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Patent 1058038 Summary

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(12) Patent: (11) CA 1058038
(21) Application Number: 309535
(54) English Title: SURGICAL STAPLING INSTRUMENT
(54) French Title: INSTRUMENT CHIRURGICAL POUR LA POSE DES AGRAFES
Status: Expired
Bibliographic Data
Abstracts

English Abstract



A B S T R A C T

A surgical stapling instrument for applying sterilized
staples to the disunited skin or fascia of a patient in order
to effect a joining of the skin or fascia. The instrument is
adapted to associate with a staple-carrying cartridge having a
plurality of staples therein. The instrument is manually powered
and includes a nose portion rotatably mounted in a hand held main
body portion and adapted to mount the staple-carrying cartridge
so that the stapling angle can be varied without rotating the
hand-held portion of the stapler. A clutch means is provided
for ensuring that the staple-advancing drive means of the instru-
ment is only activated once per stapling operation. The instru-
ment is further provided with means for preventing the insertion
of a fresh staple-carrying cartridge until the instrument is in
the readiness position for a driving stroke, and means for main-
taining the unloaded instrument in its readines position until
equipped with a cartridge.


Claims

Note: Claims are shown in the official language in which they were submitted.


The embodiments of the invention in which an exclusive property
or privilege is claimed are defined as follows:
1. A surgical stapling instrument for applying
sterilized staples to the disunited skin or fascia of a patient
for effecting a joining of the skin or fascia, the instrument
adapted to associate with a staple-carrying cartridge having
anvil means at one end thereof and adapted to house a plurality
of staples therein, a pusher element slidably mounted therein
for ejecting staples from said cartridge and for forming said
staples around said anvil means, and means for advancing said
staples in said cartridge, said surgical stapling instrument
comprising: a main body portion; means for mounting said staple-
carrying cartridge on said main body portion; drive means to
activate said staple-advancing means for driving the staples
toward said anvil means and for driving the pusher element
forward to eject a staple from the staple-carrying cartridge
and to form said staple around said anvil means; and clutch
means for preventing said drive means for activating said
staple-advancing means more than once in each stapling operation,
said clutch means comprising two surfaces movable relative to
one another with one of said two surfaces being sloped relative
to the other, a roller positioned between said two surfaces,
and a wedge member in one of said two surfaces, said wedge
member adapted to permit said roller means to move therepast
only at the respective ends of the drive means stroke.
2. The instrument defined in claim 1, wherein
said drive means comprises a thrust bar slidingly mounted for
reciprocative movement in said main body portion and wherein
said clutch means prevents said thrust bar from returning to
its initial rest position until said thrust bar has completed
its forward thrust movement.



24


3. The instrument defined in claim 2 , wherein
the sloped surface is inclined relative to said thrust bar
and defines an opening therewith which increases in size in
the direction of the forward thrust movement of said thrust
bar, and wherein said roller is positioned between and
cooperating with said sloped surface and said thrust bar.
4. The instrument defined in claim 3 , wherein
said wedge member cooperating with said roller is spring-
biased.





Description

Note: Descriptions are shown in the official language in which they were submitted.


5803~ ~
"'.
This is a divisional of Canadian Patent Application
Serial No. 181,498 filed September 20, 1973.
;' In Canadian Patent No. 953,997 issued September 3,
1977 to United States Surgical Corporation, there is disclosed
:~ a surgical stapler for joining the disunited skin of a patient.
The surgical stapler disclosed in this application employs a
staple-carrying cartridge comprising an anvil adapted to lie
1ush with the skin, a plurality of staples which are to be
follded around the anvil, and a pusher for ejecting and bending
j 10 the staples around the anvil. The surgical stapling instrument ;~
adapted to accept the staple-carrying cartridge in th-s
application is powered~l by a pressurized gas. Later develop-
,, ments of the gas-powered stapler and cartridge for applying
!.;~" sur~ical staples to external skin and internal fascia and
~j ; ,
disclosed in U.S. Patent No. 3,662,939 issued May 16, 1972

',~ to United States Surgical Corporation.

`~ Although these gas-powered instruments represent a
.;, :
marked advanced over the state of the art, there are certain

~; disadvantages associated with the use of gas-powered units
;: ,................................................................... .. .
~ , 20 of this type~ One of the obvious disadvantages is the ~`
.~ :;.:,, ;
necessity forlreplacing the gas cartridges af~er their con-

~^ tents have been exhausted, and a second is the inconvenience
.,:: ;
associated with storing and main~aining a supply of these
~ cartridges. Also, the powering mechanism is complex, is
; ; hence somewhat costly, and comprises numerous close-tolerance
elements which tend to be susceptible to malfunction. For

these and other obvious reasons, it would be advantageous to
~- have a ~imple surgical stapling instrument adapted to accept
~j staple~carry ng cartridges of the type disclosed in the
above patent application and patent, but which is powered
manually and without the intervention of a gaseous medium and
, , .
-~- the disadvantages associated therewith.

~ 2

~o~i~303~ `

: Accordingly, it is a broad object of the present
~: invention to provide a surgical stapling instrument for stapling
the disunited skin or fascia of a patient which is manually
''?I powered and wholly operated by mechanical means.
~` It is a primary object of the present invention to
.: provide a surgical stapler with means for ensuring that the
ù s~aple-advancing drive means of the instrument is activated ~:
only once in each stapling operation.
These and other objects of the inven~ion, as well
as many of the attendant advantages thereof, will become more
~' readily apparent when reference is made to the following
description taken in conjuction with the accompanying drawings.
In accordance with the invention in one aspect there
. ~ , .
is provided a surgic~l stapling instrument for applying
sterilized staples to the disunited skin or fascia of a patient
for effecting a joining of the ~ki.n or fascia, the instrument
adapted to associate with a staple-carrying cartridge having ``
anvil means at one end thereof ancl adapted to house a plurality
of staples therein, a pusher element slidably mounted therein
`i:`'` 20 for ejecting staples from said cartridge and for forming said ;-
staples around said anvil means, and means for advancing said ~.
staples in said cartridge, said surgical stapling instrument
comprising: a main body portion; means for mounting said
staple-carrying cartridge on said main body por~ion; drive
means to activate said staple-advancing means for driving the
.".~. ~, . ,
staples toward said anvil mean~ and for drivi.ng the pusher
element forward to eject a staple from the staple-carrying
cartridge and to form said staple around said anvil means;
~ . and cl~tch means for preventing said drive means for acti-
" ~
vating said staple-advancing means more than once in each
. stapling operation, said clutch means comprising two surfaces .
~" movable relative to one another with one of said two surfaces
~ i ~
~` - 3 -
. . .

. . .


:, :

3~
being sloped relative to the other, a roller positioned be-
' :
~ tween said two surfaces, and a wedge memberr in one of said
'~ two surfaces, said wedge member~adapted to permit said roller
, means to move therepast only at the respective ends of the
; drive means stroke.
~; A t~pical embodiment of the surgical stapling
instrument generally comprises a main body portion having a
. . .
~ nose portion rotatably mounted therein and adapted to receive
: ~ `
and mount a staple-carrying cartridge. The nose portion of
.: :
1~ 10 the stapler houses the drive means for advancing and forming
. : .
the staples. A pusher-activating means for driving the pusher
,~ element of the staple-carry~ng cartridge to eject and form the
`, staples around the anvil means of the cartridge comprises
``' a thrust bar slidably mounted for reciprocative movement in
the nose port~on of the stapler. The thrust bar is attached
to and adapted to~move with a collar element slidably mounted
':'`!''` on the nose portion of the stapler. A trigger means comprises
....... . .
~ a handle which is pivotally mounted on the main body portion
~, . . .
of the stapler and has means for engaging the collar element
so that the thrust bar is m~ved forward by squeezing the
trigger. A ireturn spring attached to the trigger and to the
main body portion of the stapler functions to return the
thrust bar to its initial position after the thrust st~oke of
,
3'f the bar has been completed.
:;~;.;
The drive means to activate the st~ple-advancing -~
means in the staple-carrying cartridge for driving the staples
.
toward the anvil comprises pinion gears and pinion shafts
also housed within the no~e portion of the stapler. The `
.. . ~ .
teeth of the pinion gears mesh with the teeth of a main gear '!` '.
which is a~apted to rotate in unison with a ratchet. The
main gear and ratchet are rotatably mounted mn the rear nose

.
~;, portion of the stapler. An index pawl pivotally attached to
~''``,' `
, .. . .
~ 4 - ~
~ .:

~s~

the thrust bar and operatively associated with the ~atchet
causes the ratchet, main gears, and pinions to rotate when
the thrust bar is initially moved forward and thus activates
the staple-advancing~ means in the cartridge.
As was the case in the above-mentioned application
and patent, it is desirable to rotate the particular drive -
screws of the staple-carrying cartridge 360 each time a staple
is be~ng ejected by first overdriving and then return-driving
the screws. Accordingly, and similar to the gear boxes
; " ' :
;~:, 10 disclosed in the above-mentioned application and patent, the
-~ drive means for advancing staples of the present invention isadapted to be over-driven and then returned to a position
wherein the drive screws of the cartridge are rotated exactly
. . .
360. The return movement of the staple advancing drive means ;
; is accomplished by a spring p~wl which cooperates with the
above-mentioned ratchet. This spring pawl also functions as
~. .,
``~';; a stop, preventing excessive return rotation of the ratchet.
Means are also providëdl-ifor~perventing~!;more.than~one
staple from being placed in the ready positio~ of the staple-
carrying cartridge during the stapling operation. This means
comprises a clutch means which prevents -the return of the
thrust bar to its initial position until it has completed a
full stroke, thereby ejecting a staple from the staple-carrying
cartridge. The clutch means includes a cam block mounted in
the forward end of the nose portion of the stapler and having
. ~. . ..
an inclined surface facing the thrust bar. The forward end
of the thrust bar passes through the cam blook and operatively
`;; engages a cylindrical roller positioned b-etween the thrust bar
and the inclined surface of the cam blaok. The cam block
,. :. ;
~: 30 houses a spring-biased wedge which cooperates wi-th the
i - cylindrical roller. The cooperation between these elements
is such that the cylindrical ro~ller prevents the thrust bar
'~"''' :
~,; ~ 5 -

.~':., .;
. . ~ .

:

~s~
from being returned to its initial position until it has
completed a full driving thrust movement.
Means are further provided for preventing the for-
ward movement of the thrust bar until a staple-carrying car-

-- tridge has been mounted on the s~apler. This means comprises
,.. .
- a cartridge interlock housed in the forward end of the nose
portion of the stapler and spring biased into a position such
~` that it blocks the forward movement of the thrust bar until
a cartridge is properly mounted. In its initial position,
,., , :.
~ 10 the forward end of the thrust bar abuts the rear face of the
:, ~
;~; cartridge interloak. When the staple-carrying cartridge is
,.. ~ . . . .
" mounted, the cartridge interlock is forced upward by the
: : :
staple-carrying cartridge, thereby registering an opening
in the cartridge interlock with the forward end ofi the thrust
bar such that the thrust bar is capable of ~eing moved for-
ward and driving the pusher element of the staple-carrying
cartridge to eject and form the staples.
'~` The forwardmost staple in the staple-carrying car-
, ..................................................................... .
~, tridge is advanced into the ready position during the initial

stage of the forward thrust stroke of the thrust har. At

` ~ this point, tnd ~ith the thrust ~ar partially advanced, it

~- is possible to remove the staple-carrying cartridge from the


stapler. Under these circumstances, the clutch means prevents

; the thrust bar from returning to its initial position. `

Accordingly, the thrust bar must be fully advanced before it

~; will be automatically returned to i~s initial position. The

`'~ surgeon or his attendant may not remember to follow this
.
`~ procedure, however, and may attempt to mount a staple-carrying'

~ cartridge in the stapler while the thrust bar is in this

`:~ 30 partially advanced position. This procedure could result in

,~ jamming the drive mechanisms of the staple-carrying cartridge

-~; or other undesirable mechanical difficulty.
~:',''.' ',: ''
~ ~ 6 -
,", ,,
,
.. , .. ,, ~

~5~3~
. .
To prevent such ~amming, means are provided for pre-
venting a cartridge from being mounted unless the thrust bar
has returned to its initial position. This means comprises
. .. ;
a cartridge stop lock mounted in the forward end of the nose
. portion of the stapler. When the thrust bar is in its initial
~ position, the cartridge stop lock is oriented so that a staple-
.,,
~ carrying cartridge can be easily locked in the stapler. If
, .
the thrust bar is not in its initial position, however, but
. .; .
' rather is in a partially advanced position, the cartridge stop
.~
lock is spr~mg biased into a blocking position so rlthat a
staple-carrying cartridge cannot be fully mounted in the
.;.~ .
,~r, stap~er.
While the initial movement of the trigger advances
~` .
~` the staples and the intermediate movement readies the car-
~, tridge for the stapling operation, only the final stages of
trigger movement effect the e~ection and formation of a
~j staple. Accordingly, it is desirable to alert the surgeon
to the fact that a staple is about to be ejected so that the
: .
~1 surgeon can be sure that the instrument is properly positioned.
. . .
In fact, the inventi~e instrument could be operated remo~e
from the patient until the last stage of trigger movement, and
` only then oriented in readiness for a stapling operation. As
i~
part of the present invention, the stapler is provided with a
spring-biased wedge housed in the nose portion of the stapler
. .:
which snaps into a notch on the top surface of the thrust bar
with an audible "click" just before a staple is to be eject~d.
~` At the same time, the surgeon will also feel a slight but
, ~
` noticeable change in the force required to squeeze the trigger,
.~;,:;
~;~ thus further alerting him to the fact that a staple is about

to be ejected.
. ::,,- . ;
-~ As just described, ~he drive means for advancing
; staples in the staple-carrying cartridge and for ejecting
.,, ,.~ ..
!:...................................................................... i
~ - 7 -
; . .
:,

t

~ ~5~303,~

;' staples therefrom are housed in the nose portion of the
i~ stapler which is rotatably mounted in the main body portion. --
: Since the staple-carrying cartridge is mounted in the nose
....
portion and rotatable therewith, it is possible to change the
stapling angle of the stapler by merely rotating the nose
portion while maintaining the hand-held main body portion in
"~` a fixed position.
Fig. 1 is a vertical cross section of the surgical
; stapling mnstrument of the present invention;
Fig. 2 is a horizontal cross section taken along
.i` . :
` line 2-2 of Fig. l;
Fig. 3 is similar to Fig. 2 but shows a portion of
~ ;.:: ,
' the stapler during the stapling operation;~:
`;~ Fig. 4 is a horizontal, fragmentary view of a portion
of the staple-advancing drive mechanism of the stapler during
` the staplin~ operation;
~ ~ Fig. 5 is a vertical cross section of the stapler
,~,
looking rearwardly;
; Fig. 6 is a side view, partially in section, of the
. . .: ~,
~ ,20 staple-carrying cartridge mounting pertion of the stapler
i~ after the ~artridge is mounted and ready for use;
"~,
, ` Fig. 7 is a front view of the stapler with the
$ ,-~
~` staple-carrying cartridge mounted and ready for use;
Fig. 8 is a vertical cross section taken along line
~`~ 8~8 of Fig. 2 and showing the clutch means;
` ~ Figs. 9-12 are sequential views showing the operation
...
~ - of the clutch means during a stapling operation;
, ~, . .
, Fig. 13 is a vertical cross section taken along line ~-
~" 13-13 of Fig. 2 and showin~ the position of the cartridge
interlock before the staple-carrying cartridge is inserted;
~,`; Fig. 14 is simiilar to Fig. 13 but shows the cartridge
,.. .. .
~` interlock after the insertion of the staple-carrying cartridge

: ~;. .
,~ - 8 -

,i.i~:,........................... . .

.. ,,: . :
; " ". , ~ .
,~ .,, i :

~ ~S~3~3 :
.,
which is shown in phantom lines;
Fig. 15 is a vertical cross sec~on taken along line
15-15 of Fig. 2 and showing the position of the cartridge stop
lock before the thrust bar has been advanced;
Fig. 16 is similar to Fig. 15 but shows the cartridge
stop lock after the ~hrust bar has been partially advanced;
,~i Fig. 17 shows the cooperation between the inclined
~-~, surfaces of the thrust bar and cartridge stop lock;
.....
Fig, 18 is a horizontal cross section taken along

~ 10 li~e 18-18 of Figl 1 and showing the location plate for

;` , locating the cartridge interlock, cartridge stop lock, and

pusher-engaging portion of the thrust bar;

Fig. 19 is an enlarged view ~f the rear portion of

` a staple-carrying cartridge with its cover removed;

` Fig. 20 is a cross section taken ~long line 20-2~ of

;~ Fig. 19;

~` Fig. 21 is a vertical cross section of the front
,.~,
portion of a staple-carrying cartridge; and
Fig. 22 is a view of the front portion of the car-
~, 20 tridge during the stapling operation with the cover removed.
, With reference first ~o Figs. 1-6, the surgical -
stapler of the~present invèntion will be described in general

terms. The spapler shown generally at 10 comprises housing
~ 12 having main body portion 14 and handle portion 16. Nose
", ` '~
portion 20 of stapler 10 is rotatably mounted in main ~ody

portion,14 of housing 12. Nose portion 20 includes a front
~ !
section 22 extending out ofthousing 12 and adapted to mount

staple-carrying cartridge 26. Nose portion 20 further includes
.~"
` a rear section 24 located inside housing 12 and acting to `

--;` 30 housetthe--ldriving means for advancing, ejecting, and forming
:. .
~ staples from the staple-carrying cartridge. Nose portion 20 ~

i, is conveniently formed in two parts, upper and lower, held ;
. ,,; .
:,;j, .
g _ .,
.'`., ' ,

~S13~3~
together by a pair of screws 21 and held in relative alignment
by dowel pins 23 and 25. Staple-carrying cartridge 26 is
shown fitted into nose portion 20 of stapler lQ in Fig. 6.
The staples in staple-carrying cartridge 26 are
advanced, ejected, and formed by mechanical means only and -~

i~` without the intervention of a gaseous medium. Accordingly, the
.~ .,.,~ ..
power for advancing, ejecting, and forming the staples in car-
tridge 26 comes from the manipulative force supplied to
stapler 10 by the surgeon. This force is transmitted to the
drive means of stapler 10 by means of trigger 28 which
generally comprises a handle pivotally attached to housing
12. Pivoting of trigger 28 causes a thrust bar 30, the pusher-
activating means, to drive the pusher element of staple-
carr~ing cartridge 26 for~ard to eject and form a staple
around the anvil means. At the same time, a ratchet 32 and
.... . . .
` a main gear 34 housad in the rear portion 24 of nose 20 are

~ caused to rotate. Main gear 34, in turn, rotates a pair of

;~ pinion gears 3~ and pinion shafts 38 which associate with -

the cartridge 26 to advance the staples.

~ 20 With reference now to Figs. 1 and 5, trigger 28 will

;} be described. Trigger 28 is pivotally mounted to housing 12 -
,.:
by means of stud 40 and drive pin 42. Trigger 28 is of
appropriate size and shape to be conveniently gripped by the
operating hand of a surgeon. T~e trigger includes a rearward
extending portion 44 to which is attached one end of a keturn

spring 46. The other end of return spring 46 is attached to
'`''~t housing 12 and functi~ns to return trigger 28 and thrust bar
~ 30 to their initial positions after staple forming has ;~ ~
., ." . .. .
occurred. Trigger 28 is of "Y" shape and includes a lower

30 hand-engaging portion 48 and an upper force-transmitting yoke

~`t', portion 50. Yoke 50 em~races a collar 52 slidingly mounted

around the midsection of nose portion 20 and adapted to
,....................................................................... ..
-- 1 0
. : ~
, -.:

,. !.j.;

3~
,'
rotate therewith. Collar 52 includes a cylindrically-shaped
. body member 54 having outwardly and radially extending flange
portions 56 at each end. Yoke 50 is positioned around
cylindrically-shaped body member 54 and bet~een flange por-
; tions 56. Shoulder portions 55 and 57 of nose portion 20
limit the forward and riaarward movement, respectively, of
;
collar 52. Pivoting of trigger 28 results in longitudinally

directed force's being exerted on collar 52 by yoke portion
.. ..
50 ~f trigger 28. Accordingly, when the trigger is activated,

~ collar 52 simultaneously slides along the m dsection of nose
,~ ,.
20. Also, by this arrangement, collar 52 is free to rotate

relative to trigger 28.

As best seen in Figs. 1, 3, and 17, the~`means for
, ' f
; driving the pusher element of the staple-carrying cartridge

` to eject and form staples comprises thrust bar 30 which in-~
:. ~
cludes an elongated central section 58 having a wing portion

60 near the rear end thereof. A pusher-engaging extension
~: ~
62 and an inclined surface 64 are positioned at the forward-

;~ most end of thrust bar 30. Inclined surface 64 is adapted

~; 20 to engage a stop lock mechanism which will be discussed


;~ i subsequently. A190 located near the front end of thrust bar

i 30 is an elongated notch 66 which forms part of the clutch
~",. .
~;~; means of the present invention. Located near the rear end of
... ..
~ thrust bar 30 is a second notch 68 which engages the forward

'!~' end of index pawl 70. Thrust bar 30 is slidingly mounted in
, ~ ~
~` nose portion 20 and is adapted to rotate therewith. As ~
;~,
' illustrated in Fgg. 2, wing portion 60 of thrust bar 30 lies

- near the mfidsection of collar 52, conveniently formed as two
~''i' .
~` semi-circular parts, and is rigidly attached to collar 52 by
.::. .
~i 30 means of bolts 53. Accordingly, thrust bar 30 reciprocates
.:~
; back and forth with collar 52 when trigger 28 is pivoted, and
i:
~;~` collar 52 rotates with thrust bar 30 when nose portion 20 is

~; rotated.
~, -- 11 --
.~,.~ . ,,
~: ,.,'; ,

: `


~ .
;~` The staple-advancing drive means of the stapler 10
.. ..
~:! is arranged so that when thrust bar 30 is moved forward, the
v'
'~ elements forming a part of this arrangement are activated;
:, .
` that is, the forward motion of the pusher-activating element
.
causes the rotation of the screws o staple-carrying car-

tridge 26, thereby advancing the staples. And, as will be
:,
more fully described below, the staples are slightly over- -
. .
driven during the forward stroke of thrust bar 30 and are

then returned to their proper positions as will be discussed

sub'sequently.
.... ,-; .
, With reference how to Figs. 1-4, the staple-drive
~; mechanism will be explained. The index pawl 70 is pivotally
attached to the rear end of thrust bar 30. The transverse
base portion 74 of spring 72 passes through aperture 76 in
~`~ thrust bar 30, and the inturned end of upstanding leg 78 o~
, spring 72 fits into one end of an aperture 80 in the rear
` end of thrust bar 30, and the inturned end of upstanding leg
82 fits through an aperture 84 in index pawl 70 and then into
~, the other end of aperture 80iint~hrustbbar 30. An upstanding
~'~t,-,, 20 leg 86 on the forward end of index pawl 70 fits i~to notch
68 in thrust bar 30O Notch 68 is trape~oidal in shape and has ' -
`~ inclined surface 88. The combination of spring 72 and inclined

~; surface 88 of notch 68 allows index pawl 70 to pi~ot outwardly.

t~, Index pawl 70 rides along one wall of a six-tooth
~' ratchet 32 and engages one of the teeth thereof. The index
pawl, pivotally mounted on thrust /ba~ 30, is biased toward
ratchet 32 by spring ~2. Ratchet 32 is attached to, and
~ rotates with, a main gear 34. Ratchet 32 and maln gear 34
;{,l are of unitary construction, as illustrated, and are r~tatably
~ 30 mounted in the rea~ end 24 of nose portion 20 by means of
;;;: . :
`; shaft 90. The teeth of main gear 34 mesh with the teeth of
''
~ - 12 -
:., ~ ..
'.




.... . ., . . . . ~ . : .. :

., _~
1138

-two pinion gears 36, both of which are seen in the drawings.
.:; .
Pinion gears 36 are, in turn, attached to pinion sha~ts.38
~` which are housed in, and extend longitudinally through, the
nose portion 20 of stapler lO. A tapered cylindrical body
portion 92 on the ratchet 32 and main gear 34 assembly pro-
!`~ videss a stop for ~inion gears 36 which have a rear portion
~ 94 which abuts body portion 92 of the ratchet 32 and main
.. . .
gea~ 34 assembly. (See Fig. l). T~is arrangement prevents
~` the pinion shafts from inadvertently being moved out of their
` 10 proper longitudinal position.

'~ !'' ~ Th~ust bar 30, index pawl 70, and ratchet 32 are
- ~ arranged in such a manner that the forward stroke of thrust
i~ bar 30 causes ratchet 32 and, accordingly, main gear 34 to
move slightly more than 60. As noted previou~ly, it is
., ~ . . .
;~' desired to ultimately rotate the screws associated with staple-

;~ carrying cartridge 26 precisely 360 for each staple-driving

~` operation. The staple-advancing drive means in stapler lO is

arranged so that for each 60 turn of ratchet 32 and main gear

34, pinion shafts 38 and the screws in cartridge 26 are rotated
~, ....................................................................... .
360. However, to ensure that the staples are advanced in
proper amount, it has been found desirakle to overdrive the
~; screws in cartridge 26, and thus the staples, and then to "
~.",~ :
:~, reverse the rotation of the screws so that ultima~ely they `
experience a net 360 rota~ion. It is for this reason that

`^ six-tooth ratchet 32 is ~otated slightly more than 60. It
," , , .
~: becomes necessary, therefore, to provide me~ns for ~eturning
ratchet 32 to its 60 position. The ratchet return is
brought about by means of spring~T pawl 96 as will be dis- -
:;
cussed subsequently.

With particular reference now to Figs. 2-4, the ;
.j ,~,. ,
- operation of the drive means for activating the staple-ad-

~ ` vancing mechanism of the staple-carrying cartridge and for


`` - 1
1:''''` : .

.

~al519~3~

d~iving the staples toward the anvil will be described. As
shown in Fig. 2, thrust bar 30 is in its initial at-rest
position. In this position, index pawl 70 is in engagement
with ratchet 32. Too~h portion 102 of index pawl 70, which
is the driving region thereof, i~ removed from the nearest
tooth on ratchet 32 to allow for slight "play" before the
ratchet 32 is rotated.
When thrust bar 30 moves forward during a stapling
operation, index pawl 70 rotates ratchet 32. Ratchet 32 is
. ~ . .
rotated in a clockwise direction as index pawl 70 is moved -~
forward with thrust bar 30. When ratchet 32 has been rotated
~ through approximately its desired maximum angle of slightly
`- greater than 60, the back surface of an advancing tooth of
ratchet 32 engages planar portion 104 near the end of index
pawl 70 and forces tooth portion 102 of index pawl 70 out of
, . .
engagement with ratchet 32. (See Fig. 4). The maximum angle
through which ratchet 32 is rotated is greater than that needed
to advance each staple one "staple unit". Thus, the staple-
~` advanc ng drive means is momentarily overdriven; however,
this condition is automatically corrected by spring pawl 96.
~i'` Referring now to Figs. 2 and 4, it can be seen that
spring pawl 96 is attached to the rear end 24 of nose portion
,:
~-` 20 by means of a pin 97 and comprises an arcuate section
; ~ terminating at end 106. Spring pawl 96 contacts ratchet 32
....~.1
~:;` at two points in its initial position. First, end 106 of
~ ' ' ` i
~, spring p~wl 96 contacts one of the teeth of ratchet 32.
Second, a point on spring pawl 96 partially between end 106
and the arcuate section contacts the back surface of the
. ,~. ~ , .
adjacent tooth. Accordingly, when ratchet 32 is momentarily
overdriven, spring pawl 96 is cammed outward as shown in
..... .
~`~ Fig. 4; however, ratchet 32 is then immediately returned to
.¢~:
~-~ an exactly 60 rotation by the biasing action of spring pawl
. . .
, ,i .
::';
- - 14
.

.~

~ID5~3~3~3

96. It will be noted that the counterclockwi~e rotation of
ratchet 32 terminates when end 106 of spring pawl 96 contacts
- a tooth on ratchet 32. Accordingly, when thrust ~ar 30 and
index pawl 70 are in the fully advanced position, shown in
-:.
solid lines in Fig. 3, spring pa~l 96 has the same relation-
ship to ratchet 32 as it did when thrust bar 30 and index
; pawl 70 were in their initial positions illustrated in Fig. 2.
: '
Ater the forward thrust of thrust bar 30 has bean
completed and a staple ejected from the cartridge and formed
c 10 in the patient, return spring 46 returns thrust bar 30 ~o its
; initial position. During this phase of operation, the end
: ,
:: portion 106 of spring pawl 96 prevents counterclockwise
rotation of ratchet 32. At the stage of the thrust bar re-
,; turn stroke when sloped surface 107 on index pawl 70 contacts
i~ ,
~ a tooth on ratchet 32, the index pawl begins to be cammed
, ~ .
against the force of spring 72. Further camming action then
occurs when the tooth portion 102 of index pawl 70 contacts
~, the backside of a tooth of ratchet: 32. At this stage, index
pawl 70 is pivoted outwardly into the position shown in
. .
phantom lines in Fig. 3. This outward pivotal movement is
~ permitted by spring 72 and the inclined surface 88 of notch
.. ,.-, :
68 of thrust bar 30. Finally, index pawl 70 reassumes
' the position shown in Fig. 2. At this point, stapler 10 is
.~,,;, .,
ready for another firing.
As previously stated, it is desirable to alert the
surgeon to the fact that a staple is about to be ejected and
` formed so that the suryeon can be sure that cartridge 26
."~, .................................................................. .. ..
;'" is properly positioned to effect a neat suture. This is
accomplished by means of spring-baased means 115 housed in
nose portion 20 ~f stapler 10. Spring~biased means 115
comprises an upper U-shaped member 116 which bears against
housing 12 and a lower member 117 terminating in a V-shaped ~ `

- 15 -
~ '' . , .


, ~-, - : , . ~ , :
,. i ~ , . . . . . . .. . . . ..

~581)3~ :
.
point which r~des along the top of thrust bar 30. Members

116 and 117 are spring biased apart b~ a coil spring 118. A
,
notch ll9 is provided on the top surface of thrust bar 30,
in alignment with member 117, and is adapted to receive the
V-shaped pointed end of member 117 at a stage of the stapling
` operation just before a staple leaves the cartridge. At this
stage, member 117 is snapped into notch ll9 on the top sur-
~' face of thrust bar 30 by spring 118 with an audible "click". ~-
, :
Further movement of thrust bar 30 in the forward direction

forces member 117 upward against the force of spring 118 so
~....
~ that thrust bar 30 can continue its forward movement. This
. ., ~ , .
~ sequence of events will also cause the surgeon to feel a
....................................................................... .
~ slight but noticeable change in the force required to squeeze
~; . .
the trigger, thus further alerting him tb the fact that a
staple is about to be ~ected. Member 116 also functions
to provide additional frictional resistance between houslng
12 and nose pcrtion 20 to avoid uncontrolled rotation between

nose portion 20 and housing 12 duxing normal handling and use.
I~r~,. Turning now to Fig. 8, thexe is illustrated an end

20 view of a clutch means 120. Clutch means 120 includes a cam
block 122 mounted in an opening 124 in forward end 22 of nose
portion 20. Cam block 122 has an inclined surface 126 facing
thrust bar 30 which passes through an opening 128 in cam
block 122. Inclt~ned surface 126 is positioned relative to
thrust bar 30 such that the spacing 130 between inclined

~, surface 126 and thrust bar 30 increases in the forward thrust ~-
direction of the thrust bar. A cylindrical cam roller 132 :~
~' is positioned between inclined~lsurface 126 of cam block 122
and thrust bar 30. An elongated wedge ~ 134 is housed in
~I 30 an aperture 136 in cam block 122. The forward end of wedge
134 is "V" shaped and extends into opening 130 between in-
~ clined surface 126 and thrust bar 30. The wedge pin 134 is


'.,f.~'`' - 16 -
:j.~, .
; ~,
. .

, ., : .
: ~ : , . : ,

~5~3~3~
:,.,
spring biased toward thrust bar 30 by means of a spring 138
housed in a recess 140 in cam block 122. Recess 140 lies
perpendicular to aperture 136, and the end of spring 138,
: .:
which is hook-shaped, is seated in a bore 142 through wedge
134. Cam roller 132 lies adjacent elongated notch 66 in
thrust bar 30, and its movemént is confined by notch 66 as
will be discussed subsequently. The cooperation between these
elements is such that cylindrical roller 132 prevents thrust
bar 30,!firbmibe,ing~re,tlurned to=iitsli~itial position u~t~ com-
pletion of a full thrust stroke.
Figs. 9-12 are sequential views showing the operation t
of clutch means 120 during a stapling operation. Turning first
to Fig. 9, thrust bar 30 is shown in its initial position. In
this position, cam roller 132 lies in a shallow cutout 144
positioned ~t the forwardmost end of notch 66. Cam roller
132 is positioned in the narrowest part of ,opening 130 and at
the rear of clutch means 120. Spring-biased wedge pin 134
maintains the cam roller 132 toward the rear end of clutch
means 120.
~, ., ;.
~- 20 Turning now to Fig. 10, the clutch means 120 is
, illastrated during the forward stroke of thrust bar 30. Cam
roller 132 is sh~wn rotating in a counterclockwise direction. ,~
During this stage of thrust, the surface of cam rolleE~132
~`~ contacts base 146 of notch 66 and inclined surface 126~ and
. ~ :
;~` is rotated by the movement of thrust bar 30. This rotational
``;, movement is permitted since cam roller 132 is, in effect,
~", rotati~y~~"downhill" toward the widest part of opening 130.
.. j : .
At the same time, cam roller 132 bears a~ainst spring-biased
wedge 134 which restrains the longitudinal forward movement ,~
;~ 30 of cam roller 132 so that the cam roller is kept in the
.. ,- ,~ , ~' .
~ narrowest part of opening 130. ~ ;
... .
~ - 17 -
"; :
. `; ,
, : ~,.' : '. ,~ ' ' `'

:
~L05~ 3~3
:
Still referring to Fig. 10, it can be seen that an
attempted return movement of thrust bar 30 to its initial
position from its partially advanced position would cause the
cam roller to rotate in a clockwise direction. T~is movement

: .
; is not permitted by clutch means 120, however, since clockwise
::
: rotation of cam roller 132 causes cam roller 132 to "lock"
r,', itself between thrust bar 30 and incli~ad surface 126 of cam
~ block 122, thereby preventing all but the slightest movement
,;,,. :~
-~ of thrust bar 30 toward its initial position. This occurs
because cam roller 132 is, in effect, rotating "uphill" to-
ward the narrowest part of opening 130. Furthermore, cam
roller 132 would no longer b~ bearing against spring-biased
wedge 134.
, ,, :
Turning now to Fig. 11, clutch means 120 is seen

,; at the forward end of the stroke of thrust bar 30. In this

~; position, cam roller 132 has been forced to the other ~iide
,,,:.. " :.
of wedge pin 134 by shoulder portion 148 of notch 66 and lies
in the widest region of opening 130. Once cam roller 132

has so passed wedge 134, it is housed in an area wider than
its diameter and hence is free to rotate in any direction.

Accordingly, cam roller 132 permits thrust bar 30 to move -
' rearward toward its initial position. A portion of this
operational sequenc~ is shown in Fig. 12 illustrating thrust
~`'" 2 bar 30 during its return stxoke. Here, base portion 146 of

~` n~tch 66 of thrust ~ar 30 may still lightly contact cam roller
132. However, cam roller 132 can freely rotate since opemmng
132 is sufficiently wide at ~his location. Near the end of
; the return movement of thrust bar 30 ~o its initial position,
, j,,,~* !
`; cam roller 132 is moved into cutout 144 in notch 66 and is

3'~' then ~orced past wedge 134 by shoulder portion 150 of notch

66. CUtout portion 144 allows cam roller 132 to be moved

past wedge 134 and back to its initial positioni~hown~;in ~jig. 9,
,
~; 18 -
. . :

~6)5l3~38
.
without "locking" before the completion of the return strokeO
Turning now to Fig. 13, there is sh~wn an end view
of a cartridge interlock 152 in its initial blocking position
which prevents the initiation of a thrust stroke until a
cartridge is properly installed on the stapler. Cartridge
in~erlock 152 lies in blocking and abutting relationship with
the forwardmost end of thrust bar 30 when thrust bar 30 is
in!its initial position. Cartridge interlock 152 is positioned
~,. .
, in an opening 154 in the forward end 22 of nose portion 20

,~ 10 and comprises a body portion 156 and leg portions 158. As
. ., :
shown in Fig. 13, cartridge interlock 152 is spring biased into
its initial blocking position by a pair of coll springs 160.
~, In this position, leg portions 158 of cartridge interlock
means 152 extend through o~n~ng5,1~5~In~a:l~o~at~9n~p~a~eL~Ç4
When a cartridge 26 is mounted on the stapler 10 as sh~wn in
Fig. 6, cartridge interlock 152 is for0ed upward against
the action of springs 160 and into the position illustrated
in Fig. 14. In this position, opening 166 in cartridge
~i interlock I52 registers with thrust bar 30 and allows thrust
.~l 20 bar 30 to pass therethrough. Accordingly, cartridge inter-
;l lock 152 is in the position shown in Fig. 13 when a cartridge
~:, is absent and thrust bar 30 is in its initial posi~ion, and
~ ,~ ,. .. .. ..
is in the position shown in Fig. 14 the remainder of the time.
i~ Referring now to Fig. 15, there is shown an end -, ;
`-, view of a cartridge ~top lock 170 in its initial position. -
, Cartridge stop lock 170 is adapted to prevent the mounting of `
a staple-carrying cartridge 26 in stapler 10 unless thrust
bar 30 is in its fully retracted initial position. Cartridge ,
stop lock 170 is mouhted in an opening 172 in for~ard end 22
~"~ 30 of nose portion 20. The cartridge stop lock 170 comprises

~; a body portion l74 and leg portions 176,~ Opening 178 in ~ -
;:- .- .i cartri~ge stop lock 170 registers with thrust bar 30 when ~
:, ~. ' :'
! - 19 .'
` 'i .
::'. .
' ` ,~' ~, ' : .
te~
. ;'. . ' ' ' ` ' ' . ' '' '' . '' " ~ ' '` ~ ~ '

: ,. . ' . : ' , . . :,

~D58~8
.
,
thrust bar 30 is in its initial position. In the position
shown in Fig. 1~, leg portions 176 are retracted above the
bottom of location plate 164. Accordingly, staple-carrying
cartridge 26 can be easily mounted on stapler 10.
As best seen in Fig. 17, the cartridge stop lock
~i 170 is held in its initial position by the inclined surface
. . .
~;~, 64 of thrust bar 30 which engages a correspondingly inclin~d
,~1 surface 180 of cartridge stop lock 170 when thrust bar 30
`~ is in its initial position. After thrust bar 30 has left its
initial position and is in the thrust or return portion of its
.,~,~ -
, stroke, cartridge stop lock 170 is spring b~ased downward by
.,~ ,. . .
i',~ a pair of coil springs 182 and into the position shown in
,",;; :
~,,.fj ' Fig. 16~ In this position, leg portions 176 extend through
i~i; openings 184 in location plate 164 and below the bottom ~;
thereof to prevent the mounting of staple-carrying cartridge
~ 26 until thrust bar 30 has been returned to its initial
3j~ ,
~, position. The return of thrust bar 30 to its initial position
caa~es cartridge stop lock 170 to be forced upward against the
` , action of springs 182 as best shown in Fig. 17, wherein the
initial positions of thrust bar 30 and stop lock cartridge~;
170 are shown in phantom lines.
Fig. 18 shows a top view of the location plate 164,
with thrust bar 30 in its initial position. Location plate
~3~
~j 164 is housed in an opening 185 in the forward end 22 of nose
~c
,~, portion 20. As previously described, location plate 164 has
~ ~,. 1,, i .
~` openings 165 and 184 therein for receiving leg portions 158
~' and 176 of cartridge interlock 152 and cartridge stop lock
:
~ 170, respe~tively. Location plate 164 a3~so has a longitudi~
3 nally extending opening 186 which receives pusher-engaging
:...................................................................... .
extension 62 and thereby allows thrust bar 30 to reciprocate.
.
With reference now to Figs. 6, 7, 19, and 20, the
association of the staple-carrying cartridge 26 with the ; r

; - 20 -
.:, ................................................................... :
. , ~:
~,~ . ' . : ~;
;. ..

; ~05~613~
,
stapler 10 will be explained. Staple-carrying cartridge 26,
as can be seen in the ~igures, is detachably mounted on nose
, portion 20. Staple-carrying cartridge 26 is elongated and has
a pair of upwardly extending spaced tabs 202 at its rear end.
~;` The spacing between tabs 202 is sufficient to allow pusher-
:,~.,; I
; engaging extension 62 to freely slide thereb~ween, and tabs
202 are dimensiQned and positioned so as to engage surface
203 at the rearmost end of location plate 164. Therefore,
~ ~ .
when tabs 202 engage surface 203, staple-carrying cartridge
26lcannot be inadvertently pulled out of the nose, and
cartridge 26 is fixed against forward movement during the
~ii stapling operation.
'~',t`' Staple-carrying cartridge 26 is mounted in stapler
~ 10 by inserting the end of cartridge 26 into opening 110 in
; ~ nose portion 20. The rearward end of staple-carrying car-
~`~ tridge 26 engages a leaf spring 108 which urges the cartridge `26 upwaxdly until tabs 202 are positively locked into their
associated indentations in the body of nose portion 20.
~- With cartridge 26 in this position, the rearward ends 228 of
the dri~e screws 218 forming a part of staple-carrying car-
tridge 26 are engaged by slots 39 of pinion shafts 38. The ~
cartridge 26 is removed from the stapler 10, when exhausted "
of staples, by reversing the insertion steps.
With specific reference now to Figs. 19-22, the
construction and operation of the staple-carrying cartridge
; 26 will be explained. The cartridge 26 is de~ined by a main
body 200 and has an anvil 204 at its forwardmost region
projecting out as an exten~ion of the top of cover plate 206. '~
Staple-carrying cartridge 26 houses a plurality of staples ~
` 30 208, whose crossbars 210 lie transverse to the length of -
cartridge 28 and whose points 212 face anvil 204. A pusher-
~ ., . ~ ,
element 214 covers staples 208 and is slidingly mounted within
- 21 -

.' '. ,

;8038

indentations 216 in cover plate 206. Pusher element 214 is
adapted to be engaged by pusher-engaging extension 62 of
thrust bar 30 and serves both to eject staples 208 Erom the
cartridge 26 and to form the ejected staples around anvil 204.
The means for advancing staples 208 along the length
of cartridge 26 comprises a pair of drive screws 218. Screws
` 218 are provided with threads 220 for guiding and propelling
staples 208 along main body ledges 222 between the lateral
walls 221. The pusher element 214 is guided between the tops
~i 10 of screws 218 and the bottom of cover plate 206, and serves
to hold each of the st~ples 208 against ledges 222, except
r during the driving operation. Then, the forwardmost staple
208 is advanced out of the screw-guiding threads 220 by means
of inclined surfaces 224, at the forward ends of ledges 222,
' ::
into the plane of pusher element 214, and is propelled forward,
;, . -.
i~ out of the main body portion and against anvil 204.
'.. ~ . .
Each screw 218 is prov~ded at its rearwardmost end ~-
with an extension 226 fitted at its extremity with a flat
projection 228. Screws 218 are th~eaded so that when they,
.,j~.",
~-l 20 by mea~s of projections 226 associating with pinion shaft
i 38, are rotated through 360, each staple 208 moves one --~
staple unit. A "staple unit" is defined as that distance
~:~ which is required to move the second staple from its re~diness
,,.j .
position ~nko-~7a~posit-ione~readyh~ojbe fired. IThus~ ~n~ig. 21,
~` onetstap~e~unit~-isas~own at '7a".
`? : :
In operation, while pusher element 214 is moving
forward by thrust bar 30, and after the forwardmost staple -
~ has been raised 3nto the plane of the pusher, pusher element
;;~ 214 makes contact with the staple as illustrated in Fig. 22.
~ 30 Then, the staple is ejected and formed in the disunited skin
`~^;; or fascia of the patient.
..,
... : :
:;,
- 22- ~
.. . .
.:
.. ~ .
,:: . ^:

, ..,
? ~ . ' '' '"

:~:
~58~3~
.,.
Above there have been described specific embodiments
of the present invention. It should be noted, however, that
the above des^ription was given for illustrative purpose~ only
:~ and that many alterations and modifications may be practiced
by those skilled in the art without departing from the spirit
or the scope of the present invention. It is the intent,
,; therefore, that the present invention no-t be limited to the
::
j~;' above but be limited only as defined in the appended claims.
.. . . .

'`'', 10 '`~;' ~. '

... .. .

.~ ,1 . .
"

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`:'`''', ,. ~

`,'i,~,'`, '`~`' :'.'
., ~

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,, .

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,
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~ ' ' ~, - ', ' .. ' .'.".,." ' .' ~, ; .

Representative Drawing

Sorry, the representative drawing for patent document number 1058038 was not found.

Administrative Status

For a clearer understanding of the status of the application/patent presented on this page, the site Disclaimer , as well as the definitions for Patent , Administrative Status , Maintenance Fee  and Payment History  should be consulted.

Administrative Status

Title Date
Forecasted Issue Date 1979-07-10
(45) Issued 1979-07-10
Expired 1996-07-10

Abandonment History

There is no abandonment history.

Owners on Record

Note: Records showing the ownership history in alphabetical order.

Current Owners on Record
UNITED STATES SURGICAL
Past Owners on Record
None
Past Owners that do not appear in the "Owners on Record" listing will appear in other documentation within the application.
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Document
Description 
Date
(yyyy-mm-dd) 
Number of pages   Size of Image (KB) 
Drawings 1994-04-22 6 291
Claims 1994-04-22 2 81
Abstract 1994-04-22 1 45
Cover Page 1994-04-22 1 31
Description 1994-04-22 22 1,229