LONG STAPLER RELOADS WITH CONTINUOUS CARTRIDGE

Abstract

An end effector for a surgical stapling apparatus includes a cartridge assembly and an anvil assembly. The cartridge assembly includes a cartridge channel supporting a reload. The cartridge assembly can include a cartridge channel that supports the reload. The cartridge assembly can include a hinge assembly that pivotally couples to the cartridge channel.

Claims

1-20. (canceled)

21. A surgical stapling apparatus comprising: a shaft assembly; an end effector defining a longitudinal axis, the end effector secured to the shaft assembly and including: an anvil assembly; a cartridge assembly including a cartridge channel and a hinge assembly pivotally coupled together, the hinge assembly including at least one arm that extends between the shaft assembly and the cartridge channel to enable the cartridge assembly to move relative to the anvil assembly between an open position and a closed position; and a drive beam assembly that is positioned to advance distally through the anvil and cartridge assemblies to move the cartridge assembly relative to the anvil assembly.

22. The surgical stapling apparatus of claim 21, further comprising a spring mechanism that extends between the hinge assembly and the cartridge channel to prevent the cartridge assembly from inverting.

23. The surgical stapling apparatus of claim 21, wherein the cartridge channel includes a stopper that is positioned to engage the hinge assembly to maintain the cartridge assembly in parallel relation to the anvil assembly.

24. The surgical stapling apparatus of claim 21, wherein the hinge assembly further includes at least one fastener that connects the at least one arm to the shaft assembly, the at least one arm positioned to pivot about the at least one fastener.

25. The surgical stapling apparatus of claim 21, wherein the at least one arm includes a first arm and a second arm that are laterally spaced apart by a gap that is positioned to receive the drive beam assembly.

26. The surgical stapling apparatus of claim 25, wherein the hinge assembly is movable between a first position in which the first and second arms are disposed at an angle relative to the longitudinal axis, and a second position in which the first and second arms are parallel to the longitudinal axis.

27. The surgical stapling apparatus of claim 26, wherein the first and second arms have proximal end portions pivotally coupled to a distal end portion of the shaft assembly and a proximal end portion of the anvil assembly.

28. The surgical stapling apparatus of claim 27, wherein the first and second arms have distal end portions pivotally coupled to a proximal end portion of the cartridge channel via threaded fasteners received through openings defined through the proximal end portion of the cartridge channel and openings defined through the distal end portions of the first and second arms.

29. The surgical stapling apparatus of claim 28, wherein the first and second arms include engagement wings that extend from the distal end portions of the first and second arms.

30. The surgical stapling apparatus of claim 29, wherein the engagement wings include abutment surfaces positioned to engage angled stoppers extending from outer sidewalls of the proximal end portion of the cartridge channel, and wherein the angled stoppers are configured to contact the abutment surfaces of the engagement wings to prevent the cartridge assembly from inverting.

31. An end effector for a surgical stapling apparatus, the end effector defining a longitudinal axis and comprising: an anvil assembly; a cartridge assembly including a cartridge channel supporting a reload; a drive beam assembly that is positioned to advance distally through the anvil and cartridge assemblies to move the cartridge assembly relative to the anvil assembly; and a hinge assembly that is pivotally coupled to a proximal end portion of the cartridge channel, the cartridge channel including a stopper that is positioned to engage the hinge assembly to maintain the cartridge assembly in parallel relation to the anvil assembly.

32. The end effector of claim 31, further comprising a spring mechanism that extends between the hinge assembly and the cartridge channel to prevent the cartridge assembly from inverting.

33. The end effector of claim 31, wherein the hinge assembly further includes at least one fastener that connects at least one arm of the hinge assembly to a shaft assembly, the at least one arm positioned to pivot about the at least one fastener.

34. The end effector of claim 33, wherein the at least one arm includes a first arm and a second arm that are laterally spaced apart by a gap that is positioned to receive the drive beam assembly.

35. The end effector of claim 34, wherein the hinge assembly is movable between a first position in which the first and second arms are disposed at an angle relative to the longitudinal axis, and a second position in which the first and second arms are parallel to the longitudinal axis.

36. The end effector of claim 35, wherein first and second arms have proximal end portions pivotally coupled to a proximal end portion of the anvil assembly.

37. The end effector of claim 36, wherein the first and second arms have distal end portions pivotally coupled to a proximal end portion of the cartridge channel.

38. The end effector of claim 37, wherein the first and second arms include engagement wings that extend from the distal end portions of the first and second arms.

39. The end effector of claim 38, wherein the engagement wings include abutment surfaces positioned to engage angled stoppers extending from outer sidewalls of the proximal end portion of the cartridge channel, the angled stoppers configured to contact the abutment surfaces of the engagement wings to prevent the cartridge assembly from inverting.

40. A loading unit for a surgical stapling apparatus, the loading unit comprising: a shaft assembly defining a longitudinal axis; a drive beam assembly supported in the shaft assembly; an anvil assembly; and a cartridge assembly pivotally coupled to the anvil assembly and to the shaft assembly by a hinge assembly, the cartridge assembly supporting a reload including a plurality of staples positioned to form against the anvil assembly, wherein in response to the drive beam assembly translating through the hinge assembly, the hinge assembly is pivotable from a first position transverse to the longitudinal axis of the shaft assembly to a second position in parallel relation to the longitudinal axis, and wherein the drive beam assembly is positioned to advance distally through the anvil and cartridge assemblies to move the cartridge assembly relative to the anvil assembly.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate aspects of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the aspect(s) given below, serve to explain the principles of the disclosure, wherein:

[0020] FIG. 1 is a perspective view of a surgical stapling apparatus with an end effector of a loading unit thereof in an open position in accordance with the principles of the disclosure;

[0021] FIG. 2 is an enlarged, perspective view of the indicated area of detail shown in FIG. 1;

[0022] FIG. 3 is a perspective view of the reload of FIG. 1;

[0023] FIG. 4 is a perspective view of the end effector of the reload of FIG. 1;

[0024] FIG. 5 is a perspective view of the end effector of FIG. 4 with an anvil assembly thereof removed to illustrate a cartridge assembly of the end effector more clearly;

[0025] FIG. 6 is a perspective view, with parts separated, of the end effector of FIG. 4;

[0026] FIG. 7 is an enlarged, perspective view of the indicated area of detail shown in FIG. 6;

[0027] FIG. 8 is a perspective view, with parts separated, of a distal cartridge unit of a reload of the end effector of FIG. 4;

[0028] FIG. 9 is a perspective view, with parts separated, of an intermediate cartridge unit of the reload of the end effector of FIG. 4;

[0029] FIG. 10 is a perspective view, with parts separated, of a proximal cartridge unit of the reload of the end effector of FIG. 4;

[0030] FIG. 11 is an enlarged, perspective view of the indicated area of detail shown in FIG. 2;

[0031] FIG. 12 is a perspective view, with parts separated, of the reload of FIG. 1 with the reload removed therefrom for clarity;

[0032] FIG. 13 is an enlarged, perspective view of the indicated area of detail shown in FIG. 2;

[0033] FIG. 14 is an enlarged, perspective view of the indicated area of detail shown in FIG.

[0034] FIG. 15 is an enlarged, perspective view of the indicated area of detail shown in FIG. 12;

[0035] FIG. 16 is an enlarged, perspective view of the indicated area of detail shown in FIG. 12; and

[0036] FIGS. 17-23 are progressive views illustrating the end effector of FIG. 1 moving from the open position to a closed position.

DETAILED DESCRIPTION

[0037] Aspects of the disclosed surgical stapling apparatus are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As commonly known, the term clinician refers to a doctor, a nurse, or any other care provider and may include support personnel. Additionally, the term proximal refers to the portion of structure that is closer to the clinician and the term distal refers to the portion of structure that is farther from the clinician. In addition, directional terms such as front, rear, upper, lower, top, bottom, and the like are used simply for convenience of description and are not intended to limit the disclosure attached hereto.

[0038] As used herein, the terms parallel and perpendicular are understood to include relative configurations that are substantially parallel and substantially perpendicular up to about + or 10 degrees from true parallel and true perpendicular.

[0039] In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.

[0040] Briefly, in sleeve gastrectomy procedures, for instance, surgical staplers are used to secure and cut tissue along a long line that requires multiple cartridges of staples before the entirety of the long line is cut and fastened. In particular, after an initial staple cartridge is used, the clinician is required to remove the surgical stapler from the abdomen in order to replace the used cartridge with a new stapler cartridge. The surgical stapler is then reinserted into the abdomen and fired at an adjacent location along the line. The process may be repeated multiple times (e.g., 3-4 times) before the entire length of the line is fastened.

[0041] Advantageously, the disclosed surgical stapling apparatus includes a modular reload with three cartridge units that are connected together in series to assist a clinician to perform long lines of cutting and stapling in a single firing (e.g., same firing stroke), such as in a sleeve gastrectomy procedure, instead of firing a single stapler and reloading multiple times, significantly reducing procedure time. Indeed, the disclosed surgical stapling apparatus has a corresponding length anvil that can form the staples of the three cartridge units in the same firing (e.g., in a single firing stroke). More particularly, the disclosed surgical stapling apparatus has an end effector with increased length (e.g., 23-26 cm) compared to a length of an end effector of a typical surgical stapling apparatus (e.g., 60 mm). The disclosed surgical stapling apparatus includes a hinge assembly that enables the end effector to open so that the cartridge units and tissue can be easily loaded.

[0042] With reference to FIGS. 1-5, a surgical stapling apparatus 10 of this disclosure includes a housing assembly 12 (which may include one or more handles that may be manually actuatable to fire surgical stapling apparatus 10), an adapter assembly 14 secured to housing assembly 12 and extending distally from housing assembly 12, and a loading unit 100 secured to adapter assembly 14 and extending distally from adapter assembly 14. Adapter assembly 14 and loading unit 100 define a longitudinal axis X-X that extends longitudinally therealong. Loading unit 100 may be disposable and/or include one or more disposable components.

[0043] Loading unit 100 of surgical stapling apparatus 10 is releasably secured to a distal end portion of adapter assembly 14 and includes a shaft assembly 102 that supports an end effector 104 on a distal end portion of shaft assembly 102 and a drive beam assembly 102a therein (FIG. 12). End effector 104 includes an anvil assembly 106 and a cartridge assembly 107 that houses a plurality of staples (see, e.g., staples 112d of FIG. 10) in a reload 108 thereof that may be selectively replaceable. Anvil assembly 106 includes an anvil 110 against which the plurality of staples is formed upon a firing of surgical stapling apparatus 10.

[0044] For a more detailed description of similar stapling apparatus, or components thereof, reference can be made, for example, to U.S. Pat. No. 9,713,470 to Scirica et al. and U.S. Pat. No. 8,070,033 to Milliman et al., the entire contents of each of which are incorporated herein by reference.

[0045] Turning now to FIGS. 6-11, reload 108 of cartridge assembly 107 includes a proximal cartridge unit 112, an intermediate cartridge unit 114, and a distal cartridge unit 116 which are separate and distinct cartridge units that connect together via tongue-and-groove arrangements to form a unitary structure.

[0046] Proximal cartridge unit 112 of reload 108 includes a proximal cartridge base 112a that secures to a proximal cartridge 112b via tabs 112t and supports a plurality of rows of proximal pushers 112c, a plurality of rows of proximal staples 112d, and a sled 112e that is distally advanceable through reload 108 upon a firing of surgical stapling apparatus 10. Proximal cartridge 112b has a tissue contacting surface that defines staple retention slots 112f in registration with proximal staples 112d. Proximal cartridge 112b further defines distal grooves 112g in a distal end thereof. Sled 112e is positioned to advance distally through proximal cartridge unit 112 to drive pushers 112c upwardly and cause staples 112d to fire through staple retention slots 112f defined in proximal cartridge 112b as sled 112e translates therealong.

[0047] Intermediate cartridge unit 114 of reload 108 includes an intermediate cartridge base 114a that secures to an intermediate cartridge 114b via tabs 114t and supports a plurality of rows of intermediate pushers 114c and a plurality of rows of intermediate staples 114d. Intermediate cartridge 114b defines staple retention slots 114f in registration with intermediate staples 114d for enabling sled 112e of reload 108 to fire intermediate staples 114d through staple retention slots 114f when sled 112e advances distally along intermediate cartridge unit 114 and into engagement with pushers 114c. Intermediate cartridge unit 114 further defines distal grooves 114g in a distal end thereof and includes proximal tongues 114h extending from a proximal end portion thereof. Proximal tongues 114h are configured to be received within distal grooves 112g of proximal cartridge unit 112 for securing intermediate and proximal cartridge units 114, 116 together.

[0048] Distal cartridge unit 116 of reload 108 includes a distal cartridge base 116a that secures to a distal cartridge 116b via tabs 116t and supports a plurality of rows of distal pushers 116c and a plurality of rows of distal staples 116d. Distal cartridge 116b defines staple retention slots 116f in registration with distal staples 116d for enabling sled 112e of reload 108 to fire distal staples 116d through staple retention slots 116f when sled 112e advances distally along distal cartridge unit 116 and into engagement with pushers 116c. Distal cartridge unit 116 includes proximal tongues 116h extending from a proximal end portion thereof. Proximal tongues 116h are configured to be received within distal grooves 114g of intermediate cartridge unit 114 for securing distal and intermediate cartridge units 116, 114 together. Distal cartridge unit 116 extends distally to a blunt distal tip 116g.

[0049] As seen in FIG. 11, proximal, intermediate, and distal cartridge units 112, 114, 116 define a castellated seam 118 that separates the respective cartridge units when connected together. Further, each of proximal, intermediate, and distal cartridges 112b, 114b, 116b include a sidelocks 120 that extends from a side surface thereof for facilitating securement to cartridge assembly 107. Sidelocks 120 are positioned to seat in sidewall grooves 122a defined in a cartridge channel 122 of cartridge assembly 107 at spaced-apart locations along cartridge assembly 107 to facilitate auto-location thereof. Each sidelock 120 includes a plurality of ridges 120a to facilitate finger gripping for selectively removing a respective one of the proximal, intermediate, and distal cartridge units 112, 114, 116 from cartridge assembly 107 and/or from one of the other cartridge units.

[0050] Turning now to FIGS. 12-16, anvil and cartridge assemblies 106, 107 of end effector 104 are pivotally coupled to the distal end portion of shaft assembly 102 with threaded fasteners 103 such as shoulder bolts or socket cap screws, secured to openings 105 defined through sidewalls thereof. Anvil and cartridge assemblies 106, 107 are positioned to receive drive beam assembly 102a therethrough to move the anvil and cartridge assemblies 106, 107 between open and closed positions, to fire the reload 108 supported by the cartridge assembly 107, and to cut tissue clamped between the anvil and cartridge assemblies 106, 107 with a knife 102b supported on an I-beam 102c of drive beam assembly 102a as drive beam assembly 102a advances sled 112e through anvil and cartridge assemblies 106, 107 upon a firing of surgical stapling apparatus 10. I-beam 102c includes upper and lower flanges 102d, 102e that engage anvil and cartridge assemblies 106, 107 to enable anvil and cartridge assemblies 106, 107 to move from the open position to the closed position.

[0051] Cartridge assembly 107 includes the cartridge channel 122, a hinge assembly 124 and a spring mechanism 126 supported between hinge assembly 124 and cartridge channel 122. Hinge assembly 124 pivotally couples cartridge channel 122 to the distal end portion of shaft assembly 102 to enable the end effector 104 to open so that the cartridge units 112-116 and tissue can be easily loaded between the anvil and cartridge assemblies 106, 107. Hinge assembly 124 includes a first arm 124a and a second arm 124b that are laterally spaced apart (e.g., by gap) to receive a drive beam assembly 102a therebetween. Hinge assembly 124 is movable between a first position in which first and second arms 124a, 124b are disposed at an angle (e.g., transverse) relative to longitudinal axis X (corresponding to the open or unclamped position of end effector 104) and a second position in which first and second arms 124a, 124b are parallel to longitudinal axis X (corresponding to the closed or clamped position of end effector 104). First and second arms 124a, 124b have proximal end portions pivotally coupled to the distal end portion of shaft assembly 102 and a proximal end portion of anvil assembly 106 by threaded fasteners 103 and nuts 103a. First and second arms 124a, 124b have distal end portions pivotally coupled to a proximal end portion of cartridge channel 122 via threaded fasteners 103 received through openings 105 defined through proximal end portion of cartridge channel 122 and openings 105 defined through distal end portions of first and second arms 124a, 124b. First and second arms 124a, 124b also include engagement wings 124c that extend from the distal end portion of first and second arms 124a, 124b. Engagement wings 124c include abutment surfaces 124d positioned to engage angled stoppers 128 extending from the outer sidewalls of the proximal end portion of cartridge channel 122. Stoppers 128 are configured to contact abutment surfaces 124d of engagement wings 124c to prevent cartridge assembly 107 from inverting when end effector 104 is disposed in the open position. Spring mechanism 126 is configured to urge cartridge assembly 107 toward a parallel position relative to anvil assembly 106 when end effector 104 is in the open position. Spring mechanism 126 includes arm mounts 126a secured on the distal end portion of first and second arms 124a, 124b, channel mounts 126b secured on the proximal end portion of cartridge channel 122, and tension springs 126c secured at opposite ends to arm mounts 126a and channel mounts 126b.

[0052] Turning now to FIGS. 17-23, in use, for example in a sleeve gastrectomy procedure, when surgical stapling apparatus 10 is fired, drive beam assembly 102a advances distally along hinge 124, as indicated by arrows A, so that flange 102e of I-beam 102c slides along the bottom surfaces of first and second arms 124a, 124b of hinge assembly 124. As drive beam assembly 102a advances distally along hinge assembly 124, drive beam assembly 102a causes hinge assembly 124 to pivot about pivot axes P 1 and P2 defined through fasteners 103 of end effector 104 so that cartridge assembly 107 pivots toward anvil assembly 106, as indicated by arrows B, from the open position to the closed position to clamp tissue therebetween. The drive beam assembly 102a can be drawn proximally to, for example, readjust tissue between the anvil and cartridge assemblies 106, 107 and/or a stapling area. Spring mechanism 126 and stopper 128 are positioned to relative to one another to prevent cartridge assembly 107 from inverting (e.g., about pivot axis P2) and to maintain the anvil and cartridge assemblies 106, 107 in parallel relation with one another between the open and closed positions of end effector 104. With I-beam 102c of drive beam assembly 102a positioned distally beyond hinge assembly 124 and in contact with sled 112e in reload 108, end effector 104 is disposed in the closed position (see FIGS. 21 and 22). Continued distal advancement of drive beam assembly 102a, as indicated by arrow C, causes drive beam assembly 102a to distally drive sled 112e through reload 108 so that the staples of reload 108 can be sequentially fired as knife 102b of I-beam 102c cuts the clamped and fastened tissue disposed between the anvil and cartridge assemblies 106, 107.

[0053] Further, although illustrated and described in connection with an endoscopic linear surgical stapling apparatus, the disclosed loading unit arrangement may be utilized on any suitable surgical stapling apparatus such as an open surgical stapling apparatus, a transverse surgical stapling apparatus, and/or a circular stapling apparatus, any of which may be powered or manual apparatus.

[0054] Securement of any of the components of the presently disclosed apparatus may be effectuated using known securement techniques such welding, crimping, gluing, fastening, etc.

[0055] The various aspects disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as Telesurgery. Such systems employ various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the clinician during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

[0056] The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of clinicians may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another clinician (or group of clinicians) remotely controls the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients. For a detailed description of exemplary medical work stations and/or components thereof, reference may be made to U.S. Patent Application Publication No. 2012/0116416, and PCT Application Publication No. WO2016/025132, the entire contents of each of which are incorporated by reference herein.

[0057] Persons skilled in the art will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary aspects, and that the description, disclosure, and figures should be construed merely as exemplary of particular aspects. It is to be understood, therefore, that the present disclosure is not limited to the precise aspects described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain aspects may be combined with the elements and features of certain other aspects without departing from the scope of the present disclosure, and that such modifications and variations are also included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularly shown and described.