Patent Publication Number: US-2022225988-A1

Title: Surgical stapling device with floating staple cartridge

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation of U.S. patent application Ser. No. 16/829,379, filed Mar. 25, 2020, which is a continuation of U.S. patent application Ser. No. 15/684,223, filed Aug. 23, 2017, now U.S. Pat. No. 10,624,636, the disclosure of each of which is incorporated by reference herein in its entirety. 
    
    
     BACKGROUND 
     1. Technical Description 
     The present disclosure is directed to a surgical stapling device and, more particularly, to a surgical stapling device including a tool assembly having a staple cartridge that is supported on a compressible base to accommodate tissues of different thicknesses. 
     2. Background of Related Art 
     Surgical stapling devices for ejecting staples to join tissue or tissue segments in a fast and efficient manner in a variety of surgical procedures, e.g., anastomoses procedures, are well known. Surgical stapling devices include a tool assembly having a cartridge assembly and an anvil assembly. The cartridge assembly and the anvil assembly define tissue contact surfaces that define a tissue gap when the tool assembly is in a clamped position. The tissue gap is dimensioned to receive tissue of a given thickness range to effect hemostasis. If the tissue positioned between the jaws is outside the defined range, either too thick or too thin, the tissue contact surfaces of the cartridge and anvil assemblies may not be properly positioned during firing of the stapling device to provide effective hemostasis. In addition, if the tissue thickness is misidentified by the clinician or if the tissue thickness falls near the outer edges of the range for a given staple size, the likelihood of ineffective hemostasis is increased. 
     Accordingly, a continuing need exists in the suturing arts for a surgical stapling device that is capable of providing effective hemo stasis for a greater range of tissue thicknesses. 
     SUMMARY 
     In one aspect of the disclosure, a cartridge assembly includes a cartridge channel having a bottom wall and side walls that define a recess. Each of the side walls has a first end secured to the bottom wall and a second end spaced from the bottom wall defining an elongated slot. A staple cartridge defines a longitudinal axis and includes an upper wall defining a tissue contact surface and side walls. The upper wall extends radially outward of the side walls of the staple cartridge to define a longitudinally extending shoulder that is positioned adjacent to each of the side walls of the staple cartridge. The staple cartridge is dimensioned to be received within the recess of the cartridge channel such that the shoulders of the staple cartridge rest atop the side walls of the cartridge channel. A compression strip is supported in each of the elongated slots defined in the second end of the side walls of the cartridge channel. The elongated slots and the compression strips are configured to interlock to secure the compression strips to the cartridge channel. 
     In another aspect of the disclosure, a cartridge assembly includes a cartridge channel having a bottom wall and side walls defining a recess, and a staple cartridge defining a longitudinal axis and supporting a plurality of staples and a plurality of pushers. The staple cartridge is received within the recess of the cartridge channel. The staple cartridge has an upper wall defining a tissue contact surface and a plurality of staple retention slots. A compression pad is positioned between the bottom wall of the cartridge channel and the staple cartridge. 
     In embodiments, each of the compression strips includes a connecting portion that is received within the longitudinal slot. 
     In some embodiments, the connecting portion of each of the compression strips and the elongated slot are dove-tail shaped. 
     In certain embodiments, the second end of each of the side walls of the cartridge channel includes cutouts, the cutouts intersecting the elongated slot to divide the elongated slot into a plurality of segments. 
     In embodiments, each of the compression strips is formed of a plurality of segments, and each of the plurality of segments of the compression strips has a length that corresponds to a length of one of the plurality of segments of the elongated slots. 
     In some embodiments, each of the compression strips is formed from an elastic material. 
     In certain embodiments, the cartridge assembly includes a support plate and the staple cartridge includes staples and pushers and defines an open end opposite to the upper wall. The support plate is supported on the open end of the staple cartridge to retain the staples and pushers within the staple cartridge. 
     In embodiments, the staple cartridge and the support plate define a gap with the bottom wall of the cartridge channel. 
     In some embodiments, a compression pad is positioned in the gap between the staple cartridge and the bottom wall of the cartridge channel. 
     In certain embodiments, the cartridge channel and the staple cartridge each define a knife slot, and the compression pad includes a first half positioned on one side of the knife slots and a second half positioned on the other side of the knife slots. 
     In some embodiments, the compression pad is secured to the bottom wall of the cartridge channel using an adhesive. 
     In embodiments, the compression pad is formed from an elastic material. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various embodiments of the presently disclosed tool assembly are described herein below with reference to the drawings, wherein: 
         FIG. 1  is a side perspective view of a surgical stapling device including an exemplary embodiment of the presently disclosed tool assembly in a clamped position; 
         FIG. 1A  is an enlarged view of the indicated area of detail shown in  FIG. 1 ; 
         FIG. 2  is a side perspective view of the tool assembly of  FIG. 1  in an unclamped position with an anvil assembly of the tool assembly shown in phantom; 
         FIG. 3  is a side, perspective, exploded view of a cartridge assembly of the tool assembly shown in  FIG. 2 ; 
         FIG. 3A  is a cross-sectional view taken along section line  3 A- 3 A; 
         FIG. 4  is a side perspective view of a channel member of the cartridge assembly shown in  FIG. 3  with compression strips attached to side walls of the channel member; 
         FIG. 5  is a side perspective view of the channel member of the cartridge assembly shown in  FIG. 4  with the compression strips and a compression pad supported on the channel member; 
         FIG. 6  is an enlarged view of the indicated area of detail shown in  FIG. 2 ; 
         FIG. 7  is an enlarged view of the indicated area of detail shown in  FIG. 3 ; 
         FIG. 8  is an enlarged view of the indicated area of detail shown in  FIG. 3 ; 
         FIG. 9  is a perspective view of the indicated area of detail shown in  FIG. 8  as the compression strip is attached to the side wall of the channel member; 
         FIG. 10  is a cross-sectional view taken along section line  10 - 10  of  FIG. 1A ; 
         FIG. 11  is a cross-sectional view taken along section line  11 - 11  of  FIG. 10 ; 
         FIG. 12  is a cross-sectional view taken along section line  11 - 11  of  FIG. 10  with the tool assembly clamped on relatively thin tissue; 
         FIG. 13  is a side view of a staple of the cartridge assembly of  FIG. 12  after the staple is deformed in thin tissue; 
         FIG. 14  is a cross-sectional view taken along section line  11 - 11  of  FIG. 10  with the tool assembly clamped on tissue having a relatively moderate thickness; 
         FIG. 15  is a side view of a staple of the cartridge assembly of  FIG. 14  after the staple is deformed in the tissue having a relatively moderate thickness; 
         FIG. 16  is a cross-sectional view taken along section line  11 - 11  of  FIG. 10  with the tool assembly clamped on relatively thick tissue; and 
         FIG. 17  is a side view of a staple of the cartridge assembly of  FIG. 16  after the staple is deformed in the relatively thick tissue. 
     
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
     The presently disclosed surgical stapling device including a tool assembly with a floating staple cartridge will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “endoscopic” is used generally used to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through small diameter incision or cannula. In addition, the term clinician is used generally to refer to medical personnel including doctors, nurses, and support personnel. 
     The presently disclosed surgical stapling device includes a tool assembly having an anvil assembly and a cartridge assembly including a cartridge channel and a staple cartridge supported within the cartridge channel. The cartridge assembly includes a cartridge channel having a pair of spaced sidewalls and a bottom wall. The cartridge assembly includes compression strips that are supported on upper edges of the side walls of the cartridge channel and are positioned to support the staple cartridge. In embodiments, each of the compression strips includes a connecting portion and the upper edge of each of the side walls defines a slot that is configured to receive the connecting portion of a respective compression strip to secure the compression strips to the side walls of the cartridge channel. The compression strips allow the staple cartridge to move or float in relation to the anvil assembly of the tool assembly to accommodate tissues of different thicknesses. 
     In some embodiments, the tool assembly also includes a compressible pad that is supported on the bottom wall of the channel. The staple cartridge is supported on the compressible pad within the cartridge channel such that the staple cartridge can move or float within the cartridge channel. 
       FIG. 1  illustrates an exemplary embodiment of the presently disclosed surgical stapling device shown generally as  10 . The stapling device  10  includes a handle assembly  12 , a body portion  14  that defines a longitudinal axis “X” and extends from a distal portion of the handle assembly  12 , and a tool assembly  100  supported on a distal portion of the body portion  14 . In embodiments, the handle assembly  12  includes a stationary hand grip  16 , a firing trigger  18 , a rotation knob  20 , and an articulation lever  22 . The firing trigger  18  is actuatable to move the tool assembly  100  between an unclamped position ( FIG. 2 ) and a clamped position ( FIG. 1A ) and to fire the stapling device  10 . The articulation lever  22  is rotatable to pivot the tool assembly  100  in relation to the body portion  14  about an axis transverse to the longitudinal axis “X”. The rotation knob  20  pivotally supports the body portion  14  and the tool assembly  100  on the distal portion of the handle assembly  12 . Rotation of the rotation knob  20  in relation to the handle assembly  12  causes corresponding rotation of the body portion  14  and tool assembly  100  in relation to the handle assembly  12 . 
     For a detailed description of a handle assembly  12  including the firing trigger  18 , rotation knob  20 , and articulation lever  22 , and other components of the stapling device  10  including the body portion  14 , see U.S. Pat. No. 8,418,904 (“the &#39;904 Patent”) which is incorporated herein by reference in its entirety. Although the presently disclosed tool assembly  100  is illustrated as part of a manually powered surgical stapling device  10 , it is also envisioned that the tool assembly  100  could be incorporated into a powered surgical stapling device such as disclosed in U.S. Pat. Nos. 9,055,943 and 8,806,973 and U.S. Publication No. 2015/0076206 which are also incorporated herein by reference in their entirety. 
     Referring to  FIGS. 1A and 2 , the tool assembly  100  includes an anvil assembly  102  and a cartridge assembly  104 . A proximal portion of the anvil assembly  102  is pivotally coupled to a proximal portion of the cartridge assembly  104  by a pair of pivot members  105  such that the anvil assembly  102  is pivotal in relation to the cartridge assembly  104  to move the tool assembly  100  between an unclamped position ( FIG. 2 ) and a clamped position ( FIG. 1A ). It is envisioned that the cartridge assembly could also be pivotally supported to the anvil assembly  102 . Although not shown, the anvil assembly  102  includes a tissue contact surface that includes a plurality of staple deforming depressions. See, e.g., the anvil assembly disclosed in the &#39;904 Patent. 
     Referring to  FIG. 3 , in some embodiments the cartridge assembly  104  includes a staple cartridge  106  that supports a plurality of staples  108  and a plurality of pushers  110 , a cartridge channel  112 , a staple cartridge support plate  114 , compression strips  116 , compression pads  118 , and an actuation sled  120 . It is envisioned that the cartridge assembly  104  may include only compression strips  116  or compression pads  118  as discussed in further detail below. The staple cartridge  106  includes a tissue contact surface  124  ( FIG. 3 ) that defines a central knife slot  106   a , and a plurality of rows of laterally spaced staple retention slots  124   a  in the tissue contact surface  124 . In embodiments, the tissue contact surface  124  is stepped downwardly from the central knife slot  106   a  towards the outer edge of the staple cartridge  106 . Alternately, the tissue contact surface  124  of the staple cartridge  106  can be planar. Each staple retention slot  124   a  receives one of the staples  108  and a respective pusher  110 . 
     The support plate  114  of the cartridge assembly  104  is secured to an open, lower end of the staple cartridge  106  opposite to the tissue contact surface  124  by a snap-fit or other type connection. The support plate  114  covers the open lower end of the staple cartridge  106  to retain the staples  108  and pushers  110  within the staple cartridge  106 . The staple cartridge  106  also defines a plurality of longitudinal slots  130  ( FIG. 11 ). The longitudinal slots  130  communicate with the open, lower end of the staple cartridge  106  and the staple retention slots  124   a  to accommodate the staple pushers  110  and facilitate passage of the actuation sled  120  through the staple cartridge  106 . As known in the art, advancement of the actuation sled  120  through the staple cartridge  106  lifts the pushers  110  within the retention slots  124   a  to eject the staples  108  from the retention slots  124   a  . See, e.g., the &#39;904 Patent for a detailed description of the operation, and interaction of the actuation sled  120  and pushers  110 . 
     The staple cartridge  106  includes opposite sidewalls  132  and an upper wall  134  that defines the tissue contact surface  124  and the staple retention slots  124   a  . The upper wall  134  extends radially outward of the side walls  132  to define shoulders  136  ( FIG. 3A ). The staple cartridge  106  also includes protrusions  140  ( FIG. 3 ) that extend radially outwardly of each of the side walls  132  of the staple cartridge  106  and facilitate securement of the staple cartridge  106  within the cartridge channel  112 . 
     Referring also to  FIGS. 4 and 5 , the cartridge channel  112  includes a bottom wall  144  and spaced side walls  146  that together define a recess  148  that is dimensioned to receive the staple cartridge  106  and support plate  114  when the staple cartridge  106  and the support plate  114  are assembled. The bottom wall  144  defines a central longitudinal knife slot  150  that is aligned with the central knife slot  106   a  defined in the staple cartridge  106  as well as a longitudinal knife slot  152  defined by the support plate  114 . The knife slots  106   a ,  150  and  152  are dimensioned to facilitate passage of a drive member and knife (not shown) through the staple cartridge  106 . See, e.g., the &#39;904 Patent for a detailed description of an exemplary embodiment of a drive member and knife of a surgical stapling device. 
     Referring also to  FIGS. 3 and 6-9 , the compression strips  116  are formed of a compressible and/or elastic material. Each of the compression strips  116  includes a support portion  156  and a connecting portion  158 . In embodiments, the support portion  156  of each of the compression strips  116  defines a flat surface  156   a  that is positioned and configured to support the shoulders  136  of the staple cartridge  106  ( FIG. 3A ). 
     In embodiments, the spaced side walls  146  of the cartridge channel  112  each define a retention slot  160  ( FIG. 8 ) that is configured to receive a connecting portion  158  of the compression strips  116 . In embodiments, the retention slots  160  and the connecting portions  158  of the compression strips  116  have interlocking configurations which mate to securely fasten the compression strips  116  within the retention slots  160 . In some embodiments, the retention slots  160  and the connecting portion of the compression strips  116  each include have a dove-tail configuration although other interlocking configurations are envisioned, e.g., T-shaped slots, etc. The connecting portion  158  of the compression strips  116  are slidably received within the retention slots  160  to secure the compression strips  116  to the upper edges of the side walls  146  of the cartridge channel  112 . In addition, adhesives, welding, friction fitting, or the like can be used to secure the compression strips from moving axially within the slots  160   
     Referring briefly back to  FIGS. 4 and 5 , the side walls  146  of the cartridge channel  112  each include a plurality of notches  170 . The notches  170  provide access to ends of the retention slots  160  at a plurality of locations along the side walls  146  of the cartridge channel  112  to allow the connecting portions  158  of the compression strips  116  to be inserted into the retention slots  160  at multiple locations along the side walls  146 . 
     Referring again to  FIGS. 3 to 5, 10 and 11 , in embodiments, the compression pads  118  are supported on the bottom wall  144  of the cartridge channel  112  between the bottom wall  144  and the support plate  114  of the cartridge assembly  104  ( FIG. 11 ) on opposite sides of the knife slot  150 . As discussed above regarding the compression strips  116 , the compression pads  118  are formed of an elastic and/or compressible material and support the staple cartridge  106  to facilitate movement of the staple cartridge  106  in relation to the anvil assembly  102  during clamping and firing of the surgical stapling device  10 . In embodiments, the compression pads  118  include cut outs  118   a  that provide space for expansion of the compression pad  118  during firing. Although shown as being circular, the cut outs  118   a  can be of any configuration. 
     Referring to  FIGS. 10-13 , when thin tissue T 1  is clamped between the tissue contact surface  124  of the staple cartridge  106  and the tissue contact surface  102   a  of the anvil assembly  102  and the surgical stapling device  10  is fired, the forces applied to the compression strips  116  and the compression pads  118  is minimal such that the compressible strips  116  and pads  118  undergo minimal deformation or compression. As such, very little movement of the staple cartridge  106  in relation to the anvil assembly  102  occurs. Thus, the staple cartridge  106  remains in close relation to the anvil assembly  102  and the staple  108   a  ( FIG. 13 ) undergoes substantial deformation. 
     Referring to  FIGS. 14 and 15 , when thicker tissue T 2  is clamped between the tissue contact surface  124  of the staple cartridge  106  and the tissue contact surface  102   a  of the anvil assembly  102  and the surgical stapling device  10  is fired, the forces applied to the compression strips  116  and the compression pads  118  increases such that the compressible strips  116  and compression pads  118  undergo more substantial deformation or compression. As such, the staple cartridge  106  moves further downwardly away from the anvil assembly  102  to compensate for the thicker tissue T 2 . Thus, the staple cartridge  106  becomes spaced further from the anvil assembly  102  and the staple  108   b  undergoes more substantial deformation. 
     Referring to  FIGS. 16 and 17 , when even thicker tissue T 3  is clamped between the tissue contact surface  124  of the staple cartridge  106  and the tissue contact surface  102   a  of the anvil assembly  102  and the surgical stapling device  10  is fired, the forces applied to the compression strips  116  and the compression pads  118  increases even further such that the compressible strips  116  and pads  118  undergo even more substantial deformation or compression. As such, the staple cartridge  106  moves further downwardly away from the anvil assembly  102  to compensate for the thicker tissue T 3 . Thus, the staple cartridge  106  becomes spaced even further from the anvil assembly  102  and the staple  108   b  undergoes even more substantial deformation. 
     Although the surgical stapling device  10  is illustrated to include both compression strips  116  and compression pads  118 , it is envisioned that the surgical stapling device need only include the strips  116  or the pads  118 . 
     Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. 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. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described embodiments. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.