Small diameter cartridge design for a surgical stapling instrument

[0001] 1. Technical Field

[0002] The present disclosure relates to surgical instruments and, more specifically, to staple cartridges for surgical stapling instruments having a reduced diameter.

[0003] 2. Discussion of Related Art

[0004] Surgical stapling devices for stapling tissue typically include a tool assembly having a staple cartridge, an anvil, and a knife that can be actuated to effect simultaneous dissection and suturing of tissue. When compared to traditional methods of manually applying threaded sutures to tissue, the use of surgical stapling devices to suture and dissect tissue has increased the speed of the suturing procedure and thus, minimized patient trauma.

[0005] In an endoscopic surgical procedure, a surgical stapler is inserted through a small incision in the skin or through a cannula to access a surgical site. Due to the complexity of known surgical stapling devices, a continuing need exists for small diameter surgical stapling devices that are suitable for insertion through smaller diameter openings, e.g., a 5 mm cannula, that can effectively suture and dissect tissue.

[0006] In an aspect of the present disclosure, an end effector includes a first jaw, a second jaw, and a cartridge. The first jaw has a sled and the second jaw has an anvil. The first and second jaws are moveable relative to one another. The cartridge is disposed on the first jaw and has a plurality of staples. The sled is configured to engage each staple of the plurality of staples to eject the plurality of staples from the cartridge as the sled is longitudinally translated through the cartridge. The end effector may have an approximated configuration such that the end effector is configured to fit through a 5 mm opening. The sled may be configured to directly engage each staple of the plurality of staples.

[0007] In aspects, the cartridge may define a plurality of vertical slots and a first vertical channel. The lower jaw may define a longitudinal axis with the first vertical channel parallel to the longitudinal axis. The vertical channel may pass through each vertical slot of a first line of the plurality of vertical slots.

[0008] In some aspects, a staple of the plurality of staples is disposed in each vertical slot of the plurality of vertical slots. The cartridge and the first jaw may define a sled channel and the sled may be longitudinally translatable through the sled channel. The sled may include a first fin that extends from an upper surface of the sled. The first fin may be translatable through the first vertical channel to engage each staple disposed within the vertical slots of the first line of the plurality of vertical slots.

[0009] In certain aspects, each vertical slot of the plurality of vertical slots has a first width transverse to the longitudinal axis and the first vertical channel has a second width transverse to the longitudinal axis. The second width may be less than the first width. The staple of the plurality of staples may be disposed in each vertical slot of the plurality of vertical slots and has a stapled width that is transverse to the longitudinal axis. The staple width may be less than the first width and greater than the second width such that each staple is limited to movement towards and way from a tissue contacting surface of the cartridge. Each staple of the plurality of staples may include legs that are connected by a backspan. The backspan may have a chamfered surface on a proximal end of the backspan. The chamfered surface may be disposed at a chamfer angle relative to a bottom surface of the backspan. The sled may include a first fin and may have a first angled surface that is configured to engage the chamfered surface of each staple of the plurality of staples as the sled is translated through the cartridge. The first angle may be equal to the chamfer angle. The first fin may include a second angled surface that is proximal of the first angled surface. The second angled surface may define a second angle with the upper surface of the sled. The second angle may be greater than the first angle. The second angled surface may be configured to engage the chamfered surface of each staple subsequent to the first angled surface engaging the chamfered surface of each staple.

[0010] In another aspect of the present disclosure, a loading unit includes an elongated body and an end effector that is disposed at a distal end of the elongated body. The end effector may be any of the end effectors detailed herein.

[0011] In aspects, the elongated body is configured to fit through a 5 mm opening. The end effector may be articulable relative to the elongated body. The elongated body may include a proximal end that is configured to couple the loading unit to a handle. The handle may be manually actuated or electromechanically actuated.

[0012] In another aspect of the present disclosure, a method of joining tissue includes clamping tissue between first and second jaws of a surgical instrument and translating a sled through a cartridge of the first jaw. The sled contacting each staple of a plurality of staples to eject the plurality of staples from the cartridge towards the second jaw.

[0013] In aspects, translating the sled through the cartridge includes translating the sled through a sled channel that is defined by the first jaw and the cartridge such that a first fin which extends from an upper surface of the sled contacts each of the plurality of staples. Translating the sled through the cartridge may include translating the first fin though a vertical channel and a first line of vertical slots defined by the cartridge. The first line of vertical slots may be disposed along the vertical channel. Contacting each staple of the plurality of staples with the first fin may include contacting a chamfered surface of each staple of the plurality of staples with a first angled surface of the first fin and subsequently contacting the chamfered surface of each staple of the plurality of staples with a second angled surface of the first fin. Contacting the chamfered surface of each staple of the plurality of staples with the first angled surface ejects each staple of the plurality of staples from the cartridge such that legs of the staple penetrate tissue between the first and second jaws. Contacting the chamfered surface of each staple of the plurality of staples with the second angled surface drives the legs of each staple of the plurality of staples into the angle to deform the legs to join the tissue.

[0014] Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

[0028] Embodiments of the present disclosure are now described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closest to the clinician and the term “distal” refers to the portion of the device or component thereof that is farthest from the clinician.

[0029] This disclosure relates generally to a loading unit for joining tissue with staples. The loading unit is sized to fit through a 5 mm opening or port and includes an end effector having upper and lower jaws. The lower jaw has a staple cartridge with a plurality of staples disposed therein. The lower jaw also includes a sled that is translatable through the cartridge such that the sled directly engages each staple to eject the staples from the cartridge and to drive the staples into an anvil of the upper jaw to form the staples.

[0030] Referring now to FIGS. 1A and 1B, a manually actuated surgical instrument 101 and a powered surgical instrument 201 each include a loading unit 10 provided in accordance with the present disclosure. The manually actuated surgical instrument 101 includes a housing 110, a handle assembly 112, a rotation control 114, an actuation lever 116, a retraction control 118, and an elongated portion 120. The elongated portion 120 extends from the housing 110 to support the loading unit 10 at a distal end 122 thereof.

[0031] For a detailed description of the structure and function of an exemplary manually actuated surgical instrument reference may be made to U.S. Pat. No. 7,565,993, the entire contents of which are incorporated by reference herein.

[0032] The powered surgical instrument 201 includes a powered handle 210 and an adapter 220. The powered handle 210 includes a user interface 212 and an adapter interface 214. The adapter 220 includes a distal end 222 that is configured to support the loading unit 10 and a proximal connector 224 that is configured to be received in the adapter interface 214 of the powered handle 210. For a detailed description of the structure and function of an exemplary powered handle and adapter reference may be made to U.S. Patent Publication No. 2012/0253329, the entire contents of which are incorporated by reference herein.

[0033] As seen in FIG. 1B, a loading unit 10′ includes an elongated body 20 and an end effector 30. The elongated body 20 includes a connector 22 that releasably couples to the distal end 122 of the elongated portion 120 (FIG. 1A) or the distal end 222 of the adapter 220 (FIG. 1B). The connector 22 includes tabs 24 that align and secure the connector with the elongated portion 120 or the adapter 220. The connector 22 is configured to interface with one or more drive rods, e.g., drive rod 226 of the adapter 226, to actuate one or more functions of the end effector 30 as detailed below. The elongated body 20 of the loading unit 10′ may have a diameter of about 5 mm such that the elongated body 20 may fit through a 5 mm cannula or access port. It is also contemplate that the loading unit 10, 10′ may be coupled to a robotic surgical system. For a detailed description of the structure and function of an exemplary robotic surgical system reference may be made to U.S. Pat. No. 8,828,023, the entire contents of which are hereby incorporated by reference

[0034] With continued reference to FIG. 1B, the loading unit 10′ includes a dissecting tip 310 on the upper jaw 90′. The dissecting tip 310 is configured to pierce tissue, penetrate tissue, maneuver tissue, or dissect tissue. The dissecting tip 310 may be releasably secured to the upper jaw 90′ or may be integrally formed with the upper jaw 90′. For a detailed description of the structure and function of an exemplary dissecting tip reference may be made to U.S. Pat. No. 8,496,153, the entire contents of which are hereby incorporated by reference.

[0035] The loading unit 10′ may also include a buttress 322 on the lower jaw 40 and/or a buttress 324 on the upper jaw 90′. The buttresses 322, 324 are releasably attached to tissue contacting surfaces of the lower jaw 40 and the upper jaw 90′, respectively, to aid in joining tissue together. The buttress 322, 324 may be bioabsorbable and may include medicant to promote healing of tissue joined by the end effector 30. For a detailed description of the structure and function of an exemplary buttress reference may be made to U.S. Pat. No. 8,496,683, the entire contents of which are hereby incorporated by reference.

[0036] With additional reference to FIGS. 2-4, the end effector 30 includes a first or lower jaw 40 and a second or upper jaw 90 that are moveable relative to one another between a spaced apart configuration (FIG. 2) and an approximated configuration (FIG. 3) to grasp tissue therebetween. In the approximated configuration, the end effector 30 may have a diameter of about 5 mm such that the end effector 30 may fit through a 5 mm cannula or access port. The lower jaw 40 includes a cartridge 50 having a plurality of staples 60 and the upper jaw 90 includes an anvil 92 defining a plurality of staple pockets 94. The cartridge 50 may be releasably coupled to the lower jaw 40. Alternatively, the cartridge 50 may be integrally formed with the lower jaw 40.

[0037] With particular reference to FIG. 1A, to actuate the end effector 30 of the loading unit 10 with the manually actuated surgical instrument 101, the proximal end 22 (FIG. 1B) is received in a distal end 122 of the elongated portion 120 to couple the loading unit 10 to the housing 110. Then the handle assembly 112 is actuated to move the end effector 30 to the approximated configuration and to eject staples 60 (FIG. 4) from the cartridge 50 (FIG. 4). Specifically, a moveable handle of the handle assembly 112 is drawn towards a stationary handle of the handle assembly 112 to advance a drive rod (not shown) of the surgical instrument 101 to move the end effector 30 to the approximated configuration. Next, the moveable handle is returned to an unactuated position while the drive rod remains substantially stationary. Then, the moveable handle is actuated a second time to further advance the drive rod which ejects the staples 60 from the cartridge 50 and/or to advance a knife (not explicitly shown), as detailed below.

[0038] With particular reference to FIG. 1B, to actuate the end effector 30 of the loading unit 10 with the powered surgical instrument 201, the proximal connector 224 of the adapter 220 is received within the adapter interface 214 of the powered handle 210 to couple the adapter 220 to the powered handle 210. The loading unit 10 is coupled to the adapter 220 by positioning the connector 22 of the loading unit 10 within the distal end 222 of the adapter 220 such that the drive rod 226 of the adapter is received within the connector 22 of the loading unit. The user interface 212 is then manipulated to advance the drive rod 226 which first approximates the end effector 30 and then ejects the staples 60 (FIG. 4) from the cartridge 50 (FIG. 4) as detailed below.

[0039] Referring to FIGS. 4-6, the cartridge 50 defines a plurality of vertical slots 52, longitudinal vertical channels 54, a longitudinal knife channel 56, and a longitudinal sled channel 58 that passes through a lower portion of each of the vertical slots 52, vertical channels 54, and knife channel 56. The knife channel 56 is disposed along a longitudinal axis of the end effector 30. With particular reference to FIG. 6, the vertical slots 52 are arranged in longitudinal rows which are laterally offset from and parallel to the knife channel 56. Each of the vertical channels 54 passes through one of the longitudinal rows of vertical slots 52. The vertical slots 52 have a first width W₁, transverse to the longitudinal axis of the end effector 30, and the vertical channels 54 have a second width W₂, transverse to the longitudinal axis of the end effector 30, that is smaller than the first width W₁. Each of the vertical slots 52 receives a staple 60 having a width less than the first width W₁ and greater than the second width W₂ such that each staple 60 is retained within a respective vertical slot 52. Each vertical slot 52 is sized to slidably and releasable retain a staple 60. The vertical channel 54 is sized to receive and guide a fin 44 (FIG. 9) of a sled 42 as the sled 42 is longitudinally translated through the cartridge 50 as detailed below. Further, the fin 44 has a width that is less than a width of the staple 60 as detailed below.

[0040] With reference to FIG. 7, each staple 60 includes legs 62 joined together by a backspan 64. The legs 62 extend from the backspan 64 to tips 63 which are configured to penetrate tissue. As shown, the tips 63 are angled to penetrate tissue; however, it is contemplated that the tips 63 may have a conical shape or another shape suitable for penetrating tissue. The backspan 64 includes a chamfered surface 66 on at least a proximally facing end when the staple 60 is disposed within a respective vertical slot 52 (FIG. 6). It is contemplated that each end of the backspan 64 may include a chamfered surface 66 as detailed above such that the staples 60 may be positioned in the vertical slots with either end of the backspan 64 facing proximally. The chamfered surface 66 defines a chamfer angle θ with a lower surface 65a of the backspan 64. The chamfer angle θ is in the range of about 5° to about 35° (e.g., about 30°). It is contemplated that each longitudinal row of vertical slots 52 may be sized to receive staples 60 having the same or different dimensions; e.g., length of the legs 62, length of the backspan 64, or width of the legs 62 and backspan 64; from staples 62 of another longitudinal row of vertical slots 52.

[0041] In any of the embodiments disclosed herein, the feature on the backspan 64 can be chamfers, rounds, protrusions, one or more bevels, etc., that would engage the sled surface and arranged so that the staple is pushed out of the cartridge.

[0042] The backspan 64 of each staple 60 is thicker than a backspan of a traditional staple and functions as a pusher for the respective staple 60. By having the backspan 64 function as a pusher, traditional pushers may be eliminated from the staple cartridge 50 which allows the staple cartridge 50 to have a smaller diameter than a traditional staple cartridge. The backspan 64 is substantially rectangular in cross-section with vertical side surfaces 65b and a length substantially equal to a longitudinal length of a respective vertical slot 52 such that the backspan 64 is configured to guide the staple 60 within the respective vertical slot 52 as detailed below.

[0043] Referring briefly back to FIG. 4, the lower jaw 40 includes a sled 42 that is slidable through the sled channel 58 of the cartridge 50 to eject the staples 60 from the cartridge 50. With reference to FIGS. 8 and 9A, the sled 42 includes a horizontal base 43 and one or more fins 44 extending vertically from the base 43. Each fin 44 is slidable through a vertical channel 54 of the cartridge 50 and has a first angled surface 45a and a second angled surface 45b positioned distal to the first angled surface 45a. The first angled surface 45a is substantially linear and defines a first angle α with the base 43 of the sled 42. The second angled surface 45b is substantially linear and defines a second angle γ relative to the base 43 of the sled 42. The first angle α is substantially equal to the chamfer angle θ of the chamfered surface 66 of the backspan 64 of each staple 60. The second angle γ is greater than the first angle α. The first angle α may in a range of about 5° to about 35° (e.g., 30°) and the second angle γ may be in a range of about 25° to about 45° (e.g., about 40°). For a detailed discussion of the sleds with first and second angles reference may be made to U.S. Pat. No. 7,635,074 (“the '074 Patent), the entire contents of which are hereby incorporated by reference.

[0044] As shown, the sled 42 is configured to be positioned on one side of the knife channel 56 and the lower jaw 40 may include another sled 42 disposed on either side of the knife channel 56. The sled 42 includes two fins 44 such that as the base 43 translated through the sled channel 58, each fin 44 slides or translates through a respective vertical channel 54 to eject staples 60 positioned within the vertical slots 52 aligned with the respective vertical channel 54. The fins 44 may be longitudinally offset from one another on the base 43 of the sled 42.

[0045] With reference to FIG. 9B, another sled 42′ is provided in accordance with the present disclosure. The sled 42′ includes a central fin 80 that extends from an upper surface of a base 43 thereof which is sized to slide within the knife channel 56 of the cartridge 50. The central fin 80 may include a knife 82 that extends from an upper surface of the central fin 80 which is configured to sever tissue joined together by the staples 60 as detailed below. The sled 42′ also includes fins 44 that extend from the upper surface of a base 43 laterally spaced on from and on both sides of the central fin 80. As detailed above, the fins 44 have first and second angled surfaces 45a, 45b. The fins 44 on each side of the central fin 80 are longitudinally and laterally spaced apart from one another. Examples of such sleds are disclosed in the '074 Patent.

[0046] Referring to FIGS. 4, 7, and 10, a method of joining tissue with the end effector 30 is disclosed in accordance with the present disclosure. The end effector 30 is positioned over tissue in the spaced apart configuration with the tissue positioned between the upper and lower jaws 40, 90. The upper and lower jaws 40, 90 are then approximated to grasp tissue between the upper and lower jaws 40, 90. With tissue grasped between the upper and lower jaws 40, 90, the sled 42 is translated distally through the cartridge 50 such that the fins 44 directly engage the backspans 64 of the staples to eject the staples 60 from the cartridge 50 as shown in FIG. 10. Specifically, the first angled surface 45a of a respective fin 44 engages the chamfered surface 66 of a backspan 64 of a staple 60 to eject the staple 60 from the staple cartridge 50 (i.e., move the staple 60 towards the anvil 92). As the staple 60 is ejected from the staple cartridge 50, the legs 62 of the staple 60 are driven through the tissue grasped between the upper and lower jaws 40, 90 until the tips 63 of the legs 62 engage the staple pockets 94 of the anvil 92 of the upper jaw 90. As the tips 63 engage the staple pockets 94, the second angled surface 45b of the respective fin 44 engages the chamfered surface 66 of the backspan 64 to drive the staple 60 into the anvil 92 such that the legs 62 of the staple 60 are deformed to form the staple 60 (e.g., deform into a B-shape) and join the tissue together.

[0047] The backspan 64 of the staple 60 is configured to maintain a substantially parallel relationship with a tissue contacting surface 51 of the staple cartridge 50 as the staple 60 is ejected from the cartridge 50 and driven into the anvil 92. Specifically, as detailed above, the backspan 64 has a substantially rectangular cross-section such that the vertical sides 65b of the backspan 64 slide within the vertical slot 52, and the backspan 64 has a length substantially equal to the vertical slot 52 such that the backspan 64 maintains a horizontal configuration as the staple 60 is ejected from the vertical slot 52. In addition, the legs 62 of the staple 60 may resist deformation adjacent the backspan 64 such that the legs 62 maintain a horizontal configuration of the staple 60 as the staple 60 is ejected from the vertical slot 52.

[0048] As the sled 42 is translated through the cartridge 50 to eject the staples 60 from the cartridge 50, a knife (not shown) is translated through the knife slot 56 to sever the tissue grasped between the upper and lower jaws 40, 90 between the inner rows of vertical slots 52. The knife trails the fins 44 of the sled 42 such that the knife severs the tissue after the staples 60 are formed to join the tissue. Such a configuration may reduce bleeding and enhance the severing of tissue as the knife is translated through the knife slot 56.

[0049] When the sled 42 reaches an end of the sled channel 58 and all the staples 60 are ejected and formed to join the tissue, the upper and lower jaws 40, 90 are opened to the spaced-apart configuration to release the joined tissue. The end effector 30 is then withdrawn from the surgical site. After the end effector 30 is withdrawn from the surgical site, the loading unit 10 (FIG. 1A) may be detached from the surgical instrument (e.g., surgical instrument 101, 201). With the loading unit 10 separated from surgical instrument, the loading unit 10 may be sterilized for reuse in another surgical procedure and another loading unit 10 may be secured to the surgical instrument to join additional tissue in the manner detailed above. Alternatively, after the loading unit 10 is withdrawn from the surgical site, the cartridge 50 may be detached from the lower jaw 40 and the lower jaw 40 may be reloaded with a new cartridge 50 to join additional tissue in the manner detailed above.

[0050] 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. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. 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 of the claims appended hereto.