US 3604561 A
Description (OCR text may contain errors)
United States Patent Rudolph F. Mallina Hastings-on-Iludson, N.Y.;
Harry G. Reimels, Braintree,'Mass. 848,243
Aug. 7, 1969 V v Division of Ser. No. 626,445, Mar. 28, 1967, Patent No. 3,489,330 N V 1 Sept. 14, 1971 Codman & Shurtleff, Inc.
 Inventors [211 App]. No.  Filed  Patented  Assignee  MULTIPLE STAPLER CARTRIDGE 5 Claims, 27 Drawing Figs.
 US. Cl 206/56 DE, 128/334 R, 227/19, 227/120  Int. Cl B65d 83/00  Field of Search. 206/56 M, 56 A, 56 AX, 56 DF, 63.2, 633; 128/334, 335; 221/198, 279;227/19,120, 127
 References Cited UNITED STATES PATENTS 2,055,249 9/1936 Cavanaugh 227/120 X 227/ 120 2,296,574 9/1942 Rodgers 2,853,074 9/1958 Olson 128/334 R X 3,252,643 5/1966 Strekopytor et a1. 128/334 UX 3,269,630 8/1966 Fleischer 227/19 X 3,275,211 9/1966 Hirsch et a1.. 227/120 X 3,278,107 10/1966 Rygg 206/56 DF UX 3,315,863 4/1967 ODea 206/56 DF X 3,351,191 11/1967 Mallina 206/56 DF Primary Examiner.loseph R. Leclair Assistant ExaminerSteven E. Lipman Attorneys-Robert L. Minier and James R. Hulen ABSTRACT: A miniature stapler useful in the surgical repair of tissue fastens at each actuation a single miniature staple and is constructed with two movable arms, the free ends of which function as a driver and anvil. A cartridge containing a series of staples is removably mounted between the two movable arms in such a position that the first staple in the series is pushed out of the cartridge by the driver and clinched against the anvil when the two arms are moved toward one another. After application of the staple, when the two arms move away from each other, a pusher within the cartridge operates to move the series of staples forward so that the next successive staple in the series will be in position to be applied when the movable arms again approach oneanother.
PATENTED smmsm SHEET 1 5 3,504,5 1
MW m PATENTED SEP 1 41911 SHEEI UF 5 ark INVENTOR: FVMLPA/ MULTIPLE STAPLER CARTRIDGE This application is a division of application Ser. No. 626,445 filed Mar. 28,1967 (now U.S. Pat. No. 3,489,330).
This invention relates to staplers and relates more particularly to miniature staplers of the type used by surgeons for joining together living tissues and to exchangeable cartridges for use with such staplers.
The instant invention has for its principal object the provision of a stapler that will fasten at each actuation a single miniature staple having two legs and a crown connecting the legs. The stapler of the present invention permits the surgeon to rapidly connect two or more layers of tissue by applying a plurality of staples, one staple at a time.
Complicated surgical operations on blood vessels, bronchi, large pulmonary blood vessels, intestines, and so forth require rapid suturing, a problem of increasing concern to the surgeon as the size of the vessel decreases. The stapler of the present invention enables the surgeon to quickly apply with precision a single staple or a plurality of staples in a minimum period of time.
A multiple stapler capable of successively applying a plurality of miniature staples in rapid sequence is disclosed in my issued U.S. Pat. No. 3,225,996. The stapler and cartridge of the present invention, however, function differently and provide the surgeon with a considerable advantage in that the tip of the stapler is small and affords excellent visibility at the very point that the surgeon needs good visibility during the surgical stapling procedure.
It is an object of the invention, therefore, to provide a surgical stapler that is accurate, foolproof, and reliable in use with a narrow point to permit good visibility of the working area. Another object of this invention is to provide a stapler that will at each actuation sequentially apply a series of single, miniature staples.
A further object of the invention is to provide a staple cartridge that is disposable and interchangeable and is adapted to being loaded mechanically with a plurality of miniature staples.
The foregoing and other ojbects of the invention will be best understood from the following description and examples, reference being had to the accompanying drawings wherein:
FIG. 1 is a side elevation partially in section of one embodiment of the present invention;
FIG. 2 is an inverted plan view thereof, viewed along the line 2-2 of FIG. 1;
FIG. 3 is a plan section along the line 3-3 of FIG. 1;
FIG. 4 is an end view as seen when viewed in the direction of line 4-4 of FIG. 1, parts being omitted for clearness;
FIG. 5 is a vertical cross section taken along the line 5-5 of FIG. 1;
FIG. 6 is a plan view of the stapler anvil on an enlarged scale;
FIG. 7 is a cross section thereof taken along line 7--7 of FIG. 6;
FIG. 8 is an exploded perspective view of the cartridge holder and associated slide;
FIG. 9 is a vertical cross section taken on line 9-9 of FIG.
FIG. 10 is a perspective of a staple cartridge viewed from the dispensing end;
FIG. 11 is an inverted perspective view of the cartridge shown in FIG. 10;
FIG. 12 is an exploded perspective of the cartridge as viewed from the feeding end and shows the staple pusher;
FIG. 13 is a plan of the cartridge as drawn in FIGS. 10, 11 and 12;
FIG. 14 shows the side view thereof;
FIG. 15 is the cartridge view of FIG. 14 looking at the dispensing end;
FIG. 16 is a vertical cross section taken on the line 16-16 of FIG. 14;
FIG. 17 shows a longitudinal cross section taken on the line 17-17 of FIG. 13 with staples in place;
FIG. 18 shows a plan section taken along the line 18-18 of FIG. 17;
FIG. 19 is a view of the first staple in the cartridge illustrated in FIG. 17;
FIG. 20 is a fragmented portion of the cartridge shown in FIG. 10, with the driver, staple, and anvil in position;
FIG. 21 is a modification of the stapler illustrated in FIG. I, with a cartridge in position for loading;
FIG. 22 is an edge view thereof;
FIG. 23 is a vertical cross section on an enlarged scale taken along the line 23-23 of FIG. 21;
FIG. 24 is a detailed perspective of a spring used in the modified stapler shown in FIGS. 21 and 22;
FIG. 25 is an enlarged plan view of a cartridge, some elements of which have been exaggerated in size for clearness of operation;
FIG. 26 is a cross section thereof taken on the line 26-26 of FIG. 25, and showing the driver and anvil in position for driving a staple; and
FIG. 27 is an end view as seen when viewed in the direction of line 2727 of FIG. 26.
The construction and operation of my invention will now be described with particular reference to the embodiments which have been selected for illustration in the accompanying drawings.
THREE LEAF STAPLER FIGS. 1, 2, 3 and 20 illustrate a medical stapler generally indicated at 21 comprising a pair of forceps with a driver arm 22 terminating in a driver 23 and an anvil arm 24 terminating in an anvil 25. These arms 22 and 24 are movable toward and from each other for driving a staple 26, that is held in a cartridge 28 above the anvil 25. Both arms are provided on the exterior with knurlings 30 for easier manual grasping. A cartridge holder 32 is secured to the driver arm 22 by a leaf spring 34.
Each of the arms 22 and 24 is resilient and forms a leaf spring, the arms in their normal position being spread apart as shown in FIG. 1.
As best shown in FIGS. 3, 8 and 9, a limit stop 36 bridges a slide 38, the function of which will be described below, and is secured to the cartridge holder 32. The upward movement of the upper arm 22 relative to the cartridge holder 32 is limited by the head 40 of a screw 42 which extends through a notch 44 in the stop 36. By this means the driver arm 22 is pretensioned.
The lower arm 24 of the forceps 21 terminates in an anvil 25 provided with two clinching grooves 27 and 29.
Referring now to FIGS. 3 and 8-11, the cartridge holder 32 is constructed with two prongs 45 and 47 spaced to frictionally engage two lateral grooves 49 and 51 on the staple cartridge 28. The slide 38 is held against the upper surface of the cartridge holder 32 by the shoulders 53 and 55 on the limit stop 36, and movement of the slide is limited to a direction parallel to the longitudinal axis of the cartridge holder by the projection 52, which slides between the prongs 45 and 47. The slide is normally retained in its forward position, illustrated in FIG. 1, by the tension of the spring 54 which holds the shoulders 57 and 59 of the slide 38 against the back surface of the limit stop 36.
THE STAPLE CARTRIDGE As best shown in FIGS. 10-19, the staple cartridge, which may be molded of plastic, is constructed with a centrally located pusher channel 60 that extends from the back end 62 of the cartridge to opposite parallel staple grooves 63 and 65 at the forward (dispensing) end thereof; the parallel grooves being formed by the side walls of the channel 60 and the wall of the parallel shoulders 77 and 79. Said shoulders are perpendicular to the longitudinal axis of the cartridge and the channel. Preferably, the cartridge is formed with an integral center piece 64 at the forward end of the channel, the face 66 of which is disposed between the grooves 63 and 65 and is paral-- lel with the inner surfaces of the shoulders 77 and 79 being displaced therefrom by a distance equal to the thickness of a single staple. The thickness of a staple is determined by the diameter of the wire used to form the staple, i.e., about 6-9 mils. Located within the channel of the cartridge is a plurality of miniature staples, each having two legs 67 and 69 connected by a crown 68 (see FIG. 19). As best shown in FIG. 17, the series of staples within the channel are in parallel alignment with the crown of each staple in frictional contact with the top surface 70 of the channel, the free ends 71 and 73 of each staple being in frictional contact with the tip guides 61 and 72 and pointing in a direction perpendicular to the longitudinal axis of the cartridge.
A U-shaped staple pusher 74 is provided having a cross section that conforms with the cross section of the staples and the channel. The pusher is slidably movable within the channel in the direction of the longitudinal axis of the cartridge and is in registry with the series of staples contained therein. Movement of the staple pusher toward the forward end of the cartridge forces the series of staples forward so that the first staple 26 of the series is forced against the outer walls 77 and 79 of the parallel grooves.
A projection 80 extending from the top surface 82 of the cartridge has a forward face 84 which is parallel to the shoulders 77 and 79 and in vertical alignment with the first staple 26. The projection 80 engages the driver 23 as shown in FIG. 9 and serves the dual function of retaining the cartridge on the cartridge holder against the pressure of the spring 54, and aligning the cartridge and the staple 26 with the driver and anvil. The vertical surfaces 81 and 82 at the forward end of the cartridge are spaced apart a distance slightly greater than the width of the driver 23 and prevent lateral movement of the driver as it descends to drive the staple.
Staple alignment markers 83 and 85 may be provided on the forward edges of the cartridge to assist the surgeon in lining up the instrument and cartridge with the tissue to be stapled. As shown in the drawings, serrated gripping surfaces 86 and 88 may be provided at the rear of the cartridge where obstruction of the surgeons view is not a problem.
Regarding the staple sizes that may be used where minimization is important, the following are examples of desirable sizes:
2 mm. 3 mm. Staple Staple Diameter of wire (thickness of staple) 0.006 0.009 Length of crown 68 (width of staple) 0.080 0. I20 0. I 0.140
Length of leg 69 (height of staple) OPERATION OF THE STAPLER In using the stapler the nurse or surgeon removes the sterile cartridge from its sealed container grasping it by the serrated edges 86 and 88 and sliding it onto the cartridge holder in the direction of the arrow (FIG. 1).
As the cartridge is forced onto the holder 32, the staple pusher 74 is forced against the projection 52 of slide 38 and moves it in the direction of the arrow against the tension of the spring 54. Simultaneously, the driver 23 is forced upward by the inclined surface of the projection 80 at the forward end of the cartridge, returning to its normal spread-apart position as indicated in FIG. 9 after the edge 84 of the projection has passed the end of the driver. The cartridge may then be released, as it will be held in a fixed position by the tension of the spring 54 which forces the edge 84 of the projection against the driver 23. Angular movement of the cartridge with respect to the cartridge holder is prevented by the prongs 45 and 47 of the holder which engage the longitudinal grooves 49 and 51 on the cartridge.
The lower arm or anvil spring 24 is weaker than the pretensioned driver spring 22, so that when the surgeon presses the two arms 22 and 24 toward each other, the anvil 25 will first move upward to a position that is shown in dotted lines in FIG. 9. This enables the surgeon to grasp the tissue between the anvil and the lower surface of the cartridge before driving the staple.
Further pressure will force the driver downwardly in a wide arc against the tension of the spring 34. As the driver descends, it bears against the face 66 of the center piece 64 and is directed in the plane of the grooves 63 and 65, driving the first staple 26 out of the cartridge, through the tissue, and clinching it on the anvil 25. When the staple has been driven and the surgeon releases the applied pressure, the arms return to their spread-apart position, indicated by solid lines in FIG. 9, and the spring 54 moves the slide 38 and its terminal projection 52 forward advancing the staple pusher 74 within the channel 60. The movement of the series of staples as the staple pusher advances within the channel will be understood from FIGS. 25-27. Each staple of the series is in frictional contact with the top surface 70 and the side walls 75 and 76 of the channel 60. As the driver 23 clears the top surface 70 of the channel, the next staple in the series is pushed between the top surface of the channel 70 and the upper surface of the center piece 64 against the shoulders 77 and 79 beneath the driver 23 in position for driving. It will be apparent from the above that during the use of this instrument, there will always be a staple suspended between the driver and anvil until the supply of staples in the cartridge has been used up.
RING HANDLE STAPLER In FIGS. 21 and 22 is shown a modified stapling instrument of the scissors type, which differs from the medical stapler described above in the shape of the forceps and accordingly in the location of the fulcrum 120. It will be noted that in most other respects the multiple stapler dispenser of FIGS. 21 and 22 resembles that of FIGS. I-7 and functions in a similar manner. For the parts that are alike, there will therefore be used herein the identical reference numerals, while merely corresponding parts have different prefix numerals.
The modified medical stapler illustrated comprises a scissors' type of forceps with a driver arm 122 terminating in a driver 23 and an anvil arm 124 terminating in an anvil 25. Finger grips 102 and 104 at the opposite ends of the arms 122 and 124 facilitate precise positioning and operation of the stapler deep within a body cavity. These arms 122 and 124 are movable toward and from each other about the fulcrum for driving a staple that is held in a cartridge 28 above the anvil 25.
A cartridge holder 32 is secured to the driver arm 122 by a spring 134.
As best shown in FIG. 23, a limit stop 136 is secured to the cartridge holder 32 and bridges a slide 38, the function of which has been described above. The upward movement of the upper arm 122 relative to the cartridge holder 32 is limited by the stop 136. The tension of the spring 134 normally retains the driver and cartridge holder in the spread-apart position shown in the drawings. By this means the driver arm 122 is pretensioned. The stop 136 also limits the distance between the cartridge holder 32 and the driver 23 and assures that the cartridge will be retained on the holder by the pressure of the driver against the face 84 of the cartridge projection 80.
In the modified stapler, as in the instrument described previously, the cartridge holder 32 is constructed with two prongs 45 and 47 spaced to frictionally engage the lateral grooves 49 and 51 on staple cartridge 28. The slide 38 is held against the upper surface of the cartridge holder 32 by the shoulders 153 and 155 on the limit stop 136, and movement of the slide is limited to a direction parallel to the longitudinal axis of the cartridge holder by the projection 52, which slides between the prongs 45 and 47. The slide is normally retained in its forward position, illustrated in FIG. 22, by the tension of the spring 54.
Cartrdiges for use with the stapler modified as shown in FIGS. 21 and 22 are identified in all respects with the cartridge described above and illustrated in FIGS. -20. As previously indicated, the cartridge is preferably disposable and may be made of plastic or other inexpensive material that lends itself to being sterilized, such as, for instance plastic known under the trademark DELRlN.
The operation of the modified instrument is similar to that of the one previously described. A sterile staple cartridge is slipped on the cartridge holder, past the driver, and released. The spring-biased slide will hold the face 84 of the cartridge projection 80 against the inside surface of the driver, properly positioning the cartridge on the holder with the first staple directly under the driver. The surgeon then grasps the tissue to be stapled between the anvil and the lower surface of the cartridge and drives the staple by pressure on the finger grips closing the forceps and driving the staple from the cartridge.
The spring 134 causes the driver to return to the position illustrated in FIGS. 21 and 23 when the surgeon releases the pressure on the finger grips, and a new staple is advanced within the cartridge by the staple pusher as described above.
While the invention has been described in detail according to the preferred method of construction, it will be obvious to those skilled in the art, after understanding the invention, that changes and modifications may be made therein without departing from the spirit or scope of the invention, and it is intended in the appended claims to cover such changes and modifications.
What is claimed is:
l. A cartridge having a centrally located channel extending from one end thereof and communicating with two opposite straight parallel shoulders at the forward end thereof; said parallel shoulders being perpendicular to the longitudinal axis of said cartridge and the top surface of said channel; two longitudinal grooves being located at opposite sides of said cartridge and dividing said cartridge in a plane perpendicular to said shoulders; said cartridge containing a series of miniature staples, each having two legs and a crown connecting said legs; said staples being in parallel alignment within said channel, the first staple in said series being in contact with said shoulders and being suspended at the forward end of said channel with the legs of said first staple in frictional contact with the side surfaces of said channel, the crown of all other staples in said series being in frictional contact with said top surface of said channel and the free ends of each staple pointing in a direction perpendicular to said longitudinal axis of said cartridge; and a U-shaped pusher having a cross section that conforms to the cross section of said staples and said channel; said pusher being slidably movable within said channel in the direction of said longitudinal axis of said cartridge to sequentially advance said staples toward said forward end of said cartridge and against the wall of said parallel shoulders.
2. The cartridge of claim 1, wherein said longitudinal grooves terminate at the forward end of said cartridge in a shoulder.
3. The cartridge of claim 1, wherein said opposite sides of said cartridge that extend beyond said longitudinal grooves are serrated.
4. The cartridge of claim 1, characterized by a projection on the forward end thereof that extends above said top surface of said cartridge, the forward edge of said projection being displaced from the inner walls of said opposite straight parallel shoulders a distance equal to the the ness of a staple and in alignment therewith.
5. The cartridge of claim 4, characterized by an integral center piece at the forward end of said channel, the forward surface of which lies in the plane of the forward edge of said projection.