United States Patent (19)
`Krumme et al.
`
`Patent Number:
`11)
`45) Date of Patent:
`
`4,550,870
`Nov. 5, 1985
`
`54 STAPLING DEVICE
`75 Inventors: John F. Krumme, Woodside; Darel E.
`Hodgson, Palo Alto, both of Calif.
`73) Assignee: Alchemia Ltd. Partnership, Palo
`Alto, Calif.
`21 Appl. No.: 541,546
`22 Filed:
`Oct. 13, 1983
`
`4.
`
`Primary Examiner-Paul A. Bell
`Attorney, Agent, or Firm-Howard L. Rose
`57
`ABSTRACT
`A stapling device utilizes heat recoverable material (the
`driver) having shape memory to drive staples through
`materials to be joined and in one embodiment, against
`an anvil for crimping the ends of the staples. The heat
`recoverable material, preferably a metal such as Nitinol,
`may have heat applied by a heater mounted on at least
`8 & 8 0 88 iii/19 AE one surface thereof or by induction or other method of
`& w8 & & 4
`is sw a
`s
`asses 88 as a sess so
`so us
`heating. If a heater is mounted on a surface of the
`las' s
`says
`227/DIG. 1; 227/120; 5% 2.156 driver, upon insertion of the driver into the staple de
`s
`(58) Field of Search ....................... 128/334 R, 33 C;
`vice, the heater makes electrical connection with termi
`227/DIG. 1, 19, 156, 120, 129
`mals for connection to a supply circuit. In a specific
`References Cited
`embodiment staples may be provided, fabricated from
`heat recoveralbe metal so that each staple may carry its
`U.S. PATENT DOCUMENTS
`own heat recoverable, staple driving element. The sta
`ple tines may have a heat recoverable shape with the
`3,940,935 3/1976 Richardson ........................... 60/528
`3,953,253 4/1976 Clark ................................... 148/13
`ends of the tines directed toward one another so that
`4,006,747 2/1977 Kronethal et al........... 27/2.
`staple closure occures as heat migrates from the staple
`S. 4/1977 Richardson et al. ...............22 ?g
`driving region to the tines thereof. Alternatively, the
`, 109,844 3/1978 Becht ................................
`M
`heat recoverable staple may complete a circuit through
`4,144,057 3/1979 Melton .............................. 75/134 C
`h
`4,179,057 12/1979 Becht et al. ...........................
`the staple upon contact with the anvil, thus heating the
`4,281,785 8/1981 Brooks .........
`... 227/156 X staple. Alternatively, the staples may have a heat recov
`4,304,613 12/1981 Wang et al. .
`... 148/11.5 N ered state with the ends parallel to one another so that
`the application of heat will open the staples and permit
`4,351,466 9/1982 Noiles ............................... 227/19 X
`ready removal.
`FOREIGN PATENT DOCUMENTS
`2703529 3/1978 Fed. Rep. of Germany.
`
`(56)
`
`
`
`21 Claims, 19 Drawing Figures
`
`COOK
`Exhibit 1013-0001
`
`

`

`
`
`U.S. Patent Nov. 5, 1985
`
`Sheet 1 of 3
`
`4,550,870
`
`99 292 99
`
`COOK
`Exhibit 1013-0002
`
`

`

`U.S. Patent Nov. 5, 1985
`
`Sheet 2 of 3
`
`4.550,870
`
`
`
`COOK
`Exhibit 1013-0003
`
`

`

`U.S. Patent Nov. 5, 1985
`
`Sheet 3 of 3
`
`4.550,870
`
`
`
`COOK
`Exhibit 1013-0004
`
`

`

`
`
`1.
`
`STAPLNG DEVICE
`
`O
`
`15
`
`RELATED APPLICATION
`This application is related to copending application
`Ser. No. 277,112, filed on June 25, 1981 by John F.
`Krumme and entitled Shape Memory Surgical Staple
`Apparatus and Method for Use In Surgical Suturing.
`BACKGROUND OF THE INVENTION
`The present invention relates to stapling devices and
`more particularly to surgical stapling devices utilizing a
`heat recoverable element to drive the staples.
`Surgical stapling devices are employed in many sur
`gical procedures in place of conventional suturing pro
`cedures; stapling produces less trauma to tissue than
`suturing. Surgical stapling devices, such as disclosed in
`U.S. Pat. Nos. 3,252,643; 3,692,224; 4,216,891; etc., con
`ventionally employ a pair of parallel elongated jaws
`pivoted so that they may be placed on opposite sides of
`20
`the ends of regions of tissue to be joined. One of the
`jaws carries the staples and the other jaw carries the
`anvil against which the staples are pressed and formed
`after penetrating the tissues to be joined.
`25
`In use, the tissues to be joined are placed side by side
`between the jaws and a knob is turned or other type of
`mechanical actuating mechanism operated to cause a
`lead screw or other type of drive to drive one jaw
`toward the other and clamp the tissues. When the sur
`geon determines that sufficient clamping force has been
`30
`developed on the tissues, the knob is caused to engage a
`bar that in turn engages a staple driving mechanism.
`The mechanism causes the staples to pierce the tissues
`and be pressed against the anvil whereby the ends are
`turned over to retain the staples in the tissue.
`The problems with this mechanism relate to the fact
`that the operation is relatively slow, the force applied to
`hold the tissues is basically controlled wholly by the
`surgeon, and thus may result in damage to the tissue.
`Further, the device is large, cumbersome, and awkward
`to use particularly in tight locations internally of the
`body.
`Although the invention is described as a surgical
`stapling device, it is readily apparent that such a device
`may readily be employed for many different applica
`45
`tions, particularly where it is desirable to clamp and
`then insert numerous staples for purposes of holding,
`i.e., stapling in one operation the line of material that is
`clamped between the jaws. Examples of those uses are
`in construction work applications. The invention is
`described with respect to surgical uses but as indicated,
`is applicable to a wide range of applications.
`SUMMARY OF THE INVENTION
`In accordance with the present invention, a material
`having a mechanical, i.e., shape, memory is employed to
`drive the staples thus eliminating the need for the un
`wieldy and large knob and associated mechanisms and
`their attendant problems found in present day surgical
`stapling devices of the dual-jaw type.
`The material having a shape memory may be a nickel
`titanium alloy of the type disclosed in U.S. Pat. No.
`3,174,851 known by the name "Nitinol." Further details
`of these materials may be found in NASA Publication
`SP 5110 entitled “55-NITINOL - The Alloy with a
`65
`Memory, Its Physical Metallurgy, Properties, and Ap
`plications, C. M. Jackson et al., 1972. Many other mate
`rials having similar characteristics are also known. The
`
`4,550,870
`2
`characteristic of these materials utilized in the present
`invention is the ability of a heat recoverable metallic
`material, after stressing to a non-stable configuration,
`while below a specific transition temperature, to return
`to its pre-stressed configuration when heated above
`such temperature.
`In the present invention, a pair of parallel jaws of the
`same general configuration as in the prior art may be
`clamped together by a coarse, threaded screw, a spring
`clamp or other suitable quick acting clamp. Thereafter,
`an electric heater is energized by a battery, or other
`type of electrical source, to heat the heat recoverable
`metal which may preferably have an "S" or a "C" cross
`sectional shape prior to heating. Upon heating, the ma
`terial, which is located above the base of the generally
`U-shaped staples, straightens out and drives the staples
`through the flesh clamped between the jaws and into
`contact with the anvil. The ends of the staples are
`turned and stapling is completed.
`In one specific embodiment of the invention, a nar
`row, elongated, preferably plastic member has two
`rows of parallel staggered slots. A pair of staple driving
`members, each having a plurality of generally rectangu
`lar fingers extending from a long cross member, each
`has a separate finger located in each of the slots of a
`different one of the rows. A staple may be located as
`desired in the end of any slot below a finger thus estab
`lishing two rows of staples in staggered relationship.
`The plastic member is held in a hollow, generally
`U-shaped jaw having the heat recoverable "S" or "C"
`shaped member disposed between the base of the U
`shaped member and the top of the fingered members or
`in the latter instant, a bar extending over the top of the
`fingered members.
`A metallic thin film or serpentine wire heater is
`formed or disposed on one or both sides of the heat
`recoverable member and provides sufficient heat to the
`heat recoverable member to quickly raise its tempera
`ture above its transition temperature when the heater is
`connected across an appropriate power supply. The
`subsequent recovery of the metal to its straight form
`upon heating, drives the staples through the tissue and
`against the anvil, whereby to form the staple ends to
`hold in the tissue.
`In operation, the surgeon places the tissue to be sta
`pled together, between the jaws of the device, clamps
`the jaws together and throws the switch to the heater.
`Since clamping may be effected by a quick acting mech
`anism of a rigid construction, clamping forces are con
`trolled. Further, the quick acting heater produces rapid
`stapling. The device, due to the elimination of the large
`knob and related operating mechanisms, is conveniently
`smaller than the prior art devices. Thus, the devices of
`the present invention are smaller, less expensive, and
`faster acting than the prior art devices and require far
`less attention from the surgeon, resulting in consistently
`better performance. Significantly, as in the prior art
`devices, the surgeon can proportionally control staple
`movement with the present invention as well as the
`existing units; in the present case by controlling the time
`of the heating interval. Further, the number of staples to
`be inserted may be controlled by movement of the driv
`ing member longitudinally of the body of the device,
`each staple having a separate staple drive for activation
`by the movable elongated driver carrying the heater.
`In one alternative form of the device, each staple is
`made of shape memory metal and has a small S-shaped
`
`35
`
`50
`
`55
`
`COOK
`Exhibit 1013-0005
`
`

`

`15
`
`apparatus.
`
`-
`
`4,550,870
`3
`upper region which when heated, expands and projects
`the staple through the tissue and against the staple end
`shaping anvil. To heat the individual staples, a thin strip
`heater may again be employed. The heater may be pro
`vided with a tacky material along one or both sides to
`hold the staples in a spaced relation corresponding to
`the spacing between the slots in the staple holder. The
`strip may also be brought into contact with an adjacent
`surface such as of the staple holder so that as the 'S' or
`10
`“C” shaped top of the staples expand and extend into
`the slots, the heater is stripped from the staples. The
`length of the expanded end of each staple is sufficiently
`short that it may be left on the staple. If desired, a break
`line may be provided so that the expanded end of the
`staple may be snapped off.
`In still another embodiment of the last-mentioned
`staple, the tines may be provided with a memory shape
`in the closed position. As the shaped upper end of the
`staple is heated, it expands and drives the staple. Con
`20
`currently, the heat applied to the upper end spreads to
`the tines so that after penetration of the tissue, the tines
`become heated above their transition temperature and
`the ends curl and close on one another to complete the
`stapling operation. Alternatively, the staples, upon pass
`25
`ing through the tissue, may complete an electric circuit
`by contacting a base plate, the current passing through
`the staples heating them. The force required to be ex
`erted on the tissues in such a case is somewhat less than
`where stapling is affected by pressing the ends of the
`staples against an anvil with obvious beneficial results.
`In still another embodiment of the invention, the
`staples may have a heat recoverable memory with the
`tines in the parallel position. In such case, the staple,
`once secured, may be readily removed by the applica
`tion of heat which will cause the staples to recover to
`their original shape.
`The heater-heat recoverable member combination
`may be formed by plating or coating a conductor on the
`non-tacky side of a plastic tape, for instance, 3M's Kap
`ton. The conductor (Nickel, Ni-chrome, etc.) high resis
`tivity film is then etched to provide a suitable heater
`wire, preferably serpentine, and ends pads for contact
`with terminals formed in the stapling device. The sticky
`45
`side of the tape in then contacted with the heat recover
`able member which has previously been deformed to its
`desired shape.
`The same heater tape may be employed for the sta
`ples wherein each has its own heat recoverable member.
`The staples are arrayed along the tacky side of the tape
`at intervals corresponding to the intervals between slots
`in the plastic staple holder previously mentioned.
`Heating may also be provided by coating the staples
`with a thin layer of electromagnetic material and induc
`55
`ing eddy currents therein by a varying magnetic field.
`Hot air may also be employed, or in construction work,
`a torch or the like may be employed to provide the
`necessary heat.
`The desirable transition temperature of the heat re
`60
`coverable metal employed for surgical devices is prefer
`ably in the 50 C.-60° C. range (50.0 to 50.2 atomic 26
`Nickel; the rest Titanium) well below the temperature
`of degradation of the mastic employed on the Kaptan
`tape. Other heat recoverable materials or Nitinol mix
`65
`tures may be employed to provide the same or other
`transition temperatures, beta brass and nickel-titanium
`alloys being examples of such materials.
`
`4.
`BRIEF deSCRIPTION OF THE DRAWINGS
`The above and still further objects, features and ad
`vantages of the present invention will become apparent
`upon consideration of the following detailed description
`of one specific embodiment thereof, especially when
`taken in conjunction with the accompanying drawings,
`wherein:
`FIG. 1 is an exploded view of one form of the appara
`tus of the present invention.
`FIG. 2 is a perspective view of the assembled appara
`tus of FIG. 1.
`FIG. 3 is an end view, in cross section of the assem
`bled apparatus of FIG. 2 illustrating the jaws of the
`FIG. 4 is a perspective view of the staple driving
`mechanism.
`FIG. 5 is a perspective view of a modification of the
`housing of the mechanism permitting inclusion of a
`battery therein.
`FIG. 6 is a front view of a modification of the device
`of FIG. 1.
`FIG. 7 is a view in perspective of a part of the appara
`tus of FIG. 6.
`FIG. 8 is a side view of a form of staple.
`FIG. 9 is a view in perspective of the staple in FIG.
`8
`FIG. 10 is an end view in section of an apparatus
`capable of utilizing the staple of FIGS. 8 and 9.
`FIG. 11 is an end view of the apparatus of FIG. 8
`with the heater applied to the staples.
`FIG. 12 is a side view in elevation of the staple-heater
`arrangement of the apparatus of FIG. 11.
`FIG. 13 is a front view in elevation of a modified
`form of the staple in FIGS. 8 and 9.
`FIG. 14 is a side view of a device in which a circuit
`is completed through the staple.
`FIG. 15 is a front view of a staple formed by any one
`of the above mechanisms.
`FIG. 16 is a view in perspective of a four-pronged
`staple that may be employed with the modified staple
`gun of FIG. 17.
`FIG. 17 is a front view of the internal structure of a
`staple gun for use with the staple of FIG. 16.
`FIG. 18 is a drawing of a partially completed colon
`resection procedure employing an end-to-end anos
`tomosis instrument.
`FIG. 19 is a view of such an instrument modified to
`employ Nitinol drivers and/or staples.
`DESCRIPTION OF THE INVENTION
`Referring specifically to FIGS. 1-4, of the accompa
`nying drawings, a stapler 2 comprises a pair of elon
`gated jaws 4 and 6 joined by a pivot pin 5 to permit
`pivoted movement of the jaws relative to one another.
`Upper jaw 4, as viewed in FIGS. 1-4, comprises a
`hollow inverted U-shaped member 10 having inwardly
`directed ridges 12 and 14 extending along the length of
`the inner surfaces of legs 16 and 18 of the member 10.
`A generally rectangular member 20 is adapted to be
`inserted in the member 10 and forms the staple holder of
`the apparatus. Specifically, the member 20 is provided
`with two rows of alternately arranged (staggered) slots
`22 extending through the member 20, vertically as
`viewed in FIGS. 1-3. A staple 24 is located in each slot
`22 with the open end of the staple facing the jaw 6. It
`should be noted that the members 4 and 20 may be made
`of plastic and may be molded as a single piece.
`
`30
`
`35
`
`50
`
`COOK
`Exhibit 1013-0006
`
`

`

`5
`
`10
`
`15
`
`4,550,870
`6
`5
`the battery, heating the member 34 and driving the
`Multifingered members 26 are provided with fingers
`staples.
`28 of a size and spacing between fingers such that the
`In the embodiment of FIG. 5, a quick clamping mech
`fingers are received with little play in the slots 22. One
`anism is employed. Such mechanism comprises a pro
`member is located in each row of slots 22; the number of
`trusion 35 extending forward from lower jaw 6 which is
`fingers on each member being determined by the num
`adapted to be engaged by a loop 39a of spring wire
`ber of staples it is desired to use for a specific applica
`pivoted to the jaw 4. The loop may be rotated down
`t1On.
`ward to a position under protrusion 35 thus establishing
`A shallow inverted U-shaped bar 30 is disposed on
`a fixed spacing between jaws 4 and 6 providing the
`top of the members 26. A guide 32 is located between
`benefits previously indicated.
`the members 26 to maintain alignment of the members
`Referring specifically to FIG. 6 of the accompanying
`during a stapling operation so that when a downward
`drawing, an alternative mechanism is disclosed for se
`force is applied to the bar 30, the fingers 28 are pushed
`lecting the number of staples to be driven. Individual
`against the tops of the staples, the guide 32 preventing
`staple drivers 28' with enlarged head regions 29 are
`binding of members 26.
`provided. A bar 30' is secured to the bottom of the
`Referring now specifically to FIG. 1, the staple acti
`heater 38' and both are slidable in the body member 10.
`vating mechanism is discussed. A heat recoverable
`The S-shaped member 38' is provided with electrical
`member 34 in its stable form is illustrated at numeral 36.
`contacts 40' and 40' (see FIG. 7) on the upper and
`Such member has a generally flat shape defining a thin
`lower surfaces, respectively, of the upper end of the
`vertical member as illustrated at numeral 36. Such mem
`member. These contacts engage contacts 47 and 49,
`20
`ber has a generally flat height somewhat greater than
`respectively, disposed in the body 10 and connected via
`the distance between base 37 of the U-shaped member
`flexible leads 51 to an external source 53. If an internal
`10 and the top of the bar 30 when engaged with the top
`battery source such as source 43 in FIG. 5 is employed,
`of the edges of the member 20.
`-
`then external leads are not required.
`The shape illustrated at numeral 36 is the "memory"
`As a result of such an arrangement, the heater 38
`25
`shape of the device and this is achieved by forming the
`may be adjusted in and out so as to select the number of
`member in the shape 36 and then raising its temperature
`staples in each row to be inserted.
`to the extent necessary to impart memory, i.e., about
`In an alternative form of the invention, each staple 61
`900 F. for one form of Nitino. After the member is
`(of FIGS. 8 and 9) includes its own driving mechanism.
`cooled, it is bent into a desired shape-an 'S' as viewed
`Referring to FIGS. 8-12, each staple includes an S
`30
`at 38 in FIG. 1. The shape may also be a "C" or any
`shaped region 64 terminating in a straight staple region
`other shape that produces large expansion with large
`66. The staple 61 is made out of a heat recoverable metal
`forces. The dimension of the 'S' is such that member 38
`so that when heated, the S-shaped regions straighten
`may be inserted between the base 37 and top of bar 30
`out and the staples are driven through the tissue and the
`as viewed in FIG. 3.
`ends turned over as before.
`A heater 39, which may be a Mylar film heater, is
`Heating may be accomplished again by a strip heater
`disposed along one surface of the member 34 terminat
`68 of FIGS. 11 and 12, having a sticky surface to which
`ing in contacts 40. When the heat recoverable strip 34 is
`the staples 61 adhere. The staples 61 are inserted into
`inserted into the member 10, the contacts 40 engage
`slots 70 in block 72 positioned in inverted U-shaped
`corresponding contacts 42 in the back (pivot end) of the
`member 74 of the upper jaw of the device. The slots 70
`jaw 4. Contact with a battery may be made via a cable
`in the block 72 are tapered as at 73 to accommodate the
`44 containing a switch 46.
`S-shaped part of 64 of the staple 61 as it is heated and
`The lower jaw.6 has slots 48 formed along the outer
`descends downwardly, as viewed in FIGS. 8 and 9, but
`surfaces of the sides thereof to receive the edge ridges
`before it fully straightens out.
`50 of an anvil 52 placed on the lower jaw 6. The anvil
`When the staples are inserted into slots 70, the sticky
`45
`52 is formed with conventional staple closing depres
`surface of the heater 68 extends into contact with the
`sions 54 each located under a staple containing slot 22 in
`upper surface of the block 72 so that it is peeled off of
`the jaw 4.
`the staples as they extend more deeply into the slots 70.
`The upper jaw 4 is also provided with a clamping
`When the staples are fully extended, the device is
`opened and the upper jaw pulled up so that the staples
`screw 56 which is used to hold the jaws 4 and 6 together
`during use of the device. Specifically, in use, the tissues
`are pulled out of the slots 70 and the heater strip 68 is
`fully disengaged from the staples.
`to be joined are placed side by side between the jaws 4
`and 6 and the screw 56 which extends through hole 58
`In another alternative form of the staples of FIGS.
`8-12, their shape at time of use is the same as in those
`in member 10 is rotated to thread screw into threaded
`hole 59 in jaw 6 to draw the jaws 4 and 6 together. The
`Figures, but the unstressed shape is as viewed in FIG.
`55
`11 with the tines 66 of the staple in the open position.
`switch 46 is now activated and the element 34 is heated.
`Since the heat is applied initially to the region 64 of ths
`As the transition temperature of the element 38 is ap
`staple, the region 64 straightens first and drives the
`proached, it rapidly attempts to revert to the shape
`staple through the tissue. Thereafter, the heat reaches
`illustrated at 36 in FIG. 1 pushing down with great
`the region of the tines and they resume the shape illus
`force on the bar 30, forcing the staples 24 through the
`trated in FIG. 13; thus the closing action of the staples
`tissue and against the anvil where the ends of the staples
`are turned over to complete the stapling operation.
`is enhanced.
`It should be noted that the specific heat recoverable
`In another embodiment of the invention, illustrated in
`material employed will depend upon many factors such
`FIG. 5, the upper member 4 is provided with a battery
`as desired transition temperatures, mechanical proper
`compartment 41 in which may be seated a battery 43. A
`65
`ties and related matters. Heating may be accomplished
`finger-operated slide switch 45 is provided in a conve
`as indicated by hot air blowers, hot water carrying
`nient location such as the top of the member 4. Upon
`tubing, and other known or to be developed forms of
`closing of switch 45, the heater 39 is connected across
`
`50
`
`35
`
`60
`
`COOK
`Exhibit 1013-0007
`
`

`

`15
`
`35
`
`10
`
`4,550,870
`7
`8
`heat delivering devices. Presently, in addition to the
`The shaft 102 is now moved to the left to clamp both
`Nitinol memory materials, there are such materials as
`tied ends of the colon between anvil 100 and cartridge
`AuCd, FePt3, Beta brass and InTl. Transition tempera
`108 which carries several rows of staples. The cartridge
`tures, particularly of the Nitinol materials, may readily
`is now activated to staple the two ends together, a cir
`be selected by control of atomic percentage of the mate
`cular knife is activated cutting away the tissue inwardly
`rials. Transition temperatures may be rnade to range
`of the staples whereby the anvi iOO may be maneu
`from cryogenic temperatures to approximately 150 C.
`vered out of the body.
`Referring now specifically to FIG. 14 of the accom
`Referring now specifically to FIG. 19 of the accom
`panying drawings, there is illustrated an arrangement
`panying drawings, a modification of the standard device
`wherein a driver is employed merely to move the sta
`of FIG. 18 for use in the present invention is shown.
`ples until they touch a base member at which time an
`The anvil 100 is provided with two concentric rows
`electric current is passed through the staples to cause
`of the usual staple turning indentations 110. The car
`them to close. In such an arrangement, no external
`tridge comprises a staple holder 112, a circular form of
`stapling force is required to clinch the staples. Specifi
`the member 20 of FIG. 3. The holder has two rows of
`cally, a driver is provided for the staples. The driver is
`holes aligned along shaft 102 with the indentations 110
`illustrated as a Nitinol driver 80, but it may take the
`of the anvil. The holes receive the staples. Two circular
`form of a prior art driver, i.e., a screw turned by hand as
`drivers 114 and 116 corresponding to the members 26 of
`in the prior art.
`FIG. 1 are provided which contact and are driven by a
`The driver of whatever form presses down on a bar
`circular Nitinol element 118 that is C-shaped in cross
`82 overlying staple drivers 84. A conductive plate 86 is
`20
`section. Upon heating of the element 118, the staples are
`disposed in about the location of the anvil 52 of FIG. 1.
`driven as in the device of FIG. 1. A cutter 120 is also
`A source 88 of electricity is connected between bar 82
`provided which may also be driven by a separately
`and plate 86 such that when a staple is forced through
`excited Nitinol driver.
`tissue or other work piece and contacts plate 86, a cur
`Although the invention has been described in its pre
`rent path is completed through the staple which be
`25
`ferred forms with a certain degree of particularity it is
`comes heated. A staple of the type illustrated in and
`understood that the present disclosure of the preferred
`described with respect to FIG. 13 is employed. Thus,
`forms has been made only by way of example and that
`upon generation of heat, the staple assumes the configu
`numerous changes in the details of construction and the
`ration of FIG. 13, and the stapling operation is com
`plete.
`combination and arrangement of parts may be resorted
`30
`to without departing from the spirit and the scope of the
`If the driver is of the type discussed with respect to
`FIG. 1, then the heater may also be connected across
`invention as hereinafter claimed.
`the source 88.
`What is claimed is:
`Thus far the description has been limited to the in-line
`1. A stapling device including
`stapling devices of one or more rows.
`a first member having staple receiving means for
`In staples employed in the apparatus of the invention,
`carrying staples therein,
`it is desirable that the staple not rotate in the body. Such
`means for driving the staples for causing them to
`rotation would readily result in a number of the staples
`pierce material to be stapled,
`having their opposed ends lying outside, rather than
`said means for driving comprising a driving member
`inside the body, thereby greatly complicating any
`deformed into a partially collapsed shape and upon
`needed removal procedure. The devices thus far de
`application of heat being recoverable to an ex
`scribed herein form a staple of the shape illustrated in
`panded shape,
`FIG. 15.
`said means for driving being located in said first mem
`Another form of staple that may be employed is illus
`ber between said staples and an opposing inner
`trated in FIG. 16 of the accompanying drawings. Such
`45
`surface of said first member and further comprising
`a staple 89 may be driven by a too much like that of
`means for heating said deformed member.
`FIG. 1 wherein the four fingers 90 of the staple are each
`2. A stapling device apparatus comprising:
`driven by a different member 28 (see FIG. 1). The
`a pair of elongated parallel jaws for clamping there
`mechanism for holding the individual staples must be
`between material to be stapled,
`changed and merely comprises a centrally located rod
`one of said jaws having apertures for carrying staples
`92, see FIG. 17, for receiving the staple through hole
`therein and including means for driving the staples
`94, see FIG. 16. Appropriate guide surfaces are pro
`for causing them to pierce material clamped be
`vided as necessary.
`tween the jaws,
`In such a device, the staple, since it grasps the tissue
`said means for driving comprising a deformed and at
`in dual pincers and has a flat member 96 which cannot
`least partially collapsed, member having shape
`penetrate the tissue, cannot rotate and become infected
`memory and being heat recoverable to an ex
`in the tissue.
`panded shape,
`Referring now specifically to FIG. 18, there is illus
`said one jaw defining a region for positioning said
`trated a portion of a colon this is to be resected and the
`deformed member in a staple driving relationship
`tool required to perform the anastomosis. In this draw
`60
`upon heating of said heat recoverable member, and
`ing, the diseased portion of a colon has been removed.
`means for heating said heat recoverable member.
`The end-to-end anastomosis instrument is introduced
`3. The apparatus according to claim 2, wherein said
`into the anus and the anvil 100 is extended beyond the
`end of the colon adjacent the rectum. Previously ap
`deformed member has in the deformed state a curved
`plied purse string 102 is drawn tightly about shaft 104
`shape and in the recovered state a generally flat shape.
`65
`carrying the anvil. The anvil 100 is now inserted into
`4. The apparatus according to claim 3 where said
`the proximal colon. Purse string 106, previously ap
`member is metallic and has in the deformed state the
`plied, is now drawn tight about the stem 102.
`shape of an "S".
`
`50
`
`55
`
`COOK
`Exhibit 1013-0008
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`

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`4,550,870
`10
`9
`12. The apparatus according to claim 2 wherein said
`5. The apparatus according to claim 3 wherein said
`means for heating includes an induction coil.
`member is metallic and has in the deformed state the
`13. The apparatus according to claims 1 or 2 wherein
`shape of a "C".
`one of said jaws carries at least one staple.
`6. The apparatus according to claim 2 wherein said
`14. The apparatus according to claim 13 wherein said
`means for heating comprises an electric heater wire
`deformed member and said staple are separate parts.
`secured to a surface of said deformed member.
`15. The apparatus according to claim 13 wherein said
`7. The apparatus according to claim 6 wherein said
`deformed member and said staple are a unitary part.
`16. The apparatus according to claim 15 wherein said
`one jaw has means for removably receiving said heat
`at least one staple has one or more tines having a shape
`recoverable member.
`memory in an inwardly directed position relative to one
`8. The apparatus according to claim 7 wherein said
`another.
`one jaw has means for making electrical connection to
`17. The device according to claim 13 wherein said
`said electric heater wire when said heat recoverable
`means for heating comprises means for passing an elec
`member is inserted in said jaw.
`tric current through said staple, said staple being in its
`9. The apparatus according to claim 8 wherein said
`deformed state with the tines thereof in the straightened
`heat recoverable means includes means permitting par
`position for passing through said material.
`18. The apparatus according to claim 13 wherein said
`tial insertion thereof in said one jaw whereby to drive
`staple has four tines.
`less than all possible of said staples.
`19. The stapling device of claim 13 wherein said
`10. The apparatus according to claim 2 further com
`20
`means for heating heats said first means.
`prising
`20. The apparatus according to claim 13 wherein said
`means for selectively driving only some of said sta
`pair of elongated parallel jaws are annular in shape and
`ples.
`coaxial.
`11. The apparatus according to claim 10 wherein said
`21. The apparatus accordi