Note: Descriptions are shown in the official language in which they were submitted.
CA 02708422 2010-07-08
SURGICAL DEVICE
This is a division of Canadian Serial No.: 2,489,727 filed June 11, 2003.
FIELD OF THE INVENTION
The present invention relates to a surgical device. More specifically, the
present invention relates to a linear clamping, cutting and stapling device
for
clamping, cutting and stapling tissue.
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BACKGROUND INFORMATION
One type of surgical device is a linear clamping, cutting and stapling
device. Such a device may be employed in a surgical procedure to resect a
cancerous or anomalous tissue from a gastro-intestinal tract. One conventional
linear clamping, cutting and stapling instrument is shown in Figure 1. The
device
includes a pistol grip-styled structure having an elongated shaft and distal
portion.
The distal portion includes a pair of scissors-styled gripping elements, which
clamp the open ends of the colon closed. In this device, one of the two
scissors-
styled gripping elements, such as the anvil portion, moves or pivots relative
to the
overall structure, whereas the other gripping element remains fixed relative
to the
overall structure. The actuation of this scissoring device (the pivoting of
the anvil
portion) is controlled by a grip trigger maintained in the handle.
In addition to the scissoring device, the distal portion also includes a
stapling mechanism. The fixed gripping element of the scissoring mechanism
includes a staple cartridge receiving region and a mechanism for driving the
staples up through the clamped end of the tissue against the anvil portion,
thereby sealing the previously opened end. The scissoring elements may be
integrally formed with the shaft or may be detachable such that various
scissoring
and stapling elements may be interchangeable.
One problem with the foregoing surgical devices, and in particular with the
foregoing linear clamping, cutting and stapling devices such as that
illustrated in
Figure 1, is that the opposing jaws of the clamping mechanism do not provide
adequate clamping at the distal ends of the scissors-styled gripping elements
to
insure that a section of tissue clamped between the gripping elements is
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prevented from being pushed out from between the distal ends of the gripping
elements.
SUMMARY OF THE INVENTION
In accordance with one example embodiment of the present invention, a
surgical device is provided that includes a first jaw having a distal end and
a
second jaw having a distal end. The second jaw is disposed in opposed
correspondence with the first jaw. The first jaw is pivotably coupled to the
second
jaw. The surgical device also includes a biasing element that biases the
distal
end of the first jaw towards the distal end of the second jaw. The biasing
element
may include a spring coupling the proximal end of the first jaw and the
proximal
end of the second jaw.
The device may also include a first driver disposed in the second jaw and
coupled to the first jaw. The first driver is configured to cause separation
of the
first jaw and the second jaw when the first driver is actuated for opening the
jaws
and to close the first jaw and the second jaw when the first driver is
actuated for
closing the jaws. The device may also include at least one of a cutting
element
and a stapling element disposed within the second jaw, preferably a blade
rotatably mounted on a wedge. A second driver is configured to move the
cutting
element and/or the stapling element proximally from a distal end toward the
proximal end of the second jaw to at least one of cut and staple a section of
tissue disposed between the first and second jaws.
By biasing the distal ends of the first and second jaws towards each other,
the surgical device may, in accordance with one example embodiment of the
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present invention, prevent a section of tissue which is disposed between the
first
and second jaws from escaping out from between the distal ends of the first
and
second jaws.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a perspective view of a conventional linear clamping, cutting
and stapling device;
Figure 2 is a perspective view of an electro-mechanical surgical system
according to one example embodiment of the present invention;
Figures 3(a) to 3(d) are side views of a linear clamping, cutting and stapling
attachment, at various stages of its operation, according to one example
embodiment of the present invention;
Figures 4(a) to 4(c) are side views of a linear clamping, cutting and stapling
attachment, at various stages of its operation, according to another example
embodiment of the present invention;
Figure 5(a) is a side view of a linear clamping, cutting and stapling
attachment according to another example embodiment of the present invention;
Figure 5(b) is a partial top view of the linear clamping, cutting and stapling
attachment illustrated in Figure 5(a);
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Figure 6(a) is an exploded view of a replaceable staple cartridge for use in
the linear clamping, cutting and stapling attachment illustrated in Figure
5(a);
Figure 6(b) is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 6-6 shown in Figure 5(b);
Figure 7 is a rear view of the linear clamping, cutting and stapling
attachment illustrated in Figure 5(a);
Figure 8 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 8-8 shown in Figure 6(b);
Figure 9 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 9-9 shown in Figure 6(b);
Figure 10 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 10-10 shown in Figure 9;
Figure 11 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 11-11 shown in Figure 6(b);
Figure 12 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 12-12 shown in Figure 11;
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Figure 13 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 13-13 shown in Figure 6(b);
Figure 14 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 14-14 shown in Figure 13;
Figure 15 is a side elevational view, partially in section, of a flexible
shaft of
the electro-mechanical surgical device according to one example embodiment of
the present invention;
Figure 16 is a cross-sectional view of the flexible shaft taken along the line
16-16 shown in Figure 15;
Figure 17 is a rear end view of a first coupling of the flexible shaft
illustrated in Figure 15;
Figure 18 is a front end view of a'second coupling of the flexible shaft
illustrated in Figure 15;
Figure 19 is a schematic view illustrating a motor arrangement of the
electro-mechanical surgical device illustrated in Figure 2;
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Figure 20 is a schematic view of the electro-mechanical surgical device
illustrated in Figure 2;
Figure 21 is a schematic view of an encoder of the flexible shaft illustrated
in Figure 15;
Figure 22 is a schematic view of a memory device of a linear clamping,
cutting and stapling device according to one example embodiment of the present
invention;
Figure 23 is a schematic view of a wireless remote control unit of the
electro-mechanical surgical device illustrated in Figure 2; and
Figure 24 is a schematic view of a wired remote control unit of the electro-
mechanical surgical device illustrated in Figure 2.
DETAILED DESCRIPTION
One example embodiment of a surgical device according to the present
invention is schematically illustrated in Figures 3(a) to 3(d). Referring to
Figures
3(a) to 3(d), an example embodiment of the surgical device 11a, e.g., a linear
clamping, cutting and stapling device, is illustrated. In this embodiment, a
surgical device 11a includes a first jaw 50 having a distal end 50a and a
proximal
end 50b, and a second jaw 80 having a distal end 80a and a proximal end 80b.
The first jaw 50 and the second jaw 80 are pivotably coupled at or near their
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respective proximal ends 50b, 80b. The proximal end 50b of the first jaw 50
and
the proximal end 80b of the second jaw 80 are biased away from each other via
a
biasing element 82. In this example embodiment, the biasing element 82 may be
a spring. The surgical device 1 la includes a stop element that limits the
distance
that the proximal end 50b of the first jaw 50 can be separated from the
proximal
end 80b of the second jaw 80. In the example embodiment of the present
invention illustrated in Figures 3(a) to 3(d), the stop element includes a pin
84
disposed near the proximal end 80b of the second jaw 80 that engages a slot 86
near the proximal end 50b of the first jaw 50, whereby an upper slot surface
86a
of the slot 86 contacts the pin 84 so as to limit the distance that the
proximal end
50b of the first jaw 50 can be separated from the proximal end 80b of the
second
jaw 80.
In addition, the first jaw 50 and the second jaw 80 are coupled to each
other at a location between their respective distal ends 50a, 80a and proximal
ends 50b, 80b by an externally threaded rod 90. In the example embodiment of
the present invention illustrated in Figures 3(a) to 3(d), the externally-
threaded rod
90 is pivotably coupled at a lower end 90a to a pin 92 mounted in the first
jaw 50.
A first driver 88 engages the externally-threaded rod 90 so as to extend and
retract the externally-threaded rod 90 relative to the second jaw 80, thereby
opening and closing the first jaw 50 relative to the second jaw 80. In
addition, a
first drive socket 654 of the first driver 88 is coupled to a first motor 96
by a first
drive shaft 94. As will be explained in more detail below, the first driver
88, when
engaged by the first motor 96 via the first drive shaft 94, operates to open
and
close first jaw 50 relative to second jaw 80.
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The first jaw 50 includes a clamping surface 108 that has a distal end 108a
and a proximal end I08b_ Similarly, the second jaw 80 includes a clamping
surface 106 that has a distal end 106a and a proximal end 106b. The second jaw
80 also includes a cutting and stapling element 104, which may form at least
part
of the clamping surface 106 of the second jaw 80. As explained in greater
detail
below, the cutting and stapling element 104 is configured to cut and staple a
section of tissue, e.g., tissue, when the first jaw 50 and the second jaw 80
are
in the fully closed position illustrated in Figure 3(d). The second jaw 80
also
includes a second driver 98 having a second drive socket 694 that is coupled
to a
second motor 100 by a second drive shaft 102. The second driver 98, when
engaged by the second motor 100 via the second drive shaft 102, operates to
drive the cutting and stapling element 104 to cut and staple a section of
tissue
While two drive sockets, e.g., the first drive socket 654 and the second drive
socket 694, and two corresponding drive shafts, e.g., the first drive shaft 94
and
the second drive shaft 102, are illustrated, It is possible to provide any
suitable
number of drive sockets and drive shafts. For example, a single drive shaft
may
be provided to operate the surgical. device 11a.
Figure 3(a) illustrates the surgical device 11 a in a fully open position,
wherein the first jaw 50 and the second jaw 80 are fully separated. In the
fully
open position, the externally-threaded rod 90 of the first driver 88 is in a
fully
extended position relative to the second jaw 80. The upper slot surface 86a of
the slot 86 contacts the pin 84 of the second jaw 80. Thus, the distal end 50a
of
the first jaw 50 is at a maximum distance from the distal end 80a of the
second
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jaw 80, and the proximal end 50b of the first jaw 50 is at a maximum distance
from the proximal end 80b of the second jaw 80.
When the first driver 88 is driven in a first direction, the surgical device
11a
is moved into a first partially closed position, as illustrated in Figure
3(b). In the
first partially closed position illustrated in Figure 3(b), the first jaw 50
and the
second jaw 80 are approximately parallel to each other, e.g., the distance
between the distal end 108a of the clamping surface 108 of the first jaw 50
and
the distal end 106a of the clamping surface 106 of the second jaw 80 is
approximately equal to the distance between the proximal end 108b of the
clamping surface 108 of the first jaw 50 and the proximal end 106b of the
clamping surface 106 of the second jaw 80. As shown in Figure 3(b), the
externally-threaded rod 90 is partially retracted, e.g., via the first driver
88, to a
position between its fully extended position and its fully retracted position.
The
upper slot surface 86a of the slot 86 maintains contact with the pin 84 of the
second jaw 80. Thus, in moving the surgical device 11a from the fully open
position illustrated in Figure 3(a) to the first partially closed position
illustrated in
Figure 3(b), the first jaw 50 pivots relative to the second jaw 80 around the
stop
element, e.g., around the pin 84 in contact with the upper slot surface 86a.
In this
embodiment, the first jaw 50 pivots due to the retraction of the externally
threaded
rod 90, in combination with the force of the biasing element 82. Accordingly,
the
biasing member 82 not only biases the proximal ends 50b, 80b of the jaws 50,
80
apart, but also biases the distal ends 50a, 80a of the jaws 50, 80 towards
each
other.
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Upon further engagement of the first driver 88, the surgical device 1 la is
moved into a second partially closed position, as illustrated in Figure 3(c).
In the
second partially closed position illustrated in Figure 3(c), and due to the
biasing
element 82, the distance between the distal end 108a of the clamping surface
108 of the first jaw 50 and the distal end 106a of the clamping surface 106 of
the
second jaw 80 is less than the distance between the proximal end 108b of the
clamping surface 108 of the first jaw 50 and the proximal end 106b of the
clamping surface 106 of the second jaw 80. As shown in Figure 3(c), the
externally-threaded rod 90 is still further retracted, e.g., via the first
driver 88,
relative to the partially retracted position illustrated in Figure 3(b). The
upper slot
surface 86a of the slot 86 still maintains contact with the pin 84 of the
second jaw
80. Thus, in moving the surgical device 11a from the first partially closed
position
illustrated in Figure 3(b) to the second partially closed position illustrated
in Figure
3(c), the first jaw 50 continues to pivot relative to the second jaw 80 around
the
stop element, e.g., around the pin 84 in contact with the upper slot surface
86a.
Upon still further engagement of the first driver 88, the surgical device 1 Ia
is moved into a fully closed position, as illustrated in Figure 3(d). In the
fully
closed position illustrated in Figure 3(d), the clamping surface 108 of the-
first jaw
50 is generally parallel to the clamping surface 106 of the second jaw 80. As
shown in Figure 3(d), the externally-threaded rod 90 is fully retracted, e.g.,
via the
first driver 88, relative to the partially retracted position illustrated in
Figure 3(c).
With the distal ends 106a, 108a of the clamping surfaces 106, 108 of the first
and
second jaws 50, 80 in contact as shown in Figure 3(c), this further retraction
of
the externally-threaded rod 90 causes the upper slot surface 86a of the slot
86 to
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separate from the pin 84 of the second jaw 80. Thus, in moving the surgical
device 11a from the second partially closed position illustrated in Figure
3(c) to
the fully closed position illustrated in Figure 3(d), the first jaw 50 pivots
relative to
the second jaw 80 first around the distal ends 106a, 108a of the clamping
surfaces 106, 108 of the first and second jaws 50, 80, and then, as the distal
ends
106a and 108a are gradually separated, around the section of tissue. The
biasing element 82, which is compressed in the position illustrated in Figure
3(d),
continues to bias apart the proximal ends 50b, 80b of the first and second
jaws
50, 80, and also to bias the distal end 50a of the first jaw 50 towards the
distal
end 80a of the second jaw 80.
Figures 4(a) to 4(c) are side views of a linear clamping, cutting and stapling
attachment according to another example embodiment of the present invention.
Specifically, Figure 4(a) illustrates a surgical device 11 b in an open
position,
Figure 4(b) illustrates the surgical device 11 b in a partially closed
position, and
Figure 4(c) illustrates the surgical device 11 b in a closed position. In the
example
embodiment of the present invention illustrated in Figures 4(a) to 4(c), the
first jaw
50 of the surgical device 11 b has a curved surface 1081. In particular, the
distal
end 50a of the first jaw 50 is curved towards the distal end 80a of the second
jaw
80. Thus, a clamping force that is exerted on a section of tissue (not shown)
that
is disposed between the first jaw 50 and the second jaw 80 is greater at the
distal
ends 50a, 80a of the first and second jaws 50, 80 than at the proximal ends
50b,
80b of the first and second jaws 50, 80, thereby helping to reduce the
tendency of
the section of tissue to escape out from between the distal ends 50a, 80a of
the
first and second jaws 50, 80. According to one example embodiment of the
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present invention, the first jaw 50 of the surgical device 11 b is formed of a
resilient, deformable material such that the first jaw 50 is configured to at
least
partially straighten, relative to the curved position shown in Figures 4(a) to
4(c),
when a sufficient clamping force is exerted at the distal ends 50a, 80a of the
first
and second jaws 50, 80. In addition, the surgical device 11 b may employ a
biasing element, such as a spring coupled to the proximal ends 50b, 80b of the
jaws 50, 80, as discussed above, in order to further bias the distal end 50a
of the
first jaw 50 towards the distal end 80a of the second jaw 80 and to provide a
still
greater clamping force at the distal ends 50a, 80a of the first and second
jaws 50,
80 of the surgical device 11 b.
Figures 5(a) to 14 illustrate various views of a linear clamping, cutting and
stapling attachment, according to another example embodiment of the present
invention. Specifically, Figure 5(a) is a side view of a linear clamping,
cutting and
stapling attachment according to one example embodiment of the present
invention. The surgical device 11 is configured so as to be particularly well-
suited
for endoscopic insertion into the body of a patient via a cannula (not shown)-
Figure 5(a) illustrates the first jaw 50 in opposed correspondence with the
second
jaw 80. Figure 5(b) is a partial top view of the surgical device .11,
particularly the
second jaw 80, illustrated in Figure 5(a).
Figure 6(a) is an exploded view of a replaceable staple cartridge 600, that
is configured to be employed in the example embodiment of the present
invention
illustrated in Figures 5(a) to Figure 14. The replaceable staple cartridge 600
includes a staple tray 604. The staple tray 604 has a slot 6041 at its
proximal end
604d in which a memory module 6041 is retained by a memory module retainer
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6042. The memory module 6041 may store information as described, for
example, in U.S. Patent No. 6,793,652, U.S. Patent No. 6,981,941, U.S. Patent
No. 7,032,798 and U.S. Publication No. US 2004/0111081. A wedge driver
605 is configured to be rotatably disposed through a central channel 604e of
the staple tray 604. Specifically, the wedge driver 605 has a distal end 605a
that is configured to be rotatably disposed through a central channel 604e of
the staple tray 604. The wedge driver 605 also includes an externally threaded
region 605b, a non-threaded portion 605c that rotatably extends through a
proximal orifice 604b in the proximal end 604b of the staple tray 604, and a
spur gear 605d at its proximal-most end.
The replaceable staple cartridge 600 also includes a wedge 603 having
an internally threaded bore 603a. The externally threaded region 605b of the
wedge driver 605 is configured to extend through the internally threaded bore
603a of the wedge 603. The threads of the internally threaded bore 603a of the
wedge 603 match the threads of the externally threaded region 605b of the
wedge driver 605. As is discussed further below, upon rotation of the wedge
driver 605, the wedge 603 is moved between the distal end 604c of the staple
tray 604 and the proximal end 604d of the staple tray 604 through a central
channel 604e.
The staple tray 604 also includes a plurality of vertically-disposed slots
604f in opposing walls 604g of the central channel 604e. On each side of the
central channel 604e, a staple pusher 607 is configured to be slidably
disposed
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within the slots 604f. More specifically, each of the staple pushers 607 has a
top
surface 607a running longitudinally between two rows 607b of staple pushing
fingers 607c. The staple pushing fingers 607c are configured such that each
staple pushing finger 607c in the row 607b that abuts the wall 604g of the
staple
tray 604 is retained within a corresponding slot 604f of the wall 604g so as
to be
vertically slideable therein. The staple pushing fingers 607c are positioned
over
slots 604h in the staple tray 604. The slots 604h in the staple tray 604 house
a
plurality of fasteners, e.g., staples 606. Each of the staples 606 includes a
butt
606a and a pair of prongs 606b.
The wedge 603 also includes a pair of sloped edges 603b that slideably
engage respective top surfaces 607a of the staple pushers 607. When the
wedge 603 is moved from the distal end 604c to the proximal end 604d of the
staple tray 604 through the central channel 604e, the pair of sloped edges
603b
of the wedge 603 is configured to slideably engage the respective top surfaces
607a of the staple pushers 607 in order to successively push the staple
pushing
fingers 607c of the staple pushers 607 into, and thus the staples 606 out of,
the
slots 604h in the staple tray 604. A cartridge top 611 is configured to fit
over the
central channel 604a of the staple tray 604, while a staple retainer 610 is
configured to cover the clamping surface 106 of the staple tray 604.
Figure 6(b) is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 6-6 shown in Figure 5(b). Figure 6(b)
illustrates the surgical device 11 in a fully closed position, in which the
externally
threaded rod 90 is fully retracted. In Figure 6(b), the surgical device 11 is
illustrated absent a section of tissue between the clamping surfaces 106, 108
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the first and the second jaws 50, 80, and thus the surgical device 11 is shown
in
this fully closed position having the distal end 108a of the clamping surface
108 of
the first jaw 50 in contact with the distal end 106a of the clamping surface
106 of
the second jaw 80.
As illustrated in Figure 6(b), the surgical device 11 includes a cutting and
stapling element 104 disposed within the second jaw 80. According to the
example embodiment of the present invention shown, the cutting and stapling
element 104 includes the replaceable staple cartridge 600 of Figure 6(b) that
is
replaceably mountable within the second jaw 80. The replaceable staple
cartridge 600, which was shown in an exploded view in Figure 6(a), is shown
assembled and mounted within the second jaw 80 in Figure 6(b).
As illustrated in Figure 6(b), the wedge 603 has disposed thereon a blade
51 having a cutting edge 51 a. In an alternative example embodiment, the
cutting
and stapling elements may be separately disposed. In the example embodiment
illustrated in Figure 6(b), the surgical device 11 includes a blade 51 having
a tail
region 654 with a contact face 653. The blade 51 is rotatably coupled to the
wedge 603 around pivot 51 b to allow the blade 51 to rotate between a first
and a
second position. Figure 6(b) illustrates the wedge 603 and the blade 51 in
several positions, labeled as positions A to E, as the wedge 603 and the blade
51
travel from the distal end 604c to the proximal end 604d of the staple tray
604.
In the position labeled A, the wedge 603 and the blade 51 are positioned at
the distal end 604c of the staple tray 604. In the position labeled A, the
wedge
603 and the blade 51 are housed within a housing 615 and the blade 51 is
rotated
relative to the wedge 603 so as to be in a retracted position, e.g., the
cutting edge
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51a facing upwards and is not exposed. The contact face 653 initially faces
the
proximal end 604d of the staple tray 604.
In operation, the second driver 98 causes the wedge 603 and the blade 51
to advance to the position labeled B, via, for example, rotation of the wedge
driver
605. In the position labeled B, the wedge 603 and the blade 51 are positioned
proximally relative to the distal end 604c of the staple tray 604.
Specifically, in the
position labeled B, the wedge 603 and the blade 51 are positioned such that
the
contact face 653 of the blade 51 begins to contact an actuating lip 615a of
the
housing 615. As the contact face 653 of the blade 51 begins to contact the
actuating lip 615a of the housing 615, the blade 51 begins to rotate relative
to the
wedge 603.
Further operation of the second driver 98 causes the wedge 603 and the
blade 51 to advance to the position labeled C. In the position labeled C, the
wedge 603 and the blade 51 are positioned still further proximally relative to
the
distal end 604c of the staple tray 604. Specifically, in the position labeled
C, the
wedge 603 and the blade 51 are positioned such that the contact face 653 of
the
blade 51 has fully contacted the actuating lip 615a of the housing 615. When
the
contact face 653 of the blade 51 has fully contacted the actuating lip 615a of
the
housing 615, the blade 51 is fully rotated relative to the wedge 603 such that
the
cutting edge 51a of the blade 51 is in an extended position, e.g., the cutting
edge
51a faces the proximal end 604d of the staple tray 604.
Further operation of the second driver 98 causes the wedge 603 and the
blade 51 to advance to the position labeled D. In the position labeled D, the
wedge 603 and the blade 51 are positioned approximately at the midpoint
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between the distal end 604c and the proximal end 604d of the staple tray 604.
In
the position labeled D, the blade 51 is maintained in the extended position
having
the cutting edge 51a facing the proximal end 604d of the staple tray 604 so as
to
cut a section of tissue (not shown) that is clamped between the first jaw 50
and
the second jaw 80.
Further operation of the second driver 98 causes the wedge 603 and the
blade 51 to advance to the position labeled E. In the position labeled E, the
wedge 603 and the blade 51 are positioned at the proximal end 604d of the
staple
tray 604. In the position labeled E, the blade 51 is still maintained in the
extended
position with the cutting edge 51 a facing the proximal end 604d of the staple
tray
604. Here, however, the blade 51 is enclosed within a housing 616 so that the
cutting edge 51a is not exposed.
As illustrated in Figure 6(b), the first jaw 50 includes an anvil member 700
in opposed correspondence with the second jaw 80. The anvil member 700
includes the clamping surface 108, which, along with the clamping surface 106
of
the second jaw 80, clamps a section of tissue to be cut and stapled.
The surgical device 11 also includes a biasing element 82 that biases the
proximal end 50b of the first jaw 50 apart from the proximal end 80b of the
second jaw 80, and a stop member that limits the distance that the proximal
end
50b of the first jaw 50 can be separated from the proximal end 80b of the
second
jaw 80. In the example embodiment of the present invention illustrated in
Figure
6(b), the biasing element 82 includes a spring 705 maintained in a cylindrical
housing 706 of the surgical device 11. Specifically, a first end of the spring
705
contacts an interior surface 5010 of the first jaw 50 and a second end of the
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spring 705 contacts a housing wall 708 of the cylindrical housing 706. A stop
member 707 is fixedly connected at a first end 707a to the first jaw 50,
extends
through the center of the spring 705 and through an orifice 708a of the
housing
wall 708 and into a cylindrical housing 709. A second end 707b of the stop
member 707 contacts an interior surface of the second jaw 80 when the first
jaw
50 and the second jaw 80 are in the closed position illustrated in Figure
6(b). The
second end 707b of the stop member 707 preferably has a T-shape that contacts
the cylindrical housing wall 709 but can not extend through the orifice 708a.
Thus, the contact of the second end 707b of the stop member 707 against the
cylindrical housing wall 708 operates to limit the distance that the proximal
end
50b of the first jaw 50 can be separated from the proximal end 80b of the
second
jaw 80.
Similar to the embodiment discussed above with respect to Figures 3(a) to
3(d), the second jaw 80 of the surgical device 11 also includes a first driver
88
that is coupled to a first motor 96 by a first drive shaft 94 such that, when
engaged by the first motor 96 via the first drive shaft 94, the first driver
88
operates to open and close first jaw 50 relative to second jaw 80. In the
example
embodiment shown in Figure 6(b), the first driver 88 includes an externally-
threaded rod 90 that is pivotably coupled at a lower end 90a to a pin 92 in
the first
jaw 50. The externally threaded rod 90 has a stopper 90c at an upper end 90b.
Figure 6(b) illustrates a bevel gear nut 617 that forms a part of the first
driver 88.
The bevel gear nut 617 is rotatably seated within a bearing nut 618. The
bearing
nut 618 is non-rotatably seated within an orifice of a housing plate 619 that
is
horizontally and fixedly disposed within the surgical device 11. The bevel
gear
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nut 617 has an internally threaded bore 617a through which is disposed the
externally threaded rod 90 whereby the threads of the internally threaded bore
617a of the bevel gear nut 617 match the threads of the externally threaded
rod
90. The bevel gear nut 617 also includes a plurality of gear teeth 617b.
Figure 6(b) illustrates a bevel gear driver 620 that also forms a part of the
first driver 88. The bevel gear driver 620 has a bevel gear 621 at one end
that is
rotatably seated within a bevel bearing 622. The bevel bearing 622 is non-
rotatably seated within an orifice of a housing plate 623 that is vertically
and
fixedly disposed within the surgical device 11. The plurality of gear teeth
617b of
the bevel, gear nut 617 engage a corresponding plurality of gear teeth 621a of
the
bevel gear 621. The bevel gear driver 620 also includes a first longitudinal
region
620b and a second longitudinal region 620c. The second longitudinal region
620b of the bevel gear driver 620 extends through an orifice in a housing
plate
624 that is vertically and fixedly disposed within the surgical device 11.
In this embodiment, a gear cluster 625 also forms a part of the first driver.
The gear cluster 625 has an interior central bore 626 through which the bevel
gear driver 620 extends. The gear cluster 625 has several longitudinally
disposed
regions. A first region 625a of the gear cluster 625 has a smooth cylindrical
outer
surface with a circular cross-section. In addition, the first region 625a of
the gear
cluster 625 has a radially disposed bore 6251 through which is disposed a pin
6252. The pin 6252 extends through the bore 6251 of the first region 625a of
the
gear cluster 625 and into a corresponding radially disposed bore 6201 in the
first
longitudinal region 620b of the bevel gear driver 620 in order to non-
rotatably
couple the gear cluster 625 to the bevel gear driver 620. A second region 625b
of
CA 02708422 2010-07-08
the gear cluster 625 defines a spur gear 627 having a plurality of
circumferentially-disposed spur gear teeth 6271. A third region 625c of the
gear
cluster 625 also defines a spur gear 628 having a plurality of
circumferentially-
disposed spur gear teeth 6281. A fourth region 625d of the gear cluster 625
also
defines a spur gear 629 having a plurality of circumferentially-disposed spur
gear
teeth 6291.
Additionally, in this example embodiment, the first driver further includes a
gear cluster 630. The gear cluster 630 has an interior central bore 630a
through
which a gear pin 631 extends. The gear pin 631 has a distal end 631 a that is
rotatably housed within an orifice 632a of a vertically-disposed housing plate
632
of a gearbox 6000 fixedly mounted within the surgical device 11, and a
proximal
end 631 b that rotatably extends through an orifice 635a in a verticaly-
disposed
housing plate 635 of the gearbox 6000. The gear cluster 630 has several
longitudinally disposed regions. A first region 630b of the gear cluster 630
defines a spur gear 633 having a plurality of circumferentially-disposed spur
gear
teeth 6331. A second region 630c of the gear cluster 630 also defines a spur
gear 634 having a plurality of circumferentially-disposed spur gear teeth
6341.
The surgical device 11 is configured such that the spur gear teeth 6331 of the-
spur gear 633 of the gear cluster 630 engage the spur gear teeth 6271 of the
spur
gear 627 of the gear cluster 625. Simultaneously, the spur gear teeth 6341 of
the
spur gear 634 of the gear cluster 630 engage the spur gear teeth 6281 of the
spur
gear 628 of the gear cluster 625.
The surgical device 11 also includes a keyplate assembly 710 that is
connected to the proximal end of the surgical device 11. The keyplate 710
21
CA 02708422 2010-07-08
includes an internally threaded bore 710a that is aligned with an internally
threaded bore 711 a of a housing wall 711 of the gearbox 6000 of the surgical
device 11. An externally threaded screw 712, the threads of which mate with
the
threads of internally threaded bores 710a and 711 a, extends through the
keyplate
assembly 710 and the housing wall 711 so as to fixedly connect the keyplate
assembly 710 to the housing wall 711. The keyplate assembly 710 also includes
a quick connect sleeve 713 that has quick connect slots 713a that engage
complementary quick connect elements 1664 of a flexible drive shaft 1620,
which
is described in further detail below. In order to retain the quick connect
elements
1664 of the flexible drive shaft 1620 in the quick connect slots 713a of the
quick
connect sleeve 713, the keyplate assembly 710 also includes a keyplate spring
714.
Additional features of the keyplate assembly 710 are illustrated in Figure 7,
which is a rear view of the linear clamping, cutting and stapling attachment
illustrated in Figure 5(a). Referring now to Figure 7, a backstop plate 717 is
disposed between the keyplate assembly 710 and the housing wall 711. The
backstop plate 717 is held in place by the screw 712 and has orifices 717a and
717b through which extend the first drive socket 654 of the first driver 88
and the
second drive socket 694 of the second driver 98. The keyplate assembly 710
also includes a data connector 1272 that includes electrical contacts 1276.
The
data connector 1272 of the keyplate assembly 710 is electrically and logically
connected to the memory module 6041 housed at the proximal end 604b of the
staple tray 604, by a flexible data transfer cable (not shown) extending
therebetween.
22
CA 02708422 2010-07-08
Figure 8 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 8-8 shown in Figure 6(b). Referring
now
to Figure 8, the anvil member 700 includes a longitudinally-disposed slot 701
that
extends from a distal end 700a to a proximal end 700b of the anvil member 700.
The slot 701 is aligned with the blade 51 of the second jaw 80 so that blade
51
extends into and travels along the slot 701 when the blade is moved from the
distal end 80a to the proximal end 80b of the second jaw 80. The anvil member
700 also includes a plurality of rows 702 of staple guides 703. The staple
guides
703 are configured to receive the prongs 606b of the staples 606 when the
surgical device 11 is fired and to bend the prongs 606b so as to close the
staples
606. When the surgical device 11 is in the closed position, the rows 702 of
the
staple guides 703 align with the slots 604h of the staple tray 604 in the
second
jaw 80 so that the staples 606 maintained in the slots 604h of the staple tray
604
are pushed by the staple pushing fingers 607c of the staple pushers 607 into,
and
closed by, corresponding staple guides 703 of the anvil member 700.
Figure 9 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 9-9 shown in Figure 6(b). Figure 10
is a
cross-sectional view of the linear clamping, cutting and Stapling attachment
taken
along the line 10-10 shown in Figure 9. Figure 10 illustrates a gear cluster
640
that forms a part of the first driver 88. The gear cluster 640 has an interior
central
bore 640a through which a gear pin 641 extends. The gear pin 641 has a distal
end 641 a that is rotatably housed within an orifice 635a of the housing plate
635
of the gearbox 6000 and a proximal end 641 b that rotatably extends through an
orifice 645a in a vertically-disposed housing plate 645 of the gearbox 6000.
The
23
CA 02708422 2010-07-08
gear cluster 640 has several longitudinally disposed regions. A first region
640b
of the gear cluster 640 defines a spur gear 643 having a plurality of
circumferentially-disposed spur gear teeth 6431. A second region 640c of the
gear cluster 640 also defines a spur gear 644 having a plurality of
circumferentially-disposed spur gear teeth 6441. The surgical device 11 is
configured such that the spur gear teeth 6431 of the spur gear 643 of the gear
cluster 640 engage the spur gear teeth 6291 of the spur gear 629 of the gear
cluster 625.
Figure 10 also illustrates a fire shaft assembly 690 that forms a part of the
second driver 98. As previously discussed with respect to Figures 3(a) to
3(d),
the second driver 98 is coupled to a second motor 100 by a second drive shaft
102, and operates to drive the cutting and stapling element 104 to cut and
staple
a section of tissue 52. The fire shaft assembly 690 has several longitudinally
disposed regions. A first region 690a of the fire shaft assembly 690 extends
into
and is rotatable within an orifice 692a of a vertically-disposed housing plate
692 of
the gearbox 6000. A second region 690b of the fire shaft assembly 690 defines
a
spur gear 691 having a plurality of circumferentially-disposed spur gear teeth
6911. A third region 690c of the fire shaft assembly 690 defines a second
drive
socket 694. The second drive socket 694 includes a slot 6941 into which a
drive
clip 6942 is inserted. The drive clip 6942 is configured to be non-rotatably,
releasably connected to a complementary second drive coupling 1668 of the
second drive shaft 102, which is discussed in further detail below.
Figure 11 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 11-11 shown in Figure 6(b). Figure 12
is
24
CA 02708422 2010-07-08
a cross-sectional view of the linear clamping, cutting and stapling attachment
taken along the line 12-12 shown in Figure 11. Figure 12 illustrates a clamp
shaft
assembly 650 that forms a part of the first driver 88. The clamp shaft
assembly
650 has several longitudinally disposed regions. A first region 650a of the
clamp
shaft assembly 650 extends into and is rotatable within an orifice 624a of the
housing plate 624 of the gearbox 6000. A second region 650b of the clamp shaft
assembly 650 defines a spur gear 653 having a plurality of circumferentially-
disposed spur gear teeth 6531. The surgical device 11 is configured such that
the spur gear teeth 6531 of the spur gear 653 of the clamp shaft assembly 650
engage the spur gear teeth 6441 of the spur gear 644 of the gear cluster 640.
A
third region 650c of the clamp shaft assembly 650 defines a straight
longitudinal
shaft that is partially surrounded by a gear spacer 657 that maintains the
longitudinal position of the clamp shaft assembly 650 by abutting against spur
gear 653. A fourth region 650d of the clamp shaft assembly 650 defines a first
drive socket 654. The first drive socket includes a slot 6541 into which a
drive clip
6542 is inserted. The drive clip 6542 is configured to be non-rotatably,
releasably
connected to a complementary first drive coupling 1666 of the first drive
shaft 94,
which is discussed in further detail below.
Figure 13 is a cross-sectional view of the linear clamping, cutting and
stapling attachment taken along the line 13-13 shown in Figure 6(b). Figure 14
is
a cross-sectional view of the linear clamping, cutting and stapling attachment
taken along the line 14-14 shown in Figure 13. Figure 14 illustrates a shuttle
idler
gear 660 that forms a part of the second driver 98. The shuttle idler gear 660
has
a first end 660a that extends into and is rotatably supported in an orifice
604e of a
CA 02708422 2010-07-08
housing plate 6041 that is vertically and fixedly disposed within the surgical
device
11. Similarly, the shuttle idler gear 660 has a second end 660b that extends
through and is rotatably supported in an orifice 661 a of a vertically-
disposed
housing plate 661 of the gearbox 6000. The shuttle idler gear 660 also has a
central region 660c that defines a spur gear 662 having a plurality of
circumferentially-disposed spur gear teeth 6621. The surgical device 11 is
configured such that the spur gear teeth 6621 of the spur gear 662 of the
shuttle
idler gear 660 engage the spur gear teeth 6051 of the spur gear 605d at the
proximal end of the wedge driver 605 of the replaceable staple cartridge 600.
Figure 14 also illustrates a counter shaft assembly 670 that forms a part of
the second driver 98. The counter shaft assembly 670 has several
longitudinally
disposed regions. A first region 670a of the counter shaft assembly 670
extends
through and is rotatable within an orifice 661b of the housing plate 661 of
the
gearbox 6000. In addition, the first region 670a defines a spur gear 672
having a
plurality of circumferentially-disposed spur gear teeth 6721. The example
surgical
device 11 is configured such that the spur gear teeth 6721 of the spur gear
672 of
the counter shaft assembly 670 engage the spur gear teeth 6621 of the spur
gear
662 of the shuttle idler gear 660. In addition, the first region 670a of the
counter
shaft assembly 670 includes an axially-tapered bore 6701 into which is
insertable
a pin 6702 extending from the proximal end 604d of the staple tray 604,
thereby
helping to insure that the staple cartridge 600 is properly inserted within,
and
properly engages, the first driver 88 of the second jaw 80. A second region
670b
of the counter shaft assembly 670 defines a straight longitudinal shaft. A
third
26
CA 02708422 2010-07-08
region 670c of the counter shaft assembly 670 defines a coupling 671, e.g., a
male, hexagonally-shaped coupling.
Figure 14 also illustrates a counter shaft assembly 680 that forms a part of
the second driver 98. The counter shaft assembly 680 has several
longitudinally
disposed regions. A first region 680a of the counter shaft assembly 680
defines a
coupling 682, e.g., a female, hexagonally- shaped coupling, that is configured
to
be non-rotatably coupled to the coupling 671 of the counter shaft assembly
670.
A second region 680b of the counter shaft assembly 680 defines a straight
longitudinal shaft. A third region 680c of the counter shaft assembly 680
defines
a spur gear 681 having a plurality of circumferentially-disposed spur gear
teeth
6811. The surgical device 11 is configured such that the spur gear teeth 6811
of
the spur gear 681 of the counter shaft assembly 680 engage the spur gear teeth
6911 of the spur gear 691 of the fire shaft assembly 690. A fourth region 680d
of
the counter shaft assembly 680 extends into and is rotatable within an orifice
683a of a guide bushing 683 that is mounted within the surgical device 11.
Figure 14 further illustrates a flexible data transfer cable 1278. The
flexible
data transfer cable 1278, as previously discussed, electrically and logically
connects the memory module 6041 retained in the slot 604i at the proximal end
604d of the staple tray 604 to the data connector 1272 of the keyplate
assembly
710. Advantageously, in this example embodiment, the flexible data transfer
cable 1278 is a flat data cable that extends along the interior surface 8010
of the
second jaw 80 and that has minimal cross-sectional area, e.g., so as to avoid
contact with the various gear arrangements described above.
27
CA 02708422 2010-07-08
According to one example embodiment of the present invention, the
surgical device 11 may be configured as an attachment to, or may be integral
with, an electro-mechanical surgical system, such as electro-mechanical driver
system 1510. In another embodiment, the surgical device 11 may be
configured as an attachment to, or may be integral with, a purely mechanical
device driver system, such as that illustrated in Figure 1.
Figure 2 is a perspective view of an example embodiment of an electro-
mechanical driver component 1610 according to the present invention. Such
an electro-mechanical surgical system is described in, e.g., U.S. Patent No.
6,793,652, U.S. Patent No. 6,981,941 and U.S. Patent No. 7,032,798. The
electro-mechanical driver component 1610 may include, for example, a remote
power console 1612, which includes a housing 1614 having a front panel 1615.
Mounted on the front panel 1615 are a display device 1616 and indicators
1618a, 1618b. A flexible shaft 1620 may extend from the housing 1614 and
may be detachably attached thereto via a first coupling 1622. The distal end
1624 of flexible shaft 1620 may include a second coupling 1626 adapted to
detachably couple, e.g., the surgical device 11 described above, to the distal
end 1624 of the flexible shaft 1620. The second coupling 1626 may also be
adapted to detachably attach a different surgical instrument or attachment. In
another example embodiment, the distal end 1624 of the flexible shaft 1620
may permanently attach to or be integral with a surgical instrument.
28
CA 02708422 2010-07-08
Referring to Figure 15, there is seen a side view, partially in section, of
the
flexible shaft 1620. According to one example embodiment, the flexible shaft
1620 includes a tubular sheath 1628, which may include a coating or other
sealing arrangement configured to provide a fluid-tight seal between the
interior
channel 1640 thereof and the environment. The sheath 1628 may be formed of a
tissue-compatible, sterilizable elastomeric material. The sheath 1628 may also
be formed of a material that is autoclavable. Disposed within the interior
channel
1640 of the flexible shaft 1620, and extending along the entire length
thereof, may
be a first rotatable drive shaft 94, a second rotatable drive shaft 102, a
first
steering cable 1634, a second steering cable 1635, a third steering cable
1636, a
fourth steering cable 1637 and a data transfer cable 1638. Figure 16 is a
cross-
sectional view of the flexible shaft 1620 taken along the line 16-16
illustrated in
Figure 15 and further illustrates the several cables 94, 102, 1634, 1635,
1636,
1637 and 1638. Each distal end of the steering cables 1634, 1635, 1636, 1637
is
affixed to the distal end 1624 of the flexible shaft 1620. Each of the several
cables 94, 102, 1634, 1635, 1636, 1637, 1638 may be contained within a
respective sheath.
The first rotatable drive shaft 94 and the second rotatable drive shaft 102
may be configured, for example, as highly flexible drive shafts, such as, for
example, braided or helical drive cables. It should be understood that such
highly
flexible drive cables may have limited torque transmission characteristics and
capabilities. It should also be understood that the surgical device 11, or
other
attachments connected to the flexible shaft 1620, may require a higher torque
input than the torque transmittable by the drive shafts 94, 102. The drive
shafts
29
CA 02708422 2010-07-08
94, 102 may thus be configured to transmit low torque but high speed, the high-
speed/low-torque being converted to low-speed/high-torque by gearing
arrangements disposed, for example, at the distal end and/or the proximal end
of
the drive flexible shaft 1620, in the surgical instrument or attachment and/or
in the
remote power console 1612. It should be appreciated that such gearing
arrangement(s) may be provided at any suitable location along the power train
between the motors disposed in the housing 1614 and the attached surgical
instrument or other attachment connected to the flexible shaft 1620. Such
gearing arrangement(s) may include, for example, a spur gear arrangement, a
planetary gear arrangement, a harmonic gear arrangement, cycloidal drive
arrangement, an epicyclic gear arrangement, etc.
Referring now to Figure 17, there is seen a rear end view of first coupling
1622. The first coupling 1622 includes a first connector 1644, a second
connector 1648, a third connector 1652 and a fourth connector 1656, each
rotatably secured to the first coupling 1622. Each of the connectors 1644,
1648,
1652, 1656 includes a respective recess 1646, 1650, 1654, 1658. As illustrated
in Figure 17, each recess 1646, 1650, 1654, 1658 may be hexagonally shaped. It
should be appreciated, however, that the recesses 1646, 1650, 1654, 1658 may
have any shape and configuration adapted to non-rotatably couple and rigidly
attach the connectors 1644, 1648, 1652, 1656 to respective drive shafts of the
motor arrangement contained within the housing 1612. It should be appreciated
that complementary projections may be provided on respective drive shafts of
the
motor arrangement to thereby drive the drive elements of the flexible shaft
1620.
It should also be appreciated that the recesses may be provided on the drive
CA 02708422 2010-07-08
shafts and complementary projections may be provided on the connectors 1644,
1648, 1652, 1656. Any other coupling arrangement configured to non-rotatably
and releasably couple the connectors 1644, 1648, 1652, 1656 and the drive
shafts of the motor arrangement may be provided.
One of the connectors 1644, 1648, 1652, 1656 is non-rotatably secured to
the first drive shaft 94, and another one of the connectors 1644, 1648, 1652,
1656 is non-rotatably secured to the second drive shaft 102. The remaining two
of the connectors 1644, 1648, 1652, 1656 engage with transmission elements
configured to apply tensile forces on the steering cables 1634, 1635, 1636,
1637
to thereby steer the distal end 1624 of the flexible shaft 1620. The data
transfer
cable 1638 is electrically and logically connected with data connector 1660.
The
data connector 1660 includes, for example, electrical contacts 1662,
corresponding to and equal in number to the number of individual wires
contained
in the data cable 1638. The first coupling 1622 includes a key structure 1642
configured to properly orient the first coupling 1622 to a mating and
-complementary coupling arrangement disposed on the housing 1612. The key
structure 1642 may be provided on either one, or both, of the first coupling
1622
and the mating and- complementary coupling arrangement disposed on the
housing 1612. The first coupling 1622 may include a quick-connect type
connector, which may engage the first coupling 1622 to the housing 1612 by a
simple pushing motion. Seals may be provided in conjunction with any of the
several connectors 1644, 1648, 1652, 1656, 1660 to provide a fluid-tight seal
between the interior of first coupling 1622 and the environment.
31
CA 02708422 2010-07-08
Referring now to Figure 18, there is seen a front end view of the second
coupling 1626 of the flexible shaft 1620. In the example embodiment, the
second
coupling 1626 includes a first connector 1666 and a second connector 1668,
each rotatably secured to the second coupling 1626 and each non-rotatably
secured to a distal end of a respective one of the first and second drive
shafts 94,
102. A quick-connect type fitting 1664 is provided on the second coupling 1626
to
detachably secure the device 11 thereto. The quick-connect type fitting 1664
may
be, for example, a rotary quick-connect type fitting, a bayonet type fitting,
etc. and
may be a fitting complementary to the quick connect sleeve 713 of the keyplate
assembly 710 illustrated in Figure 6(b). A key structure 1674 may be provided
on
the second coupling 1626 and may be configured to properly align the surgical
device 11 to the second coupling 1626. The key structure or other arrangement
configured to properly align the surgical device 11 to the flexible shaft 1620
may
be provided on either one, or both, of the second coupling 1626 and the
surgical
device 11. In addition, the key structure may be provided on the device 11, as
illustrated in Figure 6(b) as the slots 713a of the quick connect sleeve 713.
A
data connector 1670 having electrical contacts 1672 is also provided in the
second coupling 1626. Like the data connector 1660 of first coupling 1622, the
data connector 1670 of the second coupling 1626 includes contacts 1672
electrically and logically connected to the respective wires of the data
transfer
cable 1638 and the contacts 1662 of the data connector 1660. Seals may be
provided in conjunction with the connectors 1666, 1668, 1670 to provide a
fluid-
tight seal between the interior of the second coupling 1626 and the
environment.
32
CA 02708422 2010-07-08
Disposed within the housing 1614 of the remote power console 1612 are
electro-mechanical driver elements configured to drive the drive shafts 94,
102
and the steering cables 1634, 1635, 1636, 1637 to thereby operate the electro-
mechanical driver component 1610 and the surgical device 11 attached to the
second coupling 1626. In the example embodiment illustrated schematically in
Figure 19, five electric motors 96, 100, 1684, 1690, 1696, each operated via a
power source, may be disposed in the remote power console 1612. It should be
appreciated, however, that any appropriate number of motors may be provided,
and the motors may operate via battery power, line current, a DC power supply,
an electronically controlled DC power supply, etc. It should also be
appreciated
that the motors may be connected to a DC power supply, which is in turn
connected to line current and which supplies the operating current to the
motors.
Figure 19 illustrates schematically one possible arrangement of motors.
An output shaft 1678 of a first motor 96 engages with the first connector 1644
of
the first coupling 1622 when the first coupling 1622, and, therefore, the
flexible
shaft 1620, is engaged with the housing 1614 to thereby drive the first drive
shaft
94 and the first connector 1666 of the second coupling 1626. Similarly, an
output
shaft 1682 of a second motor 100 engages the second connector 1648 of the
first
coupling 1622 when the first coupling 1622, and, therefore, flexible shaft
1620 is
engaged with the housing 1614 to thereby drive the second drive shaft 102 and
the second connector 1668 of the second coupling 1626. An output shaft 1686 of
a third motor 1684 engages the third connector 1652 of the first coupling 1622
when the first coupling 1622, and, therefore, the flexible shaft 1620, is
engaged
with the housing 1614 to thereby drive the first and second steering cables
1634,
33
CA 02708422 2010-07-08
1635 via a first pulley arrangement 1688. An output shaft 1692 of a fourth
motor 1690 engages the fourth connector 1656 of the first coupling 1622 when
the first coupling 1622, and, therefore, the flexible shaft 1620, is engaged
with
the housing 1614 to thereby drive the third and fourth steering cables 1636,
1637 via a second pulley arrangement 1694. The third and fourth motors 1684,
1690 may be secured on a carriage 1100, which is selectively movable via an
output shaft 1698 of a fifth motor 1696 between a first position and a second
position to selectively engage and disengage the third and fourth motors 1684,
1690 with the respective pulley arrangement 1688, 1694 to thereby permit the
flexible shaft 1620 to become taut and steerable or limp as necessary. It
should be appreciated that other mechanical, electrical and/or electro-
mechanical mechanisms, etc., may be used to selectively engage and
disengage the steering mechanism. The motors may be arranged and
configured as described, for example, in U.S. Patent No, 6,517,565.
.15 It should be appreciated that any one or more of the motors 96, 100,
1684, 1690, 1696 may be, for example, a high-speed/low-torque motor, a low-
speed/high-torque motor, etc. As indicated above, the first rotatable drive
shaft
94 and the second rotatable drive shaft 102 may be configured to transmit high
speed and low torque. Thus, the first motor 96 and the second motor 100 may
be configured as high-speed/low-torque motors. Alternatively, the first motor
96 and the second motor 100 may be configured as low-speed/high-torque
motors with a torque-reducing/speed-increasing gear arrangement disposed
between the first
34
CA 02708422 2010-07-08
motor 96 and the second motor 100 and a respective one of the first rotatable
drive shaft 94 and the second rotatable drive shaft 102. Such torque-
reducing/speed-increasing gear arrangements may include, for example, a spur
gear arrangement, a planetary gear arrangement, a harmonic gear arrangement,
cycloidal drive arrangement, an epicyclic gear arrangement, etc. It should be
appreciated that any such gear arrangement may be disposed within the remote
power console 1612 or in the proximal end of the flexible shaft 1620, such as,
for
example, in the first coupling 1622. It should be appreciated that the gear
arrangement(s) may be provided at the distal and/or proximal ends of the first
rotatable drive shaft 94 and/or the second rotatable drive shaft 102 to
prevent
windup and breakage thereof.
Referring now to Figure 20, there is seen a schematic view of the electro-
mechanical driver component 1610. A controller 1122 is provided in the housing
1614 of remote power console 1612 and is configured to control all functions
and
operations of the electro-mechanical driver component 1610 and the linear
clamping, cutting and stapling device 11 or other surgical instrument or
attachment attached to the flexible shaft 1620. A memory unit 1130 is provided
and may include memory devices, such as, a ROM component 1132, a RAM
component 1134, etc. The ROM component 1132 is in electrical and logical
communication with the controller 1122 via a line 1136, and the RAM component
1134 is in electrical and logical communication with controller 1122 via line
1138.
The RAM component 1134 may include any type of random-access memory,
such as, for example, a magnetic memory device, an optical memory device, a
magneto-optical memory device, an electronic memory device, etc. Similarly,
the
CA 02708422 2010-07-08
ROM component 1132 may include any type of read-only memory, such as, for
example, a removable memory device, such as a PC-Card or PCMCIA-type
device. It should be appreciated that the ROM component 1132 and the RAM
component 1134 may be configured as a single unit or may be separate units and
that the ROM component 1132 and/or the RAM component 1134 may be
provided in the form of a PC-Card or PCMCIA-type device.
The controller 1122 is further connected to the front panel 1615 of the
housing 1614 and, more particularly, to the display device 1616 via a line
1154
and the indicators 1618a, 1618b via respective lines 1156, 1158. The lines
1116,
1118, 1124, 1126, 1128 electrically and logically connect controller 1122 to
first,
second, third, fourth and fifth motors 96, 100, 1684, 1690, 1696,
respectively. A
wired remote control unit ("RCU") 1150 is electrically and logically connected
to
the controller 1122 via a line 1152. A wireless RCU 1148 is also provided and
communicates via a wireless link 1160 with a receiving/sending unit 1146
connected via a line 1144 to a transceiver 1140. The transceiver 1140 is
electrically and logically connected to the controller 1122 via a line 1142.
The
wireless link 1160 may be, for example, an optical link, such as an infrared
link, a
radio link or any other form of wireless communication link.
A switch device 1186, which may include, for example, an array of DIP
switches, may be connected to the controller 1122 via a line 1188. The switch
device 1186 may be configured, for example, to select one of a plurality of
languages used in displaying messages and prompts on the display device 1616.
The messages and prompts may relate to, for example, the operation and/or the
36
CA 02708422 2010-07-08
status of the electro-mechanical driver component 1610 and/or to the surgical
device 11 attached thereto.
According to the example embodiment of the present invention, a first
encoder 1106 is provided within the second coupling 1626 and is configured to
output a signal in response to and in accordance with the rotation of the
first drive
shaft 94. A second encoder 1108 is also provided within the second coupling
626
and is configured to output a signal in response to and in accordance with the
rotation of the second drive shaft 102. The signal output by each of the
encoders
1106, 1108 may represent the rotational position of the respective drive shaft
94,
102 as well as the rotational direction thereof. Such encoders 1106, 1108 may
include, for example, Hall-effect devices, optical devices, etc. Although the
encoders 1106, 1108 are described as being disposed within the second coupling
1626, it should be appreciated that the encoders 1106, 1108 may be provided at
any location between the motor system and the surgical device 11. It should be
appreciated that providing the encoders 1106, 1108 within the second coupling
1626 or at the distal end of the flexible shaft 1620 may provide an accurate
determination of the drive shaft rotation. If the encoders 1106, 1108 are
disposed
at the proximal end of .the flexible shaft 1620, windup of the first and
second
rotatable drive shafts 94, 102 may result in measurement error.
Figure 21 is a schematic view of an encoder 1106, 1108, which includes a
Hall-effect device. Mounted non-rotatably on the drive shaft 94, 102 is a
magnet
1240 having a north pole 1242 and a south pole 1244. The encoder 1106, 1108
further includes a first sensor 1246 and second sensor 1248, which are
disposed
approximately 90 apart relative to the longitudinal, or rotational, axis of
the drive
37
CA 02708422 2010-07-08
shaft 94, 102. The output of the sensors 1246, 1248 is persistent and changes
its
state as a function of a change of polarity of the magnetic field in the
detection
range of the sensor. Thus, based on the output signal from the encoders 1106,
1108, the angular position of the drive shaft 94, 102 may be determined within
one-quarter revolution and the direction of rotation of the drive shaft 94,
102 may
be determined. The output of each encoder 1106, 1108 is transmitted via a
respective line 1110, 1112 of data transfer cable 1638 to controller 1122. The
controller 1122, by tracking the angular position and rotational direction of
the
drive shafts 94, 102 based on the output signal from the encoders 1106, 1108,
may thereby determine the position and/or state of the components of the
surgical
device connected to the electro-mechanical driver component 1610. That is, by
counting the revolutions of the drive shaft 94, 102, the controller 1122 may
determine the position and/or state of the components of the surgical device
connected to the electro-mechanical driver component 1610.
For example, the advancement distance of the first jaw 50 relative to the
second jaw 80 and of the wedge 603 may be functions of, and ascertainable on
the basis of, the rotation of the respective drive shafts 94, 102. By
ascertaining
an absolute position of the first jaw 50 and the wedge 603 at a point in time,
the
relative displacement of the first jaw 50 and the wedge 603, based on the
output
signal from the encoders 1106, 1108 and the known pitches of the externally
threaded rod 90 and of the wedge driver 605, may be used to ascertain the
absolute position of the first jaw 50 and the wedge 603 at all times
thereafter.
The absolute position of the first jaw 50 and the wedge 603 may be fixed and
ascertained at the time that the surgical device 11 is first coupled to the
flexible
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CA 02708422 2010-07-08
shaft 1620_ Alternatively, the position of the first jaw 50 and the wedge 603
relative to, for example, the second jaw 80 may be determined based on the
output signal from the encoders 1106, 1108.
As discussed above in connection with Figure 7, the surgical device 11
may include a data connector 1272 adapted by size and configuration to
electrically and logically connect to connector 1670 of second coupling 1626.
In
the example embodiment, the data connector 1272 includes contacts 1276 equal
in number to the number of contacts 1672 of connector 1670. The memory
module 6041 is electrically and logically connected with the data connector
1272.
Memory module 6041 may be in the form of, for example, an EEPROM, EPROM,
etc. and may be contained, for example, within the staple tray 604 of the
replaceable staple cartridge 600 in the second jaw 80 of the surgical device
11,
as illustrated in Figure 6(a).
Figure 22 schematically illustrates the memory module 6041. As seen in
Figure 22, data connector 1272 includes contacts 1276, each electrically and
logically connected to the memory module 6041 via a respective line, e.g.,
flexible
data cable 1278. The memory module 6041 may be configured to store, for
example, a serial number data 1180, an attachment type identifier (ID) data
1182
and a usage data 1184. The memory module 6041 may additionally store other
data. Both the serial number data 1180 and the ID data 1182 may be configured
as read-only data. The serial number data 1180 and/or the ID data 1182 may be
stored in a read-only section of the memory module 6041. In the example
embodiment, serial number data 1180 may be data uniquely identifying the
particular surgical device, whereas the ID data 1182 may be data identifying
the
39
CA 02708422 2010-07-08
type of the attachment, such as, e.g., for an electro-mechanical driver
component
1610 to which other types of surgical instruments or attachments are
attachable.
The usage data 1184 represents usage of the particular attachment, such as,
for
example, the number of times the first jaw 50 of the surgical device 11 has
been
opened and closed, or the number of times that the wedge 603 of the surgical
device 11 has been advanced. The usage data 1184 may be stored in a
read/write section of the memory module 6041.
It should be appreciated that the attachment attachable to the distal end
1624 of the flexible shaft 1620, e.g., surgical device 11, may be designed and
configured to be used a single time or multiple times. The attachment may also
be designed and configured to be used a predetermined number of times.
Accordingly, the usage data 1184 may be used to determine whether the surgical
device 11 has been used and whether the number of uses has exceeded the
maximum number of permitted uses. As more fully described below, an attempt
to use the attachment after the maximum number of permitted uses has been
reached will generate an ERROR condition.
Referring again to Figure 20, the controller 1122 is configured to read the
ID data 1182 from the memory module 6041 of the surgical device 11 when the
surgical device 11 is initially connected to the flexible shaft 1620. The
memory
module 6041 is electrically and logically connected to the controller 1122 via
the
line 1120 of the data transfer cable 1638. Based on the read ID data 1182, the
controller 1122 is configured to read or select from the memory unit 1130, an
operating program or algorithm corresponding to the type of surgical
instrument or
attachment connected to the flexible shaft 1620. The memory unit 1130 is
CA 02708422 2010-07-08
configured to store the operating programs or algorithms for each available
type
of surgical instrument or attachment, the controller 1122 selecting and/or
reading
the operating program or algorithm from the memory unit 1130 in accordance
with
the ID data 1182 read from the memory module 6041 of an attached surgical
instrument or attachment. As indicated above, the memory unit 1130 may include
a removable ROM component 1132 and/or RAM component 1134. Thus, the
operating programs or algorithms stored in the memory unit 1130 may be
updated, added, deleted, improved or otherwise revised as necessary. The
operating programs or algorithms stored in the memory unit 1130 may be
customizable based on, for example, specialized needs of the user. A data
entry
device, such as, for example, a keyboard, a mouse, a pointing device, a touch
screen, etc., may be connected to the memory unit 1130 via, for example, a
data
connector port, to facilitate the customization of the operating programs or
algorithms. Alternatively or additionally, the operating programs or
algorithms
may be customized and preprogrammed into the memory unit 1130 remotely from
the electro-mechanical driver component 1610. It should be appreciated that
the
serial number data 1180 and/or usage data 1184 may also be used to determine
which of a plurality of operating programs or algorithms is read or selected
from
the memory unit 1130. It should be appreciated that the operating program or
algorithm may alternatively be stored in the memory module 6041 of the
surgical
device 11 and transferred to the controller 1122 via the data transfer cable
1638.
Once the appropriate operating program or algorithm is read by or selected by
or
transmitted to, the controller 1122, the controller 1122 causes the operating
program or algorithm to be executed in accordance with operations performed by
41
CA 02708422 2010-07-08
the user via the wired RCU 1150 and/or the wireless RCU 1148. As indicated
hereinabove, the controller 1122 is electrically and logically connected with
the
first, second, third, fourth and fifth motors 96, 100, 1684, 1690, 1696 via
respective lines 1116, 1118, 1124, 1126, 1128 and is configured to control
such
motors 96, 100, 1684, 1690, 1696 in accordance with the read, selected or
transmitted operating program or algorithm via the respective lines 1116,
1118,
1124,1126,1128.
Referring now to Figure 23, there is seen a schematic view of wireless
RCU 1148. Wireless RCU 1148 includes a steering controller 1300 having a
plurality of switches 1302, 1304, 1306, 1308 arranged under a four-way rocker
1310. The operation of switches 1302, 1304, via rocker 1310, controls the
operation of first and second steering cables 1634, 1635 via third motor 1684.
Similarly, the operation of switches 1306, 1308, via rocker 1310, controls the
operation of third and fourth steering cables 1636, 1637 via fourth motor
1692. It
should be appreciated that rocker 1310 and switches 1302, 1304, 1306, 1308 are
arranged so that the operation of switches 1302, 1304 steers the flexible
shaft
1620 in the north-south direction and that the operation of switches 1306,
1308
steers the flexible shaft 1620 in the east-west direction. Reference herein to
north, south, east and west is made to a relative coordinate system.
Alternatively,
a digital joystick, an analog joystick, etc. may be provided in place of
rocker 1310
and switches 1302, 1304, 1306, 1308. Potentiometers or any other type of
actuator may also be used in place of switches 1302, 1304, 1306, 1308.
The wireless RCU 1148 further includes a steering engage/disengage
switch 1312, the operation of which controls the operation of fifth motor 696
to
42
CA 02708422 2010-07-08
selectively engage and disengage the steering mechanism. The wireless RCU
1148 also includes a two-way rocker 1314 having first and second switches
1316,
1318 operable thereby. The operation of these switches 1316, 1318 controls
certain functions of the electro-mechanical driver component 1610 and any
surgical instrument or attachment, such as the surgical device 11, attached to
the
flexible shaft 1620 in accordance with the operating program or algorithm
corresponding to the attached device. For example, operation of the two-way
rocker 1314 may control the opening and closing of the first jaw 50 and the
second jaw 80 of the surgical device 11. The wireless RCU 1148 is provided
with
yet another switch 1320, the operation of which may further control the
operation
of the electro-mechanical driver component 1610 and the device attached to the
flexible shaft 1620 in accordance with the operating program or algorithm
corresponding to the attached device. For example, operation of the switch
1320
may initiate the advancement of the wedge 603 of the surgical device 11.
The wireless RCU 1148 includes a controller 1322, which is electrically and
logically connected with the switches 1302, 1304, 1306, 1308 via line 1324,
with
the switches 1316, 1318 via line 1326, with switch 1312 via line 1328 and with
switch 1320 via line 1330. The wireless RCU 1148 may include indicators
1618a',
1618b', corresponding to the indicators 1618a, 1618b of front panel 1615, and
a
display device 1616', corresponding to the display device 1616 of the front
panel
1615. If provided, the indicators 1618a', 1618b' are electrically and
logically
connected to controller 1322 via respective lines 1332, 1334, and the display
device 1616' is electrically and logically connected to controller 1322 via
line
1336. The controller 1322 is electrically and logically connected to a
transceiver
43
CA 02708422 2010-07-08
1338 via line 1340, and the transceiver 1338 is electrically and logically
connected
to a receiver/transmitter 1342 via line 1344. A power supply, for example, a
battery, may be provided in wireless RCU 1148 to power the same. Thus, the
wireless RCU 1148 may be used to control the operation of the electro-
mechanical driver component 1610 and the device 11 attached to the flexible
shaft 1620 via wireless link 1160.
The wireless RCU 1148 may include a switch 1346 connected to a
controller 1322 via line 1348. Operation of the switch 1346 transmits a data
signal to the transmitter/receiver 1146 via wireless link 1160. The data
signal
includes identification data uniquely identifying the wireless RCU 1148. This
identification data is used by the controller 1122 to prevent unauthorized
operation of the electro-mechanical driver component 1610 and to prevent
interference with the operation of the electro-mechanical driver component 610
by
another wireless RCU. Each subsequent communication between the wireless
RCU 1148 and the electro-mechanical device surgical 610 may include the
identification data. Thus, the controller 1122 may discriminate between
wireless
RCUs and thereby allow only a single, identifiable wireless RCU 1148 to
control
the operation of the electro-mechanical driver component 1610 and the surgical
device 11 attached to the flexible shaft 1620.
Based on the positions of the components of the surgical device attached
to the flexible shaft 1620, as determined in accordance with the output
signals
from the encoders 1106, 1108, the controller 1122 may selectively enable or
disable the functions of the electro-mechanical driver component 1610 as
defined
by the operating program or algorithm corresponding to the attached device.
For
44
CA 02708422 2010-07-08
example, for the surgical device 11, the firing function controlled by the
operation
of the switch 1320 may be disabled unless the space or gap between the first
jaw
50 and the second jaw 80 is determined to be within an acceptable range.
Referring now to Figure 24, there is seen a schematic view of a wired RCU
1150. In the example embodiment, wired RCU 1150 includes substantially the
same control elements as the wireless RCU 1148 and further description of such
elements is omitted. Like elements are indicated in Figure 24 with an
accompanying prune. It should be appreciated that the functions of the electro-
mechanical driver component 1610 and the device attached to the flexible shaft
1620, e.g., the surgical device 11, may be controlled by the wired RCU 1150
and/or by the wireless RCU 1148. In the event of a battery failure, for
example, in
the wireless RCU 1148, the wired RCU 1150 may be used to control the functions
of the electro-mechanical driver component 1610 and the device attached to the
flexible shaft 1620.
As described hereinabove, the front panel 1615 of the housing 1614
includes the display device 1616 and the indicators 1618a, 1618b. The display
device 1616 may include an alpha-numeric display device, such as an LCD
display device. The display device 1616 may also include an audio output
device,
such as a speaker, a buzzer, etc. The display device 1616 is operated and
controlled by controller 1122 in accordance with the operating program or
algorithm corresponding to the device attached to the flexible shaft 1620,
e.g., the
surgical device 11. If no surgical instrument or attachment is so attached, a
default operating program or algorithm may be read by or selected by or
transmitted to controller 1122 to thereby control the operation of the display
CA 02708422 2010-07-08
device 1616 as well as the other aspects and functions of the electro-
mechanical
driver component 1610. If the surgical device 11 is attached to the flexible
shaft
1620, the display device 1616 may display, for example, data indicative of the
gap
between the first jaw 50 and the second jaw 80 as determined in accordance
with
the output signal of encoders 1106, 1108, as more fully described hereinabove.
Similarly, the indicators 1618a, 1618b are operated and controlled by the
controller 1122 in accordance with the operating program or algorithm
corresponding to the device attached to the flexible shaft 1620, e.g., the
surgical
device 11. The indicator 1618a and/or the indicator 1618b may include an audio
output device, such as a speaker, a buzzer, etc., and/or a visual indicator
device,
such as an LED, a lamp, a light, etc. If the surgical device 11 is attached to
the
flexible shaft 1620, the indicator 1618a may indicate, for example, that the
electro-mechanical driver component 1610 is in a power ON state, and the
indicator 618b may, for example, indicate whether the gap between the first
jaw
50 and the second jaw 80 is determined to be within the acceptable range. It
should be appreciated that although two indicators 1618a, 1618b are described,
any number of additional indicators may be provided as necessary.
Additionally,
it should be appreciated that although a single display device 1616 is
described,
any number of additional display devices may be provided as necessary.
The display device 1616' and the indicators 1618a', 1618b' of wired RCU
1150 and the display device 1616" and indicators 1618a", 1618b" of the
wireless
RCU 1148 are similarly operated and controlled by respective controller 1322,
1322' in accordance with the operating program or algorithm of the device
attached to the flexible shaft 1620.
46
CA 02708422 2010-07-08
As previously mentioned, the surgical device 11 may be employed to
clamp, cut and staple a section of tissue. The operation of the surgical
device 11
will now be described in connection with the removal of a cancerous or
anomalous section of tissue in a patient's bowel, which is, of course, merely
one
type of tissue and one type of surgery that may be performed using the
surgical
device 11. Generally, in operation, after cancerous or anomalous section of
tissue has been located in the gastrointestinal tract, the surgical device 11,
which
may initially be maintained in a closed position such as the position
illustrated in
Figure 3(a), is inserted into a patient's abdomen, e.g., through a cannula
(not
shown). Preferably, the surgical device 11 has a staple tray 604 pre-loaded in
the
second jaw 80. Utilizing the remote actuation provided by the electro-
mechanical
driver system 1610, the first driver 88 is engaged to drive the first jaw 50
of the
surgical device 11 into the open position relative to the second jaw 80. A
section
of tissue adjacent to the cancerous tissue is placed between the open first
and
second jaws 50, 80. Again, by remote actuation, the first driver 88 is caused
to
engage in reverse, and the first jaw 50 closes against the second jaw 80,
clamping the section of tissue therebetween. Once the section of tissue has
been
sufficiently clamped, the second driver 98 is engaged by remote. actuation,
which
causes the wedge 603 to advance from the distal end 604c of the staple tray
604
to the proximal end 604d thereof, thereby cutting and stapling the section of
tissue. According to one example embodiment of the present invention, the
second driver 98 is then engaged in reverse, which causes the wedge 603 to be
retracted from the proximal end 604d to the distal end 604c of the staple tray
604.
The surgical device 11 may then be removed from the patient's abdomen. Once
47
CA 02708422 2010-07-08
removed, the first driver 88 may again be engaged, according to some example
embodiments of the present invention, to drive the first jaw 50 of the
surgical
device 11 into the open position relative to the second jaw 80, enabling the
spent
replaceable staple cartridge 600 to be removed from the second jaw 80 of the
surgical device 11 and a new replaceable staple cartridge 600 to be inserted
into
the second jaw 80. These steps are then repeated on the other side of the
cancerous tissue, thereby removing the cancerous section of tissue, which is
stapled on both ends to prevent spilling of bowel material into the abdomen.
It is
noted however, that alternative embodiments of the present invention are
possible, wherein the surgical device 11 and/or the electro-mechanical driver
component 1610 are configured to allow only a single use of the surgical
device
11, as is described more fully below.
According to the example embodiment of the present invention, the
surgical device 11 is coupled to the second coupling 1626 of the electro-
mechanical driver component 1610 such that the first drive socket 654 engages
the first drive shaft 94 of the electro-mechanical driver component 1610 and
the
second drive socket 694 engages the second drive shaft 102 of the electro-
mechanical driver component 1610. Thus, rotation of the first driver 88 is
effected
by rotation of the first drive socket 654 which is effected by rotation of the
first
drive shaft 94 of the electro-mechanical driver component 1610. Clockwise or
counter-clockwise rotation is achieved depending on the direction of the first
motor 96. Similarly, rotation of the second driver 98 is effected by rotation
of the
second drive socket 694 which is effected by rotation of the second drive
shaft
102 of the electro-mechanical driver component 1610. Again, clockwise or
48
CA 02708422 2010-07-08
counter-clockwise rotation is achieved depending on the direction of the motor
100.
Once the surgical device 11 is inserted into the body of a patient, the first
motor 96 corresponding to the first drive shaft 94 is activated, which engages
the
first drive socket 654 at the proximal end of the clamp shaft assembly 650,
thereby causing the clamp shaft assembly 650 to turn in a first, e.g.,
clockwise,
rotation direction. Since the spur gear teeth 6531 of the spur gear 653 of the
clamp shaft assembly 650 are engaged with the spur gear teeth 6441 of the spur
gear 644 of the gear cluster 640, the rotation of the clamp shaft assembly 650
causes the gear cluster 640 to rotate in a first direction, e.g., counter-
clockwise,
that is opposite to the direction of rotation of the clamp shaft assembly 650.
Simultaneously, since the spur gear teeth 6431 of the spur gear 643 of the
gear
cluster 640 is engaged with the spur gear teeth 6291 of the spur gear 629 of
the
gear cluster 630, the rotation of the gear cluster 640 causes the gear cluster
630
to rotate in a first direction, e.g., clockwise, that is opposite to the
direction of
rotation of the clamp shaft assembly 640. At the same time, since the spur
gear
teeth 6331 of the spur gear 633 of the gear cluster 630 engage the spur gear
teeth-6271 of the spur gear 627 of the gear cluster 625, and since the spur
gear
teeth 6341 of the spur gear 634 of the gear cluster 630 engage the spur gear
teeth 6281 of the spur gear 628 of the gear cluster 625, the rotation of the
gear
cluster 630 causes the gear cluster 625 to rotate in a first direction, e.g.,
counter-
clockwise, that is opposite to the direction of rotation of the clamp shaft
assembly
630. The rotation of the gear cluster 625 causes the bevel gear 621, which,
like
the gear cluster 625 is also mounted on the bevel gear driver 620, to rotate
in a
49
CA 02708422 2010-07-08
first direction, e.g., counter-clockwise, that is the same as the direction of
rotation
of the gear cluster 625. Since the beveled gear teeth 621 a of the bevel gear
621
are engaged with the beveled gear teeth 617b of the bevel gear nut 617, the
rotation of the bevel gear 621 causes the bevel gear nut 617 to rotate within
the
bevel bearing 622 in a first, e.g., clockwise when viewed from the top,
direction.
The threads of the internally-threaded bore 617a of the bevel gear nut 617
engage the threads of the externally-threaded rod 90, such that rotation of
the
bevel gear nut 617 causes the externally-threaded rod 90, which does not
rotate
about its axis, to move in a downward direction, e.g., such that the stopper
90c at
the upper end 90b of the externally threaded rod 90 moves away from the
surface
8010 of the second jaw 80. Since the externally threaded rod 90 is coupled at
its
lower end 90a by a pin 92 to the first jaw 50, the first jaw 50 is thereby
caused to
separate from the second jaw 80. Continuous operation of the first motor 96 in
this manner eventually places the surgical device 11 in a fully open position,
e.g.,
whereby the externally-threaded rod 90 is in a fully extended position
relative to
the second jaw 80 and whereby the second end 707b of the stop member 707 is
biased by the spring 705 so as to contact the cylindrical housing wall 708. In
this
fully open position, a space is provided between the first jaw 50 and the
second
jaw 80, as illustrated in Figure 3(a).
A section of the tissue is then placed between the first jaw 50 and the
second jaw 80. Thereafter, the first motor 96 is operated in reverse such that
the
first drive shaft 94 engages the first drive socket 654 in order to cause the
clamp
shaft assembly 650 to turn in a second, e.g., counter-clockwise, rotation
direction.
The rotation of the clamp shaft assembly 650 causes the gear cluster 640 to
CA 02708422 2010-07-08
rotate in a second direction, e.g., clockwise, which in turn causes the gear
cluster
630 to rotate in a second direction, e.g., counter-clockwise. This rotation of
the
gear cluster 630 causes the gear cluster 625 to rotate in a second direction,
e.g.,
clockwise, which in turn causes the bevel gear 621 to rotate in a second
direction,
e.g., clockwise. This rotation of the bevel gear 621 causes the bevel gear nut
617
to rotate within the bevel bearing 622 in a second, e.g., counter-clockwise
when
viewed from the top, direction, thereby causing the externally-threaded rod 90
to
move in an upward direction and causing the first jaw 50 to move toward the
second jaw 80. As the externally-threaded rod 90 is gradually retracted to a
fully
retracted position, e.g., the point at which the stopper 90c of the externally
threaded rod 90 contacts the top surface of the second jaw 80, the surgical
device 11 is gradually moved first into the partially closed position
illustrated in
Figure 3(b), then into the partially closed position illustrated in Figure
3(c), and
eventually into the fully closed position illustrated in Figure 3(d). Thus,
continuous
operation of the first motor 96 in this manner eventually places the surgical
device
11 in the closed position, e.g., the position illustrated in Figure 3(d).
Next, the operator determines that it is safe and/or appropriate to begin the
cutting and stapling procedure. To begin the stapling and cutting procedure,
the
second motor 100 of the electro-mechanical driver component 1610
corresponding to the second drive shaft 102 is activated, which engages the
second drive socket 694 at a proximal end of the fire shaft assembly 690,
thereby
causing the fire shaft assembly 690 to turn in a first, e.g., clockwise,
rotation
direction. Since the spur gear teeth 6911 of the spur gear 691 of the fire
shaft
assembly 690 are engaged with the spur gear teeth 6811 of the spur gear 681 of
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CA 02708422 2010-07-08
the counter shaft assembly 680, this rotation of the first shaft assembly 690
causes rotation of the counter shaft assembly 680 in a direction that is
opposite,
e.g., counter-clockwise, to the direction of rotation of the fire shaft
assembly 690.
Since the female, hexagonally- shaped coupling 682 of the counter shaft
assembly 680 is non-rotatably coupled to the male, hexagonally-shaped coupling
671 of the counter shaft assembly 670, rotation of the counter shaft assembly
680
in this direction, e.g., counter-clockwise, causes the counter shaft assembly
670
to rotate in the same direction, e.g., counter-clockwise, as the counter shaft
assembly 680. Since the spur gear teeth 6721 of the spur gear 672 of the
counter shaft assembly 670 are engaged with the spur gear teeth 6621 of the
spur gear 662 of the shuttle idler gear 660, this rotation of the counter
shaft
assembly 670 causes rotation of the shuttle idler gear 660 in a direction that
is
opposite, e.g., clockwise, to the direction of rotation of the counter shaft
assembly
670. Furthermore, since the spur gear teeth 6621 of the spur gear 662 of the
shuttle idler gear 660 are engaged with the spur gear teeth 6051 of the spur
gear
605d at the proximal end of the wedge driver 605 of the replaceable staple
cartridge 600, this rotation of the shuttle idler gear 660 causes rotation of
the
wedge driver 605 in a direction that is opposite, e.g., counter-clockwise, to
the
direction of rotation of the shuttle idler gear 660. Preferably, and as
illustrated in
the example embodiment discussed herein, when the replaceable staple cartridge
600 is initially inserted in the second jaw 80 of the surgical device 11, the
wedge
603 and the blade 51 associated therewith are positioned at the distal end
604c
of the staple tray 604. Since the threads of the internally threaded bore 603a
of
the wedge 603 are engaged with the threads of the externally threaded region
52
CA 02708422 2010-07-08
605b of the wedge driver 605, this rotation of the wedge driver 605 causes the
wedge 603 to move from the distal end 604c toward the proximal end 604d of the
staple tray 604 through the central channel 604e of the staple tray 604.
Continuous operation of the second motor 100 in this manner will move the
wedge 603 fully through the central channel 604e. As previously discussed in
connection with Figure 6(b), the blade 51 is initially positioned such that
the
cutting edge 51 a is in a retracted position. As the wedge 603 moves
proximally
through the central channel 604e, the contact face 653 of the blade 51
contacts
the actuating lip 615a of the housing 615, which causes the blade 51 to rotate
relative to the wedge 603. Eventually the blade 51 is rotated relative to the
wedge
603 such that the cutting edge 51a of the blade 51 is in an extended position,
e.g., the cutting edge 51 a faces the proximal end 604d of the staple tray
604.
The blade 51 is maintained in this position until the wedge 603 has been moved
to the proximal end 604d of the staple tray 604, the blade 51 having thereby
cut
through the section of tissue. As the wedge 603 is being moved towards the
proximal end 604b of the staple tray 604, the sloped edges 603b of the wedge
603 engage, e.g., push down on, the respective top surfaces 607a of the staple
pushers 607, thereby causing the staple pushing fingers 607c of the staple
pushers 607 to push the staples 606, which are initially disposed within the
respective slots 604h of the staple tray 604, out of the slots 604h. The
prongs
606b of the staples 606 are pushed through the clamped section of tissue and
against the staple guides 703 of the anvil member 700, which bend and close
the
staples 606, thereby stapling the section of tissue. When the wedge 603 is
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CA 02708422 2010-07-08
moved proximally fully through the central channel 604e of the staple tray
604, all
of the staples 606 are pushed through the staple tray 604 and are thus closed.
Having cut and stapled the section of tissue, the surgical device 11 may be
removed from the patient's body, again through a cannula. According to one
embodiment of the present invention, the wedge 603 and the blade 51 may then
be returned to their original position at the distal end 604c of the staple
tray 604.
Alternatively, the staple cartridge 600 is removed from the second jaw 80
without
first retracting the wedge 603 and the blade 51, in order that a new staple
cartridge 600 be loaded into the second jaw or that the surgical device 11 may
be
separated from the flexible drive shaft 1620 to be replaced by a new surgical
device 11, as desired. In the former described embodiment, e.g., whereby the
wedge 603 and the blade 51 are returned to their original position at the
distal end
604c of the staple tray 604, the second motor 100 of the electro-mechanical
driver component 1610 is engaged in reverse such that the second drive shaft
102, via the second drive socket 694, causes the fire shaft assembly 690 to
turn
in a second, e.g., counter-clockwise, rotation direction. This rotation of the
first
shaft assembly 690 causes rotation of the counter shaft assembly 680 in a
second direction, e.g., clockwise, which in turn causes the counter shaft
assembly
670 to rotate in the same direction, e.g., clockwise. This rotation of the
counter
shaft assembly 670 causes rotation of the shuttle idler gear 660 in a second
direction, e.g., counter-clockwise, which in turn causes rotation of the wedge
driver 605 in a second direction, e.g., clockwise. This rotation of the wedge
driver
605 causes the wedge 603 to move from the proximal end 604d toward the distal
end 604c of the staple tray 604 through the central channel 604e of the staple
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tray 604. Continuous operation of the second motor 100 in this manner will
move
the wedge 603 fully through the central channel 604e and back to the distal
end
604c of the staple tray 604.
When the surgical device 11 is removed from the patient's body, the first
driver 88 may again be engaged, according to some example embodiments of the
present invention, to drive the first jaw 50 of the surgical device 11 into
the open
position relative to the second jaw 80, enabling the spent replaceable staple
cartridge 600 to be removed from the second jaw 80 of the surgical device 11
and
a new replaceable staple cartridge 600 to be inserted into the second jaw 80.
These steps, e.g., inserting the surgical device 11 into the body of the
patient,
opening the first and second jaws, clamping the first and second jaws onto a
section of tissue, cutting and stapling the section of tissue, returning the
wedge
and the blade to their initial positions and removing the surgical device 11
from
the patient's body, are then repeated on the other side of the cancerous
tissue,
thereby transecting the cancerous section of tissue, which is stapled on both
ends
to prevent spilling of bowel material into the abdomen.
The reloadability of the surgical device 11, as described above, permits the
operator to perform useful steps during the operation-of the surgical device
11.
For example, once the surgical device 11 is initially placed in the open
position,
the staple cartridge 600 may be accessed by the operator and may be inspected
to determine whether the staples 606 are ready for the procedure and/or
whether
the need exists to replace the staple cartridge 600 with a more suitable
staple
cartridge 600. Similarly, once a clamping, cutting and stapling operation has
been performed and the set of staples 606 has been used, the staple cartridge
CA 02708422 2010-07-08
600 may be accessed by the operator again in order to replace the staple
cartridge 600 with another staple cartridge 600 or to insert another set of
staples
606 into the same staple cartridge 600. Advantageously, the replaceable staple
cartridge 600 is removable when the upper jaw 80 and the lower jaw 50 are in
the
open position, so as to prevent the staple cartridge 600 from being
inadvertently
removed when the upper jaw 80 and the lower jaw 50 are clamped onto a section
of tissue to be cut and stapled.
According to an alternative embodiment of the present invention, the
surgical device 11 is non-reloadable, e.g., the staple cartridge 600 is not
removable from the second jaw 80 by an operator. Thus, after the surgical
device
11 has been actuated once to staple a section of tissue using the staples 606
in
the staple cartridge 600, the surgical device 11 cannot be actuated again to
staple
another section of tissue using a new set of staples 606 or a new staple
cartridge
600. By configuring the surgical device 11 so as to be non-reloadable, the
risk of
contamination or infection is reduced, since the surgical device 11 may not be
intentionally or unintentionally used on two different patients and may not be
re-
used on a single patient. Once a first surgical device 11 has been used, the
first
surgical device 11 may be separated from the electro-mechanical driver
component 1610 and replaced with a second surgical device 11 so that the same
clamping, cutting and stapling procedure may be performed on a different
section
of the tissue, e.g., on the opposite side of the anomalous or cancerous
tissue.
Once the second end of the bowel is also clamped, cut and stapled, the second
surgical device 11 may be separated from the electro-mechanical driver
component 1610, and the operator may discard the devices. In an alternative
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CA 02708422 2010-07-08
example embodiment, the staple cartridge 600 is configured such that, when a
first set of staples 606 in the staple cartridge 600 has been used, the
operator
may replace the staples 606 in the same staple cartridge 600 and reuse the
same
staple cartridge 600.
In accordance with still another example embodiment of the present
invention, the surgical device 11 may provide limited reloadability, whereby,
for
example, the surgical device 11 is configured to permit the staple cartridge
600 to
be replaced once, so that the clamping, cutting and stapling operation may be
performed twice on a single patient, e.g., on opposite sides of a cancerous
section of tissue, but does not permit the staple cartridge 600 to be replaced
more
than twice. In still another example embodiment of the present invention, the
surgical device 11 is configured to maintain within the staple cartridge 600
two
sets of staples 606, a first set of which is used on one side of a cancerous
section
of tissue and a second set of which is used on the other side of the cancerous
section of tissue. It should be understood that the surgical device 11 may be
configured for any predetermined number of uses and that usage may be
determined in accordance with the usage data 1184.
According to an alternative example embodiments of the present invention,
the surgical device 11 may be configured to provide more than one range of
operation. This feature may provide the advantage that sections of tissue
having
different thicknesses may be more appropriately accommodated by the surgical
device 11. For example, according to one example embodiment of the invention,
the surgical device 11 may be configured to vary the distance between the
first
jaw 50 and the second jaw 80 when the surgical device 11 is in the closed
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CA 02708422 2010-07-08
position, or to vary the distance that the wedge 603 is moved in the second
jaw
80 in order for the wedge 603 to reach a fully extended position. According to
one example embodiment, the surgical device 11 may be reloadable so as to use
two or more different sizes of staple cartridge, e.g., staple cartridges that
have
different thicknesses or that house staples 606 having different lengths. In
this
embodiment, an operator may select to employ one of two or more different
staple cartridges 600 having different size staples 606 disposed therein.
Accordingly, the memory module 6401 may include data that is readable by the
controller 1122 in order that the controller 1122 may recognize the staple
cartridge 600 as being of a particular size. The controller 1122 may then vary
the
number of turns of the first drive shaft 94 during operation so that the
distance
between the first jaw 50 and the second jaw 80 when the surgical device 11 is
moved into the closed position corresponds to the thickness of the tissue to
be
cut and stapled. Similarly, the controller 1122 may then vary the number of
turns
of the second drive shaft 102 during operation so that the position of the
wedge
603 and the blade 51 when moved into the extended position corresponds to the
thickness of the tissue to be cut and stapled. In accordance with another
example embodiment of the invention, different sizes of a non-reloadable
surgical
device 11 may be used, wherein each size of the non-reloadable surgical device
11 corresponds to a different thickness of tissue to be cut and stapled. In
this
embodiment, the memory module 6401 of the surgical device 11 may include
data readable by the controller 1122 in order that the controller 1122 may
recognize the surgical device 11 as corresponding to a particular thickness of
tissue to be cut and stapled. In still another example embodiment of the
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CA 02708422 2010-07-08
invention, the controller 1122 is configured to provide more than one range of
operation by enabling an operator to select settings that correspond to
different
thicknesses of tissue to be cut or stapled. For example, according to one
example embodiment, the controller 1122 is configured to actuate the first
drive
shaft 94 to close first jaw 50 to a first position relative to the second jaw
80 in
order to clamp a section of tissue disposed therebetween. The operator may
then select whether to actuate the second drive shaft 102 in order to cut and
staple the tissue, or whether to actuate the first drive shaft 94 again in
order to
close the first jaw 50 to a second position relative to the second jaw 80.
This
embodiment may provide the advantage that an operator is not required to pre-
select a particular size of the surgical device 11, or to pre-select a
replaceable
cartridge for the surgical device 11, before the section of tissue to be cut
and
stapled has been exposed and its thickness determined. This may prevent an
operator from pre-selecting a wrong size or from needing to keep an inventory
of
more than one size available for use.
As previously mentioned, one problem of conventional cutting and stapling
devices is that the opposing jaws of the mechanism do not adequately prevent a
section of tissue clamped therebetween from escaping out from between the
distal ends of the jaws during the operation of the device. This follows
because
the scissor-type gripping elements of conventional clamping, cutting and
stapling
devices, such as the device illustrated in Figure 1, pivot relative to each
other
around a fixed pivot point at a proximal end of the gripping elements. Thus,
since
the distance between the gripping elements is always less at a proximal end of
the gripping elements than at the distal ends of the gripping elements, the
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CA 02708422 2010-07-08
clamping force on a section of tissue disposed between the gripping elements
is
greatest near the proximal ends of the gripping elements and gradually
decreases
in the distal direction. The relatively high clamping force at the proximal
ends of
the gripping elements coupled with the relatively low clamping force at the
distal
ends of the gripping elements causes the section of tissue to be pushed
towards,
and eventually out from between, the distal ends of the gripping elements.
Thus,
the section of tissue may not be adequately cut and stapled, and the
inadequately
cut and stapled end of the tissue may permit its contents to spill into the
open
abdomen of the patient, increasing the likelihood of infection and other
complications.
In contrast, and as previously described in detail in connection with Figures
3(a) to 3(d), the surgical device 11 of the present invention, in accordance
with
various embodiments thereof, may provide a biasing element that biases the
distal ends 50a, 80a of the first and second jaws 50, 80 towards each other
during the operation of the surgical device 11. Specifically, according to one
example embodiment of the present invention, the surgical device 11 provides a
spring 82 at the proximal ends of the surgical device 11 that biases the
distal
ends 50a, 80a of the first and second jaws 50, 80 towards each other during
the
operation of the surgical device 11. Thus, the clamping force between the
distal
ends 50a, 80a of the first and second jaws 50, 80 is greater in the surgical
device
11 than the clamping force between the distal ends of the jaws of a
conventional
clamping, cutting and stapling device. The increased clarr)ping force at the
distal
ends 50a, 80a of the first and second jaws 50, 80 may prevent a section of
tissue
CA 02708422 2011-11-29
which is disposed between the first and second jaws 50 80 from escaping out
from between the distal ends 50a, 80a of the first and second jaws 50, 80.
Thus, the several aforementioned objects and advantages of the present
invention are most effectively attained. Those skilled in the art will
appreciate
that numerous modifications of the exemplary embodiment described
hereinabove may be made. Although a single exemplary embodiment of the
present invention has been described and disclosed in detail herein, the scope
of the claims should not be limited by the preferred embodiment set out in the
example, but should be given the broadest interpretation consistent with the
description as a whole.
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