Patent Description:
Anastomosis is the surgical joining of separate hollow organ sections. Typically, an anastomosis procedure follows surgery in which a diseased or defective section of hollow tissue is removed, and the end sections are stapled via a surgical stapling instrument. Depending on the desired anastomosis procedure, the end sections may be joined by circular or side-to-side organ reconstruction methods, for instance.

In a circular anastomosis procedure, the two ends of the organ sections are joined by means of a surgical stapling instrument which drives a circular array of staples through the end section of each organ section and simultaneously cores any tissue interior of the driven circular array of staples to free the tubular passage. Typically, these surgical stapling instruments include an elongated body portion having a handle portion at a proximal end to actuate the surgical stapling instrument and a staple holding component disposed at a distal end. An anvil assembly including an anvil retention rod with an attached anvil head is mounted to a trocar assembly at the distal end of the surgical stapling instrument adjacent the staple-holding component. Opposed end portions of tissue of the hollow organ(s) to be stapled are clamped between the anvil head and the staple holding component. The clamped tissue is stapled by driving one or more staples from the staple holding component so that the ends of the staples pass through the tissue and are formed by the anvil head. An annular knife is advanced to core tissue within the hollow organ to free a tubular passage within the organ.

Besides anastomosis of hollow organs, surgical stapling instruments for performing circular anastomosis have been used to treat internal hemorrhoids in the rectum. Typically, during use of a surgical stapling instrument for hemorrhoid treatment, the anvil head and the staple holding-component of the surgical stapling instrument are inserted through the anus and into the rectum with the anvil head and the staple-holding component in an open or spaced part position. Thereafter, a purse string suture is used to pull the internal hemorrhoidal tissue towards the anvil rod. Next, the anvil head and staple-holding component are approximated to clamp the hemorrhoidal tissue between the anvil head and the staple holding component. During the approximation of the anvil head and the staple-holding component, the trocar assembly is engaged with the anvil retention rod. The surgical stapling instrument is fired to remove the hemorrhoidal tissue and staple the tissue.

<CIT> is a surgical stapling device with a light source disposed within a trocar. <CIT> is a surgical stapling instrument with a a light source disposed in a hole at the tip of the trocar which is dimensioned to receive a suture.

Certain optional features of the invention are defined in the dependent claims. In accordance with the disclosure, a surgical stapling instrument includes an anvil assembly, a shell assembly, and an adapter assembly. The anvil assembly includes an anvil head and an anvil center rod extending proximally from the anvil head. The shell assembly includes an annular cartridge adapted to house a plurality of staples. The adapter assembly includes a tubular shaft supporting the shell assembly at a distal portion of the tubular shaft, and a trocar assembly. The trocar assembly includes a trocar detachably supporting the anvil center rod thereon and a light diffuser configured to scatter light received from a light source. The light diffuser is disposed adjacent a proximal portion of the trocar such that the light diffuser is surrounded by the anvil center rod when the anvil center rod is attached to the trocar.

In an aspect, the trocar assembly may further include a first member, a second member supporting the trocar at a distal end portion of the second member, and a lead screw adapted to be coupled to an actuator for rotational input. The lead screw may be rotabably supported on the first member and operatively coupled to the second member such that rotation of the lead screw causes axial displacement of the second member relative to the first member.

In another aspect, the second member may include an engaging portion defining a threaded bore threadably engaged with the lead screw.

In yet another aspect, the second member may further include a receiving portion distal of the engaging portion. The receiving portion may define a longitudinal channel configured to receive the lead screw.

In an aspect, the distal end portion of the second member may be tapered.

In another aspect, the distal end portion of the second member may include a neck portion configured to support the light diffuser about the neck portion. The neck portion may have a diameter smaller than a diameter of the trocar.

In yet another aspect, the distal end portion of the second member may define a bore in communication with the light diffuser.

In still yet another aspect, the trocar and the second member may be integrally formed or monolithically formed.

In still yet another aspect, the lead screw may define a second longitudinal channel extending therethrough.

In an aspect, the lead screw may include a distal end portion defining an opening such that the second longitudinal channel is in communication with the light diffuser.

In another aspect, the lead screw may include an annular protrusion configured to be received in a circular groove defined in an inner surface of the first member to inhibit axial displacement of the lead screw during rotation thereof.

In yet another aspect, the first member of the trocar assembly may be axially fixed with the tubular shaft.

In accordance with another aspect of the disclosure, an adapter assembly for use with a surgical stapling instrument includes a light source, a tubular shaft supporting a shell assembly of the surgical stapling instrument at a distal portion of the tubular shaft, and a trocar assembly attachable to an anvil assembly of the surgical stapling instrument. The trocar assembly is transitionable between an extended configuration and a retracted configuration. The trocar assembly includes a trocar detachably supporting the anvil center rod thereon, a lead screw adapted to be coupled to an actuator for rotational input, a first member rotatably supporting the lead screw, a second member operatively coupled to the lead screw such that rotation of the lead screw causes axial displacement of the second member relative to the first member, and a light diffuser. The lead screw defines a pathway of the light transmitted by the light source. The light diffuser is in communication with the pathway of the lead screw. The light diffuser is mounted about the second member and configured to be surrounded by the anvil center rod when the anvil center rod is attached to the trocar.

In an aspect, the trocar and the second member may be formed as a single construct.

In another aspect, the first member may be dimensioned to receive the second member therein.

In yet another aspect, the light source may be an LED.

In still yet another aspect, the second member may include an engaging portion defining a threaded bore threadably engageable with the lead screw, and a receiving portion defining a channel in communication with the light diffuser.

In still yet another aspect, the second member and the lead screw may be concentrically arranged.

In still yet another aspect, a portion of the channel of the receiving portion of the second member may be tapered.

In still yet another aspect, the light source may be disposed proximal of the lead screw.

A trocar assembly for use with a surgical stapling instrument is disclosed herein with reference to the drawings, wherein:.

A surgical stapling instrument is described in detail with reference to the drawings, wherein like reference numerals designate corresponding elements in each of the several views. As used herein, the term "distal" refers to that portion of the instrument, or component thereof which is farther from the user during customary use of the instrument while the term "proximal" refers to that portion of the instrument or component thereof which is closer to the user during customary use of the instrument.

With reference to <FIG> and <FIG>, a trocar assembly for use with a surgical instrument, in the form of a surgical stapling instrument <NUM> is shown generally as <NUM>. The trocar assembly <NUM> includes a light-emitting band (shown as a light diffuser <NUM>) that assists the clinician during attachment of an anvil assembly <NUM> to the trocar assembly <NUM>, as will be discussed. The light-emitting band further assists the clinician in determining whether the anvil assembly <NUM> is properly attached to the trocar assembly <NUM>. The surgical stapling instrument <NUM> is a circular stapling instrument including a handle assembly <NUM>, an adapter assembly <NUM> extending distally from the handle assembly <NUM> and including the trocar assembly <NUM> in accordance with the disclosure, a shell assembly <NUM> supported on a distal portion of the adapter assembly <NUM>, and an anvil assembly <NUM> operatively coupled to the handle assembly <NUM>.

The handle assembly <NUM> is illustrated as a powered assembly and includes a stationary grip <NUM>, an actuation button <NUM> for controlling firing of staples (not shown) from an annular staple cartridge <NUM> of the shell assembly <NUM>, and approximation buttons 26a, 26b for controlling axial displacement of the anvil assembly <NUM> towards and away from the shell assembly <NUM>. For a detailed description of the structure and function of exemplary powered handle assemblies, reference may be made to <CIT>and <CIT>. Although the disclosure illustrates a powered assembly, it is envisioned that the advantages of the present disclosure as described in detail below are also applicable to surgical stapling instruments having manually operated handle and body assemblies or robotically actuated surgical instruments. <CIT> (the '<NUM> Patent) discloses an example of a surgical stapling instrument including a manually actuated handle assembly It is also envisioned that the disclosed stapling instrument can be supported on a robotic system and need not include a handle assembly.

With continued reference to <FIG> and <FIG>, the adapter assembly <NUM> includes an interface portion <NUM> detachably coupled to the handle assembly <NUM>, a tubular shaft <NUM> extending distally from the interface portion <NUM>, and the trocar assembly <NUM> operatively supported within the tubular shaft <NUM>. The shell assembly <NUM> is supported on a distal portion of the tubular shaft <NUM> and includes a shell housing <NUM> and an annular staple cartridge <NUM> that defines annular rows of staple receiving pockets <NUM>. In particular, the shell assembly <NUM> may be releasably coupled to the distal portion of the tubular shaft <NUM> to facilitate replacement of the annular staple cartridge <NUM> after each use.

Each of the staple receiving pockets <NUM> supports a staple (not shown) that can be fired from the annular staple cartridge <NUM> via actuation of the actuation button <NUM> of the handle assembly <NUM> and formed within the staple forming pockets <NUM> of a staple forming surface <NUM> of an anvil head <NUM> of the anvil assembly <NUM>. The shell housing <NUM> of the shell assembly <NUM> defines an annular cavity <NUM>. The annular cavity <NUM> supports a staple pusher (not shown) and an annular knife (not shown) such that the staple pusher and the annular knife are movable in relation to the annular staple cartridge <NUM> to eject the staples from the annular staple cartridge <NUM> and to dissect or cut tissue positioned within an annulus defined by the annular staple cartridge <NUM>. For a detailed description of the structure and function of the exemplary shell assemblies reference may be made to the '<NUM> Patent.

With particular reference to <FIG>, the anvil assembly <NUM> includes an anvil head <NUM> and an anvil center rod <NUM>. The anvil head <NUM> includes the staple forming surface <NUM> that includes staple forming pockets <NUM>. The anvil center rod <NUM> includes a plurality of resilient fingers <NUM> defining a longitudinal bore <NUM> that is dimensioned to receive and releasably engage a trocar <NUM> of the trocar assembly <NUM>. In an aspect, the anvil head <NUM> may be pivotally coupled to the anvil center rod <NUM> and may be movable between an operative position for forming staples and a tilted, reduced profile position. The anvil assembly <NUM> may be releasably coupled to the trocar assembly <NUM> for concomitant axial displacement therewith relative to the shell assembly <NUM> (<FIG>) by activating an actuator (not shown) such as, e.g., an electric motor, in the handle assembly <NUM> (<FIG>). The trocar <NUM> includes a distal portion 102a that is tapered and a proximal portion 102b has a diameter larger than a diameter of the distal portion 102a. The distal portion 102a is detachably received within the longitudinal bore <NUM> that is defined by the plurality resilient fingers <NUM> of the anvil assembly <NUM>. Rotational input to the trocar assembly <NUM> (<FIG>) transitions the anvil assembly <NUM> between a spaced apart configuration and an approximated configuration, in which, the staple forming surface <NUM> of the anvil assembly <NUM> is in juxtaposed alignment with the annular staple cartridge <NUM>.

With reference now to <FIG>, the trocar assembly <NUM> includes an outer member <NUM>, an inner member <NUM> slidably disposed within the outer member <NUM>, a lead screws <NUM>, and the trocar <NUM>. In particular, the outer member <NUM>, the inner member <NUM>, the lead screw <NUM>, and the trocar <NUM> may be concentrically arranged. The outer member <NUM> includes proximal and distal end portions <NUM>, <NUM> and defines a first longitudinal channel <NUM> therein. In particular, the lead screw <NUM> is rotatably supported on, e.g., the proximal end portion <NUM>, of the outer member <NUM>. The lead screw <NUM> includes an annular protrusion <NUM> configured to be received in a circular groove defined in an inner surface of the outer member <NUM> to inhibit axial displacement of the lead screw <NUM> during rotation of the lead screw <NUM>. The outer member <NUM> may include a circular protrusion <NUM> extending radially inward from an inner surface thereof. The circular protrusion <NUM> is configured to rotatably support the lead screw <NUM> thereon. The lead screw <NUM> is operatively coupled to an actuator (not shown) such as, e.g., an electric motor, in the handle assembly <NUM> (<FIG>) for rotational input. For example, a cable (not shown) may interconnect the lead screw <NUM> and the actuator for rotational input. The cable may be formed of a flexible material to enable flexion of the cable in, e.g., radial and/or axial, directions. In this manner, the cable may accommodate the shape and contour of the adapter assembly <NUM>. Rotation of the lead screw <NUM> causes axial displacement of the anvil assembly <NUM> as will be described.

With particular reference to <FIG>, the distal end portion <NUM> of the outer member <NUM> defines an opening dimensioned to receive the inner member <NUM> therethrough to enable relative axial displacement of the inner member <NUM> within the first longitudinal channel <NUM> of the outer member <NUM>. The inner member <NUM> includes a tubular body <NUM> including an engaging portion <NUM> and a receiving portion <NUM> distal of the engaging portion <NUM>. The engaging portion <NUM> defines a threaded bore 514a that threadably engages the lead screw <NUM>. The receiving portion <NUM> is configured to support the trocar <NUM> at a distal end portion <NUM> of the receiving portion <NUM>. The inner member <NUM> and the trocar <NUM> may be integrally formed as a single construct. Alternatively, the inner member <NUM> and the trocar <NUM> may be monolithically formed. However, it is contemplated that the trocar <NUM> may be detachably supported at the distal end portion <NUM> of the receiving portion <NUM>. The receiving portion <NUM> of the inner member <NUM> defines a second longitudinal channel <NUM> extending along a length thereof. The second longitudinal channel <NUM> is dimensioned to receive the lead screw <NUM> therein. The lead screw <NUM> defines a third longitudinal channel <NUM> along the length thereof. In addition, the lead screw <NUM> further defines an opening 125a at a distal end portion <NUM> of the lead screw <NUM> such that the third longitudinal channel <NUM> is in communication with the second longitudinal channel <NUM> of the receiving portion <NUM> of the inner member <NUM>. The distal end portion <NUM> of the inner member <NUM> includes a light diffuser <NUM> that serves to diffuse light emitted through the second longitudinal channel <NUM> of the inner member <NUM>.

When the lead screw <NUM> engages the threaded bore 514a of engaging portion <NUM> of the inner member <NUM> and rotated in the direction of, e.g., an arrow "C", by activation of the actuator in the handle assembly <NUM>, the inner member <NUM> is axially displaced in the direction of an arrow "P". Axial displacement of the inner member <NUM> imparts concomitant axial displacement to the trocar <NUM>. Rotation of the lead screw <NUM> in the direction opposite of the arrow "C" causes axial displacement of the inner member <NUM> and the trocar <NUM> in the direction opposite of the arrow "P".

With particular reference to <FIG>, the adapter assembly <NUM> includes a light source <NUM> (<FIG>) such as, e.g., a light emitting diode (LED), that emits light through the third longitudinal channel <NUM> of the lead screw <NUM>. In this manner, the third longitudinal channel <NUM> serves as a pathway of the light emitted by the light source <NUM>. The third longitudinal channel <NUM> may include a surface or a coating that directs the light towards the distal end portion <NUM> of the lead screw <NUM>. Alternatively, the third longitudinal channel <NUM> may include a fiber-optic cable to transmit light therethrough. The distal end portion <NUM> of the receiving portion <NUM> of the inner member <NUM> may be tapered to direct the light towards the light diffuser <NUM>. In particular, the distal end portion <NUM> defines an opening 519a that provides communication between the light diffuser <NUM> and the third longitudinal channel <NUM> of the lead screw <NUM>. The light diffuser <NUM> is circumferentially mounted about a neck portion extending from the tapered portion 519b of the inner member <NUM>. Under such a configuration, when the light source <NUM> transmits light through the pathway provided by the third longitudinal channel <NUM> of the lead screw <NUM>, the light reaches the second longitudinal channel <NUM> of the inner member <NUM> and ultimately reaches the light diffuser <NUM> through the opening 519a. The light diffuser <NUM> circumferentially scatters the light to be detected by the clinician. In this manner, the light scattered by the light diffuser <NUM> may assist the clinician to locate and attach the anvil assembly <NUM> to the trocar <NUM>.

With reference to <FIG> and <FIG>, when the anvil assembly <NUM> is properly attached to the trocar assembly <NUM>, the light diffuser <NUM> on the inner member <NUM> is surrounded by the plurality of resilient fingers <NUM> of the anvil assembly <NUM>. In this manner, the presence or absence of the light emitted by the light diffuser <NUM> may indicate to the clinician whether the anvil assembly <NUM> is properly attached to the trocar <NUM>.

Claim 1:
A surgical stapling instrument (<NUM>) comprising:
an anvil assembly (<NUM>) including an anvil head (<NUM>) and an anvil center rod (<NUM>) extending proximally from the anvil head;
a shell assembly (<NUM>) including an annular cartridge (<NUM>) adapted to house a plurality of staples; and
an adapter assembly (<NUM>) including:
a tubular shaft (<NUM>) supporting the shell assembly (<NUM>) at a distal portion of the tubular shaft; and
a trocar assembly (<NUM>) including:
a trocar (<NUM>) detachably supporting the anvil center rod (<NUM>) thereon; and
characterised in that the trocar assembly (<NUM>) further comprises a light diffuser (<NUM>) configured to scatter light received from a light source, the light diffuser disposed adjacent a proximal portion (102b) of the trocar such that the light diffuser is surrounded by the anvil center rod (<NUM>) when the anvil center rod is attached to the trocar.