Title of Invention

A SURGICAL STAPLING AND SEVERING INSTRUMENT

Abstract This invention relates to a surgical stapling and severing instrument, comprising a handle portion (20) operably configured to produce an articulation motion and a firing motion; a shaft (23) having a longitudinal axis attached to the handle portion (20) for transferring the articulation motion and the firing motion; an articulation mechanism (240) coupling the shaft to the end effector (12) and responsive to the articulation motion to rotate the end effector (12) from the longitudinal axis of the shaft; an end effector (12) distally attached to the articulation mechanism (240); a firing mechanism (14) responsive to the firing motion and coupled for movement through the articulation mechanism (240) and end effector (12) in response to the firing motion; a pair of support plates (430, 432) flanking the firing mechanism (240) across the articulation mechanism (240), each support plate (430, 432) comprises ends (434, 436) having a pair of springs (438) longitudinally coupled with both sides of a frame recess (418) formed in the articulation mechanism (240).
Full Text Cross Reference to Related Applications
The present application is related to four co-pending and commonly-owned
applications filed on even date herewith, the disclosure of each is hereby incorporated
by reference in their entirety, these four applications befog respectively entitled:
(1) "SURGICAL STAPLING INSTRUMENT INCORPORATING A
TAPERED FIRING BAR FOR INCREASED FLEXIBILITY AROUND THE
ARTICULATION JOINT" to Frederick E. Shelion IV, Mike Setaer, and Bruce
Weisenburgh;
(2) "SURGICAL STAPLING INSTRUMENT INCORPORATING AN
ARTICULATION JOINT FOR A FIRING BAR TRACK" to Douglas B. Hoffman;
(3) "SURGICAL INSTRUMENT INCORPORATING AN ARTICULATION
MECHANISM RAVING ROTATION ABOUT THE LONGITUDINAL AXIS" to
Kenneth S. Wales, Douglas B. Hoffman, Frederick E. Shelton IV, and Jeff Swayzc;
and
(4) "A SURGICAL INSTRUMENT WITH A LATERAL-MOVING
ARTICULATION CONTROL" to Kenneth S. Wales.
Field of the Invention
The present invention relates in general to surgical stapler instruments that are
capable of apply ng lines of staples to tissue while cutting the tissue between those
staple lines and, more particularly, to improvements relating to stapler instruments
and improvements in processes for forming various components of such stapler
instruments that include an articulating shaft.
Background of the Invention
Endoscopic surgical instruments are often preferred over traditional open
surgical devices since a smaller incision tends to reduce the post-operative recovery
time and complications. Consequently, significant development has gone into a range
of endoscopic surgical instruments that are suitable for-precise placement of a distal
end effector at a desired surgical site through a cannula of a trocar: These distal end
effectors engage the tissue in a number of ways to achieve a diagnostic or therapeutic
effect (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene
therapy delivery device, and energy device using ultrasound, RF, laser, etc.).
Positioning the end effector is constrained by the trocar. Generally these
endoscopic surgical instruments include a long shaft between the end effector and a
handle portion tranipulated by the clinician, this long shaft enables insertion to a
desired depth and rotation about the longitudinal axis of the shaft, thereby positioning
the end effector 10 a degree. With judicious placement of the trocar and use of
graspers, for instance, through another trocar, often this amount of positioning is
sufficient. Surgical stapling and severing instruments, such as described in U.S. Pat.
No. 5,465,895, are an example of an endoscopic surgical instrument that successfully
positions an end effector by insertion and rotation.
Depending upon the nature of the operation, it may be desirable to further
i
adjust the positioning of the end effector of an endoscopic surgical instrument rather
than being limited to insertion and rotation. In particular, it is often desirable to orient

the end effector it an axis transverse to the longitudinal axis of the shaft of the
instrument. The transverse movement of the end effector relative to the instrument
shaft is conventionally referred to as "articulation". This articulated positioning
permits the clini:ian to more easily engage tissue in some instances. In addition,
articulated posit oning advantageously allows an endoscope to be positioned behind
the end effector without being blocked by the instrument shaft.
While the aforementioned non-articulating stapling and severing instruments
have great utility and may be successfully employed in many surgical procedures, it is
desirable to enhance their operation with the ability to articulate the end effector,
thereby giving greater clinical flexibility in their use. Articulating surgical instruments
generally use one or more firing bars that move longitudinally within the instrument
shaft and through the articulation joint to fire the staples from the cartridge and to cut
the tissue between the innermost staple lines. One common problem with these
surgical instruments is control of the firing bar through the articulation joint. At the
articulation join., the end effector is longitudinal ly spaced away from the shaft so that
the edges of the shaft and end effector don't collide during articulation. This gap must
be filled with support material or structure to prevent the firing bar from buckling out
of the joint when the single or multiple firing bars is subjected to longitudinal firing
loads. What is needed is a support structure that guides and supports the single or
multiple firing bars through the articulation joint and bends or curves as the end
effector is articulated.
U.S. Fat No. 5,673,840 describes a flexible articulation joint that is formed
from an elastomeric or plastic material that bends at the flexible joint or "flex neck".
The firing bars ire supported and guided through a hollow tube within the flex neck.
The flex neck is a portion of the jaw closure mechanism and moves longitudinally
relative to the etd effector, shaft, and firing bars when the jaws are closed on tissue.
The firing bars then move longitudinally withir. the flex neck as the staples are fired
and tissue is cut
U.S. Pat, No. 5,797,537 to Allen describes an articulation joint that pivots
around a pin, rather than bends around a flex joint. In this instrument, firing bars arc
supported between a pair of spaced support plates connected at one end to the shaft
and at another and to the end effector. At least one of those connections is a slidable
connection. The support plates extend through the articulation joint adjacent to the
flexible drive number in the plane of articulation such that the support plates bend
through the gap in the plane of articulation and the flexible firing bar bends against
the support when the tip is articulated in one direction from its aligned position. U.S.
6,330,965 from U.S. Surgical teaches the use of support plates that are fixedly
attached to the spaft and slidably attached to the end effector.
Although these known support plates guide a firing bar through an articulation
joint, it is believed that performance may be enhanced. For instance, it is often
desirable for the firing bar to be rapidly accelerated during firing in order to ensure
sufficient momentum to 6ever tissue effectively. Rigidly attached support plates may
tend to dislodge in response, allowing the firing bar to blow out from the articulation
joint. As a further example, it is desirable for the instrument to operate in the same
manner whether articulated or not. Increased friction when articulated would be
inconvenient and distracting to the clinician if required to exert a varying amount of
firing force.
Conseqaently, a significant need exists for an improved articulation
mechanism for a surgical instrument mechanisms that provides enhanced support to a
firing bar through the articulation joint.
Brief Summary of the Invention
The invention overcomes the above-noted and other deficiencies of the prior
art by providing an articulating surgical instrument that actuates an end effector with a
longitudinally translating firing mechanism advantageously supported through an
articulation mechanism by flanking support plates. In order to better respond to firing
loads on the firing mechanism, one or more ends of each support plate are resiliently
or springedly engaged to one side of the articulation mechanism, and thus are better
able to avoid buckling of the firing mechanism.
— In one aspect of the invention, a surgical instrument has a handle portion that
produces an art culation motion and a firing motion, both of which are transferred
through a shaft to an articulation mechanism. The articulation mechanism responds to
the articulation motion to rotate an end effector from the longitudinal axis of the shaft.
A firing mechanism responds to the firing motion and is coupled for movement
through the articulation mechanism and the end effector. A pair of support plates
flank the firing mechanism across the articulat on mechanism, each support plate
including an en i springedly engaged to a frame recess formed in the articulation
mechanism to assist in preventing buckling of the firing mechanism out of the
articulation mechanism. Thus various types of actuated diagnostic or therapeutic end
effectors may be incorporated into an articulating surgical instrument without
buckling at the articulation mechanism, even with high firing forces and reduces
component dimensions for endoscopic use.
— In another aspect of the invention, a surgical instrument has a handle portion
that produces a firing motion, a closing motion, and an articulation motion, each
transferred through a shaft. An articulation mechanism distally coupled to the shaft
pivots an end elfector in response to the articulation motion. The end effector
includes an elor gate channel coupled to the shaft, an anvil that is pivotally coupled to
the elongate channel and that is responsive to the closing motion from the shaft. A
firing device has a distally presented cutting ecge longitudinally received between the
elongate channel and the anvil. An articulation mechanism pivots the elongate
channel from the shaft in response to the articulation motion. A pair of support plates
flank the firing mechanism across the articulation mechanism, each support plate
including an en i springedly engaged to a frame recess formed in the articulation
mechanism. Thereby, an improved stapling and severing instrument may incorporate
a firing device that withstands high firing loads yet does not introduce significantly
increased firing forces when articulated.
These and other objects and advantages of the present invention shall be made
apparent from the accompanying drawings and the description thereof.
Brief Description of the AccompanyingFieures
The accompanying drawings, which are incorporated in and constitute a part
of this specification, illustrate embodiments of the invention, and. together with the
general description of the invention given above, and the detailed description of the
embodiments given below, serve to explain the principles of the present invention.
FIG. lis a perspective view of an articulating surgical instrument in a
nonarticulated position.
FIG. 2 is a perspective view of an articulating surgical instrument in an
articulated position.
FIG. 3 is a perspective view of an opened end effector of the articulating
surgical instrament of FIGS. 1-2.
FIG. 4 depicts a side elevation view in section of the end effector of FIG. 3 of
the surgical instrument of FIG. 1, the section g;nerally taken along lines 4-4 of FIG. 3
to expose portiens of a staple cartridge but also depicting the firing bar along the
longitudinal centerline.
FIG. 3 depicts a side elevation view in section of the end effector of FIG 4
after the firing t ar has fully fired.
FIG. 6 depicts a side elevation view in section of a handle portion of a
proximal end of the surgical instrument of FIG. 1 including a rotating articulation
control.
FIG. 7 depicts a perspective, exploded view of the handle portion of the
proximal end of the surgical instrument of FIG. 1.
FIG. 8 depicts a perspective view looking downward, forward and to the right
of a distal portion of the handle portion of the (surgical instrument of FIG. 1 partially
cutaway to expose a rotating articulation control mechanism.
FIG. 9 depicts a perspective view looking upward, rearward and to the right of
the distal portion of the handle portion of FIG. 8, partially cutaway to expose the
rotating articulation control mechanism and have a rotating articulation control knob
disassembled.
FIG. 10 depicts a top perspective detail view of a spur gear articulation
mechanism and end effector of the surgical instrument of FIG. 1 with firing and frame
portions removed.
FIG. 11 depicts a perspective, exploded view of an implement portion of the
surgical instrument of FIG. 1 including a spur gear articulation mechanism.
Fig. 12 depicts a top sectional view of the spur gear articulation mechanism of
FIG. 11.
FIG. 13 depicts a top view in section of a prior art articulation support plate
assembly.
FIG. 14 depicts a top view in section ofthe prior art articulation suppor. plate
assembly of FIG. 13 in an articulated position.
FIG. 15 depicts a top view in section of a springedly-coupled, single free-end
support plate assembly for the surgical instrument of FIG. 1.
FIG. 16 depicts a top view in section of a resilient-coupled, single free-end
support plate assembly for the surgical instrument of FIG. 1.
FIG. 17 depicts atop view in section of a spring-fingered, single free-end
support plate assembly for the surgical instrument of FIG. 1.
FIG. 18 depicts a perspective view the spring-fingered, single free-end support
plates of FIG. 12..
FIG. 19 depicts a top view in section of a springedly-coupled, dual free-end
support plate assembly for the surgical instrument of FIG. 1.
FIG. 20 depicts a top view in section of a resilient-coupled, dual free-end
support plate assembly for the surgical instrument of FIG. 1.
FIG. 21 depicts a top view in section of a spring-fingered, dual free-end
support plate assembly for the surgical instrument of FIG. I.
FIG. 22 depicts a top view in section of a resilient support plate assembly for
the surgical instrument of FIG. 1.
FIG. 23 depicts a perspective, exploded view of a pair of support plates with
bearing contact to a firing bar for the surgical instrument of FIG. 1.
Detailed Description of the Invention
Turning to the Drawings, wherein like numerals denote like components
throughout the several views, FIGS. 1-3 depict a surgical instrument, which in the
illustrative embodiment is more particularly a surgical stapling and severing
instrument 10, that is capable of practicing the unique benefits of the present
invention. In particular, the surgical stapling and severing instrument 10 is sized for
insertion, in a no larticulated state as depicted in FIG. 1, through a trocar cannula
passageway to a surgical site in a patient for performing a surgical procedure. Once
an articulation mechanism 11 and a distally attached end effector 12 are inserted
through the cannula passageway, the articulation mechanism 11 may be remotely
articulated, as depicted in FIG. 2, by an articulation control 13. Thereby, the er.d
effector 12 may teach behind an organ or approach tissue from a desired angle or for
other reasons. For instance, a firing mechanism, advantageously depicted as an E-
beam firing bar 14 (depicted in FIG. 3), that severs clamped tissue., engages an
elongate channel 16 and a pivotally attached anvil 18.
The surgical and stapling and severing instrument 10 includes a handle portion
20 connected tc an implement portion 22, the latter further comprising a shaft 23
distally terminating in the articulating mechanism 11 and the end effector 12. The
handle portion 20 includes a pistol grip 24 toward which a closure trigger 26 is
pivotally drawn by the clinician to cause clamping, or closing, of the anvil 18 toward
the elongate channel 16 of the end effector 12. A firing trigger 28 is farther outboard
of the closure trigger 26 and is pivotally drawn by the clinician to cause the stapling
and severing of clamped tissue in the end effector 12. Thereafter, a release button 30
is depressed to release the clamped tissue.
h An outermost closure sleeve 32 of the shaft 23 longitudinally translates in
response to the closure trigger 26 to pivotally close the anvil 18. Specifically, a distal
portion, or closure ring 33, of the closure sleeve 32 with respectto the articulation
mechanism 11is indirectly supported by a frame 34 of the implement portion 22
(partially visible at the articulation mechanism 11). At the articulation mechanism 11,
a proximal portion, or closure tube 35, of the closure sleeve 32 communicates with the
distal portion (c.osure ring) 33. The frame 34 is flexibly attached to the elongate
channel 16 viatne articulation mechanism 11, enabling articulation in a single plane.
The frame 34 also longitudinally slidingly supports a firing drive member 36 that
communicates a firing motion from the firing trigger 28 to the firing bar 14. Only the
firing bar 14 of he firing drive member 36 is depicted FIG. 3, but the firing drive
member 36 is described below further detail with regard to various versions of a
rotationally controlled articulation mechanism 11.
It will be appreciated that the terms "proximal" and "distal" are used herein
with reference to a clinician gripping a handle of an instrument. Thus, the end
effector 12 is distal with respect to the more proximal handle portion 20. It will be
further appreciated that for convenience and clarity, spatial terms such as "vertical"
and "horizontal' are used herein with respect to the drawings. However, surgical
instruments are used in many orientations and positions, and these terms are not
intended to be limiting and absolute.
E-BEAMFIRING BAR
FIGS. 3-5 depict the end effector 12 employing the E-beam firing bar 14 to
perform a number of functions. In FIG. 3, the firing bar 14 is proximally positioned,
allowing an unspent staple cartridge 37 to be installed into the elongate channel 16.
In particular, an upper pin 38 of the firing bar 14 resides within a recess, depicted as
an anvil pocket 40 allowing the anvil 18 to be repeatedly opened and closed. With the
end effector closed as depicted in FIG. 4, the firing bar 14 is advanced in engagement
with the anvil 18 by having the upper pin 38 enter a longitudinal anvil slot 42. A
lower most pin, or firing bar cap 44, engaged a lower surface of the elongate channel
16 by having the firing bar 14 extend through a channel slot 45. A middle pin 46
slidingly engages a top surface of the elongate channel 16, cooperating with the firing
bar cap 44. Thereby, the firing bar 14 affirmatively spaces the end effector 12 during
firing, overcoming pinching that may occur with a minimal amount of clamped tissue
and overcoming staple malformation with an excessive amount of clamped tissue.
During firing, a distally presented cutting edge 48 between the upper pin 38
and middle pin 45 of the firing bar enters a proximally presented vertical slot 49 of the
staple cartridge 37, severing tissue clamped between the staple cartridge 37 and the
anvil 18. As shown in FIG. 4, the middle pin 46 actuates the staple cartridge 37 by
entering into a firing slot within the staple cartridge 37, driving a wedge sled 41 into
upward camming contact with staple drivers 43 that in turn drive a plurality of staples
47 out of staple apertures 51 in the staple cartridge 37 into forming contact with staple
pockets 53 on an inner surface of the anvil 18. FIG. 5 depicts the firing bar 14 fully
distally translatec after completing severing and stapling tissue.
TWO-AX IS HANDLE
- With reference to FIGS. 6-7, the handle portion 20 is comprised of first and
second base sections 50 and 52, which are molded from a polymeric material such as
a glass-filled polycarbonate. The first base section 50 is provided with a plurality of
cylindrical-shaped pins 54. The second base section 52 includes a plurality of
extending members 56, each having a hexagonal-shaped opening 58. The cylindrical-
shaped pins 54 are received within the hexagonal-shaped openings 58 and are
fictionally held therein for maintaining the fir3t and second base sections 50 and 52
in assembly.
A housing cap 60 has a bore 62 extending completely through it for engaging
and rotating the implement portion 22 about its longitudinal axis. The housing cap 60
includes an inwardly protruding boss 64 extending along at least a portion of the bore
62. The protruc ing boss 64 is received within a longitudinal slot 66 formed at a
proximal portion of the closure sleeve 32 such that rotation of the housing cap 60
effects rotation of the closure sleeve 32. It will be appreciated that the boss 64 further
extends through frame 34 and into contact witit a portion of the firing drive member
36 to effect the rotation as well. Thus, the end effector 12 (not shown in FIGS. 3-4)
rotates with the housing cap 60.
A proximal end 6$ of the frame 34 passes proximally through the housing cap
60 and is provided with a circumferential notch 70 that is engaged by opposing
channel securentent members 72 extending respectively from the base sections 50 and
52. Only the channel securement member 72 c f the second base section 52 is shown.
The channel securement members 72 extending from the base sections 50, 52 serve to
secure the frame 34 to the handle portion 20 such thatthe frame 34 does not move
longitudinally relative to the handle portion 20.
The clos ure trigger 26 has a handle section 74, a gear segment section 76, and
an intermediate section 78. A bore 80 extends through the intermediate section 78. A
cylindrical support member 82 extending from the second base section 52 passes
through the bore 80 for pivotally mounting the closure trigger 26 on the handle
portion 20. A se ;ond cylindrical support member 83 extending from the second base
section 52 passes through a bore 81 of firing trigger 28 for pivotally mounting on the
handle portion 20. A hexagonal opening 84 is provided in the cylindrical support
member 83 for receiving a securement pin (not shown) extending from the first base
section 50.
A closure yoke 86 is housed within the handle portion 20 for reciprocating
movement there n and serves to transfer motion from the closure trigger 26 to the
closure sleeve 32. Support members 88 extending from the second base section 52
and securement Member 72, which extends through a recess 89 in the yoke 86,
support the yoke 86 within the handle portion 20.
A proximal end 90 of the closure sleeve 32 is provided with a flange 92 that is
snap-fitted into a receiving recess 94 formed in a distalend 96 of the yoke 86. A
proximal end 98 of the yoke 86 has a gear rack '. 00 that is engaged by the gear
segment section 76 of the closure trigger 26. When the closure trigger 26 is moved
toward the pistol grip 24 of the handle portion 2D, the yoke 86 and, hence, the closure
sleeve 32 move c istally, compressing a spring 102 that biases the yoke 86 proximally.
Distal movement of the closure sleeve 32 effects pivotal translation movement of the
anvil 18 distal ly and toward the elongate channel 16 of the end effector 12 and
proximal movement effects closing, as discussed below.
The closure trigger 26 is forward biased to an open position by a front surface
130 interacting v ith an engaging surface 128 of the firing trigger 28. Clamp first
hook 104 that pilots top to rear in the handle portion 20 about a pin 106 restrains
movement of the firing trigger 28 toward the pistol grip 24 until the closure trigger 26
is clamped to its closed position. Hook 104 restrains firing trigger 28 motion by
engaging a lockcut pin 107 in firing trigger 28. The hook 104 is also in contact with
the closure trigger 26. In particular, a forward projection 108 of the hook 104
engages a member 110 on the intermediate section 78 of the closure trigger 26, the
member 110 being outward of the bore 80 toward the handle section 74. Hook 104 is
biased toward contact with member 11 Oof the closure trigger 26 and engagement with
lockout pin 1C7 in firing trigger 28 by a release spring 112. As the closure trigger 26
is depressed, the hook 104 is moved top to rear, compressing the release spring 112
that is captured t etween a rearward projection 114 on the hook 104 and a forward
projection 116 on the release button 30.
As the ycke 86 moves distally in response to proximal movement of the
closure trigger 26, an upper latch arm 118 of the release button 30 moves along an
upper surface 12 0 on the yoke 86 until dropping into an upwardly presented recess
122 in a proxima1, lower portion of the yoke 86 The release spring 112 urges the
release button 30 outward, which pivots the upper latch arm 118 downwardly into
engagement with the upwardly presented recess 122, thereby locking the closure
trigger 26 in a t ssue clamping position.
The latch arm 118 can be moved out of the recess 122 to release the anvil 18
by pushing the release button 30 inward. Specifically, the upper latch arm 118 pivots
upward about p :n 123 of the second base section 52. The yoke 86 is then permitted to
move proximally in response to return movement of the closure trigger 26.
A firing trigger return spring 124 is located within the handle portion 20 with
one end attached to pin 106 of the second base section 52 and the other end attached
to a pin 126 on the firing trigger 28. The firing return spring 124 applies a return
force to the pin 126 for biasing the firing trigger 28 in a direction away from the pistol
grip 24 of the handle portion 20. The closure trigger 26 is also biased away from
pistol grip 24 by engaging surface 128 of firing trigger 28 biasing front surface 130 of
closure trigger 26.
As the c osure trigger 26 is moved toward the pistol grip 24, its front surface
130 engages with the engaging surface 128 on the firing trigger 28 causing the firing
trigger 28 to move to its "firing" position. When in its firing position, the firing
trigger 28 is located at an angle of approximately 45° to the pistol grip 24. After
staple firing, the spring 124 causes the firing trigger 28 to return to its initial position.
During the return movement of the firing trigger 28, its engaging surface 128 pushes
against the front surface 130 of the closure trigger 26 causing the closure trigger 26 to
return to its initial position. A stop member 132 extends from the second base section
52 to prevent the closure trigger 26 from rotating beyond its initial position.
The surgical stapling and severing instrament 10 additionally includes a
reciprocating section 134, a multiplier 136 and a drive member 138. The
reciprocating section 134 comprises a wedge sled, or wedge sled, in the implement
portion 22 (not shown in FIG. 6-7) and a metal drive rod 140.
The drive member 138 includes first and second gear racks 141 and 142. A
first notch 144 is provided on the drive member 138 intermediate the first and second
gear racks 141, 42. During return movement of the firing trigger 28, a tooth 146 on
the firing trigger 28 engages with the first notch 144 for returning the drive member
138 to its initial position after staple firing. A second notch 148 is located at a
proximal end of the metal drive rod 140 for locking the metal drive rod 140 to the
upper latch arm 118 of the release button 30 in its unfired position.
The mul iplier 136 comprises first and second integral pinion gears 150 and
152. The first integral pinion gear 150 is engaged with a first gear rack 154 provided
on the metal drive rod 140. The second integral pinion gear 152 is engaged with the
first gear rack 141 on the drive member 138. The first integral pinion gear 150 has a
first diameter and the second integral pinion gear 152 has a second diameter that is
smaller than the first diameter.
ROTATIONAL ARTICULATION CONTROL
With reference to FIGS. 6-9, the handle portion 20 advantageously
incorporates the articulation control 13 that both rotates the implement portion 22
about the longitudinal axis of the surgical instrument 1,0 and articulates the end
effector 12 to an angle with the longitudinal axis. A hollow articulation drive tube 200
is concentrically located within the closure sleeve 32 and is operably coupled to an
actuation lever 202 such that rotation of actuation lever 202 rotates tube 200 about the
longitudinal axis and causes perpendicular rotation or articulation of the closure ring
250 and end effector 12. This articulation of the closure ring 250 corresponds to the
degree and direction of rotation of actuator lever 202 viewed and manipulated by the
clinician. In the illustrative version, the relationship is one to one, with the degree of
rotation of the actuator lever 202 corresponding to the degree of articulation from the
longitudinal axis of the shaft 23, thus providing an intuitive indication to the clinician.
It will be apprec: ated that other angular relationships may be selected.
The articalation control 13 includes a pair of mirrored articulation
transmission horsings 204 that are attached to the housing cap 60. Moreover, the
articulation transmission housing 204 includes longitudinally aligned external tabs
206 that a clinician twists to effect rotation of the articulation transmission housing
204, and thus of :he end effector 12, about the longitudinal axis of the implement
portion 22. The actuator lever 202 is attached to a cylindrical articulation body 208
that resides within a cylindrical recess 210 opening generally upward and
perpendicular to the shaft 23. The lowermost portion of the articulation body 208
includes prongs 212 that snap fit into an opening 214 in the articulation transmission
housing 208 near to the shaft 23, the prongs 212 preventing the articulation body 208
from being withdrawn from the cylindrical recess 210.
Annularly presented gear teeth 216 are located about the lower portion of the
articulation body 208 and mesh with teeth 218 on an articulation yoke 220. The
articulation yoke 220 straddles an articulation rectangular window 222 formed in the
closure sleeve 52. Closure sleeve 32 is slidably moveable within the articulation
control 13 (in the longitudinal direction) to close and open the end effector 12. The
articulation drive tube 200 moves longitudinally with the closure sleeve 32 relative to
the fixed articu ation control 13. Window 222 provides clearance for a boss 224
inwardly preset ted from the articulation yoke 220 that passes through the rectangular
window 222 to engage a slot 226 in the articulation drive tube 2.00, longitudinally
positioning the articulation drive tube 200 for rotational motion. The hollow
articulation drive tube 200 extends longitudinally within the closure sleeve 32 from
the articulation mechanism 11 and terminates distally before the locking tabs 227 of
the closure sleeve 32. The tabs 227 are inwardly bent behind the proximal face of the
articulation drive tube 200 and thereby retaining the articulation drive tube 200 in the
shaft 23.
It shoulc. be appreciated that the articulation transmission housing 204 is
operatively associated to the closure tube 35 of the shaft 23. The housing cap 60
retains the articulation yoke 220 in the articulation transmission housing 204 and
retains the articulation control 13 within the handle portion 20 by presenting
proximally an o Jter diameter circular groove 228 that engages a circular inward lip
230 at the distal opening of the assembled base sections 50, 52.
FIGS. 10 and 11 depict the gear articulation mechanism 11 of FIGS. 1-2 in the
form of a spur gear articulation mechanism 240, which is generally the same as
described above but with additional articulation driving components on the other side
of the articulation mechanism 240 to thereby increase performance. Articulation
mechanism 240 has a rotatable hollow articulation drive tube 242 that is
concentrically located within closure sleeve 32 and has a distally projecting gear
section 244 about a first circumference portion 246. Gear section 244 meshes with a
spur gear 248 at ached to and proximally projecting from closure ring 250 which
pivots about pins 253 extending through first and second pivot points 252, 260
projecting distal ly from the closure sleeve 32. Thus, an articulation pivot axis passes
through both the first and second pivot points 252,260 and pins 253 rotatably couple
closure ring 250 to the closure sleeve 32. Rotation of drive 242 engages the gears 242
and 248 and articulates closure ring 250 about first and second pivot points 252, 260.
To increase the effective surface area of gear contact between the hollow
articulation driv i tube 242 and the closure ring 250, a second circumference portion
254 of the hollo v articulation drive tube 242 has a recessed distally projecting gear
section 256 extending therefrom. Gear section 256 is operably coupled to a second
spur gear 258 at ached to and proximally projecting from an opposite lateral side of
the closure ring 250 by a reversing gear 262 pivotally supported by the frame 34.
Reversing gear 262 engages both the recessed distally projecting gear section 256 on
one side and the second spur gear 258 of the closure ring 250 on the other.
When the closure trigger 26 is actuated, both the hollow articulation drive tube
242 and pivotally attached closure tube 250 of the closure sleeve 32 are moved
distally to close the anvil 18. The closure tube 35 of the closure sleeve 32 is spaced
away from the cosure ring 33 by pivot points 252, 260 pinned to pivot holes 264 and
266 centered in spur gears 248,258, and a frame opening 268 that extends
therethrough. T he frame opening 268 provides clearance so that the proximal edges
of the closure ring 33 and the distal edges of the closure tube 35 of the closure sleeve
32 do not collide during articulation.
FIG. 11 depicts in disassembled form an implement portion 270 that includes
the spur gear artculation mechanism 240. A frame 272 is longitudinally attachable to
the handle portion 20 (depicted in FIGS. 1 and 2) with a bushing 274 on its proximal
end for rotatingly engagement thereto. A frame trough 276 formed by an opening 278
longitudinally aligned with the center of the frame 272 is longer than a firing
connector 280 that slides longitudinally within the frame trough 276. The proximal
end of the firing connector 280 rotatingly engages the distal end of the metal drive bar
140 (depicted in FIG 6). The distal end of the firing connector 280 includes a slot 282
that receives a proximal end of the firing bar 14, attached therein by pins 284. A
more distal porticn of the firing bar 14 is positioned within a lower groove 286 in a
firing bar slotted guide 288 that is distally engaged with an articulating frame member
290 and the frame 272.
Articulating frame member 290 has a channel-anchoring member 292 that
distally attaches to an attachment collar 294 of a proximal portion in the elongate
channel 16. The firing bar 14 passes through a lower slot 295 in the articulating
frame member 290. The articulating frame member 290 is spaced away from the
distal end of the f rame 272 by the firing bar slotted guide 288 and flexibly attached
thereto for articulation by a resilient connector 296. A widened proximal end 298 of
the resilient connector 296 engages a distally communicating top recess 300 in the
distal end of the frame 272 and a widened distal end 302 of the resilient connector 296
engages a proximally communicating top recess 304 in the articulating frame member
290. Thereby, the elongate channel 16 is attached to the handle portion 20, albeit with
a flexible portion therebetween.
The elongate channel 16 also has an anvil cam slot 306 that pivotally receives
an anvil pivot 308 of the anvil 18. The closure ring 250 that encompasses the
articulating frame member 290 includes a distally presented tab 310 that engages an
anvil feature 312 proximate but distal to the anvil pivot 308 on the anvil 18 to thereby
effect opening. When the closure ring 250 is moved forward, its distally presented
closing face 314 contacts a ramped cylindrical closing face 316, which is distal to tab
312 of the anvil 18. This camming action closes the anvil 18 downward until the
closing face 314 of the closure ring 250 contacts a flat cylindrical face 318 of the
anvil 18.
SUPPORT PLATES
FIGS. 12-13 depict the articulation mechanism 240 along the articulation pivot
axis illustrating flexible support structures between the shaft 23 and the end effector
12 and a construction of the firing bar 14 that advantageously performs severing yet is
flexible enough for articulation. The hollow articulation drive tube 242 engages the
spur gear 248 of 1he closure ring 33. Omitted from this view are the proximal portion
35 of the closure sleeve 32 (i.e., closure tube 35) that longitudinally positions for
articulation the spur gear 248 at an upper pivot point 252 and the lower pivot point
260.
Resilient support in the articulation mechanism 240 allow articulation about
the articulation pivot axis includes a pair of support plates 400,402 that flank a
proximal portion of the firing bar 14 to prevent buckling as they pass through the
frame opening 268. Thus, the firing bar 14 is capable of transferring large loads while
being flexible. This proximal portion of the firing bar 14 is depicted as an elongate
tapered firing atrip 404 formed as one or more flat blades of spring material that are
aligned for flexing about the articulation pivot axis. This tapered firing strip 404
transitioned to a thicker distal portion, depicted as a firing bar head 406, that includes
the cutting edge 48, upper pin 38, middle pin 46 and firing bar cap 44 (pins omitted in
FIG. 12). This thicker firing bar head 406 has ircreased thickness to resist deflection
during firing, thereby ensuring an effective seve:ring and actuation of the staple
cartridge 37. The thinner cross section of the tapered firing strip 404 is more
susceptible to buckling when subjected to peak firing loads. The support plates 400,
402 advantageously mitigate the effects of peak firing loads in the tapered firing strip
404 by supporting the tapered firing strip 404 through the articulation joint to prevent
buckling of the firing bar 14. Support plates 400, 420 are longitudinally moveable
within both of the proximal and distal sides 408, 410 of the articulation mechanism
240.
As showr in FIG. 12, the pair of support plates 400, 402 each have a proximal
and distal sliding spring ends 412,414, received respectively by a frame pocket 416 in
the frame 32 and an end frame pocket 418 in the articulating frame member 290.
These pockets 416, 418 provide clearance for the spring ends 412, 414 of the support
plates 400, 402 to move within as the articulation mechanism 240 articulates,
lessening the frarne opening 268 toward the inside and lengthening the frame opening
268 toward the outside. Reversing the direction of articulation of the end effector 12
reverses movement of the spring ends 412, 414 (not shown). Insofar as the proximal
spring ends 412 tend not to be rigidly engaged to a distal extreme surface 420 of the
frame pocket 416, the support plates 400,402 are able to springedly move distally in
response to a peak firing load in the firing bar 14.
By contrast, FIGS. 14-15 depict known Prior Art support members 421, 422
formed from a spring material that rigidly attach to a proximal side 423 and slidingly
contact a distal side 424 of a known articulation mechanism 425. In FIG. 14, the
instrument is shown straight or un-articulated and a pair of free or distal ends 429 of
the support plates 421, 422 are centered within end frame pockets 418 and fixed ends
427,428 are fixedly attached to proximal side 423. With particular reference to FIG.
15, the end effector is shown articulated and a firing bar 426 and support plates
421,422 are ben from the articulation. Since the support plates 421,422 are spring
cantilever beams, they contact the firing bar 426 as shown and the free or distal ends
429 of the support plates 421,422 move proximally and distally, respectively, within
end frame pockets 418. The contact of the free or distal ends 429 of support plates
421,422 with the firing bar can induce drag loads and increase the force needed to
move the firing bar 426.
FIG. 16 depicts support plates 430, 432 that alternatively each include a
rigidly attached proximal ends 434 and a springedly attached distal ends 436 in the
end frame pocket 418 by opposing compression springs 438 engaging each end 436.
Springedly attac ling the distal ends 436 to the frame pockets 418 provides additional
control of the free distal ends to reduce drag on the firing bar 14 and enables the ends
436 to move longitudinally during articulation. Alternatively, the spring attachment
provided by the ;ompression springs 438 may be reversed, engaging the proximal
ends 434 with the distal ends 436 rigidly attached.
FIG. 17 depict the support plates 430, 432 of FIG. 16 with a resilient member
440 engaging each the distal ends 436 of each support plate 430, 432. Alternatively,
the resilient attachment by the resilient members 440 may be reversed, engaging the
proximal ends 434 with the distal ends 436 rigidly attached. Resilient members may
be formed from various elastomeric materials such as silicone, rubber, buna-n or any
one of a number of known elastomers that behave elastically. Foam materials can
also act as a spri ng and can include closed or open cell foams formed from a wide
variety of materials such as silicone foams, rubber based foams or polyethylene
foams.
FIGS. 18-19 depict support plates 442, 444 that include inner and outer bent
spring fingers 446,448 that springedly engage the end frame pocket 418 so that the
spring plates 442, 444 absorb peak firing loads from the firing bar 14. Alternatively,
the spring engagement may be reversed, with the proximal ends 434 including inner
and outer bent spring fingers 446, 448 engaging a proximal frame pocket 416 (not
depicted in FIGS. 18-19) with the distal ends 436 rigidly attached. FIG. 19 depicts
how additional flexibility may be obtained along the span of the support plate 442,
442 by introduci ng openings 450 therein.
FIG. 20 depicts the support plates 430,432 of FIG. 16 with both a frame
pocket 416 and an end frame pocket 418 incorporating opposing compression springs
438 to further m tigate the effects of firing bar loads.
FIG. 21 cepicts the support plates 430, 432 of FIG. 17 with both a frame
pocket 416 and an end frame pocket 418 incorporating resilient members 440 to
further mitiga:e the effects of firing loads on the firing bar 14.
FIG. 22 depicts support plates 452,454 ihat include inner and outer bent
spring fingers 446,448 on both ends that springedly engage both, a frame pocket 416
and an end frame pocket 418 to further mitigate the effects of firing bar loads.
FIG. 23 depicts resilient support plates 456,458 that each engage frame
pocket 416 and end frame pocket 418 to adjust to the changes in spacing on the inside
and outside of the frame opening 268 by expanding or compressing in response
thereto. Resilient support plates can be made from a number of materials with
flexible or elastomeric properties including; silicone, rubber, buna-n Isoplast or any
one of a number of known elastomers that behave elastically or resiliently.
FIG. 24 is an exploded view of low friction support plates 460, 462 that
incorporate bearings 464 to reduce frictional forces between the firing bar 14 and the
support plates 460, 462. The support plates 460, 462 have dimpled openings 466
respectively for the reception of bearings 464 to hold them into contact with the firing
bar 14. Alternatively, cylindrical bearings may be incorporated with the cylindrical
bearings oriented for distal movement of the firing bar 14.
While thc present invention has been illustrated by description of several
embodiments and while the illustrative embodiments have been described in
considerable detail, it is not the intention of the applicant to restrict or in any way
limit the scope of the appended claims to such detail. Additional advantages and
modifications may readily appear to those skilled in the art.
- The present invention has been discussed in terms of endoscopic procedures
and apparatus. However, use herein of terms such as "endoscopic", should not be
construed to limit the present invention to a surgical stapling and severing instrument
for use only in conjunction with an endoscopic tube (i.e., trocar). On the contrary, it
is believed that the present invention may find use in any procedure where access is
limited to a small incision, including but not limited to laparoscopic procedures, as
well as open procedures.
For another example, although the E-beam firing beam 14 has advantages for
an endoscopically employed surgical severing and stapling instrument 10, a similar E-
Beam may be used in other clinical procedures. It is generally accepted that
endoscopic procedures are more common than laparoscopic procedures. Accordingly,
the present invention has been discussed in terms of endoscopic procedures and
apparatus. However, use herein of terms such as "endoscopic", should not be
construed to limit the present invention to a surgical stapling and severing instrument
for use only in conjunction with an endoscopic tabe (i.e., trocar). On the contrary, it
is believed that the present invention may find use in any procedure where access is
limited to a small incision, including but not limited to laparoscopic procedures, as
well as open procedures.
For yet another example, although an illustrative handle portion 20 described
herein is manually operated by a clinician, it is consistent with aspects of the
invention for some or all of the functions of a handle portion to be powered (e.g.,
pneumatic, hydraulic, electromechanical, ultrasonic, etc.). Furthermore, controls of
each of these functions may be manually presented on a handle portion or be remotely
controlled (e.g., wireless remote, automated remote console, etc.).
As yet an additional example, although a simultaneous stapling and severing
instrument is advantageously illustrated herein, it would be consistent with aspects of
the invention supporting a firing mechanism through an articulating shaft with other
types of end effectors, such as cutters, staplers, clip applier, access device, drug/gene
therapy delivery device, and a energy device using ultrasound, RF, laser, etc.
For example, various combinations of rigidly attached, resiliently attached,
and springedly a:tached support plate ends may be used, such as resilient attached
proximal end and a springedly attached distal end.

WE CLAIM
1. A surgical stapling and severing instrument, comprising:
a handle portion (20) operably configured to produce an articulation
motion and a firing motion;
a shaft (23) having a longitudinal axis attached to the handle portion (20)
for transferring the articulation motion and the firing motion;
an articulation mechanism (240) coupling the shaft to the end effector
(12) and responsive to the articulation motion to rotate the end effector
(12) from the longitudinal axis of the shaft;
an end effector (12) distally attached to the articulation mechanism (240);
a firing mechanism (14) responsive to the firing motion and coupled for
movement through the articulation mechanism (240) and end effector
(12) in response to the firing motion;
a pair of support plates (430, 432) flanking the firing mechanism (240)
across the articulation mechanism (240),
each support plate (430, 432) comprises ends (434, 436) having a pair of
springs (438) longitudinally coupled with both sides of a frame recess
(418) formed in the articulation mechanism (240).
2. The surgical instrument as claimed in claim 1, wherein the handle portion
(20) comprises a handle means (24) for producing a rotational articulation
motion and a longitudinal firing motion, and the shaft (23) comprises a
shaft means (32) for separately transferring the rotational articulation
motion and the longitudinal firing motion.
3. The surgical instrument as claimed in claim 2, wherein the handle means
(24) comprises a means (26) for producing a longitudinal closing motion,
and the shaft means (36) comprises a means (33) for separately
transferring the longitudinal closing motion.
4. A surgical stapling and severing instrument comprising:
a handle portion (20) operable to produce a firing motion, a closing
motion, and an articulation motion;
a shaft (23) coupled to the handle portion (20) operable to separately
transfer the firing motion, the closing motion, and the articulation motion;
an elongate channel (16) coupled to the shaft (23);
an anvil (18) pivotally coupled to the elongate channel (16), responsive to
the closing motion from the shaft (23);
a firing device (14) having a distally presented cutting edge (48)
longitudinally received between the elongate channel (16) and the anvil
(18);
an articulation mechanism (240) pivoting the elongate channel (16) from
the shaft (23) in response to the articulation motion;
a pair of support plates flanking the firing mechanism (240) across the
articulation mechanism (240),
each support (430,432) plate comprising ends (434, 436) having a pair of
springs (438) longitudinally coupled with both sides of a frame recess
(418) formed in the articulation mechanism (240).
5. The surgical instrument as claimed in claim 4, wherein the firing device
engages the anvil (18) and elongate channel (16) to affirmatively space
the anvil (18) from the elongate channel (16) during longitudinal travel
between the anvil (18) and elongate channel (16).
6. The surgical instrument as claimed in claim 4, wherein the firing device
(14) comprises a distally presented cutting edge (48), the surgical
instrument comprising a staple cartridge (37) engaged by the elongate
channel (16) and having a proximally opened slot for receiving the cutting
edge (48) of the firing device, the staple cartridge (37) having a plurality
of staples (41) cammed upwardly by the distal longitudinal movement of
the firing device (14).
7. A surgical stapling and severing instrument, comprising:
a handle portion (20) operably configured to produce a rotational
articulation motion and a longitudinal firing motion;
a shaft (23) operably configured to separately transfer the rotational
articulation motion and the longitudinal firing motion;
an end effector (12) distally coupled to the shaft means (23);
an articulation mechanism (240) responsive to the rotational articulation
motion to articulate the end effector (12);
a firing bar (14) responsive to the longitudinal firing motion of the handle
portion (20), the firing bar (14) comprising:
an elongate strip (48) longitudinally positioned for movement through the
articulation mechanism (240), and
a firing bar (14) head distally connected to the elongate strip (48) and
positioned for longitudinal movement in the end effector (12);
a support plate means (240) for providing articulating support flanking the
firing bar elongate strip (48) through the articulation means; and
each support plate means comprising ends having a pair of springs
longitudinally coupled with both sides of a frame recess formed in the
articulation means.

This invention relates to a surgical stapling and severing instrument, comprising
a handle portion (20) operably configured to produce an articulation motion and
a firing motion; a shaft (23) having a longitudinal axis attached to the handle
portion (20) for transferring the articulation motion and the firing motion; an
articulation mechanism (240) coupling the shaft to the end effector (12) and
responsive to the articulation motion to rotate the end effector (12) from the
longitudinal axis of the shaft; an end effector (12) distally attached to the
articulation mechanism (240); a firing mechanism (14) responsive to the firing
motion and coupled for movement through the articulation mechanism (240) and
end effector (12) in response to the firing motion; a pair of support plates (430,
432) flanking the firing mechanism (240) across the articulation mechanism
(240), each support plate (430, 432) comprises ends (434, 436) having a pair of
springs (438) longitudinally coupled with both sides of a frame recess (418)
formed in the articulation mechanism (240).

Documents:

416-KOL-2004-FORM-27.pdf

416-kol-2004-granted-abstract.pdf

416-kol-2004-granted-claims.pdf

416-kol-2004-granted-correspondence.pdf

416-kol-2004-granted-description (complete).pdf

416-kol-2004-granted-drawings.pdf

416-kol-2004-granted-examination report.pdf

416-kol-2004-granted-form 1.pdf

416-kol-2004-granted-form 18.pdf

416-kol-2004-granted-form 2.pdf

416-kol-2004-granted-form 26.pdf

416-kol-2004-granted-form 3.pdf

416-kol-2004-granted-form 5.pdf

416-kol-2004-granted-reply to examination report.pdf

416-kol-2004-granted-specification.pdf

416-kol-2004-granted-translated copy of priority document.pdf


Patent Number 233932
Indian Patent Application Number 416/KOL/2004
PG Journal Number 17/2009
Publication Date 24-Apr-2009
Grant Date 22-Apr-2009
Date of Filing 09-Jul-2004
Name of Patentee ETHICON ENDO-SURGERY INC.
Applicant Address 4545 CREEK ROAD, CINCINNATI, OHIO
Inventors:
# Inventor's Name Inventor's Address
1 WALES, KENNETH S. 9675 SWAN PLACE, MASON, OHIO 45040
2 HEUIL, JOSEPH CHARLES 11611 THISTLEHILL DRIVE, LOVELAND, OHIO 45140
PCT International Classification Number A61B 17/072, 17/068
PCT International Application Number N/A
PCT International Filing date
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 10/615,971 2003-07-09 U.S.A.