first position.
- the second staple forming height can be larger than the first staple forming height.
- actuator 250 ′ can be utilized to move adjustment member 230 ′ into its third position, or orientation, to set a third forming height for the staples.
- a force can be applied to handle 252 ′ which can cause handle 252 ′, and adjustment member 230 ′ attached thereto, to rotate in a direction indicated by arrow “B”.
- the third position, or orientation, of adjustment member 230 ′ can allow anvil plate 134 ′ to slide a smaller distance within anvil channel 136 ′ as compared to when adjustment member 230 ′ is in its first position.
- the first and second staple forming heights can be larger than the third staple forming height.
- the first position of adjustment member 230 ′, and actuator 250 ′ can represent an intermediate position, wherein adjustment member 230 ′ can be selectively moved into its second and third positions directly from its first position.
- the first position of adjustment member 230 ′ can represent an intermediate staple height, wherein the second and third staple positions of adjustment member 230 ′ can represent taller and shorter staple heights, respectively.
- surgical stapling instrument 100 ′ can include one or more indicia thereon which can be configured to convey the staple forming heights, or at least relative forming heights, that can be selected.
- second handle portion 104 ′ can include a first indicium 245 ′ which can indicate an intermediate, or first, staple height, a second indicium 246 ′ which can indicate a taller, or second, staple height, and, in addition, a third indicium 247 ′ which can indicate a shorter, or third, staple height.
- first surfaces 231 ′, second surfaces 232 ′, and third surfaces 233 ′ can comprise or define, or at least partially comprise or define, a perimeter, or circumference, of adjustment member 230 ′.
- the perimeter, or circumference, of adjustment member 230 ′ may be non-circular. In certain embodiments, though, the perimeter, or circumference of adjustment member 230 ′, may be symmetrical, substantially symmetrical, and/or non-symmetrical.
- an adjustment member can comprise a cam rotatably positioned intermediate base 138 ′ of anvil 130 ′ and adjustment surface 145 ′ of anvil plate 134 ′, for example.
- one or more of first surfaces 231 ′, second surfaces 232 ′, and third surfaces 233 ′ can comprise or define a cam profile which, similar to the above, can be configured to either positively position anvil plate 134 ′ and/or provide a stop against which anvil plate 134 ′ can be positioned.
- an adjustment member can be slid and rotated in order to set two or more staple forming heights for staples deployed by a surgical stapling instrument.
- an adjustment member can comprise a cam profile which can be defined along the length of the adjustment member wherein longitudinal and/or rotational movement can be utilized to move the cam profile between at least first and second positions.
- surgical instrument 100 ′ can further include a detent mechanism configured to hold, or at least releasably hold, actuator 250 ′ in position.
- surgical instrument 100 ′ can further include detent member 260 ′ comprising detent body 261 ′ and one or more detent legs 262 ′.
- detent body 261 ′ can include one or more grooves, recesses, or channels 263 ′ which can be configured to receive at least a portion of proximal end 105 ′ of second handle portion 104 ′ therein such that detent member 260 ′ can be retained in position.
- proximal end 105 ′ can further include one or more grooves, channels, or recesses 265 ′ which can be configured to closely receive detent member 260 ′.
- at least a portion of detent body 261 ′, such as channel 263 ′, for example, can be press-fit, snap-fit, and/or otherwise suitably retained in recess 265 ′.
- each detent leg 262 ′ of detent member 260 ′ can include one or more projections 264 ′ extending therefrom which can be configured to engage actuator body 251 ′ and releasably hold actuator 250 ′ in position.
- actuator body 251 ′ can include one or more recesses, or holes, 269 ′ which can be configured to receive a projection 264 ′.
- the projection can be configured to hold actuator 250 ′ in its first position, for example, until a sufficient force is applied to actuator 250 ′ so as to cause the projection 264 ′ to be displaced out of recess 269 ′.
- the force applied to actuator 250 ′ can be transmitted to the projection 264 ′ and, owing to cooperating surfaces between the projection 264 ′ and recess 269 ′, the detent leg 262 ′ associated with the projection 264 ′ can be flexed or moved proximally to allow actuator body 251 ′ to be moved relative thereto.
- recess 265 ′ can include elongate portions 266 ′ which can each be configured to receive at least a portion of legs 262 ′ such that legs 262 ′ can move relative to handle portion 104 ′.
- actuator body 251 ′ can contact a projection 264 ′ extending from another leg 262 ′ and deflect the leg 262 ′ proximally such that, once actuator 250 ′ is in its second or third positions, the leg 262 ′ can spring forward, or distally, such that the projection 264 ′ can be secured within recess 269 ′.
- the interaction between projections 264 ′ and the sidewalls of recess 269 ′ can be such that actuator 250 ′ can be securely held in one of its first, second, and third positions, for example, yet permit actuator 250 ′ to be moved upon a sufficient application of force.
- the detent member 260 ′ can prevent, or at least inhibit, actuator 250 ′ and, correspondingly, adjustment member 230 ′ from being unintentionally displaced.
- each side flange 128 of first handle portion 102 can include a notch, or recess, 127 , for example, which can be configured to receive one or more latch projections 131 , for example, extending from anvil 130 , and/or any other suitable portion of second handle portion 104 .
- first handle portion 102 can further include latching mechanism 180 rotatably mounted thereto which can be utilized to engage latch projections 131 extending from second handle portion 104 and secure the first and second handle portions 102 , 104 together.
- Latching mechanism 180 can include one or more latch arms 188 extending therefrom which can be configured to engage latch projections 131 and pull and/or secure projections 131 within recesses 127 as illustrated in FIG. 7 .
- latch arms 188 can include a distal hook 189 which can be configured to wrap around at least a portion of projections 131 so as to encompass or surround, or at least partially encompass or surround, projections 131 .
- latch arms 188 can act as an over-center latch to maintain latching mechanism 180 in its latched, or closed, position.
- each projection 131 can comprise a slot, or groove, 190 positioned intermediate sidewall 191 and an enlarged end, or head, 192 of projection 131 , wherein the slot 190 can be configured to receive at least a portion of latch arm 188 .
- the slot 190 can have a width which is greater than the width of the latch arm 188 such that, when the latch arm 188 is engaged with the projection 131 , the latch arm 188 can enter into slot 190 .
- the width of each slot 190 may be slightly larger than the width of a latch arm 188 such that the latch arm is closely received within the slot 190 .
- the slot 190 , the sidewall 191 , and the head 192 of projection 131 can be sized and configured so as to prevent, or at least limit, relative lateral movement, i.e., movement away from or to the sides of anvil 130 , between latch arm 188 and projection 131 .
- the latch arms 188 can slide longitudinally within the grooves 190 as the latch arms 188 move the projections 131 into the recesses 127 in first portion 102 . Owing to such relative sliding movement between latch arms 188 and projections 131 , frictional forces can be generated therebetween which can resist the movement of latch arms 188 .
- a surgical instrument can comprise one or more latch projections having a rotatable bearing which can reduce the magnitude of the friction forces between the latch arms of a latching mechanism and the latch projections.
- an anvil 330 which can be substantially similar to anvil 130 in many respects, can comprise a latch projection 331 extending from each side thereof, wherein each latch projection 331 can comprise a rotatable bearing 393 .
- the latch arms 188 of latching mechanism 180 can contact the rotatable bearings 393 in order to position the latch projections 331 in recesses 127 .
- the latch arms 188 can slide across the surface, or outer diameter, of bearings 393 ; however, as bearings 393 can rotate relative to the latch arms 188 , the magnitude of the frictional forces between the latch arms 188 and projections 331 can be lower than the magnitude of the frictional forces between latch arms 188 and projections 131 . Owing to such lower frictional forces, a lower closing, or clamping, force may be required to actuate clamping mechanism 180 , for example.
- each rotatable bearing 393 can comprise a circular, or round, outer diameter 394 and, in addition, a circular, or round, bearing aperture 395 extending therethrough.
- each projection 331 can further comprise a shaft portion 396 extending from sidewall 391 and an enlarged end, or head, 392 extending from shaft portion 396 , wherein, as illustrated in FIG. 31 , the shaft portion 396 can extend through the bearing aperture 395 of rotatable bearing 393 .
- the shaft portion 396 can comprise a circular, or round, outer diameter which can be closely received within bearing aperture 395 such that there is little, if any, relative radial movement therebetween.
- the diameter of the bearing aperture 395 may be sufficiently larger than the outer diameter of shaft portion 396 such that bearing 393 can rotate relative to shaft portion 396 about an axis 399 .
- the rotatable bearing 393 can be retained on shaft portion 396 by the enlarged head 392 .
- the enlarged head 392 may be larger than, or define a larger diameter than, the diameter of bearing aperture 395 such that rotatable bearing 393 cannot slide off the end of shaft portion 396 .
- the sidewall 391 and the head 392 can define a gap distance therebetween and, in addition, the bearing 393 can comprise a width, wherein the gap distance can be larger than the width of bearing 393 .
- the gap distance may be slightly larger than the width of bearing 393 such that bearing 393 does not tilt, or at least substantially tilt, relative to axis 399 , for example.
- a surgical instrument can comprise a latching mechanism 380 which can comprise first and second latch arms 388 extending therefrom on opposite sides of anvil 331 and staple cartridge channel 324 .
- the latch arms 388 can contact bearings 393 in order to move bearings 393 into recesses 327 in staple cartridge channel 324 and move anvil 331 toward staple cartridge channel 324 . Such movement is illustrated with phantom lines in FIG. 41 .
- the slot 397 can further comprise a second drive surface, or sidewall, 398 b which can be positioned against another and/or opposite side of bearing 393 such that an opening force can be applied to the bearing 393 via latch arm 388 .
- the bearing 393 can move out of slot 397 .
- the first drive surface 398 a and the second drive surface 398 b can define a slot width therebetween which can be larger than the outside diameter of bearing 393 such that bearing 393 can move within slot 397 .
- the slot width may be slightly larger than the outside diameter of bearing 393 .
- At least portions of the first drive surface 398 a and the second drive surface 398 b can be parallel, or at least substantially parallel, to one another. In at least one such embodiment, at least portions of the first drive surface 398 a can be positioned opposite the second drive surface 398 b.
- a surgical stapling instrument can be configured to deform one or more surgical staples between a first, undeployed, configuration and a second, deployed, configuration.
- a surgical staple such as staple 400
- a surgical staple 400 can comprise a base 402 , a first leg, or deformable member, 404 extending from base 402 , and, in addition, a second leg, or deformable member, 406 extending from base 402 .
- the base 402 , the first leg 404 , and the second leg 406 can be comprised of a continuous wire, wherein, in at least one embodiment, the first leg 404 and the second leg 406 can each be bent in a direction which is perpendicular to the base 402 prior to staple 400 being inserted into and deformed by a surgical stapler. More particularly, the staple 400 can be manufactured such that base 402 is oriented along a baseline 401 and such that the legs 404 and 406 are oriented along lines 409 and 411 , respectively, which are perpendicular, or at least substantially perpendicular, to the baseline 401 .
- the first leg 404 can be positioned at a first end of base 402 and the second end 406 can be positioned at a second end of base 402 , wherein, in at least one embodiment, a mid-line 403 can be defined which extends through a midpoint of base 402 and which extends in a direction which is perpendicular to baseline 401 .
- the staple 400 can be configured such that the base 402 , first leg 404 , and second leg 406 lie, or at least substantially lie, in the same, or common, plane when the staple 400 is in its first, or undeployed, configuration.
- the baseline 401 along which the base 402 is oriented, and the perpendicular lines 409 and 411 , along which the legs 404 and 406 are oriented, can lie in the same plane.
- the continuous wire comprising the base 402 , the first leg 404 , and the second leg 406 can be comprised of titanium and/or stainless steel, for example.
- the first leg 404 can comprise a first end 405 and the second leg 406 can comprise a second end 407 , wherein the ends 405 and 407 can each comprise a sharp, or chisel, tip which can be configured to puncture bone and/or tissue.
- the staple 400 can be deformed by a surgical stapler in order to capture tissue, for example, within the staple 400 .
- the staple 400 can be deployed from a staple cartridge such that the ends 405 and 407 of staple legs 404 and 406 , respectively, contact an anvil positioned opposite the staple 400 .
- a first compressive force F 1 can be applied to the first leg 404 and a second compressive force F 2 can be applied to the second leg 406 while the base 402 is supported by at least a portion of the staple cartridge.
- the anvil can comprise a staple pocket which can apply the first compressive force F 1 to the first leg 404 such that the end 405 of staple leg 404 is moved toward the base 402 .
- the staple pocket can apply the second compressive force F 2 to the second staple leg 406 such that the end 407 of staple leg 404 is also moved toward base 402 .
- the staple pocket can bend the first staple leg 404 to a first side of base 402 and the second staple leg 406 to a second, or opposite, side of base 402 .
- the first leg 404 of staple 400 can be bent such that the end 405 of the first leg 404 is moved toward the base 402 and toward the second leg 406 when the first leg 404 is deformed by the first compressive force F 1 .
- the end 405 can be moved from a first side 410 of midline 403 , as illustrated in FIG. 49 , to a second side 412 of midline 403 , as illustrated in FIG. 50 .
- the second leg 406 of staple 400 can be bent such that the end 407 of the second leg 406 is moved toward the base 402 and toward the first leg 404 when the second leg 406 is deformed by the second compressive force F 2 .
- the end 407 can be moved from a second side 412 of midline 403 , as illustrated in FIG. 49 , to a first side 410 of midline 403 , as illustrated in FIG. 50 .
- the ends 405 and 407 of staple legs 404 and 406 can extend across the midline 403 in such a way that they form an angle therebetween.
- the end 405 of the first leg 404 when it is in its deformed configuration, can extend along or with respect to a first axis 414 and, similarly, the end 407 of the second leg 406 , when it is in its deformed configuration, can extend along or with respect to a second axis 416 such that the first axis 414 and the second axis 416 define an angle 417 therebetween.
- the angle 417 may be approximately 90 degrees, for example.
- the angle 417 may be in a range between approximately 0.1 degrees and approximately 89 degrees, for example.
- the angle 417 may be greater than 90 degrees, while, in at least one embodiment, the angle 417 may be greater than approximately 90 degrees but less than 180 degrees, for example.
- the first axis 414 and the second axis 416 can, in various embodiments, be oriented, or crossed, at a transverse angle with respect to each other, i.e., at least when the staple 400 is viewed from the side or elevational view of FIG. 50 . More particularly, upon reviewing FIG. 52 , it becomes evident that, although axes 414 and 416 extend in transverse directions when viewed from the side ( FIG. 50 ), the axes 414 and 416 may not, in at least one embodiment, actually intersect one another. In such embodiments, when viewing the staple 400 from the top or bottom ( FIG. 52 ), for example, the axes 414 and 416 may extend in parallel, or at least substantially parallel, directions.
- first axis 414 and the second axis 416 are not perpendicular with baseline 401 . Stated another way, the end 405 of first staple leg 404 and the end 407 of second staple leg 406 are not pointing directly downwardly toward base 402 and baseline 401 . In at least one such embodiment, the first axis 414 and the second axis 416 can each extend at an acute angle with respect to baseline 401 , for example.
- a surgical instrument can be configured to deform the staple 400 of FIG. 49 , for example, between an undeformed shape ( FIG. 49 ) and a deformed shape ( FIG. 50 ).
- the surgical instrument can comprise an anvil having a staple pocket configured to receive and deform at least a portion of the staple.
- an anvil can comprise a tissue-contacting surface 501 and a plurality of staple pockets 500 formed therein, wherein each staple pocket 500 can be configured to deform a staple 400 .
- each staple pocket 500 can comprise a longitudinal axis 599 ( FIG.
- the first forming cup 502 can be configured to receive the first staple leg 404 of staple 400 and the second forming cup 504 can be configured to receive the second staple leg 406 .
- the staple pocket 500 can be positioned relative to the staple 400 such that, as the staple 400 is ejected from a staple cartridge, for example, the end 405 of first leg 404 can enter the first forming cup 502 and the end 407 of second leg 406 can enter the second forming cup 504 .
- first staple leg 404 can contact the base 506 of first forming cup 502 such that the first compressive force F 1 can be applied to the first leg 404 and, similarly, the end 407 of second staple leg 406 can contact the base 508 of second forming cup 504 such that the second compressive force F 2 can be applied to the second leg 406 .
- the first forming cup 502 can comprise an inside portion 510 and an outside portion 512 , wherein, when the end 405 of first staple leg 404 enters into the first forming cup 502 , the end 405 can enter into the outside portion 512 .
- the end 405 Upon entering into the outside portion 512 of forming cup 502 , the end 405 can contact base 506 and, owing to a concave curve of base 506 , the end 405 can be directed inwardly toward the inside portion 510 . More particularly, referring now to FIGS.
- the base 506 can be curved toward tissue-contacting surface 501 such that, as the staple leg 404 contacts the base 506 , the end 405 can be directed downwardly, i.e., away from tissue-contacting surface 501 , and inwardly along the curved concave surface toward an inflection point 595 .
- the inflection point 595 can represent the point in which the concave surface of base 506 will begin to deflect the end 405 of first leg 404 upwardly toward the tissue-contacting surface 501 .
- the radius of curvature, r, of the concave surface can be constant, or at least substantially constant, in the longitudinal direction along the length thereof as illustrated in FIGS. 47 and 48 .
- the radius of curvature r of the concave surface of base 506 can be consistent across the width of base 506 between a first interior sidewall 516 and a first exterior sidewall 517 .
- the end 405 of first leg 404 can come into contact with a radius transition 514 positioned intermediate the base 506 and the first interior sidewall 516 .
- the radius transition 514 can be configured to direct the end 405 against the first interior sidewall 516 .
- the first interior sidewall 516 can be oriented at an angle with respect to staple pocket longitudinal axis 599 .
- the first interior sidewall 516 can be oriented at an acute angle, such as 10 degrees, for example, with respect to longitudinal axis 599 .
- the first interior sidewall 516 and the longitudinal axis 599 may be neither perpendicular nor parallel to one another.
- the first interior sidewall 516 can extend through the axis 599 such that a first portion of the first interior sidewall 516 is positioned on a first side 515 of axis 599 and a second portion of the first interior sidewall 516 is positioned on a second side 517 of axis 599 .
- the first interior sidewall 516 can extend between the first outside portion 512 and the first inside portion 510 .
- first leg 404 When the end 405 of first leg 404 contacts the first interior sidewall 516 , as described above, the end 405 can be directed along the first interior sidewall 516 and away from longitudinal axis 599 such that the staple leg 404 is bent away from the common plane of staple 400 toward the first side 515 of axis 599 . As the end 405 of first leg 404 is directed along, or bent by, the first interior sidewall 516 , as described above, the staple leg 404 can also be directed, or bent, by base 506 .
- first sidewall 516 and the first base 506 can co-operate to deform the first staple leg 404 such that end 405 is re-directed toward the base 402 and, at the same time, to a first side of the base 402 as described above.
- the end 405 of first staple leg 404 can emerge from the first inside portion 510 of first forming cup 502 and, as the staple leg 404 is further deformed by the staple pocket 500 , the end 405 can be directed along the first axis 414 ( FIG. 50 ) as described above.
- the first interior sidewall 516 can extend along an interior side of the first base 506 , wherein, in at least one embodiment, the first forming cup 502 can further comprise a first exterior sidewall 517 extending along an opposite side of the first base 506 . In certain embodiments, similar to the above, the first forming cup 502 can further comprise a transition radius 519 positioned intermediate the base 506 and the exterior sidewall 517 . In at least one embodiment, referring now to FIG. 43 , the exterior sidewall 517 can extend in a direction which is parallel, or at least substantially parallel, to the staple pocket longitudinal axis 599 . As also illustrated in FIG.
- the first interior sidewall 516 and the first exterior sidewall 517 can extend in directions which are transverse to one another.
- the interior sidewall 516 can extend at an acute angle, such as approximately 15 degrees, for example, with respect to the exterior sidewall 517 .
- the outside portion 512 of first forming cup 502 can be wider than the inside portion 510 .
- the width of the outside portion 512 and the inside portion 510 can taper between a first width and a second width.
- the outside portion 512 of first forming cup 502 can comprise a first outside wall 513 which can extend in a direction which is perpendicular to the first exterior wall 517 and/or the longitudinal axis 599 and can define the outermost portion of forming cup 502 .
- the width of the first outside wall 513 can be such that the outside portion 512 can capture the end 405 of first leg 404 and guide it into the inside portion 510 of cup 502 as described above.
- the first outside wall 513 can be at least as twice as wide as the diameter of the first leg 404 .
- the first forming cup 502 can further comprise a channeling surface 528 surrounding the first inner portion 510 and the first outer portion 512 which can be configured to guide the staple leg 404 into and/or out of the forming cup 502 .
- the inside portion 510 can further comprise an inside wall 511 which can define the innermost portion of forming cup 502 . Similar to the above, the inside wall 511 can also define the narrowest portion of forming cup 502 . In at least one embodiment, the width of the inside wall 511 may be the same, or at least substantially the same, as the diameter of first leg 404 such that the inside wall 511 can control the location in which the end 405 emerges from staple forming cup 502 .
- the second forming cup 504 can comprise an inside portion 520 and an outside portion 522 , wherein, when the end 407 of second staple leg 406 enters into the second forming cup 504 , the end 407 can enter into the outside portion 522 .
- the end 407 Upon entering into the outside portion 522 of forming cup 504 , the end 407 can contact base 508 and, owing to a concave curve of base 508 , the end 407 can be directed inwardly toward the inside portion 520 .
- the base 508 can be curved toward tissue-contacting surface 501 such that, as the staple leg 406 contacts the base 508 , the end 407 can be directed downwardly, i.e., away from tissue-contacting surface 501 , and inwardly along the curved concave surface toward an inflection point 596 .
- the inflection point 596 can represent the point in which the concave surface of base 508 will begin to deflect the end 407 of second leg 406 upwardly toward the tissue-contacting surface 501 .
- the radius of curvature, r, of the concave surface can be constant, or at least substantially constant, in the longitudinal direction along the length thereof, similar to the base 506 of first forming cup 502 illustrated in FIGS. 47 and 48 .
- the end 407 of second leg 406 can come into contact with a radius transition 524 positioned intermediate the base 508 and a second interior sidewall 526 .
- the radius transition 524 can be configured to direct the end 407 against the second interior sidewall 526 .
- the second interior sidewall 526 can be oriented at an angle with respect to staple pocket longitudinal axis 599 .
- the second interior sidewall 526 can be oriented at an acute angle, such as 10 degrees, for example, with respect to longitudinal axis 599 .
- the second interior sidewall 526 and the longitudinal axis 599 may be neither perpendicular nor parallel to one another.
- the second interior sidewall 526 can extend through the axis 599 such that a first portion of the second interior sidewall 526 is positioned on a first side 515 of axis 599 and a second portion of the second interior sidewall 526 is positioned on a second side 517 of axis 599 .
- the second interior sidewall 526 can extend between the second outside portion 522 and the second inside portion 520 .
- the staple leg 406 can also be directed, and bent, by base 508 .
- the second interior sidewall 526 and the second base 508 can co-operate to deform the second staple leg 406 such that end 407 is re-directed toward the base 402 and, at the same time, toward a second, or opposite, side of the base 402 as described above.
- the end 407 of second staple leg 406 can emerge from the second inside portion 520 of second forming cup 504 and, as the staple leg 406 is further deformed by the staple pocket 500 , the end 407 can be directed along the second axis 416 ( FIG. 50 ) as described above.
- the second interior sidewall 526 can extend along an interior side of the second base 508 , wherein, in at least one embodiment, the second forming cup 504 can further comprise a second exterior sidewall 527 extending along an opposite side of the second base 508 . In certain embodiments, similar to the above, the second forming cup 504 can further comprise a transition radius 529 positioned intermediate the base 508 and the exterior sidewall 527 . In at least one embodiment, referring now to FIG. 43 , the exterior sidewall 527 can extend in a direction which is parallel, or at least substantially parallel, to the staple pocket longitudinal axis 599 . As also illustrated in FIG.
- the second interior sidewall 526 and the second exterior sidewall 527 can extend in directions which are transverse to one another.
- the interior sidewall 526 can extend at an acute angle, such as approximately 15 degrees, for example, with respect to the exterior sidewall 527 .
- the outside portion 522 of second forming cup 504 can be wider than the inside portion 520 .
- the width of the outside portion 522 and the inside portion 520 can taper between a first width and a second width.
- the outside portion 522 of second forming cup 504 can comprise a second outside wall 523 which can extend in a direction which is perpendicular to the second exterior wall 527 and/or the longitudinal axis 599 and can define the outermost portion of forming cup 504 .
- the width of the second outside wall 523 can be such that the outside portion 522 can capture the end 407 of second leg 406 and guide it into the inside portion 520 of cup 504 as described above.
- the second outside wall 523 can be at least as twice as wide as the diameter of the second leg 406 .
- the second forming cup 504 can further comprise a channeling surface 529 surrounding the second inner portion 520 and the second outer portion 522 which can be configured to guide the staple leg 406 into and/or out of the forming cup 504 .
- the inside portion 520 can further comprise an inside wall 521 which can define the innermost portion of forming cup 504 . Similar to the above, the inside wall 521 can also define the narrowest portion of forming cup 504 . In at least one embodiment, the width of the inside wall 521 may be the same, or at least substantially the same, as the diameter of second leg 406 such that the inside wall 521 can control the location in which the end 407 emerges from staple forming cup 504 .
- the first forming cup 502 can comprise a first interior sidewall 516 and the second forming cup 504 can comprise a second interior sidewall 526 .
- the first inside portion 510 of forming cup 502 can be positioned in close proximity to, or close relation to, the second inside portion 520 of forming cup 504 such that the first interior sidewall 516 can be positioned adjacent to the second interior sidewall 526 .
- the first interior portion 510 can be offset from the staple pocket longitudinal axis 599 in the first direction 515 while the second interior portion 520 , or at least a substantial portion thereof, can be offset from the longitudinal axis 599 in the second direction 517 .
- the staple pocket 500 can comprise a wall 530 positioned intermediate the first inside portion 510 and the second inside portion 520 , wherein a first side of wall 530 can comprise the first interior sidewall 516 and wherein a second side of wall 530 can comprise the second interior sidewall 526 .
- the first interior sidewall 516 can be parallel, or at least substantially parallel to, the second interior sidewall 526 .
- the first interior sidewall 516 can define a first plane and the second interior sidewall 526 can define a second plane, wherein the first plane and the second plane can be parallel, or at least substantially parallel, to one another.
- the first interior sidewall 516 can be perpendicular, or at least substantially perpendicular, to the tissue-contacting surface 501 and, similarly, the second interior sidewall 526 can be perpendicular, or at least substantially perpendicular, to the tissue-contacting surface 501 .
- the first interior sidewall 516 can comprise a first vertical portion 516 a which is perpendicular, or at least substantially perpendicular, to the tissue-contacting surface 501 .
- the first vertical portion 516 a can extend through, or transect, the longitudinal axis 599 .
- the first vertical portion 516 a can extend along the entirety of, or only a portion of, the first interior sidewall 516 .
- the second interior sidewall 526 can comprise a second vertical portion 526 a which is perpendicular, or at least substantially perpendicular, to the tissue-contacting surface 501 .
- such a second vertical portion 526 a can extend through, or transect, the longitudinal axis 599 .
- the second vertical portion 526 a can extend along the entirety of, or only a portion of, the second interior sidewall 526 .
- the end 405 of first leg 404 can be in contact with the first vertical portion 516 a of first interior sidewall 516 at the same time the end 407 of second leg 406 is in contact with the second vertical portion 526 a of second interior sidewall 526 .
- the first vertical portion 516 a and the second vertical portion 526 a can comprise a vertical trap.
- the vertical portions 516 a and 526 a can co-operate to control, deflect, and bend the staple legs 404 and 406 in opposite directions, i.e., in directions to the sides of a common plane, as described above, when the legs 404 and 406 come into contact with the interior sidewalls 516 and 526 of forming cups 502 and 504 , respectively.
- the first vertical portion 516 a can be configured to deflect and bend the staple leg 404 to a first side of base 402 and the second vertical portion 526 a can be configured to deflect and bend the staple leg 406 to a second, or opposite, side of base 402 .
- the vertical trap comprising vertical portions 516 a and 526 a can extend along the entire length of the first and second interior sidewalls 516 and 526 , while, in other embodiments, the vertical trap may extend along only a portion of the sidewalls 516 and 526 .
- the vertical trap can be approximately 0.05 inches long, i.e., the overlap of the first vertical surface 516 a and the second vertical surface 526 a can be approximately 0.05 inches, for example, along the lengths of interior surfaces 516 and 526 .
- the length of the vertical trap can be between approximately 0.03 inches and approximately 0.10 inches, for example.
- the length of the vertical trap can be approximately twice the radius of curvature (r) of the curved concave surface of base 506 , for example. In various embodiments, the length of the vertical trap can be approximately equal to the radius of curvature (r) of base 506 , for example. In at least one embodiment, the length of the vertical trap can be between approximately 0.5*r and approximately 2*r, for example. In various embodiments, further to the above, the vertical trap can extend through the longitudinal axis 599 of staple pocket 500 such that, in at least one embodiment, at least a portion of the vertical trap can be positioned on a first side and/or a second side of axis 599 . In certain embodiments, the vertical trap can extend through the central portions of the first and second forming cups 502 and 504 .
- the first interior sidewall 516 can further comprise a first angled portion which, in at least one embodiment, can be oriented at an acute angle with respect to the tissue-contacting surface 501 . In at least one such embodiment, the first angled portion can be positioned outwardly with respect to the first vertical portion 516 a . In certain embodiments, the first interior sidewall 516 can comprise an angled portion positioned toward the outside portion 512 which can become progressively more perpendicular toward the inside portion 510 of the first forming cup 502 until the angled portion transitions into the first vertical portion 516 a .
- the second interior sidewall 526 can further comprise a second angled portion which, in at least one embodiment, can be oriented at an acute angle with respect to the tissue-contacting surface 501 . In at least one such embodiment, the second angled portion can be positioned outwardly with respect to the second vertical portion 526 a . In certain embodiments, the second interior sidewall 526 can comprise an angled portion positioned toward the outside portion 522 which can become progressively more perpendicular toward the inside portion 520 of the second forming cup 504 until the angled portion transitions into the second vertical portion 526 a.
- the staple pocket 500 can be configured to deform the first staple leg 404 such that the first end 405 is deflected a first distance X 1 from baseline 401 .
- the second staple leg 406 can be deformed such that the second end 407 is deflected a second distance X 2 from baseline 401 .
- the distance X 1 and the distance X 2 can be the same, or at least substantially the same. In various other embodiments, the distances X 1 and X 2 can be different.
- the first leg 404 can be deformed such that the first end 405 is positioned closer to base 402 than the second end 407 , for example.
- first axis 414 of deformed staple leg 404 and the second axis 416 of deformed staple leg 406 may be non-parallel. More particularly, in at least one embodiment, the first axis 414 can extend at a first angle with respect to baseline 401 and the second axis 416 can extend at a second angle with respect to baseline 401 wherein the second angle is different than the first angle. In various embodiments, the first leg 404 and the second leg 406 can extend across midline 403 at different angles. In certain other embodiments, the first leg 404 and the second leg 406 can be extend at different angles with respect to baseline 401 although one or both of the legs 404 and 406 may not extend across the midline 403 .
- a surgical stapler can comprise a staple pocket which can be configured to deform one staple leg of staple 400 such that it lies within, or substantially within, a common plane with base 402 and, in addition, deform the other staple leg of staple 400 to a side of base 402 as described above.
- the first leg 404 can be deformed such that it extends through midline 403 in a direction which is co-planar, or at least substantially co-planar, with base 402 and, in addition, the second leg 406 can be deformed such that it extends through midline 403 in a direction which is transverse to the plane.
- axis 414 and baseline 401 of staple 400 can be coplanar, or at least nearly co-planar, with one another while second axis 416 can extend in a direction which extends through such a plane.
- at least one of the first leg 404 and the second leg 406 may not extend through the midline 403 .
- the staple pocket 500 can be configured to deform the staple legs 404 and 406 of staple 400 simultaneously, or at least substantially simultaneously.
- the base 506 of first forming cup 502 can contact end 405 of first staple leg 404 at the same time, or at least substantially the same time, that the base 508 of second forming cup 504 contacts end 407 of second staple leg 406 .
- a staple pocket can be configured to deform the staple legs 404 and 406 sequentially.
- a first forming cup can be brought into contact with the first staple leg 404 before a second forming cup is brought into contact with the second staple leg 406 , for example.
- a surgical staple can comprise more than two staple legs, such as three staple legs or four staple legs, for example, and a staple pocket can comprise a corresponding quantity of staple forming cups for deforming the staple legs.
- the wire comprising the surgical staple 400 can comprise a circular, or at least substantially circular, cross-section.
- a surgical staple such as staple 600
- the staple 600 can comprise a non-circular cross-section.
- the staple 600 can comprise a base 602 , a first leg 604 , and a second leg 606 , wherein the base 602 and legs 604 and 606 can be comprised of a continuous wire.
- the continuous wire can comprise a rectangular cross-section, for example.
- the rectangular cross-section can comprise a base (b) and a height (h), wherein the base (b) can be defined relative to a central lateral axis (x), and wherein the height (h) can be defined relative to a central longitudinal axis (y).
- the rectangular cross-section can be defined as having two moments of inertia, i.e., a first moment of inertia (Ix) defined with respect to axis (x) and a second moment of inertia (Iy) defined with respect to axis (y).
- the first moment of inertia (Ix) can be calculated as (b* ⁇ 3)/12 while the second moment of inertia (Iy) can be calculated as (h*b ⁇ 3)/12.
- staple 600 comprises a rectangular, or at least substantially rectangular cross-section, any other suitable non-circular cross-section can be utilized, such as oblate, elliptical, and/or trapezoidal cross-sections, for example.
- the base (b) of surgical staple 600 is larger than the height (h) and, in view of the above, the moment of inertia (Iy) of the rectangular cross-section is larger than the moment of inertia (Ix).
- the moment of inertia ratio, i.e., Iy/Ix, of the rectangular cross-section can be greater than 1.0.
- the moment of inertia ratio can be between approximately 2.0 and approximately 2.7, for example.
- the moment of inertia ratio can be between approximately 1.1 and approximately 3.0, for example.
- the leg 604 is more likely to bend about axis (x) than about axis (y) when a force, such as compressive load F 1 , for example, is applied to the leg 604 .
- the leg 604 in such embodiments, is more likely to bend within a common plane defined by the staple 600 when it is in its undeformed state than bend to a side of staple base 602 .
- a surgical stapler comprising an anvil and staple pocket in accordance with the embodiments described herein, such as staple pocket 500 , for example, can be utilized to cause the legs 604 and 606 of staple 600 to bend out of their common plane when they are deformed.
- this lateral deflection can occur despite the fact that the moment of inertia Iy, which resists such twisting, is greater than the moment of inertia Ix.
- the first leg 604 of staple 600 can be deformed such that it is bent relative to both axis (x) and axis (y) of its cross-section and, as a result, the first staple leg 604 can be twisted or deformed such that the end 605 of first staple leg 604 is positioned on a first side of base 602 .
- the second leg 606 can be deformed such that it is bent relative to both axis (x) and axis (y) of its cross-section and, as a result, the second staple leg 606 can be twisted or deformed such that the end 607 of second staple leg 606 is positioned on a second side of base 602 .
- a surgical staple such as surgical staple 700
- the base 702 , the first leg 704 , and the second leg 706 can lie, or at least substantially lie, in a common plane when the staple 700 is an undeformed, or undeployed, configuration, i.e., a configuration prior to being deformed by an anvil of a surgical stapler, for example.
- the deformed or deployed configuration of staple 700 as illustrated in FIG.
- the first leg 704 can be deformed such that end 705 points toward base 702 and second leg 706 . More particularly, in at least one embodiment, the end 705 can lie along, or with respect to, a first axis 714 which is oriented at angle with respect to midline 703 . Similarly, the second leg 706 can be deformed such that end 707 points toward base 702 and first leg 704 . More particularly, in at least one embodiment, the end 707 can lie along, or with respect to, a second axis 716 which is oriented at angle with respect to midline 703 . In various embodiments, the ends 705 and 707 of legs 704 and 706 may not cross mid-line 703 .
- first leg 704 may be deformed such that it extends to a first side of base 702 and the end 707 of second leg 706 may be deformed such that it extends to a second, or opposite, side of base 702 such that legs 704 and 706 are not entirely positioned in-plane with base 702 in their deformed configuration, for example.
- a surgical staple such as staple 800 ( FIG. 58 ), for example, can comprise a base 802 , a first leg 804 , and a second leg 806 , wherein the staple 800 can comprise a substantially U-shaped configuration in its undeformed, or undeployed, configuration.
- legs 804 and 806 can extend in a perpendicular, or at least substantially perpendicular, direction with respect to base 802 .
- the staple 800 can be deformed into a B-shaped configuration as illustrated in FIG. 58 .
- the first leg 804 can be bent downwardly toward base 802 such that axis 814 extending through end 805 is perpendicular, or at least substantially perpendicular, to baseline 801 .
- the second leg 806 can be bent downwardly toward base 802 such that axis 816 extending through end 807 is perpendicular, or at least substantially perpendicular, to baseline 801 .
- the legs 804 and 806 can be bent such that axes 814 and 816 are parallel, or at least substantially parallel, to one another.
- the staple legs 804 and 806 can be deformed such that they do not cross centerline 803 .
- the staple legs 804 and 806 can be deformed such that they remain in-plane, or at least substantially in-plane, with base 802 .
- the surgical staple can comprise a base defining a baseline, a first leg and a second leg which extend from the base, and a midline midway between the first leg and the second leg.
- a surgical staple can be deformed such that:
- First Leg Second Leg Crosses the midline (FIG. 50) Crosses the midline (FIG. 50) Extends in-plane, or substantially in- Extends out of plane with the plane, with the base (FIG. 58) base (FIG. 52)
- the end extends in a non-
- the end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50)
- a surgical staple can be deformed such that:
- First Leg Second Leg Crosses the midline (FIG. 50) Crosses the midline (FIG. 50) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the first leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A)
- the end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50)
- a surgical staple can be deformed such that:
- First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to a first side base (FIG. 52) to a second side of the base, the distance X1 of the base, the distance X1 being different than X2 (FIG. 52A) being different than X2 (FIG. 52A)
- the end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50)
- a surgical staple can be deformed such that:
- First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the second leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A)
- the end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50)
- a surgical staple can be deformed such that:
- First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends in-plane, or substantially in- Extends out of plane with the plane, with the base (FIG. 58) base (FIG. 52) The end extends in a perpendicular The end extends in a non- direction with the baseline (FIG. 58) perpendicular direction with the baseline (FIG. 50)
- a surgical staple can be deformed such that:
- a surgical staple can be deformed such that:
- First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the second leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A)
- the end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50)
- First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends out of plane with the Extends in-plane, or substantially in- base (FIG. 52) plane, with the base (FIG. 58) The end extends in a non- The end extends in a perpendicular perpendicular direction with the direction to the baseline (FIG. 58) baseline (FIG. 50)
- a surgical staple can be deformed such that:
- the deformed staples described above comprise one or more staple legs which cross the mid-line of the staple base.
- the deformed staple legs may at least partially overlap with one another.
- the deformed staple legs when viewed from the side, may co-operate to traverse the staple base from one end to the other leaving no gap therebetween.
- Such embodiments can be particularly useful, especially when used to staple vascular tissue.
- the overlapping staple legs can compress blood vessels within the tissue regardless of where the blood vessels extend through the staple. Staples having gaps between the legs, or legs which do not extend along the entire length of the staple base when deformed, may not be able to properly compress every blood vessel in the tissue and, as a result, one or more blood vessels may leak.
- a surgical instrument can be configured to deploy a plurality of staples 400 in the manner described above and illustrated in FIGS. 50-52 .
- the surgical stapler can deploy the staples 400 in a sequential manner along a staple path and/or in a simultaneous manner, for example.
- a surgical instrument can be configured to deploy a plurality of staples 600 in the manner described above and illustrated in FIG. 55 .
- the surgical stapler can deploy the staples 600 in a sequential manner along a staple path and/or in a simultaneous manner, for example.
- a surgical instrument can be configured to deploy a plurality of staples 700 in the manner described above and illustrated in FIG. 57 .
- the surgical stapler can deploy the staples 700 in a sequential manner along a staple path and/or in a simultaneous manner, for example.
- a surgical staple can be comprised of titanium, such as titanium wire, for example.
- a surgical staple can be comprised of an alloy comprising titanium, aluminum, and/or vanadium, for example.
- the surgical staple can be comprised of surgical stainless steel and/or an alloy comprised of cobalt and chromium, for example.
- the surgical staple can be comprised of metal, such as titanium, and a metal oxide outer surface, such as titanium oxide, for example.
- the metal oxide outer surface can be coated with a material.
- reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
- the invention described herein will be processed before surgery.
- a new or used instrument is obtained and if necessary cleaned.
- the instrument can then be sterilized.
- the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag.
- the container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons.
- the radiation kills bacteria on the instrument and in the container.
- the sterilized instrument can then be stored in the sterile container.
- the sealed container keeps the instrument sterile until it is opened in the medical facility.
Abstract
A method for deforming a staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed, the method comprising positioning the first staple leg within a first cup of a staple pocket, the first cup comprising a first inner surface, applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and the second staple leg, contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward a first side of the base, and deforming the first staple leg such that the end of the first staple leg crosses a mid-line of the staple defined between the first staple leg and the second staple leg.
Description
- This non-provisional patent application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application No. 61/250,377, entitled SURGICAL STAPLER, which was filed on Oct. 9, 2009, the entire disclosure of which is incorporated by reference herein.
- i. Technical Field
- The present invention relates to stapling instruments and, in various embodiments, to a surgical stapling instrument for producing one or more rows of staples.
- ii. Background of the Related Art
- In recent years, there has been an increasing tendency for surgeons to use stapling instruments to suture body tissues such as a lung, an esophagus, a stomach, a duodenum and/or other organs in the intestinal tract. The use of an appropriate stapling instrument in many instances may perform a better job in less time and simplify previously difficult surgical procedures such as gastrointestinal anastomoses. Previous linear two and four row cutting staplers comprised cartridge-less instruments into which staples were individually hand-loaded. Other previous devices have included a presterilized disposable staple loading unit and a cutting member which could be utilized for dividing the tissue and forming the rows of staples simultaneously. An example of such a surgical stapler is disclosed in U.S. Pat. No. 3,499,591, entitled INSTRUMENT FOR PLACING LATERAL GASTROINTESTINAL ANASTOMOSES, which issued on Mar. 10, 1970, the entire disclosure of which is hereby incorporated by reference herein.
- A stapling instrument can include a pair of cooperating elongate jaw members, wherein each jaw member can be adapted to be inserted into an internal, tubular body organ to be anastomosed. In various embodiments, one of the jaw members can support a staple cartridge with at least two laterally spaced rows of staples, and the other jaw member can support an anvil with staple-forming pockets aligned with the rows of staples in the staple cartridge. Generally, the stapling instrument can further include a pusher bar and knife blade which are slidable relative to the jaw members to sequentially eject staples from the staple cartridge via camming surfaces on the pusher bar. In at least one embodiment, the camming surfaces can be configured to activate a plurality of staple drivers carried by the cartridge and associated with the individual staples to push the staples against the anvil and form laterally spaced rows of deformed staples in the tissue gripped between the jaw members. In typical stapling instruments, however, the anvil is unmovable relative to the staple cartridge once the jaw members have been assembled together and the formed height of the staples cannot be adjusted. In at least one embodiment, the knife blade can trail the pusher bar and cut the tissue along a line between the staple rows. Examples of such stapling instruments are disclosed in U.S. Pat. No. 4,429,695, entitled SURGICAL INSTRUMENTS, which issued on Feb. 7, 1984, the entire disclosure of which is hereby incorporated by reference herein.
- In at least one form of the present invention, a surgical stapler can comprise a first handle portion comprising a staple cartridge channel configured to receive a staple cartridge and a second handle portion comprising an anvil. The stapler further comprises a rotatable latch and a latch projection, wherein the latch is rotatably coupled to one of the first handle portion and the second handle portion and wherein the latch projection extends from the other of the first handle portion and the second handle portion. The latch is configured to engage the latch projection to move the first handle portion and the second handle portion toward one another. In various embodiments, the latch projection comprises a rotatable bearing wherein the latch is configured to contact the rotatable bearing when the latch engages the latch projection.
- In at least one form of the present invention, a surgical stapler can comprise an anvil having a plurality of staple pockets formed in a tissue contacting surface. Each staple pocket can comprise a longitudinal axis, a first forming cup, and a second forming cup. The first forming cup can comprise a first interior sidewall comprising a first vertical portion which is substantially perpendicular to the tissue contacting surface. The second forming cup can comprise a second interior sidewall comprising a second vertical portion which is substantially perpendicular to the tissue contacting surface. In various embodiments, the first vertical portion and the second vertical portion can extend through the longitudinal axis, wherein the first interior sidewall and the second interior sidewall can comprise a trap for deforming a first staple leg of a staple to a first side of the longitudinal axis and for deforming a second staple leg of the staple to a second side of the longitudinal axis.
- In at least one form of the present invention, a method for deforming a staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed, the method comprising positioning the first staple leg within a first cup of a staple pocket, the first cup comprising a first inner surface, applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and the second staple leg, contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward a first side of the base, and deforming the first staple leg such that the end of the first staple leg crosses a mid-line of the staple defined between the first staple leg and the second staple leg.
- The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
-
FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment of the present invention; -
FIG. 2 is an exploded perspective view of the surgical stapling instrument ofFIG. 1 ; -
FIG. 3 is an exploded elevational view of the surgical stapling instrument ofFIG. 1 ; -
FIG. 4 is a partial cross-sectional view of the surgical stapling instrument ofFIG. 1 illustrating first and second portions being assembled together; -
FIG. 5 is a partial cross-sectional view of the surgical stapling instrument ofFIG. 1 illustrating the proximal end of the first portion ofFIG. 4 being locked to the proximal end of the second portion ofFIG. 4 and illustrating the second portion being rotated toward the first portion; -
FIG. 6 is a partial cross-sectional view of the surgical stapling instrument ofFIG. 1 illustrating a latch rotatably mounted to the first portion, wherein the latch is engaged with the second portion and wherein the latch has been rotated into a partially-closed position; -
FIG. 7 is a partial cross-sectional view of the surgical stapling instrument ofFIG. 1 illustrating the latch ofFIG. 6 in a closed position; -
FIG. 8 is a perspective view of a staple cartridge assembly of the surgical stapling instrument ofFIG. 1 ; -
FIG. 9 is an exploded view of the staple cartridge assembly ofFIG. 8 ; -
FIG. 10 is a cross-sectional view of the staple cartridge assembly ofFIG. 8 taken along line 10-10 inFIG. 9 ; -
FIG. 11 is an exploded view of a staple sled and cutting member assembly of the staple cartridge assembly ofFIG. 8 ; -
FIG. 12 is a perspective view of the staple sled and cutting member assembly ofFIG. 11 ; -
FIG. 13 is a perspective view of the surgical stapling instrument ofFIG. 1 illustrating a firing actuator moved distally along a first side of the surgical stapling instrument; -
FIG. 14 is a perspective view of the surgical stapling instrument ofFIG. 1 illustrating the firing actuator ofFIG. 13 moved distally along a second side of the surgical stapling instrument; -
FIG. 15 is a cross-sectional view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention illustrating a latch in a partially-closed position and a locking mechanism engaged with a firing actuator; -
FIG. 16 is a cross-sectional view of the surgical stapling instrument ofFIG. 15 wherein the latch has been moved into a closed position and has disengaged the locking mechanism from the firing actuator; -
FIG. 17 is a perspective view of an anvil assembly of the surgical stapling instrument ofFIG. 1 ; -
FIG. 18 is an exploded perspective view of the anvil assembly ofFIG. 17 ; -
FIG. 19 is another exploded perspective view of the anvil assembly ofFIG. 17 ; -
FIG. 20 is an exploded cross-sectional elevational view of the anvil assembly ofFIG. 17 ; -
FIG. 21 is a cross-sectional assembly view of the anvil assembly ofFIG. 17 illustrating an anvil adjustment member in a first position; -
FIG. 22 is a cross-sectional assembly view of the anvil assembly ofFIG. 17 illustrating the anvil adjustment member ofFIG. 21 in a second position; -
FIG. 23 is a cross-sectional assembly view of the anvil assembly ofFIG. 17 illustrating the anvil adjustment member ofFIG. 21 in a third position; -
FIG. 24 is a perspective view of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention; -
FIG. 25 is a cross-sectional view of the surgical stapling instrument ofFIG. 24 taken along line 25-25 inFIG. 24 ; -
FIG. 26 is a partial exploded view of the proximal end of the surgical stapling instrument ofFIG. 24 including a detent mechanism for releasably holding a rotatable anvil adjustment member in position; -
FIG. 27 is a perspective view of the surgical stapling instrument ofFIG. 24 with some components removed and others shown in cross-section; -
FIG. 28 is an exploded view of portions of the surgical stapling instrument ofFIG. 24 illustrating a rotatable anvil adjustment member in a first orientation; -
FIG. 29 is a perspective view of the rotatable anvil adjustment member ofFIG. 28 ; -
FIG. 30 is an end view of the surgical stapling instrument ofFIG. 24 with some components removed and others shown in dashed lines illustrating the rotatable anvil adjustment member in the first orientation ofFIG. 28 ; -
FIG. 31 is a cross-sectional end view of the surgical stapling instrument ofFIG. 24 taken along line 31-31 inFIG. 24 ; -
FIG. 32 is an end view of the surgical stapling instrument ofFIG. 24 illustrating the rotatable anvil adjustment member ofFIG. 28 rotated in a first direction into a second orientation; -
FIG. 33 is a cross-sectional end view of the surgical stapling instrument ofFIG. 24 illustrating the anvil adjustment member in the second orientation ofFIG. 32 ; -
FIG. 34 is an end view of the surgical stapling instrument ofFIG. 24 illustrating the rotatable anvil adjustment member ofFIG. 28 rotated in a second direction into a third orientation; -
FIG. 35 is a cross-sectional end view of the surgical stapling instrument ofFIG. 24 illustrating the anvil adjustment member in the third orientation ofFIG. 34 ; -
FIG. 36 is a perspective view of an actuator for rotating the anvil adjustment member ofFIG. 28 ; -
FIG. 37 is a partial cross-sectional view of a surgical stapling instrument including a spring configured to bias the distal end of a first handle portion away from the distal end of a second handle portion when the stapling instrument is in a partially-closed configuration; -
FIG. 38 is a similar perspective view of the surgical stapling instrument ofFIG. 1 to that ofFIG. 17 ; -
FIG. 39 is a detail view of a latch projection extending from an anvil of a surgical stapling instrument in accordance with at least one alternative embodiment of the present invention; -
FIG. 40 is a diagram illustrating the latch projection ofFIG. 39 and a latch configured to engage the latch projection and move the latch projection into a latch recess; -
FIG. 41 is an elevational view of the latch projection ofFIG. 39 ; -
FIG. 42 is a perspective view of a staple pocket in accordance with at least one embodiment of the present invention; -
FIG. 43 is a top view of the staple pocket ofFIG. 42 ; -
FIG. 44 is a cross-sectional view of the staple pocket ofFIG. 42 taken along line 44-44 inFIG. 43 ; -
FIG. 45 is a cross-sectional view of the staple pocket ofFIG. 42 taken along line 45-45 inFIG. 43 ; -
FIG. 46 is another top view of the staple pocket ofFIG. 42 ; -
FIG. 47 is a cross-sectional view of the staple pocket ofFIG. 42 taken along line 47-47 inFIG. 46 ; -
FIG. 48 is a cross-sectional view of the staple pocket ofFIG. 42 taken along line 48-48 inFIG. 46 ; -
FIG. 49 is an elevational view of a surgical staple in an undeformed shape; -
FIG. 50 is an elevational view of the surgical staple ofFIG. 49 in a deformed shape in accordance with at least one embodiment of the present invention; -
FIG. 51 is a side view of the surgical staple ofFIG. 49 in the deformed shape ofFIG. 50 ; -
FIG. 52 is a plan view of the surgical staple ofFIG. 49 in the deformed shape ofFIG. 50 ; -
FIG. 52A is another plan view of the surgical staple ofFIG. 49 in the deformed shape ofFIG. 50 ; -
FIG. 53 is an elevational view of a surgical staple in an undeformed shape; -
FIG. 54 is a bottom view of the surgical staple ofFIG. 53 in an undeformed shape; -
FIG. 55 is a bottom view of the surgical staple ofFIG. 53 in a deformed shape in accordance with at least one embodiment of the present invention; -
FIG. 56 is a partial cross-sectional view of the surgical staple ofFIG. 53 ; -
FIG. 57 is an elevational view of a surgical staple in a deformed shape in accordance with at least one embodiment of the present invention; and -
FIG. 58 is an elevational view of a surgical staple in a deformed shape. - Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate preferred embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
- Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
- The entire disclosures of the following commonly-owned, non-provisional United States patent applications are hereby incorporated by reference herein:
- SURGICAL STAPLING INSTRUMENT WITH CUTTING MEMBER ARRANGEMENT, U.S. patent application Ser. No. 12/234,149, Atty. Docket No. END6414USNP/080203;
- SURGICAL STAPLER WITH APPARATUS FOR ADJUSTING STAPLE HEIGHT, U.S. patent application Ser. No. 12/234,133, Atty. Docket No. END6406USNP/080195;
- LOCKOUT ARRANGEMENT FOR A SURGICAL STAPLER, U.S. patent application Ser. No. 12/234,113, Atty. Docket No. END6405USNP/080194;
- SURGICAL STAPLER HAVING AN INTERMEDIATE CLOSING POSITION, U.S. patent application Ser. No. 12/234,143, Atty. Docket No. END6411USNP/080200;
- SURGICAL STAPLER HAVING A CLOSURE MECHANISM, filed on even date herewith, Atty. Docket No. END6612USNP/090242; and
- SURGICAL STAPLER COMPRISING A STAPLE POCKET, filed on even date herewith, Atty. Docket No. END6613USNP/090243.
- Referring to
FIG. 1 , a surgical stapling instrument, generally 100, can comprise afirst handle portion 102 and asecond handle portion 104. In various embodiments,first handle portion 102 andsecond handle portion 104 can be configured to be grasped by a surgeon, for example, and can comprisehand grip portion 106. In at least one embodiment,first handle portion 102, referring toFIGS. 2 and 3 , can include afirst cover 108 attached to afirst frame 110 and, similarly,second handle portion 104 can include asecond cover 112 attached to asecond frame 114.Covers stapling instrument 100 within a surgical site. In various embodiments, handle covers 108 and 112, for example, can includeenlarged protrusions stapling instrument 100 into a surgical site. In various embodiments, handle covers 108 and 112 can be made of plastic, lightweight materials, and/or any other suitable material, for example, while handle frames 110 and 114 can be made of stainless steel, titanium, and/or any other suitable material, for example. - In various embodiments, referring again to
FIGS. 1-3 , the distal ends ofhandle portions effector 120 which can be configured to treat tissue within a surgical site, for example. In at least one such embodiment, end-effector 120 can include astaple cartridge channel 122 configured to receive and/or retain a staple cartridge as described in greater detail further below. In certain embodiments,staple cartridge channel 122 can comprise a one-piece elongated channel-shaped frame extending from firsthandle portion frame 110. In at least one embodiment,staple cartridge channel 122 can include a pair of opposed,elongated side walls 124 connected by abottom wall 126. Along the rearward, or proximal, portion ofstaple cartridge channel 122, a pair of spaced,upstanding side flanges 128 can extend upwardly fromopposed side walls 124. In various embodiments, the width ofstaple cartridge channel 122 betweenside flanges 128 can be greater than the width of the upper jaw member, or anvil, 130 extending fromsecond handle portion 104. In at least one embodiment, the distance betweenflanges 128 can be configured to permit at least a portion ofanvil 130 to be received betweenside flanges 128 when the stapling instrument is assembled for operation. As shown inFIG. 2 , eachside flange 128 of can include a notch, or recess, 127, for example, which can be configured to receive one ormore latch projections 131, for example, extending fromanvil 130, and/or any other suitable portion ofsecond handle portion 104, as described in greater detail further below. - As indicated above, referring once again to
FIGS. 1-3 ,staple cartridge channel 122 can be configured to support and/or retain a staple cartridge, such asstaple cartridge 150, for example, within end-effector 120, wherein the staple cartridge can include one or more staples (not illustrated) removably stored therein. In various embodiments, referring toFIGS. 8-10 ,staple cartridge 150 can include one or morestaple cavities 151 which can be configured to store staples in any suitable arrangement, such as in at least two laterally-spaced longitudinal rows, for example. In at least one embodiment, referring toFIGS. 9 and 10 ,staple cartridge 150 can includestaple cartridge body 152 and pan 154, whereinstaple cartridge body 152 and/or pan 154 can be configured to define a channel, or path, for slidably receiving a staple sled and/or cutting member therein. In at least one embodiment, pan 154 can includeflexible arms 155, for example, which can be configured to engagestaple cartridge body 152 in a snap-fit and/or press-fit arrangement. Referring toFIGS. 10-12 ,staple cartridge 150 can further includestaple sled assembly 160 which can includestaple sled portion 162 and, in addition, cuttingmember 164. In various embodiments, cuttingmember 164 can includecutting edge 165 and lockarm 166, for example, whereinlock arm 166 can be configured to be press-fit and/or snap-fit intoaperture 163 instaple sled 162 when cuttingmember 164 is assembled tostaple sled portion 162. In other various embodiments,staple sled portion 162 can be integrally molded to cuttingmember 164. - Further to the above, referring to
FIGS. 8-10 ,staple cartridge body 152 can include a slot, such asslot 156, for example, which can be configured to receive at least a portion of cuttingmember 164 therein, and/or any other portion ofstaple sled assembly 160 and pusher bar assembly 200 (discussed below), whereinslot 156 can be configured to permit cuttingmember 164 to be moved between first and second positions withinstaple cartridge 150. In various embodiments,slot 156 can be configured to permit cuttingmember 164 to be moved between a proximal position (FIG. 10 ) and a distal position in order to incise tissue positioned intermediatestaple cartridge 150 andanvil 130, for example. Referring again toFIGS. 10-12 ,staple sled portion 162 can include cam, ramp, or actuator, surfaces 167 which can be configured to engage staple drivers positioned withinstaple cartridge 150. In various embodiments, referring toFIG. 9 ,staple cartridge 150 can includestaple drivers 168 which can be lifted, or slid, upwardly withinstaple cavities 151 bysled portion 162 such that the upward movement ofstaple drivers 168 can eject, or deploy, staples at least partially positioned withinstaple cavities 151. While staple drives 168 can be, in fact, lifted vertically upwardly, the term upward, and the like, can mean thatstaple drivers 168, for example, are moved toward the top surface, or deck, 158 of the staple cartridge and/or towardanvil 130, for example. In certain embodiments, as illustrated inFIG. 9 , eachstaple driver 168 can include one or moresloped surfaces 169 oriented at the same angle as acam surface 167, and/or any other suitable angle, which can provide a relatively flat, or at least substantially flat, sliding contact surface betweenstaple sled 162 andstaple drivers 168. In various embodiments, a staple driver can be configured to deploy only one staple, while, in certain embodiments, a staple driver can be configured to simultaneously deploy two or more staples located in adjacent rows, for example. Other devices are disclosed in U.S. patent application Ser. No. 12/030,424, entitled SURGICAL STAPLING INSTRUMENT WITH IMPROVED FIRING TRIGGER ARRANGEMENT, which was filed on Feb. 13, 2008, the entire disclosure of which is incorporated by reference herein. - In various embodiments, as described above, a surgical stapling instrument can include a cutting member/staple sled assembly configured to incise tissue and deploy staples from a staple cartridge. In certain embodiments, though, a surgical stapling instrument may not require, or include, a cutting member. In at least one such embodiment, a staple cartridge can include a staple sled positioned therein and/or a surgical instrument can be configured to move a staple sled into a staple cartridge in order to staple tissue, for example, without otherwise dissecting it. In certain other embodiments, a staple cartridge can include a staple sled positioned therein where a surgical instrument can include a cutting member movable into, or relative to, the staple cartridge. In at least one such embodiment, the cutting member can be advanced into contact with the staple sled such that the cutting member and staple sled can be advanced together. Thereafter, the cutting member can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge having a new staple sled. Such embodiments may be useful when a staple sled may become worn or deformed during use. Other embodiments are envisioned where a staple cartridge can include a cutting member positioned therein where a surgical instrument can include a staple sled movable into, or relative to, the staple cartridge. In at least one such embodiment, similar to the above, the staple sled can be advanced into contact with the cutting member such that the cutting member and staple sled can be advanced together. Thereafter, the staple sled can be sufficiently retracted to allow the staple cartridge to be detached from the surgical instrument and replaced with a new staple cartridge having a new cutting member. Such embodiments may be useful when a cutting member may become worn or deformed during use. In various embodiments, as described in greater detail below, the staple cartridge can include a protective housing or cover configured to prevent, or at least reduce the possibility of, a surgeon or other clinician from touching the cutting member positioned within the staple cartridge while handling the staple cartridge, for example.
- In various embodiments, further to the above,
staple cartridge channel 122 and/orstaple cartridge 150, for example, can include one or more co-operating projections and/or recesses, for example, which can be configured to removably retainstaple cartridge 150 withinstaple cartridge channel 122. Oncestaple cartridge 150 has been inserted intostaple cartridge channel 122, in various embodiments, thefirst handle portion 102 can be assembled to thesecond handle portion 104. In other various embodiments, the staple cartridge may be inserted into the staple cartridge channel after the first and second handle portions have been assembled together. In either event, referring toFIGS. 1-7 ,first handle portion 102 andsecond handle portion 104 can include proximal ends 103 and 105, respectively, which can be assembled together such that the first and second handle portions can be rotatably or pivotably coupled to one another. In various embodiments, referring toFIGS. 2 and 3 ,first handle portion 102 can include one or more pins, or projections, 111 extending therefrom which can be configured to be slidably received within one or more grooves, channels, orslots 115 insecond handle portion 104. In certain embodiments,slots 115 can be defined insecond handle frame 114 andprojections 111 can extend from aproximal end post 107 extending fromfirst handle frame 110, for example. In order to assemblefirst handle portion 102 andsecond handle portion 104, referring toFIG. 4 , the open ends ofslots 115 can be aligned withprojections 111 such thatsecond handle portion 104, for example, can be translated relative tofirst handle portion 102 andprojections 111 can be slid withinslots 115. In at least one embodiment, as illustrated inFIGS. 2 and 3 , the open ends ofslots 115 can be located proximally with respect to their closed ends. In at least one such embodiment,proximal end 105 ofsecond handle portion 104 can be positioned distally with respect toproximal end 103 offirst handle portion 102 such thatsecond handle portion 104 can be moved proximally in order to positionprojections 111 withinslots 115. In various other circumstances,first handle portion 102 can be positioned proximally with respect tosecond handle portion 104 and slid distally in order to positionprojections 111 withinslots 115. - In various embodiments, referring to
FIG. 5 ,second handle portion 104 can be rotated towardfirst handle portion 102 such thatanvil 130 can be moved into position relative tostaple cartridge 150 and/orstaple cartridge channel 122. In certain embodiments,first handle portion 102 can be rotated towardsecond handle portion 104 and/or the first and second handle portions can be rotated toward each other. In any event,projections 111 andslots 115, when engaged with one another, can comprise a pivot about which one or both of the first and second handle portions can be moved relative to each other. In various embodiments,second handle portion 104 can be moved relative tofirst handle portion 102 such thatanvil 130 is moved into close opposition tostaple cartridge 150. In certain embodiments, referring toFIG. 6 ,second handle portion 104 can be moved relative tofirst handle portion 102 such that latchprojections 131 extending fromsecond handle portion 104 can be aligned with and/or inserted intorecesses 127 withinfirst handle portion 102. In various embodiments, referring primarily toFIGS. 2 and 3 ,first handle portion 102 can further include latchingmechanism 180 rotatably mounted thereto which can be utilized to engagelatch projections 131 extending fromsecond handle portion 104 and secure the first and second handle portions together. Although not illustrated, other embodiments are envisioned in which a latching mechanism is rotatably mounted to the second handle portion and latch projections can extend from the first handle portion. In any event, in at least one embodiment,latching mechanism 180 can be mounted tofirst frame 110 by one or more pivot pins 182 which can be configured to define an axis about which latch 180 can be rotated. - In certain embodiments, referring now to
FIGS. 4 and 5 ,latching mechanism 180 can includelatch frame 184 and, in addition,latch cover 186 assembled to latchframe 184. In other various embodiments, the latch cover and the latch frame can comprise an integral unit or, in certain embodiments, the latching mechanism may not even include a cover. In certain embodiments,latch frame 184 can be channel-shaped and can include a pair of opposed,elongated side walls 185 which are spaced apart by a distance sufficient to spanfirst frame portion 110. In at least one embodiment,latch cover 186 can be made of plastic, lightweight materials, and/or any other suitable materials, for example, whilelatch frame 184 can be made of stainless steel and/or any other suitable material, for example. In certain embodiments, when latchingmechanism 180 is closed, as illustrated inFIG. 7 ,latch cover 186 can be aligned withfirst handle cover 108.Latch cover 186 can include contouredportion 187 which can be configured to assist a surgeon in manipulatingsurgical instrument 100 wherein, in at least one embodiment, contouredportion 187 can be aligned with, or at least substantially aligned with,protrusion 109 extending fromfirst handle cover 108.Latching mechanism 180 can further include one ormore latch arms 188 extending therefrom which can be configured to engage one ormore latch projections 131 extending fromsecond handle portion 104 and pull and/orsecure projections 131 withinrecesses 127 as illustrated inFIG. 7 . In at least one embodiment, at least one oflatch arms 188 can be integrally-formed withlatch frame 184. In certain embodiments, referring toFIG. 6 , at least one oflatch arms 188 can include adistal hook 189 which can be configured to wrap around at least a portion ofprojections 131 so as to encompass or surround, or at least partially encompass or surround,projections 131. In at least one embodiment, latcharms 188 can act as an over-center latch to maintainlatching mechanism 180 in its latched, or closed, position. - In use, in various circumstances, one of the
first handle portion 102 and thesecond handle portion 104 can be positioned on a first side of tissue within a surgical site and the other handle portion can be rotated into position on the opposite side of the tissue. In such embodiments,staple cartridge 150 can be positioned on one side of the tissue andanvil 130 can be positioned on the other side of the tissue. Thereafter, as also outlined above, latchingmechanism 180 can be actuated such that it can be moved between an open position and a closed position in order to latchsecond handle portion 104 tofirst handle portion 102 and apply a clamping force to the tissue positioned betweenstaple cartridge 150 andanvil 130. In certain circumstances, latchingmechanism 180 can be moved between an open position (FIG. 5 ), a partially-closed, or intermediate, position (FIG. 6 ), and a closed position (FIG. 7 ). In at least one such embodiment, referring toFIGS. 5 and 6 ,latching mechanism 180 can be moved between an open position in which latcharms 188 are not engaged withprojections 131 and a partially-closed position in which latcharms 188 are engaged withprojections 131 such that, althoughanvil 130 has been at least partially brought into opposition tostaple cartridge 150, a sufficient gap can remain betweenanvil 130 andstaple cartridge 150 which can allow end-effector 120 to be repositioned relative to the tissue, for example. Once theanvil 130 andstaple cartridge 150 have been sufficiently positioned relative to the tissue,latching mechanism 180 can be moved between its partially-closed position and a closed position, as illustrated inFIG. 7 . - In various embodiments, further to the above, a surgical stapling instrument can further include a biasing member which can be configured to bias the first handle portion of a stapling instrument away from a second handle portion. In at least one embodiment, as described in greater detail further below, a spring, and/or any suitably resilient material, can be positioned intermediate the first and second handle portions such that the anvil and staple cartridge of the stapling instrument can be biased away from each other. In certain embodiments, the spring can be configured to at least partially separate the first and second handle portions such that a gap exists between the anvil and the staple cartridge, wherein the gap can be sufficient to allow tissue to be positioned therebetween. In use, a surgeon can position such a surgical stapling instrument without having to separate and hold the first and second handle portions apart from each other. Such an instrument may be especially useful when the stapling instrument is in a partially-closed configuration and the surgeon is manipulating the instrument within a surgical site. After the surgeon is satisfied with the positioning of the stapling instrument, the surgeon can compress and/or disengage the spring and place the stapling instrument in a closed configuration.
- In various circumstances, as outlined above, the distal end of
first handle portion 102 can be moved relative to the distal end ofsecond handle portion 104, especially when latchingmechanism 180 is not engaged with, or only partially engaged with,projections 131 ofsecond handle portion 104. In such circumstances,projections 111 andslots 115 at the proximal ends of the first and second handle portions can be configured to retain at least the proximal ends of the first and second handle portions together when the distal ends of the first and second handle portions are being moved relative to each other, for example. Stated another way,projections 111 andslots 115 can cooperate to prevent, or at least inhibit,first handle portion 102 from becoming completely detached fromsecond handle portion 104. In certain embodiments, a first handle portion can include a first lock portion and a second handle portion can include a second lock portion, wherein the first and second lock portions can be configured to be engaged with one another and prevent the first handle portion from becoming completely detached from the second handle portion. In at least one embodiment,projections 111 can comprise the first lock portion andslots 115 can comprise the second lock portion. Previous stapling instruments lacked such lock portions and instead relied on a sole latching mechanism to keep the first and second handle portions together. In circumstances where the latching mechanisms of these previous stapling instruments were not fully engaged with both of the first and second handle portions, the first and second handle portions could become completely detached from one another, thereby requiring a surgeon, for example, to reposition and reassemble the handle portions. In certain circumstances, a complete detachment of the first and second handle portions of these previous staples could expose at least a portion of a cutting member. - In various embodiments, as outlined above, latching
mechanism 180 can be configured to be moved between an open position, a partially-closed position, and a closed position. When latchingmechanism 180 is in its open position, as also outlined above,projections 111 can be inserted into and/or removed fromslots 115. When latchingmechanism 180 is in its partially-closed position, referring toFIG. 6 , latcharms 188 can be configured to engagelatch projections 131 such thatprojections 111 cannot be removed fromslots 115. In at least one such embodiment, latcharms 188 and latchprojections 131 can be configured to prevent, or at least inhibit,second handle portion 104 from being moved distally with respect tofirst handle portion 102 and, as a result, prevent, or at least inhibit,projections 111 from being disengaged fromslots 115. Correspondingly, latcharms 188 and latchprojections 131 can be configured to preventfirst handle portion 102 from being moved proximally with respect tosecond handle portion 104. Similar to the above, in various embodiments, latcharms 188 and latchprojections 131 can also be configured to prevent, or at least inhibit,projections 111 from being removed fromslots 115 when latchingmechanism 180 is in its closed position (FIG. 7 ). In certain embodiments, further to the above, latchprojections 131 can extend fromsecond handle portion 104 at a location which is intermediate its proximal and distal ends. In at least one such embodiment,projections 111 andslots 115 can be configured to hold the first and second handle portions together at their proximal ends while latchingmechanism 180 can be utilized to hold the first and second handle portions together at an intermediate location. In any event, in certain embodiments, the first and second handle portions cannot be disengaged from one another unless latchingmechanism 180 is moved into its fully open position. In at least one such embodiment,projections 111 andslots 115 cannot be disengaged from one another when latchingmechanism 180 is in a closed and/or partially-closed position. - Once
anvil 130 andstaple cartridge 150 have been sufficiently positioned, the tissue positionedintermediate anvil 130 andstaple cartridge 150 can be stapled and/or incised. In various embodiments, referring toFIG. 3 ,surgical stapling instrument 100 can further includepusher bar assembly 200 which can be configured to advance and/or retractstaple sled assembly 160 withinstaple cartridge 150, for example. In at least one embodiment,pusher bar assembly 200 can includepusher bar 202 and firingactuator 204, wherein firingactuator 204 can be configured to movepusher bar 202 andstaple sled assembly 160 distally to deploy staples fromstaple cartridge 150 and deform the staples againstanvil 130 as described above. In at least one embodiment, referring toFIGS. 11 and 12 ,staple sled 162 can include a groove, channel, or slot 161 which can be configured to receive, and can be operably connected to, a distal end 201 (FIG. 3 ) ofpusher bar 202. In certain embodiments,staple sled assembly 160 can be operably engaged withpusher bar 202 whenstaple cartridge 150 is inserted intostaple cartridge channel 122. In at least one embodiment,distal end 201 and slot 161 can include cooperating features which can allowdistal end 201 and slot 161 to be assembled in a transverse direction but prevent, or at least inhibit,distal end 201 and slot 161 from being disassembled from one another in a proximal direction and/or distal direction. In other embodiments,pusher bar 202 can be advanced distally before contacting and engagingstaple sled assembly 160. In at least one such embodiment, thestaple sled assembly 160 can remain stationary until contacted bypusher bar 202. In any event, as outlined above,actuator 204 can be operably connected topusher bar 202 such that a pushing and/or pulling force can be applied toactuator 204 and transmitted topusher bar 202. In certain embodiments, as described in greater detail below,actuator 204 can be pivotably connected to aproximal end 203 ofpusher bar 202 such thatactuator 204 can be selectively rotated between at least first and second positions. - Further to the above, referring to
FIGS. 1 , 13, and 14,actuator 204 can be movable between a first position on afirst side 116 of surgical stapling instrument 100 (FIG. 13 ), a second position on a second side 117 (FIG. 14 ), and an intermediate position (FIG. 1 ) located at the proximal ends 103 and 105 of the first andsecond handle portions actuator 204 has been rotated into position on one of the first andsecond sides actuator 204 can be advanced distally. In various circumstances, as a result, a surgeon may select whether to move actuator 204 distally alongfirst side 116 orsecond side 117. Such circumstances may arise when it is more likely thatactuator 204 may impinge on tissue surrounding the surgical site, for example, whenactuator 204 is moved distally along one side of the surgical instrument as compared to the other. In various embodiments, referring toFIGS. 2 and 3 ,actuator 204 can includearm 206 extending therefrom wherearm 206 can be pivotably mounted toproximal end 203 ofpusher bar 202. In certain embodiments, referring once again toFIGS. 1 , 13, and 14,surgical instrument 100 can include a first slot (not illustrated) extending alongfirst side 116 and asecond slot 118 extending alongsecond side 117, wherein the first and second slots can be configured to slidably receive at least a portion ofactuator 204. In at least one embodiment, the sidewalls of the first and second slots can confine, or at least assist in confining, the movement ofactuator 204 such that it can be moved along a predetermined path. Referring toFIG. 14 ,second slot 118, for example, can be defined betweenfirst handle portion 102 andsecond handle portion 104 such that, whenactuator 204 is moved distally alongsecond side 117,arm 206 ofactuator 204 can be slid intermediate the first and second handle portions. Similar to the above, the first slot can also be defined intermediate the first and second handle portions. In various embodiments, referring again toFIGS. 13 and 14 ,surgical instrument 100 can further includeintermediate slot 119 which can also be configured to allowarm 206, and/or any other suitable portion ofactuator 204, to slide therein. In at least one such embodiment,intermediate slot 119 can connect the first and second slots such that, whenactuator 204 is positioned in its intermediate position,actuator 204 can be moved into either one of its first and second positions. In certain embodiments, the first slot,second slot 117, andintermediate slot 119 can be parallel, or at least substantially parallel, to one another and/or lie in the same plane, although other embodiments are envisioned in which one or more of the slots is not parallel to the others and/or lies in a different plane. Furthermore, although the first and second sides of the illustrated embodiment are located on opposite sides ofsurgical instrument 100, other embodiments are envisioned where the first and second slots, for example, are located on adjacent sides and/or sides which are not directly opposite to each other. Furthermore, other embodiments are envisioned in which the sides of a stapling instrument are not readily discernable, such as instruments having round and/or arcuate portions. - In various embodiments, further to the above,
surgical stapling instrument 100 can further include a locking mechanism which can prevent, or at least inhibit,actuator 204 and, correspondingly,staple sled assembly 160, from being advanced prematurely. In at least one embodiment, the locking mechanism can be configured to prevent, or at least inhibit, actuator 204 from being advanced distally prior to latchingmechanism 180 being moved into a closed, or an at least partially-closed, position. In certain embodiments, generally referring toFIG. 5 ,surgical stapling instrument 100 can further includinglocking mechanism 220 which can be engaged withactuator 204 and can remain engaged withactuator 204 while latchingmechanism 180 is in a fully open position (FIG. 5 ) and/or an at least substantially-open position. In various embodiments,locking mechanism 220 can include lock 222 which can be biased into engagement withactuator 204 by a biasing force applied thereto bylock spring 224, for example. In at least one such embodiment,actuator 204 can include one or more grooves, channels, or slots (not illustrated) which can be configured to receive at least a portion oflock 222. In use,locking mechanism 220 can holdactuator 204 in position until latchingmechanism 180 is moved into its fully closed position (FIG. 7 ) and/or an at least substantially closed position. In such circumstances, in at least one embodiment,latching mechanism 180 can be configured to engagelocking mechanism 220 and disengagelock 222 fromactuator 204. In at least one such embodiment, referring toFIGS. 5-7 ,latching mechanism 180 can further includecam 183 which can be configured to engagecam surface 223 onlock 222 when latchingmechanism 180 is moved into its closed position and, as a result, slide, and/or otherwise move, lock 222 away fromactuator 204. In various embodiments,cam 183 can comprise a wall, rib, and/or ridge extending fromlatch cover 186 and/orlatch frame 184. In any event, oncelock 222 has been sufficiently disengaged fromactuator 204, in at least one embodiment,actuator 204 can be moved from its intermediate position, illustrated inFIG. 1 , into one of its first and second positions, as illustrated inFIGS. 13 and 14 . - As described above,
locking mechanism 220 can be configured to prevent, or at least inhibit, drivebar 202 from being advanced distally prior to latchingmechanism 180 being moved into a predetermined position, such as, for example, a closed position and/or partially-closed position. Advantageously,locking mechanism 220 may also prevent, or at least inhibit,staple sled assembly 160 from being advanced prior to thefirst handle portion 102 and thesecond handle portion 104 being assembled together. In effect,locking mechanism 220 can prevent tissue positionedintermediate anvil 130 andstaple cartridge 150 from being cut and/or stapled prior toanvil 130 andstaple cartridge 150 being properly positioned relative to the tissue. Also, in effect,locking mechanism 220 can prevent staples from being deployed into the tissue prior to an appropriate clamping force being applied to the tissue. In any event, when latchingmechanism 180 is returned to its fully open position, and/or a partially-open position,cam 183 can be moved away fromlock 222 such thatlock spring 124 can bias lock 222 into engagement withactuator 204 once again. In various other embodiments, referring toFIGS. 15 and 16 ,locking mechanism 220′ can include alock 222′ comprising acam surface 223′ and, in addition, astop 226′ which can limit the relative movement oflock 222′. In at least one embodiment,cam 183, for example, can be configured to contactcam surface 223′ and, owing to the contoured, beveled, and/or angled surface ofcam surface 223′,cam 183 can be configured to drivelock 222′ distally as illustrated inFIG. 16 .Lock 222′ can be driven distally such thatpin 228′, which extends fromlock 222′, can be moved between a first position (FIG. 15 ) in which it is positioned withinaperture 229′ inactuator 204′ and a second position (FIG. 16 ) in whichpin 228′ has been sufficiently removed fromaperture 229′. In various embodiments, stop 226′ can be configured such that, aslock 222′ is driven distally, stop 226′ can come into contact withcam 183 oncelock 222′ has been sufficiently displaced. In such embodiments, stop 226′ can be configured to control the second, or displaced, position oflock 222′. Similar to the above, asactuator 180 is moved out of its closed position andcam 183 is disengaged from lockingmechanism 220′,lock spring 224′ can move lock 222′ into engagement withactuator 204′ once again. - In various embodiments, as described above, a firing actuator can be utilized to move a pusher bar, staple sled, and/or cutting member between first and second positions. As also described above,
pusher bar assembly 200, for example, can be utilized to move a staple sled assembly, such asstaple sled assembly 160, for example, between a proximal position (FIG. 10 ) and a distal position. In certain embodiments, a staple cartridge, such asstaple cartridge 150, for example, can include astaple sled assembly 160 contained therein, whereinstaple sled assembly 160 can be positioned in a distal position, as illustrated inFIG. 10 , when the staple cartridge is assembled to or inserted intostaple cartridge channel 122. In at least one such embodiment, referring toFIGS. 8-10 ,staple cartridge 150 can includefurther housing 170 which can be configured to cover at least a portion of cuttingmember 164 whenstaple sled assembly 160 is in its distal position, for example. In various embodiments,housing 170 can be configured to protect a surgeon, for example, when handling the staple cartridge, when inserting the staple cartridge into the surgical stapler, and/or assembling two or more portions of the surgical stapler together, for example. In at least one such embodiment, at least an upper portion of cuttingedge 165 can extend above deck, or top surface, 158 ofstaple cartridge 150 and, absent a protective housing, such ashousing 170, for example, the upper portion of cuttingedge 165 may be exposed. - In various embodiments, as described above, cutting
member 165 can be at least partially positioned within slot, or channel, 156 and, as illustrated inFIG. 10 , at least the upper, or top, portion of cuttingmember 164 can extend abovedeck 158. In at least one embodiment, referring toFIGS. 8-10 ,housing 170 can include a first wall, or portion, 172 extending from afirst portion 157 ofstaple cartridge body 152, a second wall, or portion, 174 extending from asecond portion 159 ofstaple cartridge body 152, and a top wall, or portion, 176 extending betweenfirst wall 172 andsecond wall 174. In certain embodiments, a housing may comprise only one support wall, or support portion, extending from a staple cartridge body and, in addition, a top wall, or top portion, extending therefrom. In other embodiments, a housing may comprise one or more side walls, or portions, and no top wall. In at least one such embodiment, the side walls of the housing can be configured such that they extend above the top of the cutting member, or at least extend above a cutting edge of the cutting member, for example. In any event, as illustrated inFIG. 10 , at least a portion of cuttingmember 164 can be positioned underneathtop wall 176 and/or betweenside walls staple sled assembly 160 is in its proximal position. In certain embodiments, cuttingmember 164 can be entirely positioned underneathtop wall 176, and/or entirely positioned withinhousing 170. In at least one embodiment, cuttingmember 164 can be positioned underneathtop wall 176 such that cuttingsurface 165 does not extend beyond thedistal edge 175 and/or theproximal edge 177 oftop wall 176. In at least one embodiment,housing 170 can include arear wall 178 which can be configured to limit the proximal movement of cuttingmember 164 and/or any other portion ofstaple sled assembly 160. In various embodiments, at least a portion ofhousing 170, for example, can be integrally-formed withstaple cartridge body 152. In at least one such embodiment,first wall 172,second wall 174,top wall 176, and/orrear wall 178 can be formed whenstaple cartridge body 152 is injection molded, for example. In certain embodiments, at least a portion ofhousing 170 can be assembled tostaple cartridge body 152 via a snap-fit arrangement, press-fit arrangement, and/or any other suitable manner. - In various embodiments, further to the above, cutting
member 164 can be defined by a planar, or an at least substantially planar, body having a knife edge extending along at least one side of the cutting member body. In at least one such embodiment,first wall 172 and/orsecond wall 174 can be configured and arranged such that they can include planar, or at least substantially planar,interior surfaces 173 which are parallel, or at least substantially parallel, to the side surfaces of cuttingmember 164. In certain embodiments, cuttingmember 164 can be closely received between theinterior surfaces 173 ofwalls walls slot 156. In any event, a housing can be configured such that at least a portion of the housing extends over at least a portion ofslot 156, for example. In certain embodiments,housing 170 can completely enclose or surround a cuttingmember 164 and/or cuttingsurface 165. In at least one embodiment, although not illustrated, a housing can include a break-away and/or incisable portion which can be at least partially detached, separated, and/or otherwise deformed in order to permit a cutting member to exit the housing. In at least one such embodiment, the tissue cutting surface can be configured to contact the housing to break and/or incise a housing wall, for example. In various embodiments, the housing wall can include a thin portion, a reduced-thickness portion, score mark, and/or any other configuration to facilitate the deformation and/or incision of the housing wall. In certain embodiments, a cutting member can include one or more additional cutting surfaces and/or anvils, for example, which can be configured to deform and/or incise the housing. In at least one embodiment, the housing can include a movable and/or flexible portion, such as a hinged member and/or flexible flap, for example, which can be configured to sufficiently move and/or flex to allow the cutting member to pass thereby. In any event, embodiments are envisioned in which the cutting member can have any suitable configuration for incising tissue and the protective housing can have any suitable configuration for at least partially enclosing or surrounding the cutting member. Furthermore, although a cutting member can comprise a sharpened edge as described above, other suitable cutting members are envisioned, such as those supplied with an electrical current sufficient to dissect tissue, for example. - As described above,
housing 170 can be configured to at least partially cover, enclose, and/or surround a cutting member when it is in its proximal position. In various embodiments, the cutting member can be advanced distally to incise tissue, for example, and then retracted proximally in order to position the cutting member withinhousing 170 once again. In such embodiments, the cutting member can be at least partially covered byhousing 170 when the staple cartridge is assembled to and removed from a surgical stapling instrument. In certain embodiments, a new, or unspent, staple cartridge can be inserted into the staple cartridge channel to replace the at least partially spent staple cartridge. In at least one such embodiment, the new staple cartridge can include a new cutting member and/or staple sled assembly positioned therein, although embodiments are envisioned in which the previously-used cutting member and/or staple sled assembly can be sufficiently withdrawn from the spent staple cartridge and advanced into the new staple cartridge in order to be reused once again. In embodiments where a new cutting member and/or staple sled assembly is provided with each new staple cartridge, a sharp cutting edge, for example, can be utilized with each staple cartridge. - In various embodiments, although not illustrated, a staple cartridge can include two or more housings configured to at least partially cover a cutting member when it is in two or more positions. In at least one embodiment, a staple cartridge can include a proximal housing configured to at least partially cover the cutting member when it is in a proximal position, for example, and, in addition, a distal housing configured to at least partially cover the cutting member when it is in a distal position, for example. In at least one such embodiment, the cutting member can be positioned within the proximal housing when the staple cartridge is assembled to a surgical stapling instrument and, in certain embodiments, the cutting member can be advanced into the distal housing after it has transected tissue positioned within the end-effector, for example. In such embodiments, as a result, the cutting member can be at least partially positioned within the distal housing when the staple cartridge is removed from the surgical stapler. Such embodiments may be particularly useful when a vessel, for example, is positioned intermediate the proximal housing and the distal housing of the staple cartridge. In various embodiments, although not illustrated, a cutting member can be moved proximally from a distal position to a proximal position, and/or any other suitable position.
- In various embodiments, further to the above,
anvil 130 can include one or more apertures, slots, or recesses 179 (FIG. 17 ) which can be configured to receive at least a portion ofhousing 170 whenanvil 130 is brought into close opposition tostaple cartridge 150, for example. In at least one embodiment, sufficient clearance can be present betweenhousing 170 andrecess 179 such thatanvil 130 andstaple cartridge 150 can be moved relative to each other without interference, or at least substantial interference, therebetween. In embodiments having more than one cutting member housing as outlined above, an opposing anvil can have more than one corresponding aperture for receiving the housings. In various embodiments, an anvil can include a movable cutting member and at least one housing for at least partially covering, enclosing, and/or surrounding the cutting member. In certain embodiments, although not illustrated, both an anvil and a staple cartridge can comprise at least one movable cutting member and/or at least one housing configured to at least partially cover, surround, or enclose the cutting members when they are in a proximal position, for example. - As outlined above,
pusher bar assembly 200 can be advanced distally in order to movestaple sled assembly 160 withinstaple cartridge assembly 150. In various embodiments, as also outlined above, the wedge-like cam surfaces 167 ofstaple sled 162 can be moved into engagement with thesloped surfaces 169 onstaple drivers 168 to sequentially, and/or simultaneously, drive staples fromstaple cartridge 150 againstanvil 130 and form the staples into any suitable configuration, such as B-shaped configurations, for example. In at least one such embodiment, referring toFIG. 17 ,anvil 130 can include one or more staple forming surfaces, such asstaple pockets 132, for example, which can be configured to deform the staples. In certain embodiments,anvil 130 can further include a slot, channel, or groove 133 which can be configured to slidably receive at least a portion ofstaple sled 162, cuttingmember 164, and/orpusher bar 202, for example. In at least one embodiment, although not illustrated, an anvil can include an anvil plate which can be securely and/or immovably positioned within an anvil channel defined within the anvil. In various other embodiments, as illustrated inFIGS. 18 and 19 and described in greater detail below,anvil 130 can include ananvil plate 134 movably positioned withinanvil channel 136. In certain embodiments,anvil channel 136 can includeopposite side walls 137 and, in addition, abase 138 extending betweenside walls 137. In at least one embodiment,anvil 130 can further include adistal nose portion 139, for example, assembled thereto whereinnose portion 139 can be configured to be press-fit and/or snap-fit intoanvil channel 136, for example, such thatnose portion 139 can be securely retained therein. In certain embodiments,nose portion 139 can be comprised of a soft and/or pliable material, such as rubber, for example, and can comprise any suitable shape which can facilitate the insertion ofanvil 130 into a surgical site, for example. In some embodiments, referring toFIG. 28 , a nose portion, such asnose portion 139′ can be retained to an anvil by one ormore fasteners 139 a′. Similarly, referring toFIG. 1 , a staple cartridge channel and/or staple cartridge, such asstaple cartridge 150, for example, can include a nose portion, such asnose portion 153, for example, which can facilitate the insertion ofstaple cartridge 150 into a surgical site, for example - As indicated above, staples can be deployed from a staple cartridge and deformed against an anvil. In various circumstances, the distance between the staple forming surfaces on
anvil 130 andstaple sled 162 can determine the amount in which the staples are deformed. For example, if the distance between anvil pockets 132 onanvil 130 andtop surfaces 135 on staple sled 162 (FIGS. 10-12 ) is relatively large, the staples will be deformed a lesser amount as compared to when the distance between anvil pockets 132 and sled surfaces 135 is relatively small. Correspondingly, if the distance between anvil pockets 132 and sled surfaces 135 is relatively small, the staples will be deformed a greater amount as compared to when the distance between anvil pockets 132 and sled surfaces 135 is relatively large. Often, the distance between anvil pockets 132 and sled surfaces 135 is referred to as the forming height of the staples. Sometimes the forming height of the staples can be measured between the top surface, or deck, of the staple cartridge and the staple forming surfaces on the anvil. For the purpose of this application, however, any reference to a staple forming height, or the like, can include one or both manners of measurement, where appropriate, and/or any other suitable manner of measurement. In any event, as described in greater detail below, a surgical stapling instrument, such asstapling instrument 100, for example, can include means for adjusting the staple forming height. - In various embodiments, further to the above, an anvil can include one or more forming surfaces which can be moved toward and/or away from a staple cartridge in order to set the forming height of the staples. In at least one embodiment, referring to
FIGS. 17-23 ,anvil 130 can includeanvil plate 134 which can be movably and/or slidably positioned withinanvil channel 136. In certain embodiments,anvil 130 can further include one or more retention, or guide, pins 140, whereinanvil plate 134 can include one or more retention, or guide,slots 141 configured to slidably receive at least a portion ofpins 140. In at least one such embodiment, pins 140 and/orslots 141 can be configured to define a predetermined path along whichanvil plate 134 can be moved. Referring toFIG. 18 , pins 140 andslots 141 can be structured and arranged such thatanvil plate 134 can be moved along a linear, or at least substantially linear, path, wherein the linear path can be at least partially defined byaxes pins 140 can be retained withinapertures 144 inside walls 137 wherein, in at least one embodiment, pins 140 can be press-fit withinapertures 144. In any event, as described herein, pins 140 can guideanvil plate 134 as it is moved toward and/or away fromstaple cartridge 150, for example. - In various embodiments, further to the above, a surgical stapling instrument, such as
stapling instrument 100, for example, can include one or more adjustment members configured to position a portion of an anvil, such asanvil plate 134, for example, relative to other portions of an anvil assembly and/or an opposing staple cartridge. In certain embodiments, referring toFIGS. 18 and 19 , staplinginstrument 100 can include anvilplate adjustment member 230 which can be configured to limit the range of motion ofanvil plate 134. In at least one such embodiment, referring toFIGS. 20 and 21 , adjustingmember 230 can be positionedintermediate anvil plate 134 in a first position in which first surface, or step, 231 of adjustingmember 230 is positionedintermediate base 138 ofanvil channel 136 andfirst positioning surface 145 onanvil plate 134. In such a first position,first step 231 can define the amount of relative movement possible, or permitted, betweenanvil plate 134 andanvil channel 136. For example, whenanvil 130 is clamped against tissue as described above,anvil plate 134 can contact the tissue and slide upwardly towardbase 138 untilfirst positioning surface 145 contactsfirst step 231. Oncesurface 145 and step 231 are in contact, adjustingmember 230 can prevent, or at least inhibit,anvil plate 134 from moving further towardbase 138. In at least one such embodiment, as a result, adjustingmember 230 can act as a stop such that the distance betweenbase 138 and tissue-contactingsurface 148 onanvil plate 134 can be defined by afirst distance 234. Whilebase 138 is used as a reference datum in the present example, other portions ofanvil 130 and/or an opposing staple cartridge, for example, could be used as reference datums. When adjustingmember 230 is in its first position, as described above, second surface, or step, 232 of adjustingmember 230 can be positionedintermediate base 138 andsecond positioning surface 146 onanvil plate 134, and, in addition, third surface, or step, 233 can be positionedintermediate base 138 andthird positioning surface 147. Referring toFIG. 20 ,adjustment member 230 can include two or more sets of steps, 231, 232, and/or 233 andanvil plate 134 can include two or more sets of positioningsurfaces first step 231 andfirst positioning surface 145 are described above as being configured to control the position ofanvil plate 134, the second and third steps (232, 233) ofadjustment member 230 and the second and third positioning surfaces (146, 147) ofanvil plate 134, respectively, can also be configured to control the position ofanvil plate 134. For the sake of brevity, though, the present example will be described in reference to the first surface, or step 231, as being the surface which controls the position ofanvil plate 134, although the reader will understand that thesteps anvil plate 134 as well. - In certain embodiments, the first position of
adjustment member 230 can provide for a relatively small, or short, staple forming height. In other embodiments, although not illustrated, the first position of an adjustment member can provide for an intermediate, a relatively large, and/or any other suitable staple forming height. In the event that the forming height associated with the first position of the adjustment member is suitable, a surgeon can proceed to use the surgical stapling instrument to staple and/or incise tissue as described above. In the event, however, that the staple forming height is unsuitable, a surgeon, or other clinician, can moveadjustment member 230 such thatadjustment member 230 can permitanvil plate 134 to slide upwardly a different distance whenanvil plate 134 contacts tissue positionedintermediate anvil 130 andstaple cartridge 150. In at least one such circumstance, the distance in whichanvil plate 134 is permitted to slide upwardly can be larger, thereby providing a larger forming height for the staples. Correspondingly, in other circumstances, the adjustment member can be moved such thatanvil plate 134 can slide upwardly a shorter distance whenanvil plate 134 contacts the tissue, for example, thereby providing a shorter staple forming height. While the term “upward”, and the like, can mean vertically upward, the term is not so limited; rather, “upward” can mean any direction which is toward the base of the anvil and/or away from a staple cartridge, for example. In any event,adjustment member 230 can be moved between its first position, illustrated inFIG. 21 , and a second position, illustrated inFIG. 22 , in order to increase the staple forming height. As indicated by arrow “P” inFIG. 22 ,adjustment member 230 can be slid proximally in order to moveadjustment member 230 between its first and second positions, although embodiments are envisioned where an adjustment member can be slid distally and/or any other suitable direction in order to adjustadjustment member 230. Onceadjustment member 230 has been moved into its second position, referring toFIG. 22 , first surface, or step, 231 can be positionedintermediate base 138 andsecond positioning surface 146 ofanvil plate 134. In such a second position,first step 231 can once again define the amount of relative movement permitted betweenanvil plate 134 andanvil channel 136. In at least one embodiment, similar to the above, adjustingmember 230 can act as a stop such that the distance betweenbase 138 and tissue-contactingsurface 148 onanvil plate 134 can be defined by asecond distance 235. - Further to the above,
adjustment member 230 can be moved between its second position, illustrated inFIG. 22 , and a third position, illustrated inFIG. 23 , in order to once again increase the staple forming height. As indicated by arrow “P” inFIG. 23 ,adjustment member 230 can be slid proximally in order to moveadjustment member 230 between its second and third positions. Onceadjustment member 230 has been moved into its third position, referring toFIG. 23 , first surface, or step, 231 can be positionedintermediate base 138 andthird positioning surface 147. In such a third position,first step 231 can once again define the amount of relative movement betweenanvil plate 134 andanvil channel 136. In at least one embodiment, similar to the above, adjustingmember 230 can act as a stop such that the distance betweenbase 138 and tissue-contactingsurface 148 onanvil plate 134 can be defined by athird distance 236. Whileadjustment member 230 can be selectively moved between three positions as described above to provide three different staple forming heights, other embodiments are envisioned which comprise an adjustment member which can be moved between more than three positions to provide more than three different staple forming heights. For example, an adjustment member can be movable between four positions in order to provide four staple forming heights. Further embodiments are envisioned which comprise an adjustment member which can be moved between two positions to provide two staple forming heights. Furthermore, while surfaces, or steps, 231, 232, and 233 ofadjustment member 230 are arranged in a descending order, other arrangements are envisioned in which the surfaces, or steps, are arranged in an ascending order. Other arrangements are envisioned in which the surfaces, or steps, are not necessarily arranged in either an ascending or a descending order. Similarly, positioning surfaces 145, 146, and 147 ofanvil plate 134 can be arranged in an ascending order, a descending order (FIG. 20 ), and/or any other suitable order. Furthermore, whileadjustment member 230 can be slid along an axis, other embodiments are envisioned where an adjustment member can be moved along any suitable path such as curved and/or curvi-linear paths, for example. - As described above, referring to
FIG. 21 ,adjustment member 230 can comprise three surfaces, or steps, 231, 232, and 233 whileanvil plate 134 can comprise three corresponding adjustment surfaces 145, 146, and 147. Whenadjustment member 230 is in its first position, for example,first surface 231 can be positioned such that it abuts or is adjacent tofirst adjustment surface 145,second surface 232 can be positioned such that it abuts or is adjacent tosecond adjustment surface 146, andthird surface 233 can be positioned such that it abuts or is adjacent tothird adjustment surface 147. Asadjustment member 230 is slid relative toanvil plate 134, as described above and referring toFIGS. 22 and 23 , surfaces 231, 232, and 233 ofadjustment member 230 can be sequentially indexed relative tosurfaces anvil plate 134. In at least one such embodiment, an adjustment member can have the same number of steps as the number of positioning surfaces on an anvil plate. Other embodiments are envisioned where an adjustment member has more steps than positioning surfaces on the anvil plate. In at least one such embodiment, an anvil plate can include one positioning surface wherein the steps of an adjustment member can be selectively utilized to limit the upward movement of the anvil plate, for example. In various embodiments, referring generally toadjustment member 230 andanvil plate 134, an anvil plate may include one positioning surface, such aspositioning surface 145, for example, wheresteps adjustment member 230, for example, can be selectively positionedintermediate base 138 andpositioning surface 145. In such embodiments,first step 231 can have a first thickness or height which can stop, or limit, the upward movement ofanvil plate 134 so as to define a first staple forming height,second step 232 can have a second thickness or height which can stop, or limit, the upward movement ofanvil plate 134 so as to define a second staple forming height, and, in addition,third step 233 can have a third thickness or height which can stop, or limit, the upward movement ofanvil plate 134 so as to define a third staple forming height. In at least one embodiment, the thickness or height ofsteps back surface 237 ofadjustment member 230 and a surface on the steps (231, 232, 233) which will contactanvil plate 134. In various embodiments, the difference in height, or thickness, betweenfirst step 231 andsecond step 232 can be the same, or at least substantially the same, as the difference in height, or thickness, betweensecond step 232 andthird step 233. In at least one such embodiment, as a result, the step heights can increase at a linear rate, or an at least substantially linear rate. In alternative embodiments, the difference in height, or thickness, between the first and second steps can be different than the difference in height, or thickness, between the second and the third steps. In at least one such embodiment, the first, second, and third steps may not increase or decrease in height, or thickness, at a linear rate; rather, although not illustrated, the steps may increase or decrease in height, or thickness, in a non-linear and/or geometric rate. - As described above, an adjustment member, such as
adjustment member 230, for example, can be movable between two or more positions. In various embodiments, a surgical stapling instrument can include an actuator configured to move the adjustment member. In at least one embodiment, referring toFIGS. 17-20 ,surgical stapling instrument 100 can includeactuator 250 which can be operably attached toadjustment member 230 such that a force can be applied toactuator 250 and transmitted toadjustment member 230. In certain embodiments,actuator 250 can include grasping portions, or handles, 252 which can be configured to be grasped by a surgeon, for example, in order to advance or retractadjustment member 230 withinanvil 130 as described above. In certain embodiments, graspingportions 252 can extend fromactuator body 251, whereinactuator body 251 can include one or more apertures, slots, orcavities 253 which can be configured to receive at least a portion ofadjustment member 230. In at least one such embodiment, referring toFIG. 19 ,adjustment member 230 can include lock 254 extending therefrom, wherein at least a portion oflock 254 can be received withinaperture 253 so as to retainactuator body 251 toadjustment member 230. In various embodiments, lock 254 can include one or more resilient, or flexible,legs 255 which can be deflected when they are inserted intoaperture 253 but resiliently return, or at least partially return, to their unflexed position afterfeet 256 oflegs 255 are sufficiently pushed throughaperture 253. In at least one such embodiment,feet 256 can prevent, or at least inhibit,actuator body 251 from being detached fromadjustment member 230. - In various embodiments, further to the above,
surgical stapling instrument 100 can further include a detent mechanism which can be configured to hold, or releasably hold,actuator 250 and/oradjustment member 230 in position. In at least one embodiment, referring toFIG. 19 ,detent member 260 can be attached toactuator 250 wherein, in at least some embodiments,actuator body 251 can include one or more channels, grooves, or recesses 257 which can be configured to receive and/or retain adetent body 261 ofdetent member 260 therein. In at least one embodiment,detent body 261 can include one ormore apertures 263, and/or any other suitable channels, slots, or grooves, which can be configured to receive one or more fasteners for securingdetent body 261 toactuator 251, for example.Detent member 260 can further includedetent legs 262 which can be configured to engage one or more recesses, apertures, or grooves 101 (FIGS. 2-7 ) infirst frame portion 110, for example. More particularly, referring toFIGS. 2 and 3 , eachside flange 128 can include one or more recesses 101 (101 a, 101 b, and 101 c) defined therein whereindetent legs 262 can be biased into engagement with the top surfaces ofside flanges 128 such that detentlegs 262 can be slid into, and slid out of, recesses 101. In the illustrated embodiment, each side flange can include threerecesses 101 which can be configured to removablyhold actuator 250 in a first, distal position, a second, intermediate position, and a third, proximal position, wherein the first, second, and third positions ofactuator 250 can respectively correspond with the first, second, and third positions ofadjustment member 230 described above. For example, whenactuator 250 is in its first, distal position,detent legs 262 ofdetent member 260 can be positioned withinrecess 101 a so as to removably retainactuator 250 andadjustment member 230 in their first positions. Upon the application of a sufficient force,actuator 250 can be moved proximally into its second position such thatdetent legs 162 are positioned withinrecess 101 b andactuator 250 andadjustment member 230 are retained in their second positions. Similarly; upon the application of a sufficient force,actuator 250 can be moved proximally into its third position such thatdetent legs 162 are positioned withinrecess 101 c andactuator 250 andadjustment member 230 are retained in their third positions. In various embodiments,detent legs 162 can be configured such thatactuator 250 can be returned to its first and/or second positions. - As described above,
adjustment member 230 can be moved along a pre-determined path between two or more positions byactuator 250. In various embodiments,surgical stapling instrument 100, for example, can include one or more guides for controlling or limiting the movement ofadjustment member 230 and/oractuator 250. In some embodiments,adjustment member 230 can be closely received betweenside walls 137 ofanvil 130 such thatside walls 137 can guideadjustment member 230. In at least one such embodiment,side walls 137 can be configured to control or limit the lateral or side-to-side movement ofadjustment member 230. In various embodiments,detent legs 162 ofdetent member 160 can comprise resilient members which can be configured to apply an upward biasing or pulling force onadjustment member 230 so as to positionadjustment member 230 against, or at least adjacent to,base 138 andintermediate side walls 137. In certain embodiments, referring toFIG. 19 ,base 138 ofanvil 130 can further includeguide slot 149 which can be configured to receive at least a portion ofadjustment member 230 and/oractuator 250 therein such thatguide slot 149 can limit the movement ofadjustment member 230 andactuator 250. In at least one such embodiment, lock 254 ofadjustment member 230 can be configured to extend throughguide slot 149 such that, whenlock 254 is inserted intoaperture 253 ofactuator 250 as described above,base 138 ofanvil 130 can be capturedintermediate adjustment member 230 andactuator 250. In certain embodiments,guide slot 149 can be configured to limit the movement oflock 254 such thatadjustment member 230 can be prevented, or at least inhibited, from being moved distally whenadjustment member 230 is in its first, or distal-most, position and/or, similarly, prevented, or at least inhibited, from being moved proximally whenadjustment member 230 is in its third, or proximal-most, position. - In various embodiments, further to the above, a detent member, similar to
detent member 260, for example, can be utilized to biasfirst handle portion 102 andsecond handle portion 104 away from one another. In at least one embodiment, referring toFIG. 37 ,surgical stapling instrument 100′ can include adetent member 260′ configured to positionfirst handle portion 102 andsecond handle portion 104 such that a gap exists betweenanvil 130 andstaple cartridge 150. Such a feature, as outlined above, can allow a surgeon to easily manipulate the surgical instrument without having to hold the first and second handle portions apart from one another. In certain embodiments,detent member 260′ can be sufficiently mounted tosecond handle portion 104 such that detentlegs 262′ extending fromdetent member 260′ can contactflanges 128 and, when compressed, apply a biasing force to the first and second handle portions. As seen inFIG. 37 ,legs 262′ can contactsurfaces 101 d onflanges 128. In order to compressdetent legs 262′,latch mechanism 180 can be moved into a partially-closed position such that latcharms 188 can engage, and at least partially surround, latchprojections 131. In this configuration, a surgeon can manipulate the instrument and, when satisfied with its position, movelatch mechanism 180 into a closed position and furthercompress detent legs 262′. Similar to the above,detent member 260′ can be affixed, or otherwise operably engaged with,actuator 250 such that, whenactuator 250 is moved between its first, second, and third positions as described above,legs 262′ can engagerecesses actuator 250 can have a pre-staged position in which actuator 250 is positioned distally with respect to its first position and, in addition, surfaces 101 d can comprise pre-stage surfaces against whichlegs 262′ can be positioned whenactuator 250 is in its pre-staged position. - As outlined above, an adjustment member can be slid, or translated, between first and second positions so as to adjust the forming height of staples deployed by a surgical stapling instrument. In various embodiments, although not illustrated, an adjustment member can be configured to positively displace an anvil plate toward and/or away from an opposing staple cartridge, for example. In at least one such embodiment, a surgical stapling instrument can include one or more biasing members, such as springs, for example, configured to position the anvil plate against the adjustment member such that, when the adjustment member is moved between its first and second positions, the adjustment member can displace the anvil plate between first and second positions in order to set first and second staple forming heights. In various embodiments, as a result of the above, an adjustment member can be configured to cam a portion of an anvil into position. In at least one such embodiment, an adjustment member can be slid along an axis in order to positively displace an anvil plate. In other embodiments, a rotatable adjustment member can be configured to positively displace an anvil plate toward and/or away from a staple cartridge, for example.
- Further to the above, as described in greater detail below, an adjustment member can be rotated to adjust the staple forming height. Referring to
FIGS. 24-36 ,surgical instrument 100′ can include, similar to the above, afirst handle portion 102′, asecond handle portion 104′, and alatching mechanism 180′ which can be utilized to clamp tissueintermediate anvil 130′ andstaple cartridge 150′. Referring toFIG. 25 , also similar to the above, latchingmechanism 180′ can be pivotably coupled tofirst portion 102′ by one or more pivot pins 182′, wherein latchingmechanism 180′ can include one ormore latch arms 188′ which can be configured to engagesecond portion 104′ and latch the first and second handle portions together. Also similar to the above, referring toFIGS. 25 and 27 ,surgical instrument 100′ can further includepusher bar assembly 200′ which can be configured to advance a cutting member and/or staple sled within end-effector 120′. In at least one such embodiment,pusher bar assembly 200′ can include aproximal end 203′ and anactuator 204′, whereinactuator 204′ can be rotatably mounted toproximal end 203′ and selectively positioned on first and second sides of staplinginstrument 100′. In various embodiments,surgical stapling instrument 100′ can comprise the same, or similar, features to those described in connection withsurgical stapling instrument 100 and can be operated in the same manner, or a similar manner, asinstrument 100 and, as a result, such details are not repeated herein. - In various embodiments, referring to
FIG. 27 ,surgical instrument 100′ can include arotatable adjustment member 230′ which can be selectively positioned in at least first and second positions so as to provide different staple forming heights. In certain embodiments,surgical instrument 100′ can include anactuator 250′ which can be operably connected toadjustment member 230′ such thatactuator 250′ can moveadjustment member 230′ between at least its first and second positions. In at least one embodiment, referring toFIG. 28 ,actuator 250′ can includeactuator body 251′ and grasping portion, or handle, 252′.Actuator body 251′ can include anaperture 258′ which can be configured to receive aproximal end 238′ ofadjustment member 230′ such that rotational motion, torque, and/or forces can be transmitted betweenactuator 250′ andadjustment member 230′. In at least one such embodiment, referring to FIG. 36,aperture 258′ can comprise a non-circular profile and/or a profile which includes one or more flat drive surfaces configured to transmit rotational motion betweenactuator body 251′ andactuator 230′. In certain embodiments,aperture 258′ can be sized and configured to closely receiveproximal end 238′ ofactuator 230′. In at least one embodiment,aperture 258′ can be configured to receiveproximal end 238′ in a press-fit and/or snap-fit arrangement. In various embodiments, referring again toFIG. 28 ,handle portion 104′ can include one ormore slots 259′ which can be configured to permit at least a portion ofactuator body 251′ to extend therethrough such that graspingportion 252′ can be assembled toactuator body 251′ with at least a portion ofhandle portion 104′ positioned therebetween. In at least one such embodiment,second handle portion 104′ can further includerecess 253′ which can be configured such that at least a portion, if not all, of graspingportion 252′ is positioned withinrecess 253′. In certain embodiments,recess 253′ can be configured such that graspingportion 252′ does not extend above the top surface ofsecond handle portion 104′ although, in other embodiments, an upper portion of graspingportion 252′ can extend abovesecond handle portion 104, as illustrated inFIG. 30 , such that graspingportion 252′ can be easily accessed by a surgeon. - In various embodiments, as outlined above, an adjustment member can be rotatable between at least first and second positions in order to adjust the forming height of staples deployed by a surgical stapler. In certain embodiments, referring to
FIG. 28 , a surgical stapling instrument can include an adjustment member rotatably positioned within an anvil wherein the adjustment member can be configured to limit the relative movement of a movable anvil portion. In at least one such embodiment,surgical stapling instrument 100′ can include ananvil plate 134′ which can be slidably retained withinanvil channel 136′ by retention, or guide, pins 140′, wherein guide pins 140′ can be configured to allowanvil plate 134′ to slide upwardly whenanvil plate 134′ comes into contact with tissue as described above. Referring toFIGS. 27 , 30, and 31,adjustment member 230′ can be positionable in a first position, or orientation, such that it can limit the upward movement ofanvil plate 134′ withinanvil channel 136′ and dictate the staple forming height of the staples. In at least one such embodiment, referring toFIGS. 30 and 31 ,adjustment member 230′ can include opposingfirst surfaces 231′ which can be positionedintermediate base 138′ ofanvil channel 136′ andpositioning surface 145′ ofanvil plate 134′ such that, when positioningsurface 145′ contacts one offirst surfaces 231′, tissue-contactingsurface 148′ ofanvil plate 134′ can be positioned afirst distance 234′ away from adatum surface 129′ onanvil 130′, for example. Correspondingly, formingsurfaces 132′ can be positioned a first distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a first staple height. Further to the above, afirst diameter 241′ can be defined betweenfirst surfaces 231′ wherein thefirst diameter 241′ can define the maximum upward position ofanvil plate 134′ withinanvil channel 136′. - As indicated above,
adjustment member 230′ can be rotated in order to adjust the forming height of the staples. In various embodiments,adjustment member 230′ can be rotated between its first position, or orientation, (FIGS. 30 and 31 ) and a second position, or orientation (FIGS. 32 and 33 ). In at least one embodiment, referring toFIGS. 32 and 33 , handle 252′ can be rotated in a direction indicated by arrow “A” in order to moveadjustment member 230′ between its first and second positions. Similar to the above, when actuator 230′ is in its second position, or orientation,actuator 230′ can limit the upward movement ofanvil plate 134′ withinanvil channel 136′ and dictate the staple forming height of the staples. In at least one such embodiment, referring toFIGS. 32 and 33 ,adjustment member 230′ can include opposingsecond surfaces 232′ which can be positionedintermediate base 138′ andpositioning surface 145′ such that, when positioningsurface 145′ contacts one ofsecond surfaces 232′, tissue-contactingsurface 148′ ofanvil plate 134′ can be positioned asecond distance 235′ away fromdatum surface 129′, for example. Correspondingly, formingsurfaces 132′ can be positioned a second distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a second staple height. In various embodiments, similar to the above, asecond diameter 242′ can be defined betweensecond surfaces 232′, whereinsecond diameter 242′ can define the maximum upward position ofanvil plate 134′ withinanvil channel 136′. Althoughfirst surfaces 231′ andsecond surfaces 232′ can be defined by flat, or at least substantially flat, surfaces, other embodiments are envisioned in which the first andsecond surfaces 231′ and 232′ can include at least partially arcuate, or curved, contours. In any event, referring toFIG. 27 ,adjustment member 230′ may include one ormore clearance slots 240′ which can be configured to provide clearance betweenactuator 230′ andretention pins 140′.Clearance slots 240′ can be configured to provide clearance betweenactuator 230′ andretention pins 140′ whenactuator 230′ is in its first position, second position, and/or any other suitable position. - In various embodiments, further to the above,
adjustment member 230′ can be rotated between its first position, or orientation, (FIGS. 30 and 31 ) and a third position, or orientation (FIGS. 34 and 35 ). In at least one embodiment, referring toFIGS. 34 and 35 , handle 252′ can be rotated in a direction indicated by arrow “B” in order to moveadjustment member 230′ between its first and third positions. Similar to the above, when actuator 230′ is in its third position, or orientation,actuator 230′ can limit the upward movement ofanvil plate 134′ withinanvil channel 136′ and dictate the staple forming height of the staples. In at least one such embodiment, referring toFIGS. 34 and 35 ,adjustment member 230′ can include opposingthird surfaces 233′ which can be positionedintermediate base 138′ andpositioning surface 145′ such that, when positioningsurface 145′ contacts one ofthird surfaces 233′, tissue-contactingsurface 148′ ofanvil plate 134′ can be positioned athird distance 236′ away fromdatum surface 129′, for example. Correspondingly, formingsurfaces 132′ can be positioned a third distance away from a staple cartridge such that, when staples are deployed from the staple cartridge, the staples can be deformed to a third staple height. In various embodiments, similar to the above, athird diameter 243′ can be defined betweenthird surfaces 233′, whereinthird diameter 243′ can define the maximum upward position ofanvil plate 134′ withinanvil channel 136′. Referring once again toFIGS. 34 and 35 ,third surfaces 233′ can be defined by an at least partially arcuate contour, although other embodiments are envisioned in whichthird surfaces 233′ can include flat, or at least substantially flat, contours. In at least one embodiment,adjustment member 230′ can be configured such that the largest distance, or diameter, between the arcuatethird surfaces 233′ can be utilized to define the third staple height. - As described above, referring to
FIGS. 30 and 31 ,adjustment member 230′ can be positioned in a first position, or orientation, to set a first forming height for the staples deployed bysurgical stapling instrument 100′. As also described above, referring toFIGS. 32 and 33 ,actuator 250′ can be utilized to moveadjustment member 230′ into its second position, or orientation, to set a second forming height for the staples. To do this, in at least one embodiment, a force can be applied to handle 252′ which can cause handle 252′, andadjustment member 230′ attached thereto, to rotate in a direction indicated by arrow “A”. In at least one embodiment,adjustment member 230′ and/oractuator 250′ can be sufficiently retained such that, whenadjustment member 230′ is rotated,adjustment member 230′ can be rotated about an axis, such asaxis 245′ (FIG. 27 ), for example. In at least one embodiment, referring toFIG. 25 , theproximal end 203′ ofpusher bar assembly 200′ can include one or more grooves, channels, or recesses 205′ which can be configured to receive and/or retain at least a portion ofadjustment member 230′ and/oractuator 250′ therein. In any event, as illustrated inFIGS. 30-33 , the second position, or orientation, ofadjustment member 230′ can allowanvil plate 134′ to slide a larger distance withinanvil channel 136′ as compared to whenadjustment member 230′ is in its first position. In at least one embodiment, as a result, the second staple forming height can be larger than the first staple forming height. As also described above, referring toFIGS. 34 and 35 ,actuator 250′ can be utilized to moveadjustment member 230′ into its third position, or orientation, to set a third forming height for the staples. To do this, in at least one embodiment, a force can be applied to handle 252′ which can cause handle 252′, andadjustment member 230′ attached thereto, to rotate in a direction indicated by arrow “B”. As illustrated inFIGS. 30 , 31, 34, and 35, the third position, or orientation, ofadjustment member 230′ can allowanvil plate 134′ to slide a smaller distance withinanvil channel 136′ as compared to whenadjustment member 230′ is in its first position. In at least one embodiment, as a result, the first and second staple forming heights can be larger than the third staple forming height. In at least one such embodiment, the first position ofadjustment member 230′, andactuator 250′, can represent an intermediate position, whereinadjustment member 230′ can be selectively moved into its second and third positions directly from its first position. In effect, the first position ofadjustment member 230′ can represent an intermediate staple height, wherein the second and third staple positions ofadjustment member 230′ can represent taller and shorter staple heights, respectively. In certain embodiments, referring toFIG. 24 ,surgical stapling instrument 100′ can include one or more indicia thereon which can be configured to convey the staple forming heights, or at least relative forming heights, that can be selected. For example,second handle portion 104′ can include afirst indicium 245′ which can indicate an intermediate, or first, staple height, asecond indicium 246′ which can indicate a taller, or second, staple height, and, in addition, athird indicium 247′ which can indicate a shorter, or third, staple height. - In various embodiments, further to the above, one or more of
first surfaces 231′,second surfaces 232′, andthird surfaces 233′ can comprise or define, or at least partially comprise or define, a perimeter, or circumference, ofadjustment member 230′. As discussed above, owing to the first, second, and third diameters (241′, 242′, and 243′) defined by the first, second, and third surfaces (231′, 232′, and 233′), respectively, the perimeter, or circumference, ofadjustment member 230′ may be non-circular. In certain embodiments, though, the perimeter, or circumference ofadjustment member 230′, may be symmetrical, substantially symmetrical, and/or non-symmetrical. In various embodiments, further to the above, an adjustment member can comprise a cam rotatably positionedintermediate base 138′ ofanvil 130′ andadjustment surface 145′ ofanvil plate 134′, for example. In at least one such embodiment, one or more offirst surfaces 231′,second surfaces 232′, andthird surfaces 233′, for example, can comprise or define a cam profile which, similar to the above, can be configured to either positively positionanvil plate 134′ and/or provide a stop against whichanvil plate 134′ can be positioned. In any event, although not illustrated, various embodiments are envisioned in which an adjustment member can be slid and rotated in order to set two or more staple forming heights for staples deployed by a surgical stapling instrument. In at least one such embodiment, an adjustment member can comprise a cam profile which can be defined along the length of the adjustment member wherein longitudinal and/or rotational movement can be utilized to move the cam profile between at least first and second positions. - In various embodiments, similar to the above,
surgical instrument 100′ can further include a detent mechanism configured to hold, or at least releasably hold,actuator 250′ in position. In at least one embodiment, referring toFIGS. 25 and 26 ,surgical instrument 100′ can further includedetent member 260′ comprisingdetent body 261′ and one ormore detent legs 262′. Referring toFIG. 26 ,detent body 261′ can include one or more grooves, recesses, orchannels 263′ which can be configured to receive at least a portion ofproximal end 105′ ofsecond handle portion 104′ therein such thatdetent member 260′ can be retained in position. In at least one such embodiment,proximal end 105′ can further include one or more grooves, channels, or recesses 265′ which can be configured to closely receivedetent member 260′. In certain embodiments, at least a portion ofdetent body 261′, such aschannel 263′, for example, can be press-fit, snap-fit, and/or otherwise suitably retained inrecess 265′. As also illustrated inFIG. 26 , eachdetent leg 262′ ofdetent member 260′ can include one ormore projections 264′ extending therefrom which can be configured to engageactuator body 251′ andreleasably hold actuator 250′ in position. In at least one embodiment, referring toFIG. 36 ,actuator body 251′ can include one or more recesses, or holes, 269′ which can be configured to receive aprojection 264′. When aprojection 264′ is positioned withinrecess 269′, the projection can be configured to holdactuator 250′ in its first position, for example, until a sufficient force is applied toactuator 250′ so as to cause theprojection 264′ to be displaced out ofrecess 269′. More particularly, the force applied to actuator 250′ can be transmitted to theprojection 264′ and, owing to cooperating surfaces between theprojection 264′ andrecess 269′, thedetent leg 262′ associated with theprojection 264′ can be flexed or moved proximally to allowactuator body 251′ to be moved relative thereto. In order to accommodate such proximal movement, referring toFIG. 25 ,recess 265′ can includeelongate portions 266′ which can each be configured to receive at least a portion oflegs 262′ such thatlegs 262′ can move relative to handleportion 104′. Asactuator 250′ is moved into either its second or third position,actuator body 251′ can contact aprojection 264′ extending from anotherleg 262′ and deflect theleg 262′ proximally such that, onceactuator 250′ is in its second or third positions, theleg 262′ can spring forward, or distally, such that theprojection 264′ can be secured withinrecess 269′. In at least one embodiment, further to the above, the interaction betweenprojections 264′ and the sidewalls ofrecess 269′ can be such thatactuator 250′ can be securely held in one of its first, second, and third positions, for example, yetpermit actuator 250′ to be moved upon a sufficient application of force. In such embodiments, thedetent member 260′ can prevent, or at least inhibit,actuator 250′ and, correspondingly,adjustment member 230′ from being unintentionally displaced. - As discussed above and as shown in
FIG. 2 , eachside flange 128 offirst handle portion 102 can include a notch, or recess, 127, for example, which can be configured to receive one ormore latch projections 131, for example, extending fromanvil 130, and/or any other suitable portion ofsecond handle portion 104. As also discussed above, referring primarily toFIGS. 2 and 3 ,first handle portion 102 can further include latchingmechanism 180 rotatably mounted thereto which can be utilized to engagelatch projections 131 extending fromsecond handle portion 104 and secure the first andsecond handle portions Latching mechanism 180 can include one ormore latch arms 188 extending therefrom which can be configured to engagelatch projections 131 and pull and/orsecure projections 131 withinrecesses 127 as illustrated inFIG. 7 . Referring toFIG. 6 , at least one oflatch arms 188 can include adistal hook 189 which can be configured to wrap around at least a portion ofprojections 131 so as to encompass or surround, or at least partially encompass or surround,projections 131. In at least one embodiment, latcharms 188 can act as an over-center latch to maintainlatching mechanism 180 in its latched, or closed, position. - In various embodiments, referring now to
FIG. 38 , eachprojection 131 can comprise a slot, or groove, 190 positionedintermediate sidewall 191 and an enlarged end, or head, 192 ofprojection 131, wherein theslot 190 can be configured to receive at least a portion oflatch arm 188. More particularly, in at least one embodiment, theslot 190 can have a width which is greater than the width of thelatch arm 188 such that, when thelatch arm 188 is engaged with theprojection 131, thelatch arm 188 can enter intoslot 190. In some circumstances, the width of eachslot 190 may be slightly larger than the width of alatch arm 188 such that the latch arm is closely received within theslot 190. In various circumstances, theslot 190, thesidewall 191, and thehead 192 ofprojection 131 can be sized and configured so as to prevent, or at least limit, relative lateral movement, i.e., movement away from or to the sides ofanvil 130, betweenlatch arm 188 andprojection 131. Further to the above, however, thelatch arms 188 can slide longitudinally within thegrooves 190 as thelatch arms 188 move theprojections 131 into therecesses 127 infirst portion 102. Owing to such relative sliding movement betweenlatch arms 188 andprojections 131, frictional forces can be generated therebetween which can resist the movement oflatch arms 188. In various circumstances, the magnitude of such frictional forces can be significant when the normal, or perpendicular, contact forces between thelatch arms 188 and the sidewalls ofgroove 190 are large. In many circumstances, as a result, the operator of the surgical instrument has to overcome these frictional forces when actuatingclamping mechanism 180. - In various alternative embodiments, referring now to
FIGS. 39 and 40 , a surgical instrument can comprise one or more latch projections having a rotatable bearing which can reduce the magnitude of the friction forces between the latch arms of a latching mechanism and the latch projections. In at least one embodiment, ananvil 330, which can be substantially similar toanvil 130 in many respects, can comprise alatch projection 331 extending from each side thereof, wherein eachlatch projection 331 can comprise arotatable bearing 393. In use, thelatch arms 188 of latchingmechanism 180, for example, can contact therotatable bearings 393 in order to position thelatch projections 331 inrecesses 127. In various circumstances, thelatch arms 188 can slide across the surface, or outer diameter, ofbearings 393; however, asbearings 393 can rotate relative to thelatch arms 188, the magnitude of the frictional forces between thelatch arms 188 andprojections 331 can be lower than the magnitude of the frictional forces betweenlatch arms 188 andprojections 131. Owing to such lower frictional forces, a lower closing, or clamping, force may be required to actuateclamping mechanism 180, for example. - In various embodiments, referring primarily to
FIG. 41 , eachrotatable bearing 393 can comprise a circular, or round,outer diameter 394 and, in addition, a circular, or round,bearing aperture 395 extending therethrough. In certain embodiments, eachprojection 331 can further comprise ashaft portion 396 extending fromsidewall 391 and an enlarged end, or head, 392 extending fromshaft portion 396, wherein, as illustrated inFIG. 31 , theshaft portion 396 can extend through the bearingaperture 395 ofrotatable bearing 393. In various embodiments, theshaft portion 396 can comprise a circular, or round, outer diameter which can be closely received within bearingaperture 395 such that there is little, if any, relative radial movement therebetween. The diameter of the bearingaperture 395, however, may be sufficiently larger than the outer diameter ofshaft portion 396 such thatbearing 393 can rotate relative toshaft portion 396 about anaxis 399. In various embodiments, the rotatable bearing 393 can be retained onshaft portion 396 by theenlarged head 392. More particularly, in at least one embodiment, theenlarged head 392 may be larger than, or define a larger diameter than, the diameter of bearingaperture 395 such thatrotatable bearing 393 cannot slide off the end ofshaft portion 396. In certain embodiments, thesidewall 391 and thehead 392 can define a gap distance therebetween and, in addition, the bearing 393 can comprise a width, wherein the gap distance can be larger than the width ofbearing 393. In at least one embodiment, the gap distance may be slightly larger than the width of bearing 393 such thatbearing 393 does not tilt, or at least substantially tilt, relative toaxis 399, for example. - As discussed above, the
latch arms 188 of latchingmechanism 180 can be configured to engagebearings 393 andposition bearings 393 withinrecesses 127. In various alternative embodiments, referring primarily toFIG. 40 , a surgical instrument can comprise alatching mechanism 380 which can comprise first andsecond latch arms 388 extending therefrom on opposite sides ofanvil 331 andstaple cartridge channel 324. In use, similar to the above, thelatch arms 388 can contactbearings 393 in order to movebearings 393 intorecesses 327 instaple cartridge channel 324 and moveanvil 331 towardstaple cartridge channel 324. Such movement is illustrated with phantom lines inFIG. 41 . In various embodiments, eachlatch arm 388 can at least partially define a groove, or slot, 397 therein, wherein eachslot 397 can be configured to receive abearing 393. In at least one embodiment, aslot 397 can comprise a first drive surface, or sidewall, 398 a which can be positioned against bearing 393 and, as a closing force is applied to latchingmechanism 380, thelatch arm 388 can apply a closing force to thebearing 393. In such circumstances, the bearing 393 can move further intoslot 397 as latchingmechanism 380 is rotated into its closed position. In various circumstances, theslot 397 can further comprise a second drive surface, or sidewall, 398 b which can be positioned against another and/or opposite side of bearing 393 such that an opening force can be applied to thebearing 393 vialatch arm 388. As thelatching mechanism 380 is moved into its open position, the bearing 393 can move out ofslot 397. In any event, thefirst drive surface 398 a and thesecond drive surface 398 b can define a slot width therebetween which can be larger than the outside diameter of bearing 393 such thatbearing 393 can move withinslot 397. In some embodiments, the slot width may be slightly larger than the outside diameter ofbearing 393. In at least one embodiment, at least portions of thefirst drive surface 398 a and thesecond drive surface 398 b can be parallel, or at least substantially parallel, to one another. In at least one such embodiment, at least portions of thefirst drive surface 398 a can be positioned opposite thesecond drive surface 398 b. - As described above, a surgical stapling instrument can be configured to deform one or more surgical staples between a first, undeployed, configuration and a second, deployed, configuration. In various embodiments, referring now to
FIG. 39 , a surgical staple, such asstaple 400, for example, can comprise a base 402, a first leg, or deformable member, 404 extending frombase 402, and, in addition, a second leg, or deformable member, 406 extending frombase 402. In certain embodiments, thebase 402, thefirst leg 404, and thesecond leg 406 can be comprised of a continuous wire, wherein, in at least one embodiment, thefirst leg 404 and thesecond leg 406 can each be bent in a direction which is perpendicular to thebase 402 prior to staple 400 being inserted into and deformed by a surgical stapler. More particularly, the staple 400 can be manufactured such thatbase 402 is oriented along abaseline 401 and such that thelegs lines baseline 401. In various embodiments, thefirst leg 404 can be positioned at a first end ofbase 402 and thesecond end 406 can be positioned at a second end ofbase 402, wherein, in at least one embodiment, amid-line 403 can be defined which extends through a midpoint ofbase 402 and which extends in a direction which is perpendicular tobaseline 401. The staple 400 can be configured such that thebase 402,first leg 404, andsecond leg 406 lie, or at least substantially lie, in the same, or common, plane when thestaple 400 is in its first, or undeployed, configuration. In such embodiments, thebaseline 401, along which thebase 402 is oriented, and theperpendicular lines legs - In various embodiments, further to the above, the continuous wire comprising the
base 402, thefirst leg 404, and thesecond leg 406 can be comprised of titanium and/or stainless steel, for example. In at least one embodiment, thefirst leg 404 can comprise afirst end 405 and thesecond leg 406 can comprise asecond end 407, wherein theends staple 400. In various embodiments, the staple 400 can be deployed from a staple cartridge such that the ends 405 and 407 ofstaple legs staple 400. In such circumstances, a first compressive force F1 can be applied to thefirst leg 404 and a second compressive force F2 can be applied to thesecond leg 406 while thebase 402 is supported by at least a portion of the staple cartridge. As described in greater detail below, the anvil can comprise a staple pocket which can apply the first compressive force F1 to thefirst leg 404 such that theend 405 ofstaple leg 404 is moved toward thebase 402. Similarly, the staple pocket can apply the second compressive force F2 to the secondstaple leg 406 such that theend 407 ofstaple leg 404 is also moved towardbase 402. In addition to the above, as also discussed in greater detail below, referring now toFIGS. 50-52 , the staple pocket can bend the firststaple leg 404 to a first side ofbase 402 and the secondstaple leg 406 to a second, or opposite, side ofbase 402. - In various embodiments, referring to
FIGS. 49 and 50 , thefirst leg 404 ofstaple 400 can be bent such that theend 405 of thefirst leg 404 is moved toward thebase 402 and toward thesecond leg 406 when thefirst leg 404 is deformed by the first compressive force F1. In at least one embodiment, theend 405 can be moved from afirst side 410 ofmidline 403, as illustrated inFIG. 49 , to asecond side 412 ofmidline 403, as illustrated inFIG. 50 . Similarly, thesecond leg 406 ofstaple 400 can be bent such that theend 407 of thesecond leg 406 is moved toward thebase 402 and toward thefirst leg 404 when thesecond leg 406 is deformed by the second compressive force F2. In at least one embodiment, theend 407 can be moved from asecond side 412 ofmidline 403, as illustrated inFIG. 49 , to afirst side 410 ofmidline 403, as illustrated inFIG. 50 . In the deployed, or deformed, configuration ofstaple 400, as illustrated inFIG. 50 , theends staple legs midline 403 in such a way that they form an angle therebetween. More particularly, theend 405 of thefirst leg 404, when it is in its deformed configuration, can extend along or with respect to afirst axis 414 and, similarly, theend 407 of thesecond leg 406, when it is in its deformed configuration, can extend along or with respect to asecond axis 416 such that thefirst axis 414 and thesecond axis 416 define anangle 417 therebetween. In some embodiments, theangle 417 may be approximately 90 degrees, for example. In certain embodiments, theangle 417 may be in a range between approximately 0.1 degrees and approximately 89 degrees, for example. In various embodiments, theangle 417 may be greater than 90 degrees, while, in at least one embodiment, theangle 417 may be greater than approximately 90 degrees but less than 180 degrees, for example. - In various embodiments, further to the above, the
first axis 414 and thesecond axis 416 can, in various embodiments, be oriented, or crossed, at a transverse angle with respect to each other, i.e., at least when thestaple 400 is viewed from the side or elevational view ofFIG. 50 . More particularly, upon reviewingFIG. 52 , it becomes evident that, althoughaxes FIG. 50 ), theaxes FIG. 52 ), for example, theaxes first axis 414 and thesecond axis 416 are not perpendicular withbaseline 401. Stated another way, theend 405 of firststaple leg 404 and theend 407 of secondstaple leg 406 are not pointing directly downwardly towardbase 402 andbaseline 401. In at least one such embodiment, thefirst axis 414 and thesecond axis 416 can each extend at an acute angle with respect tobaseline 401, for example. - As described above, a surgical instrument can be configured to deform the
staple 400 ofFIG. 49 , for example, between an undeformed shape (FIG. 49 ) and a deformed shape (FIG. 50 ). In various embodiments, as also described above, the surgical instrument can comprise an anvil having a staple pocket configured to receive and deform at least a portion of the staple. In certain embodiments, referring now toFIG. 42 , an anvil can comprise a tissue-contactingsurface 501 and a plurality ofstaple pockets 500 formed therein, wherein eachstaple pocket 500 can be configured to deform astaple 400. In various embodiments, eachstaple pocket 500 can comprise a longitudinal axis 599 (FIG. 43 ) and, in addition, a first formingcup 502 and a second formingcup 504 positioned relative to thelongitudinal axis 599. In use, the first formingcup 502 can be configured to receive the firststaple leg 404 ofstaple 400 and the second formingcup 504 can be configured to receive the secondstaple leg 406. More particularly, in at least one embodiment, thestaple pocket 500 can be positioned relative to the staple 400 such that, as thestaple 400 is ejected from a staple cartridge, for example, theend 405 offirst leg 404 can enter the first formingcup 502 and theend 407 ofsecond leg 406 can enter the second formingcup 504. Further to the above, theend 405 of firststaple leg 404 can contact thebase 506 of first formingcup 502 such that the first compressive force F1 can be applied to thefirst leg 404 and, similarly, theend 407 of secondstaple leg 406 can contact thebase 508 of second formingcup 504 such that the second compressive force F2 can be applied to thesecond leg 406. - In various embodiments, further to the above, the first forming
cup 502 can comprise aninside portion 510 and anoutside portion 512, wherein, when theend 405 of firststaple leg 404 enters into the first formingcup 502, theend 405 can enter into theoutside portion 512. Upon entering into theoutside portion 512 of formingcup 502, theend 405 can contactbase 506 and, owing to a concave curve ofbase 506, theend 405 can be directed inwardly toward theinside portion 510. More particularly, referring now toFIGS. 46-48 , the base 506 can be curved toward tissue-contactingsurface 501 such that, as thestaple leg 404 contacts thebase 506, theend 405 can be directed downwardly, i.e., away from tissue-contactingsurface 501, and inwardly along the curved concave surface toward aninflection point 595. In various embodiments, theinflection point 595 can represent the point in which the concave surface ofbase 506 will begin to deflect theend 405 offirst leg 404 upwardly toward the tissue-contactingsurface 501. In various embodiments, the radius of curvature, r, of the concave surface can be constant, or at least substantially constant, in the longitudinal direction along the length thereof as illustrated inFIGS. 47 and 48 . In certain embodiments, the radius of curvature r of the concave surface ofbase 506 can be consistent across the width ofbase 506 between a firstinterior sidewall 516 and a firstexterior sidewall 517. In any event, as theend 405 offirst leg 404 is advanced into theinside portion 510 of formingcup 502, theend 405 can come into contact with aradius transition 514 positioned intermediate thebase 506 and the firstinterior sidewall 516. In such embodiments, theradius transition 514 can be configured to direct theend 405 against the firstinterior sidewall 516. - As illustrated in
FIG. 43 , further to the above, the firstinterior sidewall 516 can be oriented at an angle with respect to staple pocketlongitudinal axis 599. In certain embodiments, the firstinterior sidewall 516 can be oriented at an acute angle, such as 10 degrees, for example, with respect tolongitudinal axis 599. In various embodiments, the firstinterior sidewall 516 and thelongitudinal axis 599 may be neither perpendicular nor parallel to one another. In any event, the firstinterior sidewall 516 can extend through theaxis 599 such that a first portion of the firstinterior sidewall 516 is positioned on afirst side 515 ofaxis 599 and a second portion of the firstinterior sidewall 516 is positioned on asecond side 517 ofaxis 599. In various embodiments, as a result, the firstinterior sidewall 516 can extend between the firstoutside portion 512 and the firstinside portion 510. When theend 405 offirst leg 404 contacts the firstinterior sidewall 516, as described above, theend 405 can be directed along the firstinterior sidewall 516 and away fromlongitudinal axis 599 such that thestaple leg 404 is bent away from the common plane ofstaple 400 toward thefirst side 515 ofaxis 599. As theend 405 offirst leg 404 is directed along, or bent by, the firstinterior sidewall 516, as described above, thestaple leg 404 can also be directed, or bent, bybase 506. Stated another way, thefirst sidewall 516 and thefirst base 506 can co-operate to deform the firststaple leg 404 such thatend 405 is re-directed toward thebase 402 and, at the same time, to a first side of the base 402 as described above. At some point during the insertion of firststaple leg 404 into first formingcup 502, theend 405 of firststaple leg 404 can emerge from the firstinside portion 510 of first formingcup 502 and, as thestaple leg 404 is further deformed by thestaple pocket 500, theend 405 can be directed along the first axis 414 (FIG. 50 ) as described above. - In various embodiments, further to the above, the first
interior sidewall 516 can extend along an interior side of thefirst base 506, wherein, in at least one embodiment, the first formingcup 502 can further comprise a firstexterior sidewall 517 extending along an opposite side of thefirst base 506. In certain embodiments, similar to the above, the first formingcup 502 can further comprise atransition radius 519 positioned intermediate thebase 506 and theexterior sidewall 517. In at least one embodiment, referring now toFIG. 43 , theexterior sidewall 517 can extend in a direction which is parallel, or at least substantially parallel, to the staple pocketlongitudinal axis 599. As also illustrated inFIG. 43 , the firstinterior sidewall 516 and the firstexterior sidewall 517 can extend in directions which are transverse to one another. In at least one embodiment, theinterior sidewall 516 can extend at an acute angle, such as approximately 15 degrees, for example, with respect to theexterior sidewall 517. In various embodiments, as a result, theoutside portion 512 of first formingcup 502 can be wider than theinside portion 510. In at least one such embodiment, the width of theoutside portion 512 and theinside portion 510 can taper between a first width and a second width. - In various embodiments, referring once again to
FIG. 43 , theoutside portion 512 of first formingcup 502 can comprise a firstoutside wall 513 which can extend in a direction which is perpendicular to the firstexterior wall 517 and/or thelongitudinal axis 599 and can define the outermost portion of formingcup 502. In at least one embodiment, further to the above, the width of the firstoutside wall 513 can be such that theoutside portion 512 can capture theend 405 offirst leg 404 and guide it into theinside portion 510 ofcup 502 as described above. In at least one such embodiment, the firstoutside wall 513 can be at least as twice as wide as the diameter of thefirst leg 404. In certain embodiments, the first formingcup 502 can further comprise a channelingsurface 528 surrounding the firstinner portion 510 and the firstouter portion 512 which can be configured to guide thestaple leg 404 into and/or out of the formingcup 502. In various embodiments, theinside portion 510 can further comprise aninside wall 511 which can define the innermost portion of formingcup 502. Similar to the above, theinside wall 511 can also define the narrowest portion of formingcup 502. In at least one embodiment, the width of theinside wall 511 may be the same, or at least substantially the same, as the diameter offirst leg 404 such that theinside wall 511 can control the location in which theend 405 emerges fromstaple forming cup 502. - In various embodiments, further to the above, the second forming
cup 504 can comprise aninside portion 520 and anoutside portion 522, wherein, when theend 407 of secondstaple leg 406 enters into the second formingcup 504, theend 407 can enter into theoutside portion 522. Upon entering into theoutside portion 522 of formingcup 504, theend 407 can contactbase 508 and, owing to a concave curve ofbase 508, theend 407 can be directed inwardly toward theinside portion 520. More particularly, similar to the above, the base 508 can be curved toward tissue-contactingsurface 501 such that, as thestaple leg 406 contacts thebase 508, theend 407 can be directed downwardly, i.e., away from tissue-contactingsurface 501, and inwardly along the curved concave surface toward aninflection point 596. In various embodiments, theinflection point 596 can represent the point in which the concave surface ofbase 508 will begin to deflect theend 407 ofsecond leg 406 upwardly toward the tissue-contactingsurface 501. In various embodiments, the radius of curvature, r, of the concave surface can be constant, or at least substantially constant, in the longitudinal direction along the length thereof, similar to thebase 506 of first formingcup 502 illustrated inFIGS. 47 and 48 . In any event, as theend 407 ofsecond leg 406 is advanced into theinside portion 520 of formingcup 504, theend 407 can come into contact with aradius transition 524 positioned intermediate thebase 508 and a secondinterior sidewall 526. In such embodiments, theradius transition 524 can be configured to direct theend 407 against the secondinterior sidewall 526. - As illustrated in
FIG. 43 , further to the above, the secondinterior sidewall 526 can be oriented at an angle with respect to staple pocketlongitudinal axis 599. In certain embodiments, the secondinterior sidewall 526 can be oriented at an acute angle, such as 10 degrees, for example, with respect tolongitudinal axis 599. In various embodiments, the secondinterior sidewall 526 and thelongitudinal axis 599 may be neither perpendicular nor parallel to one another. In any event, the secondinterior sidewall 526 can extend through theaxis 599 such that a first portion of the secondinterior sidewall 526 is positioned on afirst side 515 ofaxis 599 and a second portion of the secondinterior sidewall 526 is positioned on asecond side 517 ofaxis 599. In various embodiments, as a result, the secondinterior sidewall 526 can extend between the secondoutside portion 522 and the secondinside portion 520. When theend 407 ofsecond leg 406 contacts theinterior sidewall 526, as described above, theend 407 can be directed along theinterior sidewall 526 such that thestaple leg 406 is bent away from the common plane ofstaple 400 toward thesecond side 517 ofaxis 599. As theend 407 ofsecond leg 406 is directed along, and bent by, theinterior sidewall 526, as described above, thestaple leg 406 can also be directed, and bent, bybase 508. Stated another way, the secondinterior sidewall 526 and thesecond base 508 can co-operate to deform the secondstaple leg 406 such thatend 407 is re-directed toward thebase 402 and, at the same time, toward a second, or opposite, side of the base 402 as described above. At some point during the insertion of secondstaple leg 406 into second formingcup 504, theend 407 of secondstaple leg 406 can emerge from the secondinside portion 520 of second formingcup 504 and, as thestaple leg 406 is further deformed by thestaple pocket 500, theend 407 can be directed along the second axis 416 (FIG. 50 ) as described above. - In various embodiments, further to the above, the second
interior sidewall 526 can extend along an interior side of thesecond base 508, wherein, in at least one embodiment, the second formingcup 504 can further comprise a secondexterior sidewall 527 extending along an opposite side of thesecond base 508. In certain embodiments, similar to the above, the second formingcup 504 can further comprise atransition radius 529 positioned intermediate thebase 508 and theexterior sidewall 527. In at least one embodiment, referring now toFIG. 43 , theexterior sidewall 527 can extend in a direction which is parallel, or at least substantially parallel, to the staple pocketlongitudinal axis 599. As also illustrated inFIG. 43 , the secondinterior sidewall 526 and the secondexterior sidewall 527 can extend in directions which are transverse to one another. In at least one embodiment, theinterior sidewall 526 can extend at an acute angle, such as approximately 15 degrees, for example, with respect to theexterior sidewall 527. In various embodiments, as a result, theoutside portion 522 of second formingcup 504 can be wider than theinside portion 520. In at least one such embodiment, the width of theoutside portion 522 and theinside portion 520 can taper between a first width and a second width. - In various embodiments, referring once again to
FIG. 43 , theoutside portion 522 of second formingcup 504 can comprise a secondoutside wall 523 which can extend in a direction which is perpendicular to the secondexterior wall 527 and/or thelongitudinal axis 599 and can define the outermost portion of formingcup 504. In at least one embodiment, further to the above, the width of the secondoutside wall 523 can be such that theoutside portion 522 can capture theend 407 ofsecond leg 406 and guide it into theinside portion 520 ofcup 504 as described above. In at least one such embodiment, the secondoutside wall 523 can be at least as twice as wide as the diameter of thesecond leg 406. In certain embodiments, the second formingcup 504 can further comprise a channelingsurface 529 surrounding the secondinner portion 520 and the secondouter portion 522 which can be configured to guide thestaple leg 406 into and/or out of the formingcup 504. In various embodiments, theinside portion 520 can further comprise aninside wall 521 which can define the innermost portion of formingcup 504. Similar to the above, theinside wall 521 can also define the narrowest portion of formingcup 504. In at least one embodiment, the width of theinside wall 521 may be the same, or at least substantially the same, as the diameter ofsecond leg 406 such that theinside wall 521 can control the location in which theend 407 emerges fromstaple forming cup 504. - As discussed above, referring again to
FIGS. 43-45 , the first formingcup 502 can comprise a firstinterior sidewall 516 and the second formingcup 504 can comprise a secondinterior sidewall 526. As illustrated inFIG. 43 , the firstinside portion 510 of formingcup 502 can be positioned in close proximity to, or close relation to, the second insideportion 520 of formingcup 504 such that the firstinterior sidewall 516 can be positioned adjacent to the secondinterior sidewall 526. In at least one embodiment, the firstinterior portion 510, or at least a substantial portion thereof, can be offset from the staple pocketlongitudinal axis 599 in thefirst direction 515 while the secondinterior portion 520, or at least a substantial portion thereof, can be offset from thelongitudinal axis 599 in thesecond direction 517. In various embodiments, thestaple pocket 500 can comprise awall 530 positioned intermediate the firstinside portion 510 and the secondinside portion 520, wherein a first side ofwall 530 can comprise the firstinterior sidewall 516 and wherein a second side ofwall 530 can comprise the secondinterior sidewall 526. In at least one such embodiment, the firstinterior sidewall 516 can be parallel, or at least substantially parallel to, the secondinterior sidewall 526. More particularly, in at least one embodiment, the firstinterior sidewall 516 can define a first plane and the secondinterior sidewall 526 can define a second plane, wherein the first plane and the second plane can be parallel, or at least substantially parallel, to one another. In various embodiments, referring again toFIGS. 44 and 45 , the firstinterior sidewall 516 can be perpendicular, or at least substantially perpendicular, to the tissue-contactingsurface 501 and, similarly, the secondinterior sidewall 526 can be perpendicular, or at least substantially perpendicular, to the tissue-contactingsurface 501. - In various embodiments, further to the above, the first
interior sidewall 516 can comprise a first vertical portion 516 a which is perpendicular, or at least substantially perpendicular, to the tissue-contactingsurface 501. In at least one embodiment, the first vertical portion 516 a can extend through, or transect, thelongitudinal axis 599. In various embodiments, the first vertical portion 516 a can extend along the entirety of, or only a portion of, the firstinterior sidewall 516. Similarly, the secondinterior sidewall 526 can comprise a secondvertical portion 526 a which is perpendicular, or at least substantially perpendicular, to the tissue-contactingsurface 501. In at least one embodiment, such a secondvertical portion 526 a can extend through, or transect, thelongitudinal axis 599. In various embodiments, the secondvertical portion 526 a can extend along the entirety of, or only a portion of, the secondinterior sidewall 526. During the deployment ofstaple 400, further to the above, theend 405 offirst leg 404 can be in contact with the first vertical portion 516 a of firstinterior sidewall 516 at the same time theend 407 ofsecond leg 406 is in contact with the secondvertical portion 526 a of secondinterior sidewall 526. In such circumstances, the first vertical portion 516 a and the secondvertical portion 526 a can comprise a vertical trap. More particularly, thevertical portions 516 a and 526 a can co-operate to control, deflect, and bend thestaple legs legs interior sidewalls cups FIG. 52 , the first vertical portion 516 a can be configured to deflect and bend thestaple leg 404 to a first side ofbase 402 and the secondvertical portion 526 a can be configured to deflect and bend thestaple leg 406 to a second, or opposite, side ofbase 402. - In various embodiments, further to the above, the vertical trap comprising
vertical portions 516 a and 526 a can extend along the entire length of the first and secondinterior sidewalls sidewalls vertical surface 526 a can be approximately 0.05 inches, for example, along the lengths ofinterior surfaces base 506, for example. In various embodiments, the length of the vertical trap can be approximately equal to the radius of curvature (r) ofbase 506, for example. In at least one embodiment, the length of the vertical trap can be between approximately 0.5*r and approximately 2*r, for example. In various embodiments, further to the above, the vertical trap can extend through thelongitudinal axis 599 ofstaple pocket 500 such that, in at least one embodiment, at least a portion of the vertical trap can be positioned on a first side and/or a second side ofaxis 599. In certain embodiments, the vertical trap can extend through the central portions of the first and second formingcups - In various embodiments, the first
interior sidewall 516 can further comprise a first angled portion which, in at least one embodiment, can be oriented at an acute angle with respect to the tissue-contactingsurface 501. In at least one such embodiment, the first angled portion can be positioned outwardly with respect to the first vertical portion 516 a. In certain embodiments, the firstinterior sidewall 516 can comprise an angled portion positioned toward theoutside portion 512 which can become progressively more perpendicular toward theinside portion 510 of the first formingcup 502 until the angled portion transitions into the first vertical portion 516 a. In various embodiments, the secondinterior sidewall 526 can further comprise a second angled portion which, in at least one embodiment, can be oriented at an acute angle with respect to the tissue-contactingsurface 501. In at least one such embodiment, the second angled portion can be positioned outwardly with respect to the secondvertical portion 526 a. In certain embodiments, the secondinterior sidewall 526 can comprise an angled portion positioned toward theoutside portion 522 which can become progressively more perpendicular toward theinside portion 520 of the second formingcup 504 until the angled portion transitions into the secondvertical portion 526 a. - In various embodiments, referring now to
FIG. 52A , thestaple pocket 500 can be configured to deform the firststaple leg 404 such that thefirst end 405 is deflected a first distance X1 frombaseline 401. Similarly, the secondstaple leg 406 can be deformed such that thesecond end 407 is deflected a second distance X2 frombaseline 401. In certain embodiments, the distance X1 and the distance X2 can be the same, or at least substantially the same. In various other embodiments, the distances X1 and X2 can be different. In at least one such embodiment, thefirst leg 404 can be deformed such that thefirst end 405 is positioned closer tobase 402 than thesecond end 407, for example. In such embodiments, thefirst axis 414 of deformedstaple leg 404 and thesecond axis 416 of deformedstaple leg 406 may be non-parallel. More particularly, in at least one embodiment, thefirst axis 414 can extend at a first angle with respect tobaseline 401 and thesecond axis 416 can extend at a second angle with respect tobaseline 401 wherein the second angle is different than the first angle. In various embodiments, thefirst leg 404 and thesecond leg 406 can extend acrossmidline 403 at different angles. In certain other embodiments, thefirst leg 404 and thesecond leg 406 can be extend at different angles with respect tobaseline 401 although one or both of thelegs midline 403. - In various embodiments, further to the above, a surgical stapler can comprise a staple pocket which can be configured to deform one staple leg of
staple 400 such that it lies within, or substantially within, a common plane withbase 402 and, in addition, deform the other staple leg ofstaple 400 to a side ofbase 402 as described above. In at least one embodiment, thefirst leg 404 can be deformed such that it extends throughmidline 403 in a direction which is co-planar, or at least substantially co-planar, withbase 402 and, in addition, thesecond leg 406 can be deformed such that it extends throughmidline 403 in a direction which is transverse to the plane. Stated another way, in at least one embodiment,axis 414 andbaseline 401 ofstaple 400 can be coplanar, or at least nearly co-planar, with one another whilesecond axis 416 can extend in a direction which extends through such a plane. In certain embodiments, at least one of thefirst leg 404 and thesecond leg 406 may not extend through themidline 403. - In various embodiments, further to the above, the
staple pocket 500 can be configured to deform thestaple legs staple 400 simultaneously, or at least substantially simultaneously. In at least one embodiment, thebase 506 of first formingcup 502 can contact end 405 of firststaple leg 404 at the same time, or at least substantially the same time, that thebase 508 of second formingcup 504 contacts end 407 of secondstaple leg 406. In certain other embodiments, a staple pocket can be configured to deform thestaple legs staple leg 404 before a second forming cup is brought into contact with the secondstaple leg 406, for example. In various alternative embodiments, although not illustrated, a surgical staple can comprise more than two staple legs, such as three staple legs or four staple legs, for example, and a staple pocket can comprise a corresponding quantity of staple forming cups for deforming the staple legs. - In various embodiments, further to the above, the wire comprising the
surgical staple 400 can comprise a circular, or at least substantially circular, cross-section. In various other embodiments, referring now toFIGS. 53-56 , a surgical staple, such asstaple 600, for example, can comprise a non-circular cross-section. In at least one embodiment, the staple 600 can comprise a base 602, afirst leg 604, and asecond leg 606, wherein thebase 602 andlegs FIG. 56 , the rectangular cross-section can comprise a base (b) and a height (h), wherein the base (b) can be defined relative to a central lateral axis (x), and wherein the height (h) can be defined relative to a central longitudinal axis (y). In various circumstances, the rectangular cross-section can be defined as having two moments of inertia, i.e., a first moment of inertia (Ix) defined with respect to axis (x) and a second moment of inertia (Iy) defined with respect to axis (y). In at least one circumstance, the first moment of inertia (Ix) can be calculated as (b*ĥ3)/12 while the second moment of inertia (Iy) can be calculated as (h*b̂3)/12. Althoughstaple 600 comprises a rectangular, or at least substantially rectangular cross-section, any other suitable non-circular cross-section can be utilized, such as oblate, elliptical, and/or trapezoidal cross-sections, for example. - As illustrated in
FIG. 56 , the base (b) ofsurgical staple 600 is larger than the height (h) and, in view of the above, the moment of inertia (Iy) of the rectangular cross-section is larger than the moment of inertia (Ix). In various embodiments, as a result, the moment of inertia ratio, i.e., Iy/Ix, of the rectangular cross-section can be greater than 1.0. In certain embodiments, the moment of inertia ratio can be between approximately 2.0 and approximately 2.7, for example. In certain other embodiments, the moment of inertia ratio can be between approximately 1.1 and approximately 3.0, for example. As a result of the above, theleg 604 is more likely to bend about axis (x) than about axis (y) when a force, such as compressive load F1, for example, is applied to theleg 604. In any event, absent all other considerations, theleg 604, in such embodiments, is more likely to bend within a common plane defined by the staple 600 when it is in its undeformed state than bend to a side ofstaple base 602. In various embodiments, however, a surgical stapler comprising an anvil and staple pocket in accordance with the embodiments described herein, such asstaple pocket 500, for example, can be utilized to cause thelegs staple 600 to bend out of their common plane when they are deformed. In such embodiments, this lateral deflection can occur despite the fact that the moment of inertia Iy, which resists such twisting, is greater than the moment of inertia Ix. As illustrated inFIG. 55 , thefirst leg 604 ofstaple 600 can be deformed such that it is bent relative to both axis (x) and axis (y) of its cross-section and, as a result, the firststaple leg 604 can be twisted or deformed such that theend 605 of firststaple leg 604 is positioned on a first side ofbase 602. Similarly, thesecond leg 606 can be deformed such that it is bent relative to both axis (x) and axis (y) of its cross-section and, as a result, the secondstaple leg 606 can be twisted or deformed such that theend 607 of secondstaple leg 606 is positioned on a second side ofbase 602. - In various embodiments, referring now to
FIG. 57 , a surgical staple, such assurgical staple 700, for example, can comprise abase 702 and, in addition, afirst leg 704 and asecond leg 706 extending frombase 702. In certain embodiments, similar to the above, thebase 702, thefirst leg 704, and thesecond leg 706 can lie, or at least substantially lie, in a common plane when thestaple 700 is an undeformed, or undeployed, configuration, i.e., a configuration prior to being deformed by an anvil of a surgical stapler, for example. In the deformed or deployed configuration ofstaple 700, as illustrated inFIG. 57 , thefirst leg 704 can be deformed such thatend 705 points towardbase 702 andsecond leg 706. More particularly, in at least one embodiment, theend 705 can lie along, or with respect to, afirst axis 714 which is oriented at angle with respect tomidline 703. Similarly, thesecond leg 706 can be deformed such thatend 707 points towardbase 702 andfirst leg 704. More particularly, in at least one embodiment, theend 707 can lie along, or with respect to, asecond axis 716 which is oriented at angle with respect tomidline 703. In various embodiments, theends legs mid-line 703. In certain embodiments, similar to the above, theend 705 offirst leg 704 may be deformed such that it extends to a first side ofbase 702 and theend 707 ofsecond leg 706 may be deformed such that it extends to a second, or opposite, side ofbase 702 such thatlegs base 702 in their deformed configuration, for example. - In various embodiments, a surgical staple, such as staple 800 (
FIG. 58 ), for example, can comprise a base 802, afirst leg 804, and asecond leg 806, wherein the staple 800 can comprise a substantially U-shaped configuration in its undeformed, or undeployed, configuration. In at least one such embodiment,legs base 802. In various circumstances, the staple 800 can be deformed into a B-shaped configuration as illustrated inFIG. 58 . In at least one such embodiment, thefirst leg 804 can be bent downwardly towardbase 802 such thataxis 814 extending throughend 805 is perpendicular, or at least substantially perpendicular, tobaseline 801. Similarly, thesecond leg 806 can be bent downwardly towardbase 802 such thataxis 816 extending throughend 807 is perpendicular, or at least substantially perpendicular, tobaseline 801. In at least one such circumstance, thelegs axes FIG. 58 , thestaple legs centerline 803. Thestaple legs base 802. - Various examples described below are envisioned which incorporate one or more aspects of the various embodiments described above. Such examples are exemplary and various aspects of various embodiments described in this application can be combined in a single embodiment. In each of the examples described below, the surgical staple can comprise a base defining a baseline, a first leg and a second leg which extend from the base, and a midline midway between the first leg and the second leg.
- A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Crosses the midline (FIG. 50) Extends in-plane, or substantially in- Extends out of plane with the plane, with the base (FIG. 58) base (FIG. 52) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Crosses the midline (FIG. 50) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the first leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to a first side base (FIG. 52) to a second side of the base, the distance X1 of the base, the distance X1 being different than X2 (FIG. 52A) being different than X2 (FIG. 52A) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the second leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Does not cross the midline Does not cross the midline (FIG. 57) (FIG. 57) Extends in-plane, or substantially in- Extends out of plane with the plane, with the base (FIG. 58) base (FIG. 52) The end extends in a perpendicular The end extends in a non- direction with the baseline (FIG. 58) perpendicular direction with the baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to a first side base (FIG. 52) to a second side of the base, the distance X1 of the base, the distance X1 being different than X2 (FIG. 52A) being different than X2 (FIG. 52A) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends out of plane with the Extends out of plane with the base (FIG. 52) to the same side base (FIG. 52) to the same side of the base as the second leg, of the base as the second leg, the distance X1 being different the distance X1 being different than X2 (FIG. 52A) than X2 (FIG. 52A) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends out of plane with the Extends in-plane, or substantially in- base (FIG. 52) plane, with the base (FIG. 58) The end extends in a non- The end extends in a perpendicular perpendicular direction with the direction to the baseline (FIG. 58) baseline (FIG. 50) - A surgical staple can be deformed such that:
-
First Leg Second Leg Crosses the midline (FIG. 50) Does not cross the midline (FIG. 57) Extends in-plane, or substantially Extends out of plane with the in-plane, with the base (FIG. 58) base (FIG. 52) The end extends in a non- The end extends in a non- perpendicular direction with the perpendicular direction with the baseline (FIG. 50) baseline (FIG. 50) - Several of the deformed staples described above comprise one or more staple legs which cross the mid-line of the staple base. In various embodiments, as a result, the deformed staple legs may at least partially overlap with one another. More particularly, the deformed staple legs, when viewed from the side, may co-operate to traverse the staple base from one end to the other leaving no gap therebetween. Such embodiments can be particularly useful, especially when used to staple vascular tissue. More specifically, the overlapping staple legs can compress blood vessels within the tissue regardless of where the blood vessels extend through the staple. Staples having gaps between the legs, or legs which do not extend along the entire length of the staple base when deformed, may not be able to properly compress every blood vessel in the tissue and, as a result, one or more blood vessels may leak.
- In various embodiments, further to the above, a surgical instrument can be configured to deploy a plurality of
staples 400 in the manner described above and illustrated inFIGS. 50-52 . In at least one such embodiment, the surgical stapler can deploy thestaples 400 in a sequential manner along a staple path and/or in a simultaneous manner, for example. In certain embodiments, a surgical instrument can be configured to deploy a plurality ofstaples 600 in the manner described above and illustrated inFIG. 55 . In at least one such embodiment, similar to the above, the surgical stapler can deploy thestaples 600 in a sequential manner along a staple path and/or in a simultaneous manner, for example. In various embodiments, further to the above, a surgical instrument can be configured to deploy a plurality ofstaples 700 in the manner described above and illustrated inFIG. 57 . In at least one such embodiment, the surgical stapler can deploy thestaples 700 in a sequential manner along a staple path and/or in a simultaneous manner, for example. - In various embodiments, further to the above, a surgical staple can be comprised of titanium, such as titanium wire, for example. In certain embodiments, a surgical staple can be comprised of an alloy comprising titanium, aluminum, and/or vanadium, for example. In at least one embodiment, the surgical staple can be comprised of surgical stainless steel and/or an alloy comprised of cobalt and chromium, for example. In any event, the surgical staple can be comprised of metal, such as titanium, and a metal oxide outer surface, such as titanium oxide, for example. In various embodiments, the metal oxide outer surface can be coated with a material. In certain embodiments, the coating material can be comprised of polytetrafluoroethylene (PTFE), such as Teflon®, and/or a tetrafluoroehtylene (TFE) such as ethylene-tetrafluoroehtylene (ETFE), perfluroralkoxyethylene-tetrafluoroehtylene (PFA), and/or Fluorinated Ethylene Propylene (FEP), for example. Certain coatings can comprise silicon. In various embodiments, such coating materials can prevent, or at least inhibit, further oxidation of the metal. In certain embodiments, the coating materials can provide one or more lubricious surfaces against which the anvil, or staple pockets, can contact the staples in order to reduce the friction force therebetween. In various circumstances, lower friction forces between the staples and the staple pockets can reduce the force required to deform the staples.
- The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
- Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
- While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.
Claims (22)
1. A method of forming a surgical staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed by an anvil, said method comprising
supporting the base of the staple;
positioning a staple pocket of the anvil in opposition to the staple, wherein the staple pocket comprises a longitudinal axis;
positioning the first staple leg within a first cup of the staple pocket, wherein the first cup comprises a first inner surface at least partially positioned on a first side of the longitudinal axis;
positioning the second staple leg within a second cup of the staple pocket, wherein the second cup comprises a second inner surface at least partially positioned on a second side of the longitudinal axis;
applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and toward the second staple leg;
applying a second compressive force to an end of the second staple leg to bend the second staple leg toward the base and toward the first staple leg;
contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward the first side of the longitudinal axis and toward a first side of the common plane; and
contacting the second inner surface with the end of the second staple leg to bend the end of the second staple leg toward the second side of the longitudinal axis and toward a second side of the common plane;
deforming the first staple leg such that the end of the first staple leg crosses a mid-plane of the staple, wherein the mid-plane of the staple is defined between the first staple leg and the second staple leg; and
deforming the second staple leg such that the end of the second staple leg crosses the mid-plane of the staple.
2. The method of claim 1 , wherein the end of the first staple leg is deformed in a first direction, wherein the end of the second staple leg is deformed in a second direction, and wherein the first direction is transverse to the second direction.
3. The method of claim 2 , wherein an angle is defined between the first direction and the second direction, and wherein the angle is approximately 90 degrees.
4. The method of claim 2 , wherein an angle is defined between the first direction and the second direction, and wherein the angle is between approximately 0.1 degrees and approximately 90 degrees.
5. The method of claim 1 , wherein the first inner surface defines a first plane oriented at an angle with respect to the longitudinal axis, and wherein the second inner surface defines a second plane oriented at an angle with respect to the longitudinal axis.
6. The method of claim 5 , wherein the first plane and the second plane are parallel to one another.
7. The method of claim 5 , wherein the first cup and the second cup are separated by a sidewall, wherein a first side of the sidewall comprises the first inner surface, and wherein a second side of the sidewall comprises the second inner surface.
8. The method of claim 5 , wherein said positioning step further comprises placing a tissue-contacting surface of the anvil against tissue positioned intermediate the staple and the staple pocket, wherein at least a portion of the first inner surface is perpendicular to the tissue-contacting surface, and wherein at least a portion of the second inner surface is perpendicular to the tissue-contacting surface.
9. A surgical instrument capable of performing the method of claim 1 .
10. A surgical staple produced by the method of claim 1 .
11. A method of forming a surgical staple comprising a base, a first staple leg, and a second staple leg, said method comprising
supporting the base of the staple;
positioning a staple pocket of an anvil in opposition to the staple, wherein the staple pocket comprises a longitudinal axis;
positioning the first staple leg within a first cup of the staple pocket, wherein the first cup comprises a first inner surface;
positioning the second staple leg within a second cup of the staple pocket, wherein the second cup comprises a second inner surface;
applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and toward the second staple leg;
applying a second compressive force to an end of the second staple leg to bend the second staple leg toward the base and toward the first staple leg;
contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward a first side of the base; and
contacting the second inner surface with the end of the second staple leg to bend the end of the second staple leg toward a second side of the base, wherein the second side is opposite the first side;
deforming the first staple leg such that the end of the first staple leg crosses a mid-line of the staple, wherein the mid-line of the staple is defined between the first staple leg and the second staple leg; and
deforming the second staple leg such that the end of the second staple leg crosses the mid-line of the staple.
12. The method of claim 11 , wherein the end of the first staple leg is deformed in a first direction, wherein the end of the second staple leg is deformed in a second direction, and wherein the first direction is transverse to the second direction.
13. The method of claim 12 , wherein an angle is defined between the first direction and the second direction, and wherein the angle is approximately 90 degrees.
14. The method of claim 12 , wherein an angle is defined between the first direction and the second direction, and wherein the angle is between approximately 0.1 degrees and approximately 90 degrees.
15. The method of claim 11 , wherein the first inner surface defines a first plane oriented at an angle with respect to the longitudinal axis, and wherein the second inner surface defines a second plane oriented at an angle with respect to the longitudinal axis.
16. The method of claim 15 , wherein the first plane and the second plane are parallel to one another.
17. The method of claim 15 , wherein the first cup and the second cup are separated by a sidewall, wherein a first side of the sidewall comprises the first inner surface, and wherein a second side of the sidewall comprises the second inner surface.
18. The method of claim 15 , wherein said positioning step further comprises placing a tissue-contacting surface of the anvil against tissue positioned intermediate the staple and the staple pocket, wherein at least a portion of the first inner surface is perpendicular to the tissue-contacting surface, and wherein at least a portion of the second inner surface is perpendicular to the tissue-contacting surface.
19. A surgical instrument capable of performing the method of claim 11 .
20. A surgical staple produced by the method of claim 11 .
21. The surgical staple of claim 20 , wherein said staple is at least partially coated by at least one of polytetrafluoroethylene and silicon.
22. A method of forming a surgical staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed by an anvil, said method comprising
supporting the base of the staple;
positioning a staple pocket of the anvil in opposition to the staple, wherein the staple pocket comprises a longitudinal axis;
positioning the first staple leg within a first cup of the staple pocket, wherein the first cup comprises a first inner surface at least partially positioned on a first side of the longitudinal axis;
positioning the second staple leg within a second cup of the staple pocket, wherein the second cup comprises a second inner surface at least partially positioned on a second side of the longitudinal axis;
applying a first compressive force to an end of the first staple leg to bend the first staple leg toward the base and toward the second staple leg;
applying a second compressive force to an end of the second staple leg to bend the second staple leg toward the base and toward the first staple leg;
contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward the first side of the longitudinal axis and toward a first side of the common plane; and
contacting the second inner surface with the end of the second staple leg to bend the end of the second staple leg toward the second side of the longitudinal axis and toward a second side of the common plane;
deforming the first staple leg such that the end of the first staple leg is positioned along a first axis, wherein said first axis transects a mid-plane of the staple at an angle, and wherein the mid-plane of the staple is defined between the first staple leg and the second staple leg; and deforming the second staple leg such that the end of the second staple leg is positioned along a second axis, wherein said second axis transects a mid-plane of the staple at an angle.
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US12/622,130 US20110087276A1 (en) | 2009-10-09 | 2009-11-19 | Method for forming a staple |
PCT/US2010/051301 WO2011044032A2 (en) | 2009-10-09 | 2010-10-04 | Method for forming a staple |
US13/776,803 US10130359B2 (en) | 2006-09-29 | 2013-02-26 | Method for forming a staple |
US14/963,546 US10695053B2 (en) | 2006-09-29 | 2015-12-09 | Surgical end effectors with staple cartridges |
US15/692,986 US11678876B2 (en) | 2006-09-29 | 2017-08-31 | Powered surgical instrument |
US16/019,863 US11633182B2 (en) | 2006-09-29 | 2018-06-27 | Surgical stapling assemblies |
US16/545,630 US11406379B2 (en) | 2006-09-29 | 2019-08-20 | Surgical end effectors with staple cartridges |
US18/141,774 US20230329704A1 (en) | 2006-09-29 | 2023-05-01 | Surgical staples having compressible or crushable members for securing tissue therein and stapling instruments for deploying the same |
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US13/776,803 Continuation-In-Part US10130359B2 (en) | 2006-09-29 | 2013-02-26 | Method for forming a staple |
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US12/622,099 Active 2030-09-26 US8348129B2 (en) | 2008-02-13 | 2009-11-19 | Surgical stapler having a closure mechanism |
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