Note: Descriptions are shown in the official language in which they were submitted.
This is a division of our co-pending Canadian Patent Application No.
373,775 filed March 25th, 1981.
This invention relates to a surgical skin/fascia stapling instrument
which contains a plurality of staples and which allows a single staple to be
formed and removed from the instrument. This invention also relates to a
surgical stapling instrument from partially forming a staple and then returning
and picking up the next staple.
The disclosed stapling instrument has advantages over the prior art,
One advantage is the relative size of the instrument which is maintained while
the number of mechanical parts is decreased. Therefore, as a general statement,
the ease of operation and the reliability of the instrument is improved. The
operation and reliability of an instrument can be critlcal in the surgical
operating area where even seconds may determine if a surgical operation or
procedure is a success. Another advantage is the orientation of the flange
on the anvil surface. The flange orientation is opposite to the direction of
stapling. For most surgeons, the natural direction of stapling is always
away from their body. The orientation of the flange allows the surgeon to
advance the instrument and remove the formed staple in a direction away from
the body. This has still another advantage in that while stapling the surgeon
cannot accidentally brush against the open wound site.
Still another advantage of this instrument is the stapling indicator
which is on top of the handle. The instrument thus does not have to be turned
over to determine the number of staples remaining in the instrument. Still
further, another advantage is the location of the trigger means which are
internal to the handle. This seems to provide a more sterile environment and
to prevent or decrease the likelihood of pinching a finger or fingers during
use. Yet another advantage is the configuration of ~he instrument, In many
surgical procedures, the instrument configuration may give a better field of
vision of the wound site to the surgeon.
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The surgical stapling con.rol means also llas advantages over the
prior art. The control means prevents the trigger from returning to its
initial position if the compression is interrupted. This, has the advantage
of preventing a second staple from being formed on the anvil flange before a
first staple is separated from the instrument. Another advantage of the control
means is interrupted stapling. The surgeon can now stop the compression of
the trigger into the handle to realign the instrument over the wound site.
Thus, the possibility of a perfect stapling procedure is greatly enhanced.
Finally, the control means are au-tomatically disengaged on completely
compressing the trigger. Thus, the control means do not have to be manually
reset after a single staple is formed and separated from the instrument.
On partially compressing the trigger the guide means provide tension
on the guide pin and the ratchet engages the pawl. On completely compressing
the trigger, the guide pin crosses over the top of the guide means causing
the ratchet to be disengaged from the pawl.
The invention provides a surgical stapling control means comprising
a handle; a trigger pivotally attached and compressible into said handle; a
staple forming means contained in the forward portion of said handle; a
flexible arm mounted on the rearward portion of said trigger; a pawl and at
~ ~ least one guide pin attached to one end of said arm; a rnul~ th^l ratchet
attached to the rearward portion of said handle; and guide means having upper
and lower portions, said guide means positioned adjacent the rearward portion
of said handle so as to coordinate with and provide tension to said guide pin,
such that on partially compressing said trigger the lower portion of said
guide means provides tension on said guide pin and flexes said arm such that
the pawl engages said ratchet and such that on complete compression of said
trigger, the upper portion of said guide means releases tension from said
guide pin allowing said arm to relax and allowing said guide pin to cross
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over said guide means, thus causing said pawl to be disengaged from said ratchet.
The invention also provides a surgical stapling control means com-
prising a handle; a trigger pivotally attached and compressible into said
handle; a staple forming means contained in the forward portion of said handle;
a multi-toothed, flexible ratchet arm formed on the rearward portion of said
trigger; at least one guide pin attached to one end of said ratchet arm; a
nonpivoting pawl attached to the rearward portion of said handle to coordinate
with said ratchet arm; and guide means having upper and lower portions, said
guide means positioned adjacent the rearward portion of said handle so as to
coordinate with and provide tension to said guide pin, such that on partially
compressing said trigger the lower portion of said guide means provides tension
on said guide pin and flexes said ratchet arm into engagement with said pawl
and on complete compression of said trigger, the upper portion of said guide
means releases tension from said guide pin allowing said ratchet arm to relax
and allowing said guide pin to cross over said guide means, thus causing said
ratchet to be disengaged from said pawl.
In one embodiment the guide means described above are two cams
attached to each side of the handles. In another embodiment, the stapling
control means comprises two guide pins to coordinate with the two cams.
DESCRIPTION OF THE DRAWINGS
Figures 1 and 2 are side and top views respectively of the stapling
instrument;
Figure ~ is a broken perspective view of the front portion of the
instrument shown in Figures 1 and 2;
Figures 4A and 4B are perspective views showing the parts of the
stapling instrument control means in the handle and in the handle cover,
respectively;
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Figure 5 is a broken sectional view of the stapling instrument
control means;
Figure 6 is a perspective view of ~he instrument trigger, and an
expanded view of the track and track cover;
Figures 7 and 8 are sectional side, and top views respectively of
the instrument track cover;
Figures 9 and lO are sectional side, and top views respectively of
the instrument track;
Figure 11 is an expanded view showing the relationship of the forming
blade, bending anvil and retainer spring; and
Figures 12 and ]3 are broken and sectional side views of Figure 1
showing the position and relationship of the staple and retainer spring in
the initial position and on compressing the instrument trigger;
Figures 14 to 16 are broken rear views of the bending anvil showing
the relationship of the staple, forming blade, retainer spring and anvil flange
during compression of the instrument trigger;
Figllre 17 (on the same sheet as Figure 10) is an expanded view showing
the relationship of the forming blade, first bias means, guide block, track
cover, bending anvil and retainer spring.
Figures 18A and 18~ are perspective views showing an alternative
embodiment of the stapling instrument control means;
Figure 19 is a broken sectional view of the alternative stapling
instrument control means of Figure 18;
Figure 20 (on the same sheet as Figure 22) is a broken perspective
view of the alternative control means in the trigger;
Figure 21 is an expanded view of an alternative embodiment of the
track and track cover;
Figures 22 and 23 are broken sectional side and top views,
respectively of the instrument track sho~m in Figure 21;
Figure 24 is an expanded view showing the relationship of the forming
blade, bending anvil and leaf spring shown in Figure 21; and
Figures 25 to 27 are broken and sectional side views showing
respectively the position a-nd relationship of the staple and leaf spring in
the initial position, on partial compressing and on complete compressing of
the instrument trigger.
Referring to Figures l to 3~ the instrument comprises a handle l and
a trigger 2. A staple track 10 (more fully described in Figures 6 and 9 to
10) is inserted and attached to the forward portion of the handle l, for
example by cementing or sonic welding. The initial end of an indicator 13 is
visible through an opening in the forward top portion of the handle 1. A
combined ratchet stop and cover 14 (more fully described in Figures 4 and 5)
is attached to the rear portion of handle 1.
Referring to Figures 6 to 11 and 17, the track cover 3 is assembled
as follows. The first bias means 7, which preferably is a negator spring,
is mounted into the openings 3a in track cover 3. Retainer spring 15 is
inserted onto bending anvil retainer tabs 9a. The bending anvil 9 and the
retainer spring 15 are then placed through the opening 3b. The terminal end
13a of indicator 13 is mounted onto the track cover 3 in front of the spring
7 protrudes through the bottom 3c of the track cover 3,
The guide block 4 is mounted under tabs 3d. A locking wedge 8 is
then pushed into slots 3e to hold the guide block 4 on the track cover 3.
Other means for holding the guide block on the ~rack cover can be used, for
example bonding, riveting, peening, tacking or welding.
The second bias means 6, preferably a spring, is inserted into the
guide block opening 4a. The forming blade 5 is mounted through the guides
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4b in the guide block. The vertical surface of the Eorming blade 5 is between
the forward portion of the tracl; cover 3 and ~he anvil surface 9.
Referring specifically to Figures 9 and lQ, staples 12 are loaded
onto the track 10. The staple advancing means, preferably a staple pusher 11
is carried on the track lO behind the staples 12 by the first bias means 7
(shown e.g., in Figure o). The indicator 13 is carried with the staple pusher
11 by the first bias means 7. The staples 12 in Figures 9 and 10 are shown
in their orientation when the instrument is in the position shown in Figure 1.
The track cover 3 is then mounted onto the track 10 for example by
sonic welding. The spring 7 is then attached to the advancing means tab lla
by pulling back on the indicator 13 and engaging the center of the extended
spring 7 with the advancing means tab lla. The trigger pivots 2aa are placed
against stops in the forward portion of the handle 1. The track cover 3 and
track 10 are then inserted and attached to the forward portion of the handle 1,
for example by cementing or sonic welding. The trigger pivots 2aa are thus
captured.
Referring to Figures 12 to 17, the stapling instrument is used by
placing the anvil surface 9 adjacent a wound opening or between skin or fascia.
The trigger 2 is then compressed into the handle 1 (shown in Figure 1). The
front end of trigger 2 engages the top flange of forming blade 5, forcing
it down thru the guides 4b on guide block 4. The lower edges of the forming
blade have a recessed area to engage staple 12. The staple is pushed downward
and forced to bend at right angles on either side of the lower flange of
anvil 9.
In the initial or rest position, the staple 12 is adJacent the
vertical surface of the anvil 9, as shown in Figure 12. The forming blade 5
lowers and pushes the staple downward and onto the anvil flange. The forming
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of the staple around the anvil lower flange is well known in the prior art.
By releasing the trigger and advancing the instrument, the staple 12 is
separated from the anvil flange.
When releasing trigger 2, spring 6 returns forming blade 5 and
trigger 2 to their relaxed positions. Spring 7 pulls against pusher 11 to
advance the plurality of staples. Each time trigger 2 is compressed indicator
13 advances with pusher 11. An indication of the staple depletion appears
in the opening in the top forward portion of handle 1.
Referring to Figures 4 and 5, to prevent partially compressing the
trigger 2, partially forming a staple 12, and then allowing the trigger to
return and pick up the next staple, a multi-toothed ratchet 2a is built into
the rear of the trigger 2 and cam guides lb into handle 1. When the trigger
2 is compressed, the ratchet 2a engages stop 14a and prevents the trigger
from returning to its relaxed position. The trigger must be compressed past
the last ratchet tooth 2a and must be completely closed so that the guide pins
2b (more fully shown in Figure 6) move up and cross over the cam guides lb.
The guide pins are spring loaded. Thus when the trigger is
completely compressed, the guide pins cross over the top of the cam guides
lb. On releasing the trigger from a final compression, the ratchet is thus
prcvented from locking on the stop 14a.
Referring to Figures 18 and 19 showing an alternative embodiment
of the stapling instrument control means, to prevent partially compressing
the trigger 2, partially forming a staple 12, and then allowing the trigger
to return and pick up the next staple, a multi-toothed ratchet 16a is built
into the cover 16. A stop 2c is built into the trigger 2. Cam guides lb
are built into handle 1. When the trigger 2 is compressed, the ratchet
16a engages stop 2c and prevents the trigger from returning to its relaxed
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position. The trigger must be compressed past the last ratchet tooth 16a
and must be completely closed so that the guide pins 2b (more fully shown in
Figure 6) move up and cross over the cam guides lb,
The guide pins 2b are spring loaded. Thus when the trigger is
completely compressed, the guide pins cross over the top of the cam guides lb.
On releasing the trigger from a final compression, the ratchet is thus pre-
vented from locking on the stop 2c.
Referring to Figures 20 and 21 which show respectively, the
alternative control means in the trigger and an alternative embodiment of the
track and track cover, the track cover 3 is assembled as follows. The forward
portion of the track cover is identical to that shown in Figures 6 to 8. The
bias means 7 (not shown) and the bending anvil 9 are mounted identically to
the description in Figures 6 to 8 and 17. The front tabs 10a on the track 10
pass through the slots 9a and then fold onto the bending anvil 9. As shown
more fully in Figure 24, the front tabs 10a and the slots 9a are sufficiently
wide to allow the forming blade 5 to move. The terminal end 13a of indicator
13 (not shown) is mounted identically to the description in Figures 6 to 10.
The guide block 4 is mounted under tabs 3d as shown in Figures 6
to 8 and 17. Blocks 3f are adjacent slots 3h on the track cover 3, Blocks
3f diagonally support the guide block 4 on the track cover 3. Forward vertical
tabs 10b on the track 10 pass through the forward openings 3g in the track
cover 3 and then fold onto the portion of the guide block 4 in slots 3h to
hold the guide block on the track cover. Rear vertical tabs lOb pass through
the rear openings 3g and then fold onto the track cover 3.
The second bias means 6 and the forming blade 5 are mounted
identically to the description in Figures 6 & 17.
Figures 22 and 23 show an alternative embodiment of the track 10.
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In the alternative embodiment, the track 10 contains a leaf spring lOc on
the terminal end of the track. The ]eaf spring separates the staple adjacent
to the anvil surface from the anvil flange. The staples 12, staple advancing
means 11, and indicator 13 are carried on the track 10 and are identical to
the description in Figures 9 and 10. Referring to Figures 22 to 27, the
stapling instrument with the alternative embodiments is used by placing the
anvil surface 9 adjacent a wound opening or between skin or fascia. The
trigger 2 (shown in Figure 1) is then compressed into the handle 1. The front
end of trigger 2 engages the top flange of forming blade 5, forcing it down
thru the guides 4b (shown in Figure 17) on guide block 4. The lower edges of
the forming blade have a recessed area to engage staple 12. The staple is
pushed downward and displaces the leaf spring lOc. The leaf spring lOc then
moves back to its initial position to hold the ne~t staple at the terminal
end of track 10 and adjacent the anvil surface. The forming blade 5 continues
to engage staple 12 which is then forced to bend at right angles on either side
of the lower flange of anvil 9.
In the initial or rest position, the staple 12 is adjacent the
vertical surface of the anvil 9, as shown in Figure 25. The forming blade 5
lowers and pushes the staple downward and onto the anvil flange. By releasing
the trigger and advancing the instrument, the staple 12 is separated from
the anvil flange.
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