Surgical stapling apparatus with anvil support
阅读说明:本技术 具有砧支撑件的外科钉合设备 (Surgical stapling apparatus with anvil support ) 是由 贾斯汀·威廉斯 于 2019-06-28 设计创作,主要内容包括:一种圆形钉合设备包含支撑件和砧头组合件。所述砧头组合件包含砧头和紧固到所述砧头的砧帽。所述砧帽被定位成将所述支撑件选择性地紧固到所述砧头。所述砧帽是柔性的且包含外环,所述外环相对于所述砧头可选择性地移动以从所述砧头释放所述支撑件。(A circular stapling apparatus includes a support and an anvil head assembly. The anvil-head assembly includes an anvil head and an anvil cap secured to the anvil head. The anvil cap is positioned to selectively secure the support to the anvil head. The anvil cap is flexible and includes an outer ring selectively movable relative to the anvil head to release the support from the anvil head.)
1. A stapling device comprising:
an anvil head comprising a top surface and a bottom surface, the bottom surface defining a staple forming pocket;
a support supported on the bottom surface of the anvil head and positioned to cover the staple forming pockets; and
an anvil cap secured to the top surface of the anvil head and positioned to selectively secure the support to the anvil head, the anvil cap including an inner ring assembly and an outer ring selectively engageable with the support and movable relative to the inner ring assembly to separate the anvil cap from the support and release the support from the anvil head.
2. The stapling apparatus of claim 1, wherein the inner ring assembly is flexible to facilitate movement of the outer ring relative to the support.
3. The stapling apparatus of claim 2, wherein the inner ring assembly includes a flexible cup and an annular flange connecting the flexible cup to the outer ring.
4. The stapling apparatus of claim 3, further comprising a fastener securing the anvil cap to the anvil head and seated within the flexible cup.
5. The stapling apparatus of claim 4, further comprising a pin positioned in and movable relative to the anvil head to move the outer ring away from the support when the fastener maintains the flexible cup secured to the anvil head.
6. The stapling apparatus of claim 5, wherein the pin is integral with the anvil cap.
7. The stapling apparatus according to claim 5, wherein said anvil head supports a pad movable relative to said anvil head, said pad being selectively engageable with said pin to move said pin relative to said anvil head.
8. The stapling apparatus of claim 7, further comprising a cylindrical knife selectively engageable with the backing plate to move the backing plate relative to the anvil head.
9. The stapling apparatus of claim 1, wherein the support comprises fingers extending from the support, the fingers positioned along the top surface of the anvil head and disposed below the outer ring to support the support against the bottom surface of the anvil head.
10. The stapling apparatus of claim 9, wherein outer ring includes an annular lip positioned to contact the fingers to secure the support to the anvil head.
11. A circular stapling apparatus comprising:
a support member; and
an anvil-head assembly including an anvil head and an anvil cap secured to the anvil head, the anvil cap positioned to selectively secure the support to the anvil head, the anvil cap being flexible and including an outer ring selectively movable relative to the anvil head to release the support from the anvil head.
12. The circular stapling apparatus of claim 11, wherein the anvil cap includes an inner ring assembly secured to the anvil head, the inner ring assembly configured to flex in response to movement of the outer ring relative to the support.
13. The circular stapling apparatus of claim 12, wherein the inner ring assembly includes a flexible cup secured to the anvil head, and an annular flange connecting the flexible cup to the outer ring.
14. The circular stapling apparatus of claim 13, further comprising a fastener received in a pocket defined by the flexible cup, the fastener threadably coupled to the anvil to secure the flexible cup to the anvil.
15. The circular stapling apparatus of claim 14, wherein the anvil head assembly includes at least one pin received within the anvil head, the at least one pin being movable relative to the anvil head to separate the outer ring and the support.
16. The circular stapling apparatus of claim 15, wherein the at least one pin is independent of the anvil cap.
17. The circular stapling apparatus of claim 15, wherein the at least one pin comprises a plurality of spaced apart pins positioned around the anvil cap.
18. The circular stapling apparatus of claim 15, further comprising a cylindrical knife selectively movable into engagement with a pad supported in the anvil to move the pad relative to the anvil, the pad positioned to engage the at least one pin.
19. The circular stapling apparatus of claim 11, wherein the support includes fingers that support the support on the anvil head.
20. The circular stapling apparatus of claim 19, wherein the outer ring includes an annular lip that selectively captures the fingers against the anvil.
Technical Field
The present disclosure relates to surgical stapling apparatuses and, more particularly, to structures and methods for removably attaching buttress material to a circular surgical stapling apparatus for use in anastomosis procedures.
Background
Fasteners have traditionally been used to replace seams when joining various body structures (e.g., bowel or bronchial tubes). Surgical stapling devices to apply these fasteners are typically designed to simultaneously cut and seal tissue to reduce the time and risk involved in anastomosis procedures.
Surgeons use circular surgical stapling apparatuses to apply one or more surgical fasteners (e.g., staples or two-part fasteners) to body tissue for the purpose of joining segments of body tissue together and/or for creating an anastomosis. Circular surgical stapling devices generally comprise: an annular fastener magazine assembly supporting a plurality of annular rows of fasteners; an annular anvil assembly operatively associated with the fastener cartridge assembly providing a surface against which a fastener is formed upon activation of the circular stapling apparatus; and an annular blade for cutting tissue.
For most procedures, it is generally acceptable to use bare fasteners that are in direct contact with the patient's tissue. The integrity of the tissue will generally serve to prevent the fastener from tearing the tissue and damaging the seal before healing has occurred. However, in some surgical procedures, surgeons use buttress materials in conjunction with circular stapling devices to bridge, repair, and/or reinforce tissue defects within patients. In particular, the buttress material reduces trauma to the patient, reduces instances of leakage, reduces instances of bleeding, and creates a relatively strong bond between adjacent body tissues.
Accordingly, there is a need for a reliable and removable attachment of a buttress material to a circular stapling apparatus so that the buttress material does not interfere with the operation of the apparatus, remains on the apparatus until after the fastener is activated, and is conveniently and easily installed and used.
Disclosure of Invention
According to one aspect, the present disclosure is directed to a stapling apparatus. The stapling apparatus includes an anvil head, a support member, and an anvil cap. The anvil head includes a top surface and a bottom surface. The bottom surface defines a staple forming pocket. The buttress is supported on the bottom surface of the anvil head and positioned to cover the staple forming pockets. The anvil cap is secured to the top surface of the anvil head and is positioned to selectively secure the support to the anvil head. The anvil cap includes an inner ring assembly and an outer ring. The outer ring is selectively engageable with the support and movable relative to the inner ring assembly to separate the anvil cap from the support and release the support from the anvil head.
In some embodiments, the inner ring assembly may be flexible to facilitate movement of the outer ring relative to the support. The inner ring assembly may include a flexible cup and an annular flange connecting the flexible cup to the outer ring. The stapling apparatus may further include a fastener securing the anvil cap to the anvil head and seated within the flexible cup. The stapling apparatus may further include a pin positioned in the anvil head and movable relative to the anvil head to move the outer ring away from the support while the fastener maintains the flexible cup secured to the anvil head. The pin may be integral with the anvil cap. The anvil head may support a pad that is movable relative to the anvil head. The pad is selectively engageable with the pin to move the pin relative to the anvil head. The stapling apparatus may further include a cylindrical knife selectively engageable with the pad to move the pad relative to the anvil head.
In certain embodiments, the support may include fingers extending from the support. The fingers may be positioned along the top surface of the anvil head and disposed below the outer ring to support the support against the bottom surface of the anvil head. The outer ring may include an annular lip positioned to contact the fingers to secure the support to the anvil head.
According to another aspect of the present disclosure, a circular stapling apparatus is provided. The circular stapling apparatus includes a support and an anvil head assembly. The anvil-head assembly includes an anvil head and an anvil cap secured to the anvil head. The anvil cap is positioned to selectively secure the support to the anvil head. The anvil cap is flexible and includes an outer ring selectively movable relative to the anvil head to release the support from the anvil head.
In certain embodiments, the anvil cap may include an inner ring assembly secured to the anvil head. The inner ring assembly may be configured to flex in response to movement of the outer ring relative to the support. The inner ring assembly may include a flexible cup secured to the anvil head, and an annular flange connecting the flexible cup to the outer ring. The circular stapling apparatus may further include a fastener received in a pocket defined by the flexible cup. The fastener may be threadably coupled to the anvil head to secure the flexible cup to the anvil head. The anvil head assembly may include one or more pins received within the anvil head. The one or more pins may be movable relative to the anvil head to separate the outer ring from the support. The one or more pins may be independent of the anvil cap. The one or more pins may include a plurality of spaced apart pins positioned around the anvil cap. The circular stapling apparatus may further include a cylindrical knife that is selectively movable into engagement with a backing plate supported in the anvil head to move the backing plate relative to the anvil head. The shim plate may be positioned to engage the one or more pins.
In some embodiments, the support may include fingers that support the support on the anvil head. The outer ring may include an annular lip that selectively captures the fingers against the anvil head.
Other aspects, features, and advantages will be apparent from the description, drawings, and claims that follow.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above and the detailed description given below, serve to explain the principles of the disclosure, in which:
FIG. 1 is a perspective view of a surgical stapling apparatus including one embodiment of an end effector shown in an unaccessed position in accordance with the present disclosure;
FIG. 2 is an enlarged perspective view of the indicated detail area shown in FIG. 1;
FIG. 3 is a perspective view of the end effector of FIG. 1, with the anvil assembly of the end effector shown separated from the cartridge assembly of the end effector;
FIG. 4 is a perspective view of an anvil and head assembly of the anvil assembly of FIG. 3 with parts separated;
FIG. 5 is a perspective view of an anvil cap of the anvil-head assembly of FIG. 4;
FIG. 6 is a perspective view of the anvil assembly of FIG. 3 with parts separated;
FIG. 7 is a side cross-sectional view of the end effector of FIG. 1, with the end effector illustrated in an approximated position;
FIGS. 8-10 are progressive views illustrating the surgical stapling apparatus of FIG. 1 performing an anastomosis procedure;
FIG. 11 is a perspective view of another embodiment of an anvil assembly; and is
FIG. 12 is a perspective view of an anvil and head assembly of the anvil assembly of FIG. 11 with parts separated.
Detailed Description
Embodiments of the presently disclosed surgical stapling apparatus are described in detail with reference to the drawings, wherein like reference numerals designate identical or corresponding elements in each of the several views. The term "clinician" refers to a doctor, nurse, or any other medical personnel and may include support personnel, as is commonly known. In addition, the term "proximal" refers to the portion of the structure that is closer to the clinician, and the term "distal" refers to the portion of the structure that is further from the clinician. Furthermore, directional terms such as front, rear, upper, lower, top, bottom, and the like are used for convenience of description only and are not intended to limit the disclosure appended hereto.
In the following description, well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail.
Turning now to fig. 1, a surgical stapling apparatus, generally referred to as 10, is provided. In embodiments, the
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Reference may be made to Ross et al, U.S. patent No. 8,806,973, the entire contents of which are incorporated herein by reference, for a detailed description of the construction and operation of an example electro-mechanical surgical stapling apparatus, the components of which may be combined with and/or interchanged with one or more of the components of the
While the
Turning now to fig. 2-10,
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The pusher 313 of the
The cylindrical knife 314 of the
Referring now to fig. 7-10, in operation, once
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Referring to fig. 11 and 12, another embodiment of the anvil assembly 420 includes an anvil-
As can be appreciated, fastening any of the components of the disclosed apparatus can be accomplished using known fastening techniques such as welding, crimping, gluing, fastening, and the like.
The various embodiments disclosed herein may also be configured to work with robotic surgical systems, and are commonly referred to as "teleoperated surgery. Such systems use various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of the surgical instrumentation. Various robotic arms, gears, cams, pulleys, motors, mechanical motors, and the like may be used for this purpose, and may be designed with a robotic surgical system to assist the clinician during the procedure or treatment procedure. Such robotic systems may include remotely steerable systems, automated flexible surgical systems, remote articulated surgical systems, wireless surgical systems, modular or selectively configurable teleoperated surgical systems, and the like.
The robotic surgical system may be used with one or more consoles proximate to an operating room or located in remote locations. In this example, one team of clinicians may prepare a patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein, while another clinician (or a group of clinicians) remotely controls the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician can perform multiple operations at multiple locations without leaving his/her remote console, which is economically advantageous and also beneficial for a patient or a series of patients. For a detailed description of an exemplary medical workstation and/or components thereof, reference may be made to U.S. patent application publication No. 2012/0116416 and PCT application publication No. WO2016/025132, the entire contents of each of which are incorporated herein by reference.
Those of ordinary skill in the art will understand that the structures and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the description, disclosure, and figures are to be interpreted merely as illustrating specific embodiments. Accordingly, it is to be understood that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be affected therein by one of ordinary skill in the related art without departing from the scope or spirit of the disclosure. In addition, it is contemplated that elements and features illustrated or described in connection with one exemplary embodiment may be combined with elements and features of another exemplary embodiment without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Indeed, any combination of any of the presently disclosed elements and features is within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularly shown and described.
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