WO2001062161A1

WO2001062161A1 - A tissue stapling attachment for use with an electromechanical driver device

Info

Publication number: WO2001062161A1
Application number: PCT/US2001/005728
Authority: WO
Inventors: Michael P. Whitman
Original assignee: Power Medical Interventions, Inc.
Priority date: 2000-02-22
Filing date: 2001-02-21
Publication date: 2001-08-30
Also published as: EP1257206A1; ES2267726T3; DE60121138D1; ATE331472T1; AU2001238643A1; PT1257206E; JP4277470B2; DE60121138T2; US6533157B1; EP1257206B1; JP2003523253A

Abstract

A stapler attachment (100) for use with an electromechanical device driver (50) comprises a staple holding member (118) which is spring mounted to a staple closing member (124), which is, in turn, mounted to a threaded driver element (116) concentrically mounted about a threaded shaft (112) such that staple closing member (124) and the staple holding member (118) can be advanced and retracted along a track within a housing (102). A staple (130) is advanced by the rotation of the threaded shaft (112) until the staple holding member (118) is stopped against an opening lip (110) formed in an opening (108) at the distal staple discharging end (104) of the housing (102). At this position, the prongs of the staple (130) have been advanced out of the distal staple discharging end (104) and into the tissue to be joined. The staple closing member (124) continues to advance as the spring (126) between the staple holding member (118) and the staple closing member (124) compresses. This advancement permits the staple closing member (124) to deform the staple (130) into a closed D-shape conformation. The staple (130) is released from the attachment (100) through the distal staple discharging end (104) of the housing (102) upon further advancement of the staple closing member (124). Reverse rotation of the threaded shaft (112) retracts the staple closing member (124) and staple holding member (118) into a staple receiving position where a spring-loaded staple dispenser (148) pushes one of a plurality of staples (146) in a staple cartridge (144) into a staple carrying groove (140) of a staple carrying element of the staple holding member (118), in preparation for a subsequent procedure.

Description

A TISSUE STAPLING ATTACHMENT FOR USE WITH AN ELECTROMECHANICAL DRIVER DEVICE

Background of the Invention Field of the Invention

The present invention relates generally to attachments for electromechanical dπver devices, and more specifically to an attachment for an electromechanical dπver device which may be used to staple tissue. Description of the Pπor Art Upon identification of a region of herniated musculature in the abdominal wall, surgical intervention is almost always required. The procedure is straightforward in concept, but includes a number of technically sophisticated features, especially insofar as it is usually earned out remotely, i.e., through small portals formed in the patient's lower trunk. More particularly, the technique most often utilized involves forming two or three small puncture holes in the lower abdomen of the patient, inserting a corresponding cy ndπcal tube through each of the holes, passing elongate instruments through the tubes, retracting the soft tissues away from the site of the hernia, and stapling the torn tissue closed. This final closure step often further includes the use of a synthetic mesh, which is placed over the hole for the purpose of supporting the soft tissues and organs disposed above the healing hole. The mesh is stapled directly to the musculature, in the vicinity of the defect. The present mvention is directed to the instrumentation which is the stapling component.

Traditional stapling mechanisms function in a simple manner. The staple is initially disposed in a U-shape. The staple driver component contacts the bottom portion of the staple and advances the two upwardly extending prongs of the staple through the items which are to be joined, and toward a stationary anvil portion. Often the items to be coupled require the anvil portion to be disposed behind them to provide adequate support so that the staple prongs may push through. Once the prongs of the staple have advanced through the items to be joined, the prongs contact the anvil. The anvil often compπses staple bending guide grooves formed therein for guiding the plastic deformation of the staples as they advance under the motivation of the staple dπver. This plastic deformation bends (or folds) the staples toward one another in order to form the traditional box-shape from the original U-shape. The box-shaped staple is then pulled away from the stapling mechanism by virtue of its being coupled to the items it has joined.

Stapler devices utilized in laparoscopic and endoscopic surgery are significantly different than traditional stapling mechanisms in design and function. Unhke the traditional stapling mechanisms, a spatially distinct and opposing anvil portion is not practical and is therefore not used. Instead, the surgical stapler devices compπse an integrated staple dπver and anvil component which holds and advances the staple into and through the tissue to be joined. More particularly, as shown in Figure 1, the internal surgical tissue stapler devices of the pπor art compπse an elongate tube 10 which is designed to shp through the portal tube of the minimally invasive entry hole. The tip 12 of the tube 10 includes a plurality of individual staples which are sequentially engaged by the staple dπver. Each staple is initially disposed in a U-shape. The U-shape can be more specifically described by identifying the different regions thereof. The flat bottom portion of the staple has a central portion, and lateral portions. Upwardly extending prongs, which are disposed at the extreme lateral ends of the flat bottom portion, are each approximately equivalent in length, and are approximately equal to one third of the length of the flat bottom portion. The staple driver initially pushes the staple forward by pressing against the bottom portion of the staple at the central portion thereof The staple is advanced forward until the prongs have extended beyond the tip of the housing, and have penetrated the tissue to be joined. Further advancement of the staple is prevented by an anvil portion which is fixed in the tip of the mechanism. The anvil, un ke the anvil of traditional stapling mechanisms, only contacts the central portion of the bottom portion of the staple, opposite the staple driver. Stated equivalently, once the staple has been advanced fully within the tip of the device, the anvil in the tip prevents the staple from moving forward as it becomes constrained between the staple dπver on the back side and the anvil on the front.

At this time, a second mechanism is engaged in order to close the staple. This closing mechanism compπses a pair of straight tines which advance forward from within the tip, and contact the staple at the lateral portions of the bottom flat portion. The continued advancement of the prong bending tmes causes the staple to deform as the prongs of the staple are forcibly turned toward one another. However, the actual site of the bending is not along the prongs. It is at the junction of the lateral and central portions of the flat bottom portion. This causes the fully deformed staple in this surgical stapler device to attain a D-shape as opposed to the B-shape which fully deformed staples of traditional stapling mechanisms attain. Release of the staple, once it has been coupled to the joined tissue, is achieved by first retracting the tines which bent the staple, and then twisting the shaft of the device to pull the staple off the anvil.

An additional feature of the surgical stapler devices of the pnor art which should be appreciated in hght of the present invention is the means by which all of the advancing elements, i.e., the staple dπver and the prong bending tines, are motivated. In the minimally invasive surgical stapler devices of the pπor art, the elongate tubular portion terminates in a handle which includes a tπgger The tπgger has a dual function in that the compression of the tngger initially advances the staple driver without moving the prong bending tines. Once the staple has been fully advanced and is ready for bendmg, the tines are advanced through the tip to contact the staple, by continued compression of the gπp-styled tπgger. It shall be easily recognizable that the requirement of manual triggering, as well as the two-step mechanism for advancing and then forming the staple, are both fraught with potential failures. In addition, the need to twist the shaft of the device to pull the staple off the anvil once the staple has joined the tissue presents a significant πsk of tearing tissue as this action stresses both the staple and the tissue. In addition, another drawback is that the mechanism for discharging the staples is a trigger coupled to a πgid elongate shaft which translates forward and backward in correspondence with the compression and release of the trigger. The rigidity of the shaft requires the surgeon to manipulate the entire device in order to align the stapler properly. Inasmuch as hernias of the abdominal cavity often occur on the floor of the abdomen, this manipulation is often quite difficult.

Finally, with regard to the use of the surgical stapler devices of the prior art, the devices are constructed to be completely disposable. The inability to re-use the devices increases the cost of using the devices. More specifically, this feature does not diminish the overall cost of manufacturing because of the obvious medical use requirements, but does increase the cost per procedure as a new device must be used for each surgery. In fact, if more staples are required for the surgery than are provided for in the device, an entirely new device must be used because there is no possibility of simply replacing the empty staple cartridge.

It is therefore a principal object of the present invention to provide a surgical stapler device which may be easily manipulated into the proper position without having to grossly deform the soft tissues through which the elongate shaft of the device passes.

It is also an object of the present invention to provide a surgical stapler device which has a single-step staple discharging mechanism.

It is a related object of the present invention to provide a surgical stapler device which does not stress surrounding tissue when the staple is released from the tip of the device.

It is an additional object of the present mvention to provide a surgical stapler device which does not require the disposal of the tip and the staple dπver, thereby minimizing the medical waste and cost associated with the use of the device as compared with surgical stapler devices of the pπor art Other objects of the present invention shall be recognized m accordance with the description thereof provided hereinbelow, and in the Detailed Descπption of the Preferred Embodiment in conjunction with the remaining Figures.

Summary of the Invention The preceding objects of the invention are provided by a stapling attachment of the present invention which is coupleable to and remotely actuateable by an electromechanical dπver device. In particular, the attachment couples at a proximal coupling end to a distal end of a flexible dπve shaft of the electromechanical dnver device, thereby coupling a threaded shaft of the attachment to a flexible draft shaft of the flexible shaft of the electromechanical dπver device. As finger triggers actuated on the electromechanical driver device cause the flexible draft shaft to rotate, the threaded shaft rotates and advances in the housmg of the attachment a threaded dπver element of the attachment which tracks m the housing. Advancement of the threaded dπver element advances a staple closing member mounted to the threaded driver element as well as a staple holding member coupled by a spring to the staple closing member. In this manner, a staple earned in a staple carrying groove of a staple carrymg element of the staple holding member is advanced toward an opening of a distal staple discharging end of the attachment and mto the tissue to be joined. After the staple has penetrated the tissue and the staple holding member contacts an opening hp formed in the opening of the distal staple discharging end, the spring compresses as the staple closmg member continues to advance the staple toward the openmg. Continued advancement of the staple closmg mechanism pushes the staple agamst a groove hp of the staple carrymg groove and protrusion tmes of the staple closing member engage lateral portions of the flat bottom portion of the staple to close the prongs of the staple to form a D-shape and thereby join the tissue. Further advancement of the staple closmg mechanism causes a sloping surface of the staple closmg member to engage the flat bottom portion of the staple to force the staple out of the staple carrymg groove to completely discharge and release the staple from the attachment. As fmger tπggers actuated on the electromechanical dπver device cause the flexible draft shaft to reverse rotate, the threaded shaft reverse rotates and retracts the threaded dnver element, causmg the staple caπying element and the staple holdmg member to retract within the housmg until the staple carrymg element is returned to a staple receiving position adjacent a staple cartridge m the housing which contains a plurality of staples. When the staple canying element is returned to this position, a staple from the plurality of staples is pushed from the staple cartridge mto the staple carrymg groove by a spring-loaded staple dispenser in functional communication with the staple cartridge, m preparation for a second stapling procedure.

More specifically, referring now to Figure 2 with respect to the electromechanical driver device, an example embodiment of an electromechanical driver device 50 has a handle 52 and a flexible shaft 54. The handle 52 has a pistol gπp-styled design, havmg a pair of finger triggers 58a,58b which are mdependently coupled to separate motors 60,62 coupled to and powered by a power source 64 and which each turn separate flexible dπve shafts 78a,78b (descπbed more fully herembelow). The motors 60,62 are each dual-direction motors, and are also coupled to a manual drive switch 66 mounted to the top of the handle 50, by which the user can selectively alter the turning direction of each motor 60,62. In this example, the power source 64 is a rechargeable battery pack providmg a direct current.

The handle 50 further mcludes (1) a remote status mdicator 68; (2) a flexible shaft steering means 70 and (3) an optional additional electπcal supply (not shown). The remote status mdicator 68 compnses an LCD or similar read-out device by which the user ga s knowledge of the position of components (for example, whether the distal staple discharging end of the housmg of the stapler attachment is m the proper position prior to the driving of the staples). Second, the handle 50 also mcludes a manually actuateable steering means 70, for example, a joystick or track ball, for directing the movement of the flexible shaft 72 (described more fully herernbelow) Finally, the handle 50 may mclude an additional electrical power supply (not shown) and an on/ off switch (not shown) for selectively supplymg electrical power to attachments. More particularly, with respect to the flexible shaft 72, the flexible shaft compπses a tubular sheath 74, preferably formed of a simple elastomeric material which is tissue compatible and which is ster izable (i.e., is sufficiently rugged to withstand an autoclave) Various lengths of the flexible shaft 72 may be provided m conjunction with the present mvention In such a case, the flexible shaft 72 and the handle 50 should be separable and such that the interface between the proximal end of the flexible shaft 72 and the distal end of the handle 50 mcludes a couplmg means for the drive components. Specifically regarding the dπve components of the flexible shaft 72, withm the elastomeric sheath are a pair of smaller fixed tubes 76a,76b which each contain a flexible dπve shaft 78a,78b which is capable of rotating withm the correspondmg fixed tube 76a,76b. Each flexible dnve shaft 78a,78b itself is capable of translating a torque from the correspondmg drive motor 60,62 m the handle 50 to the distal end 80 of the flexible shaft 72, while still bemg flexible enough to be bent, angled, curved, etc. as the surgeon deems necessary to "snake" the flexible shaft 72 through the bowel of the patient For example, the flexible drive shafts 78a,78b may compπse a woven steel fiber cable. It shall be recognized that other flexible dπve shafts may be suitable for this purpose. In order for the distal end 80 of the flexible shaft 72 to couple with an attachment, such as the stapling attachment of the present mvention (as described more fully herernbelow), the distal tips 82a,82b of the flexible dπve shafts 78a,78b have a conformation which permits the continued translation of torque. For example, the distal tips 82a,82b of the flexible drive shafts 78a,78b are hexagonal, thereby fitting mto a socket, or hexagonal recess, of the proximal coupling end of the housmg of the stapler attachment. As suggested above, m conjunction with the manually actuatable steering means 70 mounted to the handle 50, the flexible shaft 72 further mcludes at least two steering wires 84 which are flexible, but are coupled to the inner surface of the flexible shaft 72 near the distal end 80 thereof. The steering wires 84may be axially translated relative to one another by actuation of the manually actuatable steering means 70, which action causes the flexible shaft 72 to bend and curve accordmgly. Also, as suggested above, m conjunction with the remote status mdicator 68 of the handle 50, the flexible shaft 72 further contains an electπcal lead 86 for coupling to the attachments. This electπcal lead 86 channels a signal from the attachment to the handle 50 for indicating the status of the attachment (for example, mdicatmg whether the tissue to be jomed is adjacent to the distal staple dischargmg end of the stapling attachment, or mdicatmg the number of staples left the staple cartπdge). Similarly, additional electncal leads may be provided to supply power to separate aspects of the attachment if so required.

More particularly, with respect to the stapling attachment of the present mvention, the attachment comprises a housmg havmg a distal staple discharging end and a proximal coupling end which has a socket for couplmg the attachment to the distal end of the flexible shaft. The distal staple dischargmg end has an openmg through which the staples are sequentially discharged, and an openmg hp formed m the openmg. The attachment further compπses a threaded shaft which engages the flexible draft shaft of the flexible shaft of the electromechanical driver device when the proximal coupling end is coupled to the distal end of the flexible shaft, such that the threaded shaft rotates m correspondence with the rotation of the flexible draft shaft of the flexible shaft The threaded shaft has, mounted thereabout, a threaded dπver element which is similar m structure to a nut, but which is tracked withm the housmg so that rotation of the threaded shaft causes the threaded dπver element to advance or retract along the threaded shaft withm the housmg of the attachment. The attachment further comprises a staple holdmg member, a staple carrymg element integral with said staple holdmg member, and an anvil portion integral with the staple carrymg element. The attachment further compπses a staple closmg member concentrically mounted about the staple holdmg member. The staple holdmg member and the staple closmg member are coupled together by a spring and mounted to the threaded dπver element such that advancement of the threaded driver element advances the staple holdmg member and the staple closmg member The staple closmg member compnses a pair of protrusions, or protruding tmes which are positioned to engage the staple at the lateral portions of the flat bottom portion of the staple. The staple closmg member further compπses a sloped surface which is adapted to engage the central portion of the flat bottom portion of the staple. The staple carrymg element comprises an angled staple carrymg groove havmg the anvil portion, or groove hp. The attachment further comprises a replaceable staple cartπdge mounted to the housmg of the attachment. The staple cartridge contains a plurality of staples. The staple cartridge is m functional communication with a spring-loaded staple dispenser.

When the proximal couplmg end of the housmg of the stapling attachment is coupled to the distal end of the flexible shaft of the electromechanical dπver device, the threaded shaft of the staphng attachment engages the flexible draft shaft of the flexible shaft. Remote actuation of the flexible draft shaft usmg a first fmger tπgger of the electromechanical driver device causes the flexible draft shaft to rotate, which m turn causes the threaded shaft to rotate, which causes the threaded dnver element to advance withm the housmg of the attachment. Alternate remote actuation of the flexible draft shaft usmg a second fmger trigger causes the flexible draft shaft to reverse rotate, which m turn causes the threaded shaft to reverse rotate, which causes the threaded driver element to retract withm the housmg of the attachment. Thus, as stated above, the staple holdmg member and the staple carrymg element advance and retract with the threaded dnver element. When the staple carrymg element is retracted mto a staple receiving position, adjacent to the staple cartridge, a staple is pushed by the spring- loaded staple dispenser from the staple cartridge mto the staple caπying groove of the staple canymg element. As the staple holding member and the staple closmg member advance withm the housmg, the staple is carried withm the staple carrymg groove. The angle of the staple carrymg groove ensures that the staple remains m the staple carrymg groove during this advancement. The staple is earned to the distal staple discharging end of the housmg and the prongs of the staple are inserted mto the tissue to be jomed After the prongs have penetrated the tissue, the openmg p of the distal staple dischargmg end stops the staple holding member. Upon contmued advancement of the threaded dπver element, the sprmg which couples the staple closmg member and the staple holdmg member compresses, causmg the staple closmg member to further advance. As the staple closmg member further advances, the protruding tmes engage the staple at the lateral portions of the flat bottom portion of the staple, press the staple against the groove hp of the staple carrymg groove, and bend the lateral portions of the flat bottom portion of the staple to close the prongs of the staple to form a D-shape and thereby jom the tissue. Upon continued advancement of the threaded dnver element, the staple closmg member further advances, and the sloped surface of the staple closmg member engages the central portion of the flat bottom portion of the staple to force the staple out of the staple carrymg groove to completely discharge and release the staple from the attachment. Thereafter, the threaded dnver element is retracted, causmg the staple canymg element and the staple holdmg member to retract withm the housmg. When the staple carrymg element is returned to a staple receivmg position, adjacent to the staple cartndge, a second staple is pushed by the spring-loaded staple dispenser from the staple cartπdge mto the staple carrymg groove of the staple carrymg element m preparation for a second staphng procedure.

Brief Description of the Drawings Figure 1 is a perspective view of a surgical stapler device of the prior art;

Figure 2 is a perspective view of an electromechanical driver device for use with the present mvention;

Figure 3 is a side cross-sectional view of a stapling attachment of the present mvention, m which the staple holdmg member and the staple carrymg element are m a staple-loading position; and

Figure 4 is a side cross-sectional view of a stapling attachment of the present mvention (turned 90 degrees with respect to Figure 3), m which the staple holdmg member and the staple carrymg element are m a staple-discharging disposition

Detailed Description of the Preferred Embodiments

As set forth above, the present mvention comprises a tissue stap ng attachment for use with an electromechanical driver device. More particularly, and referring now to Figures 3 and 4, a prefened embodiment of the attachment 100 compnses a housmg 102 havmg a distal staple discharging end 104 and a proximal coupling end 106 which has a socket 114 for couphng the attachment 100 to the distal end (best shown as item 80 of

Figure 2) of the flexible shaft (best shown as item 72 of Figure 2) of the electromechanical driver device (best shown m Figure 2). (Generally see co-pendmg U.S. Patent Application U.S. Seπal Number 09/324,452, entitled "An Electromechanical Dπver Device For Use With Anastomosing, Stap ng, and Resecting Instruments".) The distal staple dischargmg end 104 has an openmg 108 through which the staples are sequentially discharged, and an openmg lip 110 formed in the openmg 108. The attachment 100 further compnses a threaded shaft 112 which engages the flexible draft shaft (best shown as item 78a or item 78b of Figure 2) of the flexible shaft when the proximal coupling end 106 is coupled to the distal end of the flexible shaft, such that the threaded shaft 112 rotates m conespondence with the rotation of the flexible draft shaft of the flexible shaft. The threaded shaft 112 has, mounted thereabout, a threaded driver element 116 which is similar m structure to a nut, but which is tracked withm the housmg 102 so that rotation of the threaded shaft 112 causes the threaded driver element 116 to advance or retract along the threaded shaft 112 withm the housmg 102 of the attachment 100

The attachment 100 further compnses a staple holdmg member 118, a staple carrymg element 120 mtegral with said staple holdmg member 118, and an anvil portion 122 mtegral with the staple carrymg element 120 The attachment 100 further comprises a staple closmg member 124 concentrically mounted about the staple holdmg member 118. The staple holdmg member 118 and the staple closmg member 124 are coupled together by a spring 126 and mounted to the threaded dπver element 116 such that advancement of the threaded driver element 116 advances the staple holdmg member 118 and the staple closmg member 124. The staple closmg member 124 compnses a pair of protrusions, or protruding tmes 128 which are positioned to engage the staple 130 at the lateral portions 132 (best shown on Figure 4) of the flat bottom portion 134 (best shown on Figure 4) of the staple 130. The staple closmg member 124 further comprises a sloped surface 136 which is adapted to engage the central portion 138 (best shown on Figure 4) of the flat bottom portion 134 of the staple 130 The staple carrymg element 120 comprises an angled staple canymg groove 140 havmg the anvil portion, or groove h_P 142.

The attachment 100 further comprises a replaceable staple cartridge 144 mounted to the housmg 102 of the attachment 100. The staple cartridge 144 contams a plurahty of staples 146. The staple cartridge 144 is m functional communication with a spring- loaded staple dispenser 148. In operation, when the proximal coupling end 106 of the housing 102 of the staphng attachment 100 is coupled to the distal end of the flexible shaft of the electromechanical dπver device (best shown in Figure 2), the threaded shaft 112 of the staphng attachment 100 engages the flexible draft shaft (best shown as item 78a or item 78b on Figure 2) of the flexible shaft (best shown as item 72 on Figure 2). Remote actuation of the flexible draft shaft usmg a fmger trigger (best shown as item 58a or item 58b on Figure 2) of the electromechanical dnver device causes the flexible draft shaft to rotate, which m turn causes the threaded shaft 112 to rotate, which causes the threaded dπver element 116 to advance withm the housmg 102 of the attachment 100. Remote switching of the manual dnve switch (best shown as item 66 on Figure 2) of the electromechanical driver device and subsequent remote actuation of the fmger trigger of the electromechanical driver device causes the flexible draft shaft to reverse rotate, which m turn causes the threaded shaft 112 to reverse rotate, which causes the threaded dnver element 116 to retract withm the housmg 102 of the attachment 100. Thus, as stated above, the staple holdmg member 118 and the staple carrymg element 120 advance and retract with the threaded dπver element 116. When the staple carrymg element 120 is retracted mto a staple receiving position, adjacent to the staple cartridge 144, a staple from the plurality of staples 146 is pushed by the spπng-loaded staple dispenser 148 from the staple cartridge 144 mto the staple canymg groove 140 of the staple carrymg element 120. As the staple holdmg member 118 and the staple closmg member 124 advance withm the housmg 102, the staple 130 is earned withm the staple carrymg groove 140. The angle of the staple carrymg groove 140 ensures that the staple 130 remains m the staple carrymg groove 140 during this advancement. The staple 130 is earned to the distal staple dischargmg end 104 of the housmg 102 and the prongs 150 (best shown on Figure 4) of the staple 130 are mserted mto the tissue to be jomed After the prongs 150 have penetrated the tissue, the openmg hp 110 of the distal staple dischargmg end 104 stops the staple holdmg member 118. Upon contmued advancement of the threaded dnver element 116, the sprmg 126 which couples the staple closmg member 124 and the staple holdmg member 118 compresses, causmg the staple closmg member 124 to further advance. As the staple closmg member 124 further advances, the protruding tmes 128 engage the staple 130 at the lateral portions 132 (best shown on Figure 4) of the flat bottom portion 134 (best shown on Figure 4) of the staple 130, press the staple 130 against the groove hp 142 of the staple carrying groove 140, and bend the lateral portions 132 of the flat bottom portion 134 of the staple 130 to close the prongs 150 of the staple 130 to form a D-shape and thereby jom the tissue. Upon contmued advancement of the threaded dnver element 116, the staple closmg member 124 further advances, and the sloped surface 136 of the staple closmg member 124 engages the central portion 138 of the flat bottom portion 134 of the staple 130 to force the staple 130 out of the staple carrymg groove 140 to completely discharge and release the staple 130 from the attachment 100. Thereafter, the threaded dnver element 116 is retracted, causmg the staple carrymg element 120 and the staple holdmg member 118 to retract withm the housmg 102 When the staple carrymg element 120 is returned to a staple receivmg position, adjacent to the staple cartridge 144, a second staple is pushed mto the staple carrymg groove 140 of the staple carrymg element 120 m preparation for a second stapling procedure.

Claims

What is claimed is:

1 A stapler attachment for jommg tissue, compnsing: a) a housmg havmg an openmg and an openmg hp formed m said opening; b) a threaded rotating shaft disposed m the housmg; c) a staple closmg member mounted to said threaded rotating shaft and translating within said housmg m corcespondence with the rotation of said threaded rotating shaft; d) a staple holdmg member carrymg a staple and coupled by a sprmg to said staple closmg member ; e) wherem rotation of said threaded rotating shaft advances said staple closmg member and said staple holdmg member toward said opening and advances said staple mto tissue to be jomed until further advancement of said staple holdmg member is prevented by contact between said staple holdmg member and said openmg hp; f) wherem contmued rotation of said threaded rotating shaft further advances said staple closmg member as said sprmg is compressed; and g) wherem the continued rotation of said threaded rotating shaft causes said staple closmg member to close said staple withm the tissue.

2. The stapler attachment of claim 1, wherem said staple is loaded mto said staple holdmg member when said staple holdmg member is m a staple receivmg position withm said housmg.

3 The stapler attachment of claim 1, wherem said staple is loaded mto said staple holdmg member through the use of a spπng-loaded mechanism

4. The stapler attachment of claim 2, wherem said staple, before bemg loaded mto said staple holdmg member, is held m a staple cartπdge and is loaded mto said staple holdmg member by bemg pushed from said staple cartndge mto said staple holdmg member when said staple holdmg member is m a staple receivmg position withm said housmg.

5 The stapler attachment of claim 4, wherem said staple is pushed from said staple cartridge mto said staple holdmg member by a sprmg-loaded staple dispenser when said staple holdmg member is m a staple receivmg position withm said housmg

6. The stapler attachment of claim 1, wherem said staple closmg member is mounted concentrically around said staple holdmg member.

7. The stapler of claim 1, wherem said staple holdmg member compnses a staple canymg groove withm which said staple is earned durmg advancement of said staple holdmg member, said staple carrymg groove havmg a groove hp agamst which a flat bottom portion of said staple is pressed by said staple closmg member after said staple holdmg member comes mto contact with said openmg hp.

8. The stapler attachment of claim 1, wherem said staple canymg groove is angled to ensure that said staple remains within said groove during the advancement of said staple holdmg member.

9. The stapler attachment of claim 7, wherem after said staple closmg member presses said flat bottom portion of said staple agamst said groove hp, the contmued advancement of said staple closmg member causes said staple closmg member to press against lateral portions of said flat bottom portion of said staple until said staple is closed withm the tissue.

10. The stapler attachment of claim 9, wherem said staple closmg member comprises protrusions which engage said lateral portions of said flat bottom portion of said staple.

11. The stapler attachment of claim 1, wherem after said staple has closed withm the tissue, the continued rotation of said threaded rotatmg shaft releases said staple from said staple holdmg member

12. The stapler attachment of claim 11, a) wherem said stapler holdmg member comprises a staple carrymg groove withm which said staple is earned during advancement of said staple holdmg member, and b) wherem after said staple has closed withm the tissue, the contmued rotation of said threaded rotatmg shaft causes said staple closmg member to push said staple out of said staple canymg groove.

13. The stapler attachment of claim 12, a) wherem said stapler closmg member compπses a sloped surface which engage a central portion of a flat bottom portion of said staple, and b) wherem after said staple has closed withm the tissue, the contmued rotation of said threaded rotatmg shaft causes said sloped surface to push said staple out of said staple carrymg groove.

14. The stapler attachment of claim 12, a) wherem said staple carrymg groove has a groove p agamst which a central portion of a flat bottom portion of said staple is pressed by said staple closmg member after said staple holdmg member comes mto contact with said openmg hp, b) wherem after said staple closmg member presses said central portion against said groove hp, the contmued rotation of said threaded rotatmg shaft causes protrusions of said staple closmg member to engage lateral portions of said flat bottom portion of said staple until said staple is closed withm the tissue, c) wherem said staple closing member comprises a sloped surface whereby said staple closmg member engages said central portion, and d) wherem after said staple has closed withm the tissue, the contmued rotation of said threaded rotating shaft causes said staple closmg member to push said staple out of said staple canymg groove by engaging said central portion.

15. The stapler attachment of claim 1, wherem said staple closmg member comprises at least two protrusions which engage said staple at lateral positions thereof and causes said staple to deflect.

16. The stapler attachment of claim 15, wherem said staple holdmg member compπses an anvil portion positioned between said staple and said openmg, said anvil portion serving as a support and guide for the deflection of said staple.

17. A stapler attachment for jommg tissue, comprising: a) a housmg havmg an openmg and an openmg hp formed in said openmg; b) a staple closmg member advancing and retracting longitudinally withm said housing; c) a staple holdmg member carrymg a staple and coupled by a sprmg to said staple closmg member ; d) wherem advancement of said staple closmg member toward said openmg advances said staple holdmg member toward said openmg and advances said staple mto tissue to be jomed until further advancement of said staple holdmg member is prevented by contact between said staple holdmg member and said openmg hp; e) wherem continued advancement of said staple closmg member compresses said spring and causes said staple closmg member to close said staple withm the tissue.

18. The stapler attachment of claim 17, wherem said staple closmg member compnses at least two protrusions which engage said staple at lateral positions thereof and causes said staple to deflect.

19. The stapler attachment of claim 18, wherem said staple holdmg member comprises an anvil portion positioned between said staple and said openmg, said anvil portion serving as a support and guide for the deflection of said staple.