KR102349099B1 - Surgical stapler with articulation mechanism - Google Patents

Abstract

A handle assembly for a surgical stapler may include a rotatable actuation shaft. The actuation shaft comprises a first rotational orientation capable of operating the jaw assembly in a repeatable open and closed mode, a second rotational orientation capable of operating the jaw assembly in a staple firing mode, and a retractable mode of operating the jaw assembly. It may have a third rotational orientation. The handle assembly may include an articulation mechanism including a ball screw for selectively articulating the jaw assembly relative to the elongate shaft.

Description

Surgical stapler with articulation mechanism

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of pending U.S. Provisional Patent Application Serial No. 62/321,643, filed April 12, 2016, entitled "SURGICAL STAPLER HAVING ARTICULATION MECHANISM". The above-referenced applications are incorporated herein by reference in their entirety.

technical field

TECHNICAL FIELD This application relates generally to surgical occlusion instruments, and more particularly, to surgical staplers.

Surgical staplers are used to clamp or access tissue and staple the clamped tissue together. As such, surgical staplers have mechanisms to ensure tissue is properly positioned and captured and to drive staples through tissue. As a result, this has resulted in a plurality of triggers and handles, for example with complex mechanisms for providing proper stapling of the clamped tissue. With these complex mechanisms, surgical staplers can have increased manufacturing burden as well as potential sources of device failure and confusion to the user. Therefore, reliable stapling of clamped tissue without complicated mechanisms is desired.

In certain embodiments, a surgical stapler is provided herein. A surgical stapler includes an elongate shaft, a jaw assembly, and a handle assembly. The elongate shaft has a proximal end and a distal end. The elongate shaft defines a longitudinal axis between the proximal end and the distal end. The jaw assembly is located at the distal end of the elongate shaft. The jaw assembly includes a first jaw, a second jaw, and a plurality of staples. The jaw assembly may be selectively positioned in one of a closed configuration, an open configuration, and a firing configuration. A handle assembly is located at the distal end of the elongate shaft. The handle assembly includes a stationary handle, a movable trigger pivotably connected to the stationary handle, and an actuation shaft. The actuation shaft can slide longitudinally about a longitudinal axis of the actuation shaft within the handle assembly and can rotate about the longitudinal axis within the handle assembly.

In certain embodiments, the handle assembly further includes an articulation mechanism. The articulation mechanism includes a ball screw having a thread formed therein. The articulation mechanism further includes at least one ball bearing engageable with the thread. The articulation mechanism includes a linkage coupled to the articulation adapter. In operation, rotation of the ball screw may translate the articulation adapter. In some embodiments, the articulation mechanism may include a release mechanism. The release mechanism may disengage the ball bearings from the ball screw and may be biased to return the articulation mechanism to the longitudinal central position. The articulation adapter may be coupled to an articulation member in the shaft for selectively articulating the jaw assembly about a longitudinal axis of the elongate shaft.

In certain embodiments, a handle assembly for a surgical stapler is provided. The handle assembly includes a handle body, an actuation shaft, and an articulation mechanism. The handle body includes a stationary handle and a movable handle pivotally coupled to the handle body. An actuation shaft is mechanically coupled to the movable handle for manual actuation thereof. The actuation shaft may slide within the handle body along a longitudinal axis. The articulation mechanism includes a manually actuated articulation handle and an articulation adapter. A manually operated articulation handle is located at the proximal end of the handle body and is rotatable about a longitudinal axis. An articulation adapter is located at the distal end of the handle body. The articulation adapter is operatively coupled to the articulation handle such that rotation of the articulation handle about the longitudinal axis slides the articulation adapter in the longitudinal direction.

In certain embodiments, a handle assembly for a surgical stapler is provided. The handle assembly includes a handle body, an actuation shaft, and an articulation mechanism. The handle body includes a stationary handle and a movable handle pivotally coupled to the handle body. The actuation shaft is mechanically coupled to the movable handle for manual actuation thereof. The actuation shaft may slide within the handle body along a longitudinal axis. The articulation mechanism includes a manually operated articulation handle and a ball screw. A manually operated articulation handle is located at the proximal end of the handle body. The manually actuated articulation knob may rotate about a longitudinal axis. The ball screw is operatively coupled to the joint handle, and can be moved in the longitudinal direction by rotation of the joint handle.

In certain embodiments, a handle assembly for a surgical stapler is provided. The handle assembly includes a handle body, an actuation mechanism, and an articulation mechanism. The handle body includes a stationary handle and a movable handle pivotally coupled to the handle body. The handle body has a proximal end and a distal end, and defines a central longitudinal axis between the proximal and distal ends. The actuation mechanism is located within the handle body. The articulation mechanism includes a manually actuated articulation handle, an articulation adapter, and a first articulation link. A manually operated articulation handle is located at the proximal end of the handle body and is rotatable about a longitudinal axis. An articulation adapter is located at the distal end of the handle body. The articulation adapter is operatively coupled to the articulation handle such that rotation of the articulation handle about the longitudinal axis slides the articulation adapter in the longitudinal direction. The first articulation link operatively couples the articulation handle to the articulation adapter. A first articulation link is laterally offset from the actuation mechanism and extends longitudinally within the handle body.

1 is a perspective view of one embodiment of a surgical stapling device having jaws in an open configuration.
FIG. 2 is a perspective view of one embodiment of a reload shaft for the surgical stapling device of FIG. 1 with jaws in a closed configuration;
3 is a perspective view of one embodiment of a handle assembly having an articulation mechanism for a surgical stapling device;
4 is a perspective view of the handle assembly of FIG. 3 with the movable handle in a closed configuration;
Fig. 5 is a top view of the handle assembly of Fig. 3 with the selector in a first configuration;
Fig. 6 is a top view of the handle assembly of Fig. 3 with the selector in a second configuration;
7A is a side view of the handle assembly of FIG. 3 ;
7B is a side cross-sectional view of the handle assembly of FIG. 3 ;
8A is a side cross-sectional view of the handle assembly of FIG. 1 in an initial configuration;
Fig. 8B is a cross-sectional perspective view of the handle assembly of Fig. 8A;
9A is a side cross-sectional view of the handle assembly of FIG. 1 operated in a closed configuration;
Fig. 9B is a cross-sectional perspective view of the handle assembly of Fig. 9A;
10A is a side cross-sectional view of the handle assembly of FIG. 1 in a forward drive configuration;
10B is a cross-sectional perspective view of the handle assembly of FIG. 10A ;
11A is a side cross-sectional view of the handle assembly of FIG. 1 in a forward drive configuration;
11B is a cross-sectional perspective view of the handle assembly of FIG. 11A ;
12A is a side cross-sectional view of the handle assembly of FIG. 1 in a fully driven forward configuration;
12B is a cross-sectional perspective view of the handle assembly of FIG. 12A ;
13A is a cross-sectional side view of the handle assembly of FIG. 1 in a reverse drive configuration;
13B is a cross-sectional perspective view of the handle assembly of FIG. 13A ;
14A is a side cross-sectional view of the handle assembly of FIG. 1 in a fully driven reverse configuration;
14B is a cross-sectional perspective view of the handle assembly of FIG. 14A ;
15 is a cutaway side view of one embodiment of the articulation mechanism of the handle assembly of FIG. 3 ;
FIG. 16 is a perspective view of the articulation mechanism of FIG. 11 in an articulated position;
17A is a cutaway side view of the articulation mechanism of FIG. 15 ;
FIG. 17B is a cutaway side view of the articulation mechanism of FIG. 15 with the release button depressed;
FIG. 17C is a cutaway side view of the articulation mechanism of FIG. 15 with the release button depressed and partially returned to the central position;
17D is a cutaway side view of the articulation mechanism of FIG. 15 with the release button depressed and returned to the central position;
17E is a cutaway side view of the articulation mechanism of FIG. 15 in a central position with the release button partially released;
17F is a cutaway side view of the articulation mechanism of FIG. 15 in a central position;

1 to 2 , an embodiment of a surgical stapling device is illustrated. The illustrated embodiment of a surgical stapler 10 includes an elongate shaft 20 , a jaw assembly 30 , and a handle assembly 40 . 1 illustrates a surgical stapler 10 having a jaw assembly 30 in an open configuration. 2 illustrates a removable reload shaft assembly including an elongate shaft 20 and a jaw assembly 30 of a surgical stapler 10 having a jaw assembly 30 in a closed configuration.

1 and 2 , the illustrated embodiment of a surgical stapler 10 may be sized and configured for use in laparoscopic surgical procedures. For example, the elongate shaft 20 and jaw assembly 30 may be sized and configured to be introduced into a surgical field through an access port or trocar cannula. In some embodiments, the elongate shaft 20 and jaw assembly 30 are sized such that they can be inserted through a trocar cannula having a relatively small working channel diameter, eg, less than 8 mm in diameter. and can be configured. In other embodiments, the elongate shaft 20 and jaw assembly 30 may be configured with a trocar cannula having a larger working channel diameter, for example, a diameter such as 10 mm, 11 mm, 12 mm, or 15 mm. It may be sized and configured to be inserted through the In other embodiments, it is contemplated that certain aspects of the surgical staplers described herein may be incorporated into a surgical stapling device for use in open surgical procedures.

With continued reference to FIGS. 1 and 2 , as illustrated, the elongate shaft 20 generally includes a tubular member. The elongate shaft 20 extends from the proximal end 22 to the distal end 24 . The elongate shaft 20 defines a central longitudinal axis L of the surgical stapler 10 , which extends between the proximal end 22 and the distal end 24 .

1 and 2 , in the illustrated embodiment, the jaw assembly 30 is coupled to the elongate shaft 20 at the distal end 24 of the elongate shaft 20 . The jaw assembly (30) includes a first jaw (32) and a second jaw (34) pivotably coupled to the first jaw (32). 3 and 15-17 , the jaw assembly 30 may articulate relative to the elongate shaft 20 in response to an articulation mechanism within the handle. 1 and 8-14 illustrate a handle assembly configured to fire a center-locking jaw assembly to further illustrate an actuation mechanism of the handle assembly in a staple firing sequence. In the initial configuration, the first set 32 includes a plurality of staples 36 disposed therein.

With continued reference to FIGS. 1 and 2 , in the illustrated embodiment, the jaw assembly 30 is closed from the open configuration ( FIG. 1 ) by an actuating member or beam that is longitudinally slidable within the elongate shaft. It can be operated in a configuration ( FIG. 2 ) and in a stapling configuration. In the initial position, the beam may be positioned at the distal end 24 of the elongate shaft 20 . With the beam in its initial position, the second jaw 34 is pivoted away from the first jaw 32 such that the jaw assembly 30 is in an open configuration. When the actuating member or beam moves distally along the longitudinal axis L, the actuating beam engages the second jaw (34). Translating the actuation beam a first distance distally from the initial position may actuate the jaw assembly from an open configuration to a closed configuration. With the jaw assembly 30 in the closed configuration, the actuation beam may be returned proximally a first distance to return the jaw assembly 30 to the open configuration. A distal end of the actuating beam may advance a staple slider configured to deploy staples from the first set 32, such that further movement of the actuating beam distally beyond the first distance causes a plurality of staples ( 36) develops from Article 1 (32).

1 and 2 , in the illustrated embodiment, the handle assembly is coupled to the elongate shaft 20 at the proximal end 22 of the elongate shaft 20 . As illustrated, the handle assembly 40 includes a pistol grip configuration having a housing defining a stationary handle 42 and a movable handle 44 or trigger pivotally coupled to the stationary handle 42 . have In other embodiments, a surgical stapler including aspects described herein may have other configurations, eg, a handle having other configurations, such as scissor-grip configurations, or in-line configurations. It is contemplated that it may have assemblies. As will be further described in greater detail below, the handle assembly 40 houses an actuation mechanism configured to selectively advance the actuation shaft in response to movement of the movable handle 44 .

In some embodiments, the surgical stapler 10 may include a plurality of staples 36 positioned within a disposable cartridge, while the handle assembly 40 is configured for reuse with the plurality of staple cartridges. . In the illustrated embodiment, an elongate shaft 20 and jaw assembly 30 define a disposable cartridge that can be removably coupled to a handle assembly 40 . Accordingly, in the illustrated embodiment, the handle assembly 40 includes a coupler 46 at its distal end. The coupler 46 is adapted to engage the elongate shaft 20 of the surgical stapler 10 . The coupler 46 removably connects an actuating shaft of the handle assembly 42 to an actuating member of the elongate shaft 20 and an external connector capable of removably connecting the handle assembly 40 to the elongate shaft 20 . It may have a bayonet connection with an internal connector to which it can connect. Accordingly, the surgical stapler 10 may be configured such that the handle assembly 40 may be reused with multiple disposable cartridges during a surgical procedure. In other embodiments, some portions of the handle assembly and the elongated shaft may be reusable, while the remaining portions of the elongated shaft and jaw assembly are contemplated to define a disposable cartridge. In certain other embodiments, the handle assembly and the elongate shaft may be reusable, while the jaw assembly defines a disposable cartridge. In still other embodiments, a jaw insert housing a plurality of staples may define a disposable cartridge, while the remainder of the surgical stapler is reusable.

3-7 illustrate various views of one embodiment of a handle assembly 40 having an articulation mechanism for a surgical stapler 10 . The articulation mechanism may be located at the proximal end of the handle assembly 40 and may have an articulation handle 190 for articulation of the jaw assembly. 3 , a perspective view of a handle assembly 40 with a movable handle 44 in an open position spaced from the stationary handle 42 is illustrated. The illustrated handle assembly 40 further includes a selector 72 operatively connected to an actuation mechanism housed within the handle assembly 40 as discussed further herein. As illustrated in FIG. 3 , the selector 72 is in the first position.

Referring to FIG. 4 , another perspective view of the handle assembly 40 of FIG. 3 is illustrated. As illustrated, the movable handle 44 is in the open position positioned adjacent the stationary handle 42 and the selector 72 is in the second position. 5 and 6 illustrate a top view of the handle assembly of FIG. 3 with a selector 72 such as slider 74 in a first position ( FIG. 5 ) and in a second position ( FIG. 6 ). 7A illustrates a side view of the handle assembly 40 of FIG. 3 , and FIG. 7B illustrates a side cross-sectional view of the handle assembly 40 of FIG. 3 .

8A and 8B illustrate cross-sectional views of handle assembly 40 in an initial configuration showing operation of actuation mechanism 50 . In the illustrated embodiment, the actuation mechanism 50 moves the actuation shaft from a first position corresponding to the jaw assembly 30 in an open configuration to a second position corresponding to the jaw assembly 30 being in the closed configuration. configured to selectively move (60) and selectively translate the actuation shaft from a second position to a third position for positioning the jaw assembly (30) in a stapling configuration and deploying a plurality of staples (36) do. In the initial configuration illustrated in FIGS. 8A and 8B , actuation mechanism 50 engages actuation shaft 60 in response to movement of moveable handle 44 or trigger without deploying staples to provide an open and close function. ) can be repeatedly translated between the first and second positions. This open and close function allows the user to position the stapler 10, clamp the tissue, and reposition the stapler to find the desired staple placement position before deploying the staples.

8-14 , in the illustrated embodiment, the actuation mechanism includes a forward or forward driver 52 , a reverse driver 54 , an open driver 58 , an advancing surface 62 , a reversing surface 64 , and an open surface 66 . The forward driver 52 advances the forward driver 52 in a first direction such that movement of the movable handle 44 from an open position to a closed position, for example, distally within the handle assembly 40 . to be operatively coupled to the movable handle 44 . Forward driver 52 may include a pawl or tooth configured to engage a recess or slot.

The reverse driver 54 is configured such that the movement of the movable handle 44 from the open position to the closed position is opposed to the first direction, such as working within the handle assembly 40 , for example, in a second direction. A movable handle 44 may be operatively coupled to advance the 54 . In some embodiments, the movable handle 44 may be operatively connected to the reverse driver 54 with a geared connection including an idler gear 56 . Reverse driver 54 may include a pole or tooth configured to engage a recess or slot.

The open driver 58 advances the open driver 58 in a first direction such that movement of the movable handle 44 from the open position to the closed position, for example, distally within the handle assembly 40 . to be operatively coupled to the movable handle 44 . In the illustrated embodiment, the open driver 58 is coupled to the idle 56 with pin and slot connections for operatively connecting the open driver 58 to the movable handle 44 . The open driver 58 may include a pole or tooth configured to engage a recess or slot.

The actuation shaft 60 includes an advancing surface 62 , a receding surface 64 , and an open surface 66 formed thereon. In the illustrated embodiment, the advancing surface 62 includes a plurality of spaced apart recesses or teeth, or racks, formed longitudinally along the actuation shaft 60 . In the illustrated embodiment, the receding surface 64 includes a plurality of spaced apart recesses or teeth, or a rack, formed longitudinally along the actuating shaft 60 and angularly offset from the advancing surface 62 . do. In the illustrated embodiment, the open surface 66 includes a recess formed in the actuation shaft 60 .

In certain embodiments, the actuation shaft 60 may rotate about the longitudinal axis of the stapler 10 within the handle assembly 40 . The handle assembly 40 may include a rotation mechanism 70 for providing selective rotation of the actuation shaft 60 within the handle assembly 40 . The actuation shaft 60 may be rotatable between a first orientation in which the forward driver 52 engages the advancing surface 62 and a second orientation in which the reverse driver 54 engages the reverse surface 64 . The angular offset of the advancing surface 52 from the receding surface 54 relative to the actuating shaft 60 causes the reverse driver 54 to disengage from the receding surface 64 with the actuating shaft in the first orientation. ) and with the actuation shaft in the second orientation, the forward driver 52 is disengaged from the advancing surface 62 .

With continued reference to FIGS. 8-14 , in certain embodiments, the rotation mechanism 70 includes a selector 72 , such as a slider. The slider may extend laterally through the housing of the handle assembly 40 . The slider extends from one side of the handle assembly 40 such that positioning the slider in a first position places the actuation shaft 60 in a first orientation, and from an opposite side of the handle assembly 40 . It may be operatively connected to the actuating shaft 60 such that extending and positioning the slider in the second position may rotate the actuating shaft 60 in a second orientation. In the illustrated embodiment, the slider is in meshing engagement with a gear 78 rotatably fixed to the actuation shaft 60 and slidable longitudinally along the actuation shaft 60 (eg, It is coupled to the rack 76 (such as by a keyed connection). Preferably, a rotational mechanism 70 comprising the illustrated sliders discretely positions the actuation shaft 60 in a desired orientation, which may result in mismeshed gearing within the actuation mechanism 50 . ) to reduce the occurrence of In some embodiments, the slider may include visual indicators, such as arrows, to indicate to the user the orientation of the actuation shaft 60 and thus the mode of operation of the stapler. In other embodiments, the rotation mechanism 70 ″ ( FIG. 1 ) may include other mechanisms, such as a rotatable knob rotatably coupled directly to the actuation shaft instead of the slider selector 72 .

In the illustrated embodiment, the advancing surface 62 and the reverse surface 64 are angularly offset relative to the actuation shaft by about 90 degrees. Accordingly, the rotation mechanism 70 is configured to rotate the actuation shaft about 90 degrees between the first orientation and the second orientation. In other embodiments, the actuation surface 62 and the reverse surface 64 may have different angular offsets, such as, for example, 120 degrees, and the rotation mechanism 70 correspondingly rotates the actuation shaft 60 . may be configured to rotate. Moreover, as described in greater detail herein with respect to the open/closed mode of operation of the handle assembly 40 , in the illustrated embodiment, the opening driver 58 engages the actuation shaft in the second orientation, and in other implementations, the opening driver 58 engages the actuation shaft in the second orientation. In examples, the actuation shaft may be rotatable in a third orientation in which the open driver 58 engages the actuation shaft.

8-14 , a typical operating sequence of the actuation mechanism 50 of the handle assembly 40 is illustrated. 8A-8B and 9A-9B illustrate the operation of the handle assembly 40 in an initial configuration to provide an open/close function to the jaw assembly 30 . In FIG. 8A , the movable trigger 44 is in the open position and the actuating shaft 60 is in a first position corresponding to a first position of the actuating beam at the distal end of the elongate shaft 20 . In the initial position, the actuation shaft 60 is positioned in the second orientation such that the reverse driver 54 is angularly aligned with the retraction surface 64 . With the actuation shaft 60 in the second orientation, an open driver 58 is positioned within the open surface 66 or recess. Movement of the movable handle 44 from the open position ( FIGS. 8A - 8B ) to the closed position ( FIGS. 9A - 9B ) is to engage an advancing recess 63 formed in the actuating shaft 60 and to the actuation shaft. To drive 60 to a second position within handle assembly 40 , forward driver 52 is advanced distally along actuation shaft 60 . The second position of the actuation shaft 60 within the handle assembly 40 corresponds to a second position of the actuation beam, which positions the jaw assembly 30 in a closed configuration.

The movable handle 44 may be biased to the open position by a biasing member, such as a coil spring 68 ( FIG. 11A ). Accordingly, releasing the movable handle 44 from the closed position illustrated in FIGS. 9A-9B will return it to the open position of FIGS. 8A-8B . The operable connection of the movable handle 44 to the open driver 58 similarly moves the open driver 58 proximally within the handle assembly 40 as the movable handle 44 returns to the open position. will move In the second orientation of the actuation shaft 60 , the opening driver 58 moves the open surface 66 such that proximal movement of the opening driver 58 returns the actuation shaft 60 from the second position to the first position. ), which returns the jaw assembly 30 to the open configuration.

A user may find a desired stapling position within the surgical field by repeatedly opening and closing jaws to clamp tissue in various positions. Once the desired stapling position has been selected, the actuation mechanism 50 may be configured into a stapling or firing mode by rotating the actuation shaft 60 to a first orientation. With the jaw assembly in a closed configuration (as illustrated in FIGS. 9A-9B ) in a desired stapling position, the user moves the slider to a first position corresponding to a first orientation of the actuation shaft 60 ( FIGS. 10A-9B ). It is possible to reposition the selector 72 by sliding it to (as illustrated in FIG. 10B ). In a first orientation of the actuation shaft 60 , a forward driver 52 may engage an advance surface 62 , the reverse driver 54 angularly misaligned with the reverse surface 64 , and an open driver 58 . ) is angularly misaligned with the open surface 66 . With actuation shaft 60 in the first orientation, movable handle 44 may be released into an open position ( FIGS. 11A-11B ), which engages forward driver 52 with advancing surface 62 . do.

11A-11B and 12A-12B, with actuation shaft 60 in a first orientation and forward driver 52 engaged with advancing surface 62, actuation mechanism 50 staples You are in ring or fire mode. Several cycles of moveable handle 44 movement from the open position to the closed position and back to the open position move the actuation shaft 60 from the second position ( FIGS. 11A-11B ), the actuation shaft 60 moves the handle assembly ( 40) to the third position ( FIGS. 12A-12B ) moved to its distal-most limit. In some embodiments, the actuation mechanism may include a stop to prevent distal movement of the actuation shaft 60 in the third position. The second position of the actuating shaft corresponds to the second position of the actuating beam in the jaw assembly 30 . The third position of the actuating shaft corresponds to a third position of the actuating beam in the jaw assembly 30 , which is the position at which the plurality of staplers are deployed from the first jaw. Movement of the movable handle 44 or trigger in the firing mode to advance the actuation shaft from the second position to the third position results in the forward driver 52 ratcheting over adjacent teeth or grooves in the actuation surface 62 . It advances as a ratchet-like advancement.

13A-13B, once the actuation shaft 60 is advanced to the third position and staples are fired from the jaw assembly, the actuation mechanism 50 can be configured in a reverse mode. Accordingly, the rotation mechanism 70 may rotate the actuation shaft 60 to the second orientation to position the reverse surface 64 in angular alignment with the reverse driver 54 . The slider may be slid to a second position to rotate the actuation shaft from a first orientation ( FIGS. 12A-12B ) to a second orientation ( FIGS. 13A-13B ). With the actuation shaft 60 in the second orientation, repeated cycles of the movable handle 44 from an open position to a closed position and back to an open position cause the actuation shaft 60 to move within the handle assembly 40 . While pulling proximally at When the reverse driver 54 drives the actuation shaft 60 proximally to the second position (illustrated in FIGS. 14A-14B ), the opening driver 58 engages the open surface 66 . When the movable handle 44 is released to the open position, the opening driver 58 returns the actuation shaft 60 to the first position. (Return the handle assembly to the configuration illustrated in FIGS. 8A-8B ). With the actuation shaft 60 in the first position, the staple-free cartridge can be removed from the handle assembly 40 and a new cartridge can be coupled to the handle assembly to initiate another stapling operation.

15 , 16 and 17A-17F , one embodiment of an articulation mechanism for handle assembly 40 is illustrated. In the illustrated embodiment, the handle is capable of articulating the jaw assembly at the distal end of the shaft by up to 45° in a fully articulated position in either direction relative to the longitudinal central position. In some embodiments, the handle assembly utilizes a passive articulation mechanism that includes a series of components coupled to a manually actuated articulation knob 190 at the proximal end of the handle. In other embodiments, it is contemplated that the articulation handle and certain components of the articulation mechanism may be disposed at other locations on the handle assembly, such as, for example, at its distal end, upper surface, or stationary handle.

15 and 16 , the articulation mechanism is coupled to an articulation member 206 extending longitudinally within the reload shaft when the reload shaft is coupled to the handle. Actuation of the articulation mechanism longitudinally translates the articulation member 206 proximally or distally relative to the shaft to articulate the jaw assembly at the distal end of the shaft.

Referring to FIG. 15 , the articulation mechanism includes a ball screw 192 having at least one helical groove or thread 195 within which one or more ball bearings 194 may ride. In the illustrated embodiment, the articulation mechanism includes two ball bearings 194 that can engage two threads 195 . The ball bearing 194 is located within ball bearing openings 189 in a ball sleeve 191 located radially outward of the ball screw 192 . The ball bearings 194 are held in the threads 195 by a release sleeve 196 located radially outward of the ball bearings 194 . Rotation of the articulation handle 190 coupled to the ball sleeve 191 by, for example, connecting pins 193 rotates the ball sleeve 191 about an axis of rotation, which causes the ball bearings 194 to engage the threads 195 . movement within and correspondingly translates the ball screw 192 in the longitudinal direction. Articulation of the jaw assembly is accomplished by rotating the articulation handle 190 to correspondingly rotate the ball sleeve 191 and ball bearings 194 about the axis of rotation while their longitudinal position is fixed along the axis of rotation. is achieved The ball bearings 194 engaged in the threads 195 of the ball screw 192 will then translate the ball screw 192 forward and backward along the axis of rotation. In the illustrated embodiment, the ball sleeve 191 is generally tubular with a cavity formed therein, and a portion of the ball screw 192 is positioned within the cavity and longitudinally translates within the cavity. While the illustrated embodiment of the articulation mechanism includes two ball bearings capable of engaging threads in a ball screw, in other embodiments, the articulation mechanism comprises, for example, a single ball bearing positioned within a single helical screw or It is contemplated that one may have more or fewer than two ball bearings, such as three or more ball bearings in a corresponding number of helical threads.

15 and 16 , a ball screw 192 extends to a distal end 200 coupled to a pair of articulation links 202 . The articulation links 202 are spaced apart from each other, which preferably allows them to be positioned radially outward of the actuation shaft and actuation mechanism in the handle. As illustrated in FIG. 16 , articulation links 202 include a mating feature such as a slot formed therein so that they are keyed into a corresponding mating feature such as a post extending radially inward from the handle body. ) can make it possible to The slots stabilize the articulation links relative to the handle, and the interaction of the handle posts with the ends of the slots can define the range of articulation for the articulation mechanism. The distal ends of the articulation links 202 may be rotatably coupled to an articulation adapter 204 that may be positioned coaxially radially outward of the articulation adapter at the distal end of the handle. This rotational engagement may include an articulation bearing 205 having relatively low friction properties. This articulation bearing 205 may enable rotation of the coupled reload shaft relative to the handle assembly and longitudinal movement of the articulation adapter 204 during operation of the articulation mechanism. While the illustrated embodiment of the articulation mechanism includes two articulation links that are laterally offset from the articulation mechanism within the handle, in other embodiments, the articulation mechanism includes, for example, one articulation link or three or more articulation links. It is contemplated that one may have more or fewer than two articulation links, such as

With continued reference to FIG. 16 , the articulation adapter 204 may be coupled to the articulation member 206 in the shaft by a bayonet connection when the shaft is coupled to the handle. Articulation member 206 extends distally within the shaft and is coupled to an end effector or jaw assembly articulated to the shaft. The threads 195 articulate the jaw assembly to the left when moving the ball screw proximally as viewed from the handle relative to the longitudinal central position and moving the ball screw 192 distally as viewed from the handle relative to the central position. and may be configured to articulate the jaw assembly to the right when viewed.

Advantageously, because the helical threads 195 of the ball screw 192 are continuous, the articulation mechanism may enable the jaw assembly to be articulated to substantially finite angular positions between a desired range of motion. . In some embodiments, the articulation mechanism may be configured to provide a range of articulation motion of -45° to +45° of the jaw assembly with respect to a longitudinal central position defined by a longitudinal axis of the shaft. In other embodiments, the articulation mechanism may be configured to provide other motion articulation ranges, including ranges providing articulation greater than +/-45° or ranges providing articulation less than +/-45°. can In some embodiments, the articulation mechanism may be configured to provide articulation in a unidirectional relative to a longitudinal central position.

In some embodiments, the pitch of the threads 195 on the ball screw 192 is variable. For example, the threads 195 may advantageously include a relatively low pitch towards the ends of the threads to provide greater mechanical advantage when the jaw assembly requires more force to articulate. have. The threads 195 may include a relatively higher pitch towards the center of the threads to enable fast movement with a relatively lower mechanical advantage when the jaw assembly requires lower force for articulation. can In other embodiments, the threads 195 include a constant pitch that does not vary over the articulation range of the articulation mechanism such that rotation of the articulation handle causes a proportional amount of articulation of the stapler jaw assembly. Advantageously, such a constant pitch threaded ball screw can result in an easily predictable response during operation of the actuation mechanism.

17A-17F , the articulation mechanism may include a release mechanism that advantageously enables the articulation mechanism to be reset from any articulation position to the longitudinal central position. The release mechanism is operated by the user pressing the release button 198 . In the illustrated embodiment, the release button 198 is positioned radially nested within the articulation handle 190 .

Referring to FIG. 17B , actuation of the release button 198 will advance the release sleeve 196 distally. The radially inner surface of the release sleeve 196 includes an engagement surface 186 having a relatively small inner diameter and a release surface 188 having a relatively large inner diameter having a smooth ramp between the engagement surface and the release surface. There is a step difference. In operation, the engagement surface of the release sleeve retains the ball bearings 194 within the threads 195 of the ball screw 192 . Once the release button 198 is depressed, the engagement surface is advanced distally, which causes the ball bearings 194 to disengage from the threads 195 and a ball bearing opening in the ball sleeve 191 (FIG. 15) to the release surface. It makes it possible to advance radially outwardly through the poles 189 .

17C and 17D , once the ball bearings 194 are separated from the threads 195 , the articulation mechanism may be biased to a central position. In some embodiments, the ball screw 192 is biased to a central position by a biasing member such as two springs 197 and a spring force from a shaft. Ball bearings 194 ( FIG. 17D ) located in a central position along the threads 195 correspond to a longitudinal central position of the jaw assembly.

17E-17F, once the release button 198 is allowed to return to the undisturbed configuration, the release sleeve 196 is pulled proximally by a spring (indicated by arrows 199). The proximal movement of the release spring 196 forces the ball bearings 194 into engagement with the threads 195 of the ball screw. Accordingly, the articulation mechanism may then be used to articulate the jaw assembly from the longitudinal central position, or a stapler may be used with the jaw assembly from the longitudinal central position.

While this application discloses certain preferred embodiments and examples, the invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof. It will be understood by those skilled in the art. In addition, the various features of these inventions may be used alone or in combination with other features of these inventions other than those expressly set forth below. Accordingly, the scope of the inventions herein should not be limited to the specific embodiments disclosed hereinabove, but are intended to be determined solely by a proper interpretation of the claims.

Claims (20)

A handle assembly for a surgical stapler, comprising:
the handle body including a fixed handle and a movable handle pivotally coupled to the handle body;
an actuation shaft mechanically coupled to the movable handle for manual actuation, the actuation shaft being slidable along a longitudinal axis within the handle body; and
As an articulation mechanism,
a manually operated articulation handle positioned at the proximal end of the handle body and rotatable about the longitudinal axis;
an articulation adapter located at the distal end of the handle body, the articulation adapter operatively coupled to the articulation handle such that rotation of the articulation handle about the longitudinal axis slides the articulation adapter longitudinally , the articulation adapter;
a ball screw having a helical thread formed therein;
a ball sleeve positioned radially outward of the ball screw and having an opening formed therein; and
the articulation mechanism comprising a ball bearing positioned in the opening of the ball sleeve and engaging within the helical thread of the ball screw;
wherein the ball screw has a distal end and the handle assembly further comprises an articulation link coupled to the distal end of the ball screw and extending distally in the handle body to the articulation adapter.
delete The method according to claim 1,
wherein the ball screw is movable in a longitudinal direction with respect to the handle body, and movement of the ball bearing within the helical thread moves the ball screw longitudinally.
delete The method according to claim 1,
wherein the ball sleeve is rotatably coupled to the articulation handle.
A handle assembly for a surgical stapler, comprising:
the handle body including a fixed handle and a movable handle pivotally coupled to the handle body;
an actuation shaft mechanically coupled to the movable handle for manual actuation, the actuation shaft being slidable along a longitudinal axis within the handle body; and
As a joint mechanism,
a manually operated articulation handle positioned at the proximal end of the handle body and rotatable about the longitudinal axis;
a ball screw operatively coupled to the joint handle and movable in the longitudinal direction by rotation of the joint handle; and
and a release mechanism configured to reset the ball screw to a longitudinal central position.
7. The method of claim 6,
wherein the ball screw includes a helical thread formed therein, and wherein the articulation mechanism further comprises a ball bearing engageable within the helical thread to convert rotational motion of the articulation handle into longitudinal motion of the ball screw. handle assembly.
delete 7. The method of claim 6,
wherein the release mechanism includes the release button in operative engagement with a release sleeve such that actuation of the release button disengages the articulation handle from the ball screw.
10. The method of claim 9,
wherein the ball screw includes a helical thread formed therein, the articulation mechanism further comprising a ball bearing engageable within the helical thread to convert rotational motion of the articulation handle into longitudinal motion of the ball screw; actuation of the release mechanism separates the ball bearing from the helical thread.
11. The method of claim 10,
wherein the release sleeve has an inner surface comprising an engagement surface having a first inner diameter and a release surface having a second inner diameter greater than the first inner diameter.
12. The method of claim 11,
actuation of the release button positions the release surface adjacent the ball bearing to disengage the ball bearing from the helical thread.
7. The method of claim 6,
wherein the release mechanism further comprises a biasing member that biases the ball screw to a longitudinal central position when the release mechanism is actuated.
A handle assembly for a surgical stapler, comprising:
the handle body comprising a stationary handle and a movable handle pivotally coupled to the handle body, the handle body having a proximal end and a distal end defining a central longitudinal axis between the proximal and distal ends; the handle body;
an actuation mechanism within the handle body; and
As a joint mechanism,
a manually operated articulation handle positioned at the proximal end of the handle body and rotatable about the longitudinal axis;
an articulation adapter positioned at the distal end of the handle body, the articulation adapter operatively coupled to the articulation handle such that rotation of the articulation handle about the longitudinal axis slides the articulation adapter longitudinally being the articulation adapter;
a first articulation link operatively coupling the articulation handle to the articulation adapter and extending longitudinally within the handle body laterally offset from the actuation mechanism; and
and an articulation bearing rotatably coupling the first articulation link to the articulation adapter.
delete 15. The method of claim 14,
wherein the articulation mechanism operatively couples the articulation handle to the articulation adapter and extends longitudinally within the handle body opposite the first articulation link and laterally offset from the actuation mechanism. Further comprising, the handle assembly.
15. The method of claim 14,
wherein the actuation mechanism is an actuation shaft mechanically coupled to the movable handle for manual actuation, the actuation shaft being slidable along a longitudinal axis within the handle body and rotatable about the longitudinal axis; A handle assembly comprising an actuation shaft.
15. The method of claim 14,
The joint mechanism is
a ball sleeve having an opening formed therein, the ball sleeve being rotatably coupled to the articulation handle;
a ball bearing positioned in the opening; and
a ball screw having a helical thread formed therein and capable of longitudinally sliding within the ball sleeve;
and the ball bearing is engageable with the helical thread.
19. The method of claim 18,
and the helical threads include a constant pitch.
15. The method of claim 14,
wherein the articulation adapter comprises a bayonet coupler.

Images