CA1201350A - Medical stapling device - Google Patents
Medical stapling deviceInfo
- Publication number
- CA1201350A CA1201350A CA000432808A CA432808A CA1201350A CA 1201350 A CA1201350 A CA 1201350A CA 000432808 A CA000432808 A CA 000432808A CA 432808 A CA432808 A CA 432808A CA 1201350 A CA1201350 A CA 1201350A
- Authority
- CA
- Canada
- Prior art keywords
- driver
- track
- staple
- staples
- anvil
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
Abstract
ABSTRACT OF THE DISCLOSURE
An open wire staple is disclosed which comprises a generally U-shaped central portion, having at least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer portions starting from said central portion being at increasingly greater distances from the adjacent arcuate part of said central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part. The staple of the invention is intended for use as a medical staple.
An open wire staple is disclosed which comprises a generally U-shaped central portion, having at least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer portions starting from said central portion being at increasingly greater distances from the adjacent arcuate part of said central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part. The staple of the invention is intended for use as a medical staple.
Description
~o~
The present invention relates to rnedical staples for suturing living tissue such as disunited skin or fascia.
The prior art is replete ~ith medical stapling devices for use in suturing living tissues. United States Patent Nos.
3,643,851; 3,662,939; 3,837,555; 3,873,016; and 4,014,492 are illustrative of such devices which include means which may be operated to move a plurality of open staples along a track and sequentially into engagement with an anvil so that the staple engaging the anvil will be closed to engage it with tissues adjacent the anvil.
Typicall~, such stapling devices are rather complex and apply a staple which is rectangular or square in shape after application. Such staples may be applied in different ways.
One way involves manually pulling together and everting (tenting) the edges of tissue (e.g., skin or fascia) to be joined, placing the anvil of the stapling device transverse of the juncture between the tissues, and activating the device to apply a staple. The applied staple has a straight central portion (which contacted the anvil) extending across the juncture of the tissues, straight side portions of the staple on either end of its central portion extending along the outer surfaces of the tissue and at right angles to the central portion of the staple, and generally aligned pointed end portions piercing 3~
the tissue and extending toward each other from the ends of the straight portions opposite the central portion.
Another way involves bringing the anvil and separated sharp end portions of an open staple into contact with the surfaces of tissues to be joined while the surfaces of the tissue are co-planar, and then activating the device so that the end portions of the staple enter the tissues and pull them together as the staple is closed.
Subsequent to at least partial healing of the tissues, these staples are removed by using a tool to bend the central portion of each staple to a U-shaped configura-tion, which bending causes the pointed end portions of` the staple to separate.
Such stapling of living tissues has presented certain problems. First the open staples are pre-bent at right angles between their side and end portions. When the staple is used to ~oin tissues with co-planar surfaces in the manner described above, these sharply bent portions of-the staple must enter the tissue, which can cause tearing of the tissue adjacent the points of entry. Also, either manner of stapling with such staples results in excessive gathering of the tissues to be joined which is not recommended by some experts in the healing art (e.g., by "gathering" we mean pressing together ad~acent portions of the tissues to be ~oined, and by 'lexcessive gathering" we mean pressing together rnore of those adjacent tissue portions than is required to keep those tissues in contact ~2~
adjacent and between the staples when a moderate tension is applied across the suture).
After the staples are applied, the healing tissues swell around the staples and enclose significant portions of the side portions of the staples. When the staples are then removed by bending their central portions, their L-shaped side and end portions tend to painfully tear or stretch the joined tissues as they are withdrawn.
Also, tension across the juncture between the tissues can cause some of the applied staples to rotate until the tissues are retained between their opposite corners. Swelling of the tissues around such a rotated staple can obfuscate its orientation so that a person removing the staple may inadvertently bend one of its side portions (instead of its central portion) to a generally U-shaped configuration. This can cause its opposite side and end portion to significantly tear tissues and cause pain as the staple is removed.
The staples of the invention are shaped to enter living tissues with a minimum of tissue damage, to gather joined tissues by a predetermined amount that will just maintain the tissues in contact when a moderate tension is applied across the suture, to provide a closed staple that will not tend to rotate within the tissues, and to allow the ends of the staple to be withdrawn from swelled healiny tissue with minimum damage to the tissue by bending its central portion in the manner described above.
Applicant has deve:Loped a stapling device especially adapted for use with its novel staples. This device is of the type including a frame, an anvil mounted in a fixed position relative to -the frame, and means for moviny a plurality of open staples along a track and sequentially into engagement with the anvil to close the staple enyaging the anvil. In applicant1s stapling device, the means for moving the staples comprises a driver mounted on the frame for movement along a predetermined path generally aligned with the track between first and second positions with the driver more closely adjacent the anvil in its second position; a staple engaging member comprising a plurality of spaced lugs adapted to engage staples along the track; and means for mounting the staple engaging member to cause movement thereof from an initial position with its lugs spaced from staples along the track toward the track to an engage position with the lugs aligned with staples along the track during a first position of movement of the driver from its first toward its second position; to cause movement of the staple engaging member with the driver and along the track to move the staples and engage the leading staple with the anvil during a second portion of its movement toward the second position; to cause movement of the lugs away from the track and out of engagement with staples along the track during a first position of movement of the driver from its second position back toward its first position; and to cause movement of the staple engaging member with the driver back to its initial position during a second portion of the movement of the driver ~ac'~ to~,7ard its first position.
The staple of the invention is of the open wire type and comprises a generally U-shaped central portion, having at least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer portions starting from said central portion being at increasinyl~
greater distances from the adjacent arcuate part of s~id central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part.
Applicant has also developed a special cartridge for storing its novel staples in conjunction with the above-described stapling device. This cartridge includes portions defining a track for the staples, which portions comprise parallel elongate rails having opposed parallel grooves. A plurality of the staples have the outermost portions of their arcuate end portions in the grooves and are frictionally engaged between the rails ~ith the points of the staples pointing toward a first end of the cartridge; and are disposed in closely adiacent relationship along the grooves. The cartridge is open along one side of the rails to afford access to the staples along the track by the spaced lugs on the staple engaging member so that the lugs can move between the staples and drive the staples along the track and sequentiall~ into engagement with the anvil on the stapler assembl~ which is aligned wi~h the track at the first end of the mounted cartridge.
The present invention will be further described with reference to the accompanying drawing where like numbers refer to ~ 5 --~o~
like parts in the several vi.e~,7s, and wherein;
Figure 1 is a side view of a stapling device for dispensing the staples of the invention;
Figure 2 is an enlarged top view of the stapling device of Figure 1, having parts broken away to show details;
Figure 3 is a sectional view taken approximately along thé line 3-3 of Fiyure 2, and showing a normal position of a staple driving mechanism in the stapling device;
Figures 4 and 5 are fragmentar~ séctional views, taken approximately along the line 3-3 of Figure 2, which show sequential positions into which the staple driving mechanism is moved during the application of a staple;
Figures 6 and 7 are sectional views taken respectively along the lines 6-6 and 7-7 of Figure 5, Figure 8 is a fragmentary sectional view taken approximately along line 9-9 of Figure 6;
Figure 9 is a perspective view of a replaceable staple cartridge ror use with the stapling device of Figure l;
Figure 10 is a side view of the cartridge of Figure 9;
Figures 11 and 12 are fragmentary sectional views sequentially showing the attachment of a first embodiment of a staple applied by the stapling device of Figure 1 to suture living tissues; and Figures 13, 1~ and 15 are fragmentary sectional views sequentially showing the attachment of a second embodiment of a staple applied by the stapling device of Figure 1 to suture living tissues.
~Z()~50 Referring now to the drawing there is sho~m a stapling device or stapler 10 for dispensing the staples of this invention.
The ~21~
stapling devlce 10 includes a frame 11, an anvil 12 rnounted on the frame 11, and means for moving a pluraliky of open staples 13 along a track 14 and sequentially into engagement with the anvil 12 (Figure 11) to close the staple 13 en~aging the anvil 12 (Figure 12) so that the staple 13 may suture living tissues 16 (such as disunited skin or fascia) adjacent the anvil 12.
As is best seen in Figures 3 through 7, the means for moving the open staples along the track 14 includes a driver 18 mounted on the frame 11 for movement along a predetermined path generally aligned with the track between a first position (Figure 3) and a second position (Figure 5) with the drive 18 more closely adjacent the anvil 12 in its second position. Also included is a staple engaging member 19 comprising a plurality of spaced lugs 20 adapted to engage staples 13 along the track 14. The staple engaging member 19 is mounted by means for causing movement thereof from an initial position (Figure 3) with its lugs 20 spaced from staples 13 along the track 14 toward the track 14 to an engage position (Figure 4) with the lugs 20 aligned with and between the staples 13 along the track 14 during a first position of movement of the driver 18 from its first toward its second position; for causlng rnovement of the o.taple engaging member 19 with the driver 18 to engage and move staples 13 along the track 14 and to close the leading staple 13 alvng the track 14 around the anvil 12 during a second portion of the movement s~
of the driver to~1ard its second position ~'igures 5 and 12); for causing movement of the lugs 20 away from the track 14 and out of engagement with the staples 13 along the track 14 during a first position of movement of the driver 18 from its second position (Figure 5) back toward its first position; and to move the staple engaging member 19 with the driver 18 back to its initial position (Figure 3) during a second portion of movement of the driver 18 back toward its first position.
The driver 18 comprises an elongate driving portion 22 which has a semi-cylindrical bearing surface 23 (Figures 6 and 7) and a longitudinally extending U-shaped slot 24 along its side opposite its bearing surface 23 so that the driving portion 22 is generally C-shaped in cross section. The bearing surface 23 of the driving portion 22 is slidably mounted against a mating bearing surface 25 on the frame 11 for movement toward and away from the anvil 12. The driver 18 also includes a stepped cylindrical driven portlon (see Figures 3, 4 and 5) fixed on the end of the driving portion 22 opposite the anvil 12 and having an axis aligned with the direction of sliding movement for the driver 18. The driving portion includes three cylindrical portions 27, 28 and 29 coaxially fixed to and spaced by a cylindrical rod 30. The cylindrical front portion 27 attaches the rod 30 to the driving portion 22. The center cylindrical portion 28 retains a compression spring 31 within a chamber in the frame 11 and between itself and a collar 32 fixed to the frame 11 to provide mea,næ for biasing the driver 18 to its first position. The portion o~ the rod 30 between the center and rear cylindrical portions 28 and 29 is slidably mounted in a bearing 33 on 5 the frame 11 to provide, with the cylindrical bearing surfaces 23 and 25, the means for slidably mounting the driver 18 on the frame ll.
The rear cylindrical portion 29 is fixed on the end of the rod 30 and is concave on its side opposite the rod 30. An actuating trigger 35 is pivotably mounted by a pin 36 on a handle assembly 37 and has a knob 34 at one end adapted to engage the concave surface of the rear cylindrical portion 29, and a portion projecting from the handle assembly 37. When the projecting portion of the trigger 35 is manually squeezed into the handle assembly 37, the knob 34 will engage and move the driver 18 to its second position so that one of the staples 13 will be applied.
The frame 11 on which the driver 18, staple 20 engaging member 19 and anvil 12 are mounted is rotatable relative to the handle assembly 37 to af'ford various orientations of the width of the staple relative to the hand of a user grasping the handle assembly 37. This, together ~ith the long tapered outline of the stapling 25 device 10 to~rard the anvil 12 which allows excellent visibility Or the tissue being sutured, affords great versatility ln use of the stapling device 10. As is seen ~3,3~5~
~11-in Figures 2 and 3, the frame 11 has a cylindrical æl~rface 38 between spaced flanges 39 and the handle assembly 37 includes a cylindrical bearing 42 adapted to engage that cylindrical surface 38 so that the frame 11 may be rotated to change the orientation of the dispensed staple; the knob 34 of the trigger 35 being adapted to engage the concave surface of the cylindrical portion 29 at any relative orientation therebetween so that the stapling device lO may be activated.
If desired, the handle assembly 37 can be removed, and the stapling device 10 can be activated by manual pressure applied directly to the cylindrical portion 29.
The staple engaging member 19 is elongate and generally rectangular in cross section with two spaced parallel rows of spaced lugs 20 along one of its surfaces.
It is slidably received in the slot 24 in the drive portion 22 with the lugs 20 exposed to allow both relative longitudinal sliding movement between the driver 18 and the staple engaging member 19, and sliding movement of the staple engaging me~ber 19 into and out of the groove 25 in a direction normal to its elongate axis so that the lugs 20 can move to~Jard and away from the track 14 along which the staples 13 are spaced.
The staple engaging member 19 includes two parallel pins 40 extending transversely to the axes of the bearing surfaces 23 and 25, and engaging cam slots 41 in 12~
the driving portion 22 which guide and limit relati-Je movement between the driver 18 and staple engaging member 19. The surfaces defining the slots 41 are inclined to cause movement of the staple engaging member 19 out of the slot 24 (with its axis parallel to that of the driver 18) to a position with the lugs 20 between staples 13 along the track 14 as the staple engaging member 19 is moved toward the anvil 12 relative to the driver 1&; and conversely to cause movement of the staple engaging member 19 into the slot 24 with the lugs 20 spaced from staples 13 along the track 14 as the staple engaging member 19 is moved away from the anvil 12 relative to the driver 18. Means for frictionally retarding movement of the staple engaging member 19 with respect to the frame 11 are provided by two 15 opposed friction assemblies 43 (Figure 7). Each friction assembly 45 includes a housing 46 threadably mounted in the frame 11 and extending through a clearance opening in the driving portion 22 of the driver 18, a spring 47, and a ball 48 which is passed by the spring 47 into frictional 20 engagement with one side of the staple engaging member 19.
Such frictional engagement is ad~usted to prevent longitudinal movement of the staple engaging member 19 with the drlver 18 until the pins 40 contact the trailing ends of the slots 41. Thus with the pins 40 initially located 25 at the leading ends of the slots 41 (so that the lugs 20 are spaced from the staples 13 along the track 14) and with the driver 18 in its first position (Figure 3)~ subsequent ~Z~
movement of the driver 18 toward its second position will first cause the walls defining the slots 41 to move toward the anvil 12 relative to the pins 40, thereby moving the staple engaging member 19 at a right angle to its axis to its engage position; and will then cause movement of the staple engaging member l9 with the driver 18 during a second portion of the movement of the driver 18 toward its second position after the trailing ends of the slots 41 engage the pins 40. Subsequently upon movement of the driver 18 from its second position back toward its first position under the influence of the spring 35, the walls defining the slots 41 will first move along the pins 40 to move the staple engaging member away from the track 14, and will then carry the staple engaging member 19 back to its initial position after the trailing ends of the slots 41 engage the pins 40.
The track 14 along which the open staples 13 are spaced is defined by an elongate cartridge 50 removably mounted on the frame 11. The cartridge 50, best seen in Figures 9 and 10, includes a generally rectangular pro~ecting end portion 51 adapted to be received in a socket in the frame 11 and to be retained therein by a thumb screw 53. Also included are two parallel elongate rails 54 having opposed parallel grooves which define the track 14. The staples 13 have arcuate end portions in the grooves and frictionally engage with the rails 54, with the staples all opening toward the end of the cartridge 50 opposite its end portion 51 and being dispose-3 in closely adjacent relationship along the grooves. The cartridge 50 is open along one side of the rails 54 to afford access by the lugs 20 on the staple engaging member 19 with the staples 13 spaced along the track 14.
The open wire staple 13 used in the stapling device and the manner in which it is closed is best seen in Figures 11 and 12 which illustrate the application of one of the staples 13 to the tissue or disunited skin 16 which has been everted prior to application (as may be necessary when the flesh below the skin does not provide enough support for the skin so that the staple will enter skin disposed in a co-planar relationship). The staple 13 is formed from circular metal wire (e.g., 0.058 centimeter (0.023 inch) diameter 316L stainless steel). When open, the staple 13 consists of a generally U-shaped central portion 60 having two spaced arcuate parts 61, and two smoothly curved outer portions 63 terminating in sharp needle-like points 64. The staple is bent at an angle in the range of 75 to 90 degrees at the juncture between the portions 60 and 63 on each of its sides. When the staple 13 is open, successive parts of its outer portions 63 starting from the ad~acent arcuate part 61 are at, increasingly greater distances from the arcuate part 61 (when measured along straight lines between the successive parts of the curved outer portions 63 and the adJacent arcuate part 61) . When the open staple 13 is closed by -15~
bending its arcuate parts 61 to a generally straight condition, the curved outer portions 63 can enter and smoothly gather tissues (such as the disunited skin 16) positioned ad~acent the anvil 12. The shape of the U-shaped central portion 60, each of the curved outer portions 63 and the bends between the portions 60 and 63 are such that when the arcuate parts 61 of the central portion 60 are generally straightened to close the staple 13 (as shown in Figure 12), the shape of the staple 13 is generally D-shaped with the maximum dimension of the closed staple being parallel to and adJacent the straightened arcuate parts 61 to provide a desirable stability against rotation for the closed staple 13.
Figures 13, 14 an 15 illustrate an alternative embodiment of an open wire staple 68 according to the present invention as it is applied by the stapling device lO to suture disunited skin 69 in a co-planar relationship.
The device 10 will close the staple 68 to the generally D-shaped configuration shown in Figure 15. Like the staple 20 13, the open staple 68 includes a generally U-shaped central portion 70 having two spaced arcuate parts 71, and two smoothly curved outer portions 73 terminating in sharp points 74. The staple 68 is bent at an angle in the range of 75 to 90 degrees at the ~uncture between its portions 70 and 73 on each of its sides. When the staple 68 is open (Figure 13), successive parts of its outer portions 73 starting from the adJacent arcuate part 71 are at ~2~
increasingly greater distances from the curved part 71 (when measured on a straight line between the successive parts of the curved outer portions 73 and the adjacent arcuate part 71) . When the staple 68 is then closed by bending the arcuate parts 71 to a generally straight condition (~`igure 14), the curved outer portions 73 can enter and smoothly gather tissues (such as the disunited skin 69) positioned adjacent the anvil 12. Also the shape of the U-shaped central portion 70 and each of the curved outer portions 73 is such that when the arcuate parts 71 of the central portion 70 are generally straightened to close th staple 68, the maximum inside dimension of the closed staple 68 will be generally parallel to and ad~acent a line connecting the straightened arcuate parts 71 to provide a desirable stability against rotation for the closed staple 68. To close the staple 68, the arcuate parts 71 are bent slightly beyond straight to provide a slightly raised central portion for the closed staple 68 which allows a degree of swelling for the healing tissue 69 and easy insertion of the staple removal tool.
The wire staple 68 differs from the staple 13 in that its curved outer portions 73 have a greater radius of curvature than do the curved portions 63 for the staple 13.
Thus its curved portions 73 bite less deeply into the tisæue 69 than do the curved portions 63 which is appropriate for joining the co-planar disunited skin 69 as opposed to everted ækin 16.
~0~;~5~
It will be understood that the preferred embodiments of the stapling device 10 and staples 13 and 68 disclosed herein may be subject to many modifications and alterations without departing from the scope of the invention which is defined by the claims. For example the anvil 12 could be mounted on the frame of the stapler or on a removable cartridge which for purposes of the claims could be considered a part of the frame. Also the pair of lugs 20 at the distal end of the staple engaging member 19 may be notched to partially receive the curved portions 63 or 73 of the staple being closed to insure that the staple will stay in alignment with the tracks 14 as it is bent.
~v~
Referring now to Figures 16 through 27 of the drawing there is shown a second embodiment of a ~tapling device or stapler according to the present invention, generally designated by the numeral 110.
The stapling device 110 includes a frame 111 comprising a metal (e.g., stainless steel) guide plate 112 fixed within a two-part housing 113 of a polymeric material, an anvil 114 fixed on one end of the guide plate 112, and means for moving a plurality of open staples 115 along a track 116 defined on the guide plate 112 leading to the anvil 114 and sequentially into engagement with the anvil 114 to close the leading staple 115 by engagement with the anvil 114 (Figures 20, 21 and 25) so that the closed staple 115 may suture living tissues (such as disunited skin or fascia) adjacent the anvil 114.
As is best seen in Figure 26, the track 116 is defined by parallel elongate rails 117 formed on the guide plate 112 and having opposed grooves in which end portions of the staples 115 are frictionally received with the staples 115 opening toward the anvil 114. The rails 117 are adapted so that the staples 115 can be frictionally slid along the rails 117 to the anvil 114 from inlet ends of the rails 117 opposite the anvil 114, to which inlet ends staples 115 are fed seriatim from a stack 119 of the staples 115 (Figure 18) by means to be explained later.
The means for moving the open staples 115 along the track 116 includeq an elongate metal driver 118 guided between the rails 117 for movement along a predetermined path generally aligned with the track 116 between a first position (Figures 17, 19 and 23) and a second position (Figures 21 and 25) with the driver 118 more closely adjacent the anvil 114 in its second position. The driver 118 includes a plurality of spaced lugq 120 adapted to engage between staples 115 spaced at predetermined di~tances along the rail~ 117 through an opening between the rails 117. The stapler 110 includes means adapted for engagement between the driver 118 and the frame 111 for ~ t~5 ~
affording positioning of the lugs 120 in engagernent ~lith staples 115 spaced at said predetermined di.stances along ~he rail.s 117 wh~n the driver ll8 is in its first position and for causing the driver 118 to advance the staples 115 along the rails 117 and en~a~e the leading staple 115 with the anvil 114 (Figure 20) to close the leading staple 115 around the anvil 114 as the driver 118 reaches the second position, and for then causing movement of the lugs 120 out of engagement with the staples 115 along with rails 117 (Figure 21), around (Figure 22), and then back into en-Jagement with subsequent .staples 115 spaced along the rails 117 during movement of the driver 118 from its second position (Figures 21 and 25) back to its first position (Figures 17, 19 and 23).
As illustrated, the means adapted for engagement between the driver 118 and the frame 111 comprises cam members 122 and 124 fixed on the driver 118 and on the guide plate 112 respectively with the cam members 122 projecting transversely outwardly from the driver, and the cam members 124 projecting toward each other from the rails 117. The cam members 122 and 124 have peripheral surface portions adapted for engagement during various portions of the driver's 118 movement, including planar portions 125 and 126 adapted to enga(~e and insure movement of the driver 118 along the track 116 with the lugs 120 in engagement with the staples llS along the rails 117 during movement of the driver 118 from its first to its second position (Figure 25). Also the cam members 122 and 124 have second surface portions 127 and 128 respectively opposite the planar surface portions 125 and 126 shaped to engage and move the driver 118 around the staples 115 along the rails 117 (Figure 22) and then back to a position with the lugs 120 in engagement with subsequent staples 115 along the rails 117 during movement of the driver 118 from its second to its first position, provided the cam members 122 on the driver 118 are displaced a small distance tran.sversely a~ay from the track 116 when the driver 118 is in its second ~o~
The present invention relates to rnedical staples for suturing living tissue such as disunited skin or fascia.
The prior art is replete ~ith medical stapling devices for use in suturing living tissues. United States Patent Nos.
3,643,851; 3,662,939; 3,837,555; 3,873,016; and 4,014,492 are illustrative of such devices which include means which may be operated to move a plurality of open staples along a track and sequentially into engagement with an anvil so that the staple engaging the anvil will be closed to engage it with tissues adjacent the anvil.
Typicall~, such stapling devices are rather complex and apply a staple which is rectangular or square in shape after application. Such staples may be applied in different ways.
One way involves manually pulling together and everting (tenting) the edges of tissue (e.g., skin or fascia) to be joined, placing the anvil of the stapling device transverse of the juncture between the tissues, and activating the device to apply a staple. The applied staple has a straight central portion (which contacted the anvil) extending across the juncture of the tissues, straight side portions of the staple on either end of its central portion extending along the outer surfaces of the tissue and at right angles to the central portion of the staple, and generally aligned pointed end portions piercing 3~
the tissue and extending toward each other from the ends of the straight portions opposite the central portion.
Another way involves bringing the anvil and separated sharp end portions of an open staple into contact with the surfaces of tissues to be joined while the surfaces of the tissue are co-planar, and then activating the device so that the end portions of the staple enter the tissues and pull them together as the staple is closed.
Subsequent to at least partial healing of the tissues, these staples are removed by using a tool to bend the central portion of each staple to a U-shaped configura-tion, which bending causes the pointed end portions of` the staple to separate.
Such stapling of living tissues has presented certain problems. First the open staples are pre-bent at right angles between their side and end portions. When the staple is used to ~oin tissues with co-planar surfaces in the manner described above, these sharply bent portions of-the staple must enter the tissue, which can cause tearing of the tissue adjacent the points of entry. Also, either manner of stapling with such staples results in excessive gathering of the tissues to be joined which is not recommended by some experts in the healing art (e.g., by "gathering" we mean pressing together ad~acent portions of the tissues to be ~oined, and by 'lexcessive gathering" we mean pressing together rnore of those adjacent tissue portions than is required to keep those tissues in contact ~2~
adjacent and between the staples when a moderate tension is applied across the suture).
After the staples are applied, the healing tissues swell around the staples and enclose significant portions of the side portions of the staples. When the staples are then removed by bending their central portions, their L-shaped side and end portions tend to painfully tear or stretch the joined tissues as they are withdrawn.
Also, tension across the juncture between the tissues can cause some of the applied staples to rotate until the tissues are retained between their opposite corners. Swelling of the tissues around such a rotated staple can obfuscate its orientation so that a person removing the staple may inadvertently bend one of its side portions (instead of its central portion) to a generally U-shaped configuration. This can cause its opposite side and end portion to significantly tear tissues and cause pain as the staple is removed.
The staples of the invention are shaped to enter living tissues with a minimum of tissue damage, to gather joined tissues by a predetermined amount that will just maintain the tissues in contact when a moderate tension is applied across the suture, to provide a closed staple that will not tend to rotate within the tissues, and to allow the ends of the staple to be withdrawn from swelled healiny tissue with minimum damage to the tissue by bending its central portion in the manner described above.
Applicant has deve:Loped a stapling device especially adapted for use with its novel staples. This device is of the type including a frame, an anvil mounted in a fixed position relative to -the frame, and means for moviny a plurality of open staples along a track and sequentially into engagement with the anvil to close the staple enyaging the anvil. In applicant1s stapling device, the means for moving the staples comprises a driver mounted on the frame for movement along a predetermined path generally aligned with the track between first and second positions with the driver more closely adjacent the anvil in its second position; a staple engaging member comprising a plurality of spaced lugs adapted to engage staples along the track; and means for mounting the staple engaging member to cause movement thereof from an initial position with its lugs spaced from staples along the track toward the track to an engage position with the lugs aligned with staples along the track during a first position of movement of the driver from its first toward its second position; to cause movement of the staple engaging member with the driver and along the track to move the staples and engage the leading staple with the anvil during a second portion of its movement toward the second position; to cause movement of the lugs away from the track and out of engagement with staples along the track during a first position of movement of the driver from its second position back toward its first position; and to cause movement of the staple engaging member with the driver back to its initial position during a second portion of the movement of the driver ~ac'~ to~,7ard its first position.
The staple of the invention is of the open wire type and comprises a generally U-shaped central portion, having at least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer portions starting from said central portion being at increasinyl~
greater distances from the adjacent arcuate part of s~id central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part.
Applicant has also developed a special cartridge for storing its novel staples in conjunction with the above-described stapling device. This cartridge includes portions defining a track for the staples, which portions comprise parallel elongate rails having opposed parallel grooves. A plurality of the staples have the outermost portions of their arcuate end portions in the grooves and are frictionally engaged between the rails ~ith the points of the staples pointing toward a first end of the cartridge; and are disposed in closely adiacent relationship along the grooves. The cartridge is open along one side of the rails to afford access to the staples along the track by the spaced lugs on the staple engaging member so that the lugs can move between the staples and drive the staples along the track and sequentiall~ into engagement with the anvil on the stapler assembl~ which is aligned wi~h the track at the first end of the mounted cartridge.
The present invention will be further described with reference to the accompanying drawing where like numbers refer to ~ 5 --~o~
like parts in the several vi.e~,7s, and wherein;
Figure 1 is a side view of a stapling device for dispensing the staples of the invention;
Figure 2 is an enlarged top view of the stapling device of Figure 1, having parts broken away to show details;
Figure 3 is a sectional view taken approximately along thé line 3-3 of Fiyure 2, and showing a normal position of a staple driving mechanism in the stapling device;
Figures 4 and 5 are fragmentar~ séctional views, taken approximately along the line 3-3 of Figure 2, which show sequential positions into which the staple driving mechanism is moved during the application of a staple;
Figures 6 and 7 are sectional views taken respectively along the lines 6-6 and 7-7 of Figure 5, Figure 8 is a fragmentary sectional view taken approximately along line 9-9 of Figure 6;
Figure 9 is a perspective view of a replaceable staple cartridge ror use with the stapling device of Figure l;
Figure 10 is a side view of the cartridge of Figure 9;
Figures 11 and 12 are fragmentary sectional views sequentially showing the attachment of a first embodiment of a staple applied by the stapling device of Figure 1 to suture living tissues; and Figures 13, 1~ and 15 are fragmentary sectional views sequentially showing the attachment of a second embodiment of a staple applied by the stapling device of Figure 1 to suture living tissues.
~Z()~50 Referring now to the drawing there is sho~m a stapling device or stapler 10 for dispensing the staples of this invention.
The ~21~
stapling devlce 10 includes a frame 11, an anvil 12 rnounted on the frame 11, and means for moving a pluraliky of open staples 13 along a track 14 and sequentially into engagement with the anvil 12 (Figure 11) to close the staple 13 en~aging the anvil 12 (Figure 12) so that the staple 13 may suture living tissues 16 (such as disunited skin or fascia) adjacent the anvil 12.
As is best seen in Figures 3 through 7, the means for moving the open staples along the track 14 includes a driver 18 mounted on the frame 11 for movement along a predetermined path generally aligned with the track between a first position (Figure 3) and a second position (Figure 5) with the drive 18 more closely adjacent the anvil 12 in its second position. Also included is a staple engaging member 19 comprising a plurality of spaced lugs 20 adapted to engage staples 13 along the track 14. The staple engaging member 19 is mounted by means for causing movement thereof from an initial position (Figure 3) with its lugs 20 spaced from staples 13 along the track 14 toward the track 14 to an engage position (Figure 4) with the lugs 20 aligned with and between the staples 13 along the track 14 during a first position of movement of the driver 18 from its first toward its second position; for causlng rnovement of the o.taple engaging member 19 with the driver 18 to engage and move staples 13 along the track 14 and to close the leading staple 13 alvng the track 14 around the anvil 12 during a second portion of the movement s~
of the driver to~1ard its second position ~'igures 5 and 12); for causing movement of the lugs 20 away from the track 14 and out of engagement with the staples 13 along the track 14 during a first position of movement of the driver 18 from its second position (Figure 5) back toward its first position; and to move the staple engaging member 19 with the driver 18 back to its initial position (Figure 3) during a second portion of movement of the driver 18 back toward its first position.
The driver 18 comprises an elongate driving portion 22 which has a semi-cylindrical bearing surface 23 (Figures 6 and 7) and a longitudinally extending U-shaped slot 24 along its side opposite its bearing surface 23 so that the driving portion 22 is generally C-shaped in cross section. The bearing surface 23 of the driving portion 22 is slidably mounted against a mating bearing surface 25 on the frame 11 for movement toward and away from the anvil 12. The driver 18 also includes a stepped cylindrical driven portlon (see Figures 3, 4 and 5) fixed on the end of the driving portion 22 opposite the anvil 12 and having an axis aligned with the direction of sliding movement for the driver 18. The driving portion includes three cylindrical portions 27, 28 and 29 coaxially fixed to and spaced by a cylindrical rod 30. The cylindrical front portion 27 attaches the rod 30 to the driving portion 22. The center cylindrical portion 28 retains a compression spring 31 within a chamber in the frame 11 and between itself and a collar 32 fixed to the frame 11 to provide mea,næ for biasing the driver 18 to its first position. The portion o~ the rod 30 between the center and rear cylindrical portions 28 and 29 is slidably mounted in a bearing 33 on 5 the frame 11 to provide, with the cylindrical bearing surfaces 23 and 25, the means for slidably mounting the driver 18 on the frame ll.
The rear cylindrical portion 29 is fixed on the end of the rod 30 and is concave on its side opposite the rod 30. An actuating trigger 35 is pivotably mounted by a pin 36 on a handle assembly 37 and has a knob 34 at one end adapted to engage the concave surface of the rear cylindrical portion 29, and a portion projecting from the handle assembly 37. When the projecting portion of the trigger 35 is manually squeezed into the handle assembly 37, the knob 34 will engage and move the driver 18 to its second position so that one of the staples 13 will be applied.
The frame 11 on which the driver 18, staple 20 engaging member 19 and anvil 12 are mounted is rotatable relative to the handle assembly 37 to af'ford various orientations of the width of the staple relative to the hand of a user grasping the handle assembly 37. This, together ~ith the long tapered outline of the stapling 25 device 10 to~rard the anvil 12 which allows excellent visibility Or the tissue being sutured, affords great versatility ln use of the stapling device 10. As is seen ~3,3~5~
~11-in Figures 2 and 3, the frame 11 has a cylindrical æl~rface 38 between spaced flanges 39 and the handle assembly 37 includes a cylindrical bearing 42 adapted to engage that cylindrical surface 38 so that the frame 11 may be rotated to change the orientation of the dispensed staple; the knob 34 of the trigger 35 being adapted to engage the concave surface of the cylindrical portion 29 at any relative orientation therebetween so that the stapling device lO may be activated.
If desired, the handle assembly 37 can be removed, and the stapling device 10 can be activated by manual pressure applied directly to the cylindrical portion 29.
The staple engaging member 19 is elongate and generally rectangular in cross section with two spaced parallel rows of spaced lugs 20 along one of its surfaces.
It is slidably received in the slot 24 in the drive portion 22 with the lugs 20 exposed to allow both relative longitudinal sliding movement between the driver 18 and the staple engaging member 19, and sliding movement of the staple engaging me~ber 19 into and out of the groove 25 in a direction normal to its elongate axis so that the lugs 20 can move to~Jard and away from the track 14 along which the staples 13 are spaced.
The staple engaging member 19 includes two parallel pins 40 extending transversely to the axes of the bearing surfaces 23 and 25, and engaging cam slots 41 in 12~
the driving portion 22 which guide and limit relati-Je movement between the driver 18 and staple engaging member 19. The surfaces defining the slots 41 are inclined to cause movement of the staple engaging member 19 out of the slot 24 (with its axis parallel to that of the driver 18) to a position with the lugs 20 between staples 13 along the track 14 as the staple engaging member 19 is moved toward the anvil 12 relative to the driver 1&; and conversely to cause movement of the staple engaging member 19 into the slot 24 with the lugs 20 spaced from staples 13 along the track 14 as the staple engaging member 19 is moved away from the anvil 12 relative to the driver 18. Means for frictionally retarding movement of the staple engaging member 19 with respect to the frame 11 are provided by two 15 opposed friction assemblies 43 (Figure 7). Each friction assembly 45 includes a housing 46 threadably mounted in the frame 11 and extending through a clearance opening in the driving portion 22 of the driver 18, a spring 47, and a ball 48 which is passed by the spring 47 into frictional 20 engagement with one side of the staple engaging member 19.
Such frictional engagement is ad~usted to prevent longitudinal movement of the staple engaging member 19 with the drlver 18 until the pins 40 contact the trailing ends of the slots 41. Thus with the pins 40 initially located 25 at the leading ends of the slots 41 (so that the lugs 20 are spaced from the staples 13 along the track 14) and with the driver 18 in its first position (Figure 3)~ subsequent ~Z~
movement of the driver 18 toward its second position will first cause the walls defining the slots 41 to move toward the anvil 12 relative to the pins 40, thereby moving the staple engaging member 19 at a right angle to its axis to its engage position; and will then cause movement of the staple engaging member l9 with the driver 18 during a second portion of the movement of the driver 18 toward its second position after the trailing ends of the slots 41 engage the pins 40. Subsequently upon movement of the driver 18 from its second position back toward its first position under the influence of the spring 35, the walls defining the slots 41 will first move along the pins 40 to move the staple engaging member away from the track 14, and will then carry the staple engaging member 19 back to its initial position after the trailing ends of the slots 41 engage the pins 40.
The track 14 along which the open staples 13 are spaced is defined by an elongate cartridge 50 removably mounted on the frame 11. The cartridge 50, best seen in Figures 9 and 10, includes a generally rectangular pro~ecting end portion 51 adapted to be received in a socket in the frame 11 and to be retained therein by a thumb screw 53. Also included are two parallel elongate rails 54 having opposed parallel grooves which define the track 14. The staples 13 have arcuate end portions in the grooves and frictionally engage with the rails 54, with the staples all opening toward the end of the cartridge 50 opposite its end portion 51 and being dispose-3 in closely adjacent relationship along the grooves. The cartridge 50 is open along one side of the rails 54 to afford access by the lugs 20 on the staple engaging member 19 with the staples 13 spaced along the track 14.
The open wire staple 13 used in the stapling device and the manner in which it is closed is best seen in Figures 11 and 12 which illustrate the application of one of the staples 13 to the tissue or disunited skin 16 which has been everted prior to application (as may be necessary when the flesh below the skin does not provide enough support for the skin so that the staple will enter skin disposed in a co-planar relationship). The staple 13 is formed from circular metal wire (e.g., 0.058 centimeter (0.023 inch) diameter 316L stainless steel). When open, the staple 13 consists of a generally U-shaped central portion 60 having two spaced arcuate parts 61, and two smoothly curved outer portions 63 terminating in sharp needle-like points 64. The staple is bent at an angle in the range of 75 to 90 degrees at the juncture between the portions 60 and 63 on each of its sides. When the staple 13 is open, successive parts of its outer portions 63 starting from the ad~acent arcuate part 61 are at, increasingly greater distances from the arcuate part 61 (when measured along straight lines between the successive parts of the curved outer portions 63 and the adJacent arcuate part 61) . When the open staple 13 is closed by -15~
bending its arcuate parts 61 to a generally straight condition, the curved outer portions 63 can enter and smoothly gather tissues (such as the disunited skin 16) positioned ad~acent the anvil 12. The shape of the U-shaped central portion 60, each of the curved outer portions 63 and the bends between the portions 60 and 63 are such that when the arcuate parts 61 of the central portion 60 are generally straightened to close the staple 13 (as shown in Figure 12), the shape of the staple 13 is generally D-shaped with the maximum dimension of the closed staple being parallel to and adJacent the straightened arcuate parts 61 to provide a desirable stability against rotation for the closed staple 13.
Figures 13, 14 an 15 illustrate an alternative embodiment of an open wire staple 68 according to the present invention as it is applied by the stapling device lO to suture disunited skin 69 in a co-planar relationship.
The device 10 will close the staple 68 to the generally D-shaped configuration shown in Figure 15. Like the staple 20 13, the open staple 68 includes a generally U-shaped central portion 70 having two spaced arcuate parts 71, and two smoothly curved outer portions 73 terminating in sharp points 74. The staple 68 is bent at an angle in the range of 75 to 90 degrees at the ~uncture between its portions 70 and 73 on each of its sides. When the staple 68 is open (Figure 13), successive parts of its outer portions 73 starting from the adJacent arcuate part 71 are at ~2~
increasingly greater distances from the curved part 71 (when measured on a straight line between the successive parts of the curved outer portions 73 and the adjacent arcuate part 71) . When the staple 68 is then closed by bending the arcuate parts 71 to a generally straight condition (~`igure 14), the curved outer portions 73 can enter and smoothly gather tissues (such as the disunited skin 69) positioned adjacent the anvil 12. Also the shape of the U-shaped central portion 70 and each of the curved outer portions 73 is such that when the arcuate parts 71 of the central portion 70 are generally straightened to close th staple 68, the maximum inside dimension of the closed staple 68 will be generally parallel to and ad~acent a line connecting the straightened arcuate parts 71 to provide a desirable stability against rotation for the closed staple 68. To close the staple 68, the arcuate parts 71 are bent slightly beyond straight to provide a slightly raised central portion for the closed staple 68 which allows a degree of swelling for the healing tissue 69 and easy insertion of the staple removal tool.
The wire staple 68 differs from the staple 13 in that its curved outer portions 73 have a greater radius of curvature than do the curved portions 63 for the staple 13.
Thus its curved portions 73 bite less deeply into the tisæue 69 than do the curved portions 63 which is appropriate for joining the co-planar disunited skin 69 as opposed to everted ækin 16.
~0~;~5~
It will be understood that the preferred embodiments of the stapling device 10 and staples 13 and 68 disclosed herein may be subject to many modifications and alterations without departing from the scope of the invention which is defined by the claims. For example the anvil 12 could be mounted on the frame of the stapler or on a removable cartridge which for purposes of the claims could be considered a part of the frame. Also the pair of lugs 20 at the distal end of the staple engaging member 19 may be notched to partially receive the curved portions 63 or 73 of the staple being closed to insure that the staple will stay in alignment with the tracks 14 as it is bent.
~v~
Referring now to Figures 16 through 27 of the drawing there is shown a second embodiment of a ~tapling device or stapler according to the present invention, generally designated by the numeral 110.
The stapling device 110 includes a frame 111 comprising a metal (e.g., stainless steel) guide plate 112 fixed within a two-part housing 113 of a polymeric material, an anvil 114 fixed on one end of the guide plate 112, and means for moving a plurality of open staples 115 along a track 116 defined on the guide plate 112 leading to the anvil 114 and sequentially into engagement with the anvil 114 to close the leading staple 115 by engagement with the anvil 114 (Figures 20, 21 and 25) so that the closed staple 115 may suture living tissues (such as disunited skin or fascia) adjacent the anvil 114.
As is best seen in Figure 26, the track 116 is defined by parallel elongate rails 117 formed on the guide plate 112 and having opposed grooves in which end portions of the staples 115 are frictionally received with the staples 115 opening toward the anvil 114. The rails 117 are adapted so that the staples 115 can be frictionally slid along the rails 117 to the anvil 114 from inlet ends of the rails 117 opposite the anvil 114, to which inlet ends staples 115 are fed seriatim from a stack 119 of the staples 115 (Figure 18) by means to be explained later.
The means for moving the open staples 115 along the track 116 includeq an elongate metal driver 118 guided between the rails 117 for movement along a predetermined path generally aligned with the track 116 between a first position (Figures 17, 19 and 23) and a second position (Figures 21 and 25) with the driver 118 more closely adjacent the anvil 114 in its second position. The driver 118 includes a plurality of spaced lugq 120 adapted to engage between staples 115 spaced at predetermined di~tances along the rail~ 117 through an opening between the rails 117. The stapler 110 includes means adapted for engagement between the driver 118 and the frame 111 for ~ t~5 ~
affording positioning of the lugs 120 in engagernent ~lith staples 115 spaced at said predetermined di.stances along ~he rail.s 117 wh~n the driver ll8 is in its first position and for causing the driver 118 to advance the staples 115 along the rails 117 and en~a~e the leading staple 115 with the anvil 114 (Figure 20) to close the leading staple 115 around the anvil 114 as the driver 118 reaches the second position, and for then causing movement of the lugs 120 out of engagement with the staples 115 along with rails 117 (Figure 21), around (Figure 22), and then back into en-Jagement with subsequent .staples 115 spaced along the rails 117 during movement of the driver 118 from its second position (Figures 21 and 25) back to its first position (Figures 17, 19 and 23).
As illustrated, the means adapted for engagement between the driver 118 and the frame 111 comprises cam members 122 and 124 fixed on the driver 118 and on the guide plate 112 respectively with the cam members 122 projecting transversely outwardly from the driver, and the cam members 124 projecting toward each other from the rails 117. The cam members 122 and 124 have peripheral surface portions adapted for engagement during various portions of the driver's 118 movement, including planar portions 125 and 126 adapted to enga(~e and insure movement of the driver 118 along the track 116 with the lugs 120 in engagement with the staples llS along the rails 117 during movement of the driver 118 from its first to its second position (Figure 25). Also the cam members 122 and 124 have second surface portions 127 and 128 respectively opposite the planar surface portions 125 and 126 shaped to engage and move the driver 118 around the staples 115 along the rails 117 (Figure 22) and then back to a position with the lugs 120 in engagement with subsequent staples 115 along the rails 117 during movement of the driver 118 from its second to its first position, provided the cam members 122 on the driver 118 are displaced a small distance tran.sversely a~ay from the track 116 when the driver 118 is in its second ~o~
-2~-position (Figure 25). Such displacement i~ provided by t'~lO
parallel cantilever lifting springs 130 formed from (as by laser cutting) and fixed at one end on the guide plate 112 in the track 116 between the cam members 124 and the anvi1 114. After the driver 118 has been moved to its second position to form the leading staple 115 around the anvil 114 (Figure 25), the lifting springs 130 will lift the end of the driver 118 adjacent the anvil 114 away from the track 116 (Figure 21) so that the second surfaces 127 and 128 of the cam members 122 and 124 will engage (Figure 22) to produce the result described above aæ the driver 118 is returned to its first position.
As illustrated, an end surface 132 of the end lug 120 on the driver 118 is æpecially shaped and transversely grooved to cooperate with the anvil 114 to close the staple 115 which has a special shape for suturing fascia as is described and claimed in Canadian Patent Application No.
398,664, filed March 17, 1982. Alternatieely, however, the end surface 132 and anvil 114 could be shaped to close staples of the type described herein.
Generally, as taught in Canadian patent application No. 398,664, the staple 115 comprises a length of wire having a straight or slightly curved central portion, and arcuate end portions including straight or slightly curved terminal end parts having pointæ on their end~ opposite the central portion, with the points on the end portion and the central portion being generally aligned.
The anvil 114 projects into the track 116 at approximately a right angle to a plane defined by the side surfaces of staples 115 along ~he rails 117. The anvil 114 has an arcuate surface adapted to be engaged by the central portion and adjacent parts of the end portions of the staple 115.
The driver 118 is transversely grooved along its end qurface 132 and includes spaced projections defining its end surface 132 that will engage and bend the staple 115 around the juncture between its central and end portions. Such bending will form a generally oval shape for the central portion and X
5~
-21~
adjacent parts of the end portions of the ~taple 115 and will bring the terminal end parts of the end portions of the staple 115 into side-by-side crossed relationship with the points of each of the end portions positioned adjacent the juncture between the central portion and the other of the end portions (i.e., the terminal end parts can cro~s, terminate at, or terminate within the outer portions of the staple either at or outboard of the juncture; and, particularly with curved terminal end parts, could lay approximately along the other of the end portions).
As illustrated, the stapler 110 includes a block 129 projecting centrally into the track 116 that has a surface facing the anvil 114 adapted to engage the central portion of the ~taple 115 on its side opposite the anvil 114 to prevent it from bowing away from the anvil 114 as the staple 115 is closed. The block 129 has a ramp surface 131 over which the central portion of a staple 115 must pass a~
the staple 115 moves into engagement with the anvil 114.
While such passage might be facilitated by movably mounting the block 129 so that it can be pressed into the guide plate 112 against the bias of a spring, it ha~ been found that the block 129 can instead be fixed on the guide plate 112 and the central portion of the staple 115 (which central portion is unsupported across a notch 133 in the driver 118 adapted to receive the block 129 when the driver 118 is in its second position) will deflect over the ramp surface 131 and will audibly click into the slot between the block 129 and the anvil 114. It is also expected that for some staple sizes and/or shapes the block 129 and its function would not be needed at all.
The means for moving the staples 115 along the track 116 also include manually activatable means for moving the driver 118 between its first and ~econd positions. This manually activatable means includes an activating lever 134 pivotably mounted on the frame 111 via a pin 135 with a major portion of the lever 134 projecting along a pistol-grip portion 136 of the frame 111, and a minor X
portion projecting into a socket 139 in the hou~ing 113 parallel to the track 116 in which an end portion of the driver 118 opposite its end surface 132 is slidably received. That minor portion of the lever 134 terminates in a pin-like projection 137 that projects into a frustoconical opening 138 through the driver 118 from its smallest end.
The lever 134 is manually pivotal between (1) an unactivated position (Figure 18) with the major end portion of the lever spaced from the pistol grip 136 a small distance so that the grip and lever 134 can be received in the semi-closed hand of a user with the driver 118 in its first position, to which first position the driver 118 is biased by a coil main spring 140 tensioned between a pin 141 on the frame 111 and the distal end of a pin 142 fixed to the driver 118 and projecting at right angles to the tracks 116 away from the driver 118: and an activated position adjacent the pistol grip 136 to which the major portion of the activating lever 134 can be manually pressed, and which, via the projection 137, moves the driver 118 to its second position against the bias of the main spring 140.
The main spring 140 is disposed and mounted in the stapler 110 to provide a single spring means for biasing the driver 118 to its first po~ition and to a position with the lugs 120 in engagement with the staples 115 along the rails 117 both in the first position of the driver 118 and during movement of the driver 118 from its first position to its second position; and for biasing the second surfaces 127 and 128 of the cam members 122 and 124 into engagement with each other as the driver 118 is moved by the main spring 140 from it~ second position back to its first position. The elongate drive 118 ha~ an end 143 oppo~ite the anvil 114 guided on the guide plate 112 along a path parallel to and generally along the track 116. The cam members 122 and 124 are po~itioned near the end of the driver 118 adjacent the anvil 114. The pin 142 on the driver 118 i~ between its end 143 and the cam members 122 and 124 projects from the side of the driver 118 opposite the direction the end portion of the ~01.~
driver 118 adjacent the anvil 114 i9 displaced from the track 116 in its second position. The main spring 140 is coupled between the frame 111 and the pin 142 at an angle with respect to the driver 118 that will both bias the driver 118 to its first position and provide a torque around the end 143 oE the driver 118 opposite the anvil 114 in all po~itions of the driver 118 to bias the driver 118 toward the track 116.
The means in the stapler 110 for storing the stack of the staples 115 in side-by-~ide relationship and for feeding the stack to the end of the track 116 opposite the anvil 114 is best seen in Figures 18 and 27. The stack 119 of the staples 115 is defined by a cartridge-like structure 146 comprising a channel 147 having a generally U-shaped cross section, and two longitudinally extending guide bars 148 fastened in spaced relationship within the channel 147 via screws 149. The stack 119 of the staples 115 is disposed between the channel 1~7 and the guide bars 148 which are fastened within an opening in the housing 113 by two spaced attaching bolts 150 engaged with the guide plate 112 so that the stack 119 projects downwardly generally at right angles to the rails 117. The side of the rails 117 adjacent the stack 119 has an opening which allows the top staple 115 in the stack 119 to move between the rails 117 and into alignment with the grooves in the rails 117 that frictionally receive the staples 115 along the track 116.
The stack 119 of the staples 115 is biased toward the railæ
117 by means comprising a cantilevered follower spring 153 having one end fastened to the guide plate 112 along its end adjacent the anvil 114, and its other end projection between the guide bars 148 and biased against a generally staple-shaped follower 152 at the end of the st:ack 119 opposite the rail~ 117. The follower spring 153 i9 ~ufficiently flexible that it may be bent away from the stack 119 to afford removal of the follower 152 and addition of staples to the stack 119. Normally, the biasing of the stack caused by the follower spring 153 will cause the top X
-2~-staple 115 in the stack to be biased to a po~ition between the rails where it will be engaged by one of the lugs 120 on the driver when the driver 118 is in it first position, and will be moved off of ~he stack 119 and along the track 116 as the driver 118 is moved toward its second position.
To operate the stapler 110, a user manually squeezes the major portion of the activating lever 134 toward the pistol grip 136, causing it to pivot at the pin 135, and via its pin-like projection 137, to move the driver 118 from its first position (Figures 17, 18, 19 and 23) to its second position (Figures 21 and 25) against the bias of the main spring 140. Such movement of the driver 118 will cause the staples 115 disposed along the rails 117 to be slid toward the anvil 114 by engagement between the lugs 120 on the driver and those staples 115, including movement of the top staple 115 in the stack 119 being fed from the staple cartridge 146: with such engagement being ensured by movement of the planar surfaces 125 and 126 of the cam members 122 and 124 in engagement with each other to maintain the lugs 120 in engagement with the staples 115 along the rails 117 (Figure 20). As the driver 118 approaches its second position, the leading staple 115 disposed on its end surface 132 will enage the anvil 114 and will be closed around the anvil 114 so that it may suture living tissue such as fa~cia disposed adjacent the anvil 114 (Figures 21 and 25). When the driver 118 reaches its second position, the lifting ~prings 130 will cause the end of the driver 118 to move tran~versely away from the track 116 (Figure 21) which transverse movement, depending on the strength of the lifting ~prings 130, could occur immediately when the driver 118 reaches its second position so that the planar surfaces 125 and 126 of the cam members 122 and 124 separate, or could occur when the user of the s~apler 110 releases at least part of the force applied through the driver 118 to close the leading staple 115 around the anvil 114. In either event, such tran~verse movement will ~lide the closed staple 115 off the distal end of the anvil 114.
X
;3~;~
Upon subsequent movement of the driver 118 back to~,tard it~
first position under the influence of the main spring 140, the second surface portion 127 of the cam member 122 on the driver 118 will slide over the second surface portion 128 on the cam members 124 on the guide plate 112 (Figure 22), causing the lugs 120 on the driver 118 to move around the staples 115 along the rails 117 and back into engagement with subsequent staples 115 along the rails 117 as the driver returns to its first position. The stapler is then ready to be used again.
X
parallel cantilever lifting springs 130 formed from (as by laser cutting) and fixed at one end on the guide plate 112 in the track 116 between the cam members 124 and the anvi1 114. After the driver 118 has been moved to its second position to form the leading staple 115 around the anvil 114 (Figure 25), the lifting springs 130 will lift the end of the driver 118 adjacent the anvil 114 away from the track 116 (Figure 21) so that the second surfaces 127 and 128 of the cam members 122 and 124 will engage (Figure 22) to produce the result described above aæ the driver 118 is returned to its first position.
As illustrated, an end surface 132 of the end lug 120 on the driver 118 is æpecially shaped and transversely grooved to cooperate with the anvil 114 to close the staple 115 which has a special shape for suturing fascia as is described and claimed in Canadian Patent Application No.
398,664, filed March 17, 1982. Alternatieely, however, the end surface 132 and anvil 114 could be shaped to close staples of the type described herein.
Generally, as taught in Canadian patent application No. 398,664, the staple 115 comprises a length of wire having a straight or slightly curved central portion, and arcuate end portions including straight or slightly curved terminal end parts having pointæ on their end~ opposite the central portion, with the points on the end portion and the central portion being generally aligned.
The anvil 114 projects into the track 116 at approximately a right angle to a plane defined by the side surfaces of staples 115 along ~he rails 117. The anvil 114 has an arcuate surface adapted to be engaged by the central portion and adjacent parts of the end portions of the staple 115.
The driver 118 is transversely grooved along its end qurface 132 and includes spaced projections defining its end surface 132 that will engage and bend the staple 115 around the juncture between its central and end portions. Such bending will form a generally oval shape for the central portion and X
5~
-21~
adjacent parts of the end portions of the ~taple 115 and will bring the terminal end parts of the end portions of the staple 115 into side-by-side crossed relationship with the points of each of the end portions positioned adjacent the juncture between the central portion and the other of the end portions (i.e., the terminal end parts can cro~s, terminate at, or terminate within the outer portions of the staple either at or outboard of the juncture; and, particularly with curved terminal end parts, could lay approximately along the other of the end portions).
As illustrated, the stapler 110 includes a block 129 projecting centrally into the track 116 that has a surface facing the anvil 114 adapted to engage the central portion of the ~taple 115 on its side opposite the anvil 114 to prevent it from bowing away from the anvil 114 as the staple 115 is closed. The block 129 has a ramp surface 131 over which the central portion of a staple 115 must pass a~
the staple 115 moves into engagement with the anvil 114.
While such passage might be facilitated by movably mounting the block 129 so that it can be pressed into the guide plate 112 against the bias of a spring, it ha~ been found that the block 129 can instead be fixed on the guide plate 112 and the central portion of the staple 115 (which central portion is unsupported across a notch 133 in the driver 118 adapted to receive the block 129 when the driver 118 is in its second position) will deflect over the ramp surface 131 and will audibly click into the slot between the block 129 and the anvil 114. It is also expected that for some staple sizes and/or shapes the block 129 and its function would not be needed at all.
The means for moving the staples 115 along the track 116 also include manually activatable means for moving the driver 118 between its first and ~econd positions. This manually activatable means includes an activating lever 134 pivotably mounted on the frame 111 via a pin 135 with a major portion of the lever 134 projecting along a pistol-grip portion 136 of the frame 111, and a minor X
portion projecting into a socket 139 in the hou~ing 113 parallel to the track 116 in which an end portion of the driver 118 opposite its end surface 132 is slidably received. That minor portion of the lever 134 terminates in a pin-like projection 137 that projects into a frustoconical opening 138 through the driver 118 from its smallest end.
The lever 134 is manually pivotal between (1) an unactivated position (Figure 18) with the major end portion of the lever spaced from the pistol grip 136 a small distance so that the grip and lever 134 can be received in the semi-closed hand of a user with the driver 118 in its first position, to which first position the driver 118 is biased by a coil main spring 140 tensioned between a pin 141 on the frame 111 and the distal end of a pin 142 fixed to the driver 118 and projecting at right angles to the tracks 116 away from the driver 118: and an activated position adjacent the pistol grip 136 to which the major portion of the activating lever 134 can be manually pressed, and which, via the projection 137, moves the driver 118 to its second position against the bias of the main spring 140.
The main spring 140 is disposed and mounted in the stapler 110 to provide a single spring means for biasing the driver 118 to its first po~ition and to a position with the lugs 120 in engagement with the staples 115 along the rails 117 both in the first position of the driver 118 and during movement of the driver 118 from its first position to its second position; and for biasing the second surfaces 127 and 128 of the cam members 122 and 124 into engagement with each other as the driver 118 is moved by the main spring 140 from it~ second position back to its first position. The elongate drive 118 ha~ an end 143 oppo~ite the anvil 114 guided on the guide plate 112 along a path parallel to and generally along the track 116. The cam members 122 and 124 are po~itioned near the end of the driver 118 adjacent the anvil 114. The pin 142 on the driver 118 i~ between its end 143 and the cam members 122 and 124 projects from the side of the driver 118 opposite the direction the end portion of the ~01.~
driver 118 adjacent the anvil 114 i9 displaced from the track 116 in its second position. The main spring 140 is coupled between the frame 111 and the pin 142 at an angle with respect to the driver 118 that will both bias the driver 118 to its first position and provide a torque around the end 143 oE the driver 118 opposite the anvil 114 in all po~itions of the driver 118 to bias the driver 118 toward the track 116.
The means in the stapler 110 for storing the stack of the staples 115 in side-by-~ide relationship and for feeding the stack to the end of the track 116 opposite the anvil 114 is best seen in Figures 18 and 27. The stack 119 of the staples 115 is defined by a cartridge-like structure 146 comprising a channel 147 having a generally U-shaped cross section, and two longitudinally extending guide bars 148 fastened in spaced relationship within the channel 147 via screws 149. The stack 119 of the staples 115 is disposed between the channel 1~7 and the guide bars 148 which are fastened within an opening in the housing 113 by two spaced attaching bolts 150 engaged with the guide plate 112 so that the stack 119 projects downwardly generally at right angles to the rails 117. The side of the rails 117 adjacent the stack 119 has an opening which allows the top staple 115 in the stack 119 to move between the rails 117 and into alignment with the grooves in the rails 117 that frictionally receive the staples 115 along the track 116.
The stack 119 of the staples 115 is biased toward the railæ
117 by means comprising a cantilevered follower spring 153 having one end fastened to the guide plate 112 along its end adjacent the anvil 114, and its other end projection between the guide bars 148 and biased against a generally staple-shaped follower 152 at the end of the st:ack 119 opposite the rail~ 117. The follower spring 153 i9 ~ufficiently flexible that it may be bent away from the stack 119 to afford removal of the follower 152 and addition of staples to the stack 119. Normally, the biasing of the stack caused by the follower spring 153 will cause the top X
-2~-staple 115 in the stack to be biased to a po~ition between the rails where it will be engaged by one of the lugs 120 on the driver when the driver 118 is in it first position, and will be moved off of ~he stack 119 and along the track 116 as the driver 118 is moved toward its second position.
To operate the stapler 110, a user manually squeezes the major portion of the activating lever 134 toward the pistol grip 136, causing it to pivot at the pin 135, and via its pin-like projection 137, to move the driver 118 from its first position (Figures 17, 18, 19 and 23) to its second position (Figures 21 and 25) against the bias of the main spring 140. Such movement of the driver 118 will cause the staples 115 disposed along the rails 117 to be slid toward the anvil 114 by engagement between the lugs 120 on the driver and those staples 115, including movement of the top staple 115 in the stack 119 being fed from the staple cartridge 146: with such engagement being ensured by movement of the planar surfaces 125 and 126 of the cam members 122 and 124 in engagement with each other to maintain the lugs 120 in engagement with the staples 115 along the rails 117 (Figure 20). As the driver 118 approaches its second position, the leading staple 115 disposed on its end surface 132 will enage the anvil 114 and will be closed around the anvil 114 so that it may suture living tissue such as fa~cia disposed adjacent the anvil 114 (Figures 21 and 25). When the driver 118 reaches its second position, the lifting ~prings 130 will cause the end of the driver 118 to move tran~versely away from the track 116 (Figure 21) which transverse movement, depending on the strength of the lifting ~prings 130, could occur immediately when the driver 118 reaches its second position so that the planar surfaces 125 and 126 of the cam members 122 and 124 separate, or could occur when the user of the s~apler 110 releases at least part of the force applied through the driver 118 to close the leading staple 115 around the anvil 114. In either event, such tran~verse movement will ~lide the closed staple 115 off the distal end of the anvil 114.
X
;3~;~
Upon subsequent movement of the driver 118 back to~,tard it~
first position under the influence of the main spring 140, the second surface portion 127 of the cam member 122 on the driver 118 will slide over the second surface portion 128 on the cam members 124 on the guide plate 112 (Figure 22), causing the lugs 120 on the driver 118 to move around the staples 115 along the rails 117 and back into engagement with subsequent staples 115 along the rails 117 as the driver returns to its first position. The stapler is then ready to be used again.
X
Claims (5)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A stapling device for suturing tissues with metal staples including a frame, an anvil mounted on said frame, and means for moving a plurality of open staples along a track and sequentially into engagement with said anvil to clinch the staple engaging the anvil, wherein said means for moving comprises:
a driver mounted on said frame for movement along a predetermined path generally aligned with said track between first and second positions with said driver more closely adjacent said anvil in said second position;
a plurality of spaced lugs adapted to engage staples along said track; and means for causing engagement of said lugs with staples along said track and movement of said lugs to advance the staples along the track and engage one of the staples with the anvil to close the staple during movement of said driver from said first toward said second position; to cause movement of said lugs away from said track and out of engagement with and around staples along said track during movement of said driver from its second position back toward its first position, wherein said spaced lugs are formed on said driver; and said stapler includes means adapted for engagement between said driver and said frame, including cam members on the driver and on the frame that directly interact with each other, for affording positioning of said lugs in engagement with staples spaced at said predetermined distances along said track when said driver is in said first position and for causing said lugs to advance the staples along the track and engage the leading staple with the anvil to close the leading staple during movement of said driver from said first to said second position, and for causing movement of said lugs out of engagement with the staples along the track, around, and into engagement with subsequent staples along said track during movement of said driver from its second position back to its first position.
a driver mounted on said frame for movement along a predetermined path generally aligned with said track between first and second positions with said driver more closely adjacent said anvil in said second position;
a plurality of spaced lugs adapted to engage staples along said track; and means for causing engagement of said lugs with staples along said track and movement of said lugs to advance the staples along the track and engage one of the staples with the anvil to close the staple during movement of said driver from said first toward said second position; to cause movement of said lugs away from said track and out of engagement with and around staples along said track during movement of said driver from its second position back toward its first position, wherein said spaced lugs are formed on said driver; and said stapler includes means adapted for engagement between said driver and said frame, including cam members on the driver and on the frame that directly interact with each other, for affording positioning of said lugs in engagement with staples spaced at said predetermined distances along said track when said driver is in said first position and for causing said lugs to advance the staples along the track and engage the leading staple with the anvil to close the leading staple during movement of said driver from said first to said second position, and for causing movement of said lugs out of engagement with the staples along the track, around, and into engagement with subsequent staples along said track during movement of said driver from its second position back to its first position.
2. A stapling device according to claim 1 wherein said means adapted for engagement between said driver and said frame comprises cam members on said driver and said frame having first surfaces shaped to engage and causing movement of the lugs of said driver along said track with said lugs in engagement with said staples during movement of said driver from its first to its second position, and having opposite second surfaces shaped to engage and move said driver around the staples along the track and then back to said track with the lugs in engagement with the subsequent staples along the track during movement of said driver from its second to its first position upon displacement of the cam member on said driver a small distance transversely away from said track; and spring means between said frame and said driver for displacing said cam members said small distance when said driver is in said second position.
3. A stapling device according to claim 1 wherein said stapler further includes means for feeding a stack of said staples in side-by-side relation-ship to the end of said track opposite said anvil with the staple in said stack at said track opening toward said anvil.
4. A stapling device according to claim 2 wherein said stapler includes a single spring means for biasing said driver to its first position, to a position with said lugs in engagement with said staples both in said first position and during movement of said driver from its first to its second position, and for biasing the second surfaces of said cam members into engagement with each other as said driver is moved from said second to said first position.
5. A stapling device according to claim 4 wherein said staple driver is an elongate member having its end opposite said anvil guided on said frame along a path parallel to said track, said cam members are positioned near the end of said driver adjacent said anvil, said driver includes a pin projecting from the side of said driver opposite the direction of said displacement, and said stapler includes a spring coupled between said frame and said pin to both bias said driver to said first position and provide a torque around the end of said driver opposite said anvil in all positions of said driver to bias said driver toward said track.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US06/400,231 US4470532A (en) | 1982-07-21 | 1982-07-21 | Medical stapling device |
| US400,231 | 1982-07-21 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1201350A true CA1201350A (en) | 1986-03-04 |
Family
ID=23582753
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000432808A Expired CA1201350A (en) | 1982-07-21 | 1983-07-20 | Medical stapling device |
Country Status (2)
| Country | Link |
|---|---|
| US (1) | US4470532A (en) |
| CA (1) | CA1201350A (en) |
Families Citing this family (33)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4509518A (en) * | 1982-02-17 | 1985-04-09 | United States Surgical Corporation | Apparatus for applying surgical clips |
| EP0154815B1 (en) * | 1984-03-12 | 1991-03-13 | American Cyanamid Company | Improved skin stapler |
| US4606345A (en) * | 1984-07-16 | 1986-08-19 | Ethicon, Inc. | Surgical instrument for applying two-piece fasteners comprising U-shaped staples and frictionally held receivers (Case II) |
| US4606344A (en) * | 1984-07-16 | 1986-08-19 | Ethicon, Inc. | Surgical instrument for applying fasteners having improved gap indicating means (Case V) |
| US4607636A (en) * | 1984-07-16 | 1986-08-26 | Ethicon, Inc. | Surgical instrument for applying fasteners having tissue locking means for maintaining the tissue in the instrument while applying the fasteners (case I) |
| US4605004A (en) * | 1984-07-16 | 1986-08-12 | Ethicon, Inc. | Surgical instrument for applying fasteners said instrument including force supporting means (case IV) |
| US4807628A (en) * | 1985-04-26 | 1989-02-28 | Edward Weck & Company, Inc. | Method and apparatus for storing, dispensing, and applying surgical staples |
| US4699307A (en) * | 1986-03-19 | 1987-10-13 | The Fletcher-Terry Company | Driver for framer's and glazier's points |
| CA1286185C (en) * | 1986-07-14 | 1991-07-16 | Harold E. Froehlich | Bent back box staple and staple closing mechanism with split actuator |
| US4874122A (en) * | 1986-07-14 | 1989-10-17 | Minnesota Mining And Manufacturing Company | Bent back box staple and staple closing mechanism with split actuator |
| US4951860A (en) * | 1987-12-28 | 1990-08-28 | Edward Weck & Co. | Method and apparatus for storing, dispensing and applying surgical staples |
| US4869243A (en) * | 1988-02-26 | 1989-09-26 | Huene Donald R | Device and method for joining fractured bones |
| CA2060040A1 (en) * | 1991-02-08 | 1992-08-10 | Miguel A. Velez | Surgical staple and endoscopic stapler |
| US5258010A (en) * | 1991-05-30 | 1993-11-02 | United States Surgical Corporation | Anvilless surgical apparatus for applying surgical fasteners |
| DE4133692C2 (en) * | 1991-10-11 | 1993-09-30 | Beiersdorf Ag | Device for setting wound clips |
| US5497933A (en) * | 1991-10-18 | 1996-03-12 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
| US5356064A (en) * | 1991-10-18 | 1994-10-18 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
| US5289963A (en) * | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
| US5258009A (en) * | 1992-06-30 | 1993-11-02 | American Cyanamid Company | Malleable, bioabsorbable,plastic staple having a knotted configuration; and method and apparatus for deforming such staple |
| US5626587A (en) * | 1992-10-09 | 1997-05-06 | Ethicon Endo-Surgery, Inc. | Method for operating a surgical instrument |
| US5662662A (en) * | 1992-10-09 | 1997-09-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument and method |
| US5601224A (en) * | 1992-10-09 | 1997-02-11 | Ethicon, Inc. | Surgical instrument |
| US5560532A (en) * | 1993-10-08 | 1996-10-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to body tissue |
| US5743456A (en) * | 1993-12-16 | 1998-04-28 | Stryker Corporation | Hand actuable surgical handpiece |
| US5501689A (en) * | 1994-02-03 | 1996-03-26 | United States Surgical Corporation | Plaque stapler |
| US5626585A (en) * | 1994-09-16 | 1997-05-06 | United States Surgical Corporation | Ligating clip advance |
| ATE493939T1 (en) | 2000-04-11 | 2011-01-15 | United States Surgical Corp | DEVICE FOR REPAIRING THE MENISCUS IN A SINGLE OPERATION |
| US7048748B1 (en) | 2001-03-21 | 2006-05-23 | Uestuener Emin Tuncay | Automatic surgical suturing instrument and method |
| JP4712409B2 (en) * | 2005-02-28 | 2011-06-29 | マニー株式会社 | Medical stapler |
| US7395955B2 (en) | 2006-01-06 | 2008-07-08 | Staples The Office Superstore, Llc | Stapler |
| US7540400B2 (en) | 2006-01-06 | 2009-06-02 | Staples The Office Superstore, Llc | Stapler having a moveable strike plate with lockout mechanism |
| DE102011053781A1 (en) | 2011-09-20 | 2013-03-21 | Implantcast Gmbh | A surgical stapling |
| CN114557742B (en) * | 2022-03-30 | 2023-08-04 | 四川大学华西第二医院 | Closure device capable of being closed secondarily |
Family Cites Families (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3643851A (en) * | 1969-08-25 | 1972-02-22 | United States Surgical Corp | Skin stapler |
| US3662939A (en) * | 1970-02-26 | 1972-05-16 | United States Surgical Corp | Surgical stapler for skin and fascia |
| US3638847A (en) * | 1970-07-06 | 1972-02-01 | United States Surgical Corp | Ratchet-driven cartridge for surgical instruments |
| US3837555A (en) * | 1970-12-14 | 1974-09-24 | Surgical Corp | Powering instrument for stapling skin and fascia |
| US3873016A (en) * | 1973-11-30 | 1975-03-25 | Meyer Fishbein | Pliers type surgical stapler for joining disunited skin or fascia |
| US4014492A (en) * | 1975-06-11 | 1977-03-29 | Senco Products, Inc. | Surgical staple |
| US4043504A (en) * | 1976-03-09 | 1977-08-23 | Senco Products, Inc. | Staple cartridge and feed means for use with a surgical stapling instrument |
| US4316468A (en) * | 1977-08-05 | 1982-02-23 | Charles H. Klieman | Surgical stapler |
| US4185762A (en) * | 1978-03-27 | 1980-01-29 | Minnesota Mining And Manufacturing Company | Medical stapling device |
-
1982
- 1982-07-21 US US06/400,231 patent/US4470532A/en not_active Expired - Lifetime
-
1983
- 1983-07-20 CA CA000432808A patent/CA1201350A/en not_active Expired
Also Published As
| Publication number | Publication date |
|---|---|
| US4470532A (en) | 1984-09-11 |
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Legal Events
| Date | Code | Title | Description |
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| MKEX | Expiry |