`5,954,259
`[11] Patent Number:
`(15
`United States Patent
`Viola et al.
`[45] Date of Patent:
`Sep. 21, 1999
`
`
`[54]
`
`[75]
`
`SELF-CONTAINED POWERED SURGICAL
`APPARATUS FOR APPLYING SURGICAL
`FASTENERS
`
`Inventors: Frank J. Viola, Sandy Hook; Daniel E.
`Alesi, Sherman; Dominick L. Mastri,
`Bridgeport; Wayne P. Young, Brewster;
`Richard N. Granger, Huntington;
`Kenneth E. Toso, Wilton, all of Conn.
`
`[73] Assignee: United States Surgical Corporation,
`Norwalk, Conn.
`
`[21] Appl. No.: 08/883,790
`[22]
`Filed:
`Jun. 27, 1997
`
`Related U.S. Application Data
`
`[63] Continuation of application No. 08/319,852, Oct. 7, 1994,
`abandoned, which is a continuation-in-part of application
`No. 08/287,455, Aug. 5, 1994, abandoned.
`6
`
`veseee A61B 17/068
`[SI] Unt. C10 nen
`
`[52] USS. Cle cece 227/176.1; 227/79; 227/178.1;
`227/180.1
`[58] Field of Search 0. 227/176.1, 175.1,
`227/178.1, 180.1, 19
`
`[56]
`
`.
`References Cited
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`.
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`4,705,038 11/1987 Sjostrom et al.
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`6/1990 Stevens .
`.
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`10/1991 Husted .
`5,071,430 12/1991 de Salis et al. .
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`7/1992 Kedem .
`:
`:
`(List continued on next page.)
`
`FOREIGN PATENT DOCUMENTS
`0156774 10/1985
`European Pat. Off.
`.
`0216532
`4/1987 European Pat. Off.
`.
`0536903
`4/1993
`European Pat. Off.
`.
`0539762
`5/1993
`European Pat. Off.
`.
`0552050
`7/1993
`European Pat. Off.
`.
`0593920
`4/1994 European Pat. Off.
`.
`0598579
`5/1994
`EuropeanPat. Off.
`.
`0621006
`10/1994 European Pat. Off.
`.
`2660851
`10/1991
`France.
`2903159
`7/1980 Germany .
`3114135
`10/1982 Germany.
`4213426
`10/1992 Germany.
`51-149985
`5/1975
`Japan .
`659146
`«4/1979 USSR. .
`9308754
`5/1993 WIPO.
`9314706
`8/1993 WIPO.
`
`Primary Examiner—Scott A. Smith
`_
`ABSTRACT
`[57]
`A self-contained powered surgical apparatus for applying
`surgical fasteners to bodytissue is disclosed which includes
`a handle assembly, a gear motor assembly disposed within
`the handle assembly, a power source disposed within the
`handle assembly for energizing the motor assembly, an
`elongated body extendingdistally from the handle assembly,
`a cartridge assembly detachably connected to a distal end
`portion of the elongated body, and an elongated drive shaft
`extending through the elongated body and detachably cou-
`pling the motor assembly to the cartridge assembly.
`
`26 Claims, 9 Drawing Sheets
`
`%
`
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`9 = =~ 4}
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`
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`
`
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`1
`
`IS 1013
`
`1
`
`IS 1013
`
`
`
`5,954,259
`Page 2
`
`U.S. PATENT DOCUMENTS
`
`5,133,713
`5,133,729
`5,170,925
`5,192,292
`5,201,750
`5,207,697
`5,221,279
`5,237,884
`5,249,583
`5,258,007
`
`7/1992
`7/1992
`12/1992
`3/1993
`4/1993
`5/1993
`6/1993
`8/1993
`10/1993
`11/1993
`
`.
`
`Huanget al.
`Sjostrom .
`Maddenetal. .
`Cezanaet al. .
`Hocherlet al. .
`Carusillo etal. .
`Cooketal. .
`Seto.
`Mallaby .
`Spetzleret al. .
`
`5,261,877
`5,268,622
`5,289,963
`5,312,023
`5,318,221
`5,326,013
`5,403,327
`5,433,721
`5,467,911
`5,482,197
`5,485,947
`
`11/1993
`12/1993
`3/1994
`5/1994
`6/1994
`7/1994
`4/1995
`7/1995
`11/1995
`1/1996
`1/1996
`
`Fineetal. .
`Philipp.
`McGarryetal. .
`Green et al. .
`Green etal. .
`Green et al. .
`Thornton et al. ceeeeceereeeee 227/91
`Hoovenet al.
`.
`. 227/19
`
`Tsuruta etal. .
`Green et al. ceeeeeccneereeene 227/19
`Olson eb ale ccc ceeeecereereeees 227/19
`
`2
`
`
`
`Sheet 1 of 9
`
`5,954,259
`
`U.S. Patent
`
`Sep. 21, 1999
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`Fig.1
`
`3
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`
`
`U.S. Patent
`
`Sep. 21, 1999
`
`Sheet 2 of 9
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`5,954,259
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`Sep. 21, 1999
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`5
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`
`U.S. Patent
`
`5,954,259
`
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`
`Sep. 21, 1999
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`Sep. 21, 1999
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`11
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`5,954,259
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`1
`SELF-CONTAINED POWERED SURGICAL
`APPARATUS FOR APPLYING SURGICAL
`FASTENERS
`
`CROSS REFERENCE TO RELATED
`APPLICATIONS
`
`This is a continuation of application Ser. No. 08/319,852
`filed on Oct. 7, 1994 abandoned, which is a continuation-
`in-part of application Ser. No. 08/287,455 filed Aug. 5, 1994
`now abandoned,
`the contents of which are incorporated
`herein byreference.
`
`BACKGROUND
`
`1. Technical Field
`
`This application relates to a surgical apparatus, and morc
`particularly,
`to an apparatus for sequentially applying a
`plurality of surgical fasteners to body tissue and optionally
`incising the fastened tissue.
`2. Background of Related Art
`Surgical deviccs wherein tissucis first grasped or clamped
`between opposing jawstructure and then joined by means of
`surgical fasteners are well knownin the art. In some instru-
`ments a knife is provided to cut the tissue which has been
`joined by the fasteners. The fasteners are typically in the
`form of surgical staples however, two part polymeric fas-
`teners are also utilized.
`
`Instruments for this purpose can comprise two elongated
`members which are respectively used to capture or clamp
`tissue. Typically, one of the members carries a disposable
`cartridge which housesa plurality of staples arranged in at
`least two lateral rows while the other member comprises an
`anvil which defines a surface for forming the staple legs as
`the fasteners are driven from the edge. Generally, the sta-
`pling operation is effected by a pusher whichtravels longi-
`tudinally through the cartridge carrying member, with the
`pusher acting upon the staples to sequentially eject them
`from the cartridge. A knife may travel with the pusher
`between the staple rows to longitudinally cut and/or open the
`stapled tissue between the rowsof staples. Such instruments
`are disclosed in U.S. Pat. No. 3,079,606 to Bobrov,et al and
`US. Pat. No. 3,490,675 to Green.
`A later stapler disclosed in U.S. Pat. No. 3,499,591
`applies a double row of staples on each side of the incision.
`This is accomplished by providing a cartridge assembly in
`which a cam member movesthrough an elongate guide path
`between two sets of staggered staple carrying grooves.
`Staple drive membersare located within the grooves and are
`positioned in such a manner so as to be contacted by the
`longitudinally moving cam to effect ejection of the staples.
`Other examples of such staplers are disclosed in U.S. Pat.
`Nos. 4,429,695 and 5,065,929.
`Each of the instruments described above were designed
`for use in conventional surgical procedures wherein sur-
`geons have direct manual access to the operative site.
`However, in endoscopic or laparoscopic procedures, surgery
`is performed through a small incision or through narrow a
`cannula inserted through small entrance woundsin the skin.
`In order to address the specific needs of endoscopic and/or
`laparoscopic surgical procedures, endoscopic surgical sta-
`pling devices have been developed and are disclosed in U.S.
`Pat. Nos. 5,040,715 and 5,318,221. In general, these instru-
`ments are provided with clamping structure to effect
`approximation of an anvil and a cartridge to secure tissue
`therebetween, and staple firing structure to effect sequential
`ejection ofa plurality of fasteners from the cartridge after the
`tissue has been secured.
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`The instruments discussed above all require some degree
`of manually applied force in order to clamp, fasten and/or
`cut tissue. Surgeons have thus recognized the benefits of
`using self-powered instruments that are actuable with only a
`limited degree of physical force. Self-powered surgical
`instruments have been provided to serve these needs and
`include both gas powered surgical staplers, as shown, for
`example, in U.S. Pat. No. 5,312,023, and electrically pow-
`ered surgical instruments as described in U.S. Pat. Nos.
`4,365,638 and 5,258,007, and European Patent Application
`No. 0 552 050. In general, prior art electrically powered
`surgical instruments have been driven by external power
`sources. The instruments were connected to the power
`sources by conductive cables. Such cables could, however,
`become entangled during a surgical procedure,
`thereby
`complicating the operation. It would therefore be beneficial
`to provide a self-contained powered surgical apparatus for
`applying surgical fasteners to bodytissue. It would also be
`beneficial if such self contained powered apparatus could be
`reloadable.
`
`SUMMARY
`
`The subject application is directed to a self-contained
`powered surgical apparatus for applying surgical fasteners to
`body tissue. The apparatus includes a handle assembly, a
`motor assembly disposed within the handle assembly, a
`power source disposed within the handle assembly for
`energizing the motor assembly, an elongated body extending
`distally from the handle assembly, and a cartridge assembly
`detachably connected to a distal end portion of the elongated
`body.
`The cartridge assembly includes a housing supporting a
`plurality of surgical fasteners, an anvil associated with the
`housing and mounted for movement between an open posi-
`tion and a closed position, an actuation mechanism config-
`ured to translate relative to the housing and the anvil to
`progressively move the anvil from the open position to the
`closed position and to sequentially eject surgical fasteners
`from the housing to be formed against the anvil, and an axial
`drive screw threadably associated with the actuator for
`effectuating the longitudinal translation thereof. The pow-
`ered surgical apparatus further includes an elongated drive
`shaft which extends through the elongated body and couples
`the motor assembly to the axial drive screw of the cartridge
`assembly.
`the handle assembly includes an elongate
`Preferably,
`barrel portion within which the motor assembly is disposed,
`and a depending handle gripping portion within which the
`powersourceis disposed. A trigger mechanism is associated
`with the handle assembly for selectively actuating the motor
`assembly, and a switching mechanismis associated with the
`trigger mechanism for selectively reversing the polarity of
`the motor assembly.
`Preferably, the elongated body andthe cartridge assembly
`can rotate axially with respect to a longitudinal axis of the
`elongated body. Meansare preferably provided for prevent-
`ing such rotation comprising a plurality of recesses formed
`in and circumferentially disposed about a distal portion of
`the handle assembly, and an annular collar which is formed
`of a resilient material and mounted about a proximal end
`portion of the elongated body. The annular collar includes a
`pair of diametrically opposed radially inwardly extending
`protuberances which are dimensioned and configured to
`engage the circumferenfially disposed recesses. When the
`protuberances are engaged in respective recesses, rotation of
`the elongated body with respect to the handle assembly is
`
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`5,954,259
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`3
`prevented. Application of a radially inwardly directed force
`disengages the protuberences trom the recesses to allow
`rotation.
`
`Further features of the powered surgical apparatus of the
`subject application will become more readily apparent to
`those skilled in the art from the following detailed descrip-
`tion of the apparatus taken in conjunction with the drawings.
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`Various embodiments of the surgical apparatus of the
`subject application will be described hereinbelow with ref-
`erence to the drawings wherein:
`FIG. Lis a perspective view of a powered surgical stapling
`apparatus constructed in accordance with a preferred
`embodiment;
`FIG. 2 is a side elevational view in cross-section of the
`
`handle assembly of the powered surgical stapling apparatus
`of FIG. 1;
`FIG. 2a is a perspective view of the elongated body
`portion and the handle assembly with one of the housing
`halves removed to illustrate the motor assembly;
`FIG. 26 is a schematic representation of the switching
`mechanism for selectively controlling the operation of the
`surgical apparatus;
`FIG. 3 is a cross-sectional view taken along line 3—3 of
`FIG. 2 with the rotation collar engaged with the barrel
`portion of the handle assembly;
`FIG. 4 is a cross-sectional view taken along linc 3—3 of
`FIG. 2 with the rotation collar disengaged from the handle
`assembly to allow rotation of the elongated body portion;
`FIG. 5 is an exploded perspective viewof the cartridge
`assembly of the powered surgical apparatus illustrated in
`FIG. 1;
`FIG. 6 is a perspective viewof a distal end portion of the
`drive shaft of the powered surgical apparatus of FIG. 1
`illustrating the coupling arrangement for detachably con-
`necting the cartridge assembly of FIG.5 to the drive shaft;
`FIGS. 7 and 8 are side elevational views in partial
`cross-section of a distal end portion of the instrument body
`illustrating the connection of the carridge assembly of FIG.
`5 to the elongated bodyportion;
`FIG. 9 is a side elevational view in cross-section illus-
`
`trating the cartridge assembly of the surgical apparatus of
`FIG. 1 priorto firing the fasteners;
`FIG. 10 is a side elevational view in cross-section illus-
`trating the cartridge assembly of the surgical apparatus of
`FIG. 1 subsequent to the fasteners being fired; and
`FIG. 11 is a perspective view of the powered surgical
`stapling apparatus of FIG. 1 inscrtcd through a trocar
`cannula.
`
`DETAILED DESCRIPTION OF PREFERRED
`EMBODIMENTS
`
`In the drawings and in the description which follows,the
`term “proximal”, asis traditional, will refer to the end of the
`apparatus which is closest to the operator, while the term
`“distal” will refer to the end of the apparatus which is
`furthest from the operator.
`The present apparatus shall be discussed in terms of both
`endoscopic procedures and apparatus. However, use herein
`of terms such as “endoscopic”, “endoscopically”, and
`“endoscopic portion”, among others, should not be con-
`strued to limit the present invention to an apparatus for use
`only in conjunction with an endoscopic tube. To the
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`contrary, it is believed that the present invention may find
`use in procedures wherein access is limited to a small
`incision including but not limited to arthroscopic and/or
`laparoscopic procedures.
`Referring now to the drawings wherein like reference
`numerals identify similar structural elements of the subject
`invention,
`there is illustrated in FIG. 1 a self-contained
`powered surgical stapler constructed in accordance with a
`preferred embodimentof the subject invention and desig-
`nated generally by reference numeral 10. Surgical stapler 10
`is configured to clamp bodytissue, apply a plurality of
`surgical fasteners to the bodytissue, and form an incision in
`the fastened body tissue during a laparoscopic surgical
`procedure. In brief, surgical stapler 10 includes a handle
`portion 12, an elongale body portion 14 extending distally
`from handle portion 12, and a cartridge assembly 16 detach-
`ably connected to a distal end of bodyportion 14.
`Referring to FIGS. 2 and 2a, the handle portion 12 of
`surgical apparatus 10, composed of two housing halves,
`includes an elongated barrel section 18 and a handle grip-
`ping section 20. A motor assembly 22 having an output shaft
`(not shown) is disposed within the barrel section 18 and
`includes a gear set 24 for reducing the rotational speed ofthe
`output shaft and increasing the torque delivered by the motor
`assembly. Gear set 24 includes a pinion gear 26 which is
`directly driven by the output shaft of motor assembly 22.
`Pinion gear 26 drivesa first set of planetary gears 28 which
`are supported on a carrier 30. ‘The pinion portion of carrier
`30 then drives the second set of planetary gears 34 which in
`turn drives the hub member 36. The ring gear 32 remains
`stationary, acting as a reaction point for planetary gears 28
`and 34. A reception port 38 is formed in hub member36 for
`recciving the proximal cnd 40 of an clongated drive shaft 42.
`Drive shaft 42 extends from hub 36 through the elongate
`body portion 14 of surgical apparatus 10 to the cartridge
`assembly 16. A shaft coupling is provided at the distal end
`of drive shaft 42 for detachably connecting the cartridge
`assembly 16 to the drive shaft 42. This arrangement will be
`discussed in greater detail below with respect to FIG. 6.
`With continued reference to FIGS. 2 and 2a, motor
`assembly 22 is energized bya pair of powercells 45a and
`45b which are disposed within the handle gripping scction
`20 of handle portion 12. As shown, handle portion 12
`extends substantially perpendicular to the barrel portion 18.
`The powercells 45a, 456 can be lithium,alkaline, or nickel
`cadmium type bathes. A trigger 44 projects from gripping
`section 20 for controlling the operation of motor assembly
`22. Preferably, trigger 44 is connected to a switching assem-
`bly 46 by a link bar 48. The switching assemblyis preferably
`a double-pole-double-throw (DPDT) switch and is electri-
`cally connected to motor assembly 22. Preferably, the switch
`includesa first position corresponding to the output shaft of
`the motor assembly rotating in a first direction, a second
`position corresponding to the output shaft rotating in a
`second direction, aod a third position wherein the motor
`assemblyis not in operation. DPDT switching assemblies of
`this type are well known to the those skilled in the art.
`FIG. 2b is a schematic representation of the switching
`mechanism. As shown,terminal T3 is wired to terminal A of
`the motor and terminal T4 is wired to terminal B of the
`
`motor. The positive terminal of the power cell 45a is
`connected to positive terminal T5 and the negative terminal
`of the powercell 455 is connected to negative terminal T6.
`When link bar 48 is moved proximally upon squeezing
`trigger 44, the two middle terminals T3, T4 connect to the
`respective rear terminals T5, T6. Thus, terminal A of the
`motor will be connected to the positive terminal of the
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`5
`rotational motion from the drive shaft 42 to the drive screw
`switch and terminal B of the motor will be connected to the
`negative terminal of the switch, thereby rotating the motor
`78 will be discussed in greater detail below.
`shaft in a first direction to drive shaft 42 inafirst direction
`Housing channel 80 includes opposcd side walls 80a and
`805, and a floor 80c. An aperture 82 is defined in floor 80c
`adjacent
`the proximal end of channel 80 for receiving
`fastener 75. Opposed apertures 83a and 83b are defined in
`the side walls 80a and 80b of housing channel 80 for
`receiving a pair of outwardly extending flanges 84a and 84b
`which are formed adjacent the proximal end of anvil mem-
`ber 86 and about which anvil member 86 pivots between
`closed and open positions to capture and release bodytissue.
`A pair of spring members 85a and 85b are disposed within
`apertures 83a and 835 for biasing anvil 86 into an open
`position. Opposed engagement notches 88a and 885 are also
`defined in side walls 80a and 805, adjacentthe distal end of
`housing channel 80, for receiving a pair of detents on
`retaining cartridge 90, one of which is shown and designated
`by reference numeral 89. The detents are formed monolithi-
`cally with the fastener retaining cartridge 90 and secure the
`cartridge within a distal portion of the housing channel 80.
`With continuing reference to FIG. 5, cartridge assembly
`16 includes an elongate actuation beam 100 for progres-
`sively moving anvil member 86 from an open position to a
`closed position with respect to retainer cartridge 90, and for
`concomitantly effecting the sequential ejection of a plurality
`of surgical fasteners from retainer cartridge 90. Actuation
`beam 100 is driven by the axial drive screw 78 which, as
`noted above, is driven by drive shaft 42. An actuation sled
`120 is configured to translate through fastener retainer
`cartridge 90 to effectuate the ejection of surgical fasteners
`therefrom. Actuation sled 120 includes a base portion 122,
`a plurality of spaced apart upstanding cam plates 124, and a
`central drive plate 125. Each cam plate 124 has an angled
`cam surface for sequentially engaging a plurality of staple
`drivers (not shown) which drive surgical fasteners from
`retainer cartridge 90 through body tissue and into engage-
`ment with anvil depressions formed in anvil member 86. The
`leading edge 100a of actuation beam 100 engages drive
`plate 125 to drive actuation sled 120 through retainer
`cartridge 90. A cutting blade 130 is mounted on actuation
`beam 100 adjacent leading edge 100a and is configured to
`translate through cartridge assembly 16, trailing behind sled
`120, to form an incision in stapled body tissuc.
`A stationary support mount 92 is disposed within car-
`tridge assembly 16 to both guide the longitudinal translation
`of actuation beam 100, and support the distal end 78a of
`axial drive screw 78. The proximal end 78b of drive screw
`78 engages coupling 76 which,as noted above, is connected
`to drive shaft 42 via coupling 140. A follower nut 94 is
`thredably associated with drive screw 78 and is mounted
`within a follower housing 95.
`Follower housing 95 is mounted in such a manner so as
`to translate in a longitudinal direction in response to axial
`rotation of drive screw 78. Proximal clongate bcam exten-
`sions 96 and 98 of actuation beam 100 operatively connect
`actuation beam 100 to follower housing 95 so that
`the
`actuation beam 100 translates distally with the follower
`housing.
`A distal end of actuation beam 100 includes a retention
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`60
`
`to fire the fasteners. If it is desired at any time to stop firing,
`the trigger 44 is released to disconnect terminals T3, T4 from
`TS, T6. If it is desired to unclamp the tissue after the firing
`stroke has begun, triggcr 44 is pulled distally so that the
`middle terminals T3 and T4 connect to front terminals T1,
`T2. Thus, terminal A of the motor will be connected to the
`negative terminal of the switch and terminal B will be
`connected to the positive terminal of the switch thereby
`reversing the direction of the motor and drive shaft.
`Referring to FIGS. 3 and 4 in conjunction with FIGS. 2
`and 2a, powered surgical apparatus 10 includes a rotator
`mechanism 50 for enabling axial rotation of the body portion
`14 relative to the handle portion 12 to increase the operative
`range of the instrument Rotator mechanism 50 includes an
`annular collar 52 formed of a resilient material and con-
`
`nected to the proximal end of body portion 14 by a threaded
`fastener 51. A pair of diametrically opposed protuberances
`56a and 56b extend radially inwardly from the inner surface
`52a of collar 52 for selectively engaging a plurality of
`correspondingly configured recesses 58 defined about the
`circumference of the distal end portion of barrel section 18.
`When the protubcrances 56a, 56b cngage recesses 58 of
`barrel portion 58, collar 52 is locked in position and body
`portion 14 cannot rotate. Thus the body portion 14 will
`remain fixed as the drive shaft 42 extending therethrough
`rotates during a fastener applying operation.
`A pair of diametrically opposed disengagement pads 60a
`and 60b are provided on an outer surface 525 of collar 52,
`90° out of phase from the protuberances to release the
`protuberancesto allow rotation of collar 52. Thusto axially
`rotate body portion 14 relative to handle portion 12, a
`radially inwardly directed force is applied to pads 60a and
`605,as illustrated in FIG. 4, causing portions 53a, 535 of the
`resilient collar 52 to flex radially outwardly. This flexure
`disengages protuberances 56a and 566 from corresponding
`recesses 58a and 58b. This frees collar 52 for rotation,
`thereby allowing bodyportion 14to be rotated relative to the
`handle portion 12 to orient cartridge assembly 16 to a
`desired position.
`Turning now to cartridge assembly 16, and referring to
`FIG. 5, cartridge assembly 16 is configured as a separate unit
`whichis detachably connected to the distal end of elongated
`body portion 14. This enables the apparatus to be reloaded
`with a fresh cartridge for additional application of rows of
`fasteners. The detachability feature also enables the instru-
`ment to be manufactured as a semi-reusable instrument, if
`desired, wherein the handle portion 12 and elongate body
`portion 14 are resterilized and the cartridge assembly dis-
`carded after use.
`It
`is also contemplated that
`the entire
`apparatus could be disposable.
`Cartridge asscmbly 16 includes two main structural
`portions, a cartridge adaptor 70 and an elongated housing
`channel 80. They are mounted to one another by a threaded
`fastener 75.
`
`Adapter 70 includes a mounting portion 72 at its proximal
`end dimensioned for reception within the distal end of
`elongated body portion 14. An axial bore 74 extends through
`mounting portion 72 for rotatably supporting a cylindrical
`cartridge coupling 76. Cartridge coupling 76 is configured to
`connectat its distal end to the proximal end of an axial drive
`screw 78. Coupling 76 is detachably connected at its proxi-
`mal end to a shaft coupling 140 which is connected to the
`distal end of drive shaft 42. This coupling which transmits
`
`flange 102 for supporting a generally cylindrical cam roller
`104 and an engagementslot 106 for retaining a substantially
`planar cam beam 108. Cam roller 104 engagesandtranslates
`relative to an upper clamming surface 110 of anvil member
`86 to effect
`the progressive closure thereof as follower
`housing 95 and actuation beam 100 translate through hous-
`ing channel80to fire the fasteners. Cam beam 108 engages
`
`65
`
`14
`
`14
`
`
`
`5,954,259
`
`7
`and translates relative to the outer surface of the floor 80c of
`housing channel 80 to balance the forces exerted upon anvil
`member 86 by cam roller 104 during closure. A longitudinal
`slot 112 is defined in the floor 80c of housing channel 80 and
`a corresponding, longitudinal slot 114 is defined in anvil
`member 86 to accommodate the longitudinal translation of
`actuation beam 100. A transverse slot 114a is defined at the
`distal end of anvil slot 114 to receive camroller 104 at the
`end of its translation, and thereby permit anvil member 86
`to return to an open position underthe bias of spring 85a and
`85b following a fastening operation. Thus, the body tissue is
`automatically unclamped as soon asall the fasteners have
`been fired.
`
`Referring now to FIGS. 6-9, as noted hereinabove, the
`cartridge assembly 16 of surgical apparatus 10 is configured
`as a separate unit which is detachably mountedto the distal
`end of body portion 14 via a bayonet coupling. In addition,
`as noted above, axial drive screw78 is detachably connected
`to drive shaft 42 through cartridge coupling 76 and shaft
`coupling 140. As best seen in 'IG. 6, shaft coupling 140 is
`slidably supported in a cavity 142 formed in the distal end
`of drive shaft 42. A transverse slot 144 is formed in the distal
`
`end of coupling 140 for engaging a corresponding teeth 145
`extending from the proximal end ofcartridge coupling 76
`(see also FIG. 5). A pin 146, which is supported in opposed
`shaft slots 148a@ and 148b and extends through openings 141
`in shaft coupling 140, maintains shaft coupling 140 in cavity
`142 and permits the longitudinal translation of shaft cou-
`pling 140 against the bias of a coupling spring 150. The
`function of coupling spring 150 is two-fold. Firstly, if slot
`144 of coupling 140 and teeth 145 of coupling 76 are not
`aligned whencartridge assembly 16 is insertedinto the distal
`end of bodyportion 14, coupling spring 150 will compensate
`for the misalignment and facilitate engagement of the cou-
`plings uponinitial rotation of drive shaft 42. This occurs by
`initial compression of the spring 150 as teeth 145 abut
`surface 143 of coupling 140. When drive shaft 42 initially
`rotates and slot 144 becomesaligned with teeth 145,
`the
`spring 150 forces coupling 140 distally so slot 144 engages
`teeth 145. The second function of coupling spring 150, as
`best seen in FIGS. 7 and8, is to bias cartridge adaptor 70 in
`a distal direction when the bayonct coupling which main-
`tains cartridge assembly 16 in body portion 14 is engaged.
`The bayonet coupling includes a generally J-shaped engage-
`mentslot 156 formed in body portion 14 and corresponding
`engagement pins 158a@ and 158b which extend radially
`outwardly from cartridge adaptor 70 (see also FIG. 5).
`During attachmentof the cartridge assembly 16, the proxi-
`mal end of cartridge adaptor 70 is axially inserted into the
`distal end of body portion 14 (compressing spring 150) and
`is rotated approximately 20° to engage pins 158a and 158b
`in corresponding slots 156a and 156b (see FIG. 1). At such
`a time, coupling spring 150 urges shaft coupling 140 and
`adaptor 70 distally to maintain pins 158a@ and 1585 in an
`engaged position within slots 156a¢ and 156b.
`Referring to FIGS. 9-11, in operation, the apparatus is
`inserted through a trocar cannula 200 to access the surgical
`site. When bodytissue is captured between anvil member 86
`and retainer cartridge 90, trigger 44 is depressed to actuate
`motor assembly22, and thereby cause gearset 24 to transfer
`rolalional motion to drive shaft 42, which, in turn, transfers
`rotational motion to axial drive screw 78 through couplings
`76 and 140. At such a time, follower housing 95 translates
`io a longitudinal direction, driving actuation beam 100
`distally. As actuation beam 100translates distally, cam roller
`104 progressively moves anvil member 86 from the nor-
`mally biased open position shown in FIG. 9, to the closed
`
`5
`
`10
`
`15
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`8
`clamped position illustrated in FIG. 10. Concomitantly,
`actuation sled 120 is driven from the proximal position
`illustrated in FIG. 9, through retention cartridge 90, to the
`distal-most position shown in FIG. 10, sequentially driving
`surgical fasteners through bodytissue 160. When camroller
`104 reaches the distal end of longitudinal slot 114,it drops
`into transverse slot 1144, permitting anvil 86 to return to an
`open position and release the stapled bodytissue 160. Atthe
`conclusion of the fastener applying operation, cartridge
`assembly 16 is manipulated in such a manner so as to
`disengage pins 158a@ and 158from slots 156a and 156h,
`and detach carridge adaptor 70 from body portion 14.
`Thereafter, a new cartridge assembly containing a plurality
`of surgical fasteners and a staple firing sled disposed in a
`proximal position may be mounted to the apparatus in the
`same manner as described above for another stapling pro-
`cedure.
`
`Although the subject apparatus has been described with
`respect to preferred embodiments, it will be readily apparent
`to those having ordinary skill in the art to whichit appertains
`that changes and modifications may be made thereto without
`departing from the spirit or scope of the appended claims.
`Whatis claimed is:
`1. Aself-contained powered surgical apparatus for apply-
`ing surgical fasteners to body tissue comprising:
`a) a handle assembly;
`b) a motor assemblydisposed within the handle assembly;
`c) a powersource disposed within the handle assembly for
`energizing the motor assembly;
`d) an elongated body extending distally from the handle
`assembly;
`e) a cartridge assembly detachably connected to a distal
`end portion of the elongated body and including:
`1) a housing supporting a plurality of surgical fasteners;
`ii) an anvil associated with the housing and mounted
`for movement betweenan openposition and a closed
`position;
`iii) an actuation mechanism configured to translate
`relative to the housing and the anvil to progressively
`move the anvil from the open position to the closed
`position and to sequentially eject surgical fasteners
`from the housing to be formed against the anvil;
`iv) an axial drive screw threadably associated with the
`actuation mechanism for effectuating the translation
`thereof; and
`an elongated drive shatt extending through the elon-
`gated body and detachably coupling the axial drive
`screw of the cartridge assembly to the motor assembly.
`2. A powered surgical apparatus as recited in claim 1,
`wherein the handl