Abstract:
An exemplary surgical apparatus may include a feeder belt lying substantially in a single plane; and staples fixed to and frangibly separable from the feeder belt. A cartridge may hold at least one feeder belt, where that cartridge may be detachably held by a receiver. The cartridge itself may be reloadable. A surgical method may include providing a surgical instrument including a detachable cartridge holding a feeder belt, where staples are fixed to and frangibly separable from the feeder belt; deforming at least one staple to a deformed state; frangibly separating at least one deformed staple from the feeder belt; and removing the cartridge from the surgical instrument.

Description:
FIELD OF THE INVENTION 
     The invention generally relates to surgical staplers and stapling. 
     BACKGROUND 
     An endocutter is a surgical tool that staples and cuts tissue to transect that tissue while leaving the cut ends hemostatic. An endocutter is small enough in diameter for use in minimally invasive surgery, where access to a surgical site is obtained through a trocar, port, or small incision in the body. A linear cutter is a larger version of an endocutter, and is used to transect portions of the gastrointestinal tract. A typical endocutter receives at its distal end a disposable single-use cartridge with several rows of staples, and includes an anvil opposed to the cartridge. During actuation of an endocutter, the cartridge fires all of the staples that it holds. In order to deploy more staples, the endocutter must be moved away from the surgical site and removed from the patient, after which the old cartridge is exchanged for a new cartridge. The endocutter is then reinserted into the patient. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view of an exemplary feeder belt. 
         FIG. 2  is a perspective cutaway view of the exemplary feeder belt of  FIG. 1  positioned within a cartridge. 
         FIG. 3  is a detail top view of the proximal end of the cartridge of  FIG. 2 . 
         FIG. 4  is a perspective view of the underside of the cartridge of  FIG. 3 . 
         FIG. 5  is a perspective view of the cartridge of  FIG. 3  above a corresponding receiver. 
         FIG. 6  is a perspective view of a reloadable cartridge utilizing the exemplary feeder belt of  FIG. 1 . 
         FIG. 7  illustrates a surgical instrument for beneficial use with a staple cartridge. 
     
    
    
     The use of the same reference symbols in different figures indicates similar or identical items. 
     DETAILED DESCRIPTION 
     U.S. patent application Ser. No. 12/263,171, filed on Oct. 31, 2008 (the “Endocutter Document”), is hereby incorporated by reference herein in its entirety. The Endocutter Document describes exemplary feeder belts used in a surgical stapler. Referring to  FIG. 1 , a feeder belt  2  may be a long, narrow, thin strip of material from which one or more staples  4  extend. The feeder belt  2  and staples  4  of the present document may be substantially as set forth in the Endocutter Document, with the exception of the inventive features set forth in the present document. Each staple  4  may have a free end  6 , and an opposite end  8  that is connected to the feeder belt  2 . Advantageously, the staples  4  are frangibly affixed to the feeder belt  2 , such that they are sheared off from the feeder belt  2  during deployment. However, the staples  4  may be connected to the feeder belt  2  in any suitable manner. One or more rows  10  of staples  4  may be connected to the feeder belt  2 . Each row  10  of staples  4  is the group of staples  4  positioned at substantially the same lateral location relative to the longitudinal centerline of the feeder belt  2 , and each row  10  of staples  4  may be oriented generally longitudinally. 
     As seen in  FIG. 1 , an exemplary feeder belt  2  may be a generally flat and generally linear piece of material that carries a plurality of staples  4 . The feeder belt  2  may lie substantially in a single plane. The feeder belt  2  may be flexible, or instead may be rigid. Such a feeder belt  2  may have a proximal end  12  and a distal end  14 . Referring also to  FIG. 2 , a cartridge  20  may hold one or more feeder belts  2 . At least one feeder belt  2  may be held entirely within the cartridge  20 , for convenience in interchangeability. The cartridge  20  may be configured substantially as set forth in the Endocutter Document, with the exception of the inventive features set forth herein. The one or more feeder belts  2  may be held by the cartridge  20  in any suitable manner. As one example, the proximal end  12  and the distal end  14  of the feeder belt  2  each may be fixed to the cartridge  20 . Referring also to  FIG. 2A , the cartridge  20  may have an upper surface  22  through which one or more staple slots  24  may be defined. A knife slot  26  may also be defined in the upper surface  22  of the cartridge  20 . In order to fix a feeder belt  2  to the cartridge  20 , the proximal end of  12  of the feeder belt  2  may be fastened to the upper surface  22  of the cartridge  20  at a connection area  28  proximal to the corresponding slot  24 . Similarly, the distal end  14  of the feeder belt  2  may be connected to a similar area distal to the corresponding slot  24 . The staples  4  are oriented such that they are deployable through the corresponding staple slot  24 . The proximal end  12  of the feeder belt  2  may be fastened to the connection area  28  on the upper surface  22  of the cartridge  20  in any suitable manner. For example, the proximal end  12  of the feeder belt  2  may be welded to, adhered to, pinned or otherwise mechanically connected to, or friction or interference fit to the connection area  28 . The distal end  14  of the feeder belt  2  may be connected to the upper surface  22  of the cartridge  20  distal to the corresponding staple slot  24  in a similar or different manner. 
     Referring also to  FIG. 7 , use of the cartridge  20  may be beneficial for use in a surgical instrument  100  where an articulation  102  is utilized in the instrument proximal to the cartridge  20 . For example, the surgical instrument  100  may include a handle  104  from which a shaft  106  extends, where an articulation  102  is located in the shaft  106 . Such a surgical instrument  100  may be as described in U.S. patent application Ser. No. 12/400,760, filed on Mar. 9, 2009, which is hereby incorporated by reference in its entirety. An end effector  108  may be connected to the distal end of the shaft  106 , distal to the articulation  102 . Referring also to  FIG. 5 , the cartridge  20  is configured to be placed in and held by a receiver  40 , which may be part of the end effector  108 . By holding each feeder belt  2  inside the cartridge  20 , which in turn is held by the end effector  108 , no feeder belt  2  crosses the articulation  102 , which may simplify construction of the surgical instrument  100 . At the same time, the cartridge  20  may be configured to hold fewer staples  4  than described in the Endocutter Document. 
     The receiver  40  may receive and hold the cartridge  20  in any suitable manner. As one example, the cartridge  20  may be pressure fit into the receiver  40 . As another example, the cartridge  20  may snap into or otherwise be affirmatively held in the receiver  40  in a different manner. Referring also to  FIG. 4 , the underside  42  of the cartridge  20  may include at least one aperture  44  defined therethrough. As set forth in the Endocutter Document, one or more wedges  30  slide relative to the staples  4  in order to deploy them, and the wedges  30  may be fixed to or otherwise connected to a wedge block  44 . The wedge block  44  may include a pocket  46  defined in its underside, where that pocket  46  is aligned with the aperture  44 . A tab  48  may be located in the receiver  40 , and may be a slidable along a channel  50  defined in the lower surface of the receiver  40 . One or more cables  52  may extend proximally from the tab  48 , and may extend out of the end effector  108  through the shaft  106  to the handle  104 . One or more of the cables  52  may pass through the articulation  102  in the shaft  106 . The tab  48  is sized and shaped to be received into the pocket  46  of the wedge block  44 . 
     The cartridge  20  may be actuated substantially as set forth in the Endocutter Document. Each wedge  30  may be connected to the wedge block  44 . The wedges  30  may initially be in a distal position within the cartridge  20 . To actuate the wedges  30 , the cable or cables  52  are pulled proximally in response to input from, for example, the handle  104 . This motion of the cable or cables  52  causes the tab  48  to move proximally, which in turn moves the wedge block  44  proximally. As the wedge block  44  moves proximally, it slides the wedge or wedges  30  proximally as well. Advantageously, one wedge  30  slides along a corresponding row  10  of staples  4  to sequentially deform staples  4  upward through the corresponding staple slots  24 , and then shear staples  4  from the feeder belts  2 . A knife (not shown) also may be connected to the wedge block  44 , and may slide upward through the corresponding knife slot  26  as set forth in the Endocutter Document. 
     The wedge block  44  may be actuated to move proximally along a distance such that all of the staples  4  are deformed and then sheared off the corresponding feeder belts  2 . If so, the cartridge  20  is configured for a single firing. Alternately, the wedge block  44  may be actuated to move along a distance such that only a subset of the staples  4  are deformed and then sheared off the corresponding feeder belts  2 . If so, the cartridge  20  can be reused at least once. 
     After firing, and after the cartridge  20  is spent such that no staples  4  are left in the cartridge  20  or such that fewer staples  4  are left in the cartridge  20  than the user needs to perform another procedure, the cartridge  20  may be removed from the receiver  40 . A new cartridge  20  may then be placed in the receiver  40 , in substantially the same manner as described above. In this way, the majority of the surgical instrument  100  may be reused with regard to a patient, while only the cartridge  20  needs to be replaced when spent. Advantageously, the wedges  30  may be contained entirely within the cartridge  20 , simplifying the process of removing the cartridge  20  from the receiver  40  and replacing it with a fresh one. 
     As another example, the feeder belt  2  may form a continuous loop, such as set forth in the Endocutter Document. Such a feeder belt  2  may be held completely within the corresponding cartridge  20 . That feeder belt  2  thereby is configured to hold more staples  4  than the two-dimensional feeder belt  2  of  FIG. 1 , but may be configured to hold fewer staples  4  than described in the Endocutter Document. Such a feeder belt  2  may be advanced substantially as described in the Endocutter Document, or in any other suitable manner. Where the cartridge  20  utilizes such a feeder belt  2 , the cartridge  20  advantageously may be fired two or more times before its replacement is needed. 
     As another example, the cartridge  20  itself may be reloadable, as shown in  FIG. 6 . If so, the cartridge  20  may include one or more rear apertures  52  defined in its proximal end. After use, the spent feeder belt  2  may be slid through the corresponding rear aperture  52  and disposed of in a suitable manner. A new feeder belt  2  may then be slid through each corresponding rear aperture  52 , and may be held in place in the cartridge  20  in any suitable manner. In this way, even more of the surgical instrument  100  may be reusable in the course of treatment of a single patient. 
     While the invention has been described in detail, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention. It is to be understood that the invention is not limited to the details of construction, the arrangements of components, and/or the method set forth in the above description or illustrated in the drawings. Statements in the abstract of this document, and any summary statements in this document, are merely exemplary; they are not, and cannot be interpreted as, limiting the scope of the claims. Further, the figures are merely exemplary and not limiting. Topical headings and subheadings are for the convenience of the reader only. They should not and cannot be construed to have any substantive significance, meaning or interpretation, and should not and cannot be deemed to indicate that all of the information relating to any particular topic is to be found under or limited to any particular heading or subheading. Therefore, the invention is not to be restricted or limited except in accordance with the following claims and their legal equivalents.