Method of applying staples in lower anterior bowel resection

Patent metadata

Field	Value
Publication number	US-10045780-B2
Application number	US-201514985578-A
Country	US
Kind code	B2
Filing date	Dec 31, 2015
Priority date	Dec 31, 2015
Publication date	Aug 14, 2018
Grant date	Aug 14, 2018

Abstract

A method for manipulating tissue of a patient includes a surgical instrument having a handle assembly, a shaft assembly, and an end effector. The method includes positioning a tissue within a gap between a cartridge and an anvil and against a guide pin to laterally position the tissue relative to the cartridge and the anvil. The method also includes moving a retaining pin from an open position to a closed position to capture the tissue and moving the cartridge toward the anvil in a closed configuration. Furthermore, the method includes inhibiting deflection of a distal end portion of the end effector wherein at least at least one of the guide pin or the retaining pin connects to the distal end portion. The method further includes forming a plurality of staples within the tissue and cutting the tissue with a knife.

First claim

We claim:

1. A method of using an instrument to manipulate tissue of a patient, wherein the instrument has an end effector, the method comprising:
(a) positioning the tissue within a gap between a cartridge and an anvil of the end effector, wherein the cartridge includes a knife and a plurality of staples, wherein the anvil is located in a distal end portion of the end effector, and wherein the end effector is in an open configuration during the act of positioning the tissue between the anvil and the cartridge;
(b) positioning the tissue against a guide pin to laterally position the tissue relative to the cartridge and the anvil,
(c) moving a retaining pin from an open position toward a closed position across the gap, thereby capturing the tissue between the cartridge, the anvil, the guide pin, and the retaining pin;
(d) moving the cartridge toward the anvil such that the end effector is in a closed configuration;
(e) inhibiting deflection of the distal end portion of the end effector for aligning the cartridge and the anvil, wherein at least one of the guide pin or the retaining pin connects to the distal end portion secure the distal end portion relative to a proximal end portion of the end effector to thereby inhibit deflection of the distal end portion of the end effector;
(f) forming the plurality of staples within the tissue and fluidly sealing the tissue;
(g) sliding the knife distally toward the tissue such that the knife directs the retaining pin to lock to the distal end portion in a locked closed position; and
(h) cutting the tissue with the knife, thereby severing the tissue.

2. The method of claim 1 , wherein inhibiting deflection is provided by the guide pin connected to the distal end portion and the proximal end portion to secure the distal end portion relative to the proximal end portion of the end effector.

3. The method of claim 2 , further comprising increasing tension in the guide pin such that guide pin further inhibits deflection of the distal end portion of the end effector relative to the proximal end portion of the end effector.

4. The method of claim 1 , wherein inhibiting deflection is provided by the retaining pin connected to the distal end portion and the proximal end portion to secure the distal end portion relative to the proximal end portion of the end effector.

5. The method of claim 4 , wherein the distal end portion includes a first ledge, the retaining pin includes a second ledge, and the method further comprises overlapping the second ledge with the first ledge to lock the retaining pin in the locked closed position.

6. The method of claim 5 , wherein locking the retaining pin further includes expanding a portion of the retaining pin within the distal end portion of the end effector.

7. The method of claim 6 , wherein expanding a portion of the retaining pin further includes sliding the knife toward the anvil such that the knife forces the portion of the retaining pin to expand.

8. The method of claim 6 , wherein expanding a portion of the retaining pin further includes sliding a closure rod through the retaining pin toward the distal end portion such that the closure rod forces the portion of the retaining pin to expand.

9. The method of claim 5 , wherein the end effector includes a cam mechanism having a cam tab and a cam slot, and the method further comprises guiding the cam tab through the cam slot and rotating the retaining pin therewith to the locked closed position.

10. The method of claim 9 , wherein the guide pin is rotatably supported in a support cradle, and the method further comprises translating the support cradle and the retaining pin toward the distal end portion.

11. The method of claim 4 , wherein the distal end portion includes a first plurality of threads, the retaining pin includes a second plurality of threads, and the method further comprises threading the second plurality of threads with the first plurality of threads to lock the retaining pin in the locked closed position.

12. The method of claim 11 , wherein the end effector includes a cam mechanism having a cam tab and a spiral cam slot, and the method further comprises guiding the cam tab through the spiral cam slot and rotating the retaining pin therewith to the locked closed position.

13. The method of claim 1 , wherein the end effector is operatively attached to a body having a firing member configured to selectively actuate a firing stroke and move the cartridge from an unfired cartridge position to a fired cartridge position for forming the plurality of staples and cutting the tissue, wherein the method further comprises simultaneously communicating an audible sound and a visual indicia with a feedback generator to the operator to indicate that the firing member completed the firing stroke for actuating the cartridge to the fired cartridge position.

14. The method of claim 1 , wherein the tissue is a colon tissue, and the method further comprises performing a lower anterior resection of the colon tissue.

15. The method of claim 14 , wherein the distal end portion of the end effector includes, a first end, a second end laterally opposite from the first end, a distal crest laterally positioned between the first and second ends, wherein the distal crest projects distally beyond the first and second ends; and an arcuate distal surface extending along the distal crest and laterally between the first and second ends, wherein the arcuate distal surface at the distal crest has a radius of curvature configured to be received against a pelvic bowl of the patient to position the end effector relative to the colon tissue of the patient for manipulating the colon tissue with the cartridge, wherein the method further comprises positioning the arcuate distal surface of the distal end portion of the end effector against the pelvic bowl such that the end effector is in a predetermined orientation relative to the colon tissue thereby positioning the cartridge relative to the colon tissue for performing the lower anterior resection of the colon tissue.

16. The method of claim 1 , wherein the distal end portion of the end effector has a distal arcuate continuous surface.

17. A method of using an instrument to manipulate tissue of a patient, wherein the instrument has an end effector, the method comprising:
(a) positioning the tissue within a gap between a cartridge and an anvil of the end effector, wherein the cartridge includes a knife and a plurality of staples, wherein the anvil is located in a distal end portion of the end effector, and wherein the end effector is in an open configuration during the act of positioning the tissue between the anvil and the cartridge;
(b) positioning the tissue against a guide pin to laterally position the tissue relative to the cartridge and the anvil,
(c) moving a retaining pin from an open position toward a closed position across the gap, thereby capturing the tissue between the cartridge, the anvil, the guide pin, and the retaining pin;
(d) moving the cartridge toward the anvil such that the end effector is in a closed configuration;
(e) inhibiting deflection of the distal end portion of the end effector for aligning the cartridge and the anvil, wherein at least one of the guide pin or the retaining pin connects to the distal end portion to secure the distal end portion relative to a proximal end portion of the end effector to thereby inhibit deflection of the distal end portion of the end effector;
(f) forming the plurality of staples within the tissue and fluidly sealing the tissue; and
(g) cutting the tissue with the knife, thereby se

Assignees

• Ethicon Endo Surgery Llc
• Ethicon Llc

Inventors

• Adams Thomas
• Chow Hector
• Dickinson Steven
• Hoffman Douglas B
• Jamison Barry T
• Kimsey John S
• Labhasetwar Disha V
• Nalagatla Anil K
• Patel Sudhir
• Towers Mary R

Classifications

• A61B17/072 Primary

  for applying a row of staples in a single action, e.g. the staples being applied simultaneously · CPC title

• A61B2090/0814

  Preventing re-use · CPC title

• A61B2017/07221

  curved · CPC title

• A61B2090/0811

  for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument · CPC title

• A61B2017/07285

  characterised by its cutter · CPC title