Patent Description:
Surgical stapling devices for performing surgical procedures endoscopically are well known. Such devices are available in a variety of different configurations, e.g., linear, curved, circular, etc., and are suitable for use in a variety of different procedures. Linear surgical stapling devices include a tool assembly having an anvil and a staple cartridge that are pivotably coupled to each other at their proximal ends between open and clamped positions. In order to better navigate the tool assembly to a surgical site endoscopically, the tool assembly may include a dissector tip that extends from a distal end of the tool assembly. Typically, the dissector tip is supported on the tool assembly and is configured to separate target tissue from body tissue to facilitate placement of the tool assembly about the target tissue. During some surgical procedures, it is desirable to have an angled dissector tip whereas in other surgical procedures it is desirable to have a linear dissector tip.

A continuing need exists in the art for a surgical stapling device that is better suited to access to a variety of surgical sites.

Document <CIT>, a document falling under Article <NUM>(<NUM>) EPC, discloses a surgical instrument end effector including a tip member movably disposed at a distal end of an anvil and is configured to toggle relative to the anvil between a first discrete position and a second discrete position. Documents <CIT>, <CIT>, <CIT> and <CIT> disclose other prior art surgical stapling instruments with a movable tip.

One aspect of this disclosure is directed to a claimed surgical stapling device according to claim <NUM>. Further developments of the claimed invention can be gathered from the dependent claims.

Various aspects of the disclosed surgical stapling device are described herein below with reference to the drawings, wherein:.

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 aspects of the disclosure described herein 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 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 to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through a small diameter incision or cannula. Further, the term "clinician" is used generally to refer to medical personnel including doctors, nurses, and support personnel. As used herein, the terms "parallel" and "aligned" are understood to include relative configurations that are substantially parallel, and substantially aligned, i.e., up to about + or - <NUM> degrees from true parallel or true alignment.

The disclosed surgical stapling device includes a tool assembly that supports a dissector tip that is adjustable to allow a clinician to position the dissector tip in a configuration that facilitates easy access to a surgical site. Some aspects of the disclosure are directed to a dissector tip that is pivotable between a first orientation in which the axis defined by the dissector tip is parallel to a longitudinal axis of the tool assembly and a second position in which the axis defined by the dissector tip defines an acute angle with the longitudinal axis of the tool assembly.

<FIG> illustrates the disclosed surgical stapling device which is shown generally as stapling device <NUM> and includes a handle assembly <NUM>, an elongate body <NUM>, and a tool assembly <NUM>. The handle assembly <NUM> includes a hand grip <NUM> and a plurality of actuator buttons <NUM> and supports a rotation knob <NUM>. The rotation knob <NUM> supports the elongate body <NUM> and is rotatable in relation to the handle assembly <NUM> to facilitate rotation of the elongate body <NUM> and the tool assembly <NUM> in relation to the handle assembly <NUM>. The actuator buttons <NUM> control operation of the various functions of the stapling device <NUM> including approximation, firing and cutting. The tool assembly <NUM> can be secured directly to a distal portion of the elongate body <NUM>. Alternately, the tool assembly <NUM> can form part of a reload assembly that is releasably coupled to the elongate body <NUM> and can be replaced to facilitate reuse of the surgical stapling device. Although the stapling device <NUM> is illustrated as an electrically powered stapling device, it is envisioned that the disclosed tool assembly <NUM> is suitable for use with a manually powered surgical stapling device. <CIT> (the '<NUM> Patent) discloses a stapling device including a powered handle assembly and <CIT> (the '<NUM> Patent) discloses a manually actuated handle assembly.

<FIG> illustrate the tool assembly <NUM> which defines a longitudinal axis "X" (<FIG>) and includes a cartridge assembly <NUM>, an anvil assembly <NUM>, and a dissector tip <NUM> that is supported on the anvil assembly <NUM>. The cartridge assembly <NUM> is secured to the anvil assembly <NUM> for pivotal movement between an open position and a clamped position. For a more detailed description of the cartridge assembly <NUM> of the tool assembly <NUM>, see, e.g., the '<NUM> and ' <NUM> Patents. Although the tool assembly is illustrated as a stapling device, it is envisioned that the tool assembly could include a variety of different devices including graspers, electrical tissue sealing/cutting devices, etc..

<FIG> illustrate the anvil assembly <NUM> and dissector tip <NUM> of the tool assembly <NUM>. The anvil assembly <NUM> includes a base portion <NUM> and an anvil portion <NUM>. The base portion <NUM> includes a proximal mounting portion 116a and a longitudinal body portion 116b that extends distally from the proximal mounting portion 116a. The proximal mounting portion 116a includes spaced through bores 116c that receive pivot members <NUM> (<FIG>) that pivotably couple the cartridge assembly <NUM> to the anvil assembly <NUM>. The anvil portion <NUM> is secured to the base portion <NUM> by, e.g., welding, and includes a staple forming surface <NUM>, a proximal portion 118a, and a distal portion 118b. The staple forming surface <NUM> of the anvil portion <NUM> defines a plurality of rows of staple deforming pockets (not shown) that are positioned on opposite sides of a knife slot (not shown). The distal portion 118b of the anvil portion <NUM> includes a clevis <NUM> that has spaced arms 130a. Each of the spaced arms 130a defines an opening <NUM> that receives a clevis pin <NUM>. The distal portion 118b of the anvil portion <NUM> includes a distal face <NUM> that supports a retaining member. In aspects of the disclosure, the retaining member includes a resilient cantilevered finger <NUM> that supports a protrusion 140a. The spaced arms 130a define a cavity <NUM> and the clevis pin <NUM> extends through the cavity <NUM> between the spaced arms 130a of the clevis <NUM>.

The dissector tip <NUM> has a body <NUM> (<FIG>) that defines a longitudinal axis "Y" and includes a proximal portion 150a and a distal portion 150b. The proximal portion 150a includes a hinge portion <NUM> that defines a through bore 152a that receives the clevis pin <NUM> to pivotably secure the dissector tip <NUM> to the distal end portion 118b of the anvil portion <NUM> of the anvil assembly <NUM>. The hinge portion <NUM> of the dissector tip <NUM> has a proximal face <NUM> that defines spaced recesses 156a and 156b, each of which is positioned to receive the protrusion 140a on the cantilevered finger <NUM> of the anvil portion <NUM> of the anvil assembly <NUM> (<FIG>) as described below. The dissector tip <NUM> has an angled distal face <NUM> that extends towards the cartridge assembly <NUM> in the distal direction (<FIG>) such that the distal end of the dissector tip <NUM> has a height that decreases in the distal direction. In aspects of the disclosure, the width of the dissector tip <NUM> decreases in the distal direction (<FIG>). Alternately, the dissector tip <NUM> can have a variety of different configurations that allow the tool assembly <NUM> to access target tissue.

In some aspects of the disclosure, the dissector tip <NUM> has a through bore <NUM> (<FIG>) that extends through the tapered distal face <NUM>. The through bore <NUM> allows a clinician to lasso or grasp the dissector tip <NUM> with a suture to allow the clinician to more accurately move and position the tool assembly <NUM> within a body cavity during a surgical procedure.

The dissector tip <NUM> pivots from a first position to a second position about the clevis pin <NUM>. <FIG> illustrate the dissector tip <NUM> in the first position. In the first position, the protrusion 140a of the cantilevered finger <NUM> is received within the recess 156b on the proximal surface <NUM> of the hinge portion <NUM> of the dissector tip <NUM> to retain the dissector tip <NUM> in the first position. In the first position, the longitudinal axis "Y" of the dissector tip <NUM> and the longitudinal axis "X" of the tool assembly <NUM> define an acute angle Ω (<FIG>). It is envisioned that angle Ω can be substantially the same as an angle β defined by a tissue guide surface <NUM> of the cartridge assembly <NUM> and the longitudinal axis "X". Alternately, other angles are envisioned.

<FIG> illustrate the dissector tip <NUM> in the second position. In the second position, the longitudinal axis "Y" of the dissector tip <NUM> is substantially parallel to or coaxial with the longitudinal axis "X of the tool assembly <NUM>. In order to move the dissector tip <NUM> between the first and second positions, a clinician can apply a force to the dissector tip <NUM> to disengage the protrusion 140a from within one of the respective spaced recesses 156a and 156b and pivot the dissector tip <NUM> about the clevis pin <NUM> to position the protrusion 140a in the other recess 156a or 156b of the dissector tip <NUM>. For example, when the dissector tip <NUM> is moved from the first position (<FIG>) to the second position (<FIG>), the clinician applies a force on the dissector tip <NUM> in the direction indicated by arrow "K" in <FIG> to pivot the dissector tip <NUM> about the clevis pin <NUM> in the direction indicated by arrow "L" in <FIG> to remove the protrusion 140a of the cantilevered finger <NUM> from the recess 156b of the dissector tip <NUM> and move the protrusion 140a into the recess 156a of the dissector tip <NUM>. The cantilevered finger <NUM> is flexible to allow the protrusion 140a to move between the recesses 156a-b. Although only two positions are shown in the figures, it is envisioned that the dissector tip <NUM> may be moved between multiple positions. In that respect, it is envisioned that two or more spaced recesses 156a-b can be provided to receive the protrusion 140a of the cantilevered finger <NUM> to retain the dissector tip <NUM> in one of multiple different angular positions in relation to the longitudinal axis "X" of the tool assembly <NUM>.

<FIG> illustrate an alternative version of the anvil assembly shown generally as anvil assembly <NUM>. The dissector tip <NUM> is substantially as described above and includes a hinge portion <NUM> that includes a proximal face <NUM> that defines spaced recesses 256a and 256b. The hinge portion <NUM> is supported within a clevis <NUM> (<FIG>) of the anvil assembly <NUM> by a clevis pin <NUM>. In the anvil assembly <NUM>, the retaining member on the distal portion 218b (<FIG>) of the anvil portion <NUM> (<FIG>) includes a plunger mechanism <NUM> that includes a plunger <NUM> and a biasing member <NUM>. The plunger <NUM> includes a protrusion 242a that is received within one of the recesses 256a and 256b on the proximal face <NUM> of the dissector tip <NUM> to retain the dissector tip <NUM> in one of the first position (<FIG>) and the second position (<FIG>). The plunger <NUM> is received within a blind bore <NUM> formed in a distal face <NUM> of the anvil portion <NUM>. The biasing member <NUM> which may be in the form of a coil spring is positioned within the blind bore <NUM> and a bore 242b formed in a proximal side of the plunger <NUM> to urge the plunger <NUM> distally into engagement with the hinge portion <NUM> of the dissector tip <NUM>.

Although the drawings only show retaining structure including a protrusion and a plurality of recesses, it is also envisioned that a variety of different types of retention structures can be provided to releasably retain the dissector tips <NUM> and <NUM> in different angular positions. Further, the retaining structure can be supported on or integrally formed with either or both dissection tip <NUM> and the anvil assembly <NUM>.

Claim 1:
A surgical stapling device (<NUM>) comprising:
an elongate body (<NUM>) having a proximal portion and a distal portion; and
a tool assembly (<NUM>) defining a longitudinal axis and including:
a cartridge assembly (<NUM>);
an anvil (<NUM>, <NUM>) including a proximal portion and a distal portion, the anvil coupled to the cartridge assembly such that the tool assembly is moveable from an open position to a clamped position;
a dissector tip (<NUM>) including a body having a proximal portion (150a) and a distal portion (150b), the body having a thickness that decreases towards the distal portion of the body of the dissector tip, the body being movably coupled to the anvil for movement between a first position substantially aligned with the longitudinal axis and a second configuration defining an acute angle with the longitudinal axis; wherein the dissector tip includes a proximal face (154a) that defines spaced recesses (156a, 156b, 256a, 256b),
and
a retaining member supported on the distal portion of the anvil, the retaining member engaged with the spaced recesses of the dissector tip to releasably retain the dissector tip in one of the first or second positions.