CA1169733A - Medical stapling device - Google Patents
Medical stapling deviceInfo
- Publication number
- CA1169733A CA1169733A CA000432957A CA432957A CA1169733A CA 1169733 A CA1169733 A CA 1169733A CA 000432957 A CA000432957 A CA 000432957A CA 432957 A CA432957 A CA 432957A CA 1169733 A CA1169733 A CA 1169733A
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- Prior art keywords
- driver
- staples
- track
- staple
- movement
- Prior art date
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Abstract
ABSTRACT OF THE DISCLOSURE
A medical stapling device for suturing tissues with metal staples including a frame, an anvil mounted on the frame and means for moving a plurality of open staples along a track and sequential-ly into engagement with the anvil to clinch the staple. The moving means includes a driver operable between two positions, a plurality of spaced lugs adapted to engage the staples, and a means whereby movement of the driver to close a staple also causes the staples in the track to be moved toward the anvil.
A medical stapling device for suturing tissues with metal staples including a frame, an anvil mounted on the frame and means for moving a plurality of open staples along a track and sequential-ly into engagement with the anvil to clinch the staple. The moving means includes a driver operable between two positions, a plurality of spaced lugs adapted to engage the staples, and a means whereby movement of the driver to close a staple also causes the staples in the track to be moved toward the anvil.
Description
The present inven-tion relates to medical staples for suturing living tissue such as disunited skin or fascia.
The prior ar-t is reple-te with medical stapling devices for use in suturing living ti.ssues. United Sta-tes Patent Nos.
3,643,851; 3,662,939; 3,837,5~5; 3,873,016; and 4,014,492 are illustrative of such devices which include means which may be operated to move a plurality of open staples along a track and sequentially into engagement with an anvil so that the staple engaging the anvil will be closed to engage it with tissues adjacent the anvil.
Typically, such stapling devices are rather complex and apply a staple which is rectangular or square in shape after application. Such staples may be applied in different ways.
One way involves manually pulling together and everting (tenting) the edges of tissue (e.g., skin or fascia) to be joined, placing the anvil of the stapling device transverse of the juncture between the tissues, and activating the device to apply a staple. The applied staple has a straight central portion (which contacted the anvil) ex-tending across the juncture of the tissues, straight side portions of the staple on either end of its central portion extending along the outer surfaces of the tissue and at right angles to the central portion of the staple, and generally aligned pointed end portions piercing . ~.
'. I - 1 ~
. . .
, the tissue and extending toward each other ~rom the ends Or the straight portions opposite the central portion.
Another way involves bringing the anvil and separated sharp end portions of an open staple into contact with the surfaces of tissues to be joined while the surfaces of the tissue are co-planar, and then activating the device so that the end portions of the staple enter the tissues and pull them together as the staple is closed.
Subsequent to at least partial healing of the tissues, these staples are removed by using a tool to bend the central portion of each staple to a U-shaped configura-tion, which bending causes the pointed end portions of the staple to separate.
Such stapling of living tissues has presented certain problems. First the open staples are pre-bent at right angles between their side and end portions. When the staple is used to ~oin tissues with co-planar surfaces in the manner described above, these sharply bent portions of the staple must enter the tissue, which can cause tearing of the tissue adJacent the points of entry. Also~ either manner of stapling with such staples results in excessive gathering of the tissues to be ~oined which is not recommended by some experts in the healing art (e.g., by "gathering" we mean pressing together ad~acent portions of the tissues to be ~oined, and by "excessive gathering" we mean pressing together more of those adjacent tissue portions than is required to keep those tissues in contact 3~33 adjacent and between the staples when a moderate tension is applied across the su-ture).
After the staples are applied, the healiny -tissues swell around the staples and enclose significant portions of the side portions of the staples. When the staples are then removed by bending their central portions, their L-shaped side and end portions tend to painfully tear or stretch the joined tissues as they are withdrawn.
Also, tension across the juncture between the tissues can cause some of the appliecl staples to rotate until the tissues are retained between their opposite corners. Swelling of the tissues around such a rotated staple can obfuscate its orientation so that a person removing the staple may inadvertently bend one of its side portions (instead of its central portion) to a generally U-shaped configuration. This can cause its opposite side and end portion to significantly tear tissues and cause pain as the staple is removed.
The staples of the invention are shaped to enter living tissues with a minimum o~ tissue damage, to gather joined tissues by a predetermined amount that will just maintain the tissues in contact when a moderate tension is applied across the suture, to provide a closed staple that will not tend to rotate within the tissues, and to allow the ends oE the staple to be withdrawn from swelled healing tissue wi-th minimum damage to the tlssue by bending its central portion in the manner described above.
Applicant has developed a stapling device especially adapted for use with its novel staples. This device is of the type including a frame, an anvil mounted in a fixed position . .
73~
relative to the frame, and means for moviny a plurali,ty of open staples along a track and sequentially into engayement ~ith the anvil to close the staple engaginy the anvil. In applicant's stapling device, -the means for moving the s-taples comprises a driver mounted on the frame for movement along a predetermined path generally aligned with the track between first and second positions with the driver more closely adjacent the anvil in its second position; a staple engaging member comprising a plurality of , spaced lugs adapted to engage staples along the track;, and means for mounting the staple engaging member to cause movement thereof from an initial posi-tion with its lugs spaced from staples along the track toward the track to an engage position with the lugs aligned with staples along the track during a first position of movement of the driver from its first toward its second position; to cause movement of -the staple engaging member with the driver and along the track to move the staples and engage the leading staple with the anvil during a second portion of its movement toward the second position; to cause movement of the lugs away from the track and out of engagement with staples along the track during a first position of movement of the driver from its second position back toward i-ts first position; and to cause movement of the staple engaging member with the driver back to its initial position during a second portion of the movement of the ' driver back toward its firs-t position.
`, The staple of the invention is of the open wire type .' and comprises a generally U-shaped central portion, having at - least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer , I - 4 -.
portions s-tarting from said central portion being at increasingly greater distances from the acljacent arcuate par-t of said central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part.
Applicant has also developed a special cartridge for storing its novel staples in conjunction with the above-described stapling device. This cartridge includes portions defining a track for the staples, which portions comprise parallel elongate rails having opposed parallel grooves. A plurality of the staples have the outermost portions of their arcuate end portions in the grooves and are frictionally engaged between the rails with the points of the staples pointing toward a first end of the cartridge; and are disposed in closely adjacent relationship along the grooves. The cartridge is open along one side of the rails to afford access to the staples along the track by the spaced lugs on the staple engaging member so that the lugs can move between the staples and drive the staples along the track and sequentially into engagement with the anvil on the stapler assembly which is aligned with the track at the first end of the mounted cartridge.
The present invention will be further described with reference to the accompanying drawing where like numbers refer to ., `' .
, , :~69733 like parts in the several views, and wherein;
` Figure 1 is a side view of a stapling device for j dispensing the staples of the lnvention;
j Figure 2 is an enlarged top view of the stapling device of Figure 1, having parts bro]cen away to show details;
Figure 3 is a sectional view taken approximately along the line 3-3 of Figure 2, and showing a normal position of a staple driving mechanism in the stapling device;
: Figures 4 and 5 are fragmentary sectional views, taken approximately along the line 3-3 of Figure 2, which show sequential positions into which the staple driving mechanism is moved during the application of a staple;
Figures 6 and 7 are sectional views taken respectively along the lines 6-6 and 7-7 of Figure 5;
Figure 8 is a fragmentary sectional view taken approximately along line 9-9 of Figure 6;
Figure 9 is a perspective view of a replaceable staple cartridge for use with the stapling device of Figure l;
j Figure 10 is a side view of the cartridge of Figure 9;
Figures 11 and 12 are fragmentary sectional views sequentially showing the attachment of a first embodiment of a ~ staple applied by the stapling device of Figure 1 to suture living `~ tissues; and : Figures 13, 14 and 15 are fragmentary sectional views : . sequentially showing the attachment of a second embodiment of a staple applied by the stapling device of Figure 1 to suture llving tissues.
''`'`
~6~33 Referring now to the drawiny there is shown a stapling device or stapler 10 for dispensing the staples of this invention.
The . :
stapling device 10 includes a frame 11, an anvil 12 mounted on the frame 11, and means for moving a plurality o~ open staples 13 along a track 14 and sequentially into engagement with the anvil 12 (Flgure 11) to close the staple 13 engaging the anvil 12 (Figure 12) so that the staple 13 may suture living tissues 16 (such as disunited skin or fascia) adjacent the anvil 12.
As is best seen in Figures 3 through 7, the means for moving the open staples along the track 14 includes a driver 18 mounted on the frame 11 for movement along a predetermined path generally aligned with the track between a first position (Figure 3) and a second position (Figure 5) with the drive 18 more closely adjacent the anvil 12 in its second position. Also included is a staple engaging member 19 comprising a plurality of spaced lugs 20 adapted to engage staples 13 along the track 14. The staple engaging member 19 is mounted by means for causing movement thereof from an initial position (Figure 3) with its lugs 20 spaced from staples 13 along the track 14 toward the track 14 to an engage position (Figure 4) with the lugs 20 aligned with and between the staples 13 along the track 14 during a first position of movement of the driver 18 from its first toward its second position; for causing movement of the staple engaging member 19 with the driver 18 to engage and move staples 13 along the track 14 and to close the leading staple 13 along the track 14 around the anvil 12 during a second portion of the movement : .:
3~33 of the driver toward its second position (Figures 5 and 12); for causing movement of the lugs 20 away from the track 14 and out of engagement with the staples 13 along the track 14 during a first position of movement of the driver 18 from its second position (Figure 5) back toward its first position; and to move the staple engaging member 19 with the driver 18 back to its initial position (Figure 3) during a second portion of ~.ovement of the driver 18 back toward its first position.
The driver 18 comprises an elongate driving portion 22 which has a semi-cylindrical bearing surface 23 (Figures 6 and 7) and a longitudinally extending U-shaped slot 24 along its side opposite its bearing surface 23 so that the driving portion 22 is generally C-shaped in cross section. The bearing surface 23 of the driving portion 22 is slidably mounted against a mating bearing surface 25 on the frame 11 for movement toward and away from the anvil 12. The driver 18 also includes a stepped cylindrical driven portion (see Figures 3, 4 and 5) fixed on the end of the driving portion 22 opposite the anvil 12 and having an axis aligned with the direction of sliding movement for the driver 18. The driving portion includes three cylindrical portions 27, 28 and 29 coaxially fixed to and spaced by a cylindrical rod 30. The cylindrical front portion 27 attaches the rod 30 to the driving portion 22. The center cylindrical portion 28 retains a compression spring 31 within a chamber in the frame 11 and between itself and a .
collar 32 fixed to the frame 11 to provide means for biasing the driver 18 to lts first position. The portion of the rod 30 between the center and rear cylindrical portions 28 and 2g is slidably mounted in a bearing 33 on the frame 11 to provide, with the cylindrical bearing surfaces 23 and 25, the means for slidably mounting the driver 18 on the frame 11.
The rear cylindrical portion 29 is fixed on the end of the rod 30 and is concave on its side opposite the rod 30. An actuating trigger 35 is pivotably mounted by a pin 36 on a handle assembly 37 and has a knob 34 at one end adapted to engage the concave surface of the rear cylindrical portion 29, and a portion pro~ecting from the handle assembly 37 . When the projecting portion of the 15 trigger 35 is manually squeezed into the handle assembly 37, the knob 34 will engage and move the driver 18 to its second position so that one of the staples 13 will be applied.
The frame 11 on which the driver 18, staple 20 engaging member 19 and anvil 12 are mounted is rotatable relative to the handle assembly 37 to afford various orientations of the width of the staple relative to the hand of a user grasping the handle assembly 37. This, together with the long tapered outline of the stapling 25 device 10 toward the anvil 12 which allows excellent visibility of the tissue being sutured, affords great versatility in use of the stapling device 10. As is seen C~3~
in Figures 2 and 3, the frame 11 has a cylindrical surface 38 between spaced Elanges 39 and the handle assembly 37 includes a cylindrical bearing 42 adapted to engage that cylindrical surf ace 38 so that the frarne 11 may be rotated 5 to change the orientation of the dispensed staple; the knob 34 of the trigger 35 being adapted to engage the concave surface of the cylindrical portion 29 at any relative orientation therebetween so that the stapling device 10 may be activated.
If desired, the handle assembly 37 can be removed, and the stapling device 10 can be activated by manual pressure applied directly to the cylindrical pOrtiQn 29.
The staple engaging member 19 is elongate and 15 generally rectangular in cross section with two spaced parallel rows of spaced lugs 20 along one of its surfaces.
It is slidably received in the slot 24 in the drive portion 22 with the lugs 20 exposed to allow both relative longitudinal sliding movement between the driver 18 and the 20 staple engaging member 19, and sliding movement of the staple engaging member 19 into and out of the groove 25 in a direction normal to its elongate axis so that the lugs 20 can move toward and away from the track 14 along which the staples 13 are spaced.
The staple engaging member 19 includes two parallel pins 40 extending transversely to the axes of the bearing surfaces 23 and 25, and engaging cam slots 41 in the driving portion 22 which guide and limit relative movement between the driver 18 and staple engaging member l9. The surfaces defining the slots 41 are inclined to cause movement of the staple engaging member 19 out of the slot 24 (with its axis parallel to that of the driver 18) to a position with the lugs 20 between staples 13 along the track 14 as the staple engaging member 19 is moved toward the anvil 12 relative to the driver 18; and conversely to cause movement of the staple engaging member 19 into the slot 24 with the lugs 20 spaced from staples 13 along the track 14 as the staple engaging member 19 is moved away from the anvil 12 relative to the driver 18. Means for frictionally retarding movement of the staple engaging member 19 with respect to the frame 11 are provided by two 15 opposed friction assemblies 43 (Figure 7). Each friction assembly 45 includes a housing 46 threadably mounted in the frame 11 and extending through a clearance opening in the driving portion 22 of the driver 18, a spring 47, and a ball 48 which is passed by the spring 47 into frictional 20 engagement with one side of the staple engaging member 19.
Such frictional engagement is adjusted to prevent longitudinal movement of the staple engaging member 19 with the driver 18 until the pins 40 contact the trailing ends of the slots 41. Thus with the pins 40 initially located 25 at the leading ends of the slots 41 (so that the lugs 20 are spaced from the staples 13 along the track 14) and with the driver 18 in its first position (Figure 3), subsequent ~9 ~ 3 movement of the driver 18 toward its second position will first cause the walls defining the slots 41 to move toward the anvil 12 relative to the pins 40, thereby moving the staple engaging mernber 19 at a right angle to its axis to its engage position; and will then cause movement of the staple engaging member 19 with the driver 18 during a second portion of the movement of the driver 1~ toward its second position after the trailing ends of the slots 41 engage the pins 40. Subsequently upon movement of the driver 18 from its second position back toward its first position under the influence of the spring 35, the walls defining the slots 41 will first move along the pins 40 to move the staple engaging member away from the track 14, and will then carry the staple engaging member 19 back to its initial position after the trailing ends of the slots 41 engage the pins 40.
The track 14 along which the open staples 13 are spaced is defined by an elongate cartridge 50 removably mounted on the frame 11. The cartridge 50, best seen in Figures 9 and 10, includes a generally rectangular projecting end portion 51 adapted to be received in a socket in the frame 11 and to be retained therein by a thumb screw 53. Also included are two parallel elongate rails 54 having opposed parallel grooves which define the track 14. The staples 13 have arcuate end portions in the grooves and frictionally engage with the rails 54, with the staples all opening toward the end of the cartridge 50 opposite its end portion 51 and being disposed in closely ad~acent relationship along the grooves. The cartridge 50 i~ open alon~ one side of the rails 54 to a~ford access by the lugs 20 on the staple engaging member 19 with the staples 13 spaced along the track 14.
The open wire staple 13 used in the stapling device and the manner in which it is closed is best seen in Figures 11 and 12 which illustrate the application of one of the staples 13 to the tissue or disunited skin 16 which has been everted prior to application (as may be necessary when the flesh below the skin does not provide enough support for the skin so that the staple will enter skin disposed in a co-planar relationship). The staple 13 is formed from circular metal wire (e.g., 0.058 centimeter (0.023 inch) diameter 316L stainless steel). When open, the staple 13 consists o~ a generally U-shaped central portion 60 having two spaced arcuate parts 61, and two smoothly curved outer portions 63 terminating in sharp needle-like points 64. The staple is bent at an angle in the range of 75 to 90 degrees at the juncture between the portions 60 and 63 on each of its sides. When the staple 13 is open, successive parts of its outer portions 63 starting from the adjacent arcuate part 61 are at increasingly greater distances from the arcuate part 61 (when measured along straight lines between the successive parts of the curved outer portions 63 and the adjacent arcuate part 61). When the open staple 13 is closed by bending its arcuate parts 61 to a generally straight condition, the curved outer portions 63 can enter and smoothly gather tissues (such as the disunited skin 16) positioned ad~acent the anvil 12. The shape of the 5 U-shaped central portion 60, each of the curved outer portions 63 and the bends between the portions 60 and 63 are such that when the arcuate parts 61 of the central portion 60 are generally straightened to close the staple 13 (as shown in Figure 12), the shape of the staple 13 is generally D-shaped with the maximum dimension of the closed staple being parallel to and adjacent the straightened arcuate parts 61 to provide a desirable stability against rotation for the closed staple 13.
Figures 13, 14 an 15 illustrate an alternative 15 embodiment of an open wire staple 68 according to the present invention as it is applied by the stapling device 10 to suture disunited skin 69 in a co-planar relationship.
The device 10 will close the staple 68 to the generally D-shaped configuration shown in Figure 15. Like the staple 20 13, the open staple 68 includes a generally U-shaped central portion 70 having two spaced arcuate parts 71, and two smoothly curved outer portions 73 terminating in sharp points 74. The staple 68 is bent at an angle in the range of 75 to 90 degrees at the ~uncture between its portions 70 25 and 73 on each of its sides. When the staple 68 is open (Figure 13), successive parts of its outer portions 73 starting from the ad~acent arcuate part 71 are at -lG-increasingly greater distances from the curved part 71 (when measured on a straight line between the successive parts of the curved outer portions 73 and the adjacent arcuate part 71) . When the staple 68 is then closed by bending the arcuate parts 71 to a generally straight condition (Figure 14), the curved outer portions 73 can enter and smoothly gather tissues (such as the disunited skin 69) positioned ad~acent the anvil 12. Also the shape of the U-shaped central portion 70 and each of the curved outer portions 73 is such that when the arcuate parts 71 of the central portion 70 are generally straightened to close th staple 68, the maximum inside dimension of the closed staple 68 will be generally parallel to and adjacent a line connecting the straightened arcuate parts 71 to provide a desirable stability against rotation for the closed staple 68. To close the staple 68, the arcuate parts 71 are bent slightly beyond straight to provide a slightly raised central portion for the closed staple 68 which allows a degree of swelling for the healing tissue 69 and easy insertion o~ the staple removal tool.
The wire staple 68 differs from the staple 13 in that its curved outer portions 73 have a greater radius of curvature than do the curved portions 63 for the staple 13.
Thus its curved portions 73 bite less deeply into the tissue 69 than do the curved portions 63 which is approprlate for Joining the co-planar disunited skin 69 as opposed to everted skin 16.
It will be understood that the preferred embodiments of the stapling device 10 and staples 13 and 68 ; disclosed herein rnay be sub~ect to many modifications and alterations without departing from the scope of the invention which is defined by the claims. For example the anvil 12 could be mounted on the frame of the stapler or on a removable cartridge which for purposes of the claims could be considered a part of the frame. Also the pair of lugs 20 at the distal end of the staple engaging member l9 may be notched to partially receive the curved portions 63 or 73 of the staple being closed to insure that the staple will stay in alignment with the tracks 14 as it is bent.
The prior ar-t is reple-te with medical stapling devices for use in suturing living ti.ssues. United Sta-tes Patent Nos.
3,643,851; 3,662,939; 3,837,5~5; 3,873,016; and 4,014,492 are illustrative of such devices which include means which may be operated to move a plurality of open staples along a track and sequentially into engagement with an anvil so that the staple engaging the anvil will be closed to engage it with tissues adjacent the anvil.
Typically, such stapling devices are rather complex and apply a staple which is rectangular or square in shape after application. Such staples may be applied in different ways.
One way involves manually pulling together and everting (tenting) the edges of tissue (e.g., skin or fascia) to be joined, placing the anvil of the stapling device transverse of the juncture between the tissues, and activating the device to apply a staple. The applied staple has a straight central portion (which contacted the anvil) ex-tending across the juncture of the tissues, straight side portions of the staple on either end of its central portion extending along the outer surfaces of the tissue and at right angles to the central portion of the staple, and generally aligned pointed end portions piercing . ~.
'. I - 1 ~
. . .
, the tissue and extending toward each other ~rom the ends Or the straight portions opposite the central portion.
Another way involves bringing the anvil and separated sharp end portions of an open staple into contact with the surfaces of tissues to be joined while the surfaces of the tissue are co-planar, and then activating the device so that the end portions of the staple enter the tissues and pull them together as the staple is closed.
Subsequent to at least partial healing of the tissues, these staples are removed by using a tool to bend the central portion of each staple to a U-shaped configura-tion, which bending causes the pointed end portions of the staple to separate.
Such stapling of living tissues has presented certain problems. First the open staples are pre-bent at right angles between their side and end portions. When the staple is used to ~oin tissues with co-planar surfaces in the manner described above, these sharply bent portions of the staple must enter the tissue, which can cause tearing of the tissue adJacent the points of entry. Also~ either manner of stapling with such staples results in excessive gathering of the tissues to be ~oined which is not recommended by some experts in the healing art (e.g., by "gathering" we mean pressing together ad~acent portions of the tissues to be ~oined, and by "excessive gathering" we mean pressing together more of those adjacent tissue portions than is required to keep those tissues in contact 3~33 adjacent and between the staples when a moderate tension is applied across the su-ture).
After the staples are applied, the healiny -tissues swell around the staples and enclose significant portions of the side portions of the staples. When the staples are then removed by bending their central portions, their L-shaped side and end portions tend to painfully tear or stretch the joined tissues as they are withdrawn.
Also, tension across the juncture between the tissues can cause some of the appliecl staples to rotate until the tissues are retained between their opposite corners. Swelling of the tissues around such a rotated staple can obfuscate its orientation so that a person removing the staple may inadvertently bend one of its side portions (instead of its central portion) to a generally U-shaped configuration. This can cause its opposite side and end portion to significantly tear tissues and cause pain as the staple is removed.
The staples of the invention are shaped to enter living tissues with a minimum o~ tissue damage, to gather joined tissues by a predetermined amount that will just maintain the tissues in contact when a moderate tension is applied across the suture, to provide a closed staple that will not tend to rotate within the tissues, and to allow the ends oE the staple to be withdrawn from swelled healing tissue wi-th minimum damage to the tlssue by bending its central portion in the manner described above.
Applicant has developed a stapling device especially adapted for use with its novel staples. This device is of the type including a frame, an anvil mounted in a fixed position . .
73~
relative to the frame, and means for moviny a plurali,ty of open staples along a track and sequentially into engayement ~ith the anvil to close the staple engaginy the anvil. In applicant's stapling device, -the means for moving the s-taples comprises a driver mounted on the frame for movement along a predetermined path generally aligned with the track between first and second positions with the driver more closely adjacent the anvil in its second position; a staple engaging member comprising a plurality of , spaced lugs adapted to engage staples along the track;, and means for mounting the staple engaging member to cause movement thereof from an initial posi-tion with its lugs spaced from staples along the track toward the track to an engage position with the lugs aligned with staples along the track during a first position of movement of the driver from its first toward its second position; to cause movement of -the staple engaging member with the driver and along the track to move the staples and engage the leading staple with the anvil during a second portion of its movement toward the second position; to cause movement of the lugs away from the track and out of engagement with staples along the track during a first position of movement of the driver from its second position back toward i-ts first position; and to cause movement of the staple engaging member with the driver back to its initial position during a second portion of the movement of the ' driver back toward its firs-t position.
`, The staple of the invention is of the open wire type .' and comprises a generally U-shaped central portion, having at - least one arcuate part; and smoothly curved outer portions terminating in sharp points with successive parts of said outer , I - 4 -.
portions s-tarting from said central portion being at increasingly greater distances from the acljacent arcuate par-t of said central portion, so that, when said staple is closed by bending the arcuate part of said central portion adjacent each of said curved outer portions, said curved outer portions can enter and smoothly gather tissues. The shape of the U-shaped portion in each of the curved outer portions is such that, when the adjacent arcuate part of the central portion is generally straightened to close the staple, the maximum inside dimension of said staple will be generally parallel to said straightened arcuate part.
Applicant has also developed a special cartridge for storing its novel staples in conjunction with the above-described stapling device. This cartridge includes portions defining a track for the staples, which portions comprise parallel elongate rails having opposed parallel grooves. A plurality of the staples have the outermost portions of their arcuate end portions in the grooves and are frictionally engaged between the rails with the points of the staples pointing toward a first end of the cartridge; and are disposed in closely adjacent relationship along the grooves. The cartridge is open along one side of the rails to afford access to the staples along the track by the spaced lugs on the staple engaging member so that the lugs can move between the staples and drive the staples along the track and sequentially into engagement with the anvil on the stapler assembly which is aligned with the track at the first end of the mounted cartridge.
The present invention will be further described with reference to the accompanying drawing where like numbers refer to ., `' .
, , :~69733 like parts in the several views, and wherein;
` Figure 1 is a side view of a stapling device for j dispensing the staples of the lnvention;
j Figure 2 is an enlarged top view of the stapling device of Figure 1, having parts bro]cen away to show details;
Figure 3 is a sectional view taken approximately along the line 3-3 of Figure 2, and showing a normal position of a staple driving mechanism in the stapling device;
: Figures 4 and 5 are fragmentary sectional views, taken approximately along the line 3-3 of Figure 2, which show sequential positions into which the staple driving mechanism is moved during the application of a staple;
Figures 6 and 7 are sectional views taken respectively along the lines 6-6 and 7-7 of Figure 5;
Figure 8 is a fragmentary sectional view taken approximately along line 9-9 of Figure 6;
Figure 9 is a perspective view of a replaceable staple cartridge for use with the stapling device of Figure l;
j Figure 10 is a side view of the cartridge of Figure 9;
Figures 11 and 12 are fragmentary sectional views sequentially showing the attachment of a first embodiment of a ~ staple applied by the stapling device of Figure 1 to suture living `~ tissues; and : Figures 13, 14 and 15 are fragmentary sectional views : . sequentially showing the attachment of a second embodiment of a staple applied by the stapling device of Figure 1 to suture llving tissues.
''`'`
~6~33 Referring now to the drawiny there is shown a stapling device or stapler 10 for dispensing the staples of this invention.
The . :
stapling device 10 includes a frame 11, an anvil 12 mounted on the frame 11, and means for moving a plurality o~ open staples 13 along a track 14 and sequentially into engagement with the anvil 12 (Flgure 11) to close the staple 13 engaging the anvil 12 (Figure 12) so that the staple 13 may suture living tissues 16 (such as disunited skin or fascia) adjacent the anvil 12.
As is best seen in Figures 3 through 7, the means for moving the open staples along the track 14 includes a driver 18 mounted on the frame 11 for movement along a predetermined path generally aligned with the track between a first position (Figure 3) and a second position (Figure 5) with the drive 18 more closely adjacent the anvil 12 in its second position. Also included is a staple engaging member 19 comprising a plurality of spaced lugs 20 adapted to engage staples 13 along the track 14. The staple engaging member 19 is mounted by means for causing movement thereof from an initial position (Figure 3) with its lugs 20 spaced from staples 13 along the track 14 toward the track 14 to an engage position (Figure 4) with the lugs 20 aligned with and between the staples 13 along the track 14 during a first position of movement of the driver 18 from its first toward its second position; for causing movement of the staple engaging member 19 with the driver 18 to engage and move staples 13 along the track 14 and to close the leading staple 13 along the track 14 around the anvil 12 during a second portion of the movement : .:
3~33 of the driver toward its second position (Figures 5 and 12); for causing movement of the lugs 20 away from the track 14 and out of engagement with the staples 13 along the track 14 during a first position of movement of the driver 18 from its second position (Figure 5) back toward its first position; and to move the staple engaging member 19 with the driver 18 back to its initial position (Figure 3) during a second portion of ~.ovement of the driver 18 back toward its first position.
The driver 18 comprises an elongate driving portion 22 which has a semi-cylindrical bearing surface 23 (Figures 6 and 7) and a longitudinally extending U-shaped slot 24 along its side opposite its bearing surface 23 so that the driving portion 22 is generally C-shaped in cross section. The bearing surface 23 of the driving portion 22 is slidably mounted against a mating bearing surface 25 on the frame 11 for movement toward and away from the anvil 12. The driver 18 also includes a stepped cylindrical driven portion (see Figures 3, 4 and 5) fixed on the end of the driving portion 22 opposite the anvil 12 and having an axis aligned with the direction of sliding movement for the driver 18. The driving portion includes three cylindrical portions 27, 28 and 29 coaxially fixed to and spaced by a cylindrical rod 30. The cylindrical front portion 27 attaches the rod 30 to the driving portion 22. The center cylindrical portion 28 retains a compression spring 31 within a chamber in the frame 11 and between itself and a .
collar 32 fixed to the frame 11 to provide means for biasing the driver 18 to lts first position. The portion of the rod 30 between the center and rear cylindrical portions 28 and 2g is slidably mounted in a bearing 33 on the frame 11 to provide, with the cylindrical bearing surfaces 23 and 25, the means for slidably mounting the driver 18 on the frame 11.
The rear cylindrical portion 29 is fixed on the end of the rod 30 and is concave on its side opposite the rod 30. An actuating trigger 35 is pivotably mounted by a pin 36 on a handle assembly 37 and has a knob 34 at one end adapted to engage the concave surface of the rear cylindrical portion 29, and a portion pro~ecting from the handle assembly 37 . When the projecting portion of the 15 trigger 35 is manually squeezed into the handle assembly 37, the knob 34 will engage and move the driver 18 to its second position so that one of the staples 13 will be applied.
The frame 11 on which the driver 18, staple 20 engaging member 19 and anvil 12 are mounted is rotatable relative to the handle assembly 37 to afford various orientations of the width of the staple relative to the hand of a user grasping the handle assembly 37. This, together with the long tapered outline of the stapling 25 device 10 toward the anvil 12 which allows excellent visibility of the tissue being sutured, affords great versatility in use of the stapling device 10. As is seen C~3~
in Figures 2 and 3, the frame 11 has a cylindrical surface 38 between spaced Elanges 39 and the handle assembly 37 includes a cylindrical bearing 42 adapted to engage that cylindrical surf ace 38 so that the frarne 11 may be rotated 5 to change the orientation of the dispensed staple; the knob 34 of the trigger 35 being adapted to engage the concave surface of the cylindrical portion 29 at any relative orientation therebetween so that the stapling device 10 may be activated.
If desired, the handle assembly 37 can be removed, and the stapling device 10 can be activated by manual pressure applied directly to the cylindrical pOrtiQn 29.
The staple engaging member 19 is elongate and 15 generally rectangular in cross section with two spaced parallel rows of spaced lugs 20 along one of its surfaces.
It is slidably received in the slot 24 in the drive portion 22 with the lugs 20 exposed to allow both relative longitudinal sliding movement between the driver 18 and the 20 staple engaging member 19, and sliding movement of the staple engaging member 19 into and out of the groove 25 in a direction normal to its elongate axis so that the lugs 20 can move toward and away from the track 14 along which the staples 13 are spaced.
The staple engaging member 19 includes two parallel pins 40 extending transversely to the axes of the bearing surfaces 23 and 25, and engaging cam slots 41 in the driving portion 22 which guide and limit relative movement between the driver 18 and staple engaging member l9. The surfaces defining the slots 41 are inclined to cause movement of the staple engaging member 19 out of the slot 24 (with its axis parallel to that of the driver 18) to a position with the lugs 20 between staples 13 along the track 14 as the staple engaging member 19 is moved toward the anvil 12 relative to the driver 18; and conversely to cause movement of the staple engaging member 19 into the slot 24 with the lugs 20 spaced from staples 13 along the track 14 as the staple engaging member 19 is moved away from the anvil 12 relative to the driver 18. Means for frictionally retarding movement of the staple engaging member 19 with respect to the frame 11 are provided by two 15 opposed friction assemblies 43 (Figure 7). Each friction assembly 45 includes a housing 46 threadably mounted in the frame 11 and extending through a clearance opening in the driving portion 22 of the driver 18, a spring 47, and a ball 48 which is passed by the spring 47 into frictional 20 engagement with one side of the staple engaging member 19.
Such frictional engagement is adjusted to prevent longitudinal movement of the staple engaging member 19 with the driver 18 until the pins 40 contact the trailing ends of the slots 41. Thus with the pins 40 initially located 25 at the leading ends of the slots 41 (so that the lugs 20 are spaced from the staples 13 along the track 14) and with the driver 18 in its first position (Figure 3), subsequent ~9 ~ 3 movement of the driver 18 toward its second position will first cause the walls defining the slots 41 to move toward the anvil 12 relative to the pins 40, thereby moving the staple engaging mernber 19 at a right angle to its axis to its engage position; and will then cause movement of the staple engaging member 19 with the driver 18 during a second portion of the movement of the driver 1~ toward its second position after the trailing ends of the slots 41 engage the pins 40. Subsequently upon movement of the driver 18 from its second position back toward its first position under the influence of the spring 35, the walls defining the slots 41 will first move along the pins 40 to move the staple engaging member away from the track 14, and will then carry the staple engaging member 19 back to its initial position after the trailing ends of the slots 41 engage the pins 40.
The track 14 along which the open staples 13 are spaced is defined by an elongate cartridge 50 removably mounted on the frame 11. The cartridge 50, best seen in Figures 9 and 10, includes a generally rectangular projecting end portion 51 adapted to be received in a socket in the frame 11 and to be retained therein by a thumb screw 53. Also included are two parallel elongate rails 54 having opposed parallel grooves which define the track 14. The staples 13 have arcuate end portions in the grooves and frictionally engage with the rails 54, with the staples all opening toward the end of the cartridge 50 opposite its end portion 51 and being disposed in closely ad~acent relationship along the grooves. The cartridge 50 i~ open alon~ one side of the rails 54 to a~ford access by the lugs 20 on the staple engaging member 19 with the staples 13 spaced along the track 14.
The open wire staple 13 used in the stapling device and the manner in which it is closed is best seen in Figures 11 and 12 which illustrate the application of one of the staples 13 to the tissue or disunited skin 16 which has been everted prior to application (as may be necessary when the flesh below the skin does not provide enough support for the skin so that the staple will enter skin disposed in a co-planar relationship). The staple 13 is formed from circular metal wire (e.g., 0.058 centimeter (0.023 inch) diameter 316L stainless steel). When open, the staple 13 consists o~ a generally U-shaped central portion 60 having two spaced arcuate parts 61, and two smoothly curved outer portions 63 terminating in sharp needle-like points 64. The staple is bent at an angle in the range of 75 to 90 degrees at the juncture between the portions 60 and 63 on each of its sides. When the staple 13 is open, successive parts of its outer portions 63 starting from the adjacent arcuate part 61 are at increasingly greater distances from the arcuate part 61 (when measured along straight lines between the successive parts of the curved outer portions 63 and the adjacent arcuate part 61). When the open staple 13 is closed by bending its arcuate parts 61 to a generally straight condition, the curved outer portions 63 can enter and smoothly gather tissues (such as the disunited skin 16) positioned ad~acent the anvil 12. The shape of the 5 U-shaped central portion 60, each of the curved outer portions 63 and the bends between the portions 60 and 63 are such that when the arcuate parts 61 of the central portion 60 are generally straightened to close the staple 13 (as shown in Figure 12), the shape of the staple 13 is generally D-shaped with the maximum dimension of the closed staple being parallel to and adjacent the straightened arcuate parts 61 to provide a desirable stability against rotation for the closed staple 13.
Figures 13, 14 an 15 illustrate an alternative 15 embodiment of an open wire staple 68 according to the present invention as it is applied by the stapling device 10 to suture disunited skin 69 in a co-planar relationship.
The device 10 will close the staple 68 to the generally D-shaped configuration shown in Figure 15. Like the staple 20 13, the open staple 68 includes a generally U-shaped central portion 70 having two spaced arcuate parts 71, and two smoothly curved outer portions 73 terminating in sharp points 74. The staple 68 is bent at an angle in the range of 75 to 90 degrees at the ~uncture between its portions 70 25 and 73 on each of its sides. When the staple 68 is open (Figure 13), successive parts of its outer portions 73 starting from the ad~acent arcuate part 71 are at -lG-increasingly greater distances from the curved part 71 (when measured on a straight line between the successive parts of the curved outer portions 73 and the adjacent arcuate part 71) . When the staple 68 is then closed by bending the arcuate parts 71 to a generally straight condition (Figure 14), the curved outer portions 73 can enter and smoothly gather tissues (such as the disunited skin 69) positioned ad~acent the anvil 12. Also the shape of the U-shaped central portion 70 and each of the curved outer portions 73 is such that when the arcuate parts 71 of the central portion 70 are generally straightened to close th staple 68, the maximum inside dimension of the closed staple 68 will be generally parallel to and adjacent a line connecting the straightened arcuate parts 71 to provide a desirable stability against rotation for the closed staple 68. To close the staple 68, the arcuate parts 71 are bent slightly beyond straight to provide a slightly raised central portion for the closed staple 68 which allows a degree of swelling for the healing tissue 69 and easy insertion o~ the staple removal tool.
The wire staple 68 differs from the staple 13 in that its curved outer portions 73 have a greater radius of curvature than do the curved portions 63 for the staple 13.
Thus its curved portions 73 bite less deeply into the tissue 69 than do the curved portions 63 which is approprlate for Joining the co-planar disunited skin 69 as opposed to everted skin 16.
It will be understood that the preferred embodiments of the stapling device 10 and staples 13 and 68 ; disclosed herein rnay be sub~ect to many modifications and alterations without departing from the scope of the invention which is defined by the claims. For example the anvil 12 could be mounted on the frame of the stapler or on a removable cartridge which for purposes of the claims could be considered a part of the frame. Also the pair of lugs 20 at the distal end of the staple engaging member l9 may be notched to partially receive the curved portions 63 or 73 of the staple being closed to insure that the staple will stay in alignment with the tracks 14 as it is bent.
Claims (5)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A stapling device for suturing tissues with metal staples including a frame, an anvil mounted on said frame, and means for moving a plurality of open staples along a track and sequentially into engagement with said anvil to clinch the staple engaging the anvil, wherein said means for moving comprises:
a driver mounted on said frame for movement along a predetermined path generally aligned with said track between first and second positions with said driver more closely adjacent said anvil in said second position;
a plurality of spaced lugs adapted to engage staples along said track;
and means for causing engagement of said lugs with staples along said track and movement of said lugs to advance the staples along the track and engage one of the staples with the anvil to close the staple during movement of said driver from said first toward said second position; to cause movement of said lugs away from said track and out of engagement with and around staples along said track during movement of said driver from its second position back toward its first position.
a driver mounted on said frame for movement along a predetermined path generally aligned with said track between first and second positions with said driver more closely adjacent said anvil in said second position;
a plurality of spaced lugs adapted to engage staples along said track;
and means for causing engagement of said lugs with staples along said track and movement of said lugs to advance the staples along the track and engage one of the staples with the anvil to close the staple during movement of said driver from said first toward said second position; to cause movement of said lugs away from said track and out of engagement with and around staples along said track during movement of said driver from its second position back toward its first position.
2. A stapling device according to claim 1 wherein said spaced lugs are formed on a staple engaging member separate from said driver, and said device includes a mechanism for mounting said staple engaging member on said frame to cause movement of said staple engaging member from an initial position with said lugs spaced from staples along said track toward said track to an engage position with said lugs engaging staples along said track during a first position of movement of said driver from its first toward its second position; to cause movement of said staple engaging member with said driver to advance the staples along the track and engage one of the staples with the anvil to close the staple during a second portion of its movement toward said second position; to cause movement of said lugs away from said track and out of engagement with staples along said track during a first portion of movement of said driver from its second position back toward its first position; and to move the staple engaging member with said driver to its initial position during a second portion of movement of said driver back towards its first position.
3. A stapling device according to claim 2 wherein said mechanism for mounting mounts said staple engaging member for movement relative to said driver both parallel and normal to the predetermined path of said driver; cam members on said staple engaging member and said driver shaped to engage and cause movement of the lugs of said staple engaging member toward said track upon relative motion between said driver and said staple engaging member during said first portion of movement of said driver toward its second position, to carry said staple engaging member with said driver during said second portion of movement of said driver toward its second position, to cause movement of the lugs of said staple engaging member away from said track during relative motion between said driver and said staple engaging member during the first portion of movement of said driver from its second position back toward its first position, and to carry said staple engaging member with said driver during said second portion of movement of said driver back toward its second position; and structure in engagement between said frame and said staple engaging member for frictionally retarding relative motion therebetween to insure said relative movement and operation of said cam members between said staple engaging member and said driver.
4. A stapling device according to claim 1 wherein said track is provided by parallel elongate rails frictionally receiving end portions of said staples with said staples opening toward said anvil and being disposed in closely adjacent relationship along said rails, there being an opening between said rails on one side to afford access to the staples along said rails by said lugs.
5. A stapling device according to claim 1 wherein said track is provided by a cartridge releasably engaged with said frame and including parallel elongate rails frictionally receiving end portions of said staples with said staples opening toward said anvil and being disposed in closely spaced relationship along said rails, said cartridge having an opening between said rails on one side to afford access to the staples along said rails by said lugs.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000432957A CA1169733A (en) | 1978-03-27 | 1983-07-21 | Medical stapling device |
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US05/890,682 US4185762A (en) | 1978-03-27 | 1978-03-27 | Medical stapling device |
| CA000322263A CA1156530A (en) | 1978-03-27 | 1979-02-26 | Medical stapling device |
| CA000432957A CA1169733A (en) | 1978-03-27 | 1983-07-21 | Medical stapling device |
| US890,682 | 1986-07-25 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1169733A true CA1169733A (en) | 1984-06-26 |
Family
ID=27166100
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000432957A Expired CA1169733A (en) | 1978-03-27 | 1983-07-21 | Medical stapling device |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1169733A (en) |
-
1983
- 1983-07-21 CA CA000432957A patent/CA1169733A/en not_active Expired
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| MKEX | Expiry |