WO1998027873A1

WO1998027873A1 - Surgical stapler apparatus

Info

Publication number: WO1998027873A1
Application number: PCT/IL1997/000420
Authority: WO
Inventors: Sergey Popov
Original assignee: Sergey Popov
Priority date: 1996-12-23
Filing date: 1997-12-23
Publication date: 1998-07-02
Also published as: IL119882A0; AU5409098A

Abstract

A surgical stapler apparatus is disclosed for performing circular anastomosis on hollow organs of gastrointestinal tract such as intestines, colons, or the like. The apparatus includes anvil assembly comprising anvil (6), anvil rod (5), common control rod (CCR) (4) moving relative to the cartridge (2) upon stapling gap setting and upon stapler clamping, connector-disconnector (8) of said anvil rod (5) and CCR (4), and promotion means intended for ensuring of said anvil assembly mobility relative to cartridge during stapling period.

Description

SURGICAL STAPLER APPARATUS

FIELD OF THE INVENTION

The invention relates to medical equipment, in particular to surgical apparatuses for hollow organ anastomosis with common control rod (hereinafter "the CCR") intended both for stapling gap setting and for staples clamping. Although all descriptions are given with regard for stapler, the invention is extended to cover alternative types of surgical apparatuses for hollow organ anastomosis, for instance, with fastener appliance apparatus wherein said CCR is available.

BACKGROUND OF THE INVENTION

Surgical apparatuses for hollow organ anastomosis are known from the USA patent No. 5344059, wherein there is a rod for stapling gap setting with its actuator, and for staples clamping there is a transmitting bushing with other actuator. Said rod comprises connector, parting-coupling block of anvil and rod. Connector looks like male-female connection, where there are two springy protrusions entering circular recess of male member. When axial force is transmitted by connector, it disengages said springy protrusions, thus increasing connector transversal size and separating it. To prevent connector from separation during transmission of said axial force, there are securing means in the form of fixing orifice in apparatus housing which does not let springy protrusions to disclamp. Owing to said connector, the anvil is disengaged from surgical apparatus for separate introduction of anvil and staple cartridge into stapled hollow organ sections, which gives a lot of advantages during surgery. Then the anvil-rod block is connected by said connector, and by means of actuator of rod move the rod proximally, setting stapling gap between anvil and staple head. Upon this rod movement no large efforts are transmitted through it. Thus, no considerable efforts disclamping said springy protrusions and causing friction between them and fixing orifice emerge herein. After stapling gap setting another actuator through transmitting bushing transmits staple bending effort. In this, during staple bending, rod and connector are exposed to large axial loads but are immovable relative to housing and fixing orifice.

Therefore, there is no problem of overcoming friction forces between connector and fixing orifice.

Surgical apparatuses for hollow organ anastomosis are also known from the USA patents No. 4754909 and 4776506, wherein there is a CRR, designed both for stapling gap setting and for staples clamping. During staples clamping CRR transmits large axial efforts and in this process moves relative to the housing. This type of surgical apparatus has a number of potential advantages, in particular, facilitates application of apparatus flexible housing, allows to simplify the design and to reduce labor consumption in anastomosis. Among its demerits are lack of connector enabling to separate anvil block from apparatus for individual introduction into sutured hollow organ sections. Application of the above described connector with variable transversal size is hindered due to the fact that in these apparatuses connector is movable during staples clamping, and large friction forces arise between it and fixing orifice that hinder connector and CCR progress and even their jamming in friction zone due to scuffing. As a result, apparatus control dramatically degrades, and apparatus operation reliability decreases.

SUMMARY OF THE INVENTION

The invention objective is upgrading of hollow organ anastomosis and its execution conveniency by surgical stapler with CCR through introduction of connector-disconnector that makes the anvil removable.

Another invention objective is facilitation of control of surgical stapler with CCR and connector-disconnector.

Another invention objective is ensurance of design simplicity and low cost for surgical stapler with CCR and connector-disconnector .

Another invention objective is ensurance of high operation reliability for surgical stapler with CCR and connector- disconnector.

The aims set are achieved by surgical stapler apparatus comprising means for hollow organ circular anastomosis comprising:

- casing;

- cartridge with staples;

- common control rod (CCR) moving relative to casing both upon stapling gap setting and upon staples clamping;

- anvil assembly, comprising CCR, anvil and anvil rod whereon anvil is placed on its distal end;

- connector-disconnector (CD) of anvil rod and CCR; The alternative embodiment, wherein there are forces acting in CD directed to enhancement of at least one transversal dimension of CD during stapling period, and securing means counteracting with the forces and preventing CD from disconnection within at least stapling period so that stapling period starts from clamping commencement in sutured tissues in the apparatus and finishes by termination of staples clamping.

The alternative embodiment, wherein there are promotion means intended for ensurance of anvil assembly mobility relative to the casing during the stapling period.

Thanks to introduction of connector-disconnector, CCR and anvil rod, potential disconnection of anvil rod and anvil of surgical apparatus is provided for subsequent separate anvil and staple cartridge into sutured hollow organ parts. Such combination of apparatus with CCR and connector-disconnector results in decrease of hollow organ injury, of labor consumption in purse string suturing, suture upgrading, adjacency of sutured hollow organ parts also improves. In this process, introduction of promotion means ensures anvil block mobility, permits to facilitate apparatus control and to provide its high operation reliability.

In alternative embodiment the securing means are made means immovable relative to casing, whereas the promotion means reduce friction between CD and securing means and prevent their jamming.

In alternative embodiment securing means are made as surface of casing parts.

In alternative embodiment securing means are made as separate piece, for instance, bushing set into the casing.

In alternative embodiment friction reduction is achieved by antifriction properties of rubbing surfaces of CD and securing means .

In alternative embodiment the bushing is made of an agent constituting antifriction couple with CD material.

Said promotion means ensure anvil assembly mobility, do not demand significant housing changes, or introduction of new sophisticated parts, which permits to achieve our goal with basic design simplicity and low cost.

In alternative embodiment according to claims 9, 10 maximal apparatus operation reliability and its control conveniency is ensured, since friction and potential jamming between connector and securing means are totally eliminated.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Fig. 1 shows a portion of surgical stapler apparatus comprising casing 1, cartridge 2 with staples 3, common control rod (CCR) 4, anvil rod 5 and anvil 6 so that pieces 4,

5, and 6 comprise anvil assembly 7. CCR 4 and anvil rod 5 are interconnected by means of connector-disconnector 8, comprising rod 9 on proximal end of anvil rod 5 with circular recess 10 and collet 11 on distal end of CCR 4 with circle-spaced protrusions 12.

In an alternative embodiment (not shown) said rod is located on distal end of CCR 4, whereas said collet on proximal end of anvil rod.

Connector-disconnector is a male-female type coupling, where rod 9 is male member, and collet 11 is female member.

Typical for collet 11 is increase of its transversal size upon rod 9 insertion and its removal. Although further description of connector-disconnector design and operation is given with application of collet 11, it can basically serve only as a particular example of a female member with varying transversal dimension. This description is equally applicable to alternative types of female member with varying transversal dimension, for example, to female member with two spring engagements which are pushed apart transversally upon male member insertion and removal.

Securing means looking like surfaces 13 of an orifice in casing 1 are available which prevent connector-disconnector 8 from disconnection during stapling. In an alternative embodiment shown in Fig. 1 antifriction properties of rubbing surfaces are promotion means decreasing friction between surface 13 and connector-disconnector (CD) 8. For instance, the casing is made of polycarbonate, a relatively hard material, whereas collet 11 is made of softer nylon. Harder material which fixes surfaces 13 and thus prevents incision of collet 11 components under the effect of forces tending to increase collet transversal dimension during stapling.

In an alternative embodiment, a friction surface has an antifriction coating, specificlly, collet 11 outer surface is Teflon covered.

In an alternative embodiment a lubricant is introduced between surface 13 and collet 11 which diminishes friction between them.

In an alternative embodiment (not shown) a bushing is stably mounted in casing 1 contact zone with collet 11, which has larger hardness than collet 11 and constitutes antifriction couple with collet 11 material. In an alternative embodiment collet 11 is made of plastic, whereas said bushing, of metal .

The apparatus is supplied by the means ensuring correct anvil 6 and cartridge 2 orientation, which comprise spline protrusions 14 on anvil rod 5 and spline recesses (slots) in casing 1.

The apparatus operates as follows. Before the surgery is started, anvil assembly is moved distally by the apparatus actuator (not shown). In this, collet 11 leaves fixing orifice formed by surface 13. It allows the surgeon to relatively easy disengage anvil 6 and anvil rod 5 from CCR 4, since resilient members of collet 11 are pushed apart transversally and release rod 9. After that the surgeon introduces anvil 6 and cartridge 2 into sutured hollow organ parts in separate, performs purse string sutures on them and connects anvil rod 5 to CCR 4. In this connection collet 11 resilient members are pushed apart transversally, rod 9 enters collet 11, and protrusions 12 enter circular recess 10. Then the surgeon brings anvil 6 and cartridge 2 closer using actuator (not shown), by proximal displacement of anvil assembly 7. During this approach spline protrusions 14 enter spline recesses 16 providing required mutual orientation of anvil 6 and cartridge 2. At the moment when hollow organ tissue starts being clamped between anvil 6 and cartridge 2, collet 11 enters the orifice formed by surface 13. Upon further proximal displacement of anvil assembly 7, in particular, upon staples 3 clamping, large axial efforts are transmitted by moving connector- disconnector 8 and they strive to push collar 11 members apart transversally. As the result, collet 11 presses surface 13 impeding alteration of collet 11 transversal dimension. However, no major friction forces impeding anvil assembly 7 proximal displacement emerge between collet 11 and surface 13, since above indicated promotion means (antifriction properties of rubbing surfaces, lubrication) reduce friction factor. Besides, the incision of collet 11 members into surface 13 is also excluded thanks to larger surface 13 hardness. Another means directed against said incision and jamming of rubbing surfaces is enhancement of rubbing surface contact areas, which reduces specific pressures between rubbing surfaces. It results into unhindered termination of stapling with total staples 3 clamping and anvil assembly 7 arrival into extreme proximal position.

Fig.2 shows alternative apparatus embodiment wherein promotion means are made as bushing 16 movable relative to casing 1 and serving as securing means preventing CD 8 from disengagement during stapling. In this process, spline protrusions 14 on anvil rod 5 and distal edge surface 17 of movable bushing 16 act as rest members ensuring engagement of anvil assembly 7 and movable bushing 16. Spring 18 is mounted between movable bushing 16 and casing 1. At the moment when tissue 19 of sutured organ starts to be clamped between anvil 6 and cartridge 2, spline protrusions 14 abutt surface 17 and, further on, movable bushing 16 moves proximally together with anvil assembly 7, overcoming spring 18 resistance. In this, movable bushing 16 blocks CD 8 from disengagement, but there is no whatever friction between collet 11 and movable bushing 16, since they do not move relative to each other. In an alternative embodiment (not shown) engagement between movable bushing 16 and CD 8 at the moment of tissue 19 clamping start proceeds at the expense of friction forces between collet 11 and movable bushing 16.

Therefore, CD 8 application in the apparatus permits to provide operation conveniency buildup, decrease in labor consumption, and increase in anastomosis quality caused by potential anvil disengagement, whereas said promotion means ensure reliable CD 8 operation in the apparatus.

The invention in its broader aspects is not limited to the specific details of the preferred embodiments shown and described and those skilled in the art will recognize that the invention can be practiced with modification within the spirit and scope of the appended claims.

Claims

CLAIMS :

1. Surgical stapler apparatus comprising means for hollow organ circular anastomosis comprising:

- casing;

- cartridge with staples;

- common control rod (CCR) moving relative to said casing both upon stapling gap setting and upon staples clamping;

- anvil assembly, comprising said CCR, anvil and anvil rod whereon said anvil is placed on its distal end;

- connector-disconnector (CD) of said anvil rod and CCR.

2. The apparatus according to claim 1 , wherein there are forces acting in said CD directed to enhancement of at least one transversal dimension of said CD during stapling period, and securing means counteracting with said forces and preventing said CD from disconnection within at least said stapling period so that said stapling period starts from clamping commencement in sutured tissues in said apparatus and finishes by termination of staples clamping.

3. The apparatus according to claim 2, wherein there are promotion means intended for ensurance of said anvil assembly mobility relative to said casing during said stapling period.

4. The apparatus according to claim 3, wherein said securing means are made immovable relative to said casing, whereas said promotion means reduce friction between said CD and securing means and prevent their jamming.

5. The apparatus according to claim 4, wherein said securing means are made as surface of said casing parts.

6. The apparatus according to claim 4, wherein said securing means are made as separate piece, for instance, bushing set into said casing.

7. The apparatus according to claim 4, wherein said friction reduction is achieved by antifriction properties of rubbing surfaces of said CD and securing means.

8. The apparatus according to claim 6, 7, wherein said bushing is made of an agent constituting antifriction couple with CD material.

9. The apparatus according to claim 7, wherein said antifriction properties are ensured by antifriction coating on at least one rubbing surface.

10. The apparatus according to claim 4, wherein the surface on said securing means possesses larger of two interacting, securing means and CD, surfaces hardness, thus preventing their jamming.

11. The apparatus according to claim 4, wherein the lubricant introduced between said securing means and CD serves as promotion means.

12. The apparatus according to claim 3, wherein said promotion means are made as bushing movable relative to said casing and serving as securing means, and there are means for engagement of said movable bushing and said CD.

13. The apparatus according to claim 12, wherein friction forces between said movable bushing and CD serve as said engagement means .

14. The apparatus according to claim 12, wherein rest members located on the members of said anvil assembly and movable bushing serve as said engagement means.

15. In combination with surgical stapler apparatus comprising means for hollow organ circular anastomosis comprising:

- casing;

- cartridge with staples;

- connector-disconnector (CD) of said anvil rod and CCR.

16. Connector-disconnector located in the rod of surgical stapler apparatus comprising means for circular anastomosis, comprising:

- casing;

- cartridge with staples;

- anvil;

- said rod moves relative to said casing both upon stapling gap setting and upon staples clamping so that said rod features common control rod and anvil rod whereon said anvil is placed on its distal end;

- said common control rod and anvil rod are coupled between them by said connector-disconnector.

17. The apparatus according to claim 16, wherein there are forces acting in said CD directed to enhancement of at least one transversal dimension of said CD during stapling period, and securing means counteracting with said forces and preventing said CD from disconnection within at least said stapling period so that said stapling period starts from clamping commencement in sutured tissues in said apparatus and finishes by termination of staples clamping.

18. The apparatus according to claim 17, wherein there are promotion means intended for ensurance of said anvil assembly mobility relative to said casing during said stapling period.

19. Surgical stapler apparatus according to any of claim 1-18.