Patent Publication Number: US-2022233192-A1

Title: Surgical stapling apparatus with adjustable height clamping member

Description:
FIELD 
     This disclosure relates to surgical stapling devices having a clamping member for setting a tissue gap. More particularly, this disclosure relates to surgical stapling devices having a clamping member with an adjustable height for adjusting a tissue gap. 
     BACKGROUND 
     Surgical stapling devices for stapling tissue are well known in the art and typically include a handle assembly, a body portion extending distally from the handle assembly, and a tool assembly supported on a distal end of the body portion. The tool assembly includes first and second jaws which are movable in relation to each other between open and closed or approximated positions. The first jaw includes an anvil assembly and the second jaw supports a cartridge which houses a plurality of staples. The cartridge can also include a knife for severing tissue. In known devices, the stapling apparatus includes a clamping member that is engaged with the first and second jaws and is movable along the first and second jaws to set a tissue gap between the anvil assembly and the cartridge during a stapling procedure. However, the size of the tissue gap appropriate for a surgical procedure depends on the thickness of the tissue being treated which will change from procedure to procedure, and may change along the length of the first and second jaws. 
     A continuing need exists in the art for a surgical stapling device capable of changing the size of the tissue gap set by the clamping member to accommodate tissues of varying thickness. 
     SUMMARY 
     A surgical stapling device includes a body portion, a tool assembly, and a drive assembly. The body portion defines a longitudinal axis and has a proximal portion and a distal portion. The tool assembly is supported on the distal portion of the body portion. The tool assembly includes an anvil assembly, a channel member pivotally supported relative to the anvil assembly, and a staple cartridge releasably disposed within the channel member. The tool assembly is movable from an open position to an approximated position. The staple cartridge supports a plurality of staples and includes an actuation sled that is movable between a retracted position and an advanced position to eject the plurality of staples from the staple cartridge. The drive assembly is movably supported within the tool assembly from a retracted position to an advanced position to move the tool assembly from the open position to the approximated position and to maintain the tool assembly in the approximated position. The drive assembly includes a clamping member and an adjustment member. The clamping member includes a first clamping surface configured to engage the anvil assembly. The adjustment member includes a second clamping surface configured to engage the staple cartridge. The first clamping surface is spaced from the second clamping surface to define a clamping height. The adjustment member is moveable relative to the clamping member between a first position and a second position to change the clamping height. 
     In certain aspects of the disclosure, the first position of the adjustment member is longitudinally spaced from the second position of the adjustment member. The first position of the adjustment member may be vertically spaced from the second position of the adjustment member. The channel member may define a slot and the adjustment member may include a flange. The flange may be receivable within the slot of the channel member. The anvil assembly may define a slot and the clamping member may include a pair of flanges. The pair of flanges of the clamping member may be receivable within the slot of the anvil assembly. 
     In some aspects of the disclosure, the drive assembly includes a drive beam and a securement mechanism for securing the adjustment member relative to the drive beam. The securement member may include an adjustment knob and a thread screw extending from the adjustment knob. Movement of the drive assembly beyond the partially advanced position may move the actuation sled from a retracted position to an advanced position to eject the plurality of staples from the staple cartridge. The clamping member may include an upper flange and a lower flange interconnected by a vertical strut. The clamping member may be positioned to engage the actuation sled to move the actuation sled distally within the staple cartridge as the drive assembly moves from the retracted position towards a fully advanced position. The adjustment member may include an inclined surface and the clamping member may include an inclined surface. Movement of the adjustment member relative to the clamping member may slide the inclined surfaces relative to each other. 
     A drive assembly for a surgical stapling assembly includes a clamping member, a drive beam extending from the clamping member, and an adjustment member. The clamping member includes an upper flange portion and a vertical strut. The upper flange includes a first clamping surface configured to engage an anvil assembly. The drive beam extends from the clamping member and is configured for operable engagement with an actuation mechanism. The adjustment member is disposed relative to the clamping member and includes a second clamping surface configured to engage a staple cartridge. The first clamping surface is spaced from the second clamping surface to define a clamping height. The adjustment member is moveable relative to the clamping member between a first position and a second position to change the clamping height. 
     In certain aspects of the disclosure, the upper flange portion is configured to be received within a slot of the anvil assembly. The adjustment member may include a flange portion configured to be received within a slot of a staple cartridge. The drive assembly may further include a securement mechanism for securing the drive beam relative to the adjustment mechanism. The securement mechanism may be a threaded screw. The first position of the adjustment member may be longitudinally spaced from the second position of the adjustment member. The first position of the adjustment member may be vertically spaced from the second position of the adjustment member. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various aspects of the disclosure are described herein with reference to the drawings, wherein: 
         FIG. 1  is a side, perspective view of a powered surgical stapling device including a loading unit having a tool assembly in an open position according to aspects of the disclosure; 
         FIG. 2  is a side, perspective view of the indicated area of detail shown in  FIG. 1 ; 
         FIG. 3  is side perspective view with parts separated of the loading unit shown in  FIGS. 1 and 2 ; 
         FIG. 4  is a side perspective view a drive assembly of the surgical stapling device shown in  FIG. 1 ; 
         FIG. 5  is an enlarged, side perspective view with parts separated of the drive assembly shown in  FIG. 4 ; 
         FIG. 6  is an enlarged, side perspective view of the indicated area of detail shown in  FIG. 4 ; 
         FIG. 7  is an enlarged, side perspective view of the indicated area of detail shown in  FIG. 4 ; 
         FIG. 8  is a cross-sectional view taken along section line  8 - 8  shown in  FIG. 7 ; 
         FIG. 9  is a side, perspective view of the indicated area of detail shown in  FIG. 1 ; 
         FIG. 10  is an enlarged, side, cross-sectional view of the tool assembly shown in  FIG. 2  in the open position with the drive assembly in a first configuration and in a retracted position; 
         FIG. 11  is a side perspective view of the drive assembly shown in  FIG. 4  in the first configuration; 
         FIG. 12  is a side perspective view of the tool assembly shown in  FIG. 10  in a closed position with the drive assembly in the first configuration and in a partially advanced position; 
         FIG. 13  is a cross-sectional view taken along section line  13 - 13  shown in  FIG. 12 ; 
         FIG. 14  is a side view of the drive assembly in a second configuration; 
         FIG. 15  is a side, cross-sectional view of the tool assembly shown in  FIG. 10  in a closed position with the drive assembly in the second configuration and in a partially advanced position; 
         FIG. 16  is a cross-sectional view taken along section line  16 - 16  shown in  FIG. 15 ; 
         FIG. 17  is a side, perspective view of a manual surgical stapling device including a loading unit having a tool assembly in an open position according to other aspects of the disclosure; 
         FIG. 18  is an enlarged, side perspective view of an alternate version of the drive assembly shown in  FIG. 4 ; 
         FIG. 19  is a side, cross-sectional view taken along section line  19 - 19  shown in  FIG. 18 ; 
         FIG. 20  is a side, perspective view of various aspects of another alternate version of the drive assembly shown in  FIG. 4 ; 
         FIG. 21  is a cross-sectional view taken along section line  21 - 21  shown in  FIG. 20 ; 
         FIG. 22  is a side perspective view of yet another alternate version of the drive assembly; 
         FIG. 23  is a side cross-sectional view taken along section line  23 - 23  shown in  FIG. 22 ; 
         FIG. 24  is a side, perspective view of a dynamic clamping member of still another alternative version of the drive assembly; 
         FIG. 25  is a side, cross-sectional view taken along section line  25 - 25  shown in  FIG. 24 ; 
         FIG. 26  is a side, perspective view of a dynamic clamping member of still yet another alternative version of the drive assembly; 
         FIG. 27  is a side, cross-sectional view taken along section line  27 - 27  shown in  FIG. 26 ; 
         FIG. 28  is a side, perspective view of a dynamic clamping member of another alternate version of the drive assembly; 
         FIG. 29  is a side, cross-sectional view taken along section line  29 - 29  shown in  FIG. 28 ; 
         FIG. 30  is a side, perspective view of a dynamic clamping member and an adjustment beam of still another alternative version of the drive assembly; 
         FIG. 31  is a side, cross-sectional view of the dynamic clamping member and the adjustment beam shown in  FIG. 30 ; 
         FIG. 32  is a side perspective view of still yet another alternate version of the drive assembly; 
         FIG. 33  is a top, perspective view of a cam member of the drive assembly shown in  FIG. 32 ; 
         FIG. 34  is a side cross-sectional view taken along section line  34 - 34  shown in  FIG. 32 ; and 
         FIG. 35  is an end, cross-sectional view taken along section line  35 - 35  shown in  FIG. 34 . 
     
    
    
     DETAILED DESCRIPTION 
     The disclosed surgical stapling device 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. However, it is to be understood that the disclosed aspects of the disclosure are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure. In addition, directional terms such as front, rear, upper, lower, top, bottom, distal, proximal, and similar terms are used to assist in understanding the description and are not intended to limit the disclosure. 
     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 “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel. 
     The disclosed surgical stapling device includes a drive assembly having a dynamic clamping member that is configured with an adjustable clamp height for adjusting a maximum tissue gap between tissue contact surfaces of anvil and cartridge assemblies of the stapling device. 
       FIG. 1  illustrates a surgical stapling device according to exemplary aspects of the disclosure, shown generally as stapling device  10 . The stapling device  10  includes a powered handle assembly  20 , an adapter assembly  30  releasably secured to the powered handle assembly  20 , and a loading unit  100  releasably secured to the adapter assembly  30 . Although shown as individual or separable components, it is envisioned that any or all the powered handle assembly  20 , adapter assembly  30 , and loading unit  100  may be integrally formed. 
     As will be described in further detail below, the surgical stapling device  10  includes an adjustment mechanism  128  that is engaged with a drive assembly  120  ( FIG. 4 ) of the surgical stapling device  10 . As shown, the adjustment mechanism  128  may include an adjustment knob  128   a  that is supported on the adapter assembly  30 , the loading unit  100 , or the powered handle assembly  20 . 
       FIGS. 2 and 3  illustrate the tool assembly  104  of the loading unit  100  of the surgical stapling device  10 . The tool assembly  104  is pivotally secured to a body portion  102  ( FIG. 1 ) of the loading unit  100  and includes a jaw assembly  106  having an anvil assembly  114  and a cartridge assembly  116 . The cartridge assembly  116  includes a channel member  118 , and a staple cartridge  116   a  that is received within the channel member  118 . The anvil assembly  114  and cartridge assembly  116  are pivotable relative to each other between an open position ( FIG. 10 ) and an approximated or clamped position ( FIG. 12 ). A drive assembly  120  ( FIG. 4 ) extends from the body portion  102  of the loading unit  100  into the tool assembly  104  and is translatable through the tool assembly  104  to cause actuation of the jaw assembly  106  to fire staples “S” from the staple cartridge  116   a.    
     The loading unit  100  is substantially as described in U.S. Pat. No. 9,016,539 (“the &#39;539 patent”). Accordingly, the components of the loading unit  100  which are common to that which is disclosed in the &#39;539 patent will only be described herein to the extent necessary to fully disclose the aspects of the drive assembly  120  and its method of operation. 
     The anvil assembly  114  of the jaw assembly  106  of the tool assembly  104  defines a channel  151  ( FIG. 10 ) and includes an inner clamping surface  114   a . In certain aspects of the disclosure, the anvil assembly  114  includes an anvil body  150  and an anvil plate  152  ( FIG. 10 ) secured to the underside of the anvil body  150  to form the channel  151 . The anvil plate  152  defines plurality of staple receiving depressions (not shown). 
     The staple cartridge  116   a  of the jaw assembly  106  includes a cartridge body  156  supported in a cartridge holder  158 , a plurality of staples “S”, and a staple firing assembly  160 . The staple firing assembly  160  includes an actuation sled  162  ( FIG. 3 ) and a plurality of pusher members  164  ( FIG. 3 ). The channel member  118  defines a cavity  119  ( FIG. 3 ) that receives the staple cartridge  116   a . More specifically, the cartridge body  156  of the staple cartridge  116   a  is secured within the cavity  119  of the channel member  118  with, e.g., a snap-fit connection. Other forms of connections are contemplated and may be used in place of the snap-fit connection, or in addition thereto, to fixedly or releasably secure the cartridge assembly  116  within the cavity  119  of the channel member  118 . 
     The channel member  118  is pivotally secured to the anvil assembly  114 , and includes an inner clamping surface  118   a  ( FIG. 10 ) defining a channel or slot  161 . The cartridge body  156  defines a plurality of laterally spaced staple retention slots  153  which are positioned in alignment with the staple receiving depressions (not shown) in the anvil plate  152  ( FIG. 10 ) of the anvil assembly  114  when the jaw assembly  106  is in the clamped position. Each retention slot  153  is configured to receive a fastener or staple “S” and a pusher  164 . The actuation sled  162  is positioned within the cartridge body  156  of the cartridge assembly  116  and is configured to pass longitudinally through the cartridge body  156  into engagement with the pushers  164  to lift the pushers within the cartridge body  156  and sequentially eject the staples “S” from the cartridge body  156 . The actuation sled  162  supports a knife mechanism  166  that includes a knife that is cammed into a cutting position when the actuation sled  162  is engaged by the dynamic clamping member  122 . 
       FIGS. 4-7  illustrate the drive assembly  120  of the stapling device  10  ( FIG. 1 ) which includes a dynamic clamping member  122 , a drive beam  124 , an adjustment beam  126 , and a securement mechanism  128 . The drive beam  124  defines a longitudinal axis and extends proximally from the dynamic clamping member  122  into the body portion  102  of the loading unit  100 . The adjustment beam  126  extends along a length of the drive beam  124  and is selectively securable to the drive beam  124  by the securement mechanism  128 . A proximal end of the drive beam  124  is configured to engage a drive member (not shown) of the adapter assembly  30  and/or the powered handle assembly  20  for advancing and retracting the drive assembly  120  within the adapter assembly  30  and the tool assembly  104 . A tab  130  ( FIG. 5 ) is disposed along the length of the drive beam  124  and defines a first opening  131   a , a second opening  131   b , a third opening  131   c  (collectively, openings  131 ). In aspects of the disclosure, each of the openings  131  are oblong in a direction transverse to the longitudinal axis of the drive beam  124  to accommodate transverse movement of the adjustment beam  126  relative to the drive beam  124  as the adjustment beam  126  is moved longitudinally relative to the drive beam  124 . Although shown to include three openings  131 , it is envisioned that the drive beam  124  may include only two openings or may include more than three openings. Although the tab  130  is shown formed on the drive beam  124 , it is envisioned that the tab  130  may instead be formed on the adjustment beam  126 . As will be described in detail below, the adjustment beam  126  and the securement mechanism  128  operate as a mechanism for adjusting a clamping height “CH” ( FIG. 6 ) of the dynamic clamping member  122 . 
     In certain aspects of the disclosure, the drive beam  124  and/or the adjustment beam  126  of the drive assembly  120  is formed from a plurality of stacked sheets that are formed of a resilient or flexible material, e.g., stainless steel. 
     The dynamic clamping member  122  of the drive assembly  120  includes an upper flange portion  132 , a lower flange portion  134 , and a vertical strut  136  interconnecting the upper flange portion  132  and the lower flange portion  134 . The upper flange portion  132  is sized and dimensioned to be slidably received within the channel  151  ( FIG. 10 ) of the anvil assembly  114  and includes a clamping surface  132   a  ( FIG. 13 ) that engages the inner clamping surface  114   a  ( FIG. 13 ) of the anvil assembly  114  to cause pivoting of the cartridge assembly  116  relative to the anvil assembly  114  to move the jaw assembly  106  from the open position to the clamped position. The lower flange portion  134  is sized and dimensioned to be slidably received within the channel  161  ( FIG. 13 ) of the channel member  118  and includes inclined surfaces  134   a  facing the upper flange portion  132  of the dynamic clamping member  122 . 
     The adjustment beam  126  of the drive assembly  120  extends along a length of the drive beam  124 . A proximal portion  126   a  of the adjustment beam  126  defines an opening  127  for receiving the securement mechanism  128 . As shown, the securement mechanism  128  includes the adjustment knob  128   a  and a threaded screw  128   b , and the opening  127  is configured to securely receive the threaded screw  128   b . Although shown as a threaded connection, it is envisioned that the adjustment beam  126  may be secured relative to the drive beam  124  in any suitable manner. The opening  127  in the adjustment beam  126  is positioned to align with any one of the openings  131  in the tab  130  of the drive beam  124 . 
     An engagement portion  140  is formed on a distal end  126   b  of the adjustment beam  126  of the drive assembly  120 . The engagement portion  140  of the adjustment beam  126  includes a pair of extensions  142  that are spaced apart from one another to form a slot  141  for receiving the vertical strut  136  of the dynamic clamping member  122 . Each of the extensions  142  includes an adjustment flange  144  that is configured to be received within the channel  161  ( FIG. 10 ) of the channel member  118  and includes a clamping surface  144   a  and an opposed inclined surface  144   b . The clamping surfaces  144   a  of the adjustment flanges  144  are configured to engage the inner clamping surface  118   a  ( FIG. 10 ) of the channel member  118 . The engagement portion  140  of the adjustment beam  126  is configured such that when the vertical strut  136  of the dynamic clamping member  122  is received within the slot  141  of the engagement portion  140 , the inclined surfaces  144   b  of the adjustment flanges  144  of the engagement portion  140  of the adjustment beam  126  engage the inclined surfaces  134   a  of the lower flange portion  134  of the dynamic clamping member  122 . The distance between the clamping surface  132   a  of the of upper flange portion  132  of the dynamic clamping member  122  and the clamping surface  144   a  of the adjustment flange  144  of the engagement portion  140  of the adjustment beam  126  defines the clamping height “CH” ( FIG. 6 ). As will be described in further detail below, by changing the longitudinal position of the adjustment beam  126  of the drive assembly  120  relative to the drive beam  124  of the drive assembly  120 , the clamping height “CH” may be adjusted. 
       FIGS. 9-13  illustrate the drive assembly  120  of loading unit  100  of the stapling device  10  ( FIG. 1 ) in a first configuration. In the first configuration, the adjustment beam  126  is longitudinally positioned relative to the drive beam  124  in its distal-most position such that the opening  127  in the adjustment beam  126  is aligned with the first opening  131   a  in the drive beam  124 . When the adjustment beam  126  is in the distal-most position, the adjustment flanges  144  of the engagement portion  140  of the adjustment beam  126  are positioned relative to the lower flanges  134  of the dynamic clamping member  122  such that a first clamp height “H”, i.e., the distance between the clamping surfaces  132   a  of the upper flange portion  132  of the dynamic clamping member  122  and the clamping surfaces  144   a  of the adjustment flanges  144 , is greatest. In this manner, when the dynamic clamping member  122  is advanced, the anvil assembly  114  pivots relative to the cartridge assembly  116  to create a gap height “GH” between a tissue contacting surface  114   b  of the anvil assembly  114  and a tissue contacting surface  116   b  of the cartridge assembly  116  of the jaw assembly  106 . 
       FIG. 9  illustrates the securement mechanism  128  of the drive assembly  120  in the first position. As shown, the adapter assembly  30  defines a slot  31  along its length for accommodating movement of the securement mechanism  128  of the drive assembly  120  during operation of the stapling device  10 . The adapter assembly  30  includes markings  32  along the slot  31  to indicate the position the adjustment beam  126  relative to the drive beam  124  of the drive assembly  120 . When drive assembly  120  is in a first configuration with the securement mechanism  128  in the first position, the securement mechanism  128  aligns with the distal-most marking of the markings  32  indicating that the stapling device  10  is configured to accommodate thick tissue. 
       FIG. 10  illustrates the jaw assembly  106  of the tool assembly  104  of the loading unit  100  of the stapling device  10  ( FIG. 1 ) with the drive assembly  120  in the first configuration and in a retracted position. When the drive assembly  120  is in the retracted position, the anvil assembly  114  is spaced from the cartridge assembly  116 , i.e., in the open position, to permit placement of tissue between the tissue contacting surfaces  114   b ,  116   b  of the respective anvil assembly  114  and cartridge assembly  116 . 
       FIG. 11  illustrates the drive assembly  120  of the loading unit  100  in the first configuration with the adjustment beam  126  of the drive assembly  120  in its distal-most position relative to the drive beam  124  with the opening  127  in the adjustment beam  126  in alignment with the first opening  131   a  in the drive member  122 . When the drive assembly  120  is in the first configuration, the distance between the clamping surface  132   a  of the upper flange portion  132  of the dynamic clamping member  122  and the clamping surface  144   a  of the adjustment flanges  144  of the engagement portion  140  of the adjustment beam  126  are spaced to define a first clamping height “CH 1 ”. 
       FIGS. 12 and 13  illustrate the jaw assembly  106  of the tool assembly  104  of the stapling device  10  with the drive assembly  120  in the first configuration and in a partially advanced position, i.e., a pre-fired position in which the jaw assembly  106  is in the clamped position. When the drive assembly  120  is moved to the partially advanced position, receipt of the upper flange portion  132  of the dynamic clamping member  122  of the drive assembly  120  in the channel  151  of the anvil assembly  114  and engagement of the clamping surface  132   a  of the upper flange portion  132  of the dynamic clamping member  122  with the inner clamping surface  114   a  of the anvil assembly  114  causes the anvil assembly  114  to pivot relative to the cartridge assembly  116  to the clamped position. When the drive assembly  120  is in the first configuration and in the partially advanced position, the tissue contacting surfaces  114   b ,  116   b  of the anvil assembly  114  and the cartridge assembly  116 , respectively, are spaced to define a first gap height “GH 1 ”. Continued advancement of the drive assembly  120  through the jaw assembly  106  to an advanced position effects the stapling (and cutting) of tissue as is known in the art. 
       FIG. 14  illustrates the drive assembly  120  of the loading unit  100  in the second configuration. More particularly, the adjustment beam  126  of the drive assembly  120  is in its proximal-most position relative to the drive beam  124  of the drive assembly  120 , with the opening  127  in the adjustment beam  126  in alignment with the third opening  131   c  in the drive member  122 . When the drive assembly  120  is in the second configuration, the clamping surface  132   a  of the upper flange portion  132  of the dynamic clamping member  122  and the clamping surface  144   a  of the adjustment flanges  144  of the engagement portion  140  of the adjustment beam  126  are spaced to define a second clamp height “CH 2 ” that is less than the first clamp height “CH 1 ”. When the drive assembly  120  is in the second configuration, the stapling device  10  is configured to accommodate thinner tissue than when the drive assembly  120  is in the first configuration. 
       FIGS. 15 and 16  illustrate the jaw assembly  106  of the tool assembly  104  of the stapling device  10  ( FIG. 1 ) with the drive assembly  120  in the second configuration, and in the partially advanced position. In the partially advanced position, receipt of the upper flange portion  132  of the dynamic clamping member  122  in the channel  151  of the anvil assembly  114  and engagement of the clamping surfaces  132   a  of the upper flange portion  132  with the inner clamping surface  114   a  of the anvil assembly  114  causes the anvil assembly  114  to pivot relative to the cartridge assembly  116  to the clamped position. When the drive assembly  120  is in the second configuration and in the partially advanced position, the tissue contacting surfaces  114   b ,  116   b  of the anvil assembly  114  and the cartridge assembly  116 , respectively, are spaced to define a second gap height “GH 2 ”. Continued advancement of the drive assembly  120  through the jaw assembly  106  effects the stapling of tissue as is known in the art. 
     Although the clamp height “CH” is shown and described as having a fixed distance once the adjustment beam  126  is secured relative to the drive beam  124 , it is envisioned that the adjustment beam  126  may be moved relative to the drive beam  124  during the stapling procedure, i.e., as the drive assembly  120  is advanced through the jaw assembly  106 , to adjusted the clamping height “CH” as the drive assembly  120  is advanced. The adjustment of the clamping height “CH” may be manual or automatic. For example, in smart staplers, i.e., staplers with sensors, the sensors will sense the tissue thickness and change the tissue gap as the stapler is fired, and in non-smart staplers, a biasing member maintains a specific pressure on the tissue independent of the tissue gap height. 
     Although the adjustment mechanism shown and described above relates to powered surgical staplers, the aspects of the disclosure may be modified for use on manually actuated stapling devices. 
       FIG. 17  illustrates a manual surgical stapling device according to exemplary aspects of the disclosure, shown generally as stapling device  10 ′. The stapling device  10 ′ includes a manual handle assembly  20 ′ including an adapter assembly  30 ′, and a loading unit  100 ′ that is releasably secured to the adapter assembly  30 ′. 
     Although shown and described as used with hand-held actuation mechanisms, it is envisioned that the aspects of the disclosure may be modified for use remotely, i.e., with robotic systems (not shown). 
       FIGS. 18 and 19  illustrate a drive assembly according to other aspects of the disclosure shown generally as drive assembly  220 . The drive assembly  220  is similar to the drive assembly  120  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The drive assembly  220  includes a dynamic clamping assembly  222 , a drive beam  224 , and an adjustment beam  226  ( FIG. 19 ) slidably disposed relative to the drive beam  222  within a slot  223  formed in the drive beam  222 . The dynamic clamping assembly  222  includes a clamping member  223 , and a lower flange member  234 . The clamping member  223  includes an upper flange member  232  and a vertical strut  236 . The lower flange member  234  is secured to the vertical strut  236  of the clamping member  223  by a dovetail connection  235  ( FIG. 18 ), or in any other suitable manner. The adjustment beam  226  is secured to the lower flange member  234  in any suitable manner and operates to move the lower flange member  234  along a longitudinal axis of the drive assembly  220  relative to the vertical strut  236 . The lower flange member  234  and the vertical strut  236  include abutting inclined surfaces  234   b ,  236   a . Longitudinal movement of the lower flange member  234  relative to the vertical strut  236  varies the distance between a clamping surface  232   a  ( FIG. 18 ) of the upper flange portion  232  of the clamping member  223  and a clamping surface  234   a  ( FIG. 18 ) of the lower flange member  234 , e.g., a clamping height “CH”. 
     As shown in  FIGS. 18 and 19 , the drive assembly  220  is in a first configuration, with the adjustment beam  226  in a distal-most position relative to the drive beam  224 . When the drive assembly  220  is in the first configuration, the clamping height “C” is a first distance. As with drive assembly  120 , described above, longitudinal movement of the adjustment beam  226  relative to the drive beam  224 , as indicated by arrows “A”, moves the inclined surface  234   b  of the lower flange member  234  relative the inclined surface  236   a  of the vertical strut such that the lower flange member  234  moves towards the upper flange portion  232 , as indicated by arrow “B”, to adjust the clamping height “CH” ( FIG. 19 ) between minimum and maximum positions 
       FIGS. 20 and 21  illustrate a dynamic clamping assembly according to another aspect of the disclosure shown generally as dynamic clamping assembly  320 . The dynamic clamping assembly  320  is similar to the dynamic clamping assembly  222  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  322  includes a clamping member  323  and a lower flange member  334 . The clamping member  323  includes an upper flange portion  332  and a vertical strut  336 . The lower flange member  334  is supported within a slot  325  of in the vertical strut  336 . More particularly, the lower flange member  334  is movable vertically within the slot  325  perpendicular to a longitudinal axis of the dynamic clamping assembly  322 , as indicated by arrow “C” in  FIG. 21 . In this manner, a distance between a clamping surface  332   a  of the upper flange portion  332  and a clamping surface  334   a  of the lower flange member  334 , e.g., a clamping height “CH”, may be adjusted by raising or lowering the lower flange member  334  relative to the vertical strut  336 . 
     An adjustment member  326  ( FIG. 21 ) extends through a cylindrical passage  327  in the vertical strut  336  and through the lower flange member  334 . The adjustment member  326  is biased distally by a spring member  328  ( FIG. 21 ). The adjustment member  326  includes an inclined surface  326   a  that is configured to engage the lower flange member  334  to change the relative position of the upper flange portion  332  and the lower flange member  334 , respectively, in response to a change in the longitudinal position of the adjustment member  326  relative to the clamping member  323 . 
     A plug member  324  secures the spring member  328  within the cylindrical passage  237 . Longitudinal movement of the plug member  324  relative to the vertical strut  336  increase and decrease the compressive force on the spring member  328 . By reducing the biasing force provided by the spring member  328  to the adjustment member  326 , the adjustment member  326  is able to move relative to the lower flange member  334 . For example, the bias on the spring member  328  may be effected by a threaded rod (not shown) extending through the loading unit, e.g., loading unit  100  ( FIG. 1 ). Rotation of the threaded rod in a first direction would cause retraction of the plug  234  and thus, decompression of the spring member  328 , thereby permitting proximal movement of the adjustment member  326 . Conversely, rotation of the threaded rod in a second direction would cause advancement of the plug  328 , and thus, compress the spring member  328  thereby causing distal movement of the adjustment member  326 . 
     When the adjustment member  326  is in its distal-most position, as shown in  FIG. 21 , the dynamic clamping assembly  322  defines a first clamping height “CH 1 ”. Retraction of the adjustment member  326 , as indicated by arrow “E” in  FIG. 21 , to its proximal-most position, causes the lower flange member  334  to move away from upper flange portion  332 , as indicated by arrow “F” in  FIG. 21 ″. When the adjustment member  326  is in its proximal-most position ( FIG. 21 , shown in phantom), the dynamic clamping assembly  322  defines a second clamping height “CH 2 ”. The second clamping height “CH 2 ” is greater than the first clamping height “CH 1 ”. By positioning the adjustment member  326  with the inclined surface  326   a  aligned with the lower flange member  334 , i.e., between its proximal-most and distal-most positions, the adjustment member  326  may be positioned to create a clamping height “CH” between the first and second clamping heights “CH 1 ” and “CH 2 ”. 
       FIGS. 22 and 23  illustrate a drive assembly according to another aspect of the disclosure shown generally as drive assembly  420 . The drive assembly  420  includes a dynamic clamping assembly  422  substantially similar to the dynamic clamping assembly  322  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  422  includes a clamping member  423  and a lower flange member  434 . The clamping member  423  includes an upper flange portion  432  and a vertical strut  436 . The lower flange member  434  is supported within a slot  425  of the vertical strut  436  and is movable vertically within the slot  425  perpendicular to a longitudinal axis of the dynamic clamping assembly  422 , as indicated by arrow “G” in  FIG. 22 . In this manner, a clamping height “CH” defined between a clamping surface  432   a  ( FIG. 22 ) of the upper flange portion  432  and a clamping surface  434   a  of the lower flange member  434  may be adjusted by raising or lowering the lower flange member  434  relative to the vertical strut  436 . 
     An adjustment member  426  extends through a cylindrical passage  427  ( FIG. 22 ) in the vertical strut  436  and through the lower flange member  434 . An adjustment beam  428   a  is secured to and extends from the adjustment member  426 . The adjustment beam  428   a  extends along an axis that is parallel to a drive beam  428  that extends from the clamping member  423 . The adjustment member  426  is movable between an advanced position ( FIG. 22 ) and a retracted position by moving the adjustment beam  428   a  relative to the drive beam  428 . 
     The adjustment member  426  includes an inclined surface  426   a  that is positioned to engage the lower flange member  434  depending on the longitudinal position of the adjustment member  426  relative to the clamping member  423 . When the adjustment member  426  is in its distal-most position, as shown in  FIG. 23 , the clamping height “CH” is a first distance, and when the adjustment member  426  is in its proximal-most position (not shown), the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  426  with the inclined surface  426   a  aligned with the lower flange member  434 , i.e., between its proximal-most and distal-most positions, the clamping height “CH” may be adjusted between the first and second distances. 
       FIGS. 24 and 25  illustrate a dynamic clamping assembly according to another aspect of the disclosure shown generally as dynamic clamping assembly  522 . The dynamic clamping assembly  522  is similar to the dynamic clamping assembly  322  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  522  includes a clamping member  523  and a lower flange member  534 . The clamping member  523  includes an upper flange portion  532  and a vertical strut  536 . The lower flange member  534  is supported within a slot  525  of the vertical strut  536  and is movable vertically within the slot  525  perpendicular to a longitudinal axis of the dynamic clamping assembly  522 . In this manner, a clamping height “CH” defined between a clamping surface  532   a  ( FIG. 24 ) of the upper flange portion  532  and a clamping surface  534   a  of the lower flange member  534  may be adjusted by raising or lowering the lower flange member  534  relative to the vertical strut  536 . 
     An adjustment member  526  extends through a cylindrical passage  527  in the vertical strut  536  and through the lower flange member  534 . The adjustment member  526  includes an inclined surface  526   a  configured to engage the lower flange member  534  depending on the longitudinal position of the adjustment member  526  relative to the clamping member  523 . The adjustment member  526  is moveable along a longitudinal axis of the dynamic clamping assembly  522  by a threaded adjustment shaft  528 . By rotating the adjustment shaft  528 , the adjustment member  526  moves relative to the lower flange member  534 . 
     When the adjustment member  526  of the dynamic clamping assembly  522  is in its distal-most position, as shown in  FIG. 25 , a clamping height “CH” is a first distance, and when the adjustment member  526  is in its proximal-most position (not shown), the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  526  with the inclined surface  526   a  aligned with the lower flange member  534 , i.e., between its proximal-most and distal-most positions, the clamping height “CH” may be adjusted between the first and second distances. 
       FIGS. 26 and 27  illustrate a dynamic clamping assembly according to another aspect of the disclosure shown generally as dynamic clamping assembly  622 . The dynamic clamping assembly  622  is similar to the dynamic clamping assemblies  322 ,  522  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  622  includes a clamping member  623  and a lower flange member  634 . The clamping member  623  includes an upper flange portion  632  and a vertical strut  636 . The lower flange member  634  is supported within a slot  625  of the vertical strut  636  and is movable vertically within the slot  625  perpendicular to a longitudinal axis of the dynamic clamping assembly  622 . In this manner, a clamping height “CH” defined between a clamping surface  632   a  ( FIG. 26 ) of the upper flange portion  632  and a clamping surface  634   a  ( FIG. 26 ) of the lower flange member  634  may be adjusted by raising or lowering the lower flange member  634  relative to the vertical strut  636 . 
     An adjustment member  626  ( FIG. 27 ) extends through a cylindrical passage  627  in the vertical strut  636  and through the lower flange member  634 . The adjustment member  626  includes a conical distal portion  626   a  that is configured to engage an inclined surface  634   b  of the lower flange member  634 . Depending on the longitudinal position of the adjustment member  626  relative to the clamping member  623  the clamping height “CH” may be adjusted. The adjustment member  626  is moveable along a longitudinal axis of the dynamic clamping assembly  622  by a threaded engagement with the vertical strut  636  of the clamping member  623 . By rotating the adjustment member  626 , the adjustment member  626  move relatives to the lower flange member  634 . 
     When the adjustment member  626  of the drive is in its distal-most position, as shown in  FIG. 27 , the clamping height “CH” is a first distance, and when the adjustment member  626  is in its proximal-most position (not shown), the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  626  anywhere between its proximal-most and distal-most positions, the clamping height “CH” may be adjusted between the first and second distances. It is envisioned that the adjustment member  626  may operate as a drive member for advancing the dynamic clamping assembly  622  through a jaw assembly, for example, jaw assembly  106  ( FIG. 1 ). Alternatively, the dynamic clamping assembly  622  may be advanced by a drive member (not shown). 
       FIGS. 28 and 29  illustrate a dynamic clamping assembly according to another aspect of the disclosure shown generally as dynamic clamping assembly  722 . The dynamic clamping assembly  722  is similar to the dynamic clamping assemblies  322 ,  522 ,  622  described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  722  includes a clamping member  723  and a lower flange member  734 . The clamping member  723  includes an upper flange portion  732  and a vertical strut  736 . The lower flange member  734  is supported within a slot  725  of the vertical strut  736  and is movable vertically within the slot  725 , i.e., perpendicular to a longitudinal axis of the dynamic clamping assembly  722 . In this manner, a clamping height “CH” defined between a clamping surface  732   a  ( FIG. 28 ) of the upper flange portion  732  and a clamping surface  734   a  ( FIG. 28 ) of the lower flange member  734  may be adjusted by raising or lowering the lower flange member  734  relative to the vertical strut  736 . 
     An adjustment member  726  extends through and from a cylindrical passage  727  in the vertical strut  736  and through the lower flange member  734 . The adjustment member  726  includes a conical portion  726   a  that is configured to engage an inclined surface  734   b  of the lower flange member  734 . Depending on the longitudinal position of the adjustment member  726  relative to the clamping member  723 , the clamping height “CH” may be adjusted. The adjustment member  726  may be moveable along a longitudinal axis of the dynamic clamping assembly  722  by a threaded engagement (not shown) with the vertical strut  736  of the clamping member  723 . When the adjustment member  726  is in its proximal-most position relative to the clamping member  723 , as shown in  FIG. 29 , a clamping height “CH” is a first distance, and when the adjustment member  726  is in its distal-most position ( FIG. 29 , shown in phantom) relative to the clamping member  723 , the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  726  anywhere between its proximal-most and distal-most positions, the clamping height “CH” may be adjusted between the first and second distances. 
       FIGS. 30 and 31  illustrate a dynamic clamping assembly according to another aspect of the disclosure shown generally as dynamic clamping assembly  822 . The dynamic clamping assembly  822  is similar to the dynamic clamping assemblies described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The dynamic clamping assembly  822  includes a clamping member  823  and a lower flange member  834 . The clamping member  823  includes an upper flange portion  832  and a vertical strut  836 . The lower flange member  834  is supported within a slot  825  of the vertical strut  836 . More particularly, the lower flange member  834  is movable vertically within the slot  825 , i.e., perpendicular to a longitudinal axis of the dynamic clamping assembly  822 . In this manner, a clamping height “CH” defined between a clamping surface  832   a  ( FIG. 30 ) of the upper flange portion  832  and a clamping surface  834   a  ( FIG. 30 ) of the lower flange member  834  may be adjusted by raising or lowering the lower flange member  834  relative to the vertical strut  836 . 
     An adjustment member  826  extends through and from a cylindrical passage  827  in the vertical strut  836  and through the lower flange member  834 . The adjustment member  826  includes an inclined surface  826   a  that is configured to engage an inclined surface  834   b  of the lower flange member  834 . Depending on the longitudinal position of the adjustment member  826  relative to the clamping member  823  the clamping height “CH” may be adjusted. The adjustment member  826  is moveable along a longitudinal axis of the dynamic clamping assembly  822  to adjust a clamping height “CH” of the dynamic clamping assembly  822 . 
     When the adjustment member  826  is in its distal-most position, as shown in  FIG. 31 , the clamping height “CH” is a first distance, and when the adjustment member  826  is in its proximal-most position (not shown), the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  826  anywhere between its proximal-most and distal-most positions, the clamping height “CH” may be adjusted between the first and second distances. 
       FIGS. 32-35  illustrate a drive assembly according to another aspect of the disclosure shown generally as drive assembly  920 . The drive assembly  920  is substantially similar to the drive assemblies described hereinabove and will only be described in detail as relates to the differences therebetween. 
     The drive assembly  920  includes a dynamic clamping assembly  922  having a clamping member  923  and a lower flange member  934 . The clamping member  923  includes an upper flange portion  932  and a vertical strut  936 . The lower flange member  934  is received about and supported by the vertical strut  936  and is movable vertically relative to the vertical strut  936 , i.e., perpendicular to a longitudinal axis of the clamping member  922 . In this manner, a clamping height “CH” defined between a clamping surface  932   a  ( FIG. 30 ) of the upper flange portion  932  and a clamping surface  834   a  ( FIG. 30 ) of the lower flange member  934  may be adjusted by raising or lowering the lower flange member  934  relative to the vertical strut  936 . 
     An adjustment member  926  is supported within a cylindrical recess  925  defined by the vertical strut  936  and the lower flange member  934 . The adjustment member  926  includes a cam member  926   a . Depending on the rotational orientation of the adjustment member  926  relative to the clamping member  923 , i.e., the position of the cam member  926   a  relative to the clamping member  923 , the clamping height “CH” may be adjusted. The adjustment member  926  is rotatable about its central axis to adjust a clamping height “CH” of the dynamic clamping assembly  922 . 
     When the adjustment member  926  is oriented with the cam member  926   a  in a six o&#39;clock position, as shown in  FIG. 34 , the clamping height “CH” is a first distance, and when the adjustment member  926  is oriented in a twelve o&#39;clock position (not shown), the clamping height “CH” is a second distance. The second distance is greater than the first distance. By positioning the adjustment member  926  anywhere between the six o&#39;clock and twelve o&#39;clock positions, the clamping height “CH” may be adjusted between the first and second distances. 
     It is envisioned that the orientation of the cam member  926   a  may be adjusted by moving an adjustment beam  928   a  of the drive assembly  920  relative to a drive beam  928  of the drive assembly  920 . This may include a slotted, geared, or ratcheted arrangement, or other suitable configuration. 
     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 aspects. It is envisioned that the elements and features illustrated or described in connection with the exemplary aspects may be combined with the elements and features of another without departing from the scope of the disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described aspects. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.