Surgical stapling apparatus

[0001] This application claims the benefit of and priority to U.S. Provisional Patent Application No. 61/779,669, filed Mar. 13, 2013, the entire disclosure of which is incorporated by reference herein.

[0002] Technical Field

[0003] The present disclosure relates to surgical stapling apparatuses. More particularly, the present disclosure relates to surgical stapling apparatuses including knife drive lockout mechanisms.

[0004] Description of Related Art

[0005] Surgical stapling apparatus configured to staple, and subsequently sever tissue are well known in the art. Such stapling apparatuses typically include a housing or handle and an elongated member that extends from the housing. In certain instances, single use or multi use loading unit (MULU) reload may be configured to releasably couple to a distal end of the elongated member. In either of the aforementioned reload configurations, a tool assembly including an anvil and a cartridge may be provided on respective jaws of the reload to staple tissue. The tool assembly can include a knife to sever the stapled tissue. The reload can include a drive member having a working end which supports the knife and advances an actuation sled through the tool assembly to staple and sever tissue.

[0006] While the aforementioned reload configurations provide numerous advantages, it may be desirable to prevent inadvertent advancement of the drive member of the reload when a staple cartridge is absent from the tool assembly or has been fired.

[0007] As can be appreciated, surgical stapling apparatuses that include knife drive lockout mechanisms may prove useful in the surgical arena.

[0008] Embodiments of the present disclosure are described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user.

[0009] An aspect of the present disclosure provides a surgical stapling apparatus (a stapler). The stapler includes a housing. An elongated member extends from the housing. A reload is supported on a distal end of the elongated member. The reload includes a first jaw member that releasably supports a cartridge and a second jaw member that supports an anvil. The cartridge includes a slide deflector that is movable from a first position to a second position. One or more lockout steps are provided on one of the first and second jaw members. A drive member includes a working end that is configured to translate through the reload when the first and second jaw members are in a closed configuration. The working end urged to move toward the lockout step(s). In the first position, the slide deflector is positioned to prevent engagement of the working end of the drive member with the lockout step(s). And, in the second position the slide deflector is positioned to allow engagement of the working end of the slide deflector with the lockout step(s) to prevent further advancement of the working end. Distal translation of the working end causes the slide deflector to move from the first position to the second position.

[0010] The drive member may include a beam including a distal end having a pre-bent configuration that biases the working end towards the lockout step(s). One or more resilient member may be configured to bias the working end towards the lockout step(s). The resilient member(s) may be coupled to a pivoting member of the surgical stapling apparatus. The resilient member(s) may include a generally arcuate contacting portion that allows the working end to slide therepast and into contact with one of the slide deflector and lockout step(s). The lockout step(s) may be provided on each of the anvil and first jaw member.

[0011] The slide deflector may be removably coupled to an actuation sled of the cartridge. The slide deflector may include one or more detents thereon that may be configured to engage a corresponding indent on the working end and a corresponding indent disposed within the cartridge. The slide deflector includes a mechanical interface that is configured to engage a corresponding mechanical interface disposed within the cartridge. The mechanical interfaces disposed on the slide deflector and within the cartridge form a dovetail joint.

[0012] An aspect of the present disclosure provides a surgical stapling apparatus (a stapler). The stapler includes a housing. An elongated member extends from the housing. A reload is supported on a distal end of the elongated member. The reload includes a first jaw member that releasably supports a cartridge and a second jaw member that supports an anvil. The cartridge includes a slide deflector that is movable from a first position to a second position. One or more lockout steps are provided on one of the first and second jaw members. A drive member includes a working end that is configured to translate through the reload when the first and second jaw members are in a closed configuration. The working end urged to move toward the lockout step(s). One or more resilient members are positioned for biasing the working end towards the at least one lockout step. In the first position, the slide deflector is positioned to prevent engagement of the working end of the drive member with the lockout step(s). And, in the second position the slide deflector is positioned to allow engagement of the working end of the slide deflector with the lockout step(s) to prevent further advancement of the working end. Distal translation of the working end causes the slide deflector to move from the first position to the second position.

[0013] The resilient member(s) may be coupled to a pivoting member of the surgical stapling apparatus. The resilient member(s) may include a generally arcuate contacting portion that allows the working end to slide therepast and into contact with one of the slide deflector and lockout step(s). The lockout step(s) may be provided on each of the anvil and first jaw member.

[0014] The slide deflector may be removably coupled to an actuation sled of the cartridge. The slide deflector may include one or more detents thereon that may be configured to engage a corresponding indent on the working end and a corresponding indent disposed within the cartridge. The slide deflector includes a mechanical interface that is configured to engage a corresponding mechanical interface disposed within the cartridge. The mechanical interfaces disposed on the slide deflector and within the cartridge form a dovetail joint.

[0015] An aspect of the present disclosure provides a reload configured to couple to a surgical stapling apparatus. The reload includes a cartridge that is supported on a first jaw member of the reload. The cartridge includes a slide deflector movable from movable from a first position to a second position. One or more lockout steps are provided on one of the first and second jaw members. A drive member includes a working end configured to translate through the reload when the first and second jaw members are in a closed configuration. The working end urged to move toward the lockout step(s). In the first position, the slide deflector is positioned to prevent engagement of the working end of the drive member with the lockout step(s). And, in the second position the slide deflector is positioned to allow engagement of the working end of the slide deflector with the lockout step(s) to prevent further advancement of the working end. Distal translation of the working end causes the slide deflector to move from the first position to the second position.

[0041] Detailed embodiments of the present disclosure are disclosed herein; however, the disclosed embodiments are merely examples of the disclosure, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.

[0042] FIG. 1 illustrates a powered surgical stapling apparatus shown generally as 100. FIG. 2 illustrates a manual surgical stapling apparatus shown generally as 200. The powered apparatus includes one or more motors and an internal or external power source, whereas the manual apparatus 200 has a movable handle 236 and a mechanism for driving the functions of the apparatus. See U.S. Pat. Nos. 5,865,361; 5,782,396; International WO 04/032,760; U.S. Patent Publication No. 2010/0276741; and U.S. patent application Ser. No. 13/444,228, the entire contents of each of these disclosures is hereby incorporated by reference.

[0043] Briefly, the surgical stapling apparatus 100 includes a housings or stationary handle 102 having an actuator 136 and an elongated member 104 extending from housing 102 (FIG. 1). Likewise, surgical stapling apparatus 200 includes a housing 202 or stationary handle supporting a movable handle 236 and an elongated member 204 extending from housing 202. Surgical stapling apparatus 200 includes a retraction mechanism 216 (FIG. 2) that can be manually grasped and pulled proximally to retract a firing mechanism of the apparatus 200. Each of elongated members 104, 204 is configured to removably couple to a reload 106.

[0044] Referring to FIG. 3A, the reload 106 includes a shaft portion 109 and a tool assembly 107 supported on a distal end of the shaft portion 109. The tool assembly 107 includes first and second jaw members 108, 110 which are movable from a spaced apart configuration (FIG. 2) for positioning tissue therebetween to an approximated configuration (FIG. 13) for clamping tissue for subsequent stapling thereof.

[0045] FIG. 3B illustrates the tool assembly 107 with the jaw members 108, 110 separated and a drive member “D” having a drive beam 103 having which supports a working end 101. Working end 101 has an I-beam configuration having top and bottom flanges 118a, 118b and includes distal abutment surface 118c which engages a central support wedge 113a (FIG. 4) of an actuation sled 115. Working end 101 is configured to move through the tool assembly 107 which includes knife channel portions 114a, 114b that are defined through an anvil 111 which is supported on the jaw member 110 and jaw member 108, respectively. Specifically, the working end 101 of the drive beam 103 moves from a retracted position to an extended position to advance knife 105 and the actuation sled 115 to staple and sever tissue. The knife 105 is positioned to travel slightly behind the actuation sled 115 during a stapling procedure to form an incision between rows of stapled tissue.

[0046] Referring to FIG. 3B, a pivot assembly 150 is provided at a distal end of shaft 109 which pivotally couples tool assembly 107 to shaft 109. Pivot assembly 150 includes bottom and top portions 151a, 151b that are operably coupled to one another and to jaw members 108, 110, respectively, so as to allow articulation of jaw members 108, 110 (FIG. 3B) about an axis transverse to the longitudinal axis of the reload 106.

[0047] Reference may be made to U.S. Pat. Nos. 5,865,361 and 7,225,963, the entire contents of which are incorporated herein by reference, for a more detailed discussion of the construction and operation of reload 106.

[0048] With reference to FIGS. 3B-5, jaw member 108 of tool assembly 107 is configured to support a removable cartridge assembly 112 (cartridge 112) thereon. Cartridge 112 includes a plurality of fasteners 117a and a plurality of pusher members 117b that are operatively engaged with one or more the fasteners 117a. Cartridge 112 includes one or more retention slots 119 that are positioned longitudinally along a tissue contacting surface 121 of cartridge 112 and are configured to house fasteners 117a. A cartridge housing 123 (FIG. 4) is couple to jaw member 108. In any of the embodiments disclosed herein, cartridge 112 may be coupled to jaw 108 using detents 125 (FIG. 4), latches, clips or the like. A removable and replaceable cartridge is disclosed in U.S. patent application Ser. No. 13/280,880 entitled Multi-Use Loading Unit, the entire disclosure of which is hereby incorporated by reference herein.

[0049] Referring to FIGS. 3A-12, the reload 106 includes a locking mechanism that is configured to lock-out the drive member “D” so as to prevent firing of the apparatus when a cartridge 112 has not been installed in the jaw member 108 or when the cartridge 112 installed in jaw member 108 has already been fired. The locking mechanism includes a slide deflector 130 provided at a proximal end of cartridge 112 which is configured to prevent deflection of the working end 101 of the drive member “D” when the slide deflector 130 is in a retracted position prior to firing of the staple cartridge 112. Slide deflector 130 includes a generally elongated configuration having proximal and distal ends 131a, 131b, respectively, and is and releasably coupled to actuation sled 115. In the illustrated embodiment, the slide deflector 130 is supported between raised wedge supports of the actuation sled 115 to releasably couple the slide deflector 130 to the actuation sled 115. More specifically, slide deflector 130 is coupled to actuation sled 115 between central wedge support 113a and a right wedge support 113b of actuation sled 115 (FIG. 5).

[0050] Referring to FIGS. 6 and 7, in the pre-installed configuration of cartridge 112, proximal end 131a of slide deflector 130 extends proximally past a proximal edge of actuation sled 115. Proximal end 131a of slide deflector 130 defines an angled surface which is positioned to deflect abutment surfaces 118c, 118d of working end 101 of the drive member “D” away from respective lockout steps 120a, 120b that are provided on anvil 111 and cartridge 112, respectively, when the cartridge 112 is installed into the jaw member 108. By deflecting working end 101 in this manner, the drive member “D” is permitted to translate distally past lockout steps 120a, 120b and through knife channels 114a, 114b to effect the stapling and severing of tissue.

[0051] A detent 133 is provided adjacent a distal end 131b of slide deflector 130 and includes an inside portion 134a that is configured to securely engage a corresponding indent 137a that is provided on an interior sidewall 137b of cartridge 112 (FIG. 7). Detent 133 includes an outside portion 134b that is configured to releasably engage a corresponding indent 138 that is provided on working end 101 of the drive member “D.” Detent 138 is positioned adjacent top flange 118a. In accordance with the instant disclosure, as working end 101 of drive member “D” moves distally and advances actuation sled 115 within cartridge 112, outside portion 134b releasably engages indent 138 on working end 101 to advance the slide deflector 130 distally within cartridge 112. The slide deflector 130 will move distally with working end 101 of drive member “D” until the inside portion 134a of detent 133 engages indent 137a on interior wall 137b of cartridge 112.

[0052] Slide deflector 130 includes a sidewall 140 that extends along one side of the slide deflector 130 and defines a groove 141 configured to receive therein a corresponding guide member 139 which extends from an interior sidewall 137b of cartridge 112 (FIG. 8). Interior sidewall 137b including guide member 139 is positioned within cartridge 112 to allow distal translation of actuation sled 115 through cartridge 112. In one embodiment, groove 141 has a dovetail configuration and receives the guide member 139 of corresponding shape.

[0053] Referring to FIGS. 7-9, in accordance with the instant disclosure, when working end 101 of drive member “D” is advanced to contact and advance the actuation sled 115, actuation sled 115 initially moves independently of the slide deflector 130. Continued distal translation of working end 101 causes outside portion 134b of detent 133 of slide deflector 130 to releasably engage corresponding indent 138 of working end 101 to couple slide deflector 130 to working end 101 such that slide deflector 130 and working end 101 move distally in unison. Further distal translation of working end 101 causes groove 141 to receive guide member 139. Guide member 139 guides slide deflector 130 into engagement with interior wall 145 to prevent further distal movement of the slide deflector 130. When distal end 131b of slide deflector 130 contacts interior wall 145, outside portion 134b of slide deflector 130 disengages from corresponding indent 138 of working end 101 of drive member “D.” With groove 141 engaged with guide member 139, slide deflector 130 is secured to interior sidewall 137b and prevented from further movement within cartridge 112. More specifically, when working end 101 is moved back to the retracted configuration slide deflector 130 is retained in the advanced position with the distal end 131b in contact with interior wall 145.

[0054] Referring again to FIG. 3B, and with reference to FIG. 11, resilient member 152 is provided adjacent a proximal end of jaw member 108 and is configured to bias working end 101 of drive member “D” towards lockout steps 120a, 120b of anvil 111 and cartridge 112, respectively. Specifically, resilient member 152 is coupled to an extension 153 of bottom portion 151b of pivot assembly 150 (FIG. 3B). In the illustrated embodiment, for example, a pair of rivets 155a, 155b are configured to extend through apertures 157a, 157b that are provided at a proximal coupling end 156a of resilient member 152 and corresponding apertures 158a, 158b defined in extension 153 to secure the resilient member 152 to the pivot assembly 150 at the proximal end of the tool assembly 107. Alternatively, other coupling methods may be used to secure the resilient member 142 to the cartridge 112. In some embodiments, resilient member 152 may be operably coupled to an interior wall of jaw member 108 and/or cartridge 112.

[0055] A generally arcuate contacting portion 156b is provided on resilient member 152 and extends from proximal coupling end 156a to bias working end 101 of drive member “D” towards slide deflector 130 (when the slide deflector 130 is in a retracted position) and/or lockout steps 120a, 120b. The arcuate contacting portion 156b is configured to allow working end 101 of drive member “D” to move past the contacting portion 156b and into contact with slide deflector 130 and/or lockout steps 120a, 120b (FIGS. 17-21). In addition, arcuate contacting portion 156b is configured to permit movement of the working end 101 back to the retracted configuration after the cartridge 112 has been fired. Arcuate contacting portion 156b is configured to extend into knife channels 114a, 114b (see FIGS. 17-18) and includes a spring constant that is capable of biasing the working end 101 towards slide deflector 130 without imparting too much biasing force that would substantially alter a translation path of the working end 101.

[0056] With reference to FIGS. 11-14, lockout out step 120b is provided adjacent knife channel 114b (FIGS. 12 and 14) and is configured to contact abutment surface 118d of the working end 101 (FIG. 21). Lockout step 120b may be formed in jaw member 108 during a manufacturing process thereof. Contact between lockout step 120b and abutment surface 118d of working end 101 of drive member “D” prevents re-advancement of the drive member “D”, as discussed in further detail below.

[0057] FIGS. 15-16 illustrate jaw member 110 having anvil 111 coupled thereto. Anvil 111 includes a plurality of buckets or depressions 107 (see FIG. 3A, for example) that are configured to receive corresponding fasteners 117a therein when fasteners 117a are deployed from cartridge 112. Lockout step 120a is provided at a proximal end of anvil 111 adjacent knife channel 114a and functions in a manner similar to lockout step 120b. Specifically, lock out step 120a is configured to contact abutment surface 118c of working end 101 to prevent re-advancement of the drive member “D”. Lockout step 120a is defined in anvil 111 and covered by jaw member 110 (FIG. 15). Lockout step 120a may be aligned with lockout step 120b. Alternatively, lockout step 120a and 120b may offset or otherwise configured to accommodate various surgical procedures and/or needs.

[0058] While cartridge 112 and anvil 111 have both been described herein as including respective lockout steps 120b, 120a, it is within the purview of the instant disclosure for only one of anvil 111 or cartridge 112 to include a lockout step. As can be appreciated, however, having two lockout steps 120a, 120b provides more protection to prevent re-advancement of the drive member “D” after firing of a cartridge 112. For purposes herein, it is assumed that abutment surface 118c contacts lockout step 120a at approximately the same time abutment surface 118d contacts lockout step 120b.

[0059] In use, when a cartridge assembly 112 is not installed on jaw member 108, knife contacting portion 156b of resilient member 152 extends into knife channels 114a, 114b (FIG. 17). With knife contacting portion 156b in this configuration, engagement between knife contacting portion 156b and working end 101 of drive member “D” biases abutment surfaces 118c, 118d into respective lockout steps 120a, 120b as the drive member “D” is advanced distally within cartridge 112 to prevent further advancement of drive member “D”.

[0060] When cartridge 112 is installed on jaw member 108, proximal end 131a of slide deflector 130 is positioned proximally past lockout steps 120a, 120b (FIG. 18). In this position, slide deflector 130 prevents abutment surfaces 118, 118d of working end 101 from engaging respective lockout steps 120a, 120b. As a result thereof, drive member “D” including working end 101 is allowed to translate distally past slide deflector 130 (FIG. 19) and engage actuation sled 115 in a manner as described above.

[0061] Drive member “D” may then be moved proximally past slide deflector 103 and resilient member 152 until working end 101 returns to the retracted configuration. With the working end 101 of drive member “D” in the retracted position and the slide deflector 130 in the advanced position the slide deflector 130 is no longer positioned to prevent deflecting of the working end 101 into steps 120a, 120b by resilient member 152. Once working end 101 returns back to the retracted configuration, knife contacting portion 156b of resilient member 152 deflects the working end 101 of drive member “D” towards steps 120a, 120b to prevent further advancement of dive member “D” in a manner as described above (FIGS. 20-21).

[0062] The unique configuration of the locking mechanism including slide deflector 130 and resilient member 152 overcomes the aforementioned drawbacks that are, typically, associated with conventional surgical stapling apparatus. Specifically, slide deflector 130 including resilient member 152 prevents inadvertent advancement of the drive member “D” when a staple cartridge is absent from the tool assembly 107 or has been fired.

[0063] From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, the surgical stapling apparatus 100, 200 have been described herein as including a resilient member 152 that is configured to bias working end 101 towards lockout steps 120a, 120b, other methods and/or devices may be utilized to bias working end 101 towards lockout steps 120a, 120b.

[0064] For example, with reference to FIGS. 22-23, an alternate embodiment of locking mechanism is illustrated. This embodiment is substantially similar to the aforementioned embodiment that utilized working end 101. Accordingly, only those features that are unique to the embodiment illustrated in FIGS. 22-23 are described herein.

[0065] Unlike working end 101 that is configured to be biased towards lockout steps 120a, 120b via resilient member 152, a distal end 203a of drive beam 203 is self biased towards lockout steps 120a, 120b. Specifically, distal end 203a is pre-bent in a direction towards lockout steps 120a, 120b. Distal end 203a may be bent to provide any suitable spring constant, e.g., a spring constant approximately equal to the spring constant provided by resilient member 152.

[0066] In use, when cartridge assembly 112 is not installed on jaw member 108, the pre-bent distal end 203a of the drive beam 203 biases the working end 201 into engagement with the aforementioned lockout steps 120a, 120b. Accordingly, working end 201 of the drive member “D” is prevented form advancing distally.

[0067] When cartridge 112 is installed on jaw member 108, proximal end 131a of slide deflector 130 is positioned proximally of lockout steps 120a, 120b. Accordingly, slide deflector 130 deflects the abutment surfaces of working end 201 from engaging respective lockout steps 120a, 120b. As a result thereof, the drive member including working end 201 is allowed to translate distally past slide deflector 130 and engage actuation sled 115 in a manner as described above.

[0068] The drive member may then be moved proximally until the working end 201 is back to the retracted configuration. Once working end 201 is moved back to the retracted configuration and the slide deflector 130 is in its distal position (no longer positioned to deflect working end 201 past lockout steps 120a, 120b), the pre-bent configuration of distal end 203a locks out the drive member in a manner as described above.

[0069] The figures show a replaceable loading unit with surgical stapling and a shaft (such as a shaft 109) that can be attached to a surgical stapling apparatus. Other configurations are contemplated. For example, the replaceable loading unit can itself have a removable and replaceable cartridge assembly. Alternatively, the jaws of the instrument can be permanently attached and configured to receive a removable and replaceable cartridge.

[0070] Further, in embodiments it may prove advantageous not to utilize outside portion 134b and corresponding indent 138. In this embodiment, the aforementioned indent/detent configuration that was described above in conjunction with coupling slide deflector 130 with actuation sled 125 may be configured to maintain slide deflector 130 engaged with actuation sled 125 after working end 101 contacts actuation sled 115. As can be appreciated, certain other modifications may need to be made to cartridge 112, actuation sled 115, slide deflector 130 and/or working end 101 such that the locking mechanism functions in a manner in accordance herewith.

[0071] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.