Abstract:
The present disclosure is directed to a surgical instrument, which includes a handle assembly and an elongate member having two jaw members. The second jaw member is movable in relation to the first jaw member between an open position and a closed position. The first jaw member is supported by the elongate body and contains a plurality of fasteners. The elongate member extends distally from the handle assembly and defines both a longitudinal axis and a distal portion. A switch is placed about the handle assembly to allow the handle assembly to operate in multiple modes.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application claims the benefit of, and priority to, U.S. patent application Ser. No. 12/792,244, filed on Jun. 2, 2010 which claims the benefit of, and priority to, U.S. Provisional Application Ser. No. 61/234,369, filed on Aug. 17, 2009, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates to a surgical stapling device and, more particularly, to an endoscopic surgical stapling device having a tool assembly and an endoscopic body portion, wherein the anvil is pivoted by a motor and the staples are fired manually. 
     2. Background of Related Art 
     Surgical devices wherein tissue 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 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 cartridge which houses a plurality of staples arranged in at least 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 or cam wedge that travel longitudinally through the staple cartridge, with the cam bars or cam wedge 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 of staples on each side of the incision. This is accomplished by providing a disposable loading unit in which a cam member moves through an elongate guide path between two sets of staggered staple carrying grooves. Staple drive members are located within the grooves and are positioned in such a manner so as to be contacted by the longitudinally moving cam to 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 surgeons 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 wounds in the skin. In order to address the specific needs of endoscopic and/or laparoscopic surgical procedures, endoscopic surgical stapling devices have been developed and are disclosed in, for example, U.S. Pat. No. 5,040,715 (Green, et al.); U.S. Pat. No. 5,307,976 (Olson, et al.); U.S. Pat. No. 5,312,023 (Green, et al.); U.S. Pat. No. 5,318,221 (Green, et al.); U.S. Pat. No. 5,326,013 (Green, et al.); and U.S. Pat. No. 5,332,142 (Robinson, et al.). U.S. 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 benefits. Nonetheless, improvements are possible. 
     SUMMARY 
     In accordance with the present disclosure, a surgical instrument is provided. The surgical instrument has a handle assembly and an elongate body extending distally from the handle assembly. The handle assembly includes a handle and a switch. The switch allows the handle to have multiple modes of operation. At least one of the modes of operation is a firing mode, a clamping mode, or a retraction mode. The switch extends through both the left and right hand sides of the handle assembly. 
     The elongate body has a distal portion and defines a longitudinal axis. A first jaw member is supported by the elongate body and contains a plurality of fasteners. A second jaw member is mounted adjacent the first jaw member and is movable in relation to the first jaw member between an open position and a closed position by the handle assembly. The handle assembly is also connected to an actuation member and able to move the actuation member relative to the first jaw member to sequentially eject fasteners. 
     The switch is configured to move a slider cam over a rack member located within the handle assembly. The rack member has two sets of teeth that are diametrically opposed. A first set of teeth points distally along the longitudinal axis and is configured to engage a first pawl. A second set of teeth points proximally along the longitudinal axis and is configured to engage a second pawl. The first pawl pivots about a distal region of the first pawl. The second pawl pivots about a proximal region of the second pawl. 
     The surgical instrument has an articulation mechanism that pivots the distal portion of the elongate body about the longitudinal axis. The articulation mechanism includes a motor and power supply. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure, and together with a general description of the disclosure given above, and the detailed description of the embodiments given below, serve to explain the principles of the disclosure. 
         FIG. 1  is a perspective view of the surgical instrument in accordance with the principles of the present disclosure; 
         FIG. 2  is a perspective view of the surgical instrument of  FIG. 1 , with parts separated; 
         FIG. 3  is a side cross-sectional view of the surgical instrument of  FIG. 1 ; and 
         FIG. 4  is a side cross-sectional view of another embodiment of a surgical instrument. 
     
    
    
     Other features and advantages of the present disclosure will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the present disclosure. 
     DETAILED DESCRIPTION 
     In the drawings and in the description which follows, the term “proximal”, as is traditional, will refer to the end of the 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. 
     The present disclosure can be used with any fastening device known in the art and is intended to encompass the same, shall be discussed in terms of both conventional and endoscopic procedures and apparatus. However, the use herein of terms such as “endoscopic”, “endoscopically”, and “endoscopic portion”, among others, should not be construed to limit the present disclosure to an apparatus for use only in conjunction with an endoscopic tube. The apparatus of present disclosure may find use in procedures in these and other uses including but not limited to where access is limited to a small incision such as in arthroscopic and laparoscopic procedures, or other conventional medical procedures (i.e. Open procedures). 
     Now referring to  FIGS. 1 and 2 , a surgical instrument, e.g., a surgical stapler, in accordance with embodiments of the present disclosure is referred to as reference numeral  100 . Surgical instrument  100  includes a handle assembly  10 , an endoscopic portion  12  and an end effector  16  defining a longitudinal axis A-A extending therethrough. Further details of surgical instrument  100  are included in U.S. patent application Ser. No. 11/544,061, filed on Oct. 6, 2006, the entire contents of which are hereby incorporated by reference herein. While the features of the embodiments illustrated in  FIG. 1  is shown in connection with a particular type of surgical instrument  100 , it is envisioned that the features described with respect to  FIG. 1  are operable with other surgical instruments. 
     With continued reference to  FIGS. 1 and 2 , endoscopic portion  12  extends distally from handle assembly  10 . End effector  16  is selectively connectable to a distal end of endoscopic portion  12 . The endoscopic portion  12  is rotatable about axis A-A relative to distal portion  20  of handle assembly  10 . A knob  22  is shown in mechanical cooperation with endoscopic portion  12  to facilitate such rotation. 
     Handle assembly  10  includes a stationary handle  50 , a moveable handle  52 , and electrical contacts (i.e., conductive rings  18 ) disposed adjacent distal portion  20  of the handle assembly  10 . Conductive rings  18  are internally wired within handle assembly  10  to a power source “PS” (either within handle assembly  10  or external thereto as shown in  FIG. 2 ) and/or a micro controller. It is envisioned that conductive rings  18  are removable from handle assembly  10 . 
     Endoscopic portion  12  is shown having an articulation mechanism or actuator  24  disposed in mechanical cooperation therewith. As discussed above, articulation mechanism  24  is configured to pivot end effector  16  with respect to a longitudinal axis “A-A”. Here, an articulation knob  26  that is operatively disposed on endoscopic portion  12 , and a motor  28  disposed within a motor housing  30  of endoscopic portion  12  may be used to articulate end effector  16  engaged with endoscopic portion  12 . 
     The motor  28  is used to provide articulation and has at least one electrical contact  32  (a pair of electrical contacts  32   a  and  32   b  is shown) operably disposed with endoscopic portion  12 . Electrical contact  32  is in electrical communication with motor  28  of endoscopic portion  12  and is configured to communicate electrical power between conductive rings  18  of handle assembly  10  and motor  28 . Here, motor  28  is operatively connected to the actuation member to move the actuation member substantially along longitudinal axis A-A, i.e. to articulate end effector  16 . It is envisioned that motor  28  provides or helps provide power that is helpful for articulation of end effector  16 , rotation of endoscopic portion  12 , etc. 
     Conductive rings  18  are substantially circular in shape and disposed around distal portion  20  of handle assembly  10 . As can be appreciated, the shape and/or configuration of conductive rings  18  around distal portion  20  of handle assembly  10  helps allow substantially continuous contact between conductive rings  18  and electrical contacts  32  as endoscopic portion  12  is being rotated about longitudinal axis A-A with respect to handle assembly  10 . Thus, a complete 360° rotation is possible. Further, communication of power between motor  28  and electrical contact  32  is possible notwithstanding the rotational direction of endoscopic portion  12  with respect to handle assembly  10 . Additionally, it is envisioned that mechanical and/or electrical stops may be disposed on endoscopic portion  12  and/or distal portion  20  of handle assembly  10  to limit rotational displacement of endoscopic portion  12 . 
     While only one type of end effector  16  is illustrated in  FIG. 1 , it is contemplated that several types of end effectors  16  (e.g., a pivotable cartridge assembly, end effectors including a substantially circular cartridge assembly, parallel approximating jaw members, configured for sequential firing of staples and/or configured for simultaneous firing of staples) may be used in connection with surgical instrument  100  and may be usable with different types of endoscopic portions  12 . 
     Referring to  FIGS. 1-3 , the end effector  16  includes a cartridge assembly  40  and an anvil assembly  42 . Cartridge assembly  40  and anvil assembly  42  further define a pair of jaws. Cartridge assembly  40  houses a plurality of staples and a drive mechanism (not shown). An example of a drive mechanism is disclosed in U.S. patent application Ser. No. 10/700,250, filed on Nov. 3, 2003, the entire contents of which are hereby incorporated by reference. Anvil assembly  42  is movable in relation to cartridge assembly  40  between an open position spaced from cartridge assembly  40  and an approximated or clamped position in juxtaposed alignment with cartridge assembly  40 . End effector  16  may alternatively be arranged such that cartridge assembly  40  is movable in relation to anvil assembly  42 . Drive mechanism (not shown) is configured to eject the plurality of staples from the cartridge assembly  40  upon actuation from a drive rod  90 . The drive rod  90  is coupled through an actuation shaft  80  to the movable handle  52 . 
     Switch  60  ( FIG. 1 ) is configured to alternate the function of movable handle  52  between a grasping or “firing” mode and a “return” mode. In firing mode, end effector  16  is configured to operate as a grasping jaw mechanism, i.e., anvil assembly  42  is movable in relation to cartridge assembly  40  to grasp tissue therebetween and apply the fasteners therethrough. In return mode, end effector  16  is configured to operate as a releasing mechanism, i.e., anvil assembly  42  is movable in relation to cartridge assembly  40  to release the tissue. 
     Switch  60  includes a slide cam  62 . Switch  60  is configured to be engaged by the surgeon&#39;s finger to move slide cam  62  along an actuation shaft  80  within the handle assembly. As to be appreciated, alternatives to switch  60  are also contemplated, e.g., knobs, levers, depressible buttons, toggles, trigger assemblies, etc. 
     Handle assembly  10  includes a housing  11  formed from a pair of molded half-sections  11   a  and  11   b  ( FIG. 2 ), which forms stationary handle  50 . Half-sections  11   a  and  11   b  are formed of a thermoplastic material, e.g., polycarbonate. Alternately, other materials having the requisite strength requirements may be used to form housing  11 , e.g., surgical grade metals. Housing  11  half-sections  11   a  and  11   b  are secured to each other using known fastening techniques, e.g., adhesives, welding, interlocking structure, screws, etc. Alternately, other fastening techniques may be used. 
     Referring to  FIG. 1 , movable handle  52  is rotatably supported between housing half-sections  11   a  and  11   b . A biasing member (not shown), e.g., a torsion spring, may be included to urge movable handle  52  away from stationary handle  50  to a non-compressed position. An advancement pawl  70 , as shown in  FIG. 3 , is rotatably supported on movable handle  52  and is biased by a spring (not shown) towards the actuation shaft  80 . A return pawl  72  is also rotatably supported on movable handle  50  and is biased by a spring (not shown) towards the actuation shaft  80 . 
     Actuation shaft  80  is slidably supported between retracted and advanced positions within housing  11  and includes a distal end defining a recess  82  configured to rotatably receive the proximal end  92  of a drive rod  90 . Actuation shaft  80  includes a first toothed rack  84  and a second toothed rack  86 . Advancement pawl  70  has an engagement finger  70   a , which is biased by spring (not shown) towards toothed rack  84  of actuation shaft  80 . Return pawl  72  has an engagement finger  72   a , which is biased by spring (not shown) towards second toothed rack  86  of actuation shaft  80 . 
     Slide cam  62  is placed about actuation shaft  80  and is movable from a firing position and a return position by movement of switch  60 . In the firing position, the slide cam  62  is moved between the engagement finger  72   a  of return pawl  72  and the second toothed rack  86 . When movable handle  52  is actuated while slide cam  62  is in a firing position, i.e., is pivoted towards stationary handle  50  against the bias of a torsion spring (not shown), engagement finger  70   a  of advancement pawl  70  engages the first toothed rack  84  of actuation shaft  80  to advance actuation shaft  80  and drive rod  90  distally. As the drive rod  90  is advanced, the anvil assembly  42  moves toward the cartridge assembly  40  until the tissue therebetween is compressed and the drive mechanism (not shown) ejects the fasteners from the cartridge assembly  40 . 
     In the return position, the slide cam  62  is moved between the engagement finger  70   a  of advancement pawl  70  and the first toothed rack  84 . When movable handle  52  is actuated while slide cam  62  is in a return position, i.e., is pivoted towards stationary handle  50  against the bias of a torsion spring (not shown), engagement finger  72   a  of return pawl  72  engages the second toothed rack  86  of actuation shaft  80  to retract actuation shaft  80  and drive rod  90  proximally. As the drive rod  90  is retracted, the anvil assembly  42  moves away from the cartridge assembly  40  releasing the tissue. 
     Now referring to  FIG. 4 , another embodiment of surgical instrument  200  includes a slide cam  262  connected to a lever  260 . Lever  260  acts similarly to switch  60  above to move the slide cam  262  from a firing position to a return position. 
     It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto. 
     Although being shown as an endoscopic surgical stapler, the present system may be used with any fastener applier known in the art. 
     It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.