as) United States
`a2) Patent Application Publication (10) Pub. No.: US 2005/0263562 Al
`(43) Pub. Date: Dec. 1, 2005
`
`Shelton, IV etal.
`
`US 20050263562A1
`
`(54) ARTICULATING SURGICAL STAPLING
`INSTRUMENT INCORPORATING A
`TWO-PIECE E-BEAM FIRING MECHANISM
`
`(60) Provisional application No. 60/591,694,filed on Jul.
`28, 2004.
`
`Publication Classification
`
`(76)
`
`Inventors: Frederick E. Shelton IV, Hillsboro,
`OH (US); Kevin Ross Doll, Mason, OH
`(US); Jerry R. Morgan, Cincinnati,
`OH (US); Michael Earl Setser,
`Burlington, KY (US)
`
`Correspondence Address:
`Frost Brown Todd LLC
`2200 PNC Center
`201 East Fifth Street
`
`Cincinnati, OH 45202 (US)
`
`(21) Appl. No.:
`
`10/955,042
`
`(22)
`
`Filed:
`
`Sep. 30, 2004
`
`Related U.S. Application Data
`
`(63) Continuation-in-part of application No. 10/443,617,
`filed on May 20, 2003.
`
`articulating surgical instruments.
`
`(SL) Ute C07 caccccsscssssssssnssnssssstsnesnsstn A61B 17/04
`
`(52) US. Ch.
`cecescsssssssscnsssesnssnsennssee 227/176.1; 227/19
`
`(57)
`
`ABSTRACT
`
`A surgical severing and stapling instrument, suitable for
`laparoscopic and endoscopic clinical procedures, clamps
`tissue within an end effector of an elongate channel pivotally
`opposed by an anvil. An E-beam firing bar moves distally
`through the clamped end effector to sever tissue and to drive
`staples on each side of the cut. The E-beam firing bar
`affirmatively spaces the anvil from the elongate channel to
`assure properly formed closed staples, especially when an
`amountoftissue is clamped that is inadequate to space the
`end effector. In particular, an upper pin of the firing bar
`longitudinally moves through an anvil slot and a channelslot
`is captured between a lower cap and a middle pin of the
`firing bar to assure a minimum spacing. Forming the E-beam
`from a thickened distal portion and a thinned proximalstrip
`enhances manufacturability and facilitates use in such
`
`1
`
`IS 1016
`Intuitive Surgical v. Ethicon
`IPR2019-00880
`
`1
`
`IS 1016
`Intuitive Surgical v. Ethicon
`IPR2019-00880
`
`

`

`Patent Application Publication Dec. 1,2005 Sheet 1 of 13
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`Patent Application Publication Dec. 1,2005 Sheet 2 of 13
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`Patent Application Publication Dec. 1, 2005 Sheet 3 of 13
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`Patent Application Publication Dec. 1, 2005 Sheet 6 of 13
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`Patent Application Publication Dec. 1, 2005 Sheet 12 of 13
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`US 2005/0263562 Al
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`Dec. 1, 2005
`
`ARTICULATING SURGICAL STAPLING
`INSTRUMENT INCORPORATING A TWO-PIECE
`E-BEAM FIRING MECHANISM
`
`FIELD OF THE INVENTION
`
`[0001] The present application hereby claims the benefit
`of the U.S. provisional patent application entitled “SURGI-
`CAL INSTRUMENT INCORPORATING AN ELECTRI-
`CALLY ACTUATED ARTICULATION MECHANISM”,
`to Shelton, Ser. No. 60/591,694, filed on 28 Jul. 2004. The
`present application is a continuation-in-part patent applica-
`tion of the U.S. nonprovisional patent application entitled
`“SURGICAL STAPLING INSTRUMENT INCORPORAT-
`ING AN E-BEAM FIRING MECHANISM”to Shelton et
`
`al., Ser. No. 10/443,617, filed on 20 May 2003, the disclo-
`sure of which is hereby incorporated by reference in its
`entirety.
`
`FIELD OF THE INVENTION
`
`[0002] The present invention relates in general to surgical
`instruments that are suitable for endoscopically inserting an
`end effector that is actuated by a longitudinally drivenfiring
`member, and more particularly a surgical stapling and sev-
`ering instrument that has an articulating shaft.
`
`BACKGROUND OF THE INVENTION
`
`instruments are often pre-
`[0003] Endoscopic surgical
`ferred overtraditional open surgical devices since a smaller
`incision tends to reduce the post-operative recovery time and
`complications. 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 numberof waysto
`achieve a diagnostic or therapeutic effect (e.g., endocutter,
`grasper, cutter, staplers, clip applier, access device, drug/
`gene therapy delivery device, and energy device using
`ultrasound, RF,laser, etc.).
`
`[0004] Positioning the end effector is constrained by the
`trocar. Generally these endoscopic surgical
`instruments
`include a long shaft between the end effector and a handle
`portion manipulated by the clinician. This long shaft enables
`insertion to a desired depth and rotation about the longitu-
`dinal axis of the shaft, thereby positioning the end effector
`to a degree. With judicious placementof the trocar and use
`of graspers, for instance, through another trocar, often this
`amount of positioning is sufficient. Surgical stapling and
`severing instruments, such as described in U.S. Pat. No.
`5,465,895, are an example of an endoscopic surgical instru-
`mentthat successfully positions an end effector by insertion
`and rotation.
`
`[0005] More recently, U.S. patent Ser. No. 10/443,617,
`“SURGICAL STAPLING INSTRUMENT INCORPORAT-
`ING AN E-BEAM FIRING MECHANISM”to Shelton et
`al., filed on 20 May 2003, which has been incorporated by
`reference in its entirety, describes an improved “E-beam”
`firing bar for severing tissue and actuating staples. Some of
`the additional advantages include affirmatively spacing the
`jaws of the end effector, or more specifically a staple
`applying assembly, even if slightly too much ortoo little
`tissue is clamped for optimal staple formation. Moreover,
`
`the E-beam firing bar engages the end effector and staple
`cartridge in a way that enables several beneficial lockouts to
`be incorporated.
`
`[0006] Depending uponthe nature of the operation, it may
`be desirable to further adjust the positioning of the end
`effector of an endoscopic surgical instrument. In particular,
`it is often desirable to orient the end effector at an axis
`transverse to the longitudinal axis of the shaft of the instru-
`ment. The transverse movementof the end effector relative
`
`is conventionally referred to as
`to the instrument shaft
`“articulation”. This is typically accomplished by a pivot (or
`articulation) joint being placed in the extended shaft just
`proximal to the staple applying assembly. This allows the
`surgeon to articulate the staple applying assembly remotely
`to either side for better surgical placementof the staple lines
`and easier tissue manipulation and orientation. This articu-
`lated positioning permits the clinician to more easily engage
`tissue in some instances, such as behind an organ.
`In
`addition, articulated positioning advantageously allows an
`endoscope to be positioned behind the end effector without
`being blocked by the instrumentshaft.
`
`[0007] Approachesto articulating a surgical stapling and
`severing instrument tend to be complicated by integrating
`control of the articulation along with the control of closing
`the end effector to clamp tissue andfire the end effector (.e.,
`stapling and severing) within the small diameter constraints
`of an endoscopic instrument. Generally, the three control
`motionsare all transferred through the shaft as longitudinal
`translations. For instance, U.S. Pat. No. 5,673,840 discloses
`an accordion-like articulation mechanism (“flex-neck”) that
`is articulated by selectively drawing back one of two con-
`necting rods through the implement shaft, each rod offset
`respectively on opposite sides of the shaft centerline. The
`connecting rods ratchet through a series of discrete posi-
`tions.
`
`[0008] Another example of longitudinal control of an
`articulation mechanism is U.S. Pat. No. 5,865,361 that
`includes an articulation link offset from a camming pivot
`such that pushing or pulling longitudinal translation of the
`articulation link effects articulation to a respective side.
`Similarly, U.S. Pat. No. 5,797,537 discloses a similar rod
`passing through the shaft to effect articulation.
`
`In co-pending and commonly owned U:S. patent
`[0009]
`application Ser. No. 10/615,973, “SURGICAL INSTRU-
`MENT
`INCORPORATING
`AN ARTICULATION
`MECHANISM HAVING ROTATION ABOUT THE LON-
`GITUDINAL AXIS”, to Frederick E. Shelton IV et al, the
`disclosure of which is hereby incorporated by reference in
`its entirety, a rotational motionis used to transfer articulation
`motion as an alternative to a longitudinal motion.
`
`In the application entitled “SURGICAL STA-
`[0010]
`PLING INSTRUMENT INCORPORATING AN E-BEAM
`FIRING MECHANISM”to Shelton et al., Ser. No. 10/443,
`617, filed on 20 May 2003, the disclosure of which was
`previously incorporated by reference in its entirety, a surgi-
`cal severing and stapling instrument, suitable for laparo-
`scopic and endoscopic clinical procedures, clamps tissue
`within an end effector of an elongate channel pivotally
`opposed by an anvil. An E-beam firing bar moves distally
`through the clamped end effector to sever tissue and to drive
`staples on each side of the cut. The E-beam firing bar
`affirmatively spaces the anvil from the elongate channel to
`
`15
`
`15
`
`

`

`US 2005/0263562 Al
`
`Dec. 1, 2005
`
`assure properly formed closed staples, especially when an
`amountof tissue is clamped that is inadequate to space the
`end effector. In particular, an upper pin of the firing bar
`longitudinally moves through an anvil slot and a channelslot
`is captured between a lower cap and a middle pin of the
`firing bar to assure a minimum spacing. While this E-beam
`firing bar has a numberof advantages,additional features are
`desirable to enhance manufacturability and to minimize
`dimensional variations.
`
`[0011] Consequently, a significant need exists for a surgi-
`cal instrument with a firing bar that advantageously assures
`proper spacing between clamped jawsof an end effector and
`which facilitates articulation of its shaft.
`
`BRIEF SUMMARY OF THE INVENTION
`
`[0012] The invention overcomes the above-noted and
`other deficiencies of the prior art by providing a firing
`mechanism thataffirmatively vertically spaces an end effec-
`tor of a surgical stapling and severing instrument. Thus, the
`instrumentstructurally assures adequate spacing to achieve
`proper stapling, even in instances wheretoolittle tissue is
`clampedin the end effector. Integrally forming these features
`into an E-beam that includes a cutting edge realizes consis-
`tent spacing and performanceas the E-beamfires through an
`end effector such as a severing and stapling assembly.
`Further, proximally attaching a separate, thinnedfiring bar to
`the E-beam enhancesusein articulating surgical instruments
`wherein reduced cross sectional area and the ability to flex
`in a plane of articulation are desirable.
`
`Inone aspectof the invention, a surgical instrument
`[0013]
`includes a handle portion operable to produce a firing
`motion that actuates an implement portion. This implement
`portion has an elongate channel
`that receives a staple
`cartridge opposed by a pivotally attached anvil. A firing
`device includes a distally presented cutting edge longitudi-
`nally received between the elongate channel and the anvil,
`an upper member engageable to the anvil channel, a lower
`member engaging the channel slot, and a middle member
`operable to actuate the wedge sled, which is integral to the
`staple
`cartridge. The middle member
`advantageously
`opposes pinching of the end effector, assuring proper staple
`formation even when an otherwise too small amount of
`tissue has been clamped. These spacing and cutting features
`are advantageously formed into an E-beam while flexibility
`for articulation is provided by a thinnedfiring bar attached
`to the E-beam.
`
`[0014] These and other objects and advantages of the
`present invention shall be made apparent from the accom-
`panying drawings and the description thereof.
`DESCRIPTION OF THE FIGURES
`
`[0015] The accompanying drawings, which are incorpo-
`rated in and constitute a part of this specification, illustrate
`embodimentsof the invention, and, together with the general
`description of the invention given above, and the detailed
`description of the embodiments given below, serve to
`explain the principles of the present invention.
`
`[0016] FIG. 1 is a perspective view of an endoscopic
`surgical stapling instrumentfor surgical stapling and sever-
`ing in an open, unarticulated state.
`
`of FIG. 1 with a right half portion of a replaceable staple
`cartridge included in a staple channel.
`
`[0018] FIG. 3 is an exploded perspective view of the
`staple applying assembly of FIG. 2 with a complete replace-
`able staple cartridge and an alternative nonarticulating shaft
`configuration.
`
`[0019] FIG. 4 is a perspective view of a two-piece knife
`and firing bar (“E-beam”)of the staple applying assembly of
`FIG.2.
`
`[0020] FIG. 5 is a perspective view of a wedgesled of a
`staple cartridge of the staple applying assembly of FIG.1.
`
`[0021] FIG. 6 is a left side view in elevation taken in
`longitudinal cross section along a centerline line 6-6 of the
`staple applying assembly of FIG.2.
`
`[0022] FIG. 7 is a perspective view of the open staple
`applying assembly of FIG. 2 without the replaceable staple
`cartridge, a portion of the staple channel proximate to a
`middle pin of two-piece knife and firing bar, and without a
`distal portion of a staple channel.
`
`[0023] FIG. 8 is a front view in elevation taken in cross
`section along line 8-8 of the staple applying assembly of
`FIG. 2 depicting internal staple drivers of the staple car-
`tridge and portions of the two-piece knife and firing bar.
`
`[0024] FIG. 9 is a left side view in elevation taken
`generally along the longitudinal axis of line 6-6 of a closed
`staple applying assembly of FIG.2 to include center contact
`points between the two-piece knife and wedgesled but also
`laterally offset to show staples and staple drivers within the
`staple cartridge.
`
`[0025] FIG. 10 isa left side detail view in elevation of the
`staple applying assembly of FIG. 9 with the two-piece knife
`retracted slightly moreas typical for staple cartridge replace-
`ment.
`
`[0026] FIG. 11 isa left side detail view in elevation of the
`staple applying assembly of FIG. 10 with the two-piece
`knife beginning to fire, corresponding to the configuration
`depicted in FIG.9.
`
`[0027] FIG. 12 is a left side cross-sectional view in
`elevation of the closed staple applying assembly of FIG. 9
`after the two-piece knife and firing bar has distally fired.
`
`[0028] FIG. 13 is a left side cross-sectional view in
`elevation of the closed staple applying assembly of FIG. 12
`after firing of the staple cartridge and retraction of the
`two-piece knife.
`
`[0029] FIG. 14 isa left side cross-sectional detail view in
`elevation of the staple applying assembly of FIG. 13 with
`the two-piece knife allowed to drop into a lockout position.
`
`[0030] FIG. 15 is a top view in section taken along lines
`15-15 of an articulation joint (flex neck) of the surgical
`stapling instrument of FIG.1.
`
`[0031] FIG. 16 is a front view in elevation taken in
`vertical cross section along lines 16-16 of the articulation
`joint of FIG. 15, showing electroactive polymer (EAP) plate
`articulation actuators and EAP supportplates for a firing bar.
`
`FIG.2 is a left, front perspective view of an open
`[0017]
`staple applying assembly of the surgical stapling instrument
`
`[0032] FIG. 17 is a top view in section along lines 15-15
`of the articulation joint of FIG. 16 after articulation.
`
`16
`
`16
`
`

`

`US 2005/0263562 Al
`
`Dec. 1, 2005
`
`[0033] FIG. 18 is a perspective view of the articulation
`joint of FIG. 15.
`
`DETAILED DESCRIPTION OF THE
`INVENTION
`
`In FIGS. 1-3, a surgical stapling instrument 10 has
`[0034]
`at its distal end an endeffector, depicted as a staple applying
`assembly 12, spaced apart from a handle 14 (FIG.2) by an
`elongate shaft 16. The staple applying assembly 12 includes
`a staple channel 18 for receiving a replaceable staple car-
`tridge 20. Pivotally attached to the staple channel 18 is an
`anvil 22 that clamps tissue to the staple cartridge 20 and
`serves to deform staples 23 (FIG. 3) driven up from staple
`holes 24 in the staple cartridge 20 against staple forming
`recesses 26 (FIG. 6) in an anvil undersurface 28 into a
`closed shape. When the staple applying assembly 12 is
`closed, its cross sectional area, as well as the elongate shaft
`16 are suitable for insertion through a small surgical open-
`ing, such as through a cannula of a trocar (not shown).
`
`[0035] With particular reference to FIG. 1, correct place-
`ment and orientation of the staple applying assembly 12 is
`facilitated by controls on the handle 14. In particular, a
`rotation knob 30 causes rotation of the shaft 16 aboutits
`
`longitudinal axis, and hencerotation of the staple applying
`assembly 12. Additional positioning is enabled at an articu-
`lation joint 32 in the shaft 16 that pivots the staple applying
`assembly 12 in an arc from the longitudinal axisof the shaft
`16, thereby allowing placement behind an organ or allowing
`other instruments such as an endoscope (not shown) to be
`oriented behind the staple applying assembly 12. This articu-
`lation is advantageously effected by an articulation control
`switch 34 on the handle 14 that transmits an electrical signal
`to the articulation joint 32 to an Electroactive Polymer
`(EAP)actuator 36, powered by an EAP controller and power
`supply 38 contained within the handle 14.
`
`[0036] Once positioned with tissue in the staple applying
`assembly 12, a surgeon closes the anvil 22 by drawing a
`closure trigger 40 proximally toward a pistol grip 42. Once
`clamped thus, the surgeon may grasp a moredistally pre-
`sented firing trigger 44, drawingit back to effect firing of the
`staple applying assembly 12, which in some applicationsis
`achieved in onesingle firing stroke and in other applications
`by multiple firing strokes. Firing accomplishes simulta-
`neously stapling of at
`least
`two rows of staples while
`severing the tissue therebetween.
`
`[0037] Retraction of the firing components may be auto-
`matically initiated upon full travel. Alternatively, a retraction
`lever 46 may be drawnaft to effect retraction. With thefiring
`componentsretracted, the staple applying assembly 12 may
`be unclamped and opened by the surgeon slightly drawing
`the closure trigger 40 aft toward the pistol grip 42 and
`depressing a closure release button 48 and then releasing the
`closure trigger 40, thereby releasing the two stapled ends of
`severed tissue from the staple applying assembly 12.
`
`[0038] Staple Applying Assembly.
`
`[0039] While an articulation joint 32 is depicted in FIG. 1,
`for clarity and as an alternative application,
`the surgical
`stapling instrument 10 of FIGS. 2-14 omit an articulation
`joint 32. It should be appreciated, however, that aspects of
`the present invention have particular advantages for articu-
`lation as described below with regard to FIGS. 15-18.
`
`the staple applying assembly 12
`In FIGS. 1-3,
`[0040]
`accomplishes the functions of clamping onto tissue, driving
`staples and severing tissue by two distinct motions trans-
`ferred longitudinally down the shaft 16 over a shaft frame
`70. This shaft frame 70 is proximally attached to the handle
`14 and coupled for rotation with the rotation knob 30. An
`illustrative multi-stroke handle 14 for the surgical stapling
`and severing instrument 10 of FIG.1 is described in greater
`detail in the co-pending and co-owned U:S. patent applica-
`tion entitled “SURGICAL STAPLING INSTRUMENT
`INCORPORATING A MULTISTROKE FIRING POSI-
`TION INDICATOR AND RETRACTION MECHANISM”
`
`to Swayze and Shelton, Ser. No. 10/374,026, the disclosure
`of which is hereby incorporated by reference in its entirety,
`with additional features and variation as described herein.
`While a multi-stroke handle 14 advantageously supports
`applications with high firing forces over a long distance,
`applications consistent with the present invention may incor-
`porate a singlefiring stroke, such as described in co-pending
`and commonly owned U‘S. patent application “SURGICAL
`STAPLING INSTRUMENT HAVING SEPARATE DIS-
`TINCT CLOSING AND FIRING SYSTEMS”to Frederick
`E. Shelton IV, Michael E. Setser, and Brian J. Hemmelgarn,
`Ser. No. 10/441,632,
`the disclosure of which is hereby
`incorporated by reference in its entirety.
`
`[0041] With particular reference to FIG.3, the distal end
`of the shaft frame 70 is attached to the staple channel 18. The
`anvil 22 has a proximal pivoting end 72 that is pivotally
`received within a proximal end 74 of the staple channel 18,
`just distal to its engagement to the shaft frame 70. The
`pivoting end 72 of the anvil 22 includes a closure feature 76
`proximate but distal to its pivotal attachment with the staple
`channel 18. Thus, a closure tube 78, whose distal end
`includes a horseshoe aperture 80 that engages this closure
`feature 76, selectively imparts an opening motion to the
`anvil 22 during proximal longitudinal motion and a closing
`motion to the anvil 22 during distal longitudinal motion of
`the closure tube 78 sliding over the shaft frame 70 in
`response to the closure trigger 40.
`
`[0042] The shaft frame 70 encompassesand guidesa firing
`motion from the handle 14 through a longitudinally recip-
`rocating, two-piece knife and firing bar 90. In particular, the
`shaft frame 70 includes a longitudinalfiring bar slot 92 that
`receives a proximal portion of the two-piece knife and firing
`bar 90, specifically a laminate tapered firing bar 94. It should
`be appreciated that the laminated tapered firing bar 94 may
`be substituted with a solid firing bar or of other materials in
`applications not intended to pass through an articulation
`joint, such as depicted in FIGS. 2-14.
`
`[0043] An E-beam 102 is the distal portion of the two-
`piece knife and firmg bar 90, which facilitates separate
`closure andfiring as well as spacing of the anvil 22 from the
`elongate staple channel 18 during firing. With particular
`reference to FIGS. 3-4,
`in addition to any attachment
`treatment such as brazing or an adhesive, the knife and firing
`bar 90 are formed of a female vertical attachment aperture
`104 proximally formed in the E-beam 102 that receives a
`corresponding male attachment member 106 distally pre-
`sented by the laminated tapered firing bar 94, allowing each
`portion to be formed of a selected material and process
`suitable for their disparate functions(e.g., strength, flexibil-
`ity,
`friction). The E-beam 102 may be advantageously
`formed of a material having suitable material properties for
`
`17
`
`17
`
`

`

`US 2005/0263562 Al
`
`Dec. 1, 2005
`
`forming a pair of top pins 110, a pair of middle pins 112 and
`a bottom pin or foot 114, as well as being able to acquire a
`sharp cutting edge 116. In addition, integrally formed and
`proximally projecting top guide 118 and middle guide 120
`bracketing each vertical end of the cutting edge 116 further
`define a tissue staging area 122 assisting in guidingtissue to
`the sharp cutting edge 116 prior to being severed. The
`middle guide 120 also serves to engage and fire the staple
`applying apparatus 12 by abutting a stepped central member
`124 of a wedge sled 126 (FIG. 5)
`that effects staple
`formation by the staple applying assembly 12, as described
`in greater detail below.
`
`anvil 22 from the staple channel 18. Thus, with the E-beam
`102 retracted, the surgeon is able to repeatably open and
`close the staple applying assembly 12 until satisfied with the
`placement and orientation of tissue captured therein for
`stapling and severing, yet the E-beam 102 assists in proper
`positioning of tissue even for a staple applying assembly 12
`of reduced diameter and correspondingly reduced rigidity.
`
`In FIGS. 2-3, 5-6, 8-14, the staple applying assem-
`[0049]
`bly 12 is shown with the replaceable staple cartridge 20 that
`includes the wedge sled 126. Longitudinally aligned and
`parallel plurality of downwardly open wedge slots 202
`(FIG. 8) receive respective wedges 204 integral
`to the
`[0044] Forming these features (e.g., top pins 110, middle
`wedge sled 126. In FIGS. 8-10, the wedge sled 126 thus
`pins 112, and bottom foot 114) integrally with the E-beam
`cams upwardly a plurality of staple drivers 206 that are
`102 facilitates manufacturingat tighter tolerances relative to
`vertically slidable within staple driver recesses 208. In this
`
`one another as compared to being assembled fromaplurality illustrative version, each staple driver 206 includes two
`of parts, ensuring desired operation during firing and/or
`vertical prongs, each translating upwardly into a respective
`effective interaction with various lockout features of the
`staple hole 210 to upwardly force out and deform a staple 23
`resting thereupon against a staple forming surface 214 (FIG.
`10) of the anvil 22. A central firing recess 216 (FIG. 3)
`defined within the staple cartridge 20 proximateto the staple
`channel 18 allows the passage of the bottom, horizontal
`portion 218 (FIG. 5) of the wedge sled 126 as well as the
`middle pins 112 of the E-beam 102. Specifically, a staple
`cartridge tray 220 (FIGS. 3, 8) attaches to and underlies a
`polymerstaple cartridge body 222 that has the staple driver
`recesses 208, staple holes 210, and central firing recess 216
`formed therein. As staples 23 are thus formedto eitherside,
`the sharp cutting edge 116 enters a vertical through slot 230
`passing through the longitudinal axis of the staple cartridge
`20, excepting only a mostdistal end thereof.
`
`staple applying assembly 12.
`
`In FIGS.6-7, the surgical stapling instrument 10 is
`[0045]
`shown open, with the E-beam 102 filly retracted. During
`assembly, the lower foot 114 of the E-beam 102 is dropped
`through a widened hole 130 in the staple channel 18 and the
`E-beam 102 is then advanced such that the E-beam 102
`
`slides distally along a lower track 132 formedin the staple
`channel 18. In particular, the lower track 132 includes a
`narrow slot 133 that opens up as a widened slot 134 on an
`undersurface of the staple channel 18 to form an inverted
`T-shape in lateral cross section, as depicted particularly in
`FIGS. 7 and 8, which communicates with the widened hole
`130. Once assembled, the components proximally coupled
`to the laminate tapered firing bar 94 do not allow the lower
`foot 114 to proximally travel again to the widened hole 130
`to permit disengagement.
`
`the laminate tapered firing bar 94
`In FIG. 9,
`[0046]
`facilitates insertion of the staple applying assembly 12
`through a trocar. In particular, a more distal, downward
`projection 136 raises the E-beam 102 when fully retracted.
`This is accomplished by placement of the downward pro-
`jection 136 at a point where it cams upwardly on a proximal
`edge of the widened hole 130 in the staple channel 18.
`
`In FIG. 10, the laminate tapered firing bar 94 also
`[0047]
`enhances operation of certain lockout features that may be
`incorporated into the staple channel 18 by including a more
`proximal upward projection 138 that is urged downwardly
`by the shaft frame 70 during an initial portion of the firing
`travel. In particular, a lateral bar 140 is defined between a
`pair of square apertures 142 in the shaft frame 70 (FIG.3).
`A clip spring 144 that encompasses the lateral bar 140
`downwardly urges a portion of the laminate tapered firing
`bar 94 projecting distally out of the longitudinal firing bar
`slot 92, which ensures certain advantageous lockout features
`are engaged when appropriate. This urging is more pro-
`nouncedor confined solely to that portion ofthe firing travel
`whenthe upward projection 138 contacts the clip spring 144.
`
`In FIGS. 6-7, the E-beam 102is retracted with the
`[0048]
`top pins 110 thereof residing within an anvil pocket 150 near
`the pivoting proximal end of the anvil 22. A downwardly
`open vertical anvil slot 152 (FIG.2) laterally widens in the
`anvil 22 into an anvil internal track 154 that captures the top
`pins 110 of the E-beam 102 as they distally advance during
`firing, as depicted in FIGS. 9-10, affirmatively spacing the
`
`[0050] Firing the staple applying assembly 12 begins as
`depicted in FIG. 10 with the two-piece knife and firing bar
`90 proximally drawn until the downward projection 136
`cams the middle guide 120 on the E-beam 102 upward and
`aft, allowing a new staple cartridge 20 to be inserted into the
`staple channel 18 when the anvil 22 is open as depicted in
`FIGS. 2,6.
`
`In FIG. 11, the two-piece knife and firing bar 90
`[0051]
`has been distally advanced a small distance, allowing the
`downward projection 136 to drop into the widened hole 130
`of the lower track 132 underthe urging ofthe clip spring 144
`against the upward projection 138 of the laminate tapered
`firing bar 94. The middle guide 120 prevents further down-
`ward rotation by resting upon the stepped central member
`124 of the wedge sled 126, thus maintaining the middle pin
`112 of the E-beam within the central firing recess 216.
`
`In FIG. 12, the two-piece knife and firing bar 90
`[0052]
`has been distally fired, advancing the wedge sled 126 to
`cause formation of staples 23 while severing tissue 242
`clamped between the anvil 22 and staple cartridge 20 with
`the sharp cutting edge 116. Thereafter,
`in FIG. 13,
`the
`two-piece knife and firing bar 90 is retracted, leaving the
`wedge sled 126 distally positioned.
`
`the middle pin 112 is allowed to
`In FIG. 14,
`[0053]
`translate downinto a lockout recess 240 formedin the staple
`channel 18 (also see FIGS. 7, 10). Thus, the operator would
`receive a tactile indication as the middle pin 112 encounters
`the distal edge of the lockout recess 240 when the wedge
`sled 126 (not shownin FIG.14) is not proximally positioned
`(i.e., missing staple cartridge 20 or spent staple cartridge
`20).
`
`18
`
`18
`
`

`

`US 2005/0263562 Al
`
`Dec. 1, 2005
`
`In FIG.1, an articulation joint 32 is depicted that
`[0054]
`advantageously benefits from the flexible strength of the
`two-piece knife and firing bar 90. In FIGS. 15-18,
`the
`articulation joint 32 is depicted as a flex neck joint 300
`formed by vertebral column body 302 having laterally
`symmetric pairs of arcing recesses 304 that allow articula-
`tion in an articulation plane.
`It
`is generally known to
`simultaneously compress and expandrespective lateral sides
`306, 308 by selective movementof control rods (not shown)
`that longitudinally pass through the respective lateral sides
`306, 308. Depicted, however, are EAP plate actuators 310,
`312, each capable of powered deflection to one or both
`lateral directions.
`
`[0055] A central passage 320 (FIG. 16) defined longitu-
`dinally through the vertebral column body 302 receives a
`pair of support plates 322, 324 that prevent buckling and
`binding of the laminate tapered firing bar 94. In the illus-
`trative version, each support plate 322, 324 has a proximal
`fixed end 326 (FIG. 15) and a sliding end 328 to accom-
`modate changes in radial distance during articulation. Hav-
`ing a firing bar 94 of a thinner thickness is thus supported.
`
`[0056] While the present invention has beenillustrated by
`description of several embodiments and while the illustra-
`tive embodiments have been described in considerable
`
`detail, it is not the intention of the applicantto restrict or in
`any way limit the scope of the appended claims to such
`detail. Additional advantages and modifications may readily
`appear to those skilled in theart.
`
`[0057] For example, while there are a number of advan-
`tages to having a wedgesled integral to a staple cartridge, in
`some applications consistent with aspects of the present
`invention,
`the wedge sled may be integral instead to an
`E-beam. Forins