Patent GB-1352553-A (GB)
Title: Surgical instrument for ligating and subsequently severing tubular organs
IPC: A61B17/128
Filed: 1971-04-20
Abstract: 1352553 Instrument for ligating and severing tubular organs UNITED, STATES SURGICAL CORP 20 April 1971 [27 April 1970] 10240/71 Heading A5R  A trigger-operated surgical instrument for ligating and severing a tubular organ comprises means for clamping the organ 250, Fig. 12, against an anvil 120, means 122, 134 for advancing a wire ligature towards the anvil and curling it thereagainst around the organ, and means 134 for severing the organ, wherein the force reguired on the trigger to effect the successive operations of clamping the organ, advancing and curling the ligature thereabout, and severing the ligatured organ is substantially constant. The instrument further comprises a main body portion 10, Fig. 1, a movable - driving member 36, means 42 for mounting a ligature-carrying cartridge assembly 110, a trigger 18 pivotally mounted on the body portion and linked to a variable cam 22, Fig. 8, and the driving member. The cartridge assembly 110, which is made up of three plastics sections 112, 114, 116, is provided with a pair of ligature-carrying cylinders 118, a pair of anvils 120 two pusher rails 124 and a pusher block 122, and a pair of tissueejecting plates 160 to eject the organ parts after the ligating and severing. In operation, the tubular organ is positioned within the anvil portions of the cartridge assembly and the trigger is depressed slightly to move the assembly towards the anvils 120. The tubular organ 250 is then securely gripped between the jaws of the assembly 110. Further motion of the trigger overcomes the force exerted by spring 62 and causes relative motion between the inner and outer rods 38, 54, and also moves the pusher assembly 122 in the cartridge assembly 110 and causes ejection of a pair of ligatures from cylinders 118 which are then formed around the tubular structure 250. Further compression of the trigger 18 moves the knife blade 134 forward thus dividing the tubular organ intermediate said pair of ligatures. The different operations involved in the ligating and severing are facilitated by using a variable cam 22. The distance along the cam surface 198 that the roller 86 travels corresponds to the different operations of the instrument. For example, when the roller 86 traverses area (1), Fig. 10 (not shown), the main body of the cartridge assembly 110 and the anvil assembly 120 initially contact, each other via movements of the engaging hook 26 and driving member 36. The roller 86 moving over the peak (204) of the cam surface 198 then causes the pusher assembly 122 to move forward and eject a pair of ligatures before encountering peak (208). This second area (2) represents the interval between initial travel of the pusher assembly 122 and the instant when the bending and curling of the ligatures occurs. The roller 86 then traverses area (3) which represents the interval during which the ligature pin curl around the anvil assembly 120 and ligate the tubular organ. At the end of the movement the knife blade 134 divides the tubular organ 250. Thus, by way of the variable cam 22, engaging hook 26 and driving member 36 a multi-stage operation can occur by one movement of trigger 18 of the surgical instrument.