CA1101288A - Ligating and dividing organic structures - Google Patents
Ligating and dividing organic structuresInfo
- Publication number
- CA1101288A CA1101288A CA288,297A CA288297A CA1101288A CA 1101288 A CA1101288 A CA 1101288A CA 288297 A CA288297 A CA 288297A CA 1101288 A CA1101288 A CA 1101288A
- Authority
- CA
- Canada
- Prior art keywords
- cartridge
- main body
- staples
- pushers
- belts
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
- 210000005069 ears Anatomy 0.000 claims description 9
- 230000004044 response Effects 0.000 claims description 4
- 230000007246 mechanism Effects 0.000 abstract description 8
- 210000004204 blood vessel Anatomy 0.000 abstract description 3
- 210000005036 nerve Anatomy 0.000 abstract 1
- 238000004519 manufacturing process Methods 0.000 description 3
- 229920003023 plastic Polymers 0.000 description 3
- 230000000712 assembly Effects 0.000 description 2
- 238000000429 assembly Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- NLZUEZXRPGMBCV-UHFFFAOYSA-N Butylhydroxytoluene Chemical compound CC1=CC(C(C)(C)C)=C(O)C(C(C)(C)C)=C1 NLZUEZXRPGMBCV-UHFFFAOYSA-N 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 238000002788 crimping Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229920002457 flexible plastic Polymers 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 230000007257 malfunction Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 210000003813 thumb Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
Abstract
ABSTRACT
A cartridge is provided for ligating and dividing organic structures such as blood vessels or a band of tissue containing a plurality of blood vessels, nerves or the like. The cartridge operates in three stages and is adapted to associate with an instrument which provides power to the cartridge. After the structure is inserted between the jaws of the cartridge, the cartridge jaws close, a pair of pushers moves forward and ligates the structure at two spaced apart locations with a pair of surgical staples, and a knife then comes forward and divides the ligated structure at a position intermediate the pair of staples.
The staple feeding arrangement comprises a pair of belts advanced by the pushers, the belts each carrying a plurality of staples.
The staples are transferred from the plane of the belts to the plane of the pushers by ramp surfaces. The belts are kept from backing up during the return stroke of the pushers by a pair of detents associated with the belts. The knife is associated with the main body of the cartridge by means of a novel shifter mechanism in such a manner that the initial movement of the knife causes the jaws of the cartridge to close. A mechanism is provided to prevent the knife from severing the ligated structure in the event, for example, that all of the staples have been expelled from the cartridge. Finally, a cartridge lock mechanism maintains the operative elements of the cartridge in proper position until the cartridge is mounted on the instrument.
A cartridge is provided for ligating and dividing organic structures such as blood vessels or a band of tissue containing a plurality of blood vessels, nerves or the like. The cartridge operates in three stages and is adapted to associate with an instrument which provides power to the cartridge. After the structure is inserted between the jaws of the cartridge, the cartridge jaws close, a pair of pushers moves forward and ligates the structure at two spaced apart locations with a pair of surgical staples, and a knife then comes forward and divides the ligated structure at a position intermediate the pair of staples.
The staple feeding arrangement comprises a pair of belts advanced by the pushers, the belts each carrying a plurality of staples.
The staples are transferred from the plane of the belts to the plane of the pushers by ramp surfaces. The belts are kept from backing up during the return stroke of the pushers by a pair of detents associated with the belts. The knife is associated with the main body of the cartridge by means of a novel shifter mechanism in such a manner that the initial movement of the knife causes the jaws of the cartridge to close. A mechanism is provided to prevent the knife from severing the ligated structure in the event, for example, that all of the staples have been expelled from the cartridge. Finally, a cartridge lock mechanism maintains the operative elements of the cartridge in proper position until the cartridge is mounted on the instrument.
Description
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In applicant's Canadian Patents Nos. 976,445 and 980,201, a novel cartridge and instrument for ligating and dividing organic structures by means of surgical staples are disclosed. The present invention relates to a cartridge which, together with an instrument such as disclosed in said patents, is similarly capable of mechanically and repetitiously ligating and dividing organic structures, such as blood vessels and the like.
The cartridge of the pres~nt invention is adapted to operate in three stages such as disclosed in the above patents. ~ ;
Once the organic structure is inserted within the area of its i-jaws, the main body and wrap of the cartridge are moved forward toward an anvil member fixe~ relative to the instrument, thereby enclosing the structure within the jaws of the cartridge. Then a pair of pusher elements is advanced and moves a pair of staples toward the anvil assembly. During t:he forward portion of the pusher stroke, the respective staples encircle the structure at spaced locations and are crimped about the structure in such a manner that ~he structure is sealed at two locations. Finally, ;
20 and with the pushers at the ~orwardmost portions o~ their strokes, a knife blade advances and divides the structure intermediate the two staples. The staple closure and crimping sequence is disclosed in applicant's Canadian Patent No. 977,642.
The instrument disclosed in the above patents is of three-stage design. The forward end of the instrument is provided ;~ with three saddles which associate, respectively, with the cartridge wrap, the pushers and the knife of the three-stage cartridge disclosed therein. Three spring elements are housed in the instruments and, in conjunction with a trigger element, operate the cartridge wrap, the pushers and the knife through the three saddle elements. With a cartridge mounted on the instrument, the initial squeezing of the handle moves the cartridge rl~
In applicant's Canadian Patents Nos. 976,445 and 980,201, a novel cartridge and instrument for ligating and dividing organic structures by means of surgical staples are disclosed. The present invention relates to a cartridge which, together with an instrument such as disclosed in said patents, is similarly capable of mechanically and repetitiously ligating and dividing organic structures, such as blood vessels and the like.
The cartridge of the pres~nt invention is adapted to operate in three stages such as disclosed in the above patents. ~ ;
Once the organic structure is inserted within the area of its i-jaws, the main body and wrap of the cartridge are moved forward toward an anvil member fixe~ relative to the instrument, thereby enclosing the structure within the jaws of the cartridge. Then a pair of pusher elements is advanced and moves a pair of staples toward the anvil assembly. During t:he forward portion of the pusher stroke, the respective staples encircle the structure at spaced locations and are crimped about the structure in such a manner that ~he structure is sealed at two locations. Finally, ;
20 and with the pushers at the ~orwardmost portions o~ their strokes, a knife blade advances and divides the structure intermediate the two staples. The staple closure and crimping sequence is disclosed in applicant's Canadian Patent No. 977,642.
The instrument disclosed in the above patents is of three-stage design. The forward end of the instrument is provided ;~ with three saddles which associate, respectively, with the cartridge wrap, the pushers and the knife of the three-stage cartridge disclosed therein. Three spring elements are housed in the instruments and, in conjunction with a trigger element, operate the cartridge wrap, the pushers and the knife through the three saddle elements. With a cartridge mounted on the instrument, the initial squeezing of the handle moves the cartridge rl~
-2-.
LZ~ , wrap toward the fixed anvil assemblies, and the further squeezing overcomes the force e~erted by one of the springs and advances the pushers toward the respective anvils and ultimately, after overcoming the force exerted by another of the springs, urges the knife toward the front of the instrument to effect a severing operation. ~
In applicant's Canadian patent application No. 237,179, ~ -filed October 7, 1975, a three-stage instrument is also disclosed for operating a cartridge by means of three saddle elements.
One of the saddle elements, controlling the pusher, is in direct mechanical association with a trigger operable by the surgeon. ;
One of the remaining saddle elements, controlling the closing of the jaws, is operable in response to the position of the trigger-controlled saddle element through the means of a novel shifter dog arrangement. The third saddle element, controlling the knife of the cartridge, is actuated by a linkage whose operation is controlled directly by the trigger. In this manner, the drawbacks associated with the multiple biasing springs in applicant's Canadian Patents Nos. 976,445 and 980,201 are avoided.
Although these prior art instruments and cartridge have proved satisfactory in practice, there are certain dis-advantages associated with the cartridge. First, because of the cartridge design, the instrument is required to have a three-stage operation. This makes the instrument more complicated ;
to design and engineer and to manufacture. I~loreover, the cartridge is designed to advance the staples and transfer them out of the index plane into the plane of the pushers by means of a complex staple feeding arrangement which takes the form of a pair of interacting leaf spring assemblies. This in turn requires -close tolerances to be maintained in the manufacture of the cartridge. Also, the cartridge does not have means for locking the cartridge components in position during shipment and prior to mounting the cartridge on the instrument (or means for preventing the inadvertent actuation of the kni~e after, for example, all of the staples have been expelled from the cartridge) which is as easy to engineer and manufacture as is desired.
Accordingly, it is a broad object of this invention to provide a new cartridge design for ligating and dividing an organic structure.
It is another object of this invention to provide a new 1~ cartridge design which will ligate and divide organic structures ~;
by means of association with a two-stage instrument.
It is still another object of this invention to provide a new cartridge design in which the associated instrument powers `
the knife and pushers and the knife is so associated with the main body portions and wraps of the cartridge that the jaws of the cartridge are closed and opened as the knife is moved forward and backward.
It is yet another object o'E this invention to provide a new cartridge design which has improved means for advancing, forming, and ejecting the staples. -Another object of this invention is to provide a new cartridge design which has improved means for advancing the -staples toward the anvil assembly in readiness for ejection.
Still another object of this invention is to provide a new cartridge design which has improved means for locking the cartridge during shipment and preventing the inadvertent severing - of organic structures when all of the staples, for example, have been expelled from the cartridge.
These and other objects of the invention, as well as many of the attendant advantages thereof, will become more readily apparent when reference is made to the following description taken in conjunction with the drawings.
--4-- - `?
` :' ', :
The present invention relates to a three-stage cartridge for associating with an instrument and adapted to ligate and divide organic structures. The cartridge is simple, and yet effective, and eliminates numerous disadvantages common in prior art cartridges.
The cartridge operates in three stages. Once a tubular structure is inserted within the area of the cartridge jaws, the cartridge main body portions and associated wraps move forward toward an anvil assembly integral with a rail assembly fixed on the instrument, thereby enclosing the structure within the jaws of the cartridge. Then, a pair of pusher elements is advanced and moves a pair of staples toward the anvil assembly. At the forward portions of the pusher strokes, the respective staples encircle the tubular structure at spaced locations and are sub-sequently crimped about the structure in such a manner that the structure is sealed at two locations. Finally, and with the pushers at the forwardmost portions of their strokes, a knife blade advances and divides the tubular structure intermediate the two staples.
The cartridge houses a plurality of the staples mounted on a belt so that the staple arms overlap in a "shingle" arrange-ment. The pushers slidably mounted in the cartridge advance the belts and move the forwardmost staples up a series of ramps out of the plane of the belt and into the major planes of the pushers and then push and form the staples against the anvil assembly.
As the forwardmost pair of staples is being advanced, they are held in the teeth in the belt by leaf springs associated with the wraps. On the return stroke of the pushers, a pair of detents associated with the main body portions of the cartridge prevent the belts and staples from moving rearward from the anvil assembly.
A fail-safe mechanism is provided to stop the forward movement of the pushers and thereby prevent the knife from severing an organic structure in the jaws of the cartridge in the event that two staples have not been advanced by the pushers as, for instance, when all of the staples have been expelled from the cartridge. A ~;
loc~ing mechanism is provided to keep the respective components of the cartridge in proper position to be associated with the ~ -instrument and to prevent the accidental ejection of staples from the cartridge and the actuation of the knife before association with the instxument. Also, an ejector mechanism is provided in order to force the formed staples out of the jaws of the cartridge once the organic structure has been ligated and divided. -~
The operation of the cartridge of the invention is ;
controlled through the means of two saddle elements of an as~
sociated instrument. One of the saddle elements controls the pushers and the other saddle element controls the knife. Because of the design of the cartridge, the remaining saddle element which was used in the prior instrument designs for controlling the wrap or main body portion to open and close the jaws of the cartridge is no longer re~uired. Rather, the cartridge contains a shifter mechanism which is associated with the knife and the -~
main body portions and associated wraps.
As the knife is initially moved forward by the instru-ment, the jaws of the cartridge are closed. Conversely, the return stroke of the knife also caused by the instrument, open the jaws. Accordingly, in view of the new cartridge design, if the cartridge is associated with an instrument such as disclosed in applicant's Canadian Patents Nos. 97~,445 and 980,2Ql or with an instrument such as disclosed in applicant's Canadian patent application No. 237,179, filed October 7, 1975, the saddle (30 and 24, respectivelyl designed to be associated with the main body portion or wrap performs no function and may be omitted along with the associated apparatus for controlling and moving the saddle.
Figure 1 is a top plan view of the cartridge;
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Figure 2 is a side view of the cartridge;
Figure 3 is a cross-sectional view of the cartridge taken along the lines 3-3 in Figure l;
Figure 4 is a cross-sectional view of the cartridge taken along the lines 4-4 in Figure 3;
Figure 5 is a front view of the cartridge; :~
Figures 6-8 are a series of three cross-sectional views of the cartridge taken along the lines 3-3 in Figure 1 showing :
the movements of one of the main body portions and associated wraps, one of the pushers, the knife and the shifter dog as the jaws of the cartridge are closed and the pushers and knife advance :.
as well as the association of the c~rtridge with the drive means .
of a surgical instrume~t;
Figure 9 is a side view of the cartridge showing one of the main body portions and associated wraps and one of the pushers;
Figure 10 is a cross-sect:ional view taken along the lines 10-10 in Figure 9 and showing the association of the cartridge with the drive means of a surgical instrument shown in phantom lines;
Figures 12 and 14 are enlarged views of the forward end ` of the cartridge as shown in Figure 10 showing the advance of one of the pushers and one of the belts and the transfer of one of the forwardmost staples into the plane of the pusher; and :~
Figures 13 and 15 are enlarged views of the forward end of the cartridge as shown in Figure 11 showing the advance of one of the pushers and one of the belts and the transfer of one of `: -the forwardmost staples into the plane of the pusher in similar .
manner to Figures 12 and 14, respectively.
Referring first particularly to Figures 1-5, the cartridge 10 comprises a rail assembly 12 adapted to be fixedly secured to the instrument 14 by means of shank 15 of rail assembly 12, the projections 16 on the shank 15 and the thumb operated `
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lock (not shown~ on the instrument. A curved anvil assembly 20 comprising a pair of spaced apart anvils 22 and 24 is integral with and defined by the forward end of the rail assembly 12. A
pair of main body portions 26 are slidably mounted on the rail assembly 12, and a pair of wraps 28 are fixedly secured to and ~oveable with the respective main body portions 26 by a pair of bands 30. A pair of pusher elements 32 is slidably mounted between the main body portions 26 and the respective wraps 28. A
knife 34, centrally located in the cartridge 10, is slidably mounted between the respective wraps 28. As can be seen best in Figures 6 and 10, the saddles 36 and 38 associate with and control the movements of the knife 34 and the pushers 32, respectively, with respect to the rail assembly 12. As will be described in more detail below, the knife 34 is operatively associated with the wraps 28 by means of a novel shifter dog in such a manner that the movements of the wraps 28 and the main body portions 26 are controlled by the movement of the knife 34. For simplicity of description, only one side of the cartridge will be described, but it should be understood that the cartridge is symmetrical about its longitudinal centerline.
~ ith reference now particularly to Figures 2, 4, 10, and 11 t the cartridge 10 is provided with a staple feeding arrangement comprising a belt 40, made of flexible plastic, mounted between the guide rails 42 defined by the main body portion 26 to form a loop which passes through the belt openings 44 and 46 near each longitudinal end of the main body portion. The ends of the belt 4Q are connected together by a spring 48.
The belt 40 has a plurality of longitudinally spaced apart pairs of teeth 50 on one side thereof~ Between each pair of teeth is defined a staple-carrying groove 52. Openings 54 are provided in the belt 40 between each adjacent pair of teeth 50. A detent 60 is provided in an opening 62 in the forward portion of the side wall 63 of the main body portion 26. The detent 60 is aligned withthe openings 54 in the belt 40 and is resiliently biased into the plane of the belt 40 to prevent the belt from backing up during the return stroke of the pusher. The detent 60 has a -sloped rear surface 60', however, to permit the detent to be cammed out of the plane of the belt 40 when the belt is being advanced. A cover plate 68 is fitted into a slot 70 in the outer surface of the side wall 64 of the main body portion 26. The cover plate 68 has indicia 72 thereon which, in association with a reference mark 74 on the spring 48, may be used to determine the number of pairs of staples remaining in the cartridge.
As shown particularly in Figures 10 and 11, the staples 80 are housed in and guided by the staple-carrying grooves 52 of the belt 40. The staples 80, as mounted in the belt, have a pair of arms 82 terminating in widely spaced apart ends 84 which extend in the longitudinal direction of the main body portion 26 of the cartridge. The staples 80 also have cross-pieces 86 which extend transversely of the arms 82 and the belt 40. The cross-pieces 86 of the staples 80 are fitted into the staple-carrying grooves 52. The staples 80 are mounted on the belt 40 so that the ends 84 of the staples lie in a pair of ~;
grooves 90 defined in the main body portion 26 on both sides of the guide rails 42. The forward lower wall of the lower one of the grooves 90 is formed by the leg 94 of a "L" shaped member 96 ~ `;
fitted into the main body portion 26. The ends 84 of each of the staples 80, with the exception of the forwardmost staple, rests under the arms 82 of the preceding staple in "shingle" fashion.
The rear portion of the belt 40 is covered by a cover strap 98 shown particularly in Figure 8 positioned between the belt and the pusher 32 to keep the rear end of the pusher from interfering with the movement of the belt or staples during the advance and retraction of the pusher.
~9-The staples 80 lie along the major portion of the length of the cartridge 10 in what may be termed an index plane.
It is in the index plane that the staples are, in unison, advanced toward the anvil assembly 20 in readiness for ejection. Near the forward end of the cartridge 10, the staples 80 are transferred to the pusher plane coincident with the plane of the major portion of the pusher 32. For purposes of transferring the staples 80 from the index plane to the pusher plane, the main body portion 26 is provided with a first pair of ramps 100 which are spaced apart to act on the individual staples at their respective ends 84 and a second pair of ramps 102 which are spaced apart to act on the individual staples at their ;
respective cross-pieces 86.
Referring now particularly to Figures 3, 4, 10, 11 and 12, the pusher 32 slides along ledges 104 defined by the main body portion 26 and the wrap 28 as shown particularly in Figure 4. -~
The pusher 32 is positioned adjacent the belt 40 and the staples 80 and is adapted for movement longitudinally within the cartridge 10. As best seen in Figure 10, while the major part of the pusher 32 lies in the pusher plane, a tooth 110 at the forward ~-~
end of the pusher 32 projects into the index plane and, more specifically, into the plane of the belt teeth. The tooth 110 is centered on the belt 40 and is adapted to associate with the pairs of teeth 50 of the belt as shown particularly in Figure 12.
The rear surface 110' of the tooth 110 i5 sloped to allow the front of the pusher 32 to be cammed out of the index plane by the belt 40 during its return stroke. Forward portion 33 of pusher 32 flexes inwardly during this camming action. The forward end 111 of the pusher 32 is curved as shown particularly in Figure 11 and is adapted to cooperate with the individual staples 80 during the staple forming operation.
With reference now particularly to Figures 9, 10, 12 and 14, a spring 112 is attached to the forward end of the wrap 28. This spring 112 extends longitudinally of the cartridge 10 and is primarily positioned between the wrap 28 and the pusher 32. The forward end of the spring 112 comprises a lip 114 which has a curvature corresponding to the curvature of the forward end of the pusher 32. The lip 114 is cammed out of the pusher plane -into a slot 116 in the wrap 28 by the individual staples during the staple forming operation as shown in Figure 14. However, when the cartridge 10 is empty, the lip 114 remains in the pusher plane and prevents the pusher 32 from advancing. In this manner, and as will be discussed in more detail below, the knife 34 is also prevented from advancing and severing an organic structure enclosed in the jaws of the cartridge 10 when there are not two staples in the cartridge in front of the pushers to ligate the structure.
The spring 112 also has a leaf spring 118 located in an elongated opening 120 in the spring 112 which projects into the index plane and, more specifically, into the plane of the belt teeth 50 as shown in Figures 10 and 12. The function of the leaf ~0 spring 118 is to hold the forwardmost staple in the belt 40 in the staple-carrying groove 52 defined by the pair of teeth 50 ~ -carrying this staple until the staple is ready to be transferred out of the index plane into the pusher plane. As this occurs, the leaf spring 118 is cammed into the slot 116 in the wrap 26 by the pusher 32 as shown in Figure 14. The rear portion of the spring 112 extends through opening 122 and into opening 124 in the wrap 28 in order to securely mount the spring to the wrap.
Referring now particularly to Figures 3, 4 and 6-8, the knife 34, which has a blade 126 mounted on its forward end, slides between the wraps 28 of the cartridge 10. The knife has a notch 128 formed in its bottom surface intermediate its ends which is adapted to associate with a shifter dog 130. The shifter --11-- ~
dog 130 has an upstanding arcuate portion 132 at its rear end for fitting into the notch 128 in the knife 34. At its forward end, -the shifter dog 130 has two outwardly and downwardly extending projections 134 which fit into and are hingedly secured in slots 136 formed in the wraps 28. A longitudinally extending opening 138 is formed in the rail assembly 12 which has a sloped portion 138' at its rear end. The shifter dog 130 rides along the upper surface of the rail assembly 12 with its upstanding arcuate portion 132 locked in the notch 128 in the knife 34 as shown in Figure 3 until the main body portion 26 and associated wrap 28 are abutting against the an~il assembly 20 thus closing the jaws of the cartridge around the organic structure as shown in Figure 6.
Then, the rear end of the shifter mechanism 130 is cammed into slot 138 in the rail assembly by the sloped rear portion 128' of the notch 128 as shown in Figures 7 and 8 so that the knife can continue its advance to divide the ligated organic structure.
(See Figure 8). On the return stroke of the knife 34, the shifter dog 130 moves back into locking engagement with the notch 128 of the knife 34 so that the main body portion 26 and the associated wrap 28 are also moved away from the anvil assembly 20 to open the jaws.
With reference now particularly to Figures 1, 3 and 5, an ejector plate 140 is positioned between the forward ends of the rail assembly 12. The ejector plate 140 has an arcuate projection 142 at its forward end and a groove 144 extending longitudinally of the ejector plate for receiving the knife 34.
The ejector plate is typically made of a rigid plastic material and has a soft plastic tube 146 which fits into a hole 148 extend-ing from the top of the arcuate projection. The tube 146 is adapt-ed to be cut into by the knife 34 when severing the organicstructure. The arcuate projection has two outwardly and laterally extending ears 150 which slide in complimentary shaped slots 152 L2~
in the spaced apart anvils 22 and 24.
With reference now particularly to Figures 6-8, a :
downwardly extending lug 154 is formed on the bottom surface of the rear end of the ejector plate 140. The lug 154 extends through a longitudinally extending slot 156 formed in the anvil assembly 12. The slot 156 is made slightly longer than the length of the lug 154 thereby allowing slight relative movement between the ejector plate 140 and the anvil assembly 20.
A slot 158 is also formed in the bottom surface of the main body portions 26. The lug 154 of the ejector plate 140 extends through the slot 156 in the anvil assembly 12 into the ~.
slot 158 in the main body portions 26. The rear wall of the slot 158 in the main body portions abuts against the lug 154 of the ejector plate during its advance and causes the arcuate projection 142 to move foxward away from the anvil assembly 20 as shown in Figures 7 and 8 so that the ears 150 on the arcuate projection are not within the jaws of the instrument as the organic structure is being enclosed and ligated. Then, on the return stroke of the main body portions 26, the ejector plate 140 is moved rearward into ~
the position shown in Figures 1 and 2, for example, so that the ~ .`
ears 150 of the arcuate projection 142 engage the formed staples 80 to eject the staples and the severed organic structure from the jaws of the cartridge.
The main body portions 26 and associated wraps 28, the pushers 32, and the knife 34 are held in a fixed position relative to the rail assembly 12 until the cartridge 10 is mounted on the :
: instrument 14. In this manner, the pushers 32 are prevented from accidentally ejecting a pair of staples 80 from the cartridge 10 and the knife 34 is prevented from accidentally travelling forward in the cartridge 10 before the cartridge is mounted on the instru.-ment 14. Also, this arrangement properly positions the pushers 32 and the knife 34 to be engaged with the instrument.
Referring now particularly to Figures 1, 3 and 6-8, the pushers 32 are releasably locked or held, with respect to therail assembly 12 as follows as shown in Figures 1 and 3.
On the inside surface of each of the pushers 12 at the rear end of the pushers, there is provided an ear 160. And, mounted in a slot 162 in the rear of the rail assembly 12 is a cartridge -~
lock or retaining member 170 made of a resilient plastic material or the like. The cartridge lock 17 0 has a rounded pivot portion 172 which is supported by the lower surface of the main body portions 26. The forward end 174 of the cartridge lock is prevented fxom moving upward by the bottom surface of the wraps 28. The rear end of the cartridge lock 170 has an upstanding ~:
arcuate portion 176 and two outwardly and laterally projecting abutment surfaces 178. The rear end of the cartridge lock 170 is resiliently biased into the plane of the pushers 32 so that the abutment surfaces 178 are alignecl with the ears 160 of the pushers when the cartridge is not associated with the instrument.
Therefore, when the pushers 32 are in their rearwardmost position, with the cartridge ready to be inserted on the instru~
ment 14, the abutment surfaces 178 of the cartridge lock 170 are :
positioned in front of the ears 160 and lock the pushers 32 in position with respect to the rail assembly 12 as shown in Figures ~-1 and 3. Also, when the pushers 32 are in this position, their rear ends are adjacent an abutment 180 on the main body portions 26 so that the main body.portions 26 cannot move forward relative to the pushers 32. Finally, because of the engagement of the wraps 28 associated with the main body portions 26 and the knife 34 by means of the shifter dog 130, the knife is held in a fixed relative position with respect to the rail assembly 12. ~Iowever, when the cartridge 10 is mounted on the instrument 14, as shown in Figures 6-8, the abutment surfaces 178 of the cartridge lock 170 are moved out of the plane of the ears 160 of the pushers 32 ~:
2~38 by means of the saddle 38 acting on the arcuate projection 176 and camming the rear end of the cartridge lock 170 downward into the slot 162 in the rail assembly 12. This unlocks the cartridge and allows the cartridge to be operated.
The operation of the inventive cartridge 10 is as follows. When the cartridge 10 is mounted on the instrument 14 as shown in Figures 6 and 10, the drive element 182 of the instrument extends through the opening 184 in the main body portions 26 so that the saddles 38 and 36 associate with the pushers 32 and knife 34, respectively. For this purpose, and as shown particular-ly in Figures 7 and 8, the pushers have a slot 186 and an inwardly extending flange 188 and the knife 34 has an upwardly and outwardly extending leg 190 defining an opening 192 at their respective rear ends.
As noted previously, during shipment, the main body ;
portions 26 and associated wraps 28 are retracted and spaced from the anvil assembly 20 as shown in Figures 1-3. Upon initial activation of the instrument 14, the knife 34 and therefore, by means of the shifter dog 130, the main body portions 26 and associated wraps 28 move in the direction of arrow 200. At the same time, the pushers 32 are moved forward and the teeth 110 of the pushers 32 come into contact as shown in Figures 12 and 13, with the rear surfaces of the teeth 50 of the belt 40 carrying the first staples 80 in the cartridge and move the belts 40 and associated staples 80 forward in unison with the main body portions 26 and associated wraps 28. During this movement, the staples remain in the index plane.
With continued movement of the belts 40, the arms 82 of the staples 80 come into contact with the ramps lOQ and then the cross-pieces 86 of the staples 80 come into contact with the ramps 102. While the belts 40 are moving forward at this stage, the first staples 80 are held in the staple-carrying grooves 52 .
.2l~
of the belts 40 by the leaf springs 118. The remaining staples 80 in -the cartridge 10 axel held in the staple-carrying grooves 52 of the belts 40 by the pushers 32 and the cover straps 98. With continued forward movement of the belts 40, and with the forward-most staples being acted upon by the respective ramps 100 and 102, the staples 80 are caused to transfer, in the direction of arrow 202, from the index plànes to~the pusher planes and cam the lips 114 of the springs 112 out of the pusher planes, The pushers 32 engage and also cam the leaf springs 118 out of the pusher .
planes, (See Figures 14 and lS).
After the main body portions 26 and wraps 28 have come into contact with the anvil assembly 20 and ejector plate 140, respectively, as shown in Flgure 6, the upstanding arcuate portion 132 of the shifter dog 130 moves into the slot 138 in the anvil assembly 12 disengagin~ the wraps 28 ~rom the knife 34. (See Figures 7 and 8). The pushers 32 continue their forward movement relative to the main body portions 26 and wraps 28 and contact the respective forwardmost staples 80, now moved into the pusher planes by the ramps 100 and 102, and ~orm the same around tha :~
organic structure (not shown) housed within the jaws of the cartridge 10 as shown particularly in Figures 14 and 15 in similar manner to that shown in commonly assigned U.S. Patent No.
LZ~ , wrap toward the fixed anvil assemblies, and the further squeezing overcomes the force e~erted by one of the springs and advances the pushers toward the respective anvils and ultimately, after overcoming the force exerted by another of the springs, urges the knife toward the front of the instrument to effect a severing operation. ~
In applicant's Canadian patent application No. 237,179, ~ -filed October 7, 1975, a three-stage instrument is also disclosed for operating a cartridge by means of three saddle elements.
One of the saddle elements, controlling the pusher, is in direct mechanical association with a trigger operable by the surgeon. ;
One of the remaining saddle elements, controlling the closing of the jaws, is operable in response to the position of the trigger-controlled saddle element through the means of a novel shifter dog arrangement. The third saddle element, controlling the knife of the cartridge, is actuated by a linkage whose operation is controlled directly by the trigger. In this manner, the drawbacks associated with the multiple biasing springs in applicant's Canadian Patents Nos. 976,445 and 980,201 are avoided.
Although these prior art instruments and cartridge have proved satisfactory in practice, there are certain dis-advantages associated with the cartridge. First, because of the cartridge design, the instrument is required to have a three-stage operation. This makes the instrument more complicated ;
to design and engineer and to manufacture. I~loreover, the cartridge is designed to advance the staples and transfer them out of the index plane into the plane of the pushers by means of a complex staple feeding arrangement which takes the form of a pair of interacting leaf spring assemblies. This in turn requires -close tolerances to be maintained in the manufacture of the cartridge. Also, the cartridge does not have means for locking the cartridge components in position during shipment and prior to mounting the cartridge on the instrument (or means for preventing the inadvertent actuation of the kni~e after, for example, all of the staples have been expelled from the cartridge) which is as easy to engineer and manufacture as is desired.
Accordingly, it is a broad object of this invention to provide a new cartridge design for ligating and dividing an organic structure.
It is another object of this invention to provide a new 1~ cartridge design which will ligate and divide organic structures ~;
by means of association with a two-stage instrument.
It is still another object of this invention to provide a new cartridge design in which the associated instrument powers `
the knife and pushers and the knife is so associated with the main body portions and wraps of the cartridge that the jaws of the cartridge are closed and opened as the knife is moved forward and backward.
It is yet another object o'E this invention to provide a new cartridge design which has improved means for advancing, forming, and ejecting the staples. -Another object of this invention is to provide a new cartridge design which has improved means for advancing the -staples toward the anvil assembly in readiness for ejection.
Still another object of this invention is to provide a new cartridge design which has improved means for locking the cartridge during shipment and preventing the inadvertent severing - of organic structures when all of the staples, for example, have been expelled from the cartridge.
These and other objects of the invention, as well as many of the attendant advantages thereof, will become more readily apparent when reference is made to the following description taken in conjunction with the drawings.
--4-- - `?
` :' ', :
The present invention relates to a three-stage cartridge for associating with an instrument and adapted to ligate and divide organic structures. The cartridge is simple, and yet effective, and eliminates numerous disadvantages common in prior art cartridges.
The cartridge operates in three stages. Once a tubular structure is inserted within the area of the cartridge jaws, the cartridge main body portions and associated wraps move forward toward an anvil assembly integral with a rail assembly fixed on the instrument, thereby enclosing the structure within the jaws of the cartridge. Then, a pair of pusher elements is advanced and moves a pair of staples toward the anvil assembly. At the forward portions of the pusher strokes, the respective staples encircle the tubular structure at spaced locations and are sub-sequently crimped about the structure in such a manner that the structure is sealed at two locations. Finally, and with the pushers at the forwardmost portions of their strokes, a knife blade advances and divides the tubular structure intermediate the two staples.
The cartridge houses a plurality of the staples mounted on a belt so that the staple arms overlap in a "shingle" arrange-ment. The pushers slidably mounted in the cartridge advance the belts and move the forwardmost staples up a series of ramps out of the plane of the belt and into the major planes of the pushers and then push and form the staples against the anvil assembly.
As the forwardmost pair of staples is being advanced, they are held in the teeth in the belt by leaf springs associated with the wraps. On the return stroke of the pushers, a pair of detents associated with the main body portions of the cartridge prevent the belts and staples from moving rearward from the anvil assembly.
A fail-safe mechanism is provided to stop the forward movement of the pushers and thereby prevent the knife from severing an organic structure in the jaws of the cartridge in the event that two staples have not been advanced by the pushers as, for instance, when all of the staples have been expelled from the cartridge. A ~;
loc~ing mechanism is provided to keep the respective components of the cartridge in proper position to be associated with the ~ -instrument and to prevent the accidental ejection of staples from the cartridge and the actuation of the knife before association with the instxument. Also, an ejector mechanism is provided in order to force the formed staples out of the jaws of the cartridge once the organic structure has been ligated and divided. -~
The operation of the cartridge of the invention is ;
controlled through the means of two saddle elements of an as~
sociated instrument. One of the saddle elements controls the pushers and the other saddle element controls the knife. Because of the design of the cartridge, the remaining saddle element which was used in the prior instrument designs for controlling the wrap or main body portion to open and close the jaws of the cartridge is no longer re~uired. Rather, the cartridge contains a shifter mechanism which is associated with the knife and the -~
main body portions and associated wraps.
As the knife is initially moved forward by the instru-ment, the jaws of the cartridge are closed. Conversely, the return stroke of the knife also caused by the instrument, open the jaws. Accordingly, in view of the new cartridge design, if the cartridge is associated with an instrument such as disclosed in applicant's Canadian Patents Nos. 97~,445 and 980,2Ql or with an instrument such as disclosed in applicant's Canadian patent application No. 237,179, filed October 7, 1975, the saddle (30 and 24, respectivelyl designed to be associated with the main body portion or wrap performs no function and may be omitted along with the associated apparatus for controlling and moving the saddle.
Figure 1 is a top plan view of the cartridge;
d 8~
Figure 2 is a side view of the cartridge;
Figure 3 is a cross-sectional view of the cartridge taken along the lines 3-3 in Figure l;
Figure 4 is a cross-sectional view of the cartridge taken along the lines 4-4 in Figure 3;
Figure 5 is a front view of the cartridge; :~
Figures 6-8 are a series of three cross-sectional views of the cartridge taken along the lines 3-3 in Figure 1 showing :
the movements of one of the main body portions and associated wraps, one of the pushers, the knife and the shifter dog as the jaws of the cartridge are closed and the pushers and knife advance :.
as well as the association of the c~rtridge with the drive means .
of a surgical instrume~t;
Figure 9 is a side view of the cartridge showing one of the main body portions and associated wraps and one of the pushers;
Figure 10 is a cross-sect:ional view taken along the lines 10-10 in Figure 9 and showing the association of the cartridge with the drive means of a surgical instrument shown in phantom lines;
Figures 12 and 14 are enlarged views of the forward end ` of the cartridge as shown in Figure 10 showing the advance of one of the pushers and one of the belts and the transfer of one of the forwardmost staples into the plane of the pusher; and :~
Figures 13 and 15 are enlarged views of the forward end of the cartridge as shown in Figure 11 showing the advance of one of the pushers and one of the belts and the transfer of one of `: -the forwardmost staples into the plane of the pusher in similar .
manner to Figures 12 and 14, respectively.
Referring first particularly to Figures 1-5, the cartridge 10 comprises a rail assembly 12 adapted to be fixedly secured to the instrument 14 by means of shank 15 of rail assembly 12, the projections 16 on the shank 15 and the thumb operated `
L2~
lock (not shown~ on the instrument. A curved anvil assembly 20 comprising a pair of spaced apart anvils 22 and 24 is integral with and defined by the forward end of the rail assembly 12. A
pair of main body portions 26 are slidably mounted on the rail assembly 12, and a pair of wraps 28 are fixedly secured to and ~oveable with the respective main body portions 26 by a pair of bands 30. A pair of pusher elements 32 is slidably mounted between the main body portions 26 and the respective wraps 28. A
knife 34, centrally located in the cartridge 10, is slidably mounted between the respective wraps 28. As can be seen best in Figures 6 and 10, the saddles 36 and 38 associate with and control the movements of the knife 34 and the pushers 32, respectively, with respect to the rail assembly 12. As will be described in more detail below, the knife 34 is operatively associated with the wraps 28 by means of a novel shifter dog in such a manner that the movements of the wraps 28 and the main body portions 26 are controlled by the movement of the knife 34. For simplicity of description, only one side of the cartridge will be described, but it should be understood that the cartridge is symmetrical about its longitudinal centerline.
~ ith reference now particularly to Figures 2, 4, 10, and 11 t the cartridge 10 is provided with a staple feeding arrangement comprising a belt 40, made of flexible plastic, mounted between the guide rails 42 defined by the main body portion 26 to form a loop which passes through the belt openings 44 and 46 near each longitudinal end of the main body portion. The ends of the belt 4Q are connected together by a spring 48.
The belt 40 has a plurality of longitudinally spaced apart pairs of teeth 50 on one side thereof~ Between each pair of teeth is defined a staple-carrying groove 52. Openings 54 are provided in the belt 40 between each adjacent pair of teeth 50. A detent 60 is provided in an opening 62 in the forward portion of the side wall 63 of the main body portion 26. The detent 60 is aligned withthe openings 54 in the belt 40 and is resiliently biased into the plane of the belt 40 to prevent the belt from backing up during the return stroke of the pusher. The detent 60 has a -sloped rear surface 60', however, to permit the detent to be cammed out of the plane of the belt 40 when the belt is being advanced. A cover plate 68 is fitted into a slot 70 in the outer surface of the side wall 64 of the main body portion 26. The cover plate 68 has indicia 72 thereon which, in association with a reference mark 74 on the spring 48, may be used to determine the number of pairs of staples remaining in the cartridge.
As shown particularly in Figures 10 and 11, the staples 80 are housed in and guided by the staple-carrying grooves 52 of the belt 40. The staples 80, as mounted in the belt, have a pair of arms 82 terminating in widely spaced apart ends 84 which extend in the longitudinal direction of the main body portion 26 of the cartridge. The staples 80 also have cross-pieces 86 which extend transversely of the arms 82 and the belt 40. The cross-pieces 86 of the staples 80 are fitted into the staple-carrying grooves 52. The staples 80 are mounted on the belt 40 so that the ends 84 of the staples lie in a pair of ~;
grooves 90 defined in the main body portion 26 on both sides of the guide rails 42. The forward lower wall of the lower one of the grooves 90 is formed by the leg 94 of a "L" shaped member 96 ~ `;
fitted into the main body portion 26. The ends 84 of each of the staples 80, with the exception of the forwardmost staple, rests under the arms 82 of the preceding staple in "shingle" fashion.
The rear portion of the belt 40 is covered by a cover strap 98 shown particularly in Figure 8 positioned between the belt and the pusher 32 to keep the rear end of the pusher from interfering with the movement of the belt or staples during the advance and retraction of the pusher.
~9-The staples 80 lie along the major portion of the length of the cartridge 10 in what may be termed an index plane.
It is in the index plane that the staples are, in unison, advanced toward the anvil assembly 20 in readiness for ejection. Near the forward end of the cartridge 10, the staples 80 are transferred to the pusher plane coincident with the plane of the major portion of the pusher 32. For purposes of transferring the staples 80 from the index plane to the pusher plane, the main body portion 26 is provided with a first pair of ramps 100 which are spaced apart to act on the individual staples at their respective ends 84 and a second pair of ramps 102 which are spaced apart to act on the individual staples at their ;
respective cross-pieces 86.
Referring now particularly to Figures 3, 4, 10, 11 and 12, the pusher 32 slides along ledges 104 defined by the main body portion 26 and the wrap 28 as shown particularly in Figure 4. -~
The pusher 32 is positioned adjacent the belt 40 and the staples 80 and is adapted for movement longitudinally within the cartridge 10. As best seen in Figure 10, while the major part of the pusher 32 lies in the pusher plane, a tooth 110 at the forward ~-~
end of the pusher 32 projects into the index plane and, more specifically, into the plane of the belt teeth. The tooth 110 is centered on the belt 40 and is adapted to associate with the pairs of teeth 50 of the belt as shown particularly in Figure 12.
The rear surface 110' of the tooth 110 i5 sloped to allow the front of the pusher 32 to be cammed out of the index plane by the belt 40 during its return stroke. Forward portion 33 of pusher 32 flexes inwardly during this camming action. The forward end 111 of the pusher 32 is curved as shown particularly in Figure 11 and is adapted to cooperate with the individual staples 80 during the staple forming operation.
With reference now particularly to Figures 9, 10, 12 and 14, a spring 112 is attached to the forward end of the wrap 28. This spring 112 extends longitudinally of the cartridge 10 and is primarily positioned between the wrap 28 and the pusher 32. The forward end of the spring 112 comprises a lip 114 which has a curvature corresponding to the curvature of the forward end of the pusher 32. The lip 114 is cammed out of the pusher plane -into a slot 116 in the wrap 28 by the individual staples during the staple forming operation as shown in Figure 14. However, when the cartridge 10 is empty, the lip 114 remains in the pusher plane and prevents the pusher 32 from advancing. In this manner, and as will be discussed in more detail below, the knife 34 is also prevented from advancing and severing an organic structure enclosed in the jaws of the cartridge 10 when there are not two staples in the cartridge in front of the pushers to ligate the structure.
The spring 112 also has a leaf spring 118 located in an elongated opening 120 in the spring 112 which projects into the index plane and, more specifically, into the plane of the belt teeth 50 as shown in Figures 10 and 12. The function of the leaf ~0 spring 118 is to hold the forwardmost staple in the belt 40 in the staple-carrying groove 52 defined by the pair of teeth 50 ~ -carrying this staple until the staple is ready to be transferred out of the index plane into the pusher plane. As this occurs, the leaf spring 118 is cammed into the slot 116 in the wrap 26 by the pusher 32 as shown in Figure 14. The rear portion of the spring 112 extends through opening 122 and into opening 124 in the wrap 28 in order to securely mount the spring to the wrap.
Referring now particularly to Figures 3, 4 and 6-8, the knife 34, which has a blade 126 mounted on its forward end, slides between the wraps 28 of the cartridge 10. The knife has a notch 128 formed in its bottom surface intermediate its ends which is adapted to associate with a shifter dog 130. The shifter --11-- ~
dog 130 has an upstanding arcuate portion 132 at its rear end for fitting into the notch 128 in the knife 34. At its forward end, -the shifter dog 130 has two outwardly and downwardly extending projections 134 which fit into and are hingedly secured in slots 136 formed in the wraps 28. A longitudinally extending opening 138 is formed in the rail assembly 12 which has a sloped portion 138' at its rear end. The shifter dog 130 rides along the upper surface of the rail assembly 12 with its upstanding arcuate portion 132 locked in the notch 128 in the knife 34 as shown in Figure 3 until the main body portion 26 and associated wrap 28 are abutting against the an~il assembly 20 thus closing the jaws of the cartridge around the organic structure as shown in Figure 6.
Then, the rear end of the shifter mechanism 130 is cammed into slot 138 in the rail assembly by the sloped rear portion 128' of the notch 128 as shown in Figures 7 and 8 so that the knife can continue its advance to divide the ligated organic structure.
(See Figure 8). On the return stroke of the knife 34, the shifter dog 130 moves back into locking engagement with the notch 128 of the knife 34 so that the main body portion 26 and the associated wrap 28 are also moved away from the anvil assembly 20 to open the jaws.
With reference now particularly to Figures 1, 3 and 5, an ejector plate 140 is positioned between the forward ends of the rail assembly 12. The ejector plate 140 has an arcuate projection 142 at its forward end and a groove 144 extending longitudinally of the ejector plate for receiving the knife 34.
The ejector plate is typically made of a rigid plastic material and has a soft plastic tube 146 which fits into a hole 148 extend-ing from the top of the arcuate projection. The tube 146 is adapt-ed to be cut into by the knife 34 when severing the organicstructure. The arcuate projection has two outwardly and laterally extending ears 150 which slide in complimentary shaped slots 152 L2~
in the spaced apart anvils 22 and 24.
With reference now particularly to Figures 6-8, a :
downwardly extending lug 154 is formed on the bottom surface of the rear end of the ejector plate 140. The lug 154 extends through a longitudinally extending slot 156 formed in the anvil assembly 12. The slot 156 is made slightly longer than the length of the lug 154 thereby allowing slight relative movement between the ejector plate 140 and the anvil assembly 20.
A slot 158 is also formed in the bottom surface of the main body portions 26. The lug 154 of the ejector plate 140 extends through the slot 156 in the anvil assembly 12 into the ~.
slot 158 in the main body portions 26. The rear wall of the slot 158 in the main body portions abuts against the lug 154 of the ejector plate during its advance and causes the arcuate projection 142 to move foxward away from the anvil assembly 20 as shown in Figures 7 and 8 so that the ears 150 on the arcuate projection are not within the jaws of the instrument as the organic structure is being enclosed and ligated. Then, on the return stroke of the main body portions 26, the ejector plate 140 is moved rearward into ~
the position shown in Figures 1 and 2, for example, so that the ~ .`
ears 150 of the arcuate projection 142 engage the formed staples 80 to eject the staples and the severed organic structure from the jaws of the cartridge.
The main body portions 26 and associated wraps 28, the pushers 32, and the knife 34 are held in a fixed position relative to the rail assembly 12 until the cartridge 10 is mounted on the :
: instrument 14. In this manner, the pushers 32 are prevented from accidentally ejecting a pair of staples 80 from the cartridge 10 and the knife 34 is prevented from accidentally travelling forward in the cartridge 10 before the cartridge is mounted on the instru.-ment 14. Also, this arrangement properly positions the pushers 32 and the knife 34 to be engaged with the instrument.
Referring now particularly to Figures 1, 3 and 6-8, the pushers 32 are releasably locked or held, with respect to therail assembly 12 as follows as shown in Figures 1 and 3.
On the inside surface of each of the pushers 12 at the rear end of the pushers, there is provided an ear 160. And, mounted in a slot 162 in the rear of the rail assembly 12 is a cartridge -~
lock or retaining member 170 made of a resilient plastic material or the like. The cartridge lock 17 0 has a rounded pivot portion 172 which is supported by the lower surface of the main body portions 26. The forward end 174 of the cartridge lock is prevented fxom moving upward by the bottom surface of the wraps 28. The rear end of the cartridge lock 170 has an upstanding ~:
arcuate portion 176 and two outwardly and laterally projecting abutment surfaces 178. The rear end of the cartridge lock 170 is resiliently biased into the plane of the pushers 32 so that the abutment surfaces 178 are alignecl with the ears 160 of the pushers when the cartridge is not associated with the instrument.
Therefore, when the pushers 32 are in their rearwardmost position, with the cartridge ready to be inserted on the instru~
ment 14, the abutment surfaces 178 of the cartridge lock 170 are :
positioned in front of the ears 160 and lock the pushers 32 in position with respect to the rail assembly 12 as shown in Figures ~-1 and 3. Also, when the pushers 32 are in this position, their rear ends are adjacent an abutment 180 on the main body portions 26 so that the main body.portions 26 cannot move forward relative to the pushers 32. Finally, because of the engagement of the wraps 28 associated with the main body portions 26 and the knife 34 by means of the shifter dog 130, the knife is held in a fixed relative position with respect to the rail assembly 12. ~Iowever, when the cartridge 10 is mounted on the instrument 14, as shown in Figures 6-8, the abutment surfaces 178 of the cartridge lock 170 are moved out of the plane of the ears 160 of the pushers 32 ~:
2~38 by means of the saddle 38 acting on the arcuate projection 176 and camming the rear end of the cartridge lock 170 downward into the slot 162 in the rail assembly 12. This unlocks the cartridge and allows the cartridge to be operated.
The operation of the inventive cartridge 10 is as follows. When the cartridge 10 is mounted on the instrument 14 as shown in Figures 6 and 10, the drive element 182 of the instrument extends through the opening 184 in the main body portions 26 so that the saddles 38 and 36 associate with the pushers 32 and knife 34, respectively. For this purpose, and as shown particular-ly in Figures 7 and 8, the pushers have a slot 186 and an inwardly extending flange 188 and the knife 34 has an upwardly and outwardly extending leg 190 defining an opening 192 at their respective rear ends.
As noted previously, during shipment, the main body ;
portions 26 and associated wraps 28 are retracted and spaced from the anvil assembly 20 as shown in Figures 1-3. Upon initial activation of the instrument 14, the knife 34 and therefore, by means of the shifter dog 130, the main body portions 26 and associated wraps 28 move in the direction of arrow 200. At the same time, the pushers 32 are moved forward and the teeth 110 of the pushers 32 come into contact as shown in Figures 12 and 13, with the rear surfaces of the teeth 50 of the belt 40 carrying the first staples 80 in the cartridge and move the belts 40 and associated staples 80 forward in unison with the main body portions 26 and associated wraps 28. During this movement, the staples remain in the index plane.
With continued movement of the belts 40, the arms 82 of the staples 80 come into contact with the ramps lOQ and then the cross-pieces 86 of the staples 80 come into contact with the ramps 102. While the belts 40 are moving forward at this stage, the first staples 80 are held in the staple-carrying grooves 52 .
.2l~
of the belts 40 by the leaf springs 118. The remaining staples 80 in -the cartridge 10 axel held in the staple-carrying grooves 52 of the belts 40 by the pushers 32 and the cover straps 98. With continued forward movement of the belts 40, and with the forward-most staples being acted upon by the respective ramps 100 and 102, the staples 80 are caused to transfer, in the direction of arrow 202, from the index plànes to~the pusher planes and cam the lips 114 of the springs 112 out of the pusher planes, The pushers 32 engage and also cam the leaf springs 118 out of the pusher .
planes, (See Figures 14 and lS).
After the main body portions 26 and wraps 28 have come into contact with the anvil assembly 20 and ejector plate 140, respectively, as shown in Flgure 6, the upstanding arcuate portion 132 of the shifter dog 130 moves into the slot 138 in the anvil assembly 12 disengagin~ the wraps 28 ~rom the knife 34. (See Figures 7 and 8). The pushers 32 continue their forward movement relative to the main body portions 26 and wraps 28 and contact the respective forwardmost staples 80, now moved into the pusher planes by the ramps 100 and 102, and ~orm the same around tha :~
organic structure (not shown) housed within the jaws of the cartridge 10 as shown particularly in Figures 14 and 15 in similar manner to that shown in commonly assigned U.S. Patent No.
3,683,927. Then, once the organic structure is ligated, the knife 34 divides such structure intermediate the pair of ligating staples 80. (See Figure 8) Once a pair of staples 80 has been formed, and the organic structure has been divided, the knife 34, the pushers 32 and the main body portions 26 and associated wraps 28 are ready to be retracted from the re~ion o~ the anvil assembly 20. First, the knife 34 retracts, then the pushers 32 retract and finally the main body portions 26 and associated wraps 28 retract once S~J
, "
the upstanding arcuate portion 132 of the shifter dog 130 moves back into the notch 128 of the knife 34 during its return stroke.
This sequence is opposite to that shown in Figures 6-8. -Before continuing, it should be noted that the forward-most staples in the belts 40, save for the staples which were ~ ;
formed, were advanced by the belts 40 to a position immediately adjacent the ramps 100 and 102. The reference numeral 80a in Figure 11 shows the position of the forwardmost staples in the main body portions 26, save for the staples having been ejected, ~
after the completed movement of the belts 40 in the direction of arrow 200. These staple 80a, as well as the belts 40 and the remaining staples 80, are retained in this position by detents 60 which are positioned in the openings 54 between the forward- `
most pairs of teeth 50. (See Figures 10 and 14).
The ejector plate 140 functions to eject the formed ~ "
staples 80 and the severed organic structure from the jaws of the cartridge 10 after the completion of the ligating and dividing operations. During the forward motion of the main body portions 26, the ejector plate 140 is moved by the main body portions 26 out of the area of the anvil assembly 20 as shown in Figures 7 and 8. When the main body portions 26 retract, the ejector ;~
plate 140 is carried with the main body portions 26 into the area of the anvil assembly 20. (See Figures 1 and 3). In this manner, the inwardly extending ears 150 on the ejector plate 140 pass ;~--through the slots 152 in the pair of anvils 22 and 24 and force the staples 80 out of the area of the anvil assembly 20 and hence facilitate the ejec-tion of the divided structure from the jaws of ;~
; the cartridge 10.
As previously mentioned, the surgeon can ascertain the ;
number of staples 80 in the cartridge 10 by reference to the indicia 72 on the cover plates 68 and the index marks 74 on the springs 48. However, if the surgeon fails to note that all of -17- ~;
Z~
-the staples 80 have been expelled from the cartridge and attempts to operate the instrument the cartridge is designed to prevent the forward stroke of the pushers and the knife. This also occurs should there be any malfunction of the cartridge such that a pair of staples is not in position to be formed. This is accomplished since the lips 114 of the springs 112, not being cammed out of the pusher planes by the staples moving up the ramps 100 and 102 and into the pusher planes, form abutments or stops for the pushers 32. In short, the lips 114 of the springs 112 remain in the position shown in Figure 12 instead of being moved into the position shown in Figure 14. Accordingly, although the jaws of the instrument may close around the organic structure, the pushers 32, acted upon by the lips 114 of the springs 112, cannot move forward. Because of the design of the instrument 14, the saddle 38 associated with the pushers 32 and therefore the saddle 36 associated with the knife 34 cannot move forward result-ing in the kni~e 34 stopping in its forward movement before reaching and severing the organic structure.
Above there has been described a specific embodiment of the present invention. It should be noted, however, that the above description was given for illustrative purposes only and that many alterations and modifications may be practiced by those skilled in the art without departing from the spirit or the scope of the present invention. It is the intent therefore that the present invention not be limited to the above but be limited only as defined in the appended claims.
, "
the upstanding arcuate portion 132 of the shifter dog 130 moves back into the notch 128 of the knife 34 during its return stroke.
This sequence is opposite to that shown in Figures 6-8. -Before continuing, it should be noted that the forward-most staples in the belts 40, save for the staples which were ~ ;
formed, were advanced by the belts 40 to a position immediately adjacent the ramps 100 and 102. The reference numeral 80a in Figure 11 shows the position of the forwardmost staples in the main body portions 26, save for the staples having been ejected, ~
after the completed movement of the belts 40 in the direction of arrow 200. These staple 80a, as well as the belts 40 and the remaining staples 80, are retained in this position by detents 60 which are positioned in the openings 54 between the forward- `
most pairs of teeth 50. (See Figures 10 and 14).
The ejector plate 140 functions to eject the formed ~ "
staples 80 and the severed organic structure from the jaws of the cartridge 10 after the completion of the ligating and dividing operations. During the forward motion of the main body portions 26, the ejector plate 140 is moved by the main body portions 26 out of the area of the anvil assembly 20 as shown in Figures 7 and 8. When the main body portions 26 retract, the ejector ;~
plate 140 is carried with the main body portions 26 into the area of the anvil assembly 20. (See Figures 1 and 3). In this manner, the inwardly extending ears 150 on the ejector plate 140 pass ;~--through the slots 152 in the pair of anvils 22 and 24 and force the staples 80 out of the area of the anvil assembly 20 and hence facilitate the ejec-tion of the divided structure from the jaws of ;~
; the cartridge 10.
As previously mentioned, the surgeon can ascertain the ;
number of staples 80 in the cartridge 10 by reference to the indicia 72 on the cover plates 68 and the index marks 74 on the springs 48. However, if the surgeon fails to note that all of -17- ~;
Z~
-the staples 80 have been expelled from the cartridge and attempts to operate the instrument the cartridge is designed to prevent the forward stroke of the pushers and the knife. This also occurs should there be any malfunction of the cartridge such that a pair of staples is not in position to be formed. This is accomplished since the lips 114 of the springs 112, not being cammed out of the pusher planes by the staples moving up the ramps 100 and 102 and into the pusher planes, form abutments or stops for the pushers 32. In short, the lips 114 of the springs 112 remain in the position shown in Figure 12 instead of being moved into the position shown in Figure 14. Accordingly, although the jaws of the instrument may close around the organic structure, the pushers 32, acted upon by the lips 114 of the springs 112, cannot move forward. Because of the design of the instrument 14, the saddle 38 associated with the pushers 32 and therefore the saddle 36 associated with the knife 34 cannot move forward result-ing in the kni~e 34 stopping in its forward movement before reaching and severing the organic structure.
Above there has been described a specific embodiment of the present invention. It should be noted, however, that the above description was given for illustrative purposes only and that many alterations and modifications may be practiced by those skilled in the art without departing from the spirit or the scope of the present invention. It is the intent therefore that the present invention not be limited to the above but be limited only as defined in the appended claims.
Claims (28)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS: :
1. A cartridge adapted to be powered by a surgical instrument, said cartridge being capable of confining an organic structure in a closed area within its jaws, ligating said structure with a pair of spaced apart surgical staples, and severing said structure intermediate said surgical staples, the cartridge comprising: a rail assembly adapted to be removably mounted to the instrument; anvil means defined at the forward end of said rail assembly; an elongate main body mounted on said rail assembly for movement longitudinally relative to said rail assembly; a pair of belts mounted in said main body for movement longitudinally relative to said main body; a plurality of surgical staples carried by said belts; a pair of pushers mounted in said main body portion for movement longitudinally relative to said main body adjacent said respective belts, said pushers having a pro-jection at their forward ends adapted to extend into the plane of said respective belts for advancing said belts and said staples carried thereon toward said anvil means; ramp means associated with said main body and said belts for singly transferring said staples from the planes of said belts and into the planes of said pushers in response to the movement of said pushers toward said anvil means; a knife mounted in said main body for longitudinal movement relative to said main body; and shifter means associated with said knife and said main body for causing said main body to move forward into abutting relationship with said anvil means to close the jaws of said cartridge when said knife is initially moved toward said anvil means.
2. The cartridge of claim 1 in which said belt has a plurality of longitudinally spaced apart pairs of teeth on one side thereof, each pair of teeth defining a staple-carrying groove.
3. The cartridge of claim 2 in which said belts have a plurality of openings between each adjacent pairs of teeth, said cartridge further comprising a pair of detent means associated with said main body and aligned with said openings in said belts, said detent means being resiliently biased into the planes of said belts to prevent said belts from moving away from said anvil means on the return stroke of said pushers.
4. The cartridge of claim 3 in which said detent means have sloped rear surfaces to permit said detent means to be cammed out of the planes of said belts when said belts are being advanced toward said anvil means.
5. The cartridge of claim 1 and further comprising a cover plate associated with said main body having indicia thereon and a reference mark associated with said belt to permit the number of pairs of staples remaining in said cartrige to be ascertained.
6. The cartridge of claim 1 in which said staples have pairs of arms terminating in widely spaced apart ends which extend in the longitudinal direction of said main body toward said anvil means and cross-pieces which extend transversely of said arms and said belts, said cross-pieces of said staples being fitted into staple-carrying grooves of said belts.
7. The cartridge of claim 6 in which said arms of said staples, with the exception of the forwardmost staples in said cartridge, rest under the arms of the preceding staple in "shingle" fashion.
8. The cartridge of claim 6 in which said ramp means for transferring said staples from the planes of said belts into the planes of said pushers comprise a series of ramps which act upon said arms and said cross-pieces of said staples.
9. The cartridge of claim 1 in which the rear surfaces of said projections at the forward ends of said pushers are sloped to allow said pushers to be cammed out of the planes of said belts during the return strokes of said pushers.
10. The cartridge of claim 1 in which the forward ends of said pushers are curved and are adapted to be cooperate with said staples during the ligating operation.
11. The cartridge of claim 1 in which said main body includes a pair of spaced apart warps adjacent the respective pushers and a spring associated with each of said wraps near their forward ends.
12. The cartridge of claim 11 in which said springs have lips which are resiliently biased into the planes of said pushers and are adapted to be cammed out of the planes of said pushers by the forwardmost staples, said lips acting to prevent the forward movement of said pushers when a pair of staples is not in position in the planes of said pushers ready to be formed in the ligating operation.
13. The cartrige of claim 11 in which said springs also include leaf springs which project into the plane of said belts and are positioned to hold the forwardmost staples in said belts until said staples are ready to be transferred from the planes of said belts into the planes of said pushers.
14. The cartridge of claim 1 in which said shifter means includes means hingedly attached to said main body at one end and an upstanding arcuate portion at its other end, said knife further comprising a notch adapted to associate with said upstanding arcuate portion during the initial movement of said knife toward said anvil means and during the final stages of the movement of said knife away from said anvil means when said knife is being returned to its initial rest position.
15. The cartridge of claim 14 in which said rail assembly has a longitudinally extending opening which is adapted to receive the rear end of said upstanding arcuate portion on said shifter means to allow said shifter means to be moved out of engagement with said notch in said knife after the jaws of said instrument have been closed.
16. The cartridge of claim 1 and further comprising ejector means for ejecting said staples and said organic structure from the jaws of said cartridge after the ligating and severing operations.
17. The cartridge of claim 16 in which the forward end of said rail assembly is formed into two spaced apart sections defining spaced apart anvils at their forward ends and said ejector means is positioned between said spaced apart sections of said rail assembly.
18. The cartridge of claim 17 in which said ejector means has an arcuate projection at its forward end and a groove extending longitundinally of said ejector means for receiving said knife.
19. The cartridge of claim 18 in which said ejector means has two outwardly and laterally extending ears defined by said arcuate projection which slide in complimentary shaped slots in said spaced apart anvils.
20. The cartridge of claim 8 in which said ejector means has a downwardly extending lug formed on the bottom surface of the rear end of said ejector means, said rail assembly having a longitudinally extending slot through which said lug extends, said longitudinally extending slot being slightly longer than the length of said downwardly projecting lug to allow for slight relative movement between said ejector means and said anvil means.
21. The cartridge of claim 20 in which said ejector means is moved relative to said anvil means by means of association of said lug with said main body.
22. The cartridge of claim 1 and further comprising means for locking said main body, said pushers and said knife in a fixed position relative to said rail assembly until said cartridge is mounted on the instrument.
23. The cartridge of claim 22 in which said locking means comprises a cartridge lock which is resiliently urged into abutment with said pushers to prevent said pushers from moving toward said anvil means prior to said cartridge being mounted on said instrument.
24. The cartridge of claim 23 in which said cartridge lock has a round pivot portion which is supported by the upper surface of said main body and the rear end of said cartridge lock has an upstanding arcuate portion and two outwardly and laterally projecting abutment surfaces, said rear end of said cartridge lock being resiliently biased into the plane of said pushers so that said abutment surfaces are aligned with and in front of ears mounted on said pushers when said cartridge is not associated with said instrument.
25. The cartridge of claim 24 in which said cartridge lock is mounted on said cartridge such that it is moved out of abutment with said pushers when said cartridge is mounted on said instrument.
26. A cartridge adapted to be powered by a surgical instrument, said cartridge being capable of confining an organic structure in a closed area within its jaws, ligating said structure with a pair of spaced apart surgical staples, and severing said structure intermediate said surgical staples, the cartridge comprising: a rail assembly adapted to be removably mounted to the instrument; anvil means defined at the forward end of said rail assembly; an elongate main body mounted on said rail assembly for movement longitudinally relative to said rail assembly; staple feeding means mounted in said main body for movement with said main body; a plurality of surgical staples fed by said staple feeding means; a pair of pushers mounted in said main body portion for movement longitudinally relative to said main body adjacent said respective staple feeding means for singly transferring said staples from the planes of said staple feeding means and into the planes of said pushers; a knife mounted in said main body for longitudinal movement relative to said main body; and shifter means associated with said knife and said main body for causing said main body to move forward into abutting relationship with said anvil means to close the jaws of said cartridge when said knife is initially moved toward said anvil means.
27. A cartridge adapted to be powered by a surgical instrument, said cartridge being capable of confining an organic structure in a closed area within its jaws, ligating said structure with a pair of spaced apart surgical staples, and severing said structure intermediate said surgical staples, the cartridge com-prising: a rail assembly adapted to be removably mounted to the instrument; anvil means defined at the forward end of said rail assembly; an elongate main body mounted on said rail assembly for movement longitudinally relative to said rail assembly; a pair of belts mounted in said main body for movement longitudinally relative to said main body; a plurality of surgical staples carried by said belts; a pair of pushers mounted in said main body for movement longitudinally relative to said main body adjacent said respective belts, said pushers having a projection at their forward ends adapted to extend into the plane of said respective belts for advancing said belts and said staples carried thereon toward said anvil means; ramp means associated with said main body and said belts for singly transferring said staples from the planes of said belts and into the planes of said pushers in response to the movement of said pushers toward said anvil means;
and a knife mounted in said main body for longitudinal movement relative to said main body.
and a knife mounted in said main body for longitudinal movement relative to said main body.
28. A cartridge adapted to be powered by a surgical instrument, said cartridge being capable of confining an organic structure in a closed area within its jaws and ligating said structure with a surgical staple, the cartridge comprising: a rail assembly adapted to be removably mounted to the instrument;
anvil means defined at the forward end of said rail assembly; an elongate main body mounted on said rail assembly for movement longitudinally relative to said rail assembly; a belt mounted in said main body for movement longitudinally relative to said main body; a plurality of surgical staples carried by said belt;
a pusher mounted in said main body for movement longitudinally relative to said main body adjacent said belt, said pusher having a projection at its forward end adapted to extend into the plane of said belt for advancing said belt and said staples carried thereon toward said anvil means; and ramp means associated with said main body and said belt for singly transferring said staples from the plane of said belt and into the plane of said pusher in response to the movement of said pusher toward said anvil means.
anvil means defined at the forward end of said rail assembly; an elongate main body mounted on said rail assembly for movement longitudinally relative to said rail assembly; a belt mounted in said main body for movement longitudinally relative to said main body; a plurality of surgical staples carried by said belt;
a pusher mounted in said main body for movement longitudinally relative to said main body adjacent said belt, said pusher having a projection at its forward end adapted to extend into the plane of said belt for advancing said belt and said staples carried thereon toward said anvil means; and ramp means associated with said main body and said belt for singly transferring said staples from the plane of said belt and into the plane of said pusher in response to the movement of said pusher toward said anvil means.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US05/730,821 US4086926A (en) | 1976-10-08 | 1976-10-08 | Ligating and dividing organic structures |
| US730,821 | 1976-10-08 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1101288A true CA1101288A (en) | 1981-05-19 |
Family
ID=24936948
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA288,297A Expired CA1101288A (en) | 1976-10-08 | 1977-10-07 | Ligating and dividing organic structures |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US4086926A (en) |
| JP (1) | JPS5347185A (en) |
| CA (1) | CA1101288A (en) |
| DE (1) | DE2744824C3 (en) |
| GB (1) | GB1561018A (en) |
| HK (1) | HK58080A (en) |
Families Citing this family (352)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4349028A (en) * | 1980-10-03 | 1982-09-14 | United States Surgical Corporation | Surgical stapling apparatus having self-contained pneumatic system for completing manually initiated motion sequence |
| US4646740A (en) * | 1981-02-23 | 1987-03-03 | Edward Weck & Co., Inc. | Automatic hemoclip applier |
| US4370893A (en) * | 1981-06-08 | 1983-02-01 | Grove Valve And Regulator Company | Orifice meter with replacable orifice disc |
| JPS5844383U (en) * | 1981-09-17 | 1983-03-25 | 立山アルミニウム工業株式会社 | double glazed windows |
| JPS58176519A (en) * | 1982-04-09 | 1983-10-17 | Matsushita Electric Ind Co Ltd | Detecting apparatus of flow rate of gas |
| JPS58195121A (en) * | 1982-05-08 | 1983-11-14 | Matsushita Electric Ind Co Ltd | Detecting apparatus of flow rate of gas |
| US4470533A (en) * | 1982-08-13 | 1984-09-11 | Ethicon, Inc. | Surgical instrument for suturing tissues and organs |
| US4534351A (en) * | 1982-10-20 | 1985-08-13 | Senmed, Inc. | Ligator |
| US4556058A (en) * | 1983-08-17 | 1985-12-03 | United States Surgical Corporation | Apparatus for ligation and division with fixed jaws |
| JPS60500704A (en) * | 1983-03-30 | 1985-05-16 | ユナイテツド ステイツ サ−ジカル コ−ポレ−シヨン | Methods and devices for surgical occlusion and amputation |
| AU569730B2 (en) * | 1983-03-30 | 1988-02-18 | United States Surgical Corporation | Surgical occluding and cutting |
| US4569346A (en) * | 1983-03-30 | 1986-02-11 | United States Surgical Corporation | Safety apparatus for surgical occluding and cutting device |
| US4576165A (en) * | 1984-01-23 | 1986-03-18 | United States Surgical Corporation | Surgical ligation and cutting device with safety means |
| US4555939A (en) * | 1984-03-19 | 1985-12-03 | Honeywell Inc. | Condition responsive sensor for fluid flow measurement |
| US4612933A (en) * | 1984-03-30 | 1986-09-23 | Senmed, Inc. | Multiple-load cartridge assembly for a linear surgical stapling instrument |
| US4665916A (en) * | 1985-08-09 | 1987-05-19 | United States Surgical Corporation | Surgical stapler apparatus |
| US5197970A (en) * | 1988-01-15 | 1993-03-30 | United States Surgical Corporation | Surgical clip applicator |
| US5071052A (en) * | 1988-09-22 | 1991-12-10 | United States Surgical Corporation | Surgical fastening apparatus with activation lockout |
| US4892244A (en) * | 1988-11-07 | 1990-01-09 | Ethicon, Inc. | Surgical stapler cartridge lockout device |
| ES2078231T3 (en) * | 1988-11-11 | 1995-12-16 | United States Surgical Corp | SURGERY INSTRUMENT. |
| US5318221A (en) * | 1989-05-26 | 1994-06-07 | United States Surgical Corporation | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
| US5413268A (en) * | 1989-05-26 | 1995-05-09 | United States Surgical Corporation | Apparatus and method for placing stables in laparoscopic or endoscopic procedures |
| US5031814A (en) * | 1989-05-26 | 1991-07-16 | United States Surgical Corporation | Locking mechanism for surgical fastening apparatus |
| US5106008A (en) * | 1989-05-26 | 1992-04-21 | United States Surgical Corporation | Locking mechanism for a surgical fastening apparatus |
| US5040715B1 (en) * | 1989-05-26 | 1994-04-05 | United States Surgical Corp | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
| US5253793A (en) * | 1990-09-17 | 1993-10-19 | United States Surgical Corporation | Apparatus for applying two-part surgical fasteners |
| US5156614A (en) * | 1990-09-17 | 1992-10-20 | United States Surgical Corporation | Apparatus for applying two-part surgical fasteners |
| US5156315A (en) * | 1990-09-17 | 1992-10-20 | United States Surgical Corporation | Arcuate apparatus for applying two-part surgical fasteners |
| US5129570A (en) * | 1990-11-30 | 1992-07-14 | Ethicon, Inc. | Surgical stapler |
| US5470009A (en) * | 1990-12-06 | 1995-11-28 | United States Surgical Corporation | Surgical fastening apparatus with locking mechanism |
| CA2055943C (en) * | 1990-12-06 | 2003-09-23 | Daniel P. Rodak | Surgical fastening apparatus with locking mechanism |
| US5083695A (en) * | 1990-12-18 | 1992-01-28 | Minnesota Mining And Manufacturing Company | Stapler and firing device |
| DE69119607T2 (en) * | 1990-12-18 | 1996-11-14 | United States Surgical Corp | SAFETY DEVICE FOR SURGICAL CLAMPING DEVICES |
| US5141144A (en) * | 1990-12-18 | 1992-08-25 | Minnesota Mining And Manufacturing Company | Stapler and firing device |
| US5413267A (en) * | 1991-05-14 | 1995-05-09 | United States Surgical Corporation | Surgical stapler with spent cartridge sensing and lockout means |
| AU671685B2 (en) * | 1991-05-14 | 1996-09-05 | United States Surgical Corporation | Surgical stapler with spent cartridge sensing and lockout means |
| CA2078794C (en) * | 1991-10-18 | 1998-10-06 | Frank J. Viola | Locking device for an apparatus for applying surgical fasteners |
| US5312023A (en) * | 1991-10-18 | 1994-05-17 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
| US6250532B1 (en) * | 1991-10-18 | 2001-06-26 | United States Surgical Corporation | Surgical stapling apparatus |
| CA2075227C (en) * | 1991-10-18 | 2004-02-10 | Robert J. Geiste | Surgical fastening apparatus with shipping interlock |
| US5307976A (en) * | 1991-10-18 | 1994-05-03 | Ethicon, Inc. | Linear stapling mechanism with cutting means |
| US5364001A (en) * | 1991-10-18 | 1994-11-15 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
| US5397046A (en) * | 1991-10-18 | 1995-03-14 | United States Surgical Corporation | Lockout mechanism for surgical apparatus |
| US5478003A (en) * | 1991-10-18 | 1995-12-26 | United States Surgical Corporation | Surgical apparatus |
| AU657364B2 (en) * | 1991-10-18 | 1995-03-09 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
| US5326013A (en) * | 1991-10-18 | 1994-07-05 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
| US5395034A (en) * | 1991-11-07 | 1995-03-07 | American Cyanamid Co. | Linear surgical stapling instrument |
| CA2088883A1 (en) * | 1992-02-13 | 1993-08-14 | David T. Green | Endoscopic ligating instrument |
| US5484095A (en) * | 1992-03-31 | 1996-01-16 | United States Surgical Corporation | Apparatus for endoscopically applying staples individually to body tissue |
| US5269792A (en) * | 1992-05-26 | 1993-12-14 | Origin Medsystems, Inc. | Surgical clip |
| US5192288A (en) * | 1992-05-26 | 1993-03-09 | Origin Medsystems, Inc. | Surgical clip applier |
| US5485952A (en) * | 1992-09-23 | 1996-01-23 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5336229A (en) * | 1993-02-09 | 1994-08-09 | Laparomed Corporation | Dual ligating and dividing apparatus |
| US5447265A (en) * | 1993-04-30 | 1995-09-05 | Minnesota Mining And Manufacturing Company | Laparoscopic surgical instrument with a mechanism for preventing its entry into the abdominal cavity once it is depleted and removed from the abdominal cavity |
| US6716232B1 (en) | 1993-04-30 | 2004-04-06 | United States Surgical Corporation | Surgical instrument having an articulated jaw structure and a detachable knife |
| US5858018A (en) * | 1993-08-25 | 1999-01-12 | Apollo Camera, Llc | Low profile tool for applying spring action ligation clips |
| US5487499A (en) * | 1993-10-08 | 1996-01-30 | United States Surgical Corporation | Surgical apparatus for applying surgical fasteners including a counter |
| US5470008A (en) * | 1993-12-20 | 1995-11-28 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5527320A (en) * | 1994-02-10 | 1996-06-18 | Pilling Weck Inc. | Surgical clip applying instrument |
| WO1995023557A1 (en) * | 1994-03-01 | 1995-09-08 | United States Surgical Corporation | Surgical stapler with anvil sensor and lockout |
| US5681330A (en) * | 1994-03-02 | 1997-10-28 | Ethicon Endo-Surgery, Inc. | Sterile occlusion fasteners and instrument and method for their placement |
| CA2143560C (en) * | 1994-03-02 | 2007-01-16 | Mark Fogelberg | Sterile occlusion fasteners and instrument and method for their placement |
| US5470007A (en) * | 1994-05-02 | 1995-11-28 | Minnesota Mining And Manufacturing Company | Laparoscopic stapler with overload sensor and interlock |
| US5489058A (en) * | 1994-05-02 | 1996-02-06 | Minnesota Mining And Manufacturing Company | Surgical stapler with mechanisms for reducing the firing force |
| US5636779A (en) * | 1994-12-13 | 1997-06-10 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5988479A (en) * | 1994-12-13 | 1999-11-23 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5735445A (en) * | 1995-03-07 | 1998-04-07 | United States Surgical Corporation | Surgical stapler |
| US5706998A (en) * | 1995-07-17 | 1998-01-13 | United States Surgical Corporation | Surgical stapler with alignment pin locking mechanism |
| US5810846A (en) * | 1995-08-03 | 1998-09-22 | United States Surgical Corporation | Vascular hole closure |
| US5715988A (en) * | 1995-08-14 | 1998-02-10 | United States Surgical Corporation | Surgical stapler with lockout mechanism |
| US5718359A (en) * | 1995-08-14 | 1998-02-17 | United States Of America Surgical Corporation | Surgical stapler with lockout mechanism |
| US5762256A (en) * | 1995-08-28 | 1998-06-09 | United States Surgical Corporation | Surgical stapler |
| US5782396A (en) * | 1995-08-28 | 1998-07-21 | United States Surgical Corporation | Surgical stapler |
| US5700270A (en) * | 1995-10-20 | 1997-12-23 | United States Surgical Corporation | Surgical clip applier |
| US6109500A (en) * | 1996-10-04 | 2000-08-29 | United States Surgical Corporation | Lockout mechanism for a surgical stapler |
| US5865361A (en) | 1997-09-23 | 1999-02-02 | United States Surgical Corporation | Surgical stapling apparatus |
| US5868759A (en) * | 1997-10-10 | 1999-02-09 | United States Surgical Corporation | Surgical clip applier |
| US6241740B1 (en) | 1998-04-09 | 2001-06-05 | Origin Medsystems, Inc. | System and method of use for ligating and cutting tissue |
| US6193732B1 (en) | 1999-01-08 | 2001-02-27 | Cardiothoracic System | Surgical clips and apparatus and method for clip placement |
| US6217590B1 (en) | 1999-01-22 | 2001-04-17 | Scion International, Inc. | Surgical instrument for applying multiple staples and cutting blood vessels and organic structures and method therefor |
| US6350269B1 (en) | 1999-03-01 | 2002-02-26 | Apollo Camera, L.L.C. | Ligation clip and clip applier |
| US6264087B1 (en) | 1999-07-12 | 2001-07-24 | Powermed, Inc. | Expanding parallel jaw device for use with an electromechanical driver device |
| US7695485B2 (en) | 2001-11-30 | 2010-04-13 | Power Medical Interventions, Llc | Surgical device |
| US6716233B1 (en) | 1999-06-02 | 2004-04-06 | Power Medical Interventions, Inc. | Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities |
| US8025199B2 (en) | 2004-02-23 | 2011-09-27 | Tyco Healthcare Group Lp | Surgical cutting and stapling device |
| US7951071B2 (en) | 1999-06-02 | 2011-05-31 | Tyco Healthcare Group Lp | Moisture-detecting shaft for use with an electro-mechanical surgical device |
| US6165204A (en) * | 1999-06-11 | 2000-12-26 | Scion International, Inc. | Shaped suture clip, appliance and method therefor |
| US7285131B1 (en) * | 1999-07-28 | 2007-10-23 | Cardica, Inc. | System for performing anastomosis |
| US8016855B2 (en) | 2002-01-08 | 2011-09-13 | Tyco Healthcare Group Lp | Surgical device |
| US8281973B2 (en) | 2001-10-05 | 2012-10-09 | Tyco Healthcare Group Lp | Surgical stapling device |
| JP4458464B2 (en) * | 2001-12-04 | 2010-04-28 | パワー メディカル インターベンションズ， エルエルシー | System and method for calibrating a surgical instrument |
| US9113878B2 (en) | 2002-01-08 | 2015-08-25 | Covidien Lp | Pinion clip for right angle linear cutter |
| US20030151506A1 (en) * | 2002-02-11 | 2003-08-14 | Mark Luccketti | Method and apparatus for locating missing persons |
| ATE347316T1 (en) | 2002-06-14 | 2006-12-15 | Power Med Interventions Inc | DEVICE FOR CLAMPING, CUTTING AND STAPING TISSUE TOGETHER |
| EP1545334B1 (en) | 2002-10-04 | 2006-12-13 | Tyco Healthcare Group LP | Surgical stapler with universal articulation and tissue pre-clamp |
| JP4448449B2 (en) | 2002-10-04 | 2010-04-07 | タイコ ヘルスケア グループ エルピー | Tool assembly for a surgical stapling device |
| ES2337248T3 (en) | 2002-10-04 | 2010-04-22 | Tyco Healthcare Group Lp | TOOL ASSEMBLY FOR A SURGICAL STAPLING DEVICE. |
| US7678125B2 (en) * | 2002-11-12 | 2010-03-16 | Apollo Camera, L.L.C. | Surgical ligation clip |
| US7343920B2 (en) * | 2002-12-20 | 2008-03-18 | Toby E Bruce | Connective tissue repair system |
| US9597078B2 (en) | 2003-04-29 | 2017-03-21 | Covidien Lp | Surgical stapling device with dissecting tip |
| US20040243151A1 (en) | 2003-04-29 | 2004-12-02 | Demmy Todd L. | Surgical stapling device with dissecting tip |
| US8172870B2 (en) * | 2003-06-09 | 2012-05-08 | Microline Surgical, Inc. | Ligation clip applier |
| US7494039B2 (en) | 2003-06-17 | 2009-02-24 | Tyco Healthcare Group Lp | Surgical stapling device |
| EP1635713B1 (en) | 2003-06-17 | 2012-04-11 | Tyco Healthcare Group LP | Surgical stapling device |
| EP1677684B1 (en) | 2003-10-17 | 2012-12-05 | Tyco Healthcare Group LP | Surgical stapling device with independent tip rotation |
| US7572266B2 (en) * | 2003-10-21 | 2009-08-11 | Young Wayne P | Clip applier tool having a discharge configuration |
| CA2580931C (en) * | 2004-09-23 | 2013-05-07 | Tyco Healthcare Group Lp | Clip applying apparatus and ligation clip |
| US9138226B2 (en) | 2005-03-30 | 2015-09-22 | Covidien Lp | Cartridge assembly for a surgical stapling device |
| US7780055B2 (en) | 2005-04-06 | 2010-08-24 | Tyco Healthcare Group Lp | Loading unit having drive assembly locking mechanism |
| CA2563147C (en) | 2005-10-14 | 2014-09-23 | Tyco Healthcare Group Lp | Surgical stapling device |
| FR2895071B1 (en) * | 2005-12-19 | 2008-01-18 | Giat Ind Sa | ANTI-REBOUND LOCKING DEVICE OF A DEPLOYABLE FIN OF A PROJECTILE. |
| US7686809B2 (en) * | 2006-09-25 | 2010-03-30 | Stryker Spine | Rod inserter and rod with reduced diameter end |
| US8708210B2 (en) | 2006-10-05 | 2014-04-29 | Covidien Lp | Method and force-limiting handle mechanism for a surgical instrument |
| US8608043B2 (en) | 2006-10-06 | 2013-12-17 | Covidien Lp | Surgical instrument having a multi-layered drive beam |
| US7866525B2 (en) | 2006-10-06 | 2011-01-11 | Tyco Healthcare Group Lp | Surgical instrument having a plastic surface |
| US8147504B2 (en) * | 2007-05-05 | 2012-04-03 | Medtronic, Inc. | Apparatus and methods for delivering fasteners during valve replacement |
| US7624902B2 (en) | 2007-08-31 | 2009-12-01 | Tyco Healthcare Group Lp | Surgical stapling apparatus |
| US8061576B2 (en) | 2007-08-31 | 2011-11-22 | Tyco Healthcare Group Lp | Surgical instrument |
| US9168039B1 (en) | 2007-09-06 | 2015-10-27 | Cardica, Inc. | Surgical stapler with staples of different sizes |
| US8403956B1 (en) | 2007-09-06 | 2013-03-26 | Cardica, Inc. | Multiple-use surgical stapler |
| US7988026B2 (en) | 2007-09-06 | 2011-08-02 | Cardica, Inc. | Endocutter with staple feed |
| US8070036B1 (en) | 2007-09-06 | 2011-12-06 | Cardica, Inc | True multi-fire surgical stapler configured to fire staples of different sizes |
| EP2233081B2 (en) | 2007-09-21 | 2018-03-28 | Covidien LP | Surgical device |
| JP5357161B2 (en) | 2007-09-21 | 2013-12-04 | コヴィディエン リミテッド パートナーシップ | Surgical equipment |
| US7954685B2 (en) | 2007-11-06 | 2011-06-07 | Tyco Healthcare Group Lp | Articulation and firing force mechanisms |
| US8701959B2 (en) | 2008-06-06 | 2014-04-22 | Covidien Lp | Mechanically pivoting cartridge channel for surgical instrument |
| US7789283B2 (en) | 2008-06-06 | 2010-09-07 | Tyco Healthcare Group Lp | Knife/firing rod connection for surgical instrument |
| US7942303B2 (en) | 2008-06-06 | 2011-05-17 | Tyco Healthcare Group Lp | Knife lockout mechanisms for surgical instrument |
| US8215532B2 (en) | 2008-09-23 | 2012-07-10 | Tyco Healthcare Group Lp | Tissue stop for surgical instrument |
| US7988028B2 (en) | 2008-09-23 | 2011-08-02 | Tyco Healthcare Group Lp | Surgical instrument having an asymmetric dynamic clamping member |
| US7896214B2 (en) | 2008-09-23 | 2011-03-01 | Tyco Healthcare Group Lp | Tissue stop for surgical instrument |
| US8628544B2 (en) | 2008-09-23 | 2014-01-14 | Covidien Lp | Knife bar for surgical instrument |
| US20100191262A1 (en) * | 2009-01-26 | 2010-07-29 | Harris Jason L | Surgical stapler for applying a large staple through small delivery port and a method of using the stapler to secure a tissue fold |
| US20100187283A1 (en) * | 2009-01-26 | 2010-07-29 | Lawrence Crainich | Method For Feeding Staples In a Low Profile Surgical Stapler |
| US9713471B2 (en) | 2009-01-26 | 2017-07-25 | Ethicon Endo-Surgery, Inc. | Surgical device with tandem fasteners |
| US8439244B2 (en) | 2010-01-20 | 2013-05-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler fastening device with movable anvil |
| US8602286B2 (en) * | 2009-01-26 | 2013-12-10 | Ethicon Endo-Surgery, Inc. | Apparatus for feeding staples in a low profile surgical stapler |
| US9713468B2 (en) * | 2009-01-26 | 2017-07-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler for applying a large staple through a small delivery port and a method of using the stapler to secure a tissue fold |
| US20100187285A1 (en) * | 2009-01-26 | 2010-07-29 | Harris Jason L | Surgical stapler for applying a large staple though a small delivery port and a method of using the stapler to secure a tissue fold |
| US8469252B2 (en) | 2009-01-26 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler fastening device with adjustable anvil |
| US8801732B2 (en) * | 2009-01-26 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical stapler to secure a tissue fold |
| US8453905B2 (en) | 2009-01-26 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical fastener for applying a large staple through a small delivery port |
| US20100191255A1 (en) * | 2009-01-26 | 2010-07-29 | Lawrence Crainich | Method for Applying A Surgical Staple |
| US8317071B1 (en) | 2009-03-09 | 2012-11-27 | Cardica, Inc. | Endocutter with auto-feed buttress |
| US8397973B1 (en) | 2009-03-09 | 2013-03-19 | Cardica, Inc. | Wide handle for true multi-fire surgical stapler |
| US8356740B1 (en) | 2009-03-09 | 2013-01-22 | Cardica, Inc. | Controlling compression applied to tissue by surgical tool |
| US7918376B1 (en) | 2009-03-09 | 2011-04-05 | Cardica, Inc. | Articulated surgical instrument |
| US8292154B2 (en) | 2009-04-16 | 2012-10-23 | Tyco Healthcare Group Lp | Surgical apparatus for applying tissue fasteners |
| US8317072B1 (en) | 2009-05-03 | 2012-11-27 | Cardica, Inc. | Feeder belt for true multi-fire surgical stapler |
| US8631992B1 (en) | 2009-05-03 | 2014-01-21 | Cardica, Inc. | Feeder belt with padded staples for true multi-fire surgical stapler |
| US8985427B1 (en) | 2009-05-05 | 2015-03-24 | Cardica, Inc. | Feeder belt with internally manufactured staples for true multi-fire surgical stapler |
| US8096457B1 (en) | 2009-05-05 | 2012-01-17 | Cardica, Inc. | Articulation mechanisms for surgical instrument |
| US9289208B1 (en) | 2009-05-05 | 2016-03-22 | Cardica, Inc. | Articulation insert for surgical instrument |
| US8469253B1 (en) | 2009-05-05 | 2013-06-25 | Cardica, Inc. | Surgical staples attached to resorbable holder |
| US9038881B1 (en) | 2009-05-05 | 2015-05-26 | Cardica, Inc. | Feeder belt actuation mechanism for true multi-fire surgical stapler |
| US8365975B1 (en) | 2009-05-05 | 2013-02-05 | Cardica, Inc. | Cam-controlled knife for surgical instrument |
| US8127976B2 (en) | 2009-05-08 | 2012-03-06 | Tyco Healthcare Group Lp | Stapler cartridge and channel interlock |
| US9004339B1 (en) * | 2009-05-26 | 2015-04-14 | Cardica, Inc. | Cartridgizable feeder belt for surgical stapler |
| US8240538B1 (en) | 2009-05-29 | 2012-08-14 | Cardica, Inc. | True multi-fire surgical stapler with two-sided staple deployment |
| US8070034B1 (en) | 2009-05-29 | 2011-12-06 | Cardica, Inc. | Surgical stapler with angled staple bays |
| US8225980B1 (en) | 2009-06-02 | 2012-07-24 | Cardica, Inc. | True multi-fire surgical stapler with buttress strip |
| US8056789B1 (en) | 2009-06-03 | 2011-11-15 | Cardica, Inc. | Staple and feeder belt configurations for surgical stapler |
| US8132706B2 (en) | 2009-06-05 | 2012-03-13 | Tyco Healthcare Group Lp | Surgical stapling apparatus having articulation mechanism |
| US8087562B1 (en) | 2009-06-22 | 2012-01-03 | Cardica, Inc. | Anvil for surgical instrument |
| US8701960B1 (en) | 2009-06-22 | 2014-04-22 | Cardica, Inc. | Surgical stapler with reduced clamp gap for insertion |
| US8342378B2 (en) | 2009-08-17 | 2013-01-01 | Covidien Lp | One handed stapler |
| US8365971B1 (en) | 2009-09-23 | 2013-02-05 | Cardica, Inc. | True multi-fire linear cutter |
| US8523042B2 (en) * | 2009-10-21 | 2013-09-03 | The General Hospital Corporation | Apparatus and method for preserving a tissue margin |
| US8418907B2 (en) | 2009-11-05 | 2013-04-16 | Covidien Lp | Surgical stapler having cartridge with adjustable cam mechanism |
| US8261958B1 (en) | 2010-01-06 | 2012-09-11 | Cardica, Inc. | Stapler cartridge with staples frangibly affixed thereto |
| US8348127B2 (en) | 2010-04-07 | 2013-01-08 | Covidien Lp | Surgical fastener applying apparatus |
| US8662369B1 (en) | 2010-05-27 | 2014-03-04 | Cardica, Inc. | Barbed surgical staple |
| US8439246B1 (en) | 2010-07-20 | 2013-05-14 | Cardica, Inc. | Surgical stapler with cartridge-adjustable clamp gap |
| US8899461B2 (en) | 2010-10-01 | 2014-12-02 | Covidien Lp | Tissue stop for surgical instrument |
| US8308041B2 (en) | 2010-11-10 | 2012-11-13 | Tyco Healthcare Group Lp | Staple formed over the wire wound closure procedure |
| US8556935B1 (en) | 2011-03-15 | 2013-10-15 | Cardica, Inc. | Method of manufacturing surgical staples |
| US9655615B2 (en) | 2011-04-19 | 2017-05-23 | Dextera Surgical Inc. | Active wedge and I-beam for surgical stapler |
| US8636189B1 (en) | 2011-04-19 | 2014-01-28 | Cardica, Inc. | Active wedge for surgical stapler |
| US8631990B1 (en) | 2011-04-25 | 2014-01-21 | Cardica, Inc. | Staple trap for surgical stapler |
| US9038880B1 (en) | 2011-04-25 | 2015-05-26 | Cardica, Inc. | Articulated surgical instrument |
| US9320519B1 (en) | 2011-04-26 | 2016-04-26 | Cardica, Inc. | Single-trigger clamping and firing of surgical stapler |
| US9474527B1 (en) | 2011-04-26 | 2016-10-25 | Bryan D. Knodel | Surgical instrument with discrete articulation |
| US9566048B1 (en) | 2011-04-26 | 2017-02-14 | Cardica, Inc. | Surgical instrument with discrete cammed articulation |
| US9155536B1 (en) | 2011-04-26 | 2015-10-13 | Cardica, Inc. | Circular stapler |
| US9451959B2 (en) | 2011-06-09 | 2016-09-27 | Covidien Lp | Surgical fastener applying apparatus |
| US9271728B2 (en) | 2011-06-09 | 2016-03-01 | Covidien Lp | Surgical fastener applying apparatus |
| US9289209B2 (en) | 2011-06-09 | 2016-03-22 | Covidien Lp | Surgical fastener applying apparatus |
| US8763876B2 (en) | 2011-06-30 | 2014-07-01 | Covidien Lp | Surgical instrument and cartridge for use therewith |
| US20130012958A1 (en) | 2011-07-08 | 2013-01-10 | Stanislaw Marczyk | Surgical Device with Articulation and Wrist Rotation |
| US9724095B2 (en) | 2011-08-08 | 2017-08-08 | Covidien Lp | Surgical fastener applying apparatus |
| US9539007B2 (en) | 2011-08-08 | 2017-01-10 | Covidien Lp | Surgical fastener applying aparatus |
| US9155537B2 (en) | 2011-08-08 | 2015-10-13 | Covidien Lp | Surgical fastener applying apparatus |
| US8418790B2 (en) * | 2011-09-20 | 2013-04-16 | Deere & Company | Cooling package baffle or ducting |
| US9016539B2 (en) | 2011-10-25 | 2015-04-28 | Covidien Lp | Multi-use loading unit |
| US8740036B2 (en) | 2011-12-01 | 2014-06-03 | Covidien Lp | Surgical instrument with actuator spring arm |
| US10299815B2 (en) | 2012-01-19 | 2019-05-28 | Covidien Lp | Surgical instrument with clam releases mechanism |
| US8864010B2 (en) | 2012-01-20 | 2014-10-21 | Covidien Lp | Curved guide member for articulating instruments |
| US9084600B1 (en) | 2012-02-17 | 2015-07-21 | Cardica, Inc. | Anvil-side staple trap |
| US8979827B2 (en) | 2012-03-14 | 2015-03-17 | Covidien Lp | Surgical instrument with articulation mechanism |
| US8992547B2 (en) | 2012-03-21 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Methods and devices for creating tissue plications |
| US9526497B2 (en) | 2012-05-07 | 2016-12-27 | Covidien Lp | Surgical instrument with articulation mechanism |
| US9232944B2 (en) | 2012-06-29 | 2016-01-12 | Covidien Lp | Surgical instrument and bushing |
| US9408605B1 (en) | 2012-07-12 | 2016-08-09 | Cardica, Inc. | Single-trigger clamping and firing of surgical stapler |
| US9364217B2 (en) | 2012-10-16 | 2016-06-14 | Covidien Lp | In-situ loaded stapler |
| US9345480B2 (en) | 2013-01-18 | 2016-05-24 | Covidien Lp | Surgical instrument and cartridge members for use therewith |
| US10561432B2 (en) | 2013-03-05 | 2020-02-18 | Covidien Lp | Pivoting screw for use with a pair of jaw members of a surgical instrument |
| US9814463B2 (en) | 2013-03-13 | 2017-11-14 | Covidien Lp | Surgical stapling apparatus |
| US9717498B2 (en) | 2013-03-13 | 2017-08-01 | Covidien Lp | Surgical stapling apparatus |
| US9888921B2 (en) | 2013-03-13 | 2018-02-13 | Covidien Lp | Surgical stapling apparatus |
| US9629628B2 (en) | 2013-03-13 | 2017-04-25 | Covidien Lp | Surgical stapling apparatus |
| US9510827B2 (en) | 2013-03-25 | 2016-12-06 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
| US9445810B2 (en) | 2013-06-12 | 2016-09-20 | Covidien Lp | Stapling device with grasping jaw mechanism |
| US9662108B2 (en) | 2013-08-30 | 2017-05-30 | Covidien Lp | Surgical stapling apparatus |
| EP3065648A1 (en) | 2013-11-04 | 2016-09-14 | Covidien LP | Surgical fastener applying apparatus |
| AU2013403917A1 (en) | 2013-11-04 | 2016-04-28 | Covidien Lp | Surgical fastener applying apparatus |
| CN110063762B (en) | 2013-11-04 | 2022-04-15 | 柯惠Lp公司 | Surgical fastener applying apparatus |
| US9867613B2 (en) | 2013-12-19 | 2018-01-16 | Covidien Lp | Surgical staples and end effectors for deploying the same |
| US9629627B2 (en) | 2014-01-28 | 2017-04-25 | Coviden Lp | Surgical apparatus |
| US9848874B2 (en) | 2014-02-14 | 2017-12-26 | Covidien Lp | Small diameter endoscopic stapler |
| US9757126B2 (en) | 2014-03-31 | 2017-09-12 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
| US9668733B2 (en) | 2014-04-21 | 2017-06-06 | Covidien Lp | Stapling device with features to prevent inadvertent firing of staples |
| US9861366B2 (en) | 2014-05-06 | 2018-01-09 | Covidien Lp | Ejecting assembly for a surgical stapler |
| WO2015174985A1 (en) | 2014-05-15 | 2015-11-19 | Lp Covidien | Surgical fastener applying apparatus |
| US10039545B2 (en) | 2015-02-23 | 2018-08-07 | Covidien Lp | Double fire stapling |
| US10085749B2 (en) | 2015-02-26 | 2018-10-02 | Covidien Lp | Surgical apparatus with conductor strain relief |
| US10285698B2 (en) | 2015-02-26 | 2019-05-14 | Covidien Lp | Surgical apparatus |
| US9918717B2 (en) | 2015-03-18 | 2018-03-20 | Covidien Lp | Pivot mechanism for surgical device |
| US10463368B2 (en) | 2015-04-10 | 2019-11-05 | Covidien Lp | Endoscopic stapler |
| US10299789B2 (en) | 2015-05-05 | 2019-05-28 | Covidie LP | Adapter assembly for surgical stapling devices |
| US10117650B2 (en) | 2015-05-05 | 2018-11-06 | Covidien Lp | Adapter assembly and loading units for surgical stapling devices |
| US10039532B2 (en) | 2015-05-06 | 2018-08-07 | Covidien Lp | Surgical instrument with articulation assembly |
| US10143474B2 (en) | 2015-05-08 | 2018-12-04 | Just Right Surgical, Llc | Surgical stapler |
| US10172615B2 (en) | 2015-05-27 | 2019-01-08 | Covidien Lp | Multi-fire push rod stapling device |
| US10349941B2 (en) | 2015-05-27 | 2019-07-16 | Covidien Lp | Multi-fire lead screw stapling device |
| US10548599B2 (en) | 2015-07-20 | 2020-02-04 | Covidien Lp | Endoscopic stapler and staple |
| US9987012B2 (en) | 2015-07-21 | 2018-06-05 | Covidien Lp | Small diameter cartridge design for a surgical stapling instrument |
| US10064622B2 (en) | 2015-07-29 | 2018-09-04 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
| US10045782B2 (en) | 2015-07-30 | 2018-08-14 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
| US10213204B2 (en) | 2015-10-02 | 2019-02-26 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
| US10772632B2 (en) | 2015-10-28 | 2020-09-15 | Covidien Lp | Surgical stapling device with triple leg staples |
| US10595864B2 (en) | 2015-11-24 | 2020-03-24 | Covidien Lp | Adapter assembly for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof |
| US10111660B2 (en) | 2015-12-03 | 2018-10-30 | Covidien Lp | Surgical stapler flexible distal tip |
| US10966717B2 (en) | 2016-01-07 | 2021-04-06 | Covidien Lp | Surgical fastener apparatus |
| US10660623B2 (en) | 2016-01-15 | 2020-05-26 | Covidien Lp | Centering mechanism for articulation joint |
| US10349937B2 (en) | 2016-02-10 | 2019-07-16 | Covidien Lp | Surgical stapler with articulation locking mechanism |
| US10420559B2 (en) | 2016-02-11 | 2019-09-24 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
| US10561419B2 (en) | 2016-05-04 | 2020-02-18 | Covidien Lp | Powered end effector assembly with pivotable channel |
| US11065022B2 (en) | 2016-05-17 | 2021-07-20 | Covidien Lp | Cutting member for a surgical instrument |
| US11642126B2 (en) | 2016-11-04 | 2023-05-09 | Covidien Lp | Surgical stapling apparatus with tissue pockets |
| US10631857B2 (en) | 2016-11-04 | 2020-04-28 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
| US10492784B2 (en) | 2016-11-08 | 2019-12-03 | Covidien Lp | Surgical tool assembly with compact firing assembly |
| US10463371B2 (en) | 2016-11-29 | 2019-11-05 | Covidien Lp | Reload assembly with spent reload indicator |
| US10709901B2 (en) | 2017-01-05 | 2020-07-14 | Covidien Lp | Implantable fasteners, applicators, and methods for brachytherapy |
| US10952767B2 (en) | 2017-02-06 | 2021-03-23 | Covidien Lp | Connector clip for securing an introducer to a surgical fastener applying apparatus |
| US20180235618A1 (en) | 2017-02-22 | 2018-08-23 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
| US11350915B2 (en) | 2017-02-23 | 2022-06-07 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
| US10849621B2 (en) | 2017-02-23 | 2020-12-01 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
| US10299790B2 (en) | 2017-03-03 | 2019-05-28 | Covidien Lp | Adapter with centering mechanism for articulation joint |
| US10660641B2 (en) | 2017-03-16 | 2020-05-26 | Covidien Lp | Adapter with centering mechanism for articulation joint |
| US11324502B2 (en) | 2017-05-02 | 2022-05-10 | Covidien Lp | Surgical loading unit including an articulating end effector |
| US10603035B2 (en) | 2017-05-02 | 2020-03-31 | Covidien Lp | Surgical loading unit including an articulating end effector |
| US10524784B2 (en) | 2017-05-05 | 2020-01-07 | Covidien Lp | Surgical staples with expandable backspan |
| US10390826B2 (en) | 2017-05-08 | 2019-08-27 | Covidien Lp | Surgical stapling device with elongated tool assembly and methods of use |
| US10420551B2 (en) | 2017-05-30 | 2019-09-24 | Covidien Lp | Authentication and information system for reusable surgical instruments |
| US10478185B2 (en) | 2017-06-02 | 2019-11-19 | Covidien Lp | Tool assembly with minimal dead space |
| US10624636B2 (en) | 2017-08-23 | 2020-04-21 | Covidien Lp | Surgical stapling device with floating staple cartridge |
| US10806452B2 (en) | 2017-08-24 | 2020-10-20 | Covidien Lp | Loading unit for a surgical stapling instrument |
| CN107684447B (en) * | 2017-09-29 | 2023-09-12 | 苏州贝诺医疗器械有限公司 | Ligator and ligature nail for operation |
| CN107684446B (en) * | 2017-09-29 | 2023-09-12 | 苏州贝诺医疗器械有限公司 | Hemorrhoid ligation cutter |
| US10925603B2 (en) | 2017-11-14 | 2021-02-23 | Covidien Lp | Reload with articulation stabilization system |
| US10863987B2 (en) | 2017-11-16 | 2020-12-15 | Covidien Lp | Surgical instrument with imaging device |
| US10945732B2 (en) | 2018-01-17 | 2021-03-16 | Covidien Lp | Surgical stapler with self-returning assembly |
| US11369371B2 (en) | 2018-03-02 | 2022-06-28 | Covidien Lp | Surgical stapling instrument |
| US10849622B2 (en) | 2018-06-21 | 2020-12-01 | Covidien Lp | Articulated stapling with fire lock |
| US10736631B2 (en) | 2018-08-07 | 2020-08-11 | Covidien Lp | End effector with staple cartridge ejector |
| US10849620B2 (en) | 2018-09-14 | 2020-12-01 | Covidien Lp | Connector mechanisms for surgical stapling instruments |
| US11510669B2 (en) | 2020-09-29 | 2022-11-29 | Covidien Lp | Hand-held surgical instruments |
| US11090051B2 (en) | 2018-10-23 | 2021-08-17 | Covidien Lp | Surgical stapling device with floating staple cartridge |
| US11197673B2 (en) | 2018-10-30 | 2021-12-14 | Covidien Lp | Surgical stapling instruments and end effector assemblies thereof |
| US10912563B2 (en) | 2019-01-02 | 2021-02-09 | Covidien Lp | Stapling device including tool assembly stabilizing member |
| US11344297B2 (en) | 2019-02-28 | 2022-05-31 | Covidien Lp | Surgical stapling device with independently movable jaws |
| US11259808B2 (en) | 2019-03-13 | 2022-03-01 | Covidien Lp | Tool assemblies with a gap locking member |
| US11284892B2 (en) | 2019-04-01 | 2022-03-29 | Covidien Lp | Loading unit and adapter with modified coupling assembly |
| US11284893B2 (en) | 2019-04-02 | 2022-03-29 | Covidien Lp | Stapling device with articulating tool assembly |
| US11241228B2 (en) | 2019-04-05 | 2022-02-08 | Covidien Lp | Surgical instrument including an adapter assembly and an articulating surgical loading unit |
| US11224424B2 (en) | 2019-08-02 | 2022-01-18 | Covidien Lp | Linear stapling device with vertically movable knife |
| US11406385B2 (en) | 2019-10-11 | 2022-08-09 | Covidien Lp | Stapling device with a gap locking member |
| US11123068B2 (en) | 2019-11-08 | 2021-09-21 | Covidien Lp | Surgical staple cartridge |
| US11534163B2 (en) | 2019-11-21 | 2022-12-27 | Covidien Lp | Surgical stapling instruments |
| US11395653B2 (en) | 2019-11-26 | 2022-07-26 | Covidien Lp | Surgical stapling device with impedance sensor |
| US11707274B2 (en) | 2019-12-06 | 2023-07-25 | Covidien Lp | Articulating mechanism for surgical instrument |
| US11109862B2 (en) | 2019-12-12 | 2021-09-07 | Covidien Lp | Surgical stapling device with flexible shaft |
| US11737747B2 (en) | 2019-12-17 | 2023-08-29 | Covidien Lp | Hand-held surgical instruments |
| US11452524B2 (en) | 2020-01-31 | 2022-09-27 | Covidien Lp | Surgical stapling device with lockout |
| US11278282B2 (en) | 2020-01-31 | 2022-03-22 | Covidien Lp | Stapling device with selective cutting |
| CN115135251A (en) | 2020-02-14 | 2022-09-30 | 柯惠有限合伙公司 | Cartridge holder for surgical staples having ridges on the outer peripheral wall for gripping tissue |
| US11344301B2 (en) | 2020-03-02 | 2022-05-31 | Covidien Lp | Surgical stapling device with replaceable reload assembly |
| US11344302B2 (en) | 2020-03-05 | 2022-05-31 | Covidien Lp | Articulation mechanism for surgical stapling device |
| US11246593B2 (en) | 2020-03-06 | 2022-02-15 | Covidien Lp | Staple cartridge |
| US11707278B2 (en) | 2020-03-06 | 2023-07-25 | Covidien Lp | Surgical stapler tool assembly to minimize bleeding |
| US11317911B2 (en) | 2020-03-10 | 2022-05-03 | Covidien Lp | Tool assembly with replaceable cartridge assembly |
| US11357505B2 (en) | 2020-03-10 | 2022-06-14 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
| US11406383B2 (en) | 2020-03-17 | 2022-08-09 | Covidien Lp | Fire assisted powered EGIA handle |
| US11426159B2 (en) | 2020-04-01 | 2022-08-30 | Covidien Lp | Sled detection device |
| US11331098B2 (en) | 2020-04-01 | 2022-05-17 | Covidien Lp | Sled detection device |
| US11504117B2 (en) | 2020-04-02 | 2022-11-22 | Covidien Lp | Hand-held surgical instruments |
| US11937794B2 (en) | 2020-05-11 | 2024-03-26 | Covidien Lp | Powered handle assembly for surgical devices |
| US11406387B2 (en) | 2020-05-12 | 2022-08-09 | Covidien Lp | Surgical stapling device with replaceable staple cartridge |
| US11191537B1 (en) | 2020-05-12 | 2021-12-07 | Covidien Lp | Stapling device with continuously parallel jaws |
| US11534167B2 (en) | 2020-05-28 | 2022-12-27 | Covidien Lp | Electrotaxis-conducive stapling |
| US11191538B1 (en) | 2020-06-08 | 2021-12-07 | Covidien Lp | Surgical stapling device with parallel jaw closure |
| US11844517B2 (en) | 2020-06-25 | 2023-12-19 | Covidien Lp | Linear stapling device with continuously parallel jaws |
| US11324500B2 (en) | 2020-06-30 | 2022-05-10 | Covidien Lp | Surgical stapling device |
| US11446028B2 (en) | 2020-07-09 | 2022-09-20 | Covidien Lp | Tool assembly with pivotable clamping beam |
| US11517305B2 (en) | 2020-07-09 | 2022-12-06 | Covidien Lp | Contoured staple pusher |
| US11266402B2 (en) | 2020-07-30 | 2022-03-08 | Covidien Lp | Sensing curved tip for surgical stapling instruments |
| US11439392B2 (en) | 2020-08-03 | 2022-09-13 | Covidien Lp | Surgical stapling device and fastener for pathological exam |
| US11395654B2 (en) | 2020-08-07 | 2022-07-26 | Covidien Lp | Surgical stapling device with articulation braking assembly |
| US11602342B2 (en) | 2020-08-27 | 2023-03-14 | Covidien Lp | Surgical stapling device with laser probe |
| US11678878B2 (en) | 2020-09-16 | 2023-06-20 | Covidien Lp | Articulation mechanism for surgical stapling device |
| US11660092B2 (en) | 2020-09-29 | 2023-05-30 | Covidien Lp | Adapter for securing loading units to handle assemblies of surgical stapling instruments |
| US11406384B2 (en) | 2020-10-05 | 2022-08-09 | Covidien Lp | Stapling device with drive assembly stop member |
| US11576674B2 (en) | 2020-10-06 | 2023-02-14 | Covidien Lp | Surgical stapling device with articulation lock assembly |
| US11890007B2 (en) | 2020-11-18 | 2024-02-06 | Covidien Lp | Stapling device with flex cable and tensioning mechanism |
| US11737774B2 (en) | 2020-12-04 | 2023-08-29 | Covidien Lp | Surgical instrument with articulation assembly |
| US11819200B2 (en) | 2020-12-15 | 2023-11-21 | Covidien Lp | Surgical instrument with articulation assembly |
| US11553914B2 (en) | 2020-12-22 | 2023-01-17 | Covidien Lp | Surgical stapling device with parallel jaw closure |
| US11759206B2 (en) | 2021-01-05 | 2023-09-19 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
| US11744582B2 (en) | 2021-01-05 | 2023-09-05 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
| US11759207B2 (en) | 2021-01-27 | 2023-09-19 | Covidien Lp | Surgical stapling apparatus with adjustable height clamping member |
| US11517313B2 (en) | 2021-01-27 | 2022-12-06 | Covidien Lp | Surgical stapling device with laminated drive member |
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Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3545444A (en) * | 1967-10-02 | 1970-12-08 | United States Surgical Corp | Wire suture wrapping instrument |
| US3584628A (en) * | 1968-10-11 | 1971-06-15 | United States Surgical Corp | Wire suture wrapping instrument |
| US3683927A (en) * | 1970-08-18 | 1972-08-15 | United States Surgical Corp | Method and cartridge for ligating organic tubular structures |
| US3740994A (en) * | 1970-10-13 | 1973-06-26 | Surgical Corp | Three stage medical instrument |
| US3665924A (en) * | 1970-10-13 | 1972-05-30 | United States Surgical Corp | Suturing and dividing organic tubular structures |
| JPS4970489U (en) * | 1972-09-30 | 1974-06-19 | ||
| JPS5222122B2 (en) * | 1973-06-06 | 1977-06-15 | ||
| US3955581A (en) * | 1974-10-18 | 1976-05-11 | United States Surgical Corporation | Three-stage surgical instrument |
-
1976
- 1976-10-08 US US05/730,821 patent/US4086926A/en not_active Expired - Lifetime
-
1977
- 1977-10-05 GB GB41481/77A patent/GB1561018A/en not_active Expired
- 1977-10-05 DE DE2744824A patent/DE2744824C3/en not_active Expired
- 1977-10-07 CA CA288,297A patent/CA1101288A/en not_active Expired
- 1977-10-08 JP JP12134977A patent/JPS5347185A/en active Granted
-
1980
- 1980-10-09 HK HK580/80A patent/HK58080A/en unknown
Also Published As
| Publication number | Publication date |
|---|---|
| GB1561018A (en) | 1980-02-13 |
| DE2744824A1 (en) | 1978-04-13 |
| US4086926A (en) | 1978-05-02 |
| DE2744824B2 (en) | 1979-06-21 |
| JPS5652577B2 (en) | 1981-12-12 |
| HK58080A (en) | 1980-10-16 |
| DE2744824C3 (en) | 1980-02-14 |
| JPS5347185A (en) | 1978-04-27 |
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