US3080564A - Instrument for stitching hollow organs - Google Patents

Instrument for stitching hollow organs Download PDF

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Publication number
US3080564A
US3080564A US840494A US84049459A US3080564A US 3080564 A US3080564 A US 3080564A US 840494 A US840494 A US 840494A US 84049459 A US84049459 A US 84049459A US 3080564 A US3080564 A US 3080564A
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bar
slots
head
handle
elongated
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US840494A
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Strekopitov Alexey Alexeevich
Androssov Pavel Iossifovich
Scheinberg Solomon Aisikovich
Tulakova Lidia Sergeevna
Potechina Lidia Alexandrovna
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously

Definitions

  • This invention relates Ito medical instruments and m-ore particularly to an instrument for stitching hollow organs, for instance, the bronchial s-tump, by means of Usshaped staples of tantalum wire.
  • a further object of the invention i-s the provision of an instrument for stitching hollow organs With staples which may be conveniently and completely disassembled without the use of tools to permit thorough cleaning and sterilization of the instrument.
  • a still further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument incorporates a replaceable staple maga.- zine thereby permitting rapid reuse of the instrument.
  • Another object of the invention is the provision of au instrument for stitching hollow organs With staples which instrument is provided with means for preventing inadvertent operation of the instrument.
  • a further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument incorporates a replaceable staplemaga- Zine which may -be rapidly changed for repeated use of the instrument and in which means is provided for preventing inadvertent removal of the staple magazine.
  • a still further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument may be conveniently and economically constructed from readily available materials of a character which may be conveniently maintained in a sanitary and sterile condition.
  • FG. l is a View in perspective showing an instrument for stitching hollow organs constructed in accordance with this invention.
  • FIG. 2 an exploded view in perspective showing the rear side of a staple magazine, together with staples in the position assumedV prior to insertion in the magazine;
  • FIG. 3 a front elevational view of the staple magazine shown in FIG. 2;
  • FIG. 4 a fragmentary elevational view showing the staple driver member together with the staple driving iingers carried thereby;
  • FIG. 5 is a top plan view of the instrument shown in FIG. l;
  • FIG. 6 a side elevational view lshowing in full lines the instrument of FIG. 1 and showing in dotted lines the position assumed by a por-tion of the instrument to permit convenient land rapid changing of staple magazines;
  • FIG. 7 Ia fragmentary side elevational view showing the manner in which a staple magazine is removed and replaced
  • FIG. 8 a sectional View taken on the line 8-8 of FIG. 6 and showing the -staple ⁇ clinching anvils on the fixed jaw;
  • FIG. 9 an exploded elevational view with parts broken away and in section for greater clarity showing the instrumen-t completely disassembled kand lalso the relationship of the various parts.
  • an instrument for stitching hollow organs with staples constructed ⁇ in accordance with this invention and which may well compri-se an elongated body 10 generally rectangular in cross section and terminating at the forward end in ya jaw .portion 11 and at the rear end in an enlarged generally rectangular yoke 12 having lsidewalls 13 and 14 disposed outwardly of the sidewalls 15 and 16 of the body 10 as clearly shown in FlG. 5.
  • the yoke 12 is provided with a rear end wall 17 spaced from the rear end 18 of the body 10 to provide a vert-ical passage 19 ⁇ through the yoke 12 and the rear end wall 17 of the yoke 12 is provided with an upwardly opening notch 20, Ithe purpose of which will later appear.
  • the body 10 is provided with an upwardly opening channel 21 extending between the jaw portion 11 and the yoke 12 1and a portion of the bottom walls 22 of the channel 21 is removed 1between the yoke 12 and a point intermediate the length of the body 10 to provide a vertical slot 23 communicating with the passage 19 in the yoke 12.
  • the jaw portion 11 comprises an elongated member 24 ixed or integral with the forward lower edge of fthe body 10, as at 25, and the member 24 terminates in an upstanding iixed jaw 26 the rear surface of which is provided with a plurality of vertically spaced staple clinching anvils 27.
  • the upper edge of the member 24 is provided with a longitudinal rib 28 extending between the forward end of the body 10' and the fixed jaw 26 and the purpose of such rib will later appear.
  • the forward end of the body 10" is provided with opstanding spaced elongated ears 29 and 30 and such ears are provided with opposed inwardly opening grooves 31 and 32.
  • An elongated bar 33 having a bore 34 extending therethrough is removably and slidably received in the channel 21 of the body l()y and the bar 33 terminates at the forward end in an enlarged generally rectangular hollow head 35 open lat the forward end and received in the jaw portion 11.
  • the lower edge of the head 35 is provided wi-th a groove slidably receiving the rib 28 on the elongated member 24 of the jaw portion 1-1.
  • Outwardly projecting lugs 3'7 and 38 on the head 35 are slidably received in the grooves 31 and 32 of the ears 29 and 39 on the body 1t?
  • the sidewalls 39 of the head 35 are provided at the forward edges with forwardly and upwardly extending vertically spaced L-shaped slots 4G land 41 which are utilized for retaining a staple magazine in place in a manner to be presently described.
  • a staple magazine 42 which may well comprise an elongated block having a marginal flange 43 and a rearwardly extending rectangular portion 44 provided with oppositely :extending pins 45 and 46.
  • the rearwardly extending portion 44 of the magazine 42 is provided with a plurality of vertically spaced grooves 47 for receiving staples 4S and the grooves 47 terminate in slots 49 in the forward face of the magazine 42. It is to be noted that with the magazine 42 in position as shown in FIGS. 1 and 6, that the slots 49 in the magazine 42 are in alignment with the anvils 27 in the fixed jaw 26.
  • the rear end of the bar 33 terminates in a threaded portion ft and threadedly received thereon is a nut 51 having a linger engaging portion 52 and a reduced portion 53 which is received in the notch 20 in the end wall 17 of the yoke 12.
  • the reduced portion 53 of the nut 51 is provided with an annular groove 54 which receives the sidewall of the notch 20 in the end Wall 17 of the yoke 12.
  • a downwardly projecting xed handle 55 Adjacent the rear end of the bar 33 there is provided a downwardly projecting xed handle 55 which may be disposed at an angle convenient for use and it is to be noted as clearly shown in FIG. 6, that the handle 55 projects downwardly through the Vertical slot 23 in the body 10.
  • Oppositely extending projections 56 and 57 are provided on the handle 55 and as clearly shown in FIGS. l and 6, the projections 56 and 57 slidably engage the lower edge 58 of the body 10.
  • Forwardly of the handle 55 and integral with the bar 33 and handle 55 are downwardly extending spaced plates 59 which are provided with downwardly opening aligned slots 60.
  • the bar 33 is provided with a vertical elongated aperture 61, the purpose of which will presently appear.
  • a staple driver 62 comprising an elongated rod 63 slidably received in the bore 34 of the bar 33 and the rod 63 terminates at the forward end in a generally rectangular driver member 64 slidably received in the head 35 on the forward end of the bar 33.
  • the driver member 64 is provided on the forward edge thereof with a plurality of staple driving fingers 65 which are aligned with the grooves 47 in the staple magazine 42.
  • the rear end of the rod 63 of the staple driver 62 is provided with a vertical opening 66 in alignment with the aperture 61 in the bar 33.
  • An actuating handle 67 is provided with a pivot pin 68 removably received in the slots 60 in the plates 59 and the upper end 69 of the actuating handle 67 extends through the aperture 61 in the bar 33 and the opening 66 in the rod 63 as clearly shown in FIG. 6.
  • An elongated leaf-type return spring 76 is secured to the actuating handle 67 as at 71, in any suitable manner and the upper end of the spring 70 is provided with an oifset portion 72 which as clearly shown in FIG. 6, engages over an elongated abutment 73 secured to the fixed handle 55.
  • the off-set portion 72 of the spring 76 engaging over the abutment 73 serves to releasably maintain the pivot pin 68 in the slots 60 and also serves to urge the actuating handle 67 away from the fixed handle 55.
  • an abut-ment 74 on the fixed handle 55 and pivotally mounted on the actuating handle 67 is a stop member 75 which may moved downwardly as shown by the arrow in FIG. 6, to engage the abutment 74 and prevent movement of the actuating handle 67 toward the xed handle 55 or may be moved upwardly to the full line position shown in FIG. 6 to permit such movement of the actuating handle 67.
  • a finger engaging member 76 may be provided on the stop member 75 for conveniently operating the same and stop means in the form of pins 77 and 78 may be provided on the actuating handle 67 to limit movement of the linger engaging member 76.
  • the linger engaging member 76 is operated to move the stop member 75 out of engagement with the abutment 74 to permit operation of the actuating handle 67 which is then moved toward the fixed handle 55 thereby moving the rod 63 and driver member 64, together with the driver lingers 65 forwardly, thereby ejecting the staples 48 from the magazine 42 to pierce the walls of the organs to be stitched and the staples thereafter engage the anvils 27 on the fixed jaw 26 to clinch the same and complete the stitching operation.
  • the nut 51 may then be operated to retract t-he head 35 and magazine 42 from the fixed jaw 26 and the instrument removed from the incision.
  • the nut 51 is operated to retract the bar 33 and head 35 to such as extent that the lugs 37 and 38 are disengaged from the grooves 31 and 32 in the ears 29 and 30, at which time the head 35 and bar 33 may be moved upwardly out of the channel 21 in the body 10 to the position shown in FIGS. 6 and 7.
  • the magazine 42 may be moved downwardly and forwardly to disengage the pins 45 and 46 from the L-shaped slots 40 and 41 in the head 35 as shown in FIG. 7 and a new magazine loaded with staples may be inserted in place.
  • the bar 33 and head 35 is moved downwardly into the channel 21 of the body 10 and the nut 51 operated to move the lugs 37 and 38 into the grooves 31 and 32 of the ears 29 and 30 and the operation is repeated as described above.
  • the same may be completely dis-assembled for this purpose by operating the nut 51 to retract the bar 33 Iand head 35 to lsuch an extent that the lugs 37 and 38 are dis-engaged from the ygrooves 31 and 32 in the ears 29 and 30 and the projections 56 and 57 on the fixed handle 55 are moved rearwardly into alignment wit-h the vertical passage 19 through the yoke 12 ⁇ as clearly shown in FIG. 5.
  • the actuating handle 67 is next removed yby moving the same downwardly to cause the olf-set portion 72 of the spring to pass over the ⁇ abutment 73 on Ithe xed handle 55, at which time the pivot pin 68 will move downwardly out of the slots 60 in the plates 59 and the upper end portion 69 of the actuating handle 67 will move downwardly out of the opening 66 in the rod 63 and out of the aperture 61 in the bar 33.
  • Continued downward movement of the actuating handle 67 will permit complete removal ⁇ of the same through the vertical slot 23 in the lbody 10.
  • the bar 33 may now be moved upwardly out of the channel 21 in the body 10, since the projections 56 and 57 will pass upwardly through the vertical passage 19 in the yoke 12 and thereafter lthe rod 63 tand driver member 64 may ⁇ be removed longitudinally from the bore 34 in the bar 33, the nut 51 removed from the threaded portion 50 and the magazine 42 removed from the head 35 as clearly shown in FIG. 9.
  • the dis-assembled instrument may now be conveniently cleaned and sterilized and thereafter, re-assembled for future use. It is to 'be noted, that by merely manipulating the nut 51 that the projections S6 and 57 may be moved yalong the lower edge 58 of the body 10 and the lugs 37 and 38 engaged and dis-engaged with the grooves 31 and 32 of the ears Z9 and 30, thereby securely holding the bar 33 in place in the channel 21 of the body 10 and furthermore, the off-set portion 72 of the spring 70 in engagement with the abutment 73 operates to securely hold the actuating handle 67 in position with the pivot pin 68 in the slots 60 of the plate 59.
  • An instrument for stitching hollow organs with staples comprising an elongated body terminating at the Vforward end in a jaw portion and at the rear end in an enlarged generally rectangular yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel -being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member lixed to the lower forward edge of said body and terminating in an upstanding iixed jaw, staple clinching anvils on the rear surface of said fixed jaw ⁇ and an upstanding longitudinal rib on said member between said body and said iixed jaw, upstanding, spaced,
  • said return spring comprises a leaf spring having an off-set portion engaging said abutment to releasably retain said actuating handle in position and said pivot pin in the Slots in said plates, removal of said actuating handle and rotation of said nut to dis-engage said lugs from said grooves and move said projections into alignment with the vertical passage in said yoke permitting removal of said bar from said channel and removal of said magazine from said head.
  • An instrument for stitching hollow organs with staples comprising an elongated body terminating at the forward end -in a jaw portion and at the rear end in an enlarged yoke having side walls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall yhaving an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member iixed to said body and terminating in an upstanding fixed jaw, staple clinching anvils on the rear surface of said iixed jaw and an upstanding longitudinal rib on said member between said body and said lixed jaw, upstanding, spaced, elongated ears on the upper edge of
  • An instrument for stitching hollow organs with staples comprising an elongated body terminating at the forward end in a jaw portion and at the rear end in an enlarged yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member lixed to said body and terminating in an upstanding fixed jaw, staple clinching anvils on the rear surface of said xed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated hollow bar
  • An instrument for stitching hollow organs with staples comprising an elongated body terminating at the forward end in a jaw portion and at the rear end in an enlarged yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member xed to said body and terminating in an upstanding xed jaw, staple clinching anvils on the rear surface of said lixed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated

Description

March 12, 1963 A. A. srREKoPlTov ETAL INSTRUMENT FOR STITCHING HoLLow oRGANs 3 Sheets-Sheet 1 Filed Sept. 10, 1959 r I I I I A. A. sTREKoPl-rov ETAL 3,080,564
INSTRUMENT FOR STITCHING HoLLow oRGANs 5 Sheets-.Sheet 2 March 12, 1963 Filed sept. 1o, 1959 March 12, 1963 A. A. sTREKoPiTov ETAL 3,080,564
INSTRUMENT FOR STITCHING HoLLw oRcANs 3 Sheets-Sheet 3 Filed Sept. 10, 1959 E .mi
United States Patent O 3,680,564 INSTRUMENT FOR STITCHING HOLLOW ORGANS Alexey Alexeevich Strekopitov, 8th St. of Octobers Field 5, Apt. 26; Pavel Iossifovch Androssov, 8th St. of Octobers Field 5, Apt. 24; Solomon Aisikovich Scheinberg, 1st Dubrovskaja ul. 6, Apt. 4a; Lidia Sergeevna Tulakova, 4th Meschanskaja ul. 7, Apt. 9; Lidia Alexandrovna Potechina, Orlovo-Davidovski per. 2/ 5, Apt. 34, all of Moscow, U.S.S.R.
Filed Sept. 10, 1959, Ser. No. 840,494 6 Claims. (Cl. 1-50) This invention relates Ito medical instruments and m-ore particularly to an instrument for stitching hollow organs, for instance, the bronchial s-tump, by means of Usshaped staples of tantalum wire.
It has heretofore been proposed to utilize staples for stitching hollow organs of the body and instruments have been developed for accomplishing this operation. However, these prior art instruments have been relatively complex, diicult to clean and sterilize and thereby maintain the same in a sanitary condition and funthermore, these prior art instruments did not provide replaceable staple magazines .thereby necessitating the renewal of the staple supply by individually placing lthe staples in slots for receiving the same. This situation precluded rapid and repeated uses of the instrument, since an appreciable amount of time is required for reecharging the same with staples and, therefore, if .it were necessary to perform more than one stapling operation, it was necessary to provide a multiplicity of instruments, each containing a charge of staples and to be utilized one after the other.
It is accordingly an object of this invention to provide an instrument for stitching hollow organs with staples, which instrument may be inserted through a relatively small incision and which may be manipulated to grip the parts to be sutured `and thereafter operated by one hand to drive and clinch the staples in place.
A further object of the invention i-s the provision of an instrument for stitching hollow organs With staples which may be conveniently and completely disassembled without the use of tools to permit thorough cleaning and sterilization of the instrument.
A still further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument incorporates a replaceable staple maga.- zine thereby permitting rapid reuse of the instrument.
Another object of the invention is the provision of au instrument for stitching hollow organs With staples which instrument is provided with means for preventing inadvertent operation of the instrument.
A further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument incorporates a replaceable staplemaga- Zine which may -be rapidly changed for repeated use of the instrument and in which means is provided for preventing inadvertent removal of the staple magazine.
A still further object of the invention is the provision of an instrument for stitching hollow organs with staples, which instrument may be conveniently and economically constructed from readily available materials of a character which may be conveniently maintained in a sanitary and sterile condition.
Further objects and advantages of the invention will be apparent from the following description taken in conjunction with the accompanying drawings wherein:
FG. l is a View in perspective showing an instrument for stitching hollow organs constructed in accordance with this invention;
FIG. 2 an exploded view in perspective showing the rear side of a staple magazine, together with staples in the position assumedV prior to insertion in the magazine;
3,080,564 Patented Mar. 12, 1953 ICC FIG. 3 a front elevational view of the staple magazine shown in FIG. 2;
FIG. 4 a fragmentary elevational view showing the staple driver member together with the staple driving iingers carried thereby;
FIG. 5 is a top plan view of the instrument shown in FIG. l;
FIG. 6 a side elevational view lshowing in full lines the instrument of FIG. 1 and showing in dotted lines the position assumed by a por-tion of the instrument to permit convenient land rapid changing of staple magazines;
FIG. 7 Ia fragmentary side elevational view showing the manner in which a staple magazine is removed and replaced;
FIG. 8 a sectional View taken on the line 8-8 of FIG. 6 and showing the -staple `clinching anvils on the fixed jaw; and
FIG. 9 an exploded elevational view with parts broken away and in section for greater clarity showing the instrumen-t completely disassembled kand lalso the relationship of the various parts.
With continued reference to the drawing, there is shown an instrument for stitching hollow organs with staples constructed `in accordance with this invention and which may well compri-se an elongated body 10 generally rectangular in cross section and terminating at the forward end in ya jaw .portion 11 and at the rear end in an enlarged generally rectangular yoke 12 having lsidewalls 13 and 14 disposed outwardly of the sidewalls 15 and 16 of the body 10 as clearly shown in FlG. 5. The yoke 12 is provided with a rear end wall 17 spaced from the rear end 18 of the body 10 to provide a vert-ical passage 19` through the yoke 12 and the rear end wall 17 of the yoke 12 is provided with an upwardly opening notch 20, Ithe purpose of which will later appear.
The body 10 is provided with an upwardly opening channel 21 extending between the jaw portion 11 and the yoke 12 1and a portion of the bottom walls 22 of the channel 21 is removed 1between the yoke 12 and a point intermediate the length of the body 10 to provide a vertical slot 23 communicating with the passage 19 in the yoke 12.
The jaw portion 11 comprises an elongated member 24 ixed or integral with the forward lower edge of fthe body 10, as at 25, and the member 24 terminates in an upstanding iixed jaw 26 the rear surface of which is provided with a plurality of vertically spaced staple clinching anvils 27. The upper edge of the member 24 is provided with a longitudinal rib 28 extending between the forward end of the body 10' and the fixed jaw 26 and the purpose of such rib will later appear. The forward end of the body 10" is provided with opstanding spaced elongated ears 29 and 30 and such ears are provided with opposed inwardly opening grooves 31 and 32.
An elongated bar 33 having a bore 34 extending therethrough is removably and slidably received in the channel 21 of the body l()y and the bar 33 terminates at the forward end in an enlarged generally rectangular hollow head 35 open lat the forward end and received in the jaw portion 11. The lower edge of the head 35 is provided wi-th a groove slidably receiving the rib 28 on the elongated member 24 of the jaw portion 1-1. Outwardly projecting lugs 3'7 and 38 on the head 35 are slidably received in the grooves 31 and 32 of the ears 29 and 39 on the body 1t? and the purpose and operation of the lugs 37 and 38 will be later described, The sidewalls 39 of the head 35 are provided at the forward edges with forwardly and upwardly extending vertically spaced L-shaped slots 4G land 41 which are utilized for retaining a staple magazine in place in a manner to be presently described.
With particular reference to FIGS. 2 and 3, there is shown a staple magazine 42 which may well comprise an elongated block having a marginal flange 43 and a rearwardly extending rectangular portion 44 provided with oppositely :extending pins 45 and 46. The rearwardly extending portion 44 of the magazine 42 is provided with a plurality of vertically spaced grooves 47 for receiving staples 4S and the grooves 47 terminate in slots 49 in the forward face of the magazine 42. It is to be noted that with the magazine 42 in position as shown in FIGS. 1 and 6, that the slots 49 in the magazine 42 are in alignment with the anvils 27 in the fixed jaw 26.
The rear end of the bar 33 terminates in a threaded portion ft and threadedly received thereon is a nut 51 having a linger engaging portion 52 and a reduced portion 53 which is received in the notch 20 in the end wall 17 of the yoke 12. The reduced portion 53 of the nut 51 is provided with an annular groove 54 which receives the sidewall of the notch 20 in the end Wall 17 of the yoke 12. It will, thus, be seen that rotation of the nut 52 will operate to move the bar 33 and the head 35 on the forward end thereof longitudinally of the body 10.
Adjacent the rear end of the bar 33 there is provided a downwardly projecting xed handle 55 which may be disposed at an angle convenient for use and it is to be noted as clearly shown in FIG. 6, that the handle 55 projects downwardly through the Vertical slot 23 in the body 10. Oppositely extending projections 56 and 57 are provided on the handle 55 and as clearly shown in FIGS. l and 6, the projections 56 and 57 slidably engage the lower edge 58 of the body 10. Forwardly of the handle 55 and integral with the bar 33 and handle 55 are downwardly extending spaced plates 59 which are provided with downwardly opening aligned slots 60. The bar 33 is provided with a vertical elongated aperture 61, the purpose of which will presently appear.
As best shown in FIG. 9, there is provided a staple driver 62 comprising an elongated rod 63 slidably received in the bore 34 of the bar 33 and the rod 63 terminates at the forward end in a generally rectangular driver member 64 slidably received in the head 35 on the forward end of the bar 33. As best shown in FIGS. 4 and 9, the driver member 64 is provided on the forward edge thereof with a plurality of staple driving fingers 65 which are aligned with the grooves 47 in the staple magazine 42. The rear end of the rod 63 of the staple driver 62 is provided with a vertical opening 66 in alignment with the aperture 61 in the bar 33.
An actuating handle 67 is provided with a pivot pin 68 removably received in the slots 60 in the plates 59 and the upper end 69 of the actuating handle 67 extends through the aperture 61 in the bar 33 and the opening 66 in the rod 63 as clearly shown in FIG. 6.
An elongated leaf-type return spring 76 is secured to the actuating handle 67 as at 71, in any suitable manner and the upper end of the spring 70 is provided with an oifset portion 72 which as clearly shown in FIG. 6, engages over an elongated abutment 73 secured to the fixed handle 55. As will be seen from an inspection of FIG. 6, the off-set portion 72 of the spring 76 engaging over the abutment 73 serves to releasably maintain the pivot pin 68 in the slots 60 and also serves to urge the actuating handle 67 away from the fixed handle 55.
In order to prevent inadvertent movement of the actuating handle 67 toward the fixed handle 55, there may be provided an abut-ment 74 on the fixed handle 55 and pivotally mounted on the actuating handle 67 is a stop member 75 which may moved downwardly as shown by the arrow in FIG. 6, to engage the abutment 74 and prevent movement of the actuating handle 67 toward the xed handle 55 or may be moved upwardly to the full line position shown in FIG. 6 to permit such movement of the actuating handle 67. A finger engaging member 76 may be provided on the stop member 75 for conveniently operating the same and stop means in the form of pins 77 and 78 may be provided on the actuating handle 67 to limit movement of the linger engaging member 76.
In utilizing the instrument described above for stitching hollow organs, it is assumed that the staple magazine 42 has been tilled with staples and that the same is in proper position on the instrument as shown in FIG. 1. The jaw portion 24 of the instrument is inserted through the incision and the fixed jaw 26 is engaged With one side of the organs to be stitched. Thereafter, the nut 51 is manipulated to move the head 35 and staple magazine 42 toward the fixed jaw 26 kand into engagement with the opposite side of the organs to the stitched, thereby clamping the same between the magazine 42 and t-he fixed jaw 26. At this time, the linger engaging member 76 is operated to move the stop member 75 out of engagement with the abutment 74 to permit operation of the actuating handle 67 which is then moved toward the fixed handle 55 thereby moving the rod 63 and driver member 64, together with the driver lingers 65 forwardly, thereby ejecting the staples 48 from the magazine 42 to pierce the walls of the organs to be stitched and the staples thereafter engage the anvils 27 on the fixed jaw 26 to clinch the same and complete the stitching operation. The nut 51 may then be operated to retract t-he head 35 and magazine 42 from the fixed jaw 26 and the instrument removed from the incision.
If it is desired to perform more than one stitching operation, after removal of the instrument from the incision, the nut 51 is operated to retract the bar 33 and head 35 to such as extent that the lugs 37 and 38 are disengaged from the grooves 31 and 32 in the ears 29 and 30, at which time the head 35 and bar 33 may be moved upwardly out of the channel 21 in the body 10 to the position shown in FIGS. 6 and 7. At this time, the magazine 42 may be moved downwardly and forwardly to disengage the pins 45 and 46 from the L-shaped slots 40 and 41 in the head 35 as shown in FIG. 7 and a new magazine loaded with staples may be inserted in place. Thereafter, the bar 33 and head 35 is moved downwardly into the channel 21 of the body 10 and the nut 51 operated to move the lugs 37 and 38 into the grooves 31 and 32 of the ears 29 and 30 and the operation is repeated as described above.
Upon completion of the final stitching operation and when it is 'desired to clean land sterilize the instrument, the same may be completely dis-assembled for this purpose by operating the nut 51 to retract the bar 33 Iand head 35 to lsuch an extent that the lugs 37 and 38 are dis-engaged from the ygrooves 31 and 32 in the ears 29 and 30 and the projections 56 and 57 on the fixed handle 55 are moved rearwardly into alignment wit-h the vertical passage 19 through the yoke 12 `as clearly shown in FIG. 5. The actuating handle 67 is next removed yby moving the same downwardly to cause the olf-set portion 72 of the spring to pass over the `abutment 73 on Ithe xed handle 55, at which time the pivot pin 68 will move downwardly out of the slots 60 in the plates 59 and the upper end portion 69 of the actuating handle 67 will move downwardly out of the opening 66 in the rod 63 and out of the aperture 61 in the bar 33. Continued downward movement of the actuating handle 67 will permit complete removal `of the same through the vertical slot 23 in the lbody 10.
The bar 33 may now be moved upwardly out of the channel 21 in the body 10, since the projections 56 and 57 will pass upwardly through the vertical passage 19 in the yoke 12 and thereafter lthe rod 63 tand driver member 64 may `be removed longitudinally from the bore 34 in the bar 33, the nut 51 removed from the threaded portion 50 and the magazine 42 removed from the head 35 as clearly shown in FIG. 9.
The dis-assembled instrument may now be conveniently cleaned and sterilized and thereafter, re-assembled for future use. It is to 'be noted, that by merely manipulating the nut 51 that the projections S6 and 57 may be moved yalong the lower edge 58 of the body 10 and the lugs 37 and 38 engaged and dis-engaged with the grooves 31 and 32 of the ears Z9 and 30, thereby securely holding the bar 33 in place in the channel 21 of the body 10 and furthermore, the off-set portion 72 of the spring 70 in engagement with the abutment 73 operates to securely hold the actuating handle 67 in position with the pivot pin 68 in the slots 60 of the plate 59. Obviously, no tools or other apparatus is required to assemble ,and dis-'assemble the instrument of this invention, this being accomplished merely by manual manipulation of the parts as described above. Furthermore, it i-s to be noted that engagement of the lower end of the magazine 4Z with the rib 28 on the jaw portion 11 results in preventing inadvertent downward movement and displacement of the magazine 42, yet the same may be conveniently removed and replaced by manipulating the instrument as described above.
It will be obvious to those skilled in the Iart that various changes may be made in the invention without departing from the spirit and scope thereof and therefore the invention is not limited by that which is -shown in the drawings and described in the specification, but only as indicated in the appended claims.
We claim:
l. An instrument for stitching hollow organs with staples, said instrument comprising an elongated body terminating at the Vforward end in a jaw portion and at the rear end in an enlarged generally rectangular yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel -being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member lixed to the lower forward edge of said body and terminating in an upstanding iixed jaw, staple clinching anvils on the rear surface of said fixed jaw `and an upstanding longitudinal rib on said member between said body and said iixed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated hollow bar removably and slidably received -in said channel, said bar .terminating -at .the forward end in an enlarged generally rectangular hollow head open at the forward end and received in said jaw portion and having a groove in the lower edge slidably receiving said rib, lugs on said head slidably received in the grooves in said ears, forwardly and upwardly extending vertically spaced L-shaped slots in the forward edge of said head, a staple magazine comprising an elongated block having a plurality of vertically spaced slots for receiving staples, said :block being received in the forward end of said head, pins on said block en-gaging said L-shaped slots, the lower end of said block engaging said rib to prevent downward movement of said block and removal of said pins from said L-shaped slots, the slots in said block being disposed opposite said anvils, the rear end of said bar terminating in a threaded portion, a nut on said threaded portion, a portion of said nut being received in said notch and having an annular groove receiving the sidewall of said notch, whereby rotation of said nut will move said head toward or away from said fixed jaw, a fixed handle 4on said bar projecting downwardly through said vertical slot in said body, projections on said handle slidably engaging the lower edge of said body, said lugs and said projections serving to retain said bar in said channel, downwardly extending spaced plates on said bar adjacent said handle, downwardly opening aligned slots in said plate, said bar having a vertical aperture between said plates, a staple driver comprising an elongated rod slidably received in said bar and lterminating at the forward end in a driver member slidably received in said head, ia plurality of staple driving fingers on said driver member aligned with the slots in said magazine, the rear end of said rod having a vertical opening in alignment with said aperture, an Iactuating handle having a pivot pin removably received in the slots in said plates, the upper end of said actuating handle extending through said aperture and opening and a return spring on said actuating handle engaging Aan abutment on said fixed handle, whereby upon operation of said actuating handle said fingers will simultaneously eject staples from all of the slots in said magazine.
2. An instrument as defined in claim l in which means is provided for preventing inadvertent operation of said actuating handle.
3. An instrument as delined in claim l in which said return spring comprises a leaf spring having an off-set portion engaging said abutment to releasably retain said actuating handle in position and said pivot pin in the Slots in said plates, removal of said actuating handle and rotation of said nut to dis-engage said lugs from said grooves and move said projections into alignment with the vertical passage in said yoke permitting removal of said bar from said channel and removal of said magazine from said head.
4. An instrument for stitching hollow organs with staples, said instrument comprising an elongated body terminating at the forward end -in a jaw portion and at the rear end in an enlarged yoke having side walls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall yhaving an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member iixed to said body and terminating in an upstanding fixed jaw, staple clinching anvils on the rear surface of said iixed jaw and an upstanding longitudinal rib on said member between said body and said lixed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated hollow bar removably and slidably received in said channel, said bar terminating at the forward end in an enlarged generally rectangular hollow head open at the forward end and received in said jaw portion and having a groove in the lower edge slidably receiving said rib, lugs on said head slidably received in the grooves in said ears, forwardly and upwardly extending vertically spaced L-shaped slots in the forward edge of said head, a staple magazine comprising an elongated block having a plurality of vertically spaced slots for receiving staples, said block being received in the forward end of said head, pins on said block engaging said L-shaped slots, the lower end of said block engaging said rib to prevent downward movement of said block and removal of said pins from said L-shaped slots, the slots in said block being disposed opposite said anvils, the rear end of said bar terminating in a threaded portion, a nut on said vthreaded portion, a portion of said nut being received in said notch and having an annular groove receiving the sidewall of said notch, whereby rotation of said nut will move said head toward or away from said fixed jaw, a xed handle on said bar projecting downwardly through said vertical slot in said body, projections on said handle slidably engaging the lower edge of said body, said lugs and said projections serving to retain said bar in said channel, downwardly extending spaced plates on said bar adjacent said handle, downwardly opening aligned slots in said plates, said bar having a vertical aperture between said plates, a staple driver comprising an elongated rod slidably received in said bar and terminating at the forward end in a driver member slidably received in said head, a plurality of stable driving fingers on said driver member aligned with the slots inV said magazine, the rear end of said rod having a vertical opening in alignment with said aperture, an actuating handle having a pivot pin removably received in the slots in said plates, the upper end of said actuating handle extending through said aperture and opening and a return spring on said actuating handle engaging an abutment on said fixed handle, whereby upon operation ofV said actuating handle said lingers will simultaneously ejectstaples from all of the slots in said magazine.
5. An instrument for stitching hollow organs with staples, said instrument comprising an elongated body terminating at the forward end in a jaw portion and at the rear end in an enlarged yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member lixed to said body and terminating in an upstanding fixed jaw, staple clinching anvils on the rear surface of said xed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated hollow bar removably and slidably received in said channel, said bar terminating at the forward end in an enlarged generally rectangular hollow head open at the forward end and received in said jaw portion, lugs on said head slidably received in the grooves in said ears, forwardly and upwardly extending vertically spaced L-shaped slots in the forward edges of said head, a staple magazine comprising an elongated block having a plurality of vertically spaced slots for receiving staples, said block being received in the forward end of said head, pins on said block engaging said L-,shaped slots, the lower end of said block engaging the upper surface of said elongated member to prevent downward movement of said block and removal of said pins from said L-shaped slots, the slots in said block being disposed opposite said anvils, the rear end of said bar terminating in a threaded portion, a nut on said threaded portion, a portion or" said nut being received in said notch and having an annular groove receiving the sidewall ot said notch, whereby rotation of said nut will move said head toward or away from said fixed jaw, a fixed handle on said bar projecting downwardly through said Vertical slot in said body, projections on said handle slidably engaging the lower edge of said body, said ings and projections serving to retain said bar in said channel, downwardly extending spaced plates on said bar adjacent said handle, downwardly opening aligned slots in said plates, said bar having a vertical aperture between said plates, a staple driver comprising an elongated rod slidably received in said bar and terminating at the forward end in a driver member slidably received in said head, a plurality of staple driving iingers on driver member aligned with the slots in said magazine, the rear end of said rod having a vertical opening'in alignment with said aperture, an actuating handle having a pivot pin rem vably received in the slots in said plates, the upper end of said actuating handle extending through saidV aperture and opening and a return spring on said actuating handle engaging an abutment on said fixed handle, whereby upon operation of said actuating handle said lingers will simultaneously eject staples from all of the slots in said magazine.
6. An instrument for stitching hollow organs with staples, said instrument comprising an elongated body terminating at the forward end in a jaw portion and at the rear end in an enlarged yoke having sidewalls disposed outwardly of the sidewalls of said body and a rear end wall spaced from the rear end of said body to provide a vertical passage through said yoke, said rear end wall having an upwardly opening notch, said body having an upwardly opening channel extending between said jaw portion and said yoke, the bottom wall of said channel being removed between said yoke and a point intermediate the length of said body to provide a vertical slot communicating with the passage in said yoke, said jaw portion comprising an elongated member xed to said body and terminating in an upstanding xed jaw, staple clinching anvils on the rear surface of said lixed jaw, upstanding, spaced, elongated ears on the upper edge of said body adjacent said jaw portion, said ears having opposed inwardly opening grooves, an elongated hollow bar removably and slidably received in said channel, said bar terminating at the forward end in an enlarged generally rectangular hol-low head open at the forward end and received in said jaw portion, lugs on said head slidably received in the grooves in said ears, a staple magazine comprising an elongated block having a plurality of Vertically spaced slots for receiving staples, said block being received in the forward end of said head, means to secure said magazine to said head, the slots in the block -being disposed opposite said anvils, the rear end of said bar terminating in a threaded portion, a nut on said threaded portion, a .portion 'of said nut being received in said notch and having an annular groove receiving the sidewall of said notch, whereby rotation of said nut will move `said head toward or away from said xed jaw, a xed handle on said bar projecting downwardly through said vertical slot in said body, projections on said handles slidably engaging the lower edge of said body, said lugs and said projections serving yto retain said bar in said channel, downwardly extending spaced plates on said bar adjacent said handle, downwardly opening aligned slots in said plates, said bar having a vertical aperture between said plates, a staple driver comprising an elongated rod slidably received in said bar and terminating at the forward Aend in a driver member slidably received in said head, a plurality of staple driving lingers on said driver member aligned with the slots in said magazine, the rear end or said rod having a vertical opening in alignment with said aperture, an actuating handle having a pivot pin removably received in the slots in said plates, the upper end of said actuating handle extending through said aperture and opening and a return spring on said actuating handle engaging an abutment on said iixed handle, whereby upon operation of said actuating handle said fingers will simultaneously eject staples from all of the slots in said magazine.
References Cited in the ille of this patent UNITED STATES PATENTS 2,891,250 -iirata .lune 23, 1959

Claims (1)

1. AN INSTRUMENT FOR STITCHING HOLLOW ORGANS WITH STAPLES, SAID INSTRUMENT COMPRISING AN ELONGATED BODY TERMINATING AT THE FORWARD END IN A JAW PORTION AND AT THE REAR END IN AN ENLARGED GENERALLY RECTANGULAR YOKE HAVING SIDEWALLS DISPOSED OUTWARDLY OF THE SIDEWALLS OF SAID BODY AND A REAR END WALL SPACED FROM THE REAR END OF SAID BODY TO PROVIDE A VERTICAL PASSAGE THROUGH SAID YOKE, SAID REAR END WALL HAVING AN UPWARDLY OPENING NOTCH, SAID BODY HAVING AN UPWARDLY OPENING CHANNEL EXTENDING BETWEEN SAID JAW PORTION AND SAID YOKE, THE BOTTOM WALL OF SAID CHANNEL BEING REMOVED BETWEEN SAID YOKE AND A POINT INTERMEDIATE THE LENGTH OF SAID BODY TO PROVIDE A VERTICAL SLOT COMMUNICATING WITH THE PASSAGE IN SAID YOKE, SAID JAW PORTION COMPRISING AN ELONGATED MEMBER FIXED TO THE LOWER FORWARD EDGE OF SAID BODY AND TERMINATING IN AN UPSTANDING FIXED JAW, STAPLE CLINCHING ANVILS ON THE REAR SURFACE OF SAID FIXED JAW AND AN UPSTANDING LONGITUDINAL RIB ON SAID MEMBER BETWEEN SAID BODY AND SAID FIXED JAW, UPSTANDING, SPACED, ELONGATED EARS ON THE UPPER EDGE OF SAID BODY ADJACENT SAID JAW PORTION, SAID EARS HAVING OPPOSED INWARDLY OPENING GROOVES, AN ELONGATED HOLLOW BAR REMOVABLY AND SLIDABLY RECEIVED IN SAID CHANNEL, SAID BAR TERMINATING AT THE FORWARD END IN AN ENLARGED GENERALLY RECTANGULAR HOLLOW HEAD OPEN AT THE FORWARD END AND RECEIVED IN SAID JAW PORTION AND HAVING A GROOVE IN THE LOWER EDGE SLIDABLY RECEIVING SAID RIB, LUGS ON SAID HEAD SLIDABLY RECEIVED IN THE GROOVES IN SAID EARS, FORWARDLY AND UPWARDLY EXTENDING VERTICALLY SPACED L-SHAPED SLOTS IN THE FORWARD EDGE OF SAID HEAD, A STAPLE MAGAZINE COMPRISING AN ELONGATED BLOCK HAVING A PLURALITY OF VERTICALLY SPACED SLOTS FOR RECEIVING STAPLES, SAID BLOCK BEING RECEIVED IN THE FORWARD END OF SAID HEAD, PINS ON SAID BLOCK ENGAGING SAID L-SHAPED SLOTS, THE LOWER END OF SAID BLOCK ENGAGING SAID RIB TO PREVENT DOWNWARD MOVEMENT OF SAID BLOCK AND REMOVAL OF SAID PINS FROM SAID L-SHAPED SLOTS, THE SLOTS IN SAID BLOCK BEING DISPOSED OPPOSITE SAID ANVILS, THE REAR END OF SAID BAR TERMINATING IN A THREADED PORTION, A NUT ON SAID THREADED PORTION, A PORTION OF SAID NUT BEING RECEIVED IN SAID NOTCH AND HAVING AN ANNULAR GROOVE RECEIVING THE SIDEWALL OF SAID NOTCH, WHEREBY ROTATION OF SAID NUT WILL MOVE SAID HEAD TOWARD OR AWAY FROM SAID FIXED JAW, A FIXED HANDLE ON SAID BAR PROJECTING DOWNWARDLY THROUGH SAID VERTICAL SLOT IN SAID BODY, PROJECTIONS ON SAID HANDLE SLIDABLY ENGAGING THE LOWER EDGE OF SAID BODY, SAID LUGS AND SAID PROJECTIONS SERVING TO RETAIN SAID BAR IN SAID CHANNEL, DOWNWARDLY EXTENDING SPACED PLATES ON SAID BAR ADJACENT SAID HANDLE, DOWNWARDLY OPENING ALIGNED SLOTS IN SAID PLATE, SAID BAR HAVING A VERTICAL APERTURE BETWEEN SAID PLATES, A STAPLE DRIVER COMPRISING AN ELONGATED ROD SLIDABLY RECEIVED IN SAID BAR AND TERMINATING AT THE FORWARD END IN A DRIVER MEMBER SLIDABLY RECEIVED IN SAID HEAD, A PLURALITY OF STAPLE DRIVING FINGERS ON SAID DRIVER MEMBER ALIGNED WITH THE SLOTS IN SAID MAGAZINE, THE REAR END OF SAID ROD HAVING A VERTICAL OPENING IN ALIGNMENT WITH SAID APERTURE, AN ACTUATING HANDLE HAVING A PIVOT PIN REMOVABLY RECEIVED IN THE SLOTS IN SAID PLATES, THE UPPER END OF SAID ACTUATING HANDLE EXTENDING THROUGH SAID APERTURE AND OPENING AND A RETURN SPRING ON SAID ACTUATING HANDLE ENGAGING AN ABUTMENT ON SAID FIXED HANDLE, WHEREBY UPON OPERATION OF SAID ACTUATING HANDLE SAID FINGERS WILL SIMULTANEOUSLY EJECT STAPLES FROM ALL OF THE SLOTS IN SAID MAGAZINE.
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US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11918217B2 (en) 2021-05-28 2024-03-05 Cilag Gmbh International Stapling instrument comprising a staple cartridge insertion stop
US11723662B2 (en) 2021-05-28 2023-08-15 Cilag Gmbh International Stapling instrument comprising an articulation control display
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11931028B2 (en) 2022-02-03 2024-03-19 Cilag Gmbh International Surgical instrument with multiple program responses during a firing motion
US11931031B2 (en) 2022-05-27 2024-03-19 Cilag Gmbh International Staple cartridge comprising a deck including an upper surface and a lower surface
US11931038B2 (en) 2022-10-03 2024-03-19 Cilag Gmbh International Cartridge assemblies for surgical staplers

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