Circular stapling device including buttress material

An anvil assembly includes a circular anvil head that supports a crush ring, an anvil cap that supports an o-ring, and a circular anvil buttress member. The cap connects to the head and is movable relative to the head between approximated and unapproximated positions. The crush ring is spaced from the cap when the cap is in the approximated position and movable into engagement with the cap to move the cap to the unapproximated position. The buttress member includes a body portion and an extension portion. The body portion is supported on the head and the extension portion is secureable between the o-ring and the head when the cap is in the approximated position. The extension portion is releasable from between the o-ring and the head when the cap is disposed in the unapproximated position so that the body portion separates from the head.

TECHNICAL FIELD

The present disclosure relates to surgical stapling devices and, more particularly, to structures and methods for removably attaching buttress material to circular surgical stapling devices for use in anastomosis procedures.

BACKGROUND

Fasteners have been used to replace suturing when joining various body structures such as, for example, the bowel or bronchus. Surgical stapling devices employed to apply these fasteners are generally designed to simultaneously cut and seal tissue to reduce the time and risks involved with anastomosis procedures.

Circular surgical stapling devices are employed by surgeons to sequentially or simultaneously apply one or more surgical fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together and/or for the creation of anastomoses. Circular surgical stapling devices generally include an annular fastener cartridge assembly that supports a plurality of annular rows of fasteners, an annular anvil assembly operatively associated with the fastener cartridge assembly which provides a surface against which the fasteners are formed upon a firing of the circular stapling device, and an annular blade for cutting tissue.

For most procedures, the use of bare fasteners, with the fasteners in direct contact with the patient's tissue, is generally acceptable. The integrity of the tissue will normally serve to prevent the fasteners from tearing out of the tissue and compromising the sealing before healing has occurred. However, in some surgical operations buttress materials are employed by surgeons in combination with circular stapling devices to bridge, repair and/or reinforce tissue defects within a patient. In particular, buttress materials reduce the trauma suffered by the patient, reduce the instances of leakage, reduce the instances of bleeding, and create a relatively strong bond between adjacent body tissues.

Accordingly, there is a need for reliably and removably attaching buttress material onto a circular stapling device so that the buttress material does not interfere with the operation of the device, remains on the device until after the fasteners are fired, and is convenient and easy to install and use.

SUMMARY

According to one aspect, a circular stapling device includes a handle assembly, an elongate body that extends from the handle assembly, and an end effector mounted on a distal end of the elongate body and including a cartridge assembly and an anvil assembly.

The anvil assembly includes a circular anvil head that supports a crush ring, an anvil cap that supports an o-ring, and a circular anvil buttress member. In embodiments, the o-ring is formed of an elastomeric material including nitrile.

The anvil cap connects to the anvil head and is movable relative to the anvil head between an approximated position and an unapproximated position. The crush ring is spaced from the anvil cap when the anvil cap is disposed in the approximated position and movable into engagement with the anvil cap to move the anvil cap to the unapproximated position. The anvil cap defines a groove in a bottom surface of the anvil cap and the o-ring is secured within the groove. The o-ring is disposed in a compressed condition when the anvil cap is disposed in the approximated position and an uncompressed condition when the anvil cap is disposed in the unapproximated position.

The anvil cap includes a snap feature and the anvil head defines a first recess and a second recess. The snap feature is selectively positionable within one of the first recess and the second recess. The snap feature is positionable within the first recess when the anvil cap is disposed in the approximated position and is positionable within the second recess when the anvil cap is disposed in the unapproximated position. The first recess and the second recess are separated by a ramped partition. The snap feature cams over the ramped feature as the anvil cap moves from the approximated position to the unapproximated position. The snap feature flexes outwardly from the first recess as the snap feature cams over the ramped partition and flexes inwardly into the second recess after camming over the ramped partition. The snap feature maintains the anvil cap secured to the anvil head when the snap feature is disposed in the second recess.

The circular anvil buttress member includes a body portion and an extension portion that extends from the body portion. The body portion is supported on a tissue engaging surface of the anvil head. The extension portion is secureable between the o-ring and the anvil head when the anvil cap is disposed in the approximated position. The extension portion is releasable from between the o-ring and the anvil head when the anvil cap is disposed in the unapproximated position so that the body portion separates from the tissue engaging surface of the anvil head. The extension portion includes one or more tabs. The o-ring is compressed against the one or more tabs when the anvil cap is disposed in the approximated position to maintain the body portion supported on the tissue engaging surface of the anvil head.

In another aspect, then anvil assembly includes a circular anvil head that supports a crush ring, and anvil cap that connects to the anvil head and supports an o-ring, and a circular anvil buttress member.

The anvil cap is movable relative to the anvil head between an approximated position and an unapproximated position. The crush ring is spaced from the anvil cap when the anvil cap is disposed in the approximated position and movable into engagement with the anvil cap to move the anvil cap to the unapproximated position. The anvil cap defines a groove in a bottom surface of the anvil cap. The o-ring is secured within the groove. The o-ring is disposed in a compressed condition when the anvil cap is disposed in the approximated position and in an uncompressed condition when the anvil cap is disposed in the unapproximated position. In embodiments, the o-ring is formed of an elastomeric material including nitrile.

The anvil cap includes a snap feature and the anvil head defines a first recess and a second recess. The snap feature is selectively positionable within one of the first recess and the second recess. The snap feature is positionable within the first recess when the anvil cap is disposed in the approximated position and is positionable within the second recess when the anvil cap is disposed in the unapproximated position. The first recess and the second recess are separated by a ramped partition. The snap feature cams over the ramped feature as the anvil cap moves from the approximated position to the unapproximated position. The snap feature flexes outwardly from the first recess as the snap feature cams over the ramped partition and flexes inwardly into the second recess after camming over the ramped partition. The snap feature maintains the anvil cap secured to the anvil head when the snap feature is disposed in the second recess.

The circular anvil buttress member includes a body portion and an extension portion that extends from the body portion. The body portion is supported on a tissue engaging surface of the anvil head. The extension portion is secureable between the o-ring and the anvil head when the anvil cap is disposed in the approximated position. The extension portion is releasable from between the o-ring and the anvil head when the anvil cap is disposed in the unapproximated position so that the body portion separates from the tissue engaging surface of the anvil head. The extension portion includes one or more tabs. The o-ring is compressed against the one or more tabs when the anvil cap is disposed in the approximated position to maintain the body portion supported on the tissue engaging surface of the anvil head.

According to yet another aspect, the present disclosure is directed to a method for releasing an anvil buttress member from an anvil assembly of a circular stapling device. The method includes the step of providing a circular stapling device including an elongate member having an end effector mounted on a distal end of the elongate body. The end effector includes an anvil assembly that includes an anvil head and an anvil cap that supports an o-ring. The anvil assembly includes an extension portion of an anvil buttress member secured between the o-ring and the anvil head so that a body portion of the anvil buttress member is supported on a tissue engaging surface of the anvil head. The method involves moving the o-ring relative to anvil head to release the anvil buttress member from the anvil assembly. Another step includes moving a crush ring supported on the anvil head into engagement with the anvil cap to move the o-ring relative to the anvil head. Yet another step involves spacing the o-ring and the anvil head relative to one another in response to engagement of the crush ring with the anvil head to provide a gap between the o-ring and the anvil head sufficient to enable the extension portion of the anvil buttress member to be released from between the o-ring and the anvil head.

Other aspects, features, and advantages will be apparent from the description, drawings, and claims.

DETAILED DESCRIPTION

As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Particular embodiments of the present disclosure will be described herein with reference to the accompanying drawings. As shown in the drawings and as described throughout the following description, and as is traditional when referring to relative positioning on an object, the term “proximal” refers to the end of the device that is closer to the clinician and the term “distal” refers to the end of the device that is farther from the clinician. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.

Referring initially toFIG. 1, a circular surgical stapling device for use with a buttress material is disclosed herein and is generally designated as10. In embodiments, the surgical stapling device10is adapted for reuse and, in certain embodiments, the surgical stapling device10is adapted for a single use and can be disposable.

The circular stapling device10includes a handle assembly20, a tubular elongate body30, and an end effector40. The end effector40can be provided as a removable and replaceable assembly. The handle assembly20includes a rotatable advancing member22and a pivotable trigger member24that are operatively coupled to any number of drivers supported by the surgical stapling device10to effectuate a firing of the surgical stapling device10. The elongate body30extends distally from a distal end portion of the handle assembly20to a proximal end portion of the end effector40so that the elongate body30is disposed between the handle assembly20and the end effector40. In some embodiments, the elongate body30has a linear shape along the length of the elongate body30, and in certain embodiments, the elongate body30has a curved shape along the length of the elongate body30.

The end effector40includes a fastener cartridge assembly100, an anvil assembly200, and a shaft300. The shaft300includes a proximal end portion that is secured to the fastener cartridge assembly100and a distal end portion that is secured to the anvil assembly200. In embodiments, the fastener cartridge assembly100and/or the anvil assembly200may be replaced and the circular stapling device10may be reused. In embodiments, the end effector40supports a knife assembly with a substantially cylindrical knife400(FIG. 6) adapted to cut tissue.

Reference may be made to U.S. Pat. No. 5,915,616 to Viola et al. and commonly owned U.S. Patent Application Publication No. 2011/0174099, the entire contents of which are incorporated herein by reference, for a detailed discussion of the construction and operation of exemplary circular stapling devices.

Turning now toFIGS. 2-6, the anvil assembly200includes a circular anvil head210, an o-ring215, an anvil cap220, a circular anvil buttress member230, a crush ring member240, an anvil plate250, and a ring assembly260.

With continued reference toFIG. 4, the circular anvil head210includes a head body212that supports the crush ring member240, the ring assembly260, and the anvil plate250. The head body212has a connector214that extends proximally from the head body212and is dimensioned to operatively couple to a distal end portion302of the shaft300. The connector214defines a pair of opposed channels214a. One or more engaging passages216are defined by the head body212and extend through the head body212. As shown inFIGS. 5-6, a distal surface of the head body212includes one or more ramped partitions218that separate a first recess218aand a second recess218bdefined on opposite sides of the ramped partition218.

Referring again toFIG. 4, the anvil cap220includes a cap body222that is supported on the distal surface of the anvil head210so that the o-ring215is positionable between the cap body222and the anvil head210. In particular, the cap body222defines an annular groove222awithin which the o-ring215is dimensioned to be received. The cap body222includes one or more engaging features224and one or more snap features226that extend proximally from the cap body222. Referring also toFIGS. 5-6, the snap feature226includes a tooth226athat extends radially inwardly. The first and second recesses218a,218bof the anvil head210are each dimensioned to receive the tooth226ato facilitate securement of the anvil cap220to the anvil head210. The cap body222defines an opening228dimensioned to enable the snap feature226to flex radially outwardly to permit the anvil cap220to move relative to the anvil head210between approximated and unapproximated positions.

The anvil plate250secures to the proximal surface of the anvil head210and has an annular body252that defines an opening254therethrough. The annular body252has a tissue engaging surface256that defines a plurality of fastener forming pockets256a. The plurality of fastener forming pockets256ais arranged in an annular array about the tissue engaging surface256of the annular body252.

The circular anvil buttress member230is selectively supported on the anvil plate250and has an annular body portion232and one or more extension portions234that extends radially from the body portion232. The body portion232is dimensioned to overly the tissue engaging surface256of the anvil plate250and defines a central opening236therethrough. The extension portion234includes a plurality of spaced apart tabs234athat extend radially outwardly about the body portion232. The plurality of spaced apart tabs234aare selectively positionable between the proximal surface of the anvil cap220and the distal surface of the anvil head210to selectively secure the annular body portion232against the tissue engaging surface256of the anvil plate250when the anvil cap220is disposed in the approximated position. As described in greater detail below, the extension portion234is releasable from the between the anvil cap220and the anvil head210when the anvil cap220is moved to the unapproximated position so that the body portion232separates from the tissue engaging surface256of the anvil plate250.

The crush ring member240is supported on the anvil head210and includes a generally annular body242having a plurality of tab members244that secure to a proximal surface of the anvil head210and extend from the body242at radially spaced locations along an outer surface of the body242. The crush ring member240is dimensioned to be spaced from the one or more engaging features224of the cap body222when the anvil cap220is disposed in the approximated position and movable into engagement with the one or more engaging features224to move the anvil cap220to the unapproximated position. The annular body242defines an aperture246therethrough that is dimensioned to receive the connector214of the head body212when the crush ring member240is secured to the anvil head210.

As illustrated inFIG. 4, the ring assembly260is supported between the anvil head210and the anvil plate250. The ring assembly260includes a first annular member270, a second annular member280, and a third annular member290.

The first annular member270includes a body272having a proximal surface272aand a distal surface272bwith a central opening274defined by an inner surface272cthat extends between the proximal surface272aand the distal surface272bof the body272. The body272includes a plurality of annularly spaced apart projections276that extend distally from the distal surface272bof the body272. Each projection276includes a pair of opposed support arms276athat extend from the projection276. The opposed support arms276aare disposed substantially transverse to the projection276.

The second annular member280includes a body282having a proximal surface282aand a distal surface282bwith a central opening284defined by an inner surface282cthat extends between the proximal surface282aand the distal surface282bof the body282. The body282includes a pair of opposed nubs286that extend from the inner surface282cand are dimensioned to slide within the channels214adefined in the connector214of the anvil head210. The body282includes a plurality of ledges288extend from an outer surface282dof the body282and radially about the outer surface282dof the body282. Adjacent ledges288define a passage285therebetween that is dimensioned to receive the projections276of the first annular member270such that the opposed support arms276aof the projections276are supported against the adjacent ledges288on the distal surface282bof the second annular member280when the first and second annular members270,280are secured together. The portion of the outer surface282dof the body282positioned proximally of the ledges288is dimensioned to be seated within the central opening274defined by the first annular member270when the first and second annular members270,280are secured together. As shown inFIGS. 5 and 6, at least portions of the proximal surfaces of the first and second annular members270,280are substantially aligned when the first and second annular members270,280are secured together.

The third annular member290includes a body292having a proximal surface292aand a distal surface292bwith a central opening294defined by an inner surface292cthat extends between the proximal surface292aand the distal surface292bof the body292. As shown inFIGS. 5 and 6, when the annular members of the ring assembly260are secured together, the inner surface292cof the third annular member290radially surrounds an outer surface of the ledges288of the second annular member280and retains the projections276of the first annular member270within the passages285of the second annular member280. In this regard, the distal surface272bof the first annular member270engages the proximal surface292aof the third annular member290and at least portions of the distal surface292bof the third annular member290and the distal surface282bof the second annular member280are disposed in substantial alignment and in contact with a proximal surface of the crush ring240.

During operation of the surgical stapling device10, the anvil assembly200and the cartridge assembly100are approximated by the actuation of advancing member22until the anvil assembly200and the cartridge assembly100are suitably clamped against tissue of a patient. The trigger member24is then actuated to fire the surgical stapling device10. Upon a firing of the surgical stapling device10, the legs of the fasteners supported within the cartridge assembly100are advanced through the clamped tissue and any buttress material clamped against tissue including the anvil buttress member230and any buttress material that may supported on the cartridge assembly. As the fasteners are distally advanced, the legs of the fasteners are formed by the fastener forming pockets256adefined in the anvil plate250to secure the buttress material including the anvil buttress member230to the tissue.

Referring again toFIGS. 5-6, the knife400is simultaneously or thereafter advanced into the anvil assembly200to sever the clamped tissue and to advance into engagement with the proximal surface272aof the first annular member270of the ring assembly260. Upon engagement with the first annular member270, the knife400distally drives the entire ring assembly260toward the anvil cap220. Notably, as the ring assembly260is moved distally, the pair of opposed nubs286of the second annular member280slide through the channels214aof anvil head210such that the ring assembly260drives the crush ring member240distally into engagement with the one or more engaging features224of the anvil cap220.

The distal movement of the crush ring member240into engagement with the one or more engaging features224of the anvil cap220separates the proximal surface of the cap body222of the anvil cap220from the distal surface of the head body212of the anvil head210so that the o-ring215separates from the extension portions234of the anvil buttress member230. In particular, the teeth226aof the snap features226cam against the ramped partitions218so that each snap feature226flexes radially outwardly into the opening228of the cap body222from the first recess218aof the head body212to enable the anvil cap220to separate from the anvil head210as the anvil cap220moves from the approximated position to the unapproximated position. After camming over the ramped partitions218, the teeth226aof the snap features226snap or flexes radially inwardly into the second recess218bof the head body212to maintain the anvil cap220secured to the anvil head210. The separation of the cap body222and the head body212creates a space or gap “G” between the proximal surface of the cap body222and a distal surface of the head body212to free the extension portion234of the anvil buttress member230from between the anvil head210and the o-ring215so that the anvil buttress member230is secured to the tissue independent of the surgical stapling device10.

As illustrated inFIG. 7, an embodiment of an anvil assembly is generally referred to as anvil assembly500and is substantially similar to anvil assembly200and thus, anvil assembly500is described herein only to the extent necessary to describe the differences in construction and operation of the anvil assembly500. Anvil assembly500includes a circular anvil head210, an o-ring215, an anvil cap220, a circular anvil buttress member230, a crush ring member240, and an anvil plate250. Notably, anvil assembly500does not include ring assembly260and thus, when the circular knife400is advanced into the anvil assembly500during operation, the blade of the circular knife400directly engages the proximal surface of crush ring member240to drive the crush ring member240distally into engagement with the anvil cap220. In particular, as noted above, the distal movement of the crush ring member240into engagement with the one or more engaging features224of the anvil cap220separates the proximal surface of the cap body222of the anvil cap220from the distal surface of the head body212of the anvil head210so that the o-ring215separates from the extension portions234of the anvil buttress member230to free the anvil buttress member230.

Although a manually operated handle assembly is shown inFIG. 1, in any of the embodiments disclosed herein, the handle assembly can be powered by a motor and an external or internal power source. One or more drive shafts extending through the elongate body can drive the various functions (i.e., approximation, stapling and cutting) of the instrument.

In any of the embodiments disclosed herein, one or more of the crush ring240and parts of the ring assembly260could be eliminated. Furthermore, the circular knife may directly move the anvil cap220above to release the buttress member.

Persons skilled in the art will understand that the structures and methods specifically described herein and illustrated in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely as exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, it is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Indeed, any combination of any of the presently disclosed elements and features is within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not to be limited by what has been particularly shown and described.