5,954,259
`[11] Patent Number:
`[19]
`United States Patent
`
`Viola et al.
`[45] Date of Patent:
`Sep. 21, 1999
`
`U5005954259A
`
`[54] SELF-CONTAINED POWERED SURGICAL
`APPARATUS FOR APPLYING SURGICAL
`FASTENERS
`
`[75]
`
`-
`.
`-
`.
`Inventors. Frank J. Viola, Sandy Ilook, Daniel. E.
`Ales1, Sherman, Dominick L. Mastri,
`Bridgeport; Wayne P. Young, Brewster;
`RiChaFd N- Grangeh Huntington;
`Kenneth E. T0s0, Wilton, all of Conn.
`
`[73] Assignee: United States Surgical C0rp0rati0n,
`Norwalk, Conn.
`
`[21] APPl- NO-i 084333390
`
`[22]
`
`Filed:
`
`Jun- 271 1997
`
`Related US. 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.
`5
`
`Int. Cl.
`[51]
`[52] U.S. Cl.
`
`................................................... A61B 17/068
`..................... 227/176.1; 2.27/79; 227/178.1;
`227/180. 1
`[58] Field of Search .............................. 227/176.1, 175.1,
`227/178 1 180 1 19
`
`[56]
`
`.
`References C‘ted
`
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`11/1971 Bryan .
`.
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`6/1974 Green et al.
`.
`3,952,748
`4/1976 Kaliher et a1.
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`11/1984 Sitte et al.
`.
`4,489,724 12/1984 Arnegger .
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`1/1985 HOtta -
`495207817
`6/1985 Green ~
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`4,610,383
`9/1986 Rothfuss et al.
`4,644,952
`2/1987 Patipa et al.
`.
`4,650,460
`3/1987 Roizenblatt.
`4,655,673
`4/1987 Hawkes .
`
`.
`
`.
`
`.
`.
`
`.
`
`.
`
`4,705,038 11/1987 Sjostrom et al.
`4,733,118
`3/1988 Mihalko ~
`4,771,774
`9/1988 Simpson et al.
`4,784,137 11/1988 Kulik et al.
`.
`4,867,158
`9/1989 Sugg .
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`12/1989 Muller .
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`6/1990 Stevens
`.
`4,995,877
`2/1991 Ams et £11.
`5,040,715
`8/1991 Green et al.
`5,059,203
`10/1991 Husted ,
`5,071,430 12/1991 de Salis et al.
`5,133,359
`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 European Pat. Off.
`0621006
`10/1994
`Euro ean Pat. Off.
`2660851
`10/1991
`FranEe .
`2903159
`7/1980 Germany .
`3114135
`10/1982 Germany .
`4213426
`10/1992 Germany ~
`51—149985
`5/1975
`Japan .
`659146
`4/1979 U.S.S.R..
`9308754
`5/1993 WIPO.
`9314706
`8/1993 WIPO.
`
`Primary Examiner—Scott A. Smith
`
`[57]
`
`ABSTRACT
`
`A self-contained powered surgical apparatus for applying
`surgical fasteners to body tissue 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 extending distally 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
`
`/4
`
`
`
`
`
`,- v.:‘“_...=__:_...fl«(\IETI
`
`ii“flllflllllllllllflflfllllll MINEE\,
`"iii......-.'
`-..1.....11'.
`77777
`5 III”,—
`:v-1‘-'=\\\\\\E\_-
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`506
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`92
`80
`94
`
`
`
`
`
`
`
`
`
`1
`
`Exhibit 1031
`Intuitive v. Ethicon
`|PR2018—00935
`
`1
`
`Exhibit 1031
`Intuitive v. Ethicon
`IPR2018-00935
`
`

`

`5,954,259
`
`Page 2
`
`US. 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
`4/1 993
`5/1993
`6/1993
`8/1993
`10/1993
`1 1 /1 993
`
`.
`
`.
`Huang et a1.
`Sjostrom .
`Madden et a1.
`Cezana et a1.
`Hocherl et a],
`Carusillo et a1.
`Cook ct a1.
`.
`Seto .
`Mallaby .
`Spetzler et a].
`
`.
`
`.
`
`1
`
`.
`
`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
`
`.
`
`Fine et a1.
`Philipp ,
`McGarry et a1.
`Green et a1.
`.
`GIeen el al.
`.
`Grccn ct a1.
`.
`Thornton et a1.
`Hooven et a].
`Tsuruta et :11.
`G1een et a1,
`Olson ct a1.
`
`.
`
`..
`
`
`227/91
`
`. 227/19
`.
`
`227/19
`.
`
`. 227/19
`.
`
`2
`
`

`

`US. Patent
`
`Sep.21, 1999
`
`Sheet 1 0f9
`
`5,954,259
`
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`
`3
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`US. Patent
`
`Sep.21, 1999
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`
`Sep.21, 1999
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`5,954,259
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`

`5,954,259
`
`1
`SELF-CONTAINED POWERED SURGICAL
`APPARATUS FOR APPLYING SURGICAL
`FASTENERS
`
`CROSS REFERENCE TO RELATED
`APPLICATIONS
`
`m
`
`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 by reference.
`
`BACKGROUND
`
`1. Technical Field
`
`This application relates to a surgical apparatus, and more
`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 devices wherein tissue is first grasped or clamped
`between opposing jaw structure and then joined by means of
`surgical fasteners are well known in 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.
`
`15
`
`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 houses a 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 which travels 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/0r open the
`stapled tissue between the rows of staples. Such instruments
`are disclosed in U.S. Pat. No, 3,079,606 to Bobrov, et al and
`U.S. 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 moves through an elongate guide path
`between two sets of staggered staple carrying grooves.
`Staple drive members are 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 laparoscopie procedures, surgery
`is performed through a small incision or through narrow a
`cannula inserted through small entrance wounds in the skin.
`In order to address the specific needs of endoscopic and/or
`laparoscopie 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 e ect sequential
`
`ejection of a plurality of fasteners from the car ridge after the
`tissue has been secured.
`
`30
`
`InLA
`
`40
`
`45
`
`50
`
`55
`
`6O
`
`65
`
`12
`
`2
`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 body tissue. 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
`power source is disposed. A trigger mechanism is associated
`with the handle assembly for selectively actuating the motor
`assembly, and a switching mechanism is associated with the
`trigger mechanism for selectively reversing the polarity of
`the motor assembly.
`Preferably, the elongated body and the cartridge assembly
`can rotate axially with respect to a longitudinal axis of the
`elongated body. Means are 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
`
`12
`
`

`

`5,954,259
`
`3
`prevented. Application of a radially inwardly directed force
`disengages the protuberences from 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
`
`m
`
`4
`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 embodiment of the subject invention and desig-
`nated generally by reference numeral 10. Surgical stapler 10
`is configured to clamp body tissue, apply a plurality of
`surgical fasteners to the body tissue, and form an incision in
`the fastened body tissue during a laparoscopic surgical
`procedure. In brief, surg'cal stapler 10 includes a handle
`portion 12, an elongate body portion 14 extending distally
`from handle portion 12, and a cartridge assembly 16 detach-
`ably connected to a distal end of body portion 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. Amotor 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 of the
`output sh aft 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 drives a 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 member 36 for
`receiving the proximal end 40 of an elongated 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 by a pair of power cells 45a and
`45b which are disposed within the handle gripping section
`20 of handle portion 12. As shown, handle portion 12
`extends substantially perpendicular to the barrel portion 18.
`The power cells 45a, 45b 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 assembly is preferably
`a double-pole-double-throw (DPDT) switch and is electri-
`cally connected to motor assembly 22. Preferably, the switch
`includes a 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, and a third position wherein the motor
`assembly is not in operation. DPD’I‘ 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 Aof
`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 power cell 45]) 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
`
`15
`
`Various embodiments of the surgical apparatus of the
`subject application will be described hereinbelow with ref—
`erence to the drawings wherein:
`FIG. 1 is 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. 2b 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 line 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 view of the cartridge
`assembly of the powered surgical apparatus illustrated in
`FIG. 1'
`
`30
`
`InLA
`
`FIG. 6 is a perspective view of 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 body portion;
`FIG. 9 is a side elevational view in cross-section illus-
`trating the cartridge assembly of the surgical apparatus of
`FIG. 1 prior to 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. I inserted through a trocar
`cannula.
`
`DETAILED DESCRIPTION OF PREFERRED
`EMBODIMENTS
`
`In the drawings and in the description which follows, the
`term “proximal”, as is 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. I-Iowever, 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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`5,954,259
`
`m
`
`15
`
`5
`switch and terminal B of the motor will be connected to the
`negative terminal of the switch, thereby rotating the motor
`shaft in a first direction to drive shaft 42 in a first direction
`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
`T5, T6. If it is desired to unclamp the tissue after the firing
`stroke has begun, trigger 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 protuberances 56a, 56b engage 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.
`Apair of diametrically opposed disengagement pads 60a
`and 601) are provided on an outer surface 52b of collar 52,
`90° out of phase from the protuberances to release the
`protuberances to allow rotation of collar 52. Thus to axially
`rotate body portion 14 relative to handle portion 12, a
`radially inwardly directed force is applied to pads 60a and
`601), as illustrated in FIG. 4, causing portions 53a, 53b of the
`resilient collar 52 to flex radially outwardly. This flexure
`disengages protuberances 56a and 56b from corresponding
`recesses 58a and 58b. This frees collar 52 for rotation,
`thereby allowing body portion 14 to 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
`which is 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 assembly 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.
`
`30
`
`InLA
`
`40
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`45
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`50
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`55
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`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
`connect at 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
`
`6O
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`65
`
`14
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`6
`rotational motion from the drive shaft 42 to the drive screw
`78 will be discussed in greater detail below.
`Housing channel 80 includes opposed side walls 800 and
`80b, and a floor 800. 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 8417
`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 body tissue.
`Apair of spring members 850 and 85b are disposed within
`apertures 83a and 83b for biasing anvil 86 into an open
`position. Opposed engagement notches 88a and 88b are also
`defined in side walls 80a and 80b, adjacent the 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 1000 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 tissue.
`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 780 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 elongate beam 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
`flange 102 for supporting a generally cylindrical cam roller
`104 and an engagement slot 106 for retaining a substantially
`planar cam beam 108. Cam roller [04 engages and translates
`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 channel 80 to fire the fasteners. Cam beam 108 engages
`
`14
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`

`

`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 [04 during closure. A longitudinal
`slot 112 is defined in the floor 800 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 cam roller 104 at the
`end of its translation, and thereby permit anvil member 86
`to return to an open position under the bias of spring 850 and
`85b following a fastening operation. Thus, the body tissue is
`automatically unclamped as soon as all the fasteners have
`been fired.
`
`(A
`
`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 body tissue 160. When cam roller
`104 reaches the distal end of longitudinal slot 114, it drops
`into transverse slot 114a, permitting anvil 86 to return to an
`open position and release the stapled body tissue 160. At the
`conclusion of the fastener applying operation, cartridge
`assembly 16 is manipulated in such a manner so as to
`disengage pins 158a and 15813 from slots 156a and 156b,
`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 which it appertains
`that changes and modifications may be made thereto Without
`departing from the spirit or scope of the appended claims.
`What is claimed is:
`1. A self-contained powered surgical apparatus for apply-
`ing surgical fasteners to body tissue comprising:
`a) a handle assembly;
`b) a motor assembly disposed within the handle assembly;
`c) a power source 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:
`i) a housing supporting a plurality of surgical fasteners;
`ii) an anvil associated with the housing and mounted
`for movement between an open position 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
`f) an elongated drive shaft 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 handle assembly includes an elongate barrel
`portion within which the motor assembly is disposed, and a
`depending handle gripping portion within which the power
`source is disposed.
`3. A powered surgical apparatus as recited in claim 1,
`further comprising a trigger mechanism associated with the
`handle assembly for selectively actuating the motor assem-
`bly.
`4. A powered surgical apparatus as recited in claim 3,
`further comprising a switching mechanism associated with
`the trigger mechanism for selectively reversing the polarity
`of the motor assembly.
`5. A powered surgical apparatus as recited in claim 4,
`wherein the elongated body and cartridge assembly are
`rotatable with respect to the handle assembly.
`6. A powered surgical apparatus as recited in claim 1,
`further comprising means for preventing rotation of the
`elongated body and the cartridge assembly.
`
`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 mounted to the distal
`end of body portion 14 via a bayonet coupling. In addition,
`as noted above, axial drive screw 78 is detachably connected
`to drive shaft 42 through cartridge coupling 76 and shaft
`coupling 140. As best seen in FIG. 6, shaft coupling 140 is -
`slidably supported in a cavity 142 formed in the distal end
`of drive shaft 42. Atransverse slot 144 is formed in the distal
`end of coupling 140 for engaging a corresponding teeth 145
`extending from the proximal end of cartridge coupling 76
`(see also FIG. 5). Apin 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 when cartridge assembly 16 is inserted into the distal
`end of body portion 14, coupling spring 150 will compensate
`for the misalignment and facilitate engagement of the cou-
`plings upon initial 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 becomes aligned 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 and 8, is to bias cartridge adaptor 70 in
`a distal direction when the bayonet coupling which main-
`tains cartridge assembly 16 in body portion 14 is engaged.
`The bayonet coupling includes a generally J—shaped engage—
`ment slot 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 a