CA2155475A1 - Self-contained powered surgical apparatus - Google Patents
Self-contained powered surgical apparatusInfo
- Publication number
- CA2155475A1 CA2155475A1 CA002155475A CA2155475A CA2155475A1 CA 2155475 A1 CA2155475 A1 CA 2155475A1 CA 002155475 A CA002155475 A CA 002155475A CA 2155475 A CA2155475 A CA 2155475A CA 2155475 A1 CA2155475 A1 CA 2155475A1
- Authority
- CA
- Canada
- Prior art keywords
- recited
- assembly
- anvil
- powered surgical
- surgical apparatus
- 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
Links
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- 230000000694 effects Effects 0.000 claims description 7
- 230000000750 progressive effect Effects 0.000 claims description 6
- 238000012976 endoscopic surgical procedure Methods 0.000 claims description 4
- 230000006835 compression Effects 0.000 claims description 2
- 238000007906 compression Methods 0.000 claims description 2
- 238000000034 method Methods 0.000 description 17
- 230000000994 depressogenic effect Effects 0.000 description 4
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- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
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- 238000013461 design Methods 0.000 description 2
- 238000010304 firing Methods 0.000 description 2
- 230000003993 interaction Effects 0.000 description 2
- 238000012830 laparoscopic surgical procedure Methods 0.000 description 2
- 230000014759 maintenance of location Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
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- ATJFFYVFTNAWJD-UHFFFAOYSA-N Tin Chemical group [Sn] ATJFFYVFTNAWJD-UHFFFAOYSA-N 0.000 description 1
- 206010052428 Wound Diseases 0.000 description 1
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- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 238000012977 invasive surgical procedure Methods 0.000 description 1
- 229910052744 lithium Inorganic materials 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- 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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01H—ELECTRIC SWITCHES; RELAYS; SELECTORS; EMERGENCY PROTECTIVE DEVICES
- H01H9/00—Details of switching devices, not covered by groups H01H1/00 - H01H7/00
- H01H9/02—Bases, casings, or covers
- H01H9/06—Casing of switch constituted by a handle serving a purpose other than the actuation of the switch, e.g. by the handle of a vacuum cleaner
Abstract
A self-contained powered surgical stapling device is provided which includes an elongate body and a disposable cartridge assembly detachably supported in a distal end portion of the body. The cartridge assembly includes a frame configured to engage the distal end portion of the body, a housing supported within the frame and containing a plurality of surgical fasteners, an anvil mounted for movement with respect to the housing, an actuation assembly configured to translate relative to the housing and the anvil to progressively move the anvil from an open position to a closed position and to sequentially eject the surgical fasteners from the housing to be formed against the anvil, and an axial drive screw mounted in the frame and threadably associated with the actuation assembly for effectuating the longitudinal translation thereof. A motor assembly-having an axial drive shaft is disposed within the elongate body, and a coupling is provided for detachably connecting the axial drive shaft and the axial drive screw. A
power source is disposed within the elongate body for energizing the motor assembly.
power source is disposed within the elongate body for energizing the motor assembly.
Description
~la547a SELF-CONTAINED POWERED SURGTCAL APPARATUS
BACKGROU~D
1. Technical Field A seLf-contained powered surgical st~plinP appa,~us is provided for sequentially applying a plurality of surgical f~tçners to body tissue and optionally inricing the f~tçned tissue.
BACKGROU~D
1. Technical Field A seLf-contained powered surgical st~plinP appa,~us is provided for sequentially applying a plurality of surgical f~tçners to body tissue and optionally inricing the f~tçned tissue.
2. Back~round of Related Art Surgical devices wherein tissue is first grasped or clamped between opposing jaw structure and then joined by means of surgical fasteners are well known in the art. In some instruments a knife is provided to cut the tissue which has been joined by the fasteners. The fasteners are typically in the form of surgical staples however, two part polymeric fasteners are also ~)~ili7e~
2 o Instruments for this purpose can include two elongated members which are respectively used to capture or clamp tissue. Typically, one of the members carries a disposable cartridge which houses a plurality of staples ~l~lged in at least two lateral rows while the other member inrhldes an anvil which defines a surface for rc""ling the staple legs as the fasteners are driven from the cartridge. Generally, the stapling operation is effected by a pusher which travels longih~din~lly through the cartridge carrying member, with the pusher acting upon the staples to sequentially eject them from the cartridge. A knife may travel with the pusher between the staple rows to lon ih1tlin~11y cut and/or open the stapled tissue between the rows of staples. Such instruments are disclosed in U.S. Pat. No. 3,079,606 to Bobrov et al. and U.S. Pat. No.
2 o Instruments for this purpose can include two elongated members which are respectively used to capture or clamp tissue. Typically, one of the members carries a disposable cartridge which houses a plurality of staples ~l~lged in at least two lateral rows while the other member inrhldes an anvil which defines a surface for rc""ling the staple legs as the fasteners are driven from the cartridge. Generally, the stapling operation is effected by a pusher which travels longih~din~lly through the cartridge carrying member, with the pusher acting upon the staples to sequentially eject them from the cartridge. A knife may travel with the pusher between the staple rows to lon ih1tlin~11y cut and/or open the stapled tissue between the rows of staples. Such instruments are disclosed in U.S. Pat. No. 3,079,606 to Bobrov et al. and U.S. Pat. No.
3 o 3,490,675 to Green.
A later stapler disclosed in U.S. Pat. No. 3,499,591 to Green applies a double row of staples on each side of the incision. This is accomplished by providing a cartridge assembly in which a cam member moves through an elongate guide path between two sets of staggered staple carrying grooves. Staple drive members are 3 5 located within the grooves and are positioned in such a manner so as to be contacted by the longit~ in~lly moving cam to effect ejection of the staples.
Each of the instruments described above were designed for use in conventional surgical procedures wl~el ehl surgeons have direct manual access to the ~1~547~
operative site. However, in endoscopic or laparoscopic procedures, surgery is performed through a small incision or through narrow a cannula inserted through small entrance wounds in the skin. In order to address the specific needs of endoscopic and/or laparoscopic surgical procedures, an endoscopic surgical stapling ap~ L~Is has been developed and is disclosed in U.S. Pat. No. 5,040,715. This app~us is well suited for such procedures and incllldes a f~ctener applying assembly having an anvil and a staple cartridge provided at the distal end of an endoscopic body portion which permits the instrument to be inserted into a cannula and be remotely operated by the surgeonthrough manipulation of a pro~lllal handle mech~nicm lo The instruments diccussed above all require some degree of m~nu~lly applied force in order to clamp, fasten and/or cut tissue. Surgeons have thus recognized the benefits of using self-powered instruments that are actuable with only a limited degree of physical force. Self-powered surgical instruments have been provided to serve these needs and include both gas powered surgical staplers, as shown, for example, in U.S. Pat. No. 5,312,023, and electrically powered surgical instruments as described in U.S. Patent Nos. 4,635,638 and 5,258,007, and European Pat. Appln. No. 0 552 050.
In general, prior art electrically powered surgical instruments have been driven by external power sources. The instruments were connected to the power sources by conductive cables. Such cables could, however, become entangled during a surgical 2 o procedure, thereby complicating the operation.
It would be beneficial to provide a self-contained powered surgical appa,~ s for applying a pluralit,v of surgical staples to body tissue and concoll"~an~ly incising the stapled tissue. Such an app~tus should be compact, lightweight and easy to m~mlf~ctl-re Currently, surgical instruments are designed for use in either open, i.e.
2 5 invasive procedures, or endoscopic/laparoscopic procedures. As noted above, endoscopic instruments require elongate shafts to access remote surgical sites.
Conventional surgical instruments are not constructed in this manner. It would be advantageous to provide a powered surgical instrument which can be readily adapted for use in both conventional and laparoscopic procedures.
SUMMARY
A self-contained powered surgical app~ ~ls for applying a pluralit,v of surgical fasteners to body tissue is provided. The apparatus includes an elongate instrument body dçfining a longit~ldin~l axis, a cartridge assembly housing a plurality of 3 5 surgical fasteners, and an anvil member mounted adjacent the cartridge assembly and configured for movement with respect thereto between an open and a closed position.
The app~a~ls further includes a motor assembly disposed within the elongate instrument body, an actu~ting assembly driven by the motor assembly for ~ 4 7 :~
effectu~finE progressive closure of the anvil and sequential ejection of the surgical fasteners and a power source disposed within the body for energizing the motor assembly. Preferably, the act l~finE assembly in~ des a drive member which is threadably associated with an axial drive screw that is driven by the motor assembly.
In a plerelled embodiment, the act l~tin~ assembly inrludes a first c~mmin~ meçh~nicm configured to move the anvil member into a closed position to clamp tissue, and a second c~mmin~ meçh~nicm configured to sequentially eject fasteners from the cartridge as it tr~n~l~tes therethrough. A tissue cutting member is preferably associated with the ~çtu~tinE assembly for tr~nsl~tinE through the cartridge assembly to incise the stapled body tissue. A control for the motor assembly to operate the powered surgical apparatus preferably incllldec first and second control buttons for effecting distal and proximal movement of the ~ctu~tinE assembly.
In one embodiment, the powered surgical app~al~ls incll-des an elongate shaft configured to engage with a proximal end of the main instrument body to f~ilit~te utilization ofthe app~LIls during an endoscopic procedure. Preferably, the extension shaft interacts with the motor control buttons at the proximal end of the main instrument body to operate the appa~L~ls from a location remote from the surgical site.
In another embodiment, the powered surgical appa~LIls is insçn~led to be employed during a laparoscopic procedure by providing a mer.h~nical hand which is 2 o configured to extend into the abdominal cavity through a cannula and be remotely manipulated to actuate the appal~L~ls.
In another embodiment, the powered surgical app~L-ls incl~des an elongate body d~fininE a lon~ihl(lin~l axis, and a disposable cartridge assembly which is det~çh~bly supported in a distal end portion of the elongate body.
The disposable cartridge assembly inl~h1des a frame having a proximal end portion configured to engage the distal end portion of the elongate body, and a housing supported within the frame and co,~ ni'lE a plurality of surgical fasteners. An anvil member is pivotably associated with the frame and is mounted for movement with respect to the housing between an open position and a closed position. An actuation 3 o assembly is disposed within the frame and is configured to translate in a lonEit~1tlin~l direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and seq~lçnti~lly eject the surgical fasteners from the housing to be formed against the anvil. An axial drive screw is rotatably mounted within the frame and threadably associated with the actuation assembly for effechl~finE the 3 5 lonEihltlin~l translation thereof.
The surgical app~ s further in~ des a motor assembly having an axial drive shaft, and a coupling to det~çh~bly connect the axial drive screw of the cartridge assembly to the axial drive shaft of the motor. A power source is disposed within the `- 21~5475 elongate body for energizing the motor assembly. Preferably, a bayonet-type fitting is associated with the distal end portion of the elongate body and the pl o~illlal end portion of the frame to f~c,ilit~te the det~c,h~ble connection of the cartridge assembly.
Further features of the powered surgical appal~LIls will become more 5 readily appale"~ to those skilled in the art from the following detailed description ofthe invention taken in conjunction with the drawings.
BRIEF DESCRIPTION OF T~E DRAWINGS
Various embodiments of the powered surgical apparatus will be 10 described hereinbelow with I efel ence to the drawings wherein:
Fig. l is a perspective view of a powered stapling device constructed in accordance with a prefelled embodiment;
Fig. 2A is an illustration depicting the powered stapling device of Fig. l with a flexible extension shaft ~tt~ched thereto in use during a laparoscopic procedure;
Fig. 2B is an illustration depicting the powered stapling device of Fig. l with a rigid extension shaft ~tt~rhed thereto in use during a laparoscopic procedure;
Fig. 3 is an illustration depicting a mech~nical hand opel~ing the powered stapling device of Fig. l during a laparoscopic procedure;
Fig. 4 is an exploded perspective view of the powered stapling device of Fig. l;
Fig. 5 is a sch~m~tic representation ofthe switching mech~nism for controlling the operation of the motor assembly;
Fig. 6 is a side elevational view in cross-section taken along line 6-6 of Fig. 1 illustrating the relative position of the internal components of the powered 2 5 stapling device prior to actuation;
Fig. 7 is a top plan view in cross-section illustrating the relative position of the internal components of the powered stapling device prior to actuation;
Fig. 8 is a cross-sectional view taken along line 8-8 of Fig. 6 illustrating the actu~tin~ assembly;
3 o Fig. 9 is a cross-sectional view taken along line 9-9 of Fig. 6 illustrating the drive shaft of the motor assembly;
Fig. l0 is a cross-sectional view taken along line l0-l0 of Fig. 6 illustrating the interaction between the drive shaft of the motor assembly and the axial drlve screw;
3 5 Fig. l l is a side elevational view in cross-section illustrating the relative position of the internal components of the powered stapling device during a stapling operation;
~lSS47~
Fig. 12 is a side elevational view in cross-section illustrating the relative position of the internal components of the powered stapling device at the completion of a stapling operation;
Fig. 13 is a perspective view of another powered stapling device 5 constructed in accordance with a pr~Ç~lled embodiment ofthe subject application which inr.llldec a det~çh~ble cartridge assembly that can be discarded after a stapling operation;
Fig. 14 is an exploded perspective view of the det~ch~hle cartridge assembly illustrated in Fig. 13;
Fig. 15 is an enlarged side elevational view in cross section of a portion 10 ofthe stapling device of Fig. 13 illustrating the coupling engagement ofthe axial drive screw of the cartridge assembly and the axial drive shaft of the motor assembly;- Fig. 16 is an exploded perspective view in partial cross-section illustrating the components of the stapling deceive which f~cilit~te the det~ch~hle connection of the cartridge assembly and the instrument body;
Fig. 17 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the motor assembly and power cells housed within the elongate body ofthe surgical app~L~ls of Fig. 13;
Fig. 18 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the cartridge assembly ofthe subject application prior to a stapling operation; and Fig. 19 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the cartridge assembly ofthe subject invention at the conclusion of a stapling operation.
DETAILED DESCRIPTTON OF PREFERRED EMBODIMENTS
In the drawings and in the description which follows, the term "proximal", as is traditional, will refer to the end of the appa~ s which is closest to the operator, while the term "distal" will refer to the end of the appal ~L~1S which is furthest from the operator.
The appa.~LLls shall be diccucsed in terms of both conventional and endoscopic procedures. However, use herein of terms such as "endoscopic", "endoscopically", and "endoscopic portion", among others, should not be construed to limit the present appa,~ s for use only in conjunction with an endoscopic tube. To the co~ y, it is believed that the present apparatus may find use in procedures wherein 3 5 access is limited to a small incision incll1rlinp but not limited to arthroscopic and/or laparoscopic procedures.
Referring now to the drawings wherein like reference numerals identify similar structural elements of the appa ~LLIS, there is illustrated in Fig. 1 a self-contained 21SS47.S
powered surgical stapler constructed in accordance with a preferred embodiment and design~ted generally by reference numeral 10.
Referring to Fig. 1, powered surgical appa,~l~ls 10 is configured for use as a hand-held device for applying a plurality of surgical staples to tubular vessels and body tissue during conventional invasive surgical procedures. By way of example only, surgical app~ s 10 may have a length measuring from about 5.0 inches to about 7.0 inches, and an outer diameter of about .450 inches to about .500 inches. Plere,~bly, the length of surgical appa~L~Is 10 is between 6.0 inches and 6.5 inches, while the plt;relled mPter iS between .470 inches and .480 inches. Clearly, other dimensions are 0 contçmrlated. In one embo-lim~Pnt surgical app~lus 10 is also adapted for use in endoscopic procedures through remote actuation from a location outside the patient's body, as shown in Figs. 2A and 2B. This is achieved by providing an elongated extension shaft 12 which anache~ to the proximal end of surgical app~ ~us 10 by commonly known connective methods such as snap fit. Extension shaft 12 is preferably dimensioned and configured for insertion through a c~nmll~ or trocar device and has a length measuring from about 10.0 inches to about 17.0 inches. A flexible shaft 12 or rigid shaft 12' can be utili7ed Referring to Fig. 3, in another embodiment, surgical appa, ~IS 10 is intçn~ed to be operated by a mechanical hand 15 which is configured to extend through trocar device 17 during a laparoscopic surgical procedure. Mechanical hand 15 inrl~des four articulated fingers 15a-15d and an opposable thumb 15e which are hinged together to enable relative movement between a constricted position wherein the forehand and fingers are drawn together into a n~uwed formation to f~ilit~te their extension through trocar 17 and a relaxed position wherein the forehand and fingers are deployed 2 5 into a spread position to perfomm dexterous tasks such as operating surgical appa~ s 10 by actu~ting a switch provided on the app~ s.
Referring to Fig. 4, surgical app~ s 10 inrlllde~ an elongate body 20 in~lu(ling complimentary body sections 22 and 24 which define a series of intemal chambers for housing and supporting various mechanical components of app~ ~L~IS l O.
3 o The intemal chambers defined within body sections 22 and 24 include distal chamber 26, medial chamber 28, and proximal chamber 30.
The components housed within body sections 22 and 24 of surgical app~ s 10 include an elongate housing channel 32 having a base 34 and opposed upst~ntling channel walls 38a and 38b. Housing channel 32 is m~int~ined within the 3 5 distal chamber 26 of body 20 and is configured to support the assembly 40 and the actu~ting assembly 42.
The assembly 40 int ludes an elongate staple cartridge 44 having a plurality of transverse slots 46 each configured to support a respective staple 48 and ~l~a47a staple pusher 50. Cartridge 44 is also provided with five spaced apart longitudin~l slots inr.lu~ling a central slot 52 and lateral slot pairs 54a, 54b and 56a, 56b. The lateral slot pairs 54a, 54b and 56a, 56b serve to accommodate longitu~in~l translation of theelongate G~mming bars 58a, 58b and 60a, 60b of ~ctu~ting assembly 42 while the central 5 slot 52 serves to accommodate longitutlin~l translation of a cutting blade 62. ~rh1~ting assembly 42 and the components associated therewith will be described in greater detail hereinbelow.
Assembly 40 further inr,ludes an elongate anvil 64 which defines an interior fastener fo~ g surface 65 against which staples are driven when ejected from cartridge 44 by the actu~ting assembly 42. A pair of outwardly depending wings 66a and 66b are formed ~djacçnt the proximal end of anvil 64 for çng~ging a pair of correspondingly positioned reception slots 68a and 68b formed in the opposed upst~nding channel walls 38a and 38b of housing channel 32. The engagement of wings 66a and 66b within slots 68a and 68b f~rilit~tes pivotal movement of anvil 64 with 15 respect to cartridge 44. A longitu~in~l slot 70 extends along a substantial portion ofthe length of anvil 64 to accommodate the longitudin~l translation of cutting blade 62 and the portion of actu~ting assembly 42 which supports the cutting blade. Similarly, a longitu(lin~l slot 75 is formed in the base 34 of housing channel 32 (see Fig. 6). The orientation and length of slots 70 and 75 correspond substantially to that of the central 2 o slot 52 provided in cartridge 44.
A spring 65 extends from the pl ox,~"al end of anvil 64 and is att~ched to body section 22 (or alternatively base 34) to bias the anvil towards the cartridge 44.
Thus, in use, as tissue is positioned between the anvil and cartridge, the anvil is forced - away from the cartridge by the tissue. Actuation of the actu~ting assembly (~ cussed 2 5 below) forces anvil 64 into closer cooperative ~lignm~nt with cartridge 44 to more firmly and progressively clamp the tissue. In an alternate embodiment, the anvil 64 is biased to an open position, i.e. biased away from cartridge 44, by, for example, a pair of springs positioned at a proximal end of the anvil between the anvil and cartridge 44. It is also contemplated that the anvil can be connected for free movement with respect to 3 o the cartridge without a spring bias.
As best seen in Fig. 4, actu~ting assembly 42 includes two pairs of elongate c~lllllling bars 58a, 58b and 60a, 60b. The c~mming bars serve to sequentially eject staples 48 from cartridge 44 through interaction with staple pushers 50. In particular, each ofthe elongate c~"""i"g bars inrl.ldes a distal head portion 72 having an 3 5 angled c~mming surface 74. C~mming surface 74 is configured to contact staple pushers 50 and drive the staple pushers in a direction transverse to the longitu(lin~l axis of cartridge 44, thereby urging the staples from cartridge 44. An engagement notch 76 21~ ~ 4 ~ ~
-is formed adjac~nt the proxilllal end of each ofthe s~mming bars for eng~ging corresponding grooves 78 provided in drive member 80.
Drive member 80 incl~des a threaded bore 82 for operatively ~ng~ging an axial drive screw 84. Drive screw 84 is driven by a motor assembly 86 and is connected to the drive shaft 88 of motor assembly 86 by a supporting hub assembly which in~ludçs an outer support hub 90, an interme~iate support hub 92, and an inner çng~g~m.o,nt hub 94 (see Fig. 9). Engagement hub 94 is f~stçne~ to the pro~ill,al end of drive screw 84 and is engaged within the intern e~ te support hub 92. As shown in Fig. 10, drive shaft 88 is keyed into the opposed end of support hub 92. Support hub 92 is coaxially lo disposed within outer support hub 90 which is ~ )ed with the medial charnber 28 of elongate body 20. Motor assembly 86 and the power cells 98a-98c which supply energy thereto are ~ ined with the proxi."al chamber 30 of elongate body 20. A transferplate 158 is disposed between the distal-most power cell 98a and the p-oxill,al end of motor assembly 86 for transferring energy from the power cell to the motor assembly.
~ctuating assembly 42 further inc.llldes a ca.l.ll.;l-g beam 100 for effectuating the progressive closure of anvil 64 to clamp body tissue disposed between fastener forming surface 65 of anvil 64 and the tissue contacting surface 45 of staple cartridge 44. C~mming beam 100 includes an upper beam portion 102, a central webportion 104, and a lower beam portion 106. Central web portion 104 supports cutting blade 62. Upper and lower beam extensions 108 and 109 extend plo~il"ally from central web portion 104 to engage drive member 80. As shown, the upper and lowerbeam portions 102, 106 are substantially planar. Thus, the mer.h~nicm for clamping the anvil (c~mming beam 100) and the me~h~nicm for firing the staples from the cartridge (c~mming bars 58a, 58b and 60a, 60b) are directly connected to drive member 80. In use, the upper beam portion 102 of C~.. ;l-g beam 100 progressively contacts the outer surface 67 of anvil 64 to effect progressive anvil closure. The central web 104 tr~n~l~tes through slots 52, 70, and 75, and the lower beam portion 106 tr~nCl~tes along the outer surface 35 of the base 34 of housing channel 32 to ,.~i..t~ anvil closure during a stapling procedure.
3 o Referring to Fig. 8 in conjunction with Fig. 4, a support gate 110 is mounted intermerliate housing channel 32 which has an aperture 115 for supporting the distal end portion of axial drive screw 84. As best seen in Fig. 4, support gate 110 inclndçc a pair of opposed winglets 112a and 112b for eng~ging corresponding reception slots 114a and 114b in the opposed channel walls 38a and 38b of housing 3 5 channel 32. Upper and lower grooves 116 and 118 are formed in support gate 110 to accommodate the translation of the upper and lower beam extensions 108 and 109.
Lateral slot pairs 120a, 120b and 122a, 122b are provided in support gate 110 toaccommodate the translation of c,~mming bar pairs 58a, 58b and 60a, 60b.
215547~
, g Surgical appa,~us 10 further inGl~-des a switching assembly 130 for selectively controlling the operation of motor assembly 86. Switching assembly 130 inc.l~ldes distal and plox~lllal switch housings 132 and 134, and right and left spring biased actuation buttons 136 and 138. A plurality of coiled colllpression springs 135 bias actuation buttons 136 and 138 in a proximal direction. Switch housings 132 and 134 are mounted to one another and f~ctçned to the pro~illlal end of surgical app~lus io by a threaded connector 140, and are operatively separated from one another by a distal inc~ ting ring 141, a distal contact plate 142, a medial inc~ tin~ ring 143, and a proximal contact plate 144. A distal contact ring 145 is disposed between distal switch housing 132 and spring 137.
Distal contact plate 142 incl~1des a pair of opposed upturned contact tabs 142a and-142b, and pr~illlal contact plate 144 in~ ldes a pair of opposed upturned contact tabs 144a and 144b which are positioned 60 out of phase with tabs 142a and 142b. Each actuation button has associated therewith three contact pins, two of which interact with contact plates 142 and 144 to control the relative movement of drive screw 84. In particular, actuation button 136 includes two long pins 146a and 146b and one short pin 146c. Short pin 146c is seated within a central reception port 147c, while long pins 146a and 146b are seated within lateral reception ports 147a and 147b.
Long pin 146a and short pin 146c are positioned to selectively engage contact tabs 142a and 144b respectively, while long pin 146b remains free from electrical contact. Similarly, actuation button 138 incl~1des long pins 150a and 150b, and short pin 150c. Short pin 150c is seated within a central reception port 151 c, while long pins 150a and 150b are seated within l~teral reception ports 151a and 151b. Long pin 150b and short pin 150c are positioned to selectively engage contact tabs 142b and 144b 2 5 respectively, while long pin 150a remains free from electrical contact.
The wiring configuration of switching assembly 130 is illustrated in Fig. 5 and incl~ldes motor line 152 which interconnects the positive terminal 86a of motor assembly 86 to contact pins 146a and 150c, and a motor line 154 which interconnects the negative terminal 86b of motor assembly 86 to contact pins 146c and 150b. Inaddition, a trancmiccion line 156 extends between battery transfer plate 158 and contact plate 144, and a tr~ncmicsion line 160 interconnects contact plate 142 and contact ring 145.
In use, when actuation button 138 is depressed, long pin 150b contacts tab 142b of distal contact plate 142 and short pin 150c contacts tab 144b of proximal contact plate 144. Thus, the positive terminals of power cells 98a-98c will be connected to the negative terminal 86b of ~notor assembly 86 and the negative terminals of power cells 98a-98c will be connected to the positive terminal 86a of motor assembly 86, causing drive shaft 88 to rotate in a clockwise direction to move drive member 80 21aa 473 distally. When actuation button 136 is depressed, long pin 146a contacts tab 142a of distal contract plate 142 and short pin 146c contacts tab 144a proxi"lal contact plate 144. Thus, the positive terminals of power cells 98a-98c will be connected to the positive terminal 86a of motor assembly 86 and the negative terminals of power cells 98a-98c will be connected to the negative terminal 86b of motor assembly 86, causing drive shaft 88 to rotate in a counter-clockwise direction to move the axial drive m.omh.o.r 80 in a pro~ lal direction. It is also envisioned that a single actuator button can be provided which will be actuable to operate an axial drive screw having a reverse thread formed therein. The reverse thread will cause a distally trAn~l~ting drive screw to 1 0 automatically translate in a pl oxll,al direction at the conclusion of a fastener forming stroke.
- As ~iccussed briefly hereinabove, surgical app~LIls 10 is preferably designed for insertion through a trocar or cannula device to apply surgical staples to body tissue located within a body cavity while being actuable remote from the surgical site. Shaft 12 includes elongate trAn~mi~ion members 12a and 12b (or 12a' and 12b') for effectuAting remote actuation of switching assembly 130 (see Figs. 2A and 2B).
TrAn~miccion members 12a and 12b (or 12a' and 12b') may include a pair of substantially rigid rods for ~ g a mechanical signal to actuation buttons 136 and 138, or, in the alternative, the trAn~mi~sion members may include ll~nc~iccion cables for directing 2 o an electrical signal to switching assembly 130. In either instance, the sha~ would include two actuation buttons to respectively actuate buttons 136 and 138 and cause the rotation of drive screw 84 in opposed directions.
Referring now to Figs. 6 and 7, prior to operating the surgical stapling device 10, the anvil 64 is disposed in a free-movement position to fAcilit~te th e capture 2 5 of body tissue (or spring biased to a closed or an open position as in the aforelllelllioned alternate embodiments). Movement of anvil 64 is accommodated by the pivotal ~ngAglomP.nt of anvil wings 66a and 66b in reception slots 68a and 68b. The pivotal movement of anvil 64 is best seen in Fig. 6. Prior to actuation, c~mming beam 100 is ,.,Ail-~Ai"ed within a support seat 26a defined in the distal chamber 26 of instrument body 3 o 20. At such a time, the upper beam portion 102 is out of contact with the outer surface 67 of anvil 64 pelllliL~ing the pivotal movement thereof. Also at this time, the distal head portion 72 of each of the c~mming bars 58a, 58b and 60a, 60b is disposed proximal to and out of contact with the proximal-most staple pushers 50 in cartridge 44.
Upon actuation, i.e. when actuation button 136 is depressed, motor 3 5 assembly 86 is energized and drive shaft 88 rotates axial drive screw 84, causing drive member 80 to translate in a distal direction. As best seen in Fig. 11, as drive member 80 trAn~l~tes distally, the upper beam portion 102 of c.~mming beam 100 progressively urges anvil 64 toward cartridge 44 to clamp body tissue 165 therebetween.
21~ ~ ~ 7 ~
.
Concol-~iLalllly, the r,~mming surface 74 on the distal head portion 72 of each of the ç~mming bars of actuation assembly 42 interacts with staple pushers 50 to sequentially eject surgical staples 48 from cartridge 44.
Staples ejected from cartridge 44 are driven through body tissue 165 and formed against the inner fastener forrning surface 65 of anvil 64. As the rows of staples are placed in body tissue 165, cutting blade 62, which travels behind the distal head portion 72 of each of the c~ bars of actuation assembly 42, cuts the stapled body tissue, forrning an incision between the staple rows.
Continued actuation of motor assembly 86 effects distal translation of o drive member 80 until the drive member contacts support gate 110. At such a time, c~ .1 ll l l; i-g beam 100 is disposed at the distal end of fastener applying assembly 40 and the distal head 70 of each of the r,~mming bars is disposed within the distal portion 45 of staple cartridge 44. Following the stapling operation, depression of actuation button 138 causes drive member 80 to translate proximally, drawing therewith c~mminP: beam 100 and c~mmin~ bars 58a, 58b and 60a, 60b to their proxill,al-most position (Fig. 6).
It is also contemplated that the staple cartridge 44 can be removable so that once actuation assembly 42 has returned to its proximal-most position after firing the fasteners, staple cartridge 44 can be removed and replaced with a loaded staple cartridge and actuation button 136 can be depressed again to fire the stapling app~ s.
2 o Referring now to Fig. 13, there is illustrated another self-contained powered surgical apparatus constructed in accordance with a prerell~d embodiment of the subject application and decign~ted generally by reference numeral 200. Surgical appa~ s 200 is configured to sequentiaDy apply a plurality of surgical fasteners to body tissue during conventional and/or endoscopic surgical procedures. In brief, surgical appal~ s 200 includes an elongate instrument body 210 and a disposable cartridgeassembly 220 which is det~r.h~kly connected to a distal end portion of the instrument body 210 by a bayonette-type coupling arrangement. Instrument body 210 houses a motor assembly 212 and a plurality of power cells or batteries 214 for enelgi~ g the motor assembly. The power cells can be lithium, alkaline or nickel-cadmi.-m batteries.
3 o An in~ul~1ing material is wrapped around the power cells to isolate them from conductive outer casing 215. A conductive contact plate 216 is disposed between the terminal end 212a of motor assembly 212 and the distal-most battery 214a, and a coiled spring 218 is disposed within the pl oxilllal end of instrument body 210 to bias the batteries distally (see Fig. 17).
3 5 Referring to Figs. 13 and 14, cartridge assembly 220 infh~des a frame 222 having an adapter 224 configured to det~rh~bly engage a distal end portion of instrument body 210 (see generally Fig. 16), and a housing channel 226 configured to retain a cartridge 228 cont~ining a plurality of surgical fasteners 230. Cartridge 21~47a assembly 220 further inr,ludçs an anvil 232 which is pivotably mounted to housing channel 226, and an actuation assembly design~ted generally by reference numeral 240 which is driven by motor assembly 212 and configured to eject the surgical fasteners 230 from cartridge 228, and conco~ anlly move anvil 232 between an open position and a 5 closed position ~see generally Figs. 18 and 19).
With continuing reference to Fig. 14, adapter 224 inrludes an elongate distal portion 234 and a prox.l,lal mounting portion 236 dimensioned and configured for reception within the distal end of instrument body 210. Housing channel 226 inrludes opposed side walls 226a and 226b, and a floor 226c. An aperture 238 is defined in floor 226c ~djacçnt the pro~illlal end of housing channel 226 for receiving a threaded fastener 242 which mounts the housing channel 226 to the adapter 224. A pair of opposed apertures 244a and 244b are defined in the side walls 226a and 226b of hrl~cing channel 226 for receiving a pair of outwardly extçn~ling flanges 232a and 232b which are formed adjacçnt the proximal end of anvil 232 and about which anvil 232 pivots between closed and opened positions to capture and release body tissue. A pair of spring members 246a and 246b are disposed within apertures 244a and 244b for biasing anvil 232 into an open position. Opposed ~ng~g~ment notches 248a and 248b are also defined in the opposed side walls 226a and 226b of housing channel 226 for receiving a pair of corresponding detents formed on cartridge 228, i.e. detent 228b. The detents are formed 2 o monolithically with the fastener ret~ining cartridge 228 and secure the cartridge within the distal portion of housing channel 226.
With contin~ing lerelence to Fig. 14, the actuation assembly 240 of cartridge assembly 220 in~ludes an actuation sled 250 configured to translate through cartridge 228 to effectuate the ejection of surgical fasteners therefrom. Sled 250 2 5 includes a plurality of spaced apart upst~nding cam plates 252 each having an angled leading edge 254 for sequentially çng~ging a plurality of staple drivers 256 which drive surgical fasteners 230 from cartridge 228. Actuation sled 250 is driven through cartridge 228 by an actuation beam 260 and an axial drive screw 270. Actuation beam 260 has a pair of parallel elongate beam extensions 262 and 264 the proximal ends of 3 o which are mounted to a follower housing 266. Follower housing 266 supports a drive nut 268 which is threadably associated with axial drive screw 270. Follower housing 266 is mounted within frame 222 in such a manner so that axial rotation of drive screw 270 causes the lon ih~in~l translation thereof. The distal end 270a of drive screw 270 is rotatably supported in a stationary support mount 272 which is m~in~ined within frame 3 5 222 and engaged in a slotted region 235 of the distal portion of adapter 234. Support mount 272 also serves to guide the longitu(lin~l translation of beam extensions 262 and 264 as actuation beam 260 is driven in a longitudin~l direction by follower housing 266.
2155~ 7~
A knife blade 265 is mounted adjacent the leading edge of actuation beam 260 forcutting body tissue as actuator 250 tr~ncl~tes through cartridge 228.
Referring to Figs. 14-16, the proximal end 270b of drive screw 270 is configured to engage a screw coupling 274. Screw coupling 274 is rotatably supported within an axial bore 276 defined in the p~ oxil"al mounting portion 236 of adapter 224 and is det~h~hly connected at a proximal end to a shaft coupling 278 which is supported on the drive shaft 280 of motor assembly 212. The cooperative ~ng~ m~nt of the two couplings will be ~ c--ssed in greater detail hereinbelow.
Referring once again to Fig. 14, the distal end of actuation beam 260 include a retention flange 282 for supporting a generally cylindrical cam roller 284 and an engagement slot 286 for ret~ining a substantially planar cam beam 288. Cam roller 284 ~ng~es and tr~n~l~tes relative to an upper c~mming surface 290 of anvil 232 to effectuate the progressive closure thereof as follower housing 266 and actuation beam 260 translate through housing channel 226 to fire surgical fasteners 230 from cartridge 228. Cam beam 288 engages and tr~n~l~tes relative to the outer surface ofthe floor 226c of housing channel 226 to balance the forces exerted upon anvil 232 by cam roller 284 during closure. A longitudin~l slot 292 is defined in the floor 226c of housing channel 226 and a corresponding longitu(lin~l slot 294 is defined in the anvil 232 to accommodate the longit~l(lin~l translation of ~ct~l~ti~n beam 260. A transverse slot 2 o extension 296 is defined at the distal end of anvil slot 294 to receive cam roller 284 at the end of its translation, and thereby permit anvil 232 to return to an open position under the bias of spring members 246a and 246b following a f~ctçning operation. Thus, body tissue is automatically Im~ mred as soon as all of the fasteners have been fired.
Referring now to Figs. 13 and 16, as noted hereinabove, the cartridge 2 5 assembly 220 of surgical apparatus 200 is configured as a separate unit which is det~çh~bly mounted to the distal end ofthe instrument body 210 by a bayonette-type coupling arrangement. The bayonette coupling arrangement in~llldes a pair of generally J-shaped slots 304 defined adjacent the distal end of instrument body 210, and a pair of corresponding engagement pins 312 and 314 mounted in the proximal mounting portion 3 o 234 of adaptor 224 (see also Fig. 14). During att~hm~nt of cartridge assembly 220, the proximal mounting portion 236 of adapter 224 is axially rotated approximately 20degrees to engage pins 312 and 314 in corresponding slots 302, 304.
Referring to Figs. 16 and 17, a coiled compression spring 316 is supported on the drive shaft 280 of motor assembly 212 for biasing the shaft coupling 3 5 278 in a distal direction. Shaft coupling 278 is supported within a stepped axial bore 318 defined in instrument body 210 and inel~ldes a transverse slot 320 which is dimensioned and configured to engage a corresponding teeth 322 formed at the proximal end of screw coupling 274. The function of coupling spring 316 is two fold.
2 1 5 ~ 4 7 5 Firstly, if teeth 322 and flange 322 are not aligned when the ploxilllal mounting portion of adapter 224 is inserted into the distal end of instrument body 210, coupling spring 316 will col-lpensate for the mic~lignm~nt and f~cilit~te engagement of the couplings upon initial rotation of drive shaft 280. More particularly, upon insertion of the adapter, if mi c~ligne~l~ teeth 322 will abut the distal-most surface of shaft coupling 278. When drive shaft 280 initially rotates and slot 320 aligns with flange 322, coupling spring 316 will decompl ess and force shaft coupling 278 in a distal direction to cause the two couplings to det~ch~bly engage. The second function of coupling spring 316 is to bias adapter 224 in a distal direction when the bayonette coupling which det~ch~bly 0 ",~ ,c cartridge assembly 220 in body portion 210 is engaged.
Referring to Figs. 15-17, a switch 330 is provided for selectively controlling the operation of motor assembly 212. Switch 330 is a touch-sensitivecontact switch that is wrapped around the circumference of instrument body 210 within a recessed area 332. Switch 330 inchldes an outer contact layer 330a, a medial in~ ting layer 330b, and an inner conductive layer 330c. A slot 333 is provided in in.cul~tin~ layer 330b to permit contact between the outer contact layer 330a and the inner conductive layer 330c. A motor control circuit is defined by a first electrically conductive metallic strip 334 which connects switch 330 to the conductive outer casing 215 of instrument body 210, a second conductive strip 235 which connects outer casing 2 o 215 to the terminal T ofthe proximal-most power cell 214d, and a third conductive strip 336 which connects switch 330 to the terminal end 21 2a of motor assembly 212.
Referring now to Figs. 18 and 19, in operation, when surgical app~ ~ s 200 is introduced into a surgical site, body tissue is captured between anvil 232 and cartridge 228. A radially inwardly directed force in two locations on switch 330 brings 2 5 outer layer 330a into contact with inner layer 330c, then causing current to flow to motor assembly 212 to rotate the drive shaft 280 of motor assembly 212. The rotational motion of drive shaft 280 is ll~lsr~lled to drive screw 270 through couplings 274 and 278. Axial rotation of drive screw 270 causes corresponding longiturlin~l translation of follower housing 266 and actuation bearn 260.
As actuation bearn 260 tr~ncl~tes distally, cam roller 284 progressively moves anvil 232 from the normally biased open position shown in Fig. 18 to the closed position illustrated in Fig. 19. Concomi~ ly, actuation sled 250 is driven from the ploxilllal position illustrated in Fig. 18, through fastener retention cartridge 228, to the distal-most position shown in Fig. 19 sequentially çng~ging staple drivers 256 so as to 3 5 drive surgical fasteners 230 through body tissue 350. At the same time, knife blade 265 trails actuation sled 250 to forrn an incision in the stapled body tissue 350. When cam roller 284 reaches the distal end of longitu~lin~l slot 294, it drops into transverse slot extension 296, permitting anvil 232 to return to an open position and release the stapled 21~.5475 body tissue 350. At the conclusion ofthe fastener applying operation, cartridge assembly 212 is manipulated in such a manner so as to di~çng~ge pins 312 and 314 ~om slots 302 and 304, and detach the cartridge adapter 224 from the distal end of instrument body 210. Thereafter, the cartridge assembly may be discarded and a new 5 cartridge assembly may be det~çh~bly mounted to instrument body 210.
.~lthough the app~uls has been described with respect to plere"ed embodimçnt~, it will be readily appalenl to those having o~dil~a,y skill in the art to which it appertains that changes and modifications may be made thereto without departing from the spirit or scope of the appended claims.
A later stapler disclosed in U.S. Pat. No. 3,499,591 to Green applies a double row of staples on each side of the incision. This is accomplished by providing a cartridge assembly in which a cam member moves through an elongate guide path between two sets of staggered staple carrying grooves. Staple drive members are 3 5 located within the grooves and are positioned in such a manner so as to be contacted by the longit~ in~lly moving cam to effect ejection of the staples.
Each of the instruments described above were designed for use in conventional surgical procedures wl~el ehl surgeons have direct manual access to the ~1~547~
operative site. However, in endoscopic or laparoscopic procedures, surgery is performed through a small incision or through narrow a cannula inserted through small entrance wounds in the skin. In order to address the specific needs of endoscopic and/or laparoscopic surgical procedures, an endoscopic surgical stapling ap~ L~Is has been developed and is disclosed in U.S. Pat. No. 5,040,715. This app~us is well suited for such procedures and incllldes a f~ctener applying assembly having an anvil and a staple cartridge provided at the distal end of an endoscopic body portion which permits the instrument to be inserted into a cannula and be remotely operated by the surgeonthrough manipulation of a pro~lllal handle mech~nicm lo The instruments diccussed above all require some degree of m~nu~lly applied force in order to clamp, fasten and/or cut tissue. Surgeons have thus recognized the benefits of using self-powered instruments that are actuable with only a limited degree of physical force. Self-powered surgical instruments have been provided to serve these needs and include both gas powered surgical staplers, as shown, for example, in U.S. Pat. No. 5,312,023, and electrically powered surgical instruments as described in U.S. Patent Nos. 4,635,638 and 5,258,007, and European Pat. Appln. No. 0 552 050.
In general, prior art electrically powered surgical instruments have been driven by external power sources. The instruments were connected to the power sources by conductive cables. Such cables could, however, become entangled during a surgical 2 o procedure, thereby complicating the operation.
It would be beneficial to provide a self-contained powered surgical appa,~ s for applying a pluralit,v of surgical staples to body tissue and concoll"~an~ly incising the stapled tissue. Such an app~tus should be compact, lightweight and easy to m~mlf~ctl-re Currently, surgical instruments are designed for use in either open, i.e.
2 5 invasive procedures, or endoscopic/laparoscopic procedures. As noted above, endoscopic instruments require elongate shafts to access remote surgical sites.
Conventional surgical instruments are not constructed in this manner. It would be advantageous to provide a powered surgical instrument which can be readily adapted for use in both conventional and laparoscopic procedures.
SUMMARY
A self-contained powered surgical app~ ~ls for applying a pluralit,v of surgical fasteners to body tissue is provided. The apparatus includes an elongate instrument body dçfining a longit~ldin~l axis, a cartridge assembly housing a plurality of 3 5 surgical fasteners, and an anvil member mounted adjacent the cartridge assembly and configured for movement with respect thereto between an open and a closed position.
The app~a~ls further includes a motor assembly disposed within the elongate instrument body, an actu~ting assembly driven by the motor assembly for ~ 4 7 :~
effectu~finE progressive closure of the anvil and sequential ejection of the surgical fasteners and a power source disposed within the body for energizing the motor assembly. Preferably, the act l~finE assembly in~ des a drive member which is threadably associated with an axial drive screw that is driven by the motor assembly.
In a plerelled embodiment, the act l~tin~ assembly inrludes a first c~mmin~ meçh~nicm configured to move the anvil member into a closed position to clamp tissue, and a second c~mmin~ meçh~nicm configured to sequentially eject fasteners from the cartridge as it tr~n~l~tes therethrough. A tissue cutting member is preferably associated with the ~çtu~tinE assembly for tr~nsl~tinE through the cartridge assembly to incise the stapled body tissue. A control for the motor assembly to operate the powered surgical apparatus preferably incllldec first and second control buttons for effecting distal and proximal movement of the ~ctu~tinE assembly.
In one embodiment, the powered surgical app~al~ls incll-des an elongate shaft configured to engage with a proximal end of the main instrument body to f~ilit~te utilization ofthe app~LIls during an endoscopic procedure. Preferably, the extension shaft interacts with the motor control buttons at the proximal end of the main instrument body to operate the appa~L~ls from a location remote from the surgical site.
In another embodiment, the powered surgical appa~LIls is insçn~led to be employed during a laparoscopic procedure by providing a mer.h~nical hand which is 2 o configured to extend into the abdominal cavity through a cannula and be remotely manipulated to actuate the appal~L~ls.
In another embodiment, the powered surgical app~L-ls incl~des an elongate body d~fininE a lon~ihl(lin~l axis, and a disposable cartridge assembly which is det~çh~bly supported in a distal end portion of the elongate body.
The disposable cartridge assembly inl~h1des a frame having a proximal end portion configured to engage the distal end portion of the elongate body, and a housing supported within the frame and co,~ ni'lE a plurality of surgical fasteners. An anvil member is pivotably associated with the frame and is mounted for movement with respect to the housing between an open position and a closed position. An actuation 3 o assembly is disposed within the frame and is configured to translate in a lonEit~1tlin~l direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and seq~lçnti~lly eject the surgical fasteners from the housing to be formed against the anvil. An axial drive screw is rotatably mounted within the frame and threadably associated with the actuation assembly for effechl~finE the 3 5 lonEihltlin~l translation thereof.
The surgical app~ s further in~ des a motor assembly having an axial drive shaft, and a coupling to det~çh~bly connect the axial drive screw of the cartridge assembly to the axial drive shaft of the motor. A power source is disposed within the `- 21~5475 elongate body for energizing the motor assembly. Preferably, a bayonet-type fitting is associated with the distal end portion of the elongate body and the pl o~illlal end portion of the frame to f~c,ilit~te the det~c,h~ble connection of the cartridge assembly.
Further features of the powered surgical appal~LIls will become more 5 readily appale"~ to those skilled in the art from the following detailed description ofthe invention taken in conjunction with the drawings.
BRIEF DESCRIPTION OF T~E DRAWINGS
Various embodiments of the powered surgical apparatus will be 10 described hereinbelow with I efel ence to the drawings wherein:
Fig. l is a perspective view of a powered stapling device constructed in accordance with a prefelled embodiment;
Fig. 2A is an illustration depicting the powered stapling device of Fig. l with a flexible extension shaft ~tt~ched thereto in use during a laparoscopic procedure;
Fig. 2B is an illustration depicting the powered stapling device of Fig. l with a rigid extension shaft ~tt~rhed thereto in use during a laparoscopic procedure;
Fig. 3 is an illustration depicting a mech~nical hand opel~ing the powered stapling device of Fig. l during a laparoscopic procedure;
Fig. 4 is an exploded perspective view of the powered stapling device of Fig. l;
Fig. 5 is a sch~m~tic representation ofthe switching mech~nism for controlling the operation of the motor assembly;
Fig. 6 is a side elevational view in cross-section taken along line 6-6 of Fig. 1 illustrating the relative position of the internal components of the powered 2 5 stapling device prior to actuation;
Fig. 7 is a top plan view in cross-section illustrating the relative position of the internal components of the powered stapling device prior to actuation;
Fig. 8 is a cross-sectional view taken along line 8-8 of Fig. 6 illustrating the actu~tin~ assembly;
3 o Fig. 9 is a cross-sectional view taken along line 9-9 of Fig. 6 illustrating the drive shaft of the motor assembly;
Fig. l0 is a cross-sectional view taken along line l0-l0 of Fig. 6 illustrating the interaction between the drive shaft of the motor assembly and the axial drlve screw;
3 5 Fig. l l is a side elevational view in cross-section illustrating the relative position of the internal components of the powered stapling device during a stapling operation;
~lSS47~
Fig. 12 is a side elevational view in cross-section illustrating the relative position of the internal components of the powered stapling device at the completion of a stapling operation;
Fig. 13 is a perspective view of another powered stapling device 5 constructed in accordance with a pr~Ç~lled embodiment ofthe subject application which inr.llldec a det~çh~ble cartridge assembly that can be discarded after a stapling operation;
Fig. 14 is an exploded perspective view of the det~ch~hle cartridge assembly illustrated in Fig. 13;
Fig. 15 is an enlarged side elevational view in cross section of a portion 10 ofthe stapling device of Fig. 13 illustrating the coupling engagement ofthe axial drive screw of the cartridge assembly and the axial drive shaft of the motor assembly;- Fig. 16 is an exploded perspective view in partial cross-section illustrating the components of the stapling deceive which f~cilit~te the det~ch~hle connection of the cartridge assembly and the instrument body;
Fig. 17 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the motor assembly and power cells housed within the elongate body ofthe surgical app~L~ls of Fig. 13;
Fig. 18 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the cartridge assembly ofthe subject application prior to a stapling operation; and Fig. 19 is a side elevational view in cross-section taken along line 17-17 of Fig. 13 illustrating the cartridge assembly ofthe subject invention at the conclusion of a stapling operation.
DETAILED DESCRIPTTON OF PREFERRED EMBODIMENTS
In the drawings and in the description which follows, the term "proximal", as is traditional, will refer to the end of the appa~ s which is closest to the operator, while the term "distal" will refer to the end of the appal ~L~1S which is furthest from the operator.
The appa.~LLls shall be diccucsed in terms of both conventional and endoscopic procedures. However, use herein of terms such as "endoscopic", "endoscopically", and "endoscopic portion", among others, should not be construed to limit the present appa,~ s for use only in conjunction with an endoscopic tube. To the co~ y, it is believed that the present apparatus may find use in procedures wherein 3 5 access is limited to a small incision incll1rlinp but not limited to arthroscopic and/or laparoscopic procedures.
Referring now to the drawings wherein like reference numerals identify similar structural elements of the appa ~LLIS, there is illustrated in Fig. 1 a self-contained 21SS47.S
powered surgical stapler constructed in accordance with a preferred embodiment and design~ted generally by reference numeral 10.
Referring to Fig. 1, powered surgical appa,~l~ls 10 is configured for use as a hand-held device for applying a plurality of surgical staples to tubular vessels and body tissue during conventional invasive surgical procedures. By way of example only, surgical app~ s 10 may have a length measuring from about 5.0 inches to about 7.0 inches, and an outer diameter of about .450 inches to about .500 inches. Plere,~bly, the length of surgical appa~L~Is 10 is between 6.0 inches and 6.5 inches, while the plt;relled mPter iS between .470 inches and .480 inches. Clearly, other dimensions are 0 contçmrlated. In one embo-lim~Pnt surgical app~lus 10 is also adapted for use in endoscopic procedures through remote actuation from a location outside the patient's body, as shown in Figs. 2A and 2B. This is achieved by providing an elongated extension shaft 12 which anache~ to the proximal end of surgical app~ ~us 10 by commonly known connective methods such as snap fit. Extension shaft 12 is preferably dimensioned and configured for insertion through a c~nmll~ or trocar device and has a length measuring from about 10.0 inches to about 17.0 inches. A flexible shaft 12 or rigid shaft 12' can be utili7ed Referring to Fig. 3, in another embodiment, surgical appa, ~IS 10 is intçn~ed to be operated by a mechanical hand 15 which is configured to extend through trocar device 17 during a laparoscopic surgical procedure. Mechanical hand 15 inrl~des four articulated fingers 15a-15d and an opposable thumb 15e which are hinged together to enable relative movement between a constricted position wherein the forehand and fingers are drawn together into a n~uwed formation to f~ilit~te their extension through trocar 17 and a relaxed position wherein the forehand and fingers are deployed 2 5 into a spread position to perfomm dexterous tasks such as operating surgical appa~ s 10 by actu~ting a switch provided on the app~ s.
Referring to Fig. 4, surgical app~ s 10 inrlllde~ an elongate body 20 in~lu(ling complimentary body sections 22 and 24 which define a series of intemal chambers for housing and supporting various mechanical components of app~ ~L~IS l O.
3 o The intemal chambers defined within body sections 22 and 24 include distal chamber 26, medial chamber 28, and proximal chamber 30.
The components housed within body sections 22 and 24 of surgical app~ s 10 include an elongate housing channel 32 having a base 34 and opposed upst~ntling channel walls 38a and 38b. Housing channel 32 is m~int~ined within the 3 5 distal chamber 26 of body 20 and is configured to support the assembly 40 and the actu~ting assembly 42.
The assembly 40 int ludes an elongate staple cartridge 44 having a plurality of transverse slots 46 each configured to support a respective staple 48 and ~l~a47a staple pusher 50. Cartridge 44 is also provided with five spaced apart longitudin~l slots inr.lu~ling a central slot 52 and lateral slot pairs 54a, 54b and 56a, 56b. The lateral slot pairs 54a, 54b and 56a, 56b serve to accommodate longitu~in~l translation of theelongate G~mming bars 58a, 58b and 60a, 60b of ~ctu~ting assembly 42 while the central 5 slot 52 serves to accommodate longitutlin~l translation of a cutting blade 62. ~rh1~ting assembly 42 and the components associated therewith will be described in greater detail hereinbelow.
Assembly 40 further inr,ludes an elongate anvil 64 which defines an interior fastener fo~ g surface 65 against which staples are driven when ejected from cartridge 44 by the actu~ting assembly 42. A pair of outwardly depending wings 66a and 66b are formed ~djacçnt the proximal end of anvil 64 for çng~ging a pair of correspondingly positioned reception slots 68a and 68b formed in the opposed upst~nding channel walls 38a and 38b of housing channel 32. The engagement of wings 66a and 66b within slots 68a and 68b f~rilit~tes pivotal movement of anvil 64 with 15 respect to cartridge 44. A longitu~in~l slot 70 extends along a substantial portion ofthe length of anvil 64 to accommodate the longitudin~l translation of cutting blade 62 and the portion of actu~ting assembly 42 which supports the cutting blade. Similarly, a longitu(lin~l slot 75 is formed in the base 34 of housing channel 32 (see Fig. 6). The orientation and length of slots 70 and 75 correspond substantially to that of the central 2 o slot 52 provided in cartridge 44.
A spring 65 extends from the pl ox,~"al end of anvil 64 and is att~ched to body section 22 (or alternatively base 34) to bias the anvil towards the cartridge 44.
Thus, in use, as tissue is positioned between the anvil and cartridge, the anvil is forced - away from the cartridge by the tissue. Actuation of the actu~ting assembly (~ cussed 2 5 below) forces anvil 64 into closer cooperative ~lignm~nt with cartridge 44 to more firmly and progressively clamp the tissue. In an alternate embodiment, the anvil 64 is biased to an open position, i.e. biased away from cartridge 44, by, for example, a pair of springs positioned at a proximal end of the anvil between the anvil and cartridge 44. It is also contemplated that the anvil can be connected for free movement with respect to 3 o the cartridge without a spring bias.
As best seen in Fig. 4, actu~ting assembly 42 includes two pairs of elongate c~lllllling bars 58a, 58b and 60a, 60b. The c~mming bars serve to sequentially eject staples 48 from cartridge 44 through interaction with staple pushers 50. In particular, each ofthe elongate c~"""i"g bars inrl.ldes a distal head portion 72 having an 3 5 angled c~mming surface 74. C~mming surface 74 is configured to contact staple pushers 50 and drive the staple pushers in a direction transverse to the longitu(lin~l axis of cartridge 44, thereby urging the staples from cartridge 44. An engagement notch 76 21~ ~ 4 ~ ~
-is formed adjac~nt the proxilllal end of each ofthe s~mming bars for eng~ging corresponding grooves 78 provided in drive member 80.
Drive member 80 incl~des a threaded bore 82 for operatively ~ng~ging an axial drive screw 84. Drive screw 84 is driven by a motor assembly 86 and is connected to the drive shaft 88 of motor assembly 86 by a supporting hub assembly which in~ludçs an outer support hub 90, an interme~iate support hub 92, and an inner çng~g~m.o,nt hub 94 (see Fig. 9). Engagement hub 94 is f~stçne~ to the pro~ill,al end of drive screw 84 and is engaged within the intern e~ te support hub 92. As shown in Fig. 10, drive shaft 88 is keyed into the opposed end of support hub 92. Support hub 92 is coaxially lo disposed within outer support hub 90 which is ~ )ed with the medial charnber 28 of elongate body 20. Motor assembly 86 and the power cells 98a-98c which supply energy thereto are ~ ined with the proxi."al chamber 30 of elongate body 20. A transferplate 158 is disposed between the distal-most power cell 98a and the p-oxill,al end of motor assembly 86 for transferring energy from the power cell to the motor assembly.
~ctuating assembly 42 further inc.llldes a ca.l.ll.;l-g beam 100 for effectuating the progressive closure of anvil 64 to clamp body tissue disposed between fastener forming surface 65 of anvil 64 and the tissue contacting surface 45 of staple cartridge 44. C~mming beam 100 includes an upper beam portion 102, a central webportion 104, and a lower beam portion 106. Central web portion 104 supports cutting blade 62. Upper and lower beam extensions 108 and 109 extend plo~il"ally from central web portion 104 to engage drive member 80. As shown, the upper and lowerbeam portions 102, 106 are substantially planar. Thus, the mer.h~nicm for clamping the anvil (c~mming beam 100) and the me~h~nicm for firing the staples from the cartridge (c~mming bars 58a, 58b and 60a, 60b) are directly connected to drive member 80. In use, the upper beam portion 102 of C~.. ;l-g beam 100 progressively contacts the outer surface 67 of anvil 64 to effect progressive anvil closure. The central web 104 tr~n~l~tes through slots 52, 70, and 75, and the lower beam portion 106 tr~nCl~tes along the outer surface 35 of the base 34 of housing channel 32 to ,.~i..t~ anvil closure during a stapling procedure.
3 o Referring to Fig. 8 in conjunction with Fig. 4, a support gate 110 is mounted intermerliate housing channel 32 which has an aperture 115 for supporting the distal end portion of axial drive screw 84. As best seen in Fig. 4, support gate 110 inclndçc a pair of opposed winglets 112a and 112b for eng~ging corresponding reception slots 114a and 114b in the opposed channel walls 38a and 38b of housing 3 5 channel 32. Upper and lower grooves 116 and 118 are formed in support gate 110 to accommodate the translation of the upper and lower beam extensions 108 and 109.
Lateral slot pairs 120a, 120b and 122a, 122b are provided in support gate 110 toaccommodate the translation of c,~mming bar pairs 58a, 58b and 60a, 60b.
215547~
, g Surgical appa,~us 10 further inGl~-des a switching assembly 130 for selectively controlling the operation of motor assembly 86. Switching assembly 130 inc.l~ldes distal and plox~lllal switch housings 132 and 134, and right and left spring biased actuation buttons 136 and 138. A plurality of coiled colllpression springs 135 bias actuation buttons 136 and 138 in a proximal direction. Switch housings 132 and 134 are mounted to one another and f~ctçned to the pro~illlal end of surgical app~lus io by a threaded connector 140, and are operatively separated from one another by a distal inc~ ting ring 141, a distal contact plate 142, a medial inc~ tin~ ring 143, and a proximal contact plate 144. A distal contact ring 145 is disposed between distal switch housing 132 and spring 137.
Distal contact plate 142 incl~1des a pair of opposed upturned contact tabs 142a and-142b, and pr~illlal contact plate 144 in~ ldes a pair of opposed upturned contact tabs 144a and 144b which are positioned 60 out of phase with tabs 142a and 142b. Each actuation button has associated therewith three contact pins, two of which interact with contact plates 142 and 144 to control the relative movement of drive screw 84. In particular, actuation button 136 includes two long pins 146a and 146b and one short pin 146c. Short pin 146c is seated within a central reception port 147c, while long pins 146a and 146b are seated within lateral reception ports 147a and 147b.
Long pin 146a and short pin 146c are positioned to selectively engage contact tabs 142a and 144b respectively, while long pin 146b remains free from electrical contact. Similarly, actuation button 138 incl~1des long pins 150a and 150b, and short pin 150c. Short pin 150c is seated within a central reception port 151 c, while long pins 150a and 150b are seated within l~teral reception ports 151a and 151b. Long pin 150b and short pin 150c are positioned to selectively engage contact tabs 142b and 144b 2 5 respectively, while long pin 150a remains free from electrical contact.
The wiring configuration of switching assembly 130 is illustrated in Fig. 5 and incl~ldes motor line 152 which interconnects the positive terminal 86a of motor assembly 86 to contact pins 146a and 150c, and a motor line 154 which interconnects the negative terminal 86b of motor assembly 86 to contact pins 146c and 150b. Inaddition, a trancmiccion line 156 extends between battery transfer plate 158 and contact plate 144, and a tr~ncmicsion line 160 interconnects contact plate 142 and contact ring 145.
In use, when actuation button 138 is depressed, long pin 150b contacts tab 142b of distal contact plate 142 and short pin 150c contacts tab 144b of proximal contact plate 144. Thus, the positive terminals of power cells 98a-98c will be connected to the negative terminal 86b of ~notor assembly 86 and the negative terminals of power cells 98a-98c will be connected to the positive terminal 86a of motor assembly 86, causing drive shaft 88 to rotate in a clockwise direction to move drive member 80 21aa 473 distally. When actuation button 136 is depressed, long pin 146a contacts tab 142a of distal contract plate 142 and short pin 146c contacts tab 144a proxi"lal contact plate 144. Thus, the positive terminals of power cells 98a-98c will be connected to the positive terminal 86a of motor assembly 86 and the negative terminals of power cells 98a-98c will be connected to the negative terminal 86b of motor assembly 86, causing drive shaft 88 to rotate in a counter-clockwise direction to move the axial drive m.omh.o.r 80 in a pro~ lal direction. It is also envisioned that a single actuator button can be provided which will be actuable to operate an axial drive screw having a reverse thread formed therein. The reverse thread will cause a distally trAn~l~ting drive screw to 1 0 automatically translate in a pl oxll,al direction at the conclusion of a fastener forming stroke.
- As ~iccussed briefly hereinabove, surgical app~LIls 10 is preferably designed for insertion through a trocar or cannula device to apply surgical staples to body tissue located within a body cavity while being actuable remote from the surgical site. Shaft 12 includes elongate trAn~mi~ion members 12a and 12b (or 12a' and 12b') for effectuAting remote actuation of switching assembly 130 (see Figs. 2A and 2B).
TrAn~miccion members 12a and 12b (or 12a' and 12b') may include a pair of substantially rigid rods for ~ g a mechanical signal to actuation buttons 136 and 138, or, in the alternative, the trAn~mi~sion members may include ll~nc~iccion cables for directing 2 o an electrical signal to switching assembly 130. In either instance, the sha~ would include two actuation buttons to respectively actuate buttons 136 and 138 and cause the rotation of drive screw 84 in opposed directions.
Referring now to Figs. 6 and 7, prior to operating the surgical stapling device 10, the anvil 64 is disposed in a free-movement position to fAcilit~te th e capture 2 5 of body tissue (or spring biased to a closed or an open position as in the aforelllelllioned alternate embodiments). Movement of anvil 64 is accommodated by the pivotal ~ngAglomP.nt of anvil wings 66a and 66b in reception slots 68a and 68b. The pivotal movement of anvil 64 is best seen in Fig. 6. Prior to actuation, c~mming beam 100 is ,.,Ail-~Ai"ed within a support seat 26a defined in the distal chamber 26 of instrument body 3 o 20. At such a time, the upper beam portion 102 is out of contact with the outer surface 67 of anvil 64 pelllliL~ing the pivotal movement thereof. Also at this time, the distal head portion 72 of each of the c~mming bars 58a, 58b and 60a, 60b is disposed proximal to and out of contact with the proximal-most staple pushers 50 in cartridge 44.
Upon actuation, i.e. when actuation button 136 is depressed, motor 3 5 assembly 86 is energized and drive shaft 88 rotates axial drive screw 84, causing drive member 80 to translate in a distal direction. As best seen in Fig. 11, as drive member 80 trAn~l~tes distally, the upper beam portion 102 of c.~mming beam 100 progressively urges anvil 64 toward cartridge 44 to clamp body tissue 165 therebetween.
21~ ~ ~ 7 ~
.
Concol-~iLalllly, the r,~mming surface 74 on the distal head portion 72 of each of the ç~mming bars of actuation assembly 42 interacts with staple pushers 50 to sequentially eject surgical staples 48 from cartridge 44.
Staples ejected from cartridge 44 are driven through body tissue 165 and formed against the inner fastener forrning surface 65 of anvil 64. As the rows of staples are placed in body tissue 165, cutting blade 62, which travels behind the distal head portion 72 of each of the c~ bars of actuation assembly 42, cuts the stapled body tissue, forrning an incision between the staple rows.
Continued actuation of motor assembly 86 effects distal translation of o drive member 80 until the drive member contacts support gate 110. At such a time, c~ .1 ll l l; i-g beam 100 is disposed at the distal end of fastener applying assembly 40 and the distal head 70 of each of the r,~mming bars is disposed within the distal portion 45 of staple cartridge 44. Following the stapling operation, depression of actuation button 138 causes drive member 80 to translate proximally, drawing therewith c~mminP: beam 100 and c~mmin~ bars 58a, 58b and 60a, 60b to their proxill,al-most position (Fig. 6).
It is also contemplated that the staple cartridge 44 can be removable so that once actuation assembly 42 has returned to its proximal-most position after firing the fasteners, staple cartridge 44 can be removed and replaced with a loaded staple cartridge and actuation button 136 can be depressed again to fire the stapling app~ s.
2 o Referring now to Fig. 13, there is illustrated another self-contained powered surgical apparatus constructed in accordance with a prerell~d embodiment of the subject application and decign~ted generally by reference numeral 200. Surgical appa~ s 200 is configured to sequentiaDy apply a plurality of surgical fasteners to body tissue during conventional and/or endoscopic surgical procedures. In brief, surgical appal~ s 200 includes an elongate instrument body 210 and a disposable cartridgeassembly 220 which is det~r.h~kly connected to a distal end portion of the instrument body 210 by a bayonette-type coupling arrangement. Instrument body 210 houses a motor assembly 212 and a plurality of power cells or batteries 214 for enelgi~ g the motor assembly. The power cells can be lithium, alkaline or nickel-cadmi.-m batteries.
3 o An in~ul~1ing material is wrapped around the power cells to isolate them from conductive outer casing 215. A conductive contact plate 216 is disposed between the terminal end 212a of motor assembly 212 and the distal-most battery 214a, and a coiled spring 218 is disposed within the pl oxilllal end of instrument body 210 to bias the batteries distally (see Fig. 17).
3 5 Referring to Figs. 13 and 14, cartridge assembly 220 infh~des a frame 222 having an adapter 224 configured to det~rh~bly engage a distal end portion of instrument body 210 (see generally Fig. 16), and a housing channel 226 configured to retain a cartridge 228 cont~ining a plurality of surgical fasteners 230. Cartridge 21~47a assembly 220 further inr,ludçs an anvil 232 which is pivotably mounted to housing channel 226, and an actuation assembly design~ted generally by reference numeral 240 which is driven by motor assembly 212 and configured to eject the surgical fasteners 230 from cartridge 228, and conco~ anlly move anvil 232 between an open position and a 5 closed position ~see generally Figs. 18 and 19).
With continuing reference to Fig. 14, adapter 224 inrludes an elongate distal portion 234 and a prox.l,lal mounting portion 236 dimensioned and configured for reception within the distal end of instrument body 210. Housing channel 226 inrludes opposed side walls 226a and 226b, and a floor 226c. An aperture 238 is defined in floor 226c ~djacçnt the pro~illlal end of housing channel 226 for receiving a threaded fastener 242 which mounts the housing channel 226 to the adapter 224. A pair of opposed apertures 244a and 244b are defined in the side walls 226a and 226b of hrl~cing channel 226 for receiving a pair of outwardly extçn~ling flanges 232a and 232b which are formed adjacçnt the proximal end of anvil 232 and about which anvil 232 pivots between closed and opened positions to capture and release body tissue. A pair of spring members 246a and 246b are disposed within apertures 244a and 244b for biasing anvil 232 into an open position. Opposed ~ng~g~ment notches 248a and 248b are also defined in the opposed side walls 226a and 226b of housing channel 226 for receiving a pair of corresponding detents formed on cartridge 228, i.e. detent 228b. The detents are formed 2 o monolithically with the fastener ret~ining cartridge 228 and secure the cartridge within the distal portion of housing channel 226.
With contin~ing lerelence to Fig. 14, the actuation assembly 240 of cartridge assembly 220 in~ludes an actuation sled 250 configured to translate through cartridge 228 to effectuate the ejection of surgical fasteners therefrom. Sled 250 2 5 includes a plurality of spaced apart upst~nding cam plates 252 each having an angled leading edge 254 for sequentially çng~ging a plurality of staple drivers 256 which drive surgical fasteners 230 from cartridge 228. Actuation sled 250 is driven through cartridge 228 by an actuation beam 260 and an axial drive screw 270. Actuation beam 260 has a pair of parallel elongate beam extensions 262 and 264 the proximal ends of 3 o which are mounted to a follower housing 266. Follower housing 266 supports a drive nut 268 which is threadably associated with axial drive screw 270. Follower housing 266 is mounted within frame 222 in such a manner so that axial rotation of drive screw 270 causes the lon ih~in~l translation thereof. The distal end 270a of drive screw 270 is rotatably supported in a stationary support mount 272 which is m~in~ined within frame 3 5 222 and engaged in a slotted region 235 of the distal portion of adapter 234. Support mount 272 also serves to guide the longitu(lin~l translation of beam extensions 262 and 264 as actuation beam 260 is driven in a longitudin~l direction by follower housing 266.
2155~ 7~
A knife blade 265 is mounted adjacent the leading edge of actuation beam 260 forcutting body tissue as actuator 250 tr~ncl~tes through cartridge 228.
Referring to Figs. 14-16, the proximal end 270b of drive screw 270 is configured to engage a screw coupling 274. Screw coupling 274 is rotatably supported within an axial bore 276 defined in the p~ oxil"al mounting portion 236 of adapter 224 and is det~h~hly connected at a proximal end to a shaft coupling 278 which is supported on the drive shaft 280 of motor assembly 212. The cooperative ~ng~ m~nt of the two couplings will be ~ c--ssed in greater detail hereinbelow.
Referring once again to Fig. 14, the distal end of actuation beam 260 include a retention flange 282 for supporting a generally cylindrical cam roller 284 and an engagement slot 286 for ret~ining a substantially planar cam beam 288. Cam roller 284 ~ng~es and tr~n~l~tes relative to an upper c~mming surface 290 of anvil 232 to effectuate the progressive closure thereof as follower housing 266 and actuation beam 260 translate through housing channel 226 to fire surgical fasteners 230 from cartridge 228. Cam beam 288 engages and tr~n~l~tes relative to the outer surface ofthe floor 226c of housing channel 226 to balance the forces exerted upon anvil 232 by cam roller 284 during closure. A longitudin~l slot 292 is defined in the floor 226c of housing channel 226 and a corresponding longitu(lin~l slot 294 is defined in the anvil 232 to accommodate the longit~l(lin~l translation of ~ct~l~ti~n beam 260. A transverse slot 2 o extension 296 is defined at the distal end of anvil slot 294 to receive cam roller 284 at the end of its translation, and thereby permit anvil 232 to return to an open position under the bias of spring members 246a and 246b following a f~ctçning operation. Thus, body tissue is automatically Im~ mred as soon as all of the fasteners have been fired.
Referring now to Figs. 13 and 16, as noted hereinabove, the cartridge 2 5 assembly 220 of surgical apparatus 200 is configured as a separate unit which is det~çh~bly mounted to the distal end ofthe instrument body 210 by a bayonette-type coupling arrangement. The bayonette coupling arrangement in~llldes a pair of generally J-shaped slots 304 defined adjacent the distal end of instrument body 210, and a pair of corresponding engagement pins 312 and 314 mounted in the proximal mounting portion 3 o 234 of adaptor 224 (see also Fig. 14). During att~hm~nt of cartridge assembly 220, the proximal mounting portion 236 of adapter 224 is axially rotated approximately 20degrees to engage pins 312 and 314 in corresponding slots 302, 304.
Referring to Figs. 16 and 17, a coiled compression spring 316 is supported on the drive shaft 280 of motor assembly 212 for biasing the shaft coupling 3 5 278 in a distal direction. Shaft coupling 278 is supported within a stepped axial bore 318 defined in instrument body 210 and inel~ldes a transverse slot 320 which is dimensioned and configured to engage a corresponding teeth 322 formed at the proximal end of screw coupling 274. The function of coupling spring 316 is two fold.
2 1 5 ~ 4 7 5 Firstly, if teeth 322 and flange 322 are not aligned when the ploxilllal mounting portion of adapter 224 is inserted into the distal end of instrument body 210, coupling spring 316 will col-lpensate for the mic~lignm~nt and f~cilit~te engagement of the couplings upon initial rotation of drive shaft 280. More particularly, upon insertion of the adapter, if mi c~ligne~l~ teeth 322 will abut the distal-most surface of shaft coupling 278. When drive shaft 280 initially rotates and slot 320 aligns with flange 322, coupling spring 316 will decompl ess and force shaft coupling 278 in a distal direction to cause the two couplings to det~ch~bly engage. The second function of coupling spring 316 is to bias adapter 224 in a distal direction when the bayonette coupling which det~ch~bly 0 ",~ ,c cartridge assembly 220 in body portion 210 is engaged.
Referring to Figs. 15-17, a switch 330 is provided for selectively controlling the operation of motor assembly 212. Switch 330 is a touch-sensitivecontact switch that is wrapped around the circumference of instrument body 210 within a recessed area 332. Switch 330 inchldes an outer contact layer 330a, a medial in~ ting layer 330b, and an inner conductive layer 330c. A slot 333 is provided in in.cul~tin~ layer 330b to permit contact between the outer contact layer 330a and the inner conductive layer 330c. A motor control circuit is defined by a first electrically conductive metallic strip 334 which connects switch 330 to the conductive outer casing 215 of instrument body 210, a second conductive strip 235 which connects outer casing 2 o 215 to the terminal T ofthe proximal-most power cell 214d, and a third conductive strip 336 which connects switch 330 to the terminal end 21 2a of motor assembly 212.
Referring now to Figs. 18 and 19, in operation, when surgical app~ ~ s 200 is introduced into a surgical site, body tissue is captured between anvil 232 and cartridge 228. A radially inwardly directed force in two locations on switch 330 brings 2 5 outer layer 330a into contact with inner layer 330c, then causing current to flow to motor assembly 212 to rotate the drive shaft 280 of motor assembly 212. The rotational motion of drive shaft 280 is ll~lsr~lled to drive screw 270 through couplings 274 and 278. Axial rotation of drive screw 270 causes corresponding longiturlin~l translation of follower housing 266 and actuation bearn 260.
As actuation bearn 260 tr~ncl~tes distally, cam roller 284 progressively moves anvil 232 from the normally biased open position shown in Fig. 18 to the closed position illustrated in Fig. 19. Concomi~ ly, actuation sled 250 is driven from the ploxilllal position illustrated in Fig. 18, through fastener retention cartridge 228, to the distal-most position shown in Fig. 19 sequentially çng~ging staple drivers 256 so as to 3 5 drive surgical fasteners 230 through body tissue 350. At the same time, knife blade 265 trails actuation sled 250 to forrn an incision in the stapled body tissue 350. When cam roller 284 reaches the distal end of longitu~lin~l slot 294, it drops into transverse slot extension 296, permitting anvil 232 to return to an open position and release the stapled 21~.5475 body tissue 350. At the conclusion ofthe fastener applying operation, cartridge assembly 212 is manipulated in such a manner so as to di~çng~ge pins 312 and 314 ~om slots 302 and 304, and detach the cartridge adapter 224 from the distal end of instrument body 210. Thereafter, the cartridge assembly may be discarded and a new 5 cartridge assembly may be det~çh~bly mounted to instrument body 210.
.~lthough the app~uls has been described with respect to plere"ed embodimçnt~, it will be readily appalenl to those having o~dil~a,y skill in the art to which it appertains that changes and modifications may be made thereto without departing from the spirit or scope of the appended claims.
Claims (43)
1. A self-contained powered surgical apparatus for applying surgical fasteners to body tissue comprising:
a) an elongate body defining a longitudinal axis;
b) a cartridge supported by said elongate body and housing a plurality of surgical fasteners and having a tissue engaging surface thereon;
c) an anvil member having a fastener forming surface thereon, the anvil member mounted adjacent the cartridge and configured for relative movement between an open position wherein said fastener forming surface is spaced from said tissue engaging surface and a closed position wherein said fastener forming surface is in close cooperative alignment with said tissue engaging surface;
d) a motor assembly disposed within the elongate body;
e) a power source disposed within the elongate body for energizing the motor assembly; and f) an actuating assembly driven by the motor assembly; and g) wherein the actuating assembly moves in a longitudinal direction to effect relative movement of the anvil member and the cartridge and to effect sequential ejection of a plurality of surgical fasteners from the cartridge.
a) an elongate body defining a longitudinal axis;
b) a cartridge supported by said elongate body and housing a plurality of surgical fasteners and having a tissue engaging surface thereon;
c) an anvil member having a fastener forming surface thereon, the anvil member mounted adjacent the cartridge and configured for relative movement between an open position wherein said fastener forming surface is spaced from said tissue engaging surface and a closed position wherein said fastener forming surface is in close cooperative alignment with said tissue engaging surface;
d) a motor assembly disposed within the elongate body;
e) a power source disposed within the elongate body for energizing the motor assembly; and f) an actuating assembly driven by the motor assembly; and g) wherein the actuating assembly moves in a longitudinal direction to effect relative movement of the anvil member and the cartridge and to effect sequential ejection of a plurality of surgical fasteners from the cartridge.
2. A powered surgical apparatus as recited in Claim 1, wherein the actuating assembly includes a first camming mechanism for progressively moving the anvil member into the closed position and a second comprising mechanism for sequentially ejecting a plurality of fasteners from the cartridge mechanism.
3. A powered surgical apparatus as recited in Claim 2, further comprising a drive member threadably associated with an axial drive screw driven by the motor assembly.
4. A powered surgical apparatus as recited in Claim 1, further comprising a tissue cutting member operatively associated with the actuating assembly for incising tissue as a plurality of surgical fasteners are ejected from the cartridge.
5. A powered surgical apparatus as recited in Claim 1, further comprising an actuator for selectively controlling the motor assembly to operate the apparatus.
6. A powered surgical apparatus as recited in Claim 5 wherein the actuator includes a first actuator button for effecting distal translation of the actuating assembly and a second actuator button for effecting proximal translation of the actuating assembly.
7. A powered surgical apparatus as recited in Claim 5 further comprising an elongate extension member configured to engage a proximal end of the elongate body to facilitate utilization of said apparatus during an endoscopic surgical procedure.
8. A powered surgical apparatus as recited in Claim 7 wherein the elongate extension member includes a pair of rods or cables for interacting with the actuator to effectuate remote operation of the apparatus.
9. A powered surgical apparatus as recited in Claim 8 wherein the actuator and extension member each include a pair of actuator buttons.
10. A powered surgical apparatus as recited in Claim 1 wherein the elongate body has a substantially uniform diameter.
11. A powered surgical apparatus as recited in Claim 1 wherein the elongate body has an operative length of less than 7.0 inches.
12. A powered surgical apparatus as recited in Claim 1 wherein the anvil member is biased to the open position.
13 . A powered surgical apparatus as recited in Claim 1 wherein the anvil member is biased to the open position.
14. A powered surgical apparatus as recited in Claim 1 wherein the actuating assembly progressively moves the anvil member from the open position to the closed position and concominantly ejects the plurality of surgical fasteners from the cartridge.
15. A powered surgical apparatus for applying surgical fasteners to body tissue comprising:
a) an elongate main instrument body;
b) a cartridge supported by the main instrument body, and housing a plurality of surgical fasteners;
c) an anvil against which fasteners are driven when ejected from the cartridge;
d) an actuating assembly operatively associated with a distal end portion of the main instrument body, wherein the actuating assembly is actuable toengage body tissue and sequentially apply a plurality of surgical fastenersthereto;
e) a motor assembly disposed within the main instrument body for actuating the actuating assembly; and f) an elongate extension shaft configured to engage with a proximal end of the main instrument body to facilitate utilization of the main instrument body during an endoscopic surgical procedure.
a) an elongate main instrument body;
b) a cartridge supported by the main instrument body, and housing a plurality of surgical fasteners;
c) an anvil against which fasteners are driven when ejected from the cartridge;
d) an actuating assembly operatively associated with a distal end portion of the main instrument body, wherein the actuating assembly is actuable toengage body tissue and sequentially apply a plurality of surgical fastenersthereto;
e) a motor assembly disposed within the main instrument body for actuating the actuating assembly; and f) an elongate extension shaft configured to engage with a proximal end of the main instrument body to facilitate utilization of the main instrument body during an endoscopic surgical procedure.
16. A powered surgical apparatus as recited in Claim 15, further comprising a controller associated with a proximal end of the main instrument body for selectively controlling the motor assembly.
17. A powered surgical apparatus as recited in Claim 15, wherein the elongate extension shaft includes a pair of rods or cable for interacting with the controller to effectuate remote operation of the motor assembly.
18. A powered surgical apparatus as recited in Claim 16, wherein the main instrument body has an operative length ranging from about 5.0 inches to about 7.0 inches, and the extension shaft has an operative length ranging from about .450 inches to about .500 inches.
19. A powered surgical apparatus as recited in Claim 15, further comprising a power source disposed within one of said main instrument body and said elongate extension shaft for energizing the motor assembly.
20. A powered surgical apparatus as recited in Claim 17, further comprising an axial drive screw driven by the motor assembly and formed with a helical thread defining a distal threaded portion having a first pitch and a proximal threaded portion having a second pitch.
21. A powered surgical apparatus as recited in Claim 20, wherein the proximal threaded portion has a greater pitch than the distal threaded portion, the distal threaded portion effecting a fastener driving stroke and the distal threaded portion effecting a fastener forming stroke.
22. A powered surgical apparatus as recited in Claim 18, further comprising a stationary thrust pin positioned within the elongate body for interacting with the helical thread of the axial drive screw to effectuate longitudinal translation thereof.
23. A powered surgical apparatus as recited in Claim 15, wherein the actuating assembly pivots the anvil with respect to the cartridge.
24. A self-contained powered surgical apparatus for applying surgical fasteners to body tissue comprising:
a) an elongate body defining a longitudinal axis;
b) a cartridge assembly detachably supported in a distal end portion of the elongate body, and including i) a frame having a proximal end portion configured to engage the distal end portion of the elongate body;
ii) a housing supported within the frame and containing a plurality of surgical fasteners;
iii) an anvil pivotably associated with the frame and mounted for movement with respect to the housing between an open position and a closed position;
iv) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to sequentially eject the surgical fasteners from the housing to be formed against the anvil; and v) an axial drive screw rotatably mounted within the frame and threadably associated with the actuation assembly for effectuating the longitudinal translation thereof;
c) a motor assembly disposed within the elongate body and including an axial drive shaft;
d) a coupling disposed within the elongate body for detachably connecting the axial drive shaft of the motor assembly and the axial drive screw of the cartridge assembly; and e) a power source disposed within the elongate body for energizing the motor assembly.
a) an elongate body defining a longitudinal axis;
b) a cartridge assembly detachably supported in a distal end portion of the elongate body, and including i) a frame having a proximal end portion configured to engage the distal end portion of the elongate body;
ii) a housing supported within the frame and containing a plurality of surgical fasteners;
iii) an anvil pivotably associated with the frame and mounted for movement with respect to the housing between an open position and a closed position;
iv) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to sequentially eject the surgical fasteners from the housing to be formed against the anvil; and v) an axial drive screw rotatably mounted within the frame and threadably associated with the actuation assembly for effectuating the longitudinal translation thereof;
c) a motor assembly disposed within the elongate body and including an axial drive shaft;
d) a coupling disposed within the elongate body for detachably connecting the axial drive shaft of the motor assembly and the axial drive screw of the cartridge assembly; and e) a power source disposed within the elongate body for energizing the motor assembly.
25. A powered surgical apparatus as recited in Claim 24, wherein a bayonet-type fitting is associated with the distal end portion of the elongate body and the proximal end portion of the frame to facilitate detachable engagement of thecartridge assembly.
26. A powered surgical apparatus as recited in Claim 25, wherein the bayonet-type fitting includes a generally J-shaped slot defined in one of the distal end portion of the elongate body and the proximal end portion of the frame, and a corresponding engagement pin provided on the other of the distal end portion of the elongate body and the proximal end portion of the frame.
27. A powered surgical apparatus as recited in Claim 24, further comprising an actuation switch for selectively controlling the operation of the motor assembly.
28. A powered surgical apparatus as recited in Claim 27, wherein the actuation switch is disposed proximate an intermediate portion of the elongate body.
29. A powered surgical apparatus as recited in Claim 24, wherein the coupling is spring biased in a distal direction.
30. A powered surgical apparatus as recited in Claim 24, wherein the anvil is spring biased into the open position.
31. A powered surgical apparatus as recited in Claim 24, wherein the anvil includes an inner fastener forming surface against which fasteners are driven when ejected from the housing, and an opposed outer camming surface.
32. A powered surgical apparatus as recited in Claim 31, wherein the actuation assembly includes a cam roller dimensioned and configured to engage the outer camming surface of the anvil to effect the progressive closure thereof.
33. A self-contained powered surgical apparatus for applying surgical fasteners to body tissue comprising:
a) an elongate body defining a longitudinal axis;
b) a disposable cartridge assembly detachably supported in a distal end portion of the elongate body, and including i) a frame having opposed distal and proximal end portions;
ii) a housing supported within the distal end portion of the frame and containing a plurality of surgical fasteners;
iii) an anvil pivotably associated with the frame and mounted for movement with respect to the housing between an open position and a closed position;
iv) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to sequentially eject the surgical fasteners from the housing to be formed against the anvil; and v) an axial drive screw rotatably mounted within the proximal end portion of the frame and threadably associated with the actuation assembly for effectuating the longitudinal translation thereof;
c) means for detachably connecting the proximal end portion of frame and the distal end portion of the elongate body;
d) a motor assembly disposed within the elongate body and including an axial drive shaft;
e) means for detachably connecting the axial drive shaft of the motor assembly and the axial drive screw of the cartridge assembly; and f) a power source disposed within the elongate body for energizing the motor assembly.
a) an elongate body defining a longitudinal axis;
b) a disposable cartridge assembly detachably supported in a distal end portion of the elongate body, and including i) a frame having opposed distal and proximal end portions;
ii) a housing supported within the distal end portion of the frame and containing a plurality of surgical fasteners;
iii) an anvil pivotably associated with the frame and mounted for movement with respect to the housing between an open position and a closed position;
iv) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to sequentially eject the surgical fasteners from the housing to be formed against the anvil; and v) an axial drive screw rotatably mounted within the proximal end portion of the frame and threadably associated with the actuation assembly for effectuating the longitudinal translation thereof;
c) means for detachably connecting the proximal end portion of frame and the distal end portion of the elongate body;
d) a motor assembly disposed within the elongate body and including an axial drive shaft;
e) means for detachably connecting the axial drive shaft of the motor assembly and the axial drive screw of the cartridge assembly; and f) a power source disposed within the elongate body for energizing the motor assembly.
34. A powered surgical apparatus as recited in Claim 33, wherein the means for detachably connecting the frame to the elongate body comprises a bayonet-type fitting.
35. A powered surgical apparatus as recited in Claim 34, wherein the bayonet-type fitting includes a generally J-shaped slot defined in the distal end portion of the elongate body and a corresponding engagement pin provided on the proximal end portion of the frame.
36. A powered surgical apparatus as recited in Claim 34, wherein the means for detachably connecting the axial drive shaft and the axial drive screw comprises a coupling member disposed within the elongate body.
37. A powered surgical apparatus as recited in Claim 36, further comprising a coiled compression spring for biasing the coupling member in a distal direction.
38. A disposable cartridge assembly for a surgical apparatus configured to sequentially apply a plurality of surgical fasteners to body tissue, the apparatus including an elongated body and an actuator mounted for axial rotation within the elongated body, the cartridge assembly comprising:
a) an elongate housing defining a longitudinal axis and containing a plurality of surgical fasteners;
b) a frame supporting the housing and configured to be detachably mounted to a distal end portion of the elongated body of the apparatus;
c) an anvil associated with the frame and mounted for pivotal movement with respect to the housing between an open position and a closed position;
d) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to concomitantly sequentially eject surgical fasteners from the housing to be formed against the anvil; and e) an axial drive screw rotatably mounted within the frame and threadably associated with the actuation assembly for effectuating the translation thereof, whereby a proximal end of the drive screw is configured to detachably engage a distal end of the actuator such that axial rotation of the actuator causes corresponding longitudinal translation of the actuation assembly.
a) an elongate housing defining a longitudinal axis and containing a plurality of surgical fasteners;
b) a frame supporting the housing and configured to be detachably mounted to a distal end portion of the elongated body of the apparatus;
c) an anvil associated with the frame and mounted for pivotal movement with respect to the housing between an open position and a closed position;
d) an actuation assembly configured to translate in a longitudinal direction relative to the housing and the anvil to progressively move the anvil from the open position to the closed position and to concomitantly sequentially eject surgical fasteners from the housing to be formed against the anvil; and e) an axial drive screw rotatably mounted within the frame and threadably associated with the actuation assembly for effectuating the translation thereof, whereby a proximal end of the drive screw is configured to detachably engage a distal end of the actuator such that axial rotation of the actuator causes corresponding longitudinal translation of the actuation assembly.
39. A disposable cartridge assembly as recited in Claim 38, further comprising a cutting blade configured to translate through the cartridge assembly in conjunction with the actuation assembly to form an incision in stapled body tissue.
40. A disposable cartridge assembly as recited in Claim 38, wherein the anvil is normally biased into the open position.
41. A disposable cartridge assembly as recited in Claim 40, wherein the anvil includes an inner fastener forming surface against which fasteners are driven when ejected from the housing, and an opposed outer camming surface.
42. A disposable cartridge assembly as recited in Claim 41, wherein the actuation assembly includes a cylindrical roller cam dimensioned and configured to engage the outer camming surface of the anvil to effect the progressive closure thereof as the actuation assembly translates in a longitudinal direction.
43. A disposable cartridge assembly as recited in Claim 42, wherein a slot is defined in the anvil to receive the cam roller and permit the anvil to return to the normally biased open position at the conclusion of a fastening operation.
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US28745594A | 1994-08-05 | 1994-08-05 | |
US08/287,455 | 1994-08-05 | ||
US08/319,907 US5779130A (en) | 1994-08-05 | 1994-10-07 | Self-contained powered surgical apparatus |
US08/319,907 | 1994-10-07 |
Publications (1)
Publication Number | Publication Date |
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CA2155475A1 true CA2155475A1 (en) | 1996-02-06 |
Family
ID=23244107
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002155475A Abandoned CA2155475A1 (en) | 1994-08-05 | 1995-08-04 | Self-contained powered surgical apparatus |
Country Status (5)
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US (1) | US5779130A (en) |
EP (6) | EP2243432A3 (en) |
CA (1) | CA2155475A1 (en) |
DE (3) | DE69536077D1 (en) |
ES (4) | ES2216002T3 (en) |
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EP1889576B1 (en) | 2012-05-02 |
DE69532942D1 (en) | 2004-06-03 |
EP2243432A3 (en) | 2011-05-04 |
ES2345632T3 (en) | 2010-09-28 |
EP2243433B8 (en) | 2013-12-11 |
EP1889576A3 (en) | 2009-09-09 |
EP1426012A1 (en) | 2004-06-09 |
DE69535626T2 (en) | 2008-07-24 |
EP1889576A2 (en) | 2008-02-20 |
DE69536077D1 (en) | 2010-06-24 |
EP1839596A1 (en) | 2007-10-03 |
EP2243433A3 (en) | 2011-05-11 |
EP2243433A2 (en) | 2010-10-27 |
US5779130A (en) | 1998-07-14 |
DE69535626D1 (en) | 2007-11-29 |
EP2243433B1 (en) | 2013-10-30 |
ES2386646T3 (en) | 2012-08-24 |
EP2243432A2 (en) | 2010-10-27 |
DE69532942T2 (en) | 2005-05-25 |
EP0705570A1 (en) | 1996-04-10 |
ES2216002T3 (en) | 2004-10-16 |
EP1839596B1 (en) | 2010-05-12 |
EP0705570B1 (en) | 2004-04-28 |
EP1426012B1 (en) | 2007-10-17 |
ES2294379T3 (en) | 2008-04-01 |
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