US007490749B2
`
`(12) United States Patent
`US 7,490,749 B2
`(10) Patent No.:
`Schall et al.
`(45) Date of Patent:
`*Feb. 17, 2009
`
`(54) SURGICAL STAPLING AND CUTTING
`INSTRUMENT WITH MANUALLY
`RETRACTABLE FIRING MEMBER
`
`(75)
`
`Inventors: Christopher J. Schall, Cincinnati, OH
`(US); Chad P. Boudreaux, Cincinnati,
`OH (US)
`
`4,396,139 A
`4,402,445 A
`4,415,112 A
`4,429,695 A
`4,475,679 A
`4,500,024 A
`
`8/1983 Hall et al.
`9/1983 Green
`11/1983 Green
`2/1984 Green
`10/1984 F1eury, Jr.
`2/1985 DiGiovanni et al.
`
`(73) Assignee: Ethicon Endo-Surgery, Inc., Cincinnati,
`OH (US)
`
`(Continued)
`FOREIGN PATENT DOCUMENTS
`
`( * ) Notice:
`
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 19 days.
`
`CA
`
`2458946 Al
`
`3/2003
`
`This patent is subject to a terminal dis-
`claimer.
`
`(Continued)
`OTHER PUBLICATIONS
`
`(21) Appl.No.: 11/729,355
`
`(22)
`
`Filed:
`
`Mar. 28, 2007
`
`(65)
`
`Prior Publication Data
`
`US 2008/0237298 A1
`
`Oct. 2, 2008
`
`(51)
`
`Int. Cl.
`(2006.01)
`A6IB 17/068
`(52) US. Cl.
`................... 227/176.1; 227/19; 227/180.1;
`606/139; 606/219
`(58) Field of Classification Search ................... 227/19,
`227/1761,175.1,175.2,180.1,178.1; 606/139,
`606/219
`
`See application file for complete search history.
`
`(56)
`
`References Cited
`U.S. PATENT DOCUMENTS
`
`3,490,675 A
`3,551,987 A
`3,643,851 A
`3,662,939 A
`3,717,294 A
`3,819,100 A
`4,331,277 A
`4,383,634 A
`
`l/l970 Green et al.
`l/l97l Wilkinson
`2/1972 Green et al.
`5/1972 Bryan
`2/1973 Green
`6/1974 Noiles et 31.
`5/1982 Green
`5/1983 Green
`
`U.S. Appl. No. ll/729,013, filed Mar. 28, 2007.
`
`(Continued)
`
`Primary ExamineriScott A. Smith
`
`(57)
`
`ABSTRACT
`
`A surgical stapling and severing instrument particularly
`suited to endoscopic procedures incorporates a handle that
`produces separate closing and firing motions to actuate an end
`effector. In particular, the handle produces multiple firing
`strokes in order to reduce the required amount of force
`required to fire (i.e., staple and sever) the end effector. A
`linked transmission reduces the required handle longitudinal
`length, yet achieves a rigid, strong configuration when
`straightened for firing. A traction biased firing mechanism
`avoids binding in driving this straightened linked rack. The
`instrument further has a manually actuatable retraction sys-
`tem that does not require the use of additional springs or other
`mechanisms to generate retraction forces which must be over-
`come when generating the forces necessary to fire the device.
`In various embodiments, the retraction system provides a
`visual indication to the surgeon as to how far firing has pro-
`gressed.
`
`19 Claims, 25 Drawing Sheets
`
`
`
`2X
`
`16
`
`IS 1001
`
`IS 1001
`
`1
`
`

`

`US 7,490,749 B2
`
`Page 2
`
`US. PATENT DOCUMENTS
`
`4,522,327
`4,530,453
`4,566,620
`4,573,622
`4,580,712
`4,610,383
`4,629,107
`4,655,222
`4,671,445
`4,715,520
`4,728,020
`4,754,909
`4,767,044
`4,821,939
`4,869,414
`4,869,415
`4,941,623
`4,944,443
`5,065,929
`5,071,430
`5,129,570
`5,137,198
`5,158,567
`5,211,649
`5,221,036
`5,222,975
`5,258,009
`5,282,806
`5,282,829
`5,304,204
`5,342,395
`5,342,396
`5,350,400
`5,366,479
`5,397,324
`5,425,745
`5,465,895
`5,474,566
`5,478,354
`5,480,089
`5,482,197
`5,484,451
`5,485,947
`5,485,952
`5,487,499
`5,489,058
`5,497,933
`5,503,320
`5,509,596
`5,529,235
`5,535,934
`5,535,935
`5,540,375
`5,547,117
`5,554,169
`5,560,532
`5,562,239
`5,562,241
`5,562,682
`5,564,615
`5,575,799
`5,577,654
`5,580,067
`5,584,425
`5,586,711
`5,588,579
`5,588,580
`5,588,581
`5,597,107
`5,601,224
`5,603,443
`
`>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
`
`6/1985
`7/1985
`1/1986
`3/1986
`4/1986
`9/1986
`12/1986
`4/1987
`6/1987
`12/1987
`3/1988
`7/1988
`8/1988
`4/1989
`9/1989
`9/1989
`7/1990
`7/1990
`11/1991
`12/1991
`7/1992
`8/1992
`10/1992
`5/1993
`6/1993
`6/1993
`11/1993
`2/1994
`2/1994
`4/1994
`8/1994
`8/1994
`9/1994
`11/1994
`3/1995
`6/1995
`11/1995
`12/1995
`12/1995
`1/1996
`1/1996
`1/1996
`1/1996
`1/1996
`1/1996
`2/1996
`3/1996
`4/1996
`4/1996
`6/1996
`7/1996
`7/1996
`7/1996
`8/1996
`9/1996
`10/1996
`10/1996
`10/1996
`10/1996
`10/1996
`11/1996
`11/1996
`12/1996
`12/1996
`12/1996
`12/1996
`12/1996
`12/1996
`1/1997
`2/1997
`2/1997
`
`Korthoff et al.
`Green
`Green et al.
`Green et al.
`Green
`Rothfuss et al.
`Fedotov et al.
`Florez et a1.
`Barker et al.
`Roehr, Jr. et al.
`Green et al.
`Barker et al.
`Green
`Green
`Green et al.
`Fox
`Pruitt
`Oddsen et al.
`Schulze et al.
`de Salis et al.
`Schulze et al.
`Nobis et al.
`Green
`Kohler et al.
`Takase
`Crainich
`Conners
`Haber et al.
`Hermes
`Bregen
`Jarrett et al.
`Cook
`Esposito et al.
`McGarry et a1.
`Carroll et al.
`Green et al.
`Knodel et a1.
`Alesi et al.
`Tovey et a1.
`Blewett
`Green et al.
`Akopov et al.
`Olson et al.
`Fontayne
`Sorrentino et al.
`Plyley et al.
`DeFonzo et al.
`Webster et al.
`Green et al.
`Boiarski et al.
`Boiarski et al.
`Vidal et a1.
`Bolanos et al.
`Hamblin et al.
`Green et al.
`DeFonzo et al.
`Boiarski et al.
`Knodel et a1.
`Oberlin et al.
`Bishop et al.
`Bolanos et al.
`Bishop
`Hamblin et al.
`Savage et al.
`Plyley et al.
`Schnut et al.
`Paul et al.
`Conlon et a1.
`Knodel et a1.
`Bishop et al.
`Clark et a1.
`
`5,605,272
`5,605,273
`5,607,094
`5,624,452
`5,628,446
`5,630,539
`5,630,540
`5,632,432
`5,634,584
`5,636,779
`5,636,780
`5,639,008
`5,645,209
`5,647,526
`5,649,937
`5,651,491
`5,653,373
`5,653,374
`5,655,698
`5,657,921
`5,662,258
`5,662,260
`5,667,527
`5,669,544
`5,673,840
`5,673,841
`5,680,981
`5,680,982
`5,690,269
`5,692,668
`5,697,543
`5,702,408
`5,704,534
`5,706,997
`5,711,472
`5,715,987
`5,716,366
`5,718,359
`5,725,536
`5,725,554
`5,732,871
`5,735,874
`5,743,456
`5,752,644
`5,758,814
`5,762,255
`5,762,256
`5,779,130
`5,779,132
`5,782,397
`5,785,232
`5,794,834
`5,797,536
`5,797,537
`5,797,538
`5,820,009
`5,826,776
`5,836,503
`5,839,639
`5,855,311
`5,865,361
`5,871,135
`5,878,937
`5,894,979
`5,897,562
`5,901,895
`5,911,353
`5,941,442
`5,954,259
`6,010,054
`6,032,849
`6,079,606
`6,083,242
`
`>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
`
`2/1997
`2/1997
`3/1997
`4/1997
`5/1997
`5/1997
`5/1997
`5/1997
`6/1997
`6/1997
`6/1997
`6/1997
`7/1997
`7/1997
`7/1997
`7/1997
`8/1997
`8/1997
`8/1997
`8/1997
`9/1997
`9/1997
`9/1997
`9/1997
`10/1997
`10/1997
`10/1997
`10/1997
`11/1997
`12/1997
`12/1997
`12/1997
`1/1998
`1/1998
`1/1998
`2/1998
`2/1998
`2/1998
`3/1998
`3/1998
`3/1998
`4/1998
`4/1998
`5/1998
`6/1998
`6/1998
`6/1998
`7/1998
`7/1998
`7/1998
`7/1998
`8/1998
`8/1998
`8/1998
`8/1998
`10/1998
`10/1998
`11/1998
`11/1998
`1/1999
`2/1999
`2/1999
`3/1999
`4/1999
`4/1999
`5/1999
`6/1999
`8/1999
`9/1999
`1/2000
`3/2000
`6/2000
`7/2000
`
`Witt et al.
`Hamblin et al.
`Clark et al.
`Yates
`Geiste et a1.
`Plyley et al.
`Blewett
`Schulze et al.
`Okorocha et al.
`Palmer
`Green et al.
`Gallagher et al.
`Green et al.
`Green et al.
`Bito et al.
`Heaton et a1.
`Green et al.
`Young et al.
`Yoon
`Young et al.
`Knodel et a1.
`Yoon
`Cook
`Schulze et al.
`Schulze et al.
`Schulze et al.
`Mililli et a1.
`Schulze et al.
`Bolanos et a1.
`Schulze et al.
`Burdorff
`Wales et al.
`Huitema et al.
`Green et al.
`Bryan
`Kelley et al.
`Yates
`Palmer et al.
`Oberlin et al.
`Simon et al.
`Clark et al.
`Measamer et al.
`Jones et al.
`Bolanos et a1.
`Gallagher et al.
`Chrisman et al.
`Mastri et al.
`Alesi et al.
`Knodel et a1.
`Koukline
`Vidal et a1.
`Hamblin et al.
`Smith et al.
`Oberlin et al.
`Heaton et a1.
`Melling et al.
`Schulze et al.
`Ehrenfels et al.
`Sauer et al.
`Hamblin et al.
`Milliman et al.
`Williamson, IV et al.
`Green et al.
`Powell
`Bolanos et a1.
`Heaton et a1.
`Bolanos et a1.
`Geiste et a1.
`Viola et a1.
`Johnson et a1.
`Mastri et al.
`Milliman et al.
`Cook
`
`2
`
`

`

`US 7,490,749 B2
`
`Page 3
`
`6,086,600 A
`6,102,271 A
`6,109,500 A
`6,117,158 A
`6,155,473 A
`6,171,330 B1
`6,202,914 B1
`6,241,139 B1
`6,250,532 B1
`6,264,086 B1
`6,264,087 B1
`6,273,897 B1
`6,315,184 B1
`6,330,965 B1
`6,387,113 B1
`RE37,814 E
`6,443,973 B1
`6,488,197 B1
`6,491,201 B1
`6,505,768 B2
`6,616,686 B2
`6,619,529 B2
`6,629,988 B2
`6,644,532 B2
`6,669,073 B2
`6,681,978 B2
`6,681,979 B2
`6,695,199 B2
`6,698,643 B2
`6,716,233 B1
`6,755,338 B2
`6,773,438 B1
`6,786,382 B1
`6,805,273 B2
`6,817,508 B1
`6,817,509 B2
`6,830,174 B2
`6,843,403 B2
`RE38,708 E
`6,877,647 B2
`6,905,057 B2
`6,945,444 B2
`6,953,138 B1
`6,953,139 B2
`6,964,363 B2
`6,978,921 B2
`6,978,922 B2
`6,981,628 B2
`6,986,451 B1
`6,988,649 B2
`6,988,650 B2
`7,000,818 B2
`7,000,819 B2
`7,008,435 B2
`7,032,798 B2
`7,032,799 B2
`7,044,352 B2
`7,044,353 B2
`7,055,731 B2
`7,056,330 B2
`7,059,508 B2
`7,070,083 B2
`7,077,856 B2
`7,083,075 B2
`7,090,684 B2
`7,097,089 B2
`7,108,709 B2
`7,111,769 B2
`7,114,642 B2
`7,118,582 B1
`7,128,253 B2
`7,140,527 B2
`7,143,923 B2
`
`7/2000 Kortenbach
`8/2000 Longo et a1.
`8/2000 Alli et a1.
`9/2000 Measamer et a1.
`12/2000 Tompkins et al.
`1/2001 Benchetrit
`3/2001 Geiste et a1.
`6/2001 Milliman et a1.
`6/2001 Green et a1.
`7/2001 McGuckin, Jr.
`7/2001 Whitman
`8/2001 Dalessandro et a1.
`11/2001 Whitman
`12/2001 Milliman et a1.
`5/2002 Hawkins et a1.
`8/2002 Allgeyer
`9/2002 Whitman
`12/2002 Whitman
`12/2002 Whitman
`1/2003 Whitman
`9/2003 Coleman et a1.
`9/2003 Green et a1.
`10/2003 Weadock
`11/2003 Green et a1.
`12/2003 Milliman et a1.
`1/2004 Geiste et a1.
`1/2004 Whitman
`2/2004 Whitman
`3/2004 Whitman
`4/2004 Whitman
`6/2004 Hahnen et a1.
`8/2004 Knodel et a1.
`9/2004 Hoffman
`10/2004 Bilotti et a1.
`11/2004 Racenet et a1.
`11/2004 Geiste et a1.
`12/2004 Hillstead et a1.
`1/2005 Whitman
`3/2005 Bolanos et a1.
`4/2005 Green et a1.
`6/2005 Swayze et a1.
`9/2005 Gresham et a1.
`10/2005 Dworak et a1.
`10/2005 Milliman et a1.
`11/2005 Wales et a1.
`12/2005 Shelton, IV et a1.
`12/2005 Bilotti et a1.
`1/2006 Wales
`1/2006 Mastri et a1.
`1/2006 Shelton, IV et a1.
`1/2006 Schwemberger et al.
`2/2006 Shelton, IV et a1.
`2/2006 Swayze et a1.
`3/2006 Cummins
`4/2006 Whitman et a1.
`4/2006 Viola et a1.
`5/2006 Shelton, IV et a1.
`5/2006 Mastri et a1.
`6/2006 Shelton, IV et a1.
`6/2006 Gayton
`6/2006 Shelton, IV et a1.
`7/2006 Jankowski
`7/2006 Whitman
`8/2006 Swayze et a1.
`8/2006 McGuckin, Jr. et a1.
`8/2006 Marczyk
`9/2006 Cummins
`9/2006 Wales et a1.
`10/2006 Whitman
`10/2006 Wang et a1.
`10/2006 Mastri et a1.
`11/2006 Ehrenfels et a1.
`12/2006 Shelton, IV et a1.
`
`12/2006 Scirica et a1.
`7,143,924 B2
`12/2006 Shelton, IV et a1.
`7,143,925 B2
`7,143,926 B2 * 12/2006 Shelton et a1.
`........... 227/177.1
`7,147,138 B2
`12/2006 Shelton, IV
`7,159,750 B2
`1/2007 Racenet et al.
`7,168,604 B2
`1/2007 Milliman et a1.
`7,188,758 B2
`3/2007 Viola et a1.
`7,210,609 B2
`5/2007 Leiboff et a1.
`7,213,736 B2
`5/2007 Wales et a1.
`7,220,272 B2
`5/2007 Weadock
`7,225,964 B2
`6/2007 Mastri et a1.
`7,238,195 B2
`7/2007 Viola
`7,246,734 B2
`7/2007 Shelton, IV
`7,258,262 B2
`8/2007 Mastri et a1.
`7,303,107 B2
`12/2007 Milliman et a1.
`7,328,828 B2
`2/2008 Ortiz et a1.
`7,354,447 B2
`4/2008 Shelton, IV et a1.
`7,398,908 B2
`7/2008 Holsten et a1.
`2002/0117534 A1
`8/2002 Green et a1.
`2004/0006372 A1
`1/2004 Racenet et a1.
`2004/0094597 A1
`5/2004 Whitman et a1.
`2004/0108357 A1
`6/2004 Milliman et a1.
`2004/0122471 A1
`6/2004 Toby et a1.
`2004/0164123 A1
`8/2004 Racenet et a1.
`2004/0167572 A1
`8/2004 Roth et a1.
`2004/0173659 A1
`9/2004 Green et a1.
`2004/0222268 A1
`11/2004 Bilotti et a1.
`2004/0232201 A1
`11/2004 Wenchell et a1.
`2004/0243151 A1
`12/2004 Demmy et a1.
`2004/0254608 A1
`12/2004 Huitema et a1.
`2005/0023324 A1
`2/2005 Doll et a1.
`2005/0070958 A1
`3/2005 Swayze et a1.
`2005/0072827 A1
`4/2005 Mollenauer
`2005/0103819 A1
`5/2005 Racenet et a1.
`2005/0119669 A1
`6/2005 Demmy
`2005/0125009 A1
`6/2005 Perry et a1.
`2005/0143759 A1
`6/2005 Kelly
`2005/0145671 A1
`7/2005 Viola
`2005/0184121 A1
`8/2005 Heinrich
`2005/0187576 A1
`8/2005 Whitman et a1.
`2005/0189397 A1
`9/2005 Jankowski
`2005/0216055 A1
`9/2005 Scirica et a1.
`2005/0263562 A1
`12/2005 Shelton, IV et a1.
`2005/0263563 A1
`12/2005 Racenet et a1.
`2005/0274768 A1
`12/2005 Cummins et a1.
`2006/0011699 A1
`1/2006 Olson et a1.
`2006/0047307 A1
`3/2006 Ortiz et a1.
`2006/0047308 A1
`3/2006 Ortiz et a1.
`2006/0049229 A1
`3/2006 Milliman et a1.
`2006/0052825 A1
`3/2006 Ransick et a1.
`2006/0060630 A1
`3/2006 Shelton, IV et al.
`2006/0085033 A1
`4/2006 Criscuolo et a1.
`2006/0097026 A1
`5/2006 Shelton, IV
`2006/0100643 A1
`5/2006 Laufer et a1.
`2006/0151567 A1
`7/2006 Roy
`2006/0226196 A1
`10/2006 Hueil et a1.
`2006/0278680 A1
`12/2006 Viola et a1.
`2006/0278681 A1
`12/2006 Viola et a1.
`2006/0289602 A1
`12/2006 Wales et a1.
`2007/0023477 A1
`2/2007 Whitman et a1.
`2007/0034666 A1
`2/2007 Holsten et a1.
`2007/0045379 A1
`3/2007 Shelton, IV
`2007/0073340 A1
`3/2007 Shelton, IV et a1.
`2007/0075114 A1
`4/2007 Shelton, IV et a1.
`2007/0083234 A1
`4/2007 Shelton, IV et a1.
`2007/0084897 A1
`4/2007 Shelton, IV et a1.
`2007/0102452 A1
`5/2007 Shelton, IV et a1.
`2007/0102453 A1
`5/2007 Morgan et a1.
`2007/0102472 A1
`5/2007 Shelton, IV
`2007/0102473 A1
`5/2007 Shelton, IV et a1.
`2007/0102474 A1
`5/2007 Shelton, IV et a1.
`2007/0106317 A1
`5/2007 Shelton, IV et a1.
`2007/0114261 A1
`5/2007 Ortiz et a1.
`
`3
`
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`US 7,490,749 B2
`
`Page 4
`
`2007/0158385 A1
`2007/0170225 A1
`2007/0175949 A1
`2007/0175950 A1
`2007/0175951 A1
`2007/0175952 A1
`2007/0175953 A1
`2007/0175955 A1
`2007/0175956 A1
`2007/0175957 A1
`2007/0175958 A1
`2007/0175959 A1
`2007/0175960 A1
`2007/0175961 A1
`2007/0175962 A1
`2007/0175964 A1
`2007/0179476 A1
`2007/0194079 A1
`2007/0194080 A1
`2007/0194081 A1
`2007/0194082 A1
`2007/0233053 A1
`2007/0262116 A1
`2007/0295780 A1
`2008/0029570 A1
`2008/0029571 A1
`2008/0029572 A1
`2008/0029573 A1
`2008/0029574 A1
`2008/0029575 A1
`2008/0029576 A1
`2008/0029577 A1
`2008/0035701 A1
`2008/0041917 A1
`2008/0078800 A1
`2008/0078801 A1
`2008/0078802 A1
`2008/0078803 A1
`2008/0078804 A1
`2008/0078805 A1
`2008/0078806 A1
`2008/0078807 A1
`2008/0078808 A1
`2008/0082115 A1
`2008/0082124 A1
`2008/0082125 A1
`2008/0082126 A1
`2008/0164296 A1
`2008/0167522 A1
`2008/0167644 A1
`2008/0167670 A1
`2008/0167671 A1
`2008/0167672 A1
`2008/0167736 A1
`2008/0169327 A1
`2008/0169328 A1
`2008/0169329 A1
`2008/0169330 A1
`2008/0169331 A1
`2008/0169332 A1
`2008/0169333 A1
`
`7/2007 Hueil et a1.
`7/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Swayze et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Shelton, IV et al.
`8/2007 Hueil et a1.
`8/2007 Swayze et al.
`8/2007 Hueil et a1.
`8/2007 Morgan et al.
`10/2007 Shelton, IV et al.
`11/2007 Hueil et a1.
`12/2007 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Shelton et al.
`2/2008 Racenet et al.
`2/2008 Racenet et al.
`4/2008 Hess et al.
`4/2008 Shelton et al.
`4/2008 Hess et al.
`4/2008 Shelton et al.
`4/2008 Shelton et al.
`4/2008 Omaits et al.
`4/2008 Omaits et al.
`4/2008 Hess et al.
`4/2008 Hess et al.
`4/2008 Morgan et al.
`4/2008 Hess et al.
`4/2008 Murray et al.
`4/2008 Murray et al.
`7/2008 Shelton et al.
`7/2008 Giordano et al.
`7/2008 Shelton et al.
`7/2008 Shelton et al.
`7/2008 Giordano et al.
`7/2008 Giordano et al.
`7/2008 Swayze et al.
`7/2008 Shelton et al.
`7/2008 Shelton
`7/2008 Shelton et al.
`7/2008 Shelton et al.
`7/2008 Shelton et al.
`7/2008 Shelton et al.
`7/2008 Shelton et al.
`
`FOREIGN PATENT DOCUMENTS
`
`CA
`CA
`DE
`DE
`DE
`DE
`DE
`DE
`EP
`
`2512960 A1
`2514274 A1
`273689 C
`9412228 U
`69328576 T2
`20112837 U1
`20121753 U1
`10314072 A1
`0122046 A1
`
`1/2006
`1/2006
`5/ 1914
`9/1994
`1/2001
`10/2001
`4/2003
`10/2004
`10/1984
`
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`FR
`GB
`GB
`JP
`JP
`JP
`JP
`JP
`JP
`
`0033548 B1
`0639349 A2
`0593920 A1
`0600182 A2
`0630612 B1
`0634144 A1
`0646356 A2
`0646357 A1
`0669104 A1
`0679367 A2
`0392547 B1
`0685204 A1
`0699418 A1
`0702937 A1
`0705571 A1
`0484677 B2
`0541987 B1
`0667119 B1
`0770355 A1
`0503662 B1
`0625335 B1
`0552423 B1
`0592244 B1
`0648476 B1
`0603472 B1
`0878169 A1
`0760230 B1
`0537572 B1
`0552050 B1
`1090592 A1
`1256318 B1
`0908152 B1
`0872213 B1
`1238634 A2
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`1256317 B1
`1728473 A1
`1728475 A2
`1479346 B1
`1484024 Bl
`1300117 B1
`1112936 A
`939929 A
`2336214 A
`6007357 A
`7051273 A
`8033641 A
`8229050 A
`2001286477 A
`2002369820 A
`
`5/1986
`2/1994
`4/1994
`6/1994
`12/1994
`1/1995
`4/1995
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`3/1956
`10/1963
`10/1999
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`4
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`

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`W0
`
`W0
`W0
`W0
`W0
`W0
`W0
`W0
`W0
`
`W0
`
`2005505322 T
`2005103293 A
`2187249 C2
`2225170 C2
`1377053 A1
`1561964 A1
`1722476 A1
`WO 93/08755 A1
`WO 95/18572 A1
`WO 95/29639 A1
`WO 96/35464 A1
`WO 98/30153 A1
`WO 99/12483 A1
`WO 99/15086 A1
`WO 99/34744 A1
`WO 00/57796 A1
`WO 00/64365 A1
`WO 00/72762 A1
`WO 00/72765 A1
`WO 01/05702 A1
`WO 01/10482 A1
`WO 01/62158 A2
`WO 01/62162 A1
`WO 01/62164 A2
`WO 01/91646 A1
`WO 02/17799 A1
`WO 02/19920 A1
`WO 02/30297 A2
`WO 02/32322 A2
`WO 02/43571 A2
`W0 02/067785 A2
`W0 02/098302 A1
`W0 03/000138 A2
`
`W0 03/001329 A2
`W0 03/013363 A1
`W0 03/020106 A2
`W0 03/079909 A3
`W0 03/030743 A2
`W0 03/037193 A1
`W0 03/047436 A3
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`2/2005
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`W0
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`W0
`W0
`W0
`W0
`W0
`W0
`W0
`W0
`W0
`W0
`
`W0 03/063694 A1
`W0 03/077769 A1
`W0 03/082126 A1
`W0 03/088845 A2
`W0 03/090630 A2
`W0 03/094743 A1
`W0 03/094745 A1
`W0 03/094746 A1
`W0 03/094747 A1
`W0 03/101313 A1
`W0 03/105702 A2
`WO 2004/006980 A2
`WO 2004/032754 A2
`WO 2004/032760 A2
`WO 2004/032762 A1
`WO 2004/032763 A2
`WO 2004/047653 A2
`WO 2004/049956 A2
`WO 2004/086987 A1
`WO 2004/096057 A2
`WO 2004/112618 A2
`WO 2004/112652 A2
`WO 2005/027983 A2
`WO 2005/096954 A2
`WO 2005/115251 A2
`WO 2006/044490 A2
`WO 2006/044581 A2
`WO 2006/044810 A2
`WO 2006/083748 A1
`WO 2006/132992 A1
`WO 2007/016290 A2
`
`8/2003
`9/2003
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`3/2005
`10/2005
`12/2005
`4/2006
`4/2006
`4/2006
`8/2006
`12/2006
`2/2007
`
`OTHER PUBLICATIONS
`
`Disclosed Anonymously, “Motor-Driven Surgical Stapler Improve-
`ments ” Research Disclosure Database No 526041 Published' Feb
`'
`2008.,
`'
`’
`'
`C.C. Thompson et al., “Peroral Endoscopic Reduction of Dilated
`'
`'
`lAn t
`' After Roux-en-Y Gastric B assAPos-
`Clamojejuna
`. as “no“.
`.
`.
`.
`,,yp
`'
`s1ble New Option for Patients With Weight Regain, Surg Endosc
`(2006) vol. 20 pp 1744-1748
`’
`'
`'
`
`* cited by examiner
`
`5
`
`

`

`US. Patent
`
`Feb. 17, 2009
`
`Sheet 1 0f 25
`
`US 7,490,749 B2
`
`IG.
`
`1 F
`
`6
`
`

`

`U.S. Patent
`
`Feb.17,2009
`
`Sheet20f25
`
`US 7,490,749 B2
`
`
`
`7
`
`

`

`US. Patent
`
`Feb. 17, 2009
`
`Sheet 3 0f 25
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`US 7,490,749 B2
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`
`
`8
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`

`

`US. Patent
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`Feb. 17, 2009
`
`Sheet 4 0f 25
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`US 7,490,749 B2
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`
`
`9
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`

`

`U.S. Patent
`
`Feb.17,2009
`
`Sheet50f25
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`US 7,490,749 B2
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`Sheet60f25
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`US 7,490,749 B2
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`11
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`

`U.S. Patent
`
`Feb.17,2009
`
`Sheet70f25
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`US 7,490,749 B2
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`

`

`U.S. Patent
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`Feb.17,2009
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`Sheet80f25
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`US 7,490,749 B2
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`US. Patent
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`Feb. 17, 2009
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`Sheet 9 0f 25
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`US 7,490,749 B2
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`US. Patent
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`Feb. 17, 2009
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`US 7,490,749 B2
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`US. Patent
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`US. Patent
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`US 7,490,749 B2
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`US. Patent
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`Feb. 17, 2009
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`

`U.S. Patent
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`Feb.17,2009
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`Sheet250f25
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`US 7,490,749 B2
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`

`

`US 7,490,749 B2
`
`1
`SURGICAL STAPLING AND CUTTING
`INSTRUMENT WITH MANUALLY
`RETRACTABLE FIRING MEMBER
`
`CROSS REFERENCE TO RELATED
`APPLICATIONS
`
`The present application is related to commonly-owned
`US. patent application Ser. No. 11/729,013, to Chad P. Bou-
`dreaux and Christopher J. Schall, filed Mar. 28, 2007, entitled
`“Surgical Stapling and Cutting Instrument With Side
`Mounted Refraction Member”, the disclosure of which is
`hereby incorporated by reference in its entirety.
`
`FIELD OF THE INVENTION
`
`The present invention relates in general to endoscopic sur-
`gical instruments including, but not limited to, surgical sta-
`pler instruments that are capable of applying lines of staples
`to tissue while cutting the tissue between those staple lines
`and, more particularly, to improvements relating to surgical
`stapler instruments and improvements in processes for form-
`ing various components of such surgical stapler instruments
`that have manual retraction capabilities.
`
`BACKGROUND OF THE INVENTION
`
`Endoscopic surgical instruments are often preferred over
`traditional open surgical devices since a smaller incision
`tends to reduce the post-operative recovery time and compli-
`cations. Consequently, significant development has gone into
`a range of endoscopic surgical instruments that are suitable
`for precise placement of a distal end effector at a desired
`surgical site through a cannula of a trocar. These distal end
`effectors engage the tissue in a number of ways to achieve a
`diagnostic or therapeutic effect (e. g., endocutter, grasper, cut-
`ter, staplers, clip applier, access device, drug/gene therapy
`delivery device, and energy device using ultrasound, RF,
`laser, etc.).
`Known surgical staplers include an end effector that simul-
`taneously makes a longitudinal incision in tissue and applies
`lines of staples on opposing sides of the incision. The end
`effector includes a pair of cooperating jaw members that, if
`the instrument is intended for endoscopic or laparoscopic
`applications, are capable of passing through a cannula pas-
`sageway. One of the jaw members receives a staple cartridge
`having at least two laterally spaced rows of staples. The other
`jaw member defines an anvil having staple-forming pockets
`aligned with the rows of staples in the cartridge. The instru-
`ment commonly includes a plurality of reciprocating wedges
`which, when driven distally, pass through openings in the
`staple cartridge and engage drivers supporting the staples to
`effect the firing of the staples toward the anvil.
`An example of a surgical stapler suitable for endoscopic
`applications is described in US. Pat. No. 5,465,895 to Brian
`D. Knodel, Richard P. Nuchols, and Warren P. Williamson,
`IV, which advantageously provides distinct closing and firing
`actions. Thereby, a clinician is able to close the jaw members
`upon tissue to position the tissue prior to firing. Once the
`clinician has determined that the jaw members are properly
`gripping tissue, the clinician can then fire the surgical stapler
`with a single firing stroke, thereby severing and stapling the
`tissue. The simultaneous severing and stapling avoids com-
`plications that may arise when performing such actions
`sequentially with different surgical tools that respectively
`only sever or staple.
`
`2
`
`One specific advantage of being able to close upon tissue
`before firing is that the clinician is able to verify via an
`endoscope that the desired location for the cut has been
`achieved, including that a sufficient amount oftissue has been
`captured between opposing jaws. Otherwise, opposing jaws
`may be drawn too close together, especially pinching at their
`distal ends, and thus not effectively forming closed staples in
`the severed tissue. At the other extreme, an excessive amount
`of clamped tissue may cause binding and an incomplete fir-
`1ng.
`Generally, a single closing stroke followed by a single
`firing stroke is a convenient and efficient way to perform
`severing and stapling. However, in some instances, it would
`be desirable for multiple firing strokes to be required. For
`example, surgeons are able to select a length of staple car-
`tridge for the desired length of cut from a range ofjaw sizes.
`Longer staple cartridges require a longer firing stroke. Thus,
`to effect the firing, a hand-squeezed trigger is required to exert
`a larger force for these longer staple cartridges in order to
`sever more tissue and drive more staples as compared to a
`shorter staple cartridge. It would be desirable for the amount
`offorce to be lower and comparable to shorter cartridges so as
`not to exceed the hand strength of some surgeons. In addition,
`some surgeons, not familiar with the larger staple cartridges,
`may become concerned that binding or other malfunction has
`occurred when an unexpectedly higher force is required.
`One approach for lowering the required force for a firing
`stroke is a ratcheting mechanism that allows a firing trigger to
`be stroked multiple times, as described in US. Pat. Nos.
`5,762,256 and 6,330,965, the disclosures ofwhich are herein
`incorporated by reference. These known surgical stapling
`instruments with multiple-stroke firing mechanisms do not
`have the advantages of a separate closure and firing actions.
`Other ratcheting surgical instruments are disclosed in com-
`monly-owned US. Pat. No. 7,083,075, issuedAug. 1, 2006 to
`Jeffrey S. Swayze, Frederick E. Shelton, IV, Kevin Ross Doll,
`and Douglass B. Hoffman, entitled Multi-Stroke Mechanism
`With Automatic End of Stroke Retraction, which is hereby
`incorporated by reference. Various embodiments disclosed
`therein employ a handle that produces separate closing and
`firing motions to actuate an end effector. In particular, the
`handle is configured to generate the firing force necessary to
`staple and sever the tissue clamped within the end effector
`through multiple actuations of a firing trigger. The device may
`further employ a linked transmission which reduces the
`required handle length, yet achieves a rigid, strong configu-
`ration when straightened for firing. A traction biased firing
`mechanism avoids binding in driving this straightened linked
`rack in cooperation with an anti-backup mechanism, with a
`lockout mechanism that prevents releasing the closure trigger
`during firing. Furthermore, an external indicator gives feed-
`back to the surgeon as to how far firing has progressed, as well
`as providing a manual retraction capability. These embodi-
`ments also generally employ a relatively strong spring to
`automatically retract the cutting member after the end effec-
`tor has been fired. While such designs are extremely effective,
`the use ofthe retraction spring requires additional firing force
`to be generated to overcome the opposing spring force during
`firing. This problem can also be somewhat exacerbated when
`using articulating end effectors. In particular, when an articu-
`lating end effector is employed, a larger return spring must
`generally be employed to retract the articulating firing mem-
`ber. Use of such larger spring further increases the amount of
`firing forces that must be generated to overcome the spring
`force and fire the end effector components.
`Consequently, a significant need exists for a surgical sta-
`pling instrument having a multiple stroke or other type of
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`US 7,490,749 B2
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`3
`firing mechanism that is equipped with a manually actuatable
`retraction mechanism and does not employ an additional
`retraction means such as a spring or the like that generates
`forces that must be overcome during the firing stroke.
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`These and other objects and advantages of the present
`invention shall be made apparent from the accompanying
`drawings and the description thereof.
`
`BRIEF DESCRIPTION OF THE FIGURES
`
`SUMMARY
`
`In one aspect of the invention, there is provided a surgical
`instrument has a handle assembly and an end effector for
`performing a surgical operation. The end effector is operably
`coupled to the handle assembly and may operably support a
`firing member that is movable from a retracted position to a
`fired position in response to a longitudinal firing motion
`applied thereto. The instrument may also include a firing
`drive that is supported by the handle assembly and is config-
`ured to selectively generate the longitudinal firing motion
`upon actuation of a firing trigger operably coupled to the
`handle assembly. A retraction assembly may be supported by
`the handle assembly and interface with the firing drive such
`that manual actuation of the retraction assembly causes the
`firing drive to apply a sole retraction motion which is com-
`municated to the firing member to cause the firing member to
`move from the fired position to the retracted position.
`In another general aspect of various embodiments of the
`present invention there is provided a surgical instrument that
`has a handle assembly that is coupled to an end effector for
`performing a surgical operation. The end effector may oper-
`ably support a firing member that is movable from a retracted
`position to a fired position in response to a longitudinal firing
`motion applied thereto. A linked rack may be operably sup-
`ported by the handle assembly and a firing rod may commu-
`nicate with the linked rack and the end effector for transmit-
`
`ting the firing and retraction motions from the linked rack to
`the end effector. A firing trigger may be operably supported
`by the handle assembly and may be configured to interface
`with the linked rack such that actuation of the firing trigger
`causes the linked rack to apply the firing motion to the firing
`rod. A first gear may be in meshing engagement with the
`linked rack and a retraction lever may be movably supported
`by the handle assembly and may be configured to interface
`with the first gear such that actuation of the retraction lever
`applies the sole retraction motion or force to the first gear
`which thereby transfers the sole retraction motion to the
`linked rack.
`
`In still another general aspect of various embodiments of
`the present invention there is provided a surgical instrument
`that has a handle assembly that is coupled to an end effector.
`The end effector may operably support a firing member that is
`movable from a retracted position to a fired position in
`response to a longitudinal firing motion applied thereto. A
`first linked rack may be operably supported by the handle
`assembly. A firing rod may communicate with the linked rack
`and the end effector for transmitting the firing and retraction
`motions from the linked rack to the end effector. A firing
`trigger may be operably supported by the handle assembly
`and may be configured to selectively interface with the linked
`rack such that actuation of the firing trigger causes the linked
`rack to apply the firing motion to the firing rod. A second gear
`rack may be operably supported by the handle assembly. A
`drive gear may be in meshing engagement with the first linked
`rack and the second gear rack. A retraction lever may be
`movably coupled to the handle assembly and the second gear
`rack such that actuation ofthe retraction lever applies the sole
`retraction motion to the drive gear which thereby transfers the
`sole retraction motion to the linked rack.
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`The accompanying drawings, which are incorporated in
`and constitute a part of this specification, illustrate embodi-
`ments ofthe invention, and, together with the general descrip-
`tion ofthe invention