Surgical Stapling Instrument

Abstract

A surgical stapling instrument ( 1 ) comprises a staple fastening assembly ( 2 ) including a curved cartridge device ( 10 ) and a curved anvil ( 12 ). The cartridge device ( 10 ) comprises at least one curved open row of staples which are formed by a staple forming face of the anvil ( 12 ). The anvil ( 12 ) can be moved relatively with respect to the cartridge device ( 10 ). A handle ( 4 ) in the proximal end region of the instrument is operatively connected to the staple fastening assembly ( 2 ). A flexible backbone, preferably an endoscope ( 6 ), is arranged between the handle ( 4 ) and the staple fastening assembly ( 2 ) and guides force transmitters ( 8, 9 ) of the moving device and the staple driving device.

1 . Surgical stapling instrument comprising:
 a staple fastening assembly ( 2 ;  102 ) in the distal end region of the instrument ( 1 ;  100 ), including a curved cartridge device ( 10 ), which comprises at least one curved open row ( 76 ,  77 ,  78 ) of staples ( 70 ) having a concave side and a convex side, and, opposite to the cartridge device ( 10 ), a curved anvil ( 12 ), which has a staple forming face ( 80 ) and is adapted to cooperate with the cartridge device ( 10 ) for forming the ends of the staples ( 70 ) exiting from the cartridge device ( 10 ),   a moving device ( 8 ,  24 ,  26 ,  28 ,  29 ,  30 ,  53 ,  60 ) adapted to move the anvil ( 12 ) relatively with respect to the cartridge device ( 10 ), essentially in parallel relationship, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue,   a staple driving device ( 9 ,  32 ,  34 ,  36 ,  37 ,  38 ,  57 ,  64 ) adapted to drive the staples ( 70 ) out of the cartridge device ( 10 ) towards the anvil ( 12 ),   a handle ( 4 ;  104 ) in the proximal end region of the instrument ( 1 ;  100 ), which handle ( 4 ;  104 ) is operatively connected to the staple fastening assembly ( 2 ;  102 ) and which comprises actuating members ( 24 ,  32 ) coupled to force transmitters ( 8 ,  9 ) of the moving device and of the staple driving device,   characterized in that a flexible backbone ( 6 ;  106 ,  108 ) is arranged between the handle ( 4 ;  104 ) and the staple fastening assembly ( 2 ;  102 ), which flexible backbone ( 6 ;  106 ,  108 ) guides the force transmitters ( 8 ,  9 ) of the moving device and of the staple driving device.   
   
   
       2 . Stapling instrument according to  claim 1 , characterized by
 a knife ( 72 ), which is contained in the cartridge device ( 10 ) and which is positioned on the concave side of at least one row ( 76 ,  77 ) of staples ( 70 ), and   a knife actuating device ( 9 ,  32 ,  34 ,  36 ,  37 ,  38 ,  57 ,  64 ) adapted to move the knife ( 72 ) towards the anvil ( 12 ), which knife actuating device preferably is coupled to the staple driving device.   
   
   
       3 . Stapling instrument according to  claim 1  or  2 , characterized in that the flexible backbone ( 6 ;  106 ,  108 ) comprises a flexible endoscope ( 6 ;  106 ), which preferably is removably mounted. 
   
   
       4 . Stapling instrument according to  claim 1  or  2 , characterized in that the stapling instrument ( 1 ;  100 ) is adapted to be used with an independent flexible endoscope ( 6 ;  106 ) forming at least part of the flexible backbone ( 6 ;  106 ,  108 ). 
   
   
       5 . Stapling instrument according to  claim 3  or  4 , characterized in that the force transmitters ( 8 ,  9 ) of the moving device and of the staple driving device are located at the outside of the endoscope ( 6 ) and are attached to the endoscope ( 6 ) by a plurality of spaced holders ( 16 ). 
   
   
       6 . Stapling instrument according to  claim 3  or  4 , characterized in that the flexible backbone ( 106 ,  108 ) comprises a flexible guide ( 108 ), which is arranged alongside the endoscope ( 106 ) and which accommodates the force transmitters of the moving device and of the staple driving device. 
   
   
       7 . Stapling instrument according to one of  claims 1  to  6 , characterized in that at least one of the force transmitters ( 8 ,  9 ) of the moving device and of the staple driving device comprises a flexible rotary rod ( 50 ,  54 ) adapted to be rotated around its longitudinal axis upon actuation of the related actuating member ( 24 ,  32 ) of the handle ( 4 ) and adapted to transform its rotary motion to a longitudinal motion at the staple fastening assembly ( 2 ). 
   
   
       8 . Stapling instrument according to  claim 7 , characterized in that the at least one of the force transmitters ( 8 ,  9 ) is adapted to be rotated via a gear transmission ( 26 ,  28 ,  29 ;  34 ,  36 ,  37 ) operated by the related actuating member ( 24 ,  32 ). 
   
   
       9 . Stapling instrument according to  claim 7  or  8 , characterized in that the at least one of the force transmitters ( 8 ,  9 ) is adapted to transform its rotary motion to a longitudinal motion via a screw drive ( 53 ,  57 ). 
   
   
       10 . Stapling instrument according to one of  claims 1  to  9 , characterized in that the staple fastening assembly ( 2 ) is adapted to allow unobstructed access towards concave inner faces of the cartridge device ( 10 ) and of the anvil ( 12 ). 
   
   
       11 . Stapling instrument according to one of  claims 1  to  10 , characterized in that the staple forming face ( 80 ) of the anvil ( 12 ) is generally planar. 
   
   
       12 . Stapling instrument according to one of  claims 1  to  11 , characterized in that the cartridge device ( 10 ) and the anvil ( 12 ) have a generally arc-like shape in a cross-sectional plane, the arc extending over an angle in the range 10° to 350°. 
   
   
       13 . Stapling instrument according to one of  claims 1  to  12 , characterized in that the anvil ( 12 ) is supported by means of at least one arm ( 60 ,  74 ) extending from an end of the anvil ( 12 ) and generally running in parallel to the direction of relative movement of the anvil ( 12 ) with respect to the cartridge device ( 10 ). 
   
   
       14 . Stapling instrument according to one of  claims 1  to  13 , characterized in that the distance between the cartridge device ( 10 ) and the anvil ( 12 ) in the closed position is adjustable. 
   
   
       15 . Stapling instrument according to one of  claims 1  to  14 , characterized in that the cartridge device comprises a replaceable cartridge containing the staples. 
   
   
       16 . Stapling instrument according to one of  claims 1  to  15 , characterized in that the staple fastening assembly is removably mounted. 
   
   
       17 . Stapling instrument according to one of  claims 1  to  16 , characterized in that the handle is removably mounted.