US005865361A
`e
`5,865,361
`(114) Patent Number:
`United States Patent 55
`Millimanet al.
`[45] Date of Patent:
`Feb. 2, 1999
`
`
`[54] SURGICAL STAPLING APPARATUS
`
`[75]
`
`Inventors: Keith L. Milliman, Bethel; Frank J.
`Viola, Sandy Hook; Joseph Orban,
`.
`NowaRandolph F. Lehn,Stratford,
`
`.
`
`:
`:
`:
`.
`[73] Assignee: United States Surgical Corporation,
`Norwalk, Conn.
`
`[21] Appl. No.: 935,980
`
`[22]
`
`Filed:
`
`Sep. 23, 1997
`
`P
`Int, Cdn eee ceeeeeeeeeeseeneeneenees A61B 17/068
`(51)
`[52] U.S. Che veces 227/176.1; 227/19; 227/178.1
`[58] Field of Search... 227/19, 175.1,
`227/176.1, 175.3, 178.1, 179.1
`
`[56]
`
`:
`References Cited
`U.S. PATENT DOCUMENTS
`
`Re. 34,519
`1/1994 Fox et al.
`.
`508 W100 Cobroyefal.
`4,244,372
`1/1981 Kapitanov etal. .
`4,429,695
`2/1984 Green .
`4,520,817
`6/1985 Green.
`4,589,413
`5/1986 Malyshevetal. .
`4,605,001
`8/1986 Rothfuss etal. .
`4,608,981
`9/1986 Rothfuss etal. .
`4,610,383
`9/1986 Rothfuss et al.
`.
`4,633,861
`1/1987 Chowetal. .
`4,633,874
`1/1987 Chowetal. .
`4,672,964
`6/1987 Dee etal. .
`4,763,669
`8/1988 Jaeger.
`4,863,088
`9/1989 Redmondetal. .
`4,880,015
`11/1989 Nierman .
`4,892,244
`1/1990 Fox etal...
`en Ifoot ee
`5.040.715
`e/1091 Green ot al
`5.065.929
`11/1991 Schulze et all
`5074.454 12/1991 Peters .
`.
`5,083,695
`1/1992 Foslien et al.
`.
`5,111,987
`5/1992 Moeinzadehetal. .
`5,129,570
`7/1992 Schulze etal. .
`
`
`
`5,141,144
`8/1992 Foslien et al.
`5,152,279
`10/1992 Wilk .
`5,209,747
`5/1993 Knoepfler.
`oor 5)food om et al.
`3282,
`uadri .
`5,307,976
`5/1994 Olson et al..
`
`.
`
`.
`
`5/1994 Gren etal. .
`5,312,023
`6/1994 Greenet al..
`5,318,221
`7/1994 Greenet al.
`.
`5,326,013
`7/1994 Hassleretal. .
`5,330,302
`7/1994 Robinsonetal. .
`5,332,142
`9/1994 Tacovelli .
`5,350,391
`10/1994 Kambinetal. .
`5,354,311
`5,374,277 12/1994 Hassler.
`5,376,095
`12/1994 Ortiz .
`5,383,888
`1/1995 Zvenyatsky et al.
`5,397,046
`3/1995 Savageet al.
`.
`5,415,334
`5/1995 Williamson,IV etal. .
`5,415,335
`5/1995 Knodel,Jr..
`5,433,721
`7/1995 Hoovenetal. .
`5,465,895
`11/1995 Knodel et al.
`.
`5,467,911
`11/1995 Tsuruta et al.
`.
`5,474,566
`12/1995 Alesiet al.
`.
`
`.
`
`(List continued on next page.)
`FOREIGN PATENT DOCUMENTS
`0 484 677.
`5/1992 European Pat. Off.
`0 589 306
`3/1994 European Pat. Off.
`0 591946
`4/1994 European Pat. Off.
`0 592 243.
`4/1994 European Pat. Off.
`0 656 188
`6/1994 European Pat. Off.
`0 621 009
`10/1994 European Pat. Off.
`2 681 775
`10/1991
`France .
`43 00307.
`7/1994 Germany .
`980703
`12/1982 Russian Federation .
`990220
`1/1983 Russian Federation .
`.
`.
`.
`Primary Examiner—Scott A. Smith
`[57]
`ABSTRACT
`Asurgical stapling device particularly suited for endoscopic
`procedures is described. The device can be used with both
`articulating and non-articulating disposable loading units
`and has a sensing mechanism for sensing the type of
`disposable loading unit secured to the device.
`
`4 Claims, 39 Drawing Sheets
`
`IS 1011
`
`IS 1011
`
`1
`
`

`

`5,865,361
`Page 2
`
`U.S. PATENT DOCUMENTS
`
`5,474,571
`5,484,451
`5,486,185
`5,487,500
`
`12/1995 Lang .
`1/1996 Akopovet al.
`1/1996 Freitas et al.
`.
`1/1996 Knodeletal. .
`
`.
`
`5,507,426
`5,535,937
`5,582,617
`5,607,095
`5,615,820
`5,651,491
`
`4/1996
`7/1996
`12/1996
`3/1997
`4/1997
`TAQOT
`
`Youngetal. .
`Boiarski et al. cc cceeeeeeeeeeees 227/19
`Kliemanetal. .
`Smith et al. cece 227/176.1
`« 227/176.1
`Viola «0.0...
`
`Heaton et al. occ ceceeeereeee 227/175.1
`
`2
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 1 of 39
`
`5,865,361
`
`3
`
`

`

`U.S. Patent
`
` Feb. 2, 1999
`
`FIG.2
`
`Sheet 2 of 39
`
`5,865,361
`
`
`
`B
`
`
`6 |
` TTT=
`
`
`
`
`4
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 3 of 39
`
`5,865,361
`
`5
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 4 of 39
`
`5,865,361
`
`\\ <A
`
`
`WS PySaat
`
`
`
`
`
`6
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 5 of 39
`
`5,865,361
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`af=Layeeeeeee,°fTieD2MUN—NS(ZiaOYpasace‘\[|BSSSSESSNSEIRNSOena8ngCdSASSIVeaA,NRLLALLATETTPTPTT|OLLL\=roDCEFRON)SSae
`
`ee”;aeSererieieemenwaar,oohzo—_+—
`e4HeA,VoBt!'eenfoMd
`96|ZuQY>~oyctBit
`SIIILPALI<_#2
`PRNPAEfamed]rNAW~~S/SSS,921*~_____
`
`(2zeYeVfY
`
`&&celJfe}
`LyJaUU.dl
`
`7
`
`
`
`
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 6 of 39
`
`5,865,361
`
`
`
`8
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 7 of 39
`
`5,865,361
`
`rar“s.RSS]
`
`ESSare=Synl,—aNSs
`SY9&1Yro__
`
`“)<aLakScarce7aFfDONTE
`
`INdsTAacpcEoladtrgenortega
`elISYZ
`
`
`
`--——--—_____08!
`
`7Ol“OlaC|C|BL
`
`
`
`9
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 8 of 39
`
`5,865,361
`
`“Sls
`
`VOl
`
`10
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 9 of 39
`
`5,865,361
`
`
`
`
`
`
`——ttES ¥ :
`
`i=e
`
`MEETOTAbr; RK«SY
`
`
`
`
`
`
`FIG. 10B
`
`
`
`FIG. 10c
`
`11
`
`

`

`o)
`
`S
`~~»
`o
`
`©S=
`
`~
`
`S~
`
`S
`o%
`So
`~y
`
`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 10 of 39
`
`5,865,361
`
`FIG.I2
`
`Sy
`
`\}
`
`%
`
`12
`
`

`

`Sheet 11 of 39
`
`5,865,361
`
`Feb. 2, 1999
`
`U.S. Patent
`
`13
`
`13
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 12 of 39
`
`5,865,361
`
`14
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 13 of 39
`
`5,865,361
`
`52
`
`14
`
`199
` =}LLLn
`
`
`
`
`
`15
`
`

`

`5,865,361
`
`193
`
`254
`
`FIG.20
`
`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 14 of 39
`
`
`
`16
`
`

`

`Sheet 15 of 39
`
`5,865,361
`
`Feb. 2, 1999
`
`U.S. Patent
`
`17
`
`17
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 16 of 39
`
`5,865,361
`
`204
`
`214
`
`FIG. 22
`
`18
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 17 of 39
`
`5,865,361
`
`
`
`19
`
`19
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 18 of 39
`
`5,865,361 FIG.26
`
`~y
`
`”a
`
`)
`
`20
`
`

`

`Sheet 19 of 39
`
`5,865,361
`
`Feb. 2, 1999
`
`U.S. Patent
`
`21
`
`21
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 20 of 39
`
`5,865,361
`
`
`
`
`
`si
`ys
`= jffV
`.
`= & I;
`
`vt
`
`8N
`
`a\
`
`&
`
`22
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 21 of 39
`
`5,865,361
`
`23
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 22 of 39
`
`5,865,361
`
`
`
`
`286
`
`.fi
`
`284
`
`26
`
`II
`ll
`
`280
`
`283
`
`
`
`hos||\MI
`FIG.34!
`
`ilNS285
`
`24
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 23 of 39
`
`5,865,361
`
`25
`
`

`

`U.S. Patent
`
`Sheet 24 of 39
`
`5,865,361
`
`Feb. 2, 1999
`
`882av
`
` IPAahaaaAfGaZLLE,
`Neosz=708
`oz°F6¢“Sls
`pS‘iTl
`
`
`
`
`
`26
`
`26
`
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 25 of 39
`
`5,865,361
`
`
`
`27
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 26 of 39
`
`5,865,361
`
`28
`
`

`

`Sheet 27 of 39
`
`U.S. Patent
`
`Feb. 2, 1999
`
`NEESER
`FaeVioa
`
`
`
`
`66}
`
`eS
`
`YN\ACTIWLELELEVELEBA\LLLLD
`Wy)TAOIDssstJ//12
`
`5,865,361
`
`
`
`
`
`964664a(_OneO62Fr&E20soy
`
`77“Old
`
`aMS¢
`
`
`
`
`
`GeSIFP2LLaLT.=.=
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`29
`
`29
`
`
`
`
`
`

`

`v,
`
`“(YS|
`
`cel
`
`
`
`
`
`WeeaSEERLieeein<pba
`Ke=aNa=921
`Nawee=¥LS
`
`U.S. Patent
`
`OG!
`
`89h
`
`©O
`
`D
`
`SC—————=
`
`
`YFytas
`
`SN
`LNoes
`
`
`
`
`
`
`
`
`
`Nelee
`
`
`
`5,865,361
`
`SO
`
`o
`
`pp
`Uf
`
`S
`
`c6
`
`Ve7“Sls
`
`wy,
`lig
`
`
`
`{tN“BSSfiN|SSTDLONDEnsTD,Narr,LUIUUUUAUZHUD
`
`Feb. 2, 1999
`
`Sheet 28 of 39
`
`30
`
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 29 of 39
`
`5,865,361
`
`992=the
`
`892
`
`eH
`NY
`
`
`
`
`
`aELeeheeAhtttlLSOOVA
`SALLIIBS
`
`<p”
`
`theOgé
`uzS7“Old4oaz%&e
`°0é¢
`
`
`
`SSSR—iS
`SSStdZNC/A)Ereee
`Teed,—s—=oyoe
`
`
`
`
`YVOP2PTATLITLELIZZAYSi“MNR
`
`31
`
`

`

`Sheet 30 of 39
`
`5,865,361
`
`U.S. Patent
`
`Feb. 2, 1999
`
`IWNNWNBES
`
`32
`
`32
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 31 of 39
`
`
`
`5,865,361
`
`4\(@TINO—:"=rf
`2ze—”
`YeeSHYSTPeoodl
`
`LZee—=VSSCYMXMUUUD?
`
`TIS>Y}2DNN£8~sfYIKESLX.
`aaaAETATAaay2,TonPRNALEZ
`
`zgd992
`
`
`
`
`
`
`Lnea|WyNeSL=Fr
`
`
`
`aee|\72aee_
`
`87“Sls
`
`
`
`(Steememmenenememeam:whaummemeesunsuAy,-To]er
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`33
`
`
`
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 32 of 39
`
`5,865,361
`
`a602
`
`98¢
`
`—
`
`67
`
`eedOS\B——NSayFACheee
`narwebehersBeehhyhahaeheehlawAaSyAmM)
`nn)aWahSC
`
`ierDrderi
`LeLG2il=DaudiMiteGAaltlittiW
` C\_a.b-
`ys
`SIsiAnkhagdnpelakbehSetbatAhokSPeRkRatetehdedieeoSRDLleahalOEhePIDokaLDeLDEEODLPBeCeee
`
`
`
`
`
`so
`
`34
`
`

`

`U.S. Patent
`
`
`
`PORee|NSKNiy~yNYaaDs
`
`Feb. 2, 1999
`
` aRprrrrcsprreerry
`
`[ss727CLITVfSORI tpAPEDDIT
`
`
`
` SSNS
`
`CaeeastS____}EWSROY
`
`i
`
`35
`
`Sheet 33 of 39
`
`5,865,361
`
`
` TURUVAPTIT
`
`aEAPEEEIEY,7Pee
`
`35
`
`
`
`
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 34 of 39
`
`5,865,361
`
`OeH-80¢
`
`CLODDDedaDedDe
`
`
`
`eeeTOueii[LP
`deleSi)yeBoe
`
`CEROCEEAO)Eh
`VfeeEeEe
`
`
`60z==SSSSSSESASEEREROSesYo
`nOenTre7rrraaeaaTy
`CHOAGHSOHSS_\} uh-SS(ligssisisssisiss
`
`
`
`Pbtt)i
`
`eG‘Ols
`
`IS“Sls
`
`36
`
`36
`
`
`

`

`Zr
`
`sess-=(o5=SNpeer
`
`“ lsalls
`
`‘nh
`ey
`Wf
`aN
`iN &
`
`Na
`NES
`N:
`ings
`
`Ix
`HN hl
`i
`NY hy
`NE
`EN
`KX
`_INS
`Ye FN A
`ALA Wis
`
`
`4H IAS
`Hfie
`
`
`
`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 35 of 39
`
`5,865,361
`
`
`
`‘s
`
`y
`
` LPCSSSseSS
`
`FIG.53
`
`
`
`AL
`
`
`
`Zz
`
`37
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 36 of 39
`
`5,865,361
`
`
`
`
`
`SeePPTIIIT
`
`ifffezEcZPETDE——pe
`SNH—OT“BS vee
`
`SPTELETIDvrrerrend —
`
`
`
`
`
`
`
`
`
`
`
`
`
`38
`
`

`

`Sheet 37 of 39
`
`
`
`
`
`
`
`
`
`U.S. Patent
`
`Feb. 2, 1999
`
`5,865,361
`
`
`
`FIG. 60
`
`FIG. 6|
`
`39
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 38 of 39
`
`
`
`5,865,361
`
`40
`
`40
`
`

`

`U.S. Patent
`
`Feb. 2, 1999
`
`Sheet 39 of 39
`
`5,865,361
`
`298
`
`304
`
`288
`
`52 CLAEBELODADALAIATAGAGGLH
`\ 7)wnnn
`Ze(KouMe,
`
`
`
`
`
` />———4 pd
`TONSESSSS
`
`
`330
`
`
`
` LLLLOMaalhLdpeaeieof
`
`7TRwrBASS=A
`
`
`
`
`
`~|“54
`
`
`A1
`
`41
`
`

`

`5,865,361
`
`1
`SURGICAL STAPLING APPARATUS
`
`BACKGROUND
`
`1. Technical Field
`
`This application relates to a surgical stapling apparatus,
`and moreparticularly, to an articulating mechanism for use
`with an endoscopic surgical stapling apparatus for sequen-
`tially applying a plurality of surgical fasteners to body tissue
`and optionally incising fastened tissue.
`2. Background of Related Art
`Surgical devices whereintissue is first grasped or clamped
`between opposing jaw structure and then joined by surgical
`fasteners are well known in the art. In some instruments 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 but two part polymeric fasteners can also be
`utilized.
`
`Instruments for this purpose can include two elongated
`members which are respectively used to capture or clamp
`tissue. Typically, one of the members carries a staple car-
`tridge which housesa plurality of staples arranged in atleast
`two lateral rows while the other member has an anvil that
`
`defines a surface for forming the staple legs as the staples are
`driven from the staple cartridge. Generally,
`the stapling
`operation is effected by cam bars that travel longitudinally
`through the staple cartridge, with the cam bars acting upon
`staple pushers to sequentially eject the staples from the
`staple cartridge. A knife can travel between the staple rows
`to longitudinally cut and/or open the stapled tissue between
`the rows of staples. Such instruments are disclosed, for
`example,
`in U.S. Pat. No. 3,079,606 and U.S. Pat. No.
`3,490,675.
`A later stapler disclosed in U.S. Pat. No. 3,499,591
`applies a double row ofstaples on each side of the incision.
`This is accomplished by providing a disposable loading unit
`in which a cam member movesthrough an elongate guide
`path between twosets of staggered staple carrying grooves.
`Staple drive membersare located within the grooves and are
`positioned in such a manner so as to be contacted by the
`longitudinally moving cam memberto effect ejection of the
`staples from the staple cartridge of the disposable loading
`unit. Other examples of such staplers are disclosed in U'S.
`Pat. Nos. 4,429,695 and 5,065,929.
`Each of the instruments described above were designed
`for use in conventional surgical procedures wherein sur-
`geons have direct manual access to the operative site.
`However, in endoscopic or laparoscopic procedures, surgery
`is performed through a small incision or through a narrow
`cannula inserted through small entrance woundsin the skin.
`In order to address the specific needs of endoscopic and/or
`laparoscopic surgical procedures, endoscopic surgical sta-
`pling devices have been developed and are disclosed in, for
`example, U.S. Pat. Nos. 5,040,715 (Green,et al.); 5,307,976
`(Olson,et al.); 5,312,023 (Green, et al.); 5,318,221 (Green,
`et al.); 5,326,013 (Green,et al.); and 5,332,142 (Robinson,
`et al.).
`US. Surgical, the assignee of the present application, has
`manufactured and marketed endoscopic stapling
`instruments, such as the Multifire ENDO GIA* 30 and
`Multifire ENDO GIA* 60 instruments, for several years.
`These instruments have provided significant clinical ben-
`efits. Nonetheless, improvements are possible, for example,
`by reducing the cost and complexity of manufacture.
`Current laparoscopic linear stapling devices are config-
`ured to operate with disposable loading units (U.S. Surgical)
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`2
`and staple cartridges (Ethicon) of only one size. For
`example, individual linear staplers are presently available
`for applying parallel rows of staples measuring 30 mm, 45
`mm and 60 mm in length. Thus, during a normal operation,
`a surgeon may be required to utilize several different sta-
`pling instruments to perform a single laparoscopic surgical
`procedure. Such practices increase the time, complexity and
`overall costs associated with laparoscopic surgical proce-
`dures. In addition, costs are greater in designing and manu-
`facturing multiple stapler sizes, as opposed to creating a
`single, multipurpose stapler.
`It would be extremely beneficial to provide a surgical
`device for use during laparoscopic and/or endoscopic sur-
`gical procedures that can be employed with several different
`sized disposable loading units to reduce the overall costs
`associated with such procedures. It would also be particu-
`larly beneficial if the device could perform multiple tasks,
`using disposable loading units of varying size and of varying
`purpose, such as, for example, to staple, clip, cut and/or
`articulate.
`
`In making improvements or modifications to the current
`instruments, it would be highly desirable notto sacrifice any
`of the important benefits of the MULTIFIRE ENDO GIA*
`30 and 60 instruments as compared to other commercially
`available products, e.g., the endoscopic stapling instruments
`manufactured and marketed by Ethicon, Inc. For example,
`any improvement should advantageously provide a fresh
`knife blade for each firing of the instrument and ensure that
`the disposable loading unit
`is securely retained in the
`stapling instrument unless and until
`the operating team
`chooses to remove it. These advantages have historically
`been found in the U.S. Surgical instruments, but not in the
`Ethicon instruments.
`
`SUMMARY
`
`In accordance with the present disclosure, a surgical
`stapling apparatus for sequentially applying a plurality of
`fasteners to body tissue and simultaneously incising tissue is
`provided. The surgical stapling apparatus is adapted to
`receive disposable loading units having rows of staples
`having a linear length of between 30 mm and 60 mm. The
`surgical stapling apparatus is also adapted to receive articu-
`lating and non-articulating disposable loading units.
`The surgical stapling apparatus includes a handle assem-
`bly having a movable handle and a stationary handle. The
`movable handle is movable through an actuation stroke to
`clamp tissue and to effect ejection of staples from the
`disposable loading unit. An elongated body extendsdistally
`from the handle assembly and defines a longitudinal axis. An
`actuation shaft having a toothed rack is operably associated
`with the movable handle by a pawl mechanism. The distal
`end of the actuation shaft is connected to a control rod
`
`having a distal end adapted to operatively engage an axial
`drive assembly located within a disposable loading unit.
`The stapling apparatus includes an articulation mecha-
`nism having an articulation lever operatively engaged with
`acam memberhaving a stepped camming channel. The cam
`member is engaged with a translation member which
`includes a pin dimensionedto be received within the stepped
`camming channelsuch that pivotable movementof the lever
`causes linear movement of the translation member. A first
`
`articulation link includes a proximal end adapted to engage
`the translation memberand a distal end adapted to engage a
`second articulation link positioned within the disposable
`loading unit. Linear movement of the translation member
`causes linear movement of the articulation links to cause
`
`articulation of a tool assembly of the disposable loading unit.
`42
`
`42
`
`

`

`5,865,361
`
`3
`The surgical stapling apparatus also preferably includes a
`sensing mechanism for sensing the type of disposable load-
`ing unit secured to the elongated body of the apparatus. The
`sensing mechanism includes a sensing tube positioned
`within the elongated body to engage a disposable loading
`unit secured to the elongated body. A sensing cylinder
`connected to the sensing tube engages a locking ring having
`a tab portion configured to engage the articulation mecha-
`nism in a first position to prevent movement of the articu-
`lation lever. The locking ring is moved by the sensing
`cylinder when anarticulating disposable loading unit is
`secured to the elongated body of the stapling apparatus to a
`second position to disengage the tab portion from the
`articulation mechanism to permit movementof the articu-
`lation lever. In contrast, a non-articulating disposable load-
`ing unit will not unlock the articulation lever.
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`Various preferred embodiments are described herein with
`reference to the drawings:
`FIG. 1 is a perspective view of one preferred embodiment
`of the presently disclosed surgical stapling apparatus;
`FIG. 2 is a top view of the surgical apparatus shown in
`FIG. 1;
`FIG. 3 is a side view of the surgical apparatus shown in
`FIG. 1;
`FIG. 4 is a perspective view with parts separated of the
`handle assembly of the surgical apparatus shownin FIG. 1;
`FIG. 5 is a cross-sectional view of a portion of the firing
`lockout mechanism shownin FIG. 4;
`FIG. 6 is a perspective oftheslide plate of the anti-reverse
`clutch mechanism ofthe surgical apparatus;
`FIG. 7 is an enlarged perspective view of the anti- reverse
`clutch mechanism shownin FIG. 1;
`FIG. 8 is a side cross-sectional view of the surgical
`stapling apparatus shown in FIG. 1 in the non-actuated
`position with the disposable loading unit removed;
`FIG. 9 is a perspective view with parts separated of the
`rotation member, the articulation mechanism, and the elon-
`gated body of the surgical stapling apparatus shown in FIG.
`1;
`
`FIG. 10 is an enlarged view ofthe indicated area of detail
`shown in FIG. 8;
`FIG. 10ais a perspective view of the translation member
`of the articulating mechanism and the proximal end of the
`elongated body of the surgical stapling apparatus shown in
`FIG. 1;
`FIG. 105 is an enlarged cross-sectional view of the
`indicated area of detail of FIG. 8;
`FIG. 10¢ is a cross-sectional view along section line
`10c—10c of FIG. 8;
`FIG. 11 is a perspective view of the cam memberof the
`articulation mechanism of the surgical stapling apparatus
`shown in FIG. 1;
`FIG. 12 is a top view of the cam memberofthe articu-
`lation mechanism of the surgical stapling apparatus shown
`in FIG. 1;
`FIG. 12a is a perspective view of a non-articulating
`disposable loading unit usable with the surgical stapling
`apparatus shown in FIG. 1;
`FIG. 12b is a perspective view of the preferred articulat-
`ing disposable loading unit of the surgical stapling apparatus
`shown in FIG. 1;
`FIG. 13 is a cross-sectional view taken along section line
`13—13 of FIG. 10;
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`4
`FIG. 14 is a cross-sectional view taken along section line
`14—14 of FIG. 10;
`FIG. 15 is a cross-sectional view taken along section line
`15—15 of FIG. 10;
`FIG. 16 is an enlarged view of the indicated area of detail
`shownin FIG. 8;
`FIG. 17 is a side perspective view of the blocking plate of
`the surgical stapling apparatus shown in FIG. 1;
`FIG. 18 is a top perspective view of the blocking plate of
`the surgical stapling apparatus shown in FIG. 1;
`FIG. 19 is a perspective view of a disposable loading unit
`usable with the surgical stapling apparatus of FIG. 1;
`FIG. 20 is another perspective view of a disposable
`loading unit usable with the surgical stapling apparatus of
`FIG. 1;
`FIG. 21 is a perspective view of the tool assembly of the
`surgical stapling apparatus of FIG. 1 with parts separated;
`FIG. 22 is an enlarged perspective view of the distal end
`of the anvil assembly showinga plurality of staple deform-
`ing cavities;
`FIG. 23 is an enlarged perspective view of the distal end
`of the staple cartridge of the surgical stapling apparatus
`shown in FIG. 1;
`FIG. 24 is a side cross-sectional view taken along section
`line 24—24 of FIG. 23;
`FIG. 25 is a bottom perspective view of the staple
`cartridge shown in FIG. 21;
`FIG. 26 is an enlarged perspective view of the actuation
`sled, the pushers and the fasteners shown in FIG. 21;
`FIG. 27 is an enlarged perspective view with parts sepa-
`rated of the proximal housing portion and mounting assem-
`bly of the disposable loading unit shown in FIG. 19;
`FIG. 28 is an enlarged perspective view of the mounting
`assembly of the disposable loading unit shown in FIG. 19
`mounted to a distal end portion of the proximal housing
`portion;
`FIG. 29 is an enlarged perspective view of the proximal
`housing portion and the mounting assembly of the dispos-
`able loading unit shown in FIG. 19 with the upper housing
`half removed;
`FIG. 30 is a perspective view of the proximal housing
`portion and the mounting assembly of the disposable loading
`unit shown in FIG. 19 with the upper housing half removed;
`FIG. 31 is a perspective view with parts separated of the
`axial drive assembly;
`FIG. 32 is an enlarged perspective view of the axial drive
`assembly shown in FIG. 31;
`FIG. 33 is an enlarged perspective view of the proximal
`end of the axial drive assembly shown in FIG. 31 including
`the locking device;
`FIG. 34 is an enlarged perspective view of the distal end
`of the axial drive assembly shown in FIG. 31;
`FIG. 35 is an enlarged perspective view of the distal end
`of the elongated body of the stapling apparatus shown in
`FIG. 1;
`FIG. 36 is an enlarged perspective view of the locking
`device shown in FIG. 33;
`FIG. 37 is an enlarged perspective view of a lower
`housing half of the proximal housing portion of the dispos-
`able loading unit shown in FIG. 27;
`FIG. 38 is a side cross-sectional view of the disposable
`loading unit shown in FIG. 20;
`FIG. 39 is an enlarged view of the indicated area of detail
`shown in FIG. 38;
`
`43
`
`43
`
`

`

`5,865,361
`
`5
`FIG. 40 is a perspective view of the surgical stapling
`apparatus shown in FIG. 1 with the disposable loading unit
`of FIG. 19 detached from the elongated body;
`FIG. 41 is an enlarged perspective view of the disposable
`loading unit of FIG. 19 during attachment to the elongated
`body of the surgical stapling apparatus shown in FIG. 1;
`FIG. 42 is another enlarged perspective view of the
`disposable loading unit of FIG. 19 during attachmentto the
`elongated body of the surgical stapling apparatus shown in
`FIG. 1;
`FIG. 43 is a cross-sectional view taken along section line
`43—43 of FIG. 41;
`FIG. 43a is a side cross-sectional view of the rotation
`
`knob, articulation mechanism, and sensing mechanism dur-
`ing insertion of a disposable loading unit into the elongated
`body of the surgical stapling apparatus;
`FIG. 44 is a cross-sectional view taken along section line
`44—44 of FIG. 42;
`FIG. 45 is a side cross-sectional view of the distal end of
`
`the disposable loading unit of FIG. 1 with tissue positioned
`between the anvil and clamp assemblies;
`FIG. 46 is a side cross-sectional view of the handle
`
`assembly with the movable handle in an actuated position;
`FIG. 47is an enlarged view ofthe indicated area of detail
`shown in FIG. 46;
`FIG. 48 is a cross-sectional view of the proximal end of
`the disposable loading unit of FIG. 19 and the distal end of
`the elongated body of the surgical stapling apparatus shown
`in FIG. 1 with the control rod in a partially advanced
`position;
`FIG. 49 is a cross-sectional view of the tool assembly of
`the surgical stapling apparatus shown in FIG. 1 positioned
`about tissue in the clamped position;
`FIG. 50 is a cross-sectional view of the handle assembly
`of the stapling apparatus of FIG. 1 during the clamping
`stroke of the apparatus;
`FIG. 51 is a side cross-sectional view of the distal end of
`
`the tool assembly of the stapling apparatus shown in FIG. 1
`during firing of the apparatus;
`FIG. 52 is a side cross-sectional view of the distal end of
`
`the tool assembly of the stapling apparatus shown in FIG. 1
`after firing of the apparatus;
`FIG. 53 is a side cross-sectional view of the handle
`
`assembly of the apparatus during retraction of the actuation
`shaft;
`FIG. 54 is a side cross-sectional view of the handle
`
`assembly of the stapling apparatus during actuation of the
`emergency release button;
`FIG. 55 is a top view ofthe articulation mechanism of the
`surgical stapling apparatus;
`FIG. 56 is a side cross-sectional view of the articulation
`mechanism and rotation member of the surgical stapling
`apparatus shown in FIG. 1;
`FIG. 57 is a top view of the distal end of the elongated
`body, the mounting assembly, and the proximal end of the
`tool assembly during articulation of the stapling apparatus;
`FIG. 58 is a perspective view of the surgical stapling
`apparatus during articulation of the tool assembly;
`FIG. 59 is a perspective view of the surgical stapling
`apparatus during articulation and rotation of the tool assem-
`bly;
`FIG. 60 is a top view of the distal end of the disposable
`loading unit immediately prior to articulation;
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`6
`FIG. 61 is a top view of the distal end of the elongated
`body, the mounting assembly, and the proximal end of the
`tool assembly during articulation of the stapling apparatus;
`FIG. 62is a partial cross-sectional view of a portion of the
`disposable loading unit during retraction of the locking
`device; and
`FIG. 63is a partial cross-sectional view of a portion of the
`disposable loading unit with the locking device in the locked
`position.
`DETAILED DESCRIPTION OF PREFERRED
`EMBODIMENTS
`
`Preferred embodiments of the presently disclosed endo-
`scopic surgical stapling apparatus will now be described in
`detail with reference to the drawings, in which like reference
`numerals designate identical or corresponding elements in
`each of the several views.
`
`In the drawings and in the description that follows, the
`term “proximal”, as is traditional, will refer to the end of the
`stapling 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.
`FIGS. 1-3 illustrate one embodiment of the presently
`disclosed surgical stapling apparatus shown generally as 10.
`Briefly, surgical stapling apparatus 10 includes a handle
`assembly 12 and an elongated body 14. A disposable loading
`unit or DLU 16 is releasably secured to a distal end of
`elongated body 14. Disposable loading unit 16 includes a
`tool assembly 17 having a cartridge assembly 18 housing a
`plurality of surgical staples and an anvil assembly 20 mov-
`ably securedin relation to cartridge assembly 18. Disposable
`loading unit 16 is configured to apply linear rowsofstaples
`measuring from about 30 mm to about 60 mm in length.
`Disposable loading units having linear rows of staples of
`other lengths are also envisioned, e.g., 45 mm. Handle
`assembly 12 includes a stationary handle member 22, a
`movable handle member 24, and a barrel portion 26. A
`rotatable member 28 is preferably mounted on the forward
`end of barrel portion 26 to facilitate rotation of elongated
`body 14 with respect to handle assembly 12. An articulation
`lever 30 is also preferably mounted on the forward end of
`barrel portion 26 adjacent rotatable knob 28 to facilitate
`articulation of tool assembly 17. A pair of retraction knobs
`32 are movably positioned along barrel portion 26 to return
`surgical stapling apparatus 10 to a retracted position, as will
`be described in detail below.
`
`Referring to FIG. 4, handle assembly 12 includes housing
`36, which is preferably formed from molded housing half-
`sections 36a and 36b, which formsstationary handle mem-
`ber 22 and barrel portion 26 of handle assembly 12 (See FIG.
`1). Movable handle member 24 is pivotably supported
`between housing half-sections 36a and 36b about pivot pin
`38. A biasing member 40, which is preferably a torsion
`spring, biases movable handle 24 away from stationary
`handle 22. An actuation shaft 46 is supported within barrel
`portion 26 of housing 36 and includes a toothed rack 48. A
`driving pawl 42 having a rack engagementfinger 43 with
`laterally extending wings 43a and 435 is pivotably mounted
`to one end of movable handle 24 about a pivot pin 44. A
`biasing member 50, which is also preferably a torsion
`spring,is positioned to urge engagementfinger 43 of driving
`pawl 42 towards toothed rack 48 of actuation shaft 46.
`Movable handle 24 is pivotable to move engagementfinger
`43 of driving pawl 42 into contact with toothed rack 48 of
`actuation shaft 46 to advance the actuation shaft linearly in
`the distal direction. The forward end of actuation shaft 46
`
`44
`
`44
`
`

`

`5,865,361
`
`7
`rotatably receives the proximal end 49 of a control rod 52
`such that linear advancement of actuation shaft 46 causes
`corresponding linear advancement of control rod 52. A
`locking pawl 54 having a rack engagement member 55 is
`pivotably mounted within housing 36 about pivot pin 57 and
`is biased towards toothed rack 48 by biasing member 56,
`whichis also preferably a torsion spring. Engagement mem-
`ber 55 of locking pawl 54 is movable into engagement with
`toothed rack 48 to retain actuation shaft 46 in a longitudi-
`nally fixed position.
`A retraction mechanism 58 which includes a pair of
`retractor knobs 32 (See FIG. 1) is connected to the proximal
`end of actuation shaft 46 by a coupling rod 60. Coupling rod
`60 includes right and left engagementportions 62a and 62b
`for receiving retractor knobs 32 and a central portion 62c
`which is dimensioned and configured to translate within a
`pair of longitudinal slots 34a formed in actuation shaft 46
`adjacent the proximal end thereof. A release plate 64 is
`operatively associated with actuation shaft 46 and is
`mounted for movement with respect thereto in response to
`manipulation of retractor knobs 32. A pair of spaced apart
`pins 66 extend outwardly from a lateral face of actuation
`shaft 46 to engage a pair of corresponding angled cam slots
`68 formedin release plate 64. Upon rearward movement of
`retractor knobs 32, pins 66 can release plate 64 downwardly
`with respect to actuation shaft 46 and with respect to toothed
`rack 48 such that the bottom portion of release plate 64
`extends below toothed rack 48 to disengage engagement
`finger 43 of driving pawl 42 from toothed rack 48. A
`transverse slot 70 is formed at the proximal end of release
`plate 64 to accommodate the central portion 62c¢ of coupling
`rod 60, and elongated slots 34 (See FIG. 1) are defined in the
`barrel section 26 of handle assembly 12 to accommodate the
`longitudinal translation of coupling rod 60 as retraction
`knobs 32 are pulled rearwardly to retract actuation shaft 46
`and thusretract control rod 52 rearwardly. Actuation shaft 46
`is biased proximally by spring 72 which is secured at one
`end to coupling rod portion 62 via connector 74 and at the
`other end to post 76 on actuation shaft 46.
`Referring also to FIG. 5, handle assembly 12 includes a
`firing lockout assembly 80 which includes a plunger 82 and
`a pivotable locking member 83. Plunger 82 is biased to a
`central position by biasing springs 84 and includes annular
`tapered camming surfaces 85. Each end of plunger 82
`extends through housing 36 (See FIG. 1) adjacent an upper
`end of stationary handle 22. Pivotable locking member83is
`pivotably attached at its distal end between housing half-
`sections 36a and 36b about pivot pin 86 and includes a
`locking surface 88 and proximal extension 90 havinga slot
`89 formed therein. Locking member83 is biased by spring
`92 counter-clockwise (as viewed in FIG. 4) to move locking
`surface 88 to a position to abut the distal end of actuation
`shaft 46 to prevent advancementof shaft 46 and subsequent
`firing of stapling apparatus 10. Annular tapered camming
`surface 85 is positioned to extend into tapered slot 89 in
`proximal extension 90. Lateral movement of plunger 82 in
`either direction against the bias of either spring 84 moves
`tapered camming surface 85 into engagement with the
`sidewalls of tapered slot 89 to pivot locking member 83
`clockwise about pivot pin 86, as viewed in FIG. 4, to move
`blocking surface 88 to a position to permit advancementof
`actuation shaft 46 and thusfiring of stapling apparatus 10.
`Blocking surface 88 is retained in this position by recesses
`87 which receive the tapered tip of camming surface 85 to
`lock locking member 83 in a counter-clockwise position.
`Operation of firing lockout assembly 80 will be further
`illustrated below.
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`8
`Referring to FIGS. 4, 6, and 7, handle mechanism 12 also
`includesan anti-reverse clutch mechanism which includes a
`first gear 94 rotatably mounted ona first shaft 96, and second
`gear 98 mounted on a second shaft 100, and a slide plate 102
`(FIGS. 6 and 7) slidably mounted within housing 36. Slide
`plate 102 includes an elongated slot 104 dimensioned and
`configured to be slidably positioned about locking pawl
`pivot