Stapling device

Elongated-member-driving apparatus – Surgical stapler – With magazine

Patent

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Details

227 19, 227119, 227120, 606219, A61B 17068

Patent

active

057823979

DESCRIPTION:

BRIEF SUMMARY
FIELD OF THE INVENTION

The present invention relates to a stapling device. More particularly, the stapling device has a unique configuration, suitable for use as a tissue proximation device, an endoscopic surgical microstapler for the attachment of tissues such as for the reanastomosis of gastrointestinal organs and gynecological procedures with "B" shaped staples. The stapler also has an improved feed and insertion mechanism.


BACKGROUND OF THE INVENTION

Surgery often involves the reattachment or reanastomosis of various internal tissues or organs, especially in the later stages of a surgical procedure, e.g. during closure. This tissue fastening may also be a primary object of a surgical procedure, or merely incidental thereto. Presently, there are a number of methods available to perform this tissue proximation and attachment. These include the use of single filament sutures, braided sutures, dissolvable sutures, permanent sutures, steel sutures, staples, clips, dissolvable plastics, permanent plastics, surgical adhesives and other methods. Many of these procedures suffer from the limitations that their applicability is limited, or the procedure is time consuming and requires great skill.
A number of fastener types are available having differing shapes. Each fastener type has properties which determine its applicability, and differing fasteners generally have differing insertion methods and apparatus.
The relevant prior art includes U.S. Pat. No. 3,225,996, GB 1,095,441 and CA 186,605. In addition, United States Surgical Co. has developed various surgical staplers, CMT-0,15 (prior to 1972), CMT-0,25 and CMT-0,4 (prior to 1968, U.S. patent application Ser. No. 108,566) and CMT-3 (prior to 1972, U.S. patent application Ser. No. 312,602, May 22, 1972).
The art has been presented with some difficulties relating to tissue proximation and attachment during endoscopic or laparoscopic procedures. These difficulties may be related to organ manipulation limitations posed by conventional endoscopic instruments. For example, with a dual incision procedure, it is difficult to retain organs in an appropriate and anatomically correct position for the time necessary to complete the attachment. Therefore, endoscopic procedures have evolved in a manner which minimizes the need for extensive organ reattachment or reanastomosis employing the endoscopic instrument. Tools have been made available to perform such procedures quickly and efficiently, but as a result the versatility may be of narrow scope. Procedures which do not fall within the scope of available endoscopic instruments must be performed as full open field surgical procedures. Intestinal reanastomosis may be accomplished by way of intraluminal techniques; however, the available instrumentation tend to be highly specialized for this purpose.
The art also teaches stapling techniques for fastening co-planar sheets, as in the conventional desktop office stapler. The conventional stapler has a number of elements. First, the staple itself is generally a steel wire bent into a U-shape having 90.degree. bends at the corners. The stapler normally includes a sequential feed for a plurality of staples, which are aligned parallel to each other in a feed channel. The channel of staples is fed sequentially to an active region of the stapler by a spring, providing an advancing force from a rear hinged proximal portion toward a distal end, from which the staples are ejected. The hinge connects and maintains in proper alignment, the staple ejection mechanism with a former element (hereinafter a "former") which sits below the tips of the distal-most staple with the staple feed mechanism. When the two hinged portions, the staple ejection mechanism and the former, are pressed together, first the tips of the staple engage the item to be stapled, in alignment with the former. Next, a hammer member having a thickness approximately equal to that of a single staple, presses the staple downward, out of vertical alignment with the channel formed by the supply of staples in reserve, and

REFERENCES:
patent: 5009356 (1991-04-01), Rothfuss et al.
patent: 5174487 (1992-12-01), Rothfuss et al.
patent: 5197649 (1993-03-01), Bessler et al.

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