Patent Publication Number: US-2022225984-A1

Title: Reloadable cartridge assembly

Description:
TECHNICAL FIELD 
     The present disclosure relates generally to a reloadable cartridge assembly of a surgical stapler. 
     BACKGROUND 
     A reloadable cartridge assembly can be used in a number of surgical devices. One example includes use as a surgical stapler. A surgical stapler is a fastening device used to clamp tissue between opposing jaw structures to join tissue using surgical fasteners. A reloadable cartridge can include two elongated members used to clamp the tissue. One of the elongated members can include one or more reloadable cartridges and the other elongated member can include an anvil that can be used to form a staple when driven from the reloadable cartridge. A surgical stapler can receive one or more reloadable cartridges. An example of reloadable cartridges can include having rows of staples having a linear length. A row of staples can have a linear length between 30 mm and 60 mm, for example. A staple can be ejected by actuation of a movable handle member that is a part of a surgical handle assembly of the surgical stapler. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a schematic diagram of a surgical stapler including a surgical handle assembly and a reloadable cartridge assembly in an unclamped position in accordance with a number of embodiments of the present disclosure. 
         FIG. 2A  is a schematic diagram of a reloadable cartridge assembly in an unclamped position in accordance with a number of embodiments of the present disclosure. 
         FIG. 2B  is a schematic diagram of a portion of a reloadable cartridge assembly in an unclamped position in accordance with a number of embodiments of the present disclosure. 
         FIG. 3  is a schematic diagram of a reloadable cartridge assembly in a clamped position in accordance with a number of embodiments of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure includes apparatuses for a reloadable cartridge assembly. An example apparatus includes a first elongated member including a staple cartridge configured to eject a number of staples and a second elongated member pivotally coupled to the first elongated member, wherein the second elongated member includes a number of pockets configured to receive and form the number of staples ejected from the staple cartridge, and wherein a furthest distal pocket of the number of pockets is less than 6 millimeters (mm) from a distal end of the second elongated member. In some examples, the furthest distal pocket of the number of pockets can be less than 2 mm from the distal end of the second elongated member. 
     During use of a surgical stapler with a surgical handle assembly coupled to a reloadable cartridge, the elongated members (e.g., jaws) of the reloadable cartridge assembly can be moved to a clamped position in response to a toothed rack or other structure being moved in a linear distal direction in response to a moveable handle of the surgical handle assembly being moved in a proximal direction. The reloadable cartridge assembly can advance to an unclamped position in response to the toothed rack being moved in the linear proximal direction. Once in a clamped position, the staples can be delivered by continued advancement of the toothed rack in a linear distal direction. 
     In a number of embodiments, the surgical handle assembly with the surgical stapler coupled to the reloadable cartridge assembly can deploy a number of staples. The reloadable cartridge assembly can deploy the number of staples in response to a user changing the mode of the surgical stapler from clamp/unclamp to staple and moving the movable handle member in the proximal direction. 
     In some examples, the surgical stapler can be an endoscopic stapler for general, abdominal, gynecologic, pediatric, and/or thoracic surgery. The surgical stapler can be utilized for resection, transection, and/or creation of anastomoses, for example. 
     In the following detailed description of the present disclosure, reference is made to the accompanying drawings that form a part hereof, and in which is shown by way of illustration how one or more embodiments of the disclosure may be practiced. These embodiments are described in sufficient detail to enable those of ordinary skill in the art to practice the embodiments of this disclosure, and it is to be understood that other embodiments may be utilized and that process, electrical, and structural changes may be made without departing from the scope of the present disclosure. 
     It is to be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a”, “an”, and “the” can include both singular and plural referents, unless the context clearly dictates otherwise. In addition, “a number of”, “at least one”, and “one or more” (e.g., a number of pockets) can refer to one or more pockets, whereas a “plurality of” is intended to refer to more than one of such things. Furthermore, the words “can” and “may” are used throughout this application in a permissive sense (i.e., having the potential to, being able to), not in a mandatory sense (i.e., must). The term “include,” and derivations thereof, means “including, but not limited to”. The terms “coupled” and “coupling” mean to be directly or indirectly connected physically or for access to and movement of the movable handle member, as appropriate to the context. 
     The figures herein follow a numbering convention in which the first digit or digits correspond to the figure number and the remaining digits identify an element or component in the figure. Similar elements or components between different figures may be identified by the use of similar digits. For example,  106  may reference element “ 6 ” in  FIG. 1 , and a similar element may be referenced as  206  in  FIG. 2A . As will be appreciated, elements shown in the various embodiments herein can be added, exchanged, and/or eliminated so as to provide a number of additional embodiments of the present disclosure. In addition, the proportion and/or the relative scale of the elements provided in the figures are intended to illustrate certain embodiments of the present disclosure and should not be taken in a limiting sense. 
       FIG. 1  is a schematic diagram of a surgical stapler  100  including a surgical handle assembly  102  and a reloadable cartridge assembly  103  in an unclamped position in accordance with a number of embodiments of the present disclosure. As shown in the example of  FIG. 1 , the reloadable cartridge assembly  103  (e.g. a disposable loading unit) can be releasably secured to a distal end of an elongated body of the surgical handle assembly  102  via shaft  106 . 
     In this example, the reloadable cartridge assembly  103  can include a first elongated member  107  and a second elongated member  109 . The reloadable cartridge assembly  103  can be in a clamped position when the first elongated member  107  and the second elongated member  109  are clamping tissue, proximate to each other, and/or contacting each other. The reloadable cartridge assembly  103  can be in an unclamped position when the first elongated member  107  and the second elongated member  109  are not clamping tissue, receiving tissue, and/or are not in contact with each other. 
     In a number of embodiments, the first elongated member  107  can house one or more staple cartridges. The second elongated member can have an anvil that can be used to form a staple when driven from the staple cartridge. As mentioned, a reloadable cartridge assembly  103  can receive reloadable cartridge assemblies having rows of staples. 
     The surgical handle assembly  102  coupled to the reloadable cartridge assembly  103  can advance the reloadable cartridge assembly  103  to the clamped position in response to the user actuating the movable handle member  104  of the surgical handle assembly  102  in a proximal direction. A shaft of the surgical handle assembly  102  can interface with a drive mechanism included in the reloadable cartridge assembly  103  when the surgical handle assembly  102  and the reloadable cartridge assembly  103  are connected. Distal movement of the drive mechanism in response to the user actuating the movable handle member  104  in the proximal direction can move an I-beam distally. The I-beam can be included in the reloadable cartridge assembly  103  and can actuate the first elongated member  107  and/or the second elongated member  109 . The I-beam can move the reloadable cartridge assembly  103  to the clamped position in response to the I-beam moving in the distal direction. 
     The user can also advance the reloadable cartridge assembly  103  to the unclamped position in response to the user actuating the movable handle member  104  in a distal direction. Proximal movement of the drive mechanism in response to the user actuating the movable handle member  104  in the distal direction can move the I-beam distally and accordingly, the I-beam can move the reloadable cartridge assembly  103  to the unclamped position in response to the I-beam moving in the proximal direction. 
     In a number of embodiments, the surgical handle assembly  102  coupled to the reloadable cartridge assembly  103  can deploy a number of staples. The reloadable cartridge assembly  103  can deploy the number of staples in response to the user moving the movable handle member  104  to the most proximal position after a user changes the mode of the stapler from clamp/unclamp to staple. For example, further movement of the I-beam in the distal direction can cause a mechanism included in the first elongated member  107  to eject a number of staples and/or a blade to move towards a distal end (e.g., distal end  224  in  FIGS. 2A and 2B ) of a first slot (e.g., first slot  218  in  FIG. 2A ) of the second elongated member  109  and/or a distal end of a second slot of the first elongated member  107 . 
     In some examples, a distal end of the surgical stapler  100  can be inserted into a body of a patient or through a trocar or similar devices when the reloadable cartridge assembly  103  is in a clamped position. Once the distal end of the surgical stapler  100  is positioned in the body of the patient, the user can release or move the movable handle member  104  to a distal position to place the reloadable cartridge assembly  103  into an unclamped position. The user can position the reloadable cartridge assembly to place tissue between the first elongated member  107  and the second elongated member  109  and move the movable handle member  104  to a proximal position to move the reloadable cartridge assembly to the clamped position again and clamp the tissue. 
     In a number of embodiments herein, the surgical handle assembly  102  is shown as being manually actuated. Other handle assemblies such as ones that are driven by an electric motor may also be used. In these motor driven handle assemblies, a disposable or reusable/rechargeable battery may be used. It is also envisioned that the handle assembly could be replaced by a robotic or remotely controlled mechanism. In this embodiment, the physician/user is remote from the patient and controls the device from a computer input station or the like. In this embodiment, the reload cartridge assembly  103  could be connected to a robotic or remotely controlled arm. 
     In some examples, the reloadable cartridge assembly  103  is shown to include a connection to the surgical handle assembly  102  which allows the distal end of the reloadable cartridge assembly  103  to be clamped and/or unclamped. The embodiments described herein are equally applicable to a configuration wherein the surgical handle assembly  102  comprises the reloadable cartridge assembly  103 . In various embodiments, the reloadable cartridge assembly  103  could comprise a connector and the elongated members  107  and  109  or just a staple cartridge configured to be removably positioned in one of the elongated members  107  and  109 . 
       FIG. 2A  is a schematic diagram of a reloadable cartridge assembly  203  in an unclamped position in accordance with a number of embodiments of the present disclosure. The reloadable cartridge assembly  203  can include a shaft  206 , a first elongated member  207 , a second elongated member  209 , and a pin  212 . 
     A proximal end of the first elongated member  207  can be pivotally coupled to a proximal end of the second elongated member  209 . In some examples, the first elongated member  207  and the second elongated member  209  can be pivotally coupled via pin  212 . A distal end of shaft  206  can be coupled to the proximal end of the first elongated member  207  and/or the second elongated member  209 . 
     In a number of embodiments, a distal end  208  of the first elongated member  207  and/or a distal end  210  of the second elongated member  209  can be blunt. Damage to adjacent tissue and/or organs can be avoided when the distal end  208  of the first elongated member  207  is blunt and/or when the distal end  210  of the second elongated member  209  is blunt. For example, distal end  208  and/or distal end  210  can be substantially perpendicular to other sides of the first and/or second elongated members  207  and  209 . In some examples, distal end  208  and/or distal end  210  can be coupled to other sides of the first and/or second elongated members  207  and  209  via smooth (e.g., rounded) surfaces. 
     The first elongated member  207  can house a staple cartridge including a number of staples and/or a mechanism configured to eject the number of staples when the reloadable cartridge assembly  203  is in a clamped position. As illustrated in  FIGS. 2A and 2B , the second elongated member  209  can include a number of pockets  214  and/or a number of grooves  216 . A groove of the number of grooves  216  can create an opening from a first pocket of the number of pockets  214  to a second pocket of the number of pockets  214 . In some examples, pairs of pockets of the number of pockets  214  and a groove of the number of grooves  216  can run parallel to a longitudinal axis of the second elongated member  209 . 
     The number of pockets  214  and/or the number of grooves can be configured to receive and form the number of staples ejected from the staple cartridge. For example, a first pocket of the number of pockets  214  can be configured to receive a first portion of a staple of the number of staples, a second pocket of the number of pockets  214  can be configured to receive a second portion of the staple, and a groove of the number of grooves  216  can be configured to receive and fold the first portion and the second portion of the staple. In some examples, the first portion of the staple can be a first leg of a staple, the second portion of the staple can be a second leg, and a third portion of the staple can be a crown that couples the first leg to the second leg. As the staple is ejected from the staple cartridge, the first leg and the second leg are each received in a pocket of the number of pockets  214  and then are bent towards each other in a groove of the number of grooves  216 . 
     In a number of embodiments, the furthest distal pocket of the number of pockets  214  can be a distance  220  from a distal end  210  of the second elongated member  209 . Distance  220  can be 6 mm, 4 mm, or 2 mm, or less, for example. Distance  220  can be zero, however, to have adequate tissue compression to ensure optimal staple formation, distance  220  may be greater than zero. 
     Often positioning a reloadable cartridge assembly  203  within a body of a patient can be difficult because an organ and/or tissue to be transected can be close to or touching adjacent organs and/or tissue. In some examples, reducing distance  220  between the furthest distal pocket of the number of pockets  214  and the distal end  210  of the second elongated member  209  can improve clinical outcomes. For example, when distance  220  is minimized (e.g., the furthest distal pocket of the number of pockets  214  is near the distal end  210  of the second elongated member  209 ), the user can determine the most distal staple will be ejected very close to the distal end of the elongated member. Accordingly, the user can more accurately place the number of staples in tissue and/or organs and avoid placing staples in the wrong tissue and/or organs. 
     Reducing the distance  220  between the furthest distal pocket of the number of pockets  214  and the distal end  210  of the second elongated member  209  can also reduce damage to adjacent tissue and/or organs that may occur as a result of the user needing to place the reloadable cartridge assembly  203  further into the patient&#39;s body or further into adjacent tissue and/or organs. To properly place the number staples at the desired location in the body, the user may need to go a further distance into the body and/or into adjacent tissue and/or organs of the patient if the distance  220  is a greater distance. For example, when transecting a stomach, a spleen, a diaphragm, and/or a duodenum may be contacting or adjacent to the stomach. If distance  220  is reduced, there may be less chance of the second elongated member  209  contacting the spleen, diaphragm, and/or the duodenum and/or less surface area on the spleen, diaphragm, and/or the duodenum contacted by the second elongated member  209 . 
     As illustrated in  FIG. 2A , the second elongated member  209  can include a first slot  218 . Although not illustrated in  FIG. 2A , the first elongated member  207  can include a second slot. First slot  218  of the second elongated member  209  and/or the second slot of the first elongated member can receive a blade to cut tissue in response to and/or simultaneously to the number of staples being ejected from the staple cartridge when the reloadable cartridge assembly  203  is in the clamped position. 
     A distal end  224  of the first slot  218  can be a distance  222  from the distal end  210  of the second elongated member  209 . Distance  222  can be 8 mm, 6 mm, or 4 mm or less. In some examples, distance  222  can be at least partially based on distance  220 . For example, if distance  220  is 2 mm, distance  222  can be 3.5 mm. 
     In some examples, reducing distance  222  can improve clinical outcomes. For example, when distance  222  is minimized, the user can determine tissue and/or organs will be cut close to the distal end  220  of the second elongated member  209 . Accordingly, the user can more accurately cut tissue and/or organs and avoid cutting the wrong tissue and/or organs. 
     The second slot of the first elongated member  207  can have similar or the same dimensions as the first slot  218 . For example, the distal end  210  of the first slot  218  can be less than 1 mm from a distal end of the second slot when the reloadable cartridge assembly  203  is in the clamped position. Accordingly, a distance between a distal end of the second slot and the distal end  210  of the second elongated member  209  can be equal to distance  222  when the reloadable cartridge assembly  203  is in the clamped position. For example, the distance between the distal end of the second slot and the distal end  210  of the second elongated member  209  can be less than 8 mm when distance  222  is less than 8 mm. 
       FIG. 3  is a schematic diagram of a reloadable cartridge assembly  303  in a clamped position in accordance with a number of embodiments of the present disclosure. The reloadable cartridge  303  can include a shaft  306 , a first elongated member  307 , and a second elongated member  309 , as previously described in  FIG. 2A . 
     In some examples, a distal end  308  of the first elongated member  307  can be a distance  330  from a distal end  310  of the second elongated member when the reloadable cartridge assembly  303  is in a clamped position. For example, the distal end  308  of the first elongated member  307  can be greater than 9 mm from the distal end  310  of the second elongated member  309  when the reloadable cartridge assembly  303  is in the clamped position. 
     Increasing the distance  330  between the distal end  308  of the first elongated member  307  and the distal end  310  of the second elongated member when the reloadable cartridge assembly  303  is in the clamped position can reduce damage to adjacent tissue and/or organs. For example, to properly place a number staples at a desired location in a body, a user may need to get close to and/or contact adjacent tissue and/or organs of the patient. The user can use the distal end  308  of the elongated member  308  to push away tissue and/or organs from the second elongated member  309  to prevent clamping, stapling, and/or cutting the wrong tissue and/or organs. 
     Although specific embodiments have been illustrated and described herein, those of ordinary skill in the art will appreciate that an arrangement calculated to achieve the same results can be substituted for the specific embodiments shown. This disclosure is intended to cover adaptations or variations of one or more embodiments of the present disclosure. It is to be understood that the above description has been made in an illustrative fashion, and not a restrictive one. Combination of the above embodiments, and other embodiments not specifically described herein will be apparent to those of skill in the art upon reviewing the above description. The scope of the one or more embodiments of the present disclosure includes other applications in which the above structures and processes are used. Therefore, the scope of one or more embodiments of the present disclosure should be determined with reference to the appended claims, along with the full range of equivalents to which such claims are entitled. 
     In the foregoing Detailed Description, some features are grouped together in a single embodiment for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the disclosed embodiments of the present disclosure have to use more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all features of a single disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment.