Cartridgizable feeder belt for surgical stapler

[0001] The invention generally relates to surgical staplers and stapling.

[0002] An endocutter is a surgical tool that staples and cuts tissue to transect that tissue while leaving the cut ends hemostatic. An endocutter is small enough in diameter for use in minimally invasive surgery, where access to a surgical site is obtained through a trocar, port, or small incision in the body. A linear cutter is a larger version of an endocutter, and is used to transect portions of the gastrointestinal tract. A typical endocutter receives at its distal end a disposable single-use cartridge with several rows of staples, and includes an anvil opposed to the cartridge. During actuation of an endocutter, the cartridge fires all of the staples that it holds. In order to deploy more staples, the endocutter must be moved away from the surgical site and removed from the patient, after which the old cartridge is exchanged for a new cartridge. The endocutter is then reinserted into the patient.

[0010] The use of the same reference symbols in different figures indicates similar or identical items.

[0011] U.S. patent application Ser. No. 12/263,171, filed on Oct. 31, 2008 (the “Endocutter Document”), is hereby incorporated by reference herein in its entirety. The Endocutter Document describes exemplary feeder belts used in a surgical stapler. Referring to FIG. 1, a feeder belt 2 may be a long, narrow, thin strip of material from which one or more staples 4 extend. The feeder belt 2 and staples 4 of the present document may be substantially as set forth in the Endocutter Document, with the exception of the inventive features set forth in the present document. Each staple 4 may have a free end 6, and an opposite end 8 that is connected to the feeder belt 2. Advantageously, the staples 4 are frangibly affixed to the feeder belt 2, such that they are sheared off from the feeder belt 2 during deployment. However, the staples 4 may be connected to the feeder belt 2 in any suitable manner. One or more rows 10 of staples 4 may be connected to the feeder belt 2. Each row 10 of staples 4 is the group of staples 4 positioned at substantially the same lateral location relative to the longitudinal centerline of the feeder belt 2, and each row 10 of staples 4 may be oriented generally longitudinally.

[0012] As seen in FIG. 1, an exemplary feeder belt 2 may be a generally flat and generally linear piece of material that carries a plurality of staples 4. The feeder belt 2 may lie substantially in a single plane. The feeder belt 2 may be flexible, or instead may be rigid. Such a feeder belt 2 may have a proximal end 12 and a distal end 14. Referring also to FIG. 2, a cartridge 20 may hold one or more feeder belts 2. At least one feeder belt 2 may be held entirely within the cartridge 20, for convenience in interchangeability. The cartridge 20 may be configured substantially as set forth in the Endocutter Document, with the exception of the inventive features set forth herein. The one or more feeder belts 2 may be held by the cartridge 20 in any suitable manner. As one example, the proximal end 12 and the distal end 14 of the feeder belt 2 each may be fixed to the cartridge 20. Referring also to FIG. 2A, the cartridge 20 may have an upper surface 22 through which one or more staple slots 24 may be defined. A knife slot 26 may also be defined in the upper surface 22 of the cartridge 20. In order to fix a feeder belt 2 to the cartridge 20, the proximal end of 12 of the feeder belt 2 may be fastened to the upper surface 22 of the cartridge 20 at a connection area 28 proximal to the corresponding slot 24. Similarly, the distal end 14 of the feeder belt 2 may be connected to a similar area distal to the corresponding slot 24. The staples 4 are oriented such that they are deployable through the corresponding staple slot 24. The proximal end 12 of the feeder belt 2 may be fastened to the connection area 28 on the upper surface 22 of the cartridge 20 in any suitable manner. For example, the proximal end 12 of the feeder belt 2 may be welded to, adhered to, pinned or otherwise mechanically connected to, or friction or interference fit to the connection area 28. The distal end 14 of the feeder belt 2 may be connected to the upper surface 22 of the cartridge 20 distal to the corresponding staple slot 24 in a similar or different manner.

[0013] Referring also to FIG. 7, use of the cartridge 20 may be beneficial for use in a surgical instrument 100 where an articulation 102 is utilized in the instrument proximal to the cartridge 20. For example, the surgical instrument 100 may include a handle 104 from which a shaft 106 extends, where an articulation 102 is located in the shaft 106. Such a surgical instrument 100 may be as described in U.S. patent application Ser. No. 12/400,760, filed on Mar. 9, 2009, which is hereby incorporated by reference in its entirety. An end effector 108 may be connected to the distal end of the shaft 106, distal to the articulation 102. Referring also to FIG. 5, the cartridge 20 is configured to be placed in and held by a receiver 40, which may be part of the end effector 108. By holding each feeder belt 2 inside the cartridge 20, which in turn is held by the end effector 108, no feeder belt 2 crosses the articulation 102, which may simplify construction of the surgical instrument 100. At the same time, the cartridge 20 may be configured to hold fewer staples 4 than described in the Endocutter Document.

[0014] The receiver 40 may receive and hold the cartridge 20 in any suitable manner. As one example, the cartridge 20 may be pressure fit into the receiver 40. As another example, the cartridge 20 may snap into or otherwise be affirmatively held in the receiver 40 in a different manner. Referring also to FIG. 4, the underside 42 of the cartridge 20 may include at least one aperture 44 defined therethrough. As set forth in the Endocutter Document, one or more wedges 30 slide relative to the staples 4 in order to deploy them, and the wedges 30 may be fixed to or otherwise connected to a wedge block 44. The wedge block 44 may include a pocket 46 defined in its underside, where that pocket 46 is aligned with the aperture 44. A tab 48 may be located in the receiver 40, and may be a slidable along a channel 50 defined in the lower surface of the receiver 40. One or more cables 52 may extend proximally from the tab 48, and may extend out of the end effector 108 through the shaft 106 to the handle 104. One or more of the cables 52 may pass through the articulation 102 in the shaft 106. The tab 48 is sized and shaped to be received into the pocket 46 of the wedge block 44.

[0015] The cartridge 20 may be actuated substantially as set forth in the Endocutter Document. Each wedge 30 may be connected to the wedge block 44. The wedges 30 may initially be in a distal position within the cartridge 20. To actuate the wedges 30, the cable or cables 52 are pulled proximally in response to input from, for example, the handle 104. This motion of the cable or cables 52 causes the tab 48 to move proximally, which in turn moves the wedge block 44 proximally. As the wedge block 44 moves proximally, it slides the wedge or wedges 30 proximally as well. Advantageously, one wedge 30 slides along a corresponding row 10 of staples 4 to sequentially deform staples 4 upward through the corresponding staple slots 24, and then shear staples 4 from the feeder belts 2. A knife (not shown) also may be connected to the wedge block 44, and may slide upward through the corresponding knife slot 26 as set forth in the Endocutter Document.

[0016] The wedge block 44 may be actuated to move proximally along a distance such that all of the staples 4 are deformed and then sheared off the corresponding feeder belts 2. If so, the cartridge 20 is configured for a single firing. Alternately, the wedge block 44 may be actuated to move along a distance such that only a subset of the staples 4 are deformed and then sheared off the corresponding feeder belts 2. If so, the cartridge 20 can be reused at least once.

[0017] After firing, and after the cartridge 20 is spent such that no staples 4 are left in the cartridge 20 or such that fewer staples 4 are left in the cartridge 20 than the user needs to perform another procedure, the cartridge 20 may be removed from the receiver 40. A new cartridge 20 may then be placed in the receiver 40, in substantially the same manner as described above. In this way, the majority of the surgical instrument 100 may be reused with regard to a patient, while only the cartridge 20 needs to be replaced when spent. Advantageously, the wedges 30 may be contained entirely within the cartridge 20, simplifying the process of removing the cartridge 20 from the receiver 40 and replacing it with a fresh one.

[0018] As another example, the feeder belt 2 may form a continuous loop, such as set forth in the Endocutter Document. Such a feeder belt 2 may be held completely within the corresponding cartridge 20. That feeder belt 2 thereby is configured to hold more staples 4 than the two-dimensional feeder belt 2 of FIG. 1, but may be configured to hold fewer staples 4 than described in the Endocutter Document. Such a feeder belt 2 may be advanced substantially as described in the Endocutter Document, or in any other suitable manner. Where the cartridge 20 utilizes such a feeder belt 2, the cartridge 20 advantageously may be fired two or more times before its replacement is needed.

[0019] As another example, the cartridge 20 itself may be reloadable, as shown in FIG. 6. If so, the cartridge 20 may include one or more rear apertures 52 defined in its proximal end. After use, the spent feeder belt 2 may be slid through the corresponding rear aperture 52 and disposed of in a suitable manner. A new feeder belt 2 may then be slid through each corresponding rear aperture 52, and may be held in place in the cartridge 20 in any suitable manner. In this way, even more of the surgical instrument 100 may be reusable in the course of treatment of a single patient.

[0020] While the invention has been described in detail, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention. It is to be understood that the invention is not limited to the details of construction, the arrangements of components, and/or the method set forth in the above description or illustrated in the drawings. Statements in the abstract of this document, and any summary statements in this document, are merely exemplary; they are not, and cannot be interpreted as, limiting the scope of the claims. Further, the figures are merely exemplary and not limiting. Topical headings and subheadings are for the convenience of the reader only. They should not and cannot be construed to have any substantive significance, meaning or interpretation, and should not and cannot be deemed to indicate that all of the information relating to any particular topic is to be found under or limited to any particular heading or subheading. Therefore, the invention is not to be restricted or limited except in accordance with the following claims and their legal equivalents.