SURGICAL FASTENER APPLYING APPARATUS
BACKGROUND OF THE INVENTION
This invention relates to surgical fastener applying 5 apparatus, and more particularly to surgical fastener applying apparatus in which the tissue to be fastened is first clamped in the apparatus and then fastened by application of the fasteners. ^
Various devices have been developed for applying surgical fasteners in lieu of conventional sutures. Some of these devices apply metal staples; others apply twopart fasteners of resinous materials. The term "surgical fasteners" is used herein as a generic term for all such fasteners.
Many surgical fastener applying devices, especially those intended for fastening internal body tissue, are designed to clamp the tissue before applying the surgical fasteners to it. The known devices of this kind take 2Q several forms. Hirsch et al. U.S. Pat. No. 3,275,211 shows a device in which a surgical staple holding assembly reciprocates linearly relative to an anvil in response to rotation of a control knob. After tissue has been clamped between the anvil and the staple holding 25 assembly, a plurality of metal surgical staples are driven simultaneously by operation of a pivoting handle.
Green U.S. Pat. Nos. 4,354,628 and 4,383,634 show other devices which accomplish a similar result in a different way. In the Green devices, the staple holding 30 assemblies are pivotally mounted relative to the anvil (although limited relative linear translation of these elements may also be possible in these devices). Pivoting levers are used to pivot the staple holding assembly toward the anvil in order to clamp the tissue between 35 these elements. After the tissue has been clamped, a pivoting handle is operated to simultaneously drive a plurality of metal staples through the tissue.
Green U.S. Pat. No. 4,383,634 (FIG. 14) shows that the use of levers to control the tissue clamping function 40 is not limited to devices in which the fastener holding assembly and the anvil are pivotally related. This principle can also be applied to devices in which the fastener holding assembly translates linearly relative to the anvil as in the Hirsch et al. device. 45
Devices of the type shown by Hirsch et al., in which a knob is used for controlling the position of the staple holding assembly, have the characteristic that the spacing between the staple holding assembly and the anvil is adjustable by the operator. On the other hand, Opera- 50 tion of devices of the type shown by Green, in which levers are used to close the device on the tissue, may be faster.
Because the spacing between the staple holding assembly and the anvil in devices of the type shown by 55 Green is not adjustable, it is generally not possible to adjust the location of the apparatus relative to the tissue after the tissue has been clamped. Of course, it is usually possible to reopen the instrument and reposition it if the original position is not satisfactory. But it would be 60 desirable to have the ability to adjust the position of the apparatus relative to the tissue without having to completely reopen the instrument.
It is therefore an object of this invention to improve surgical fastener applying apparatus of the type in 65 which levers are used to operate the elements which clamp the tissue prior to application of the surgical fasteners.
It is a more particular object of this invention to provide surgical fastener applying apparatus having levers for operating the elements which clamp the tissue prior to fastening and having an intermediate latching position in which the instrument is partly closed on the tissue but the tissue is not clamped so that the position of the instrument relative to the tissue can be adjusted without reopening the instrument.
SUMMARY OF THE INVENTION
These and other objects of the invention are accomplished in accordance with the principles of the invention by providing releasable latching elements on the lever members which operate the tissue clamping elements in surgical fastener applying apparatus having lever-actuated tissue clamping. The latching elements releasably hold the tissue clamping elements in a partially closed position in which the tissue is not yet fully clamped. Accordingly, the position of the instrument relative to the tissue can be adjusted if desired. When the position of the instrument is completely satisfactory, the instrument is operated further to clamp the tissue and apply the surgical fasteners.
Further features of the invention, its nature and various advantages will be more apparent from the accompanying drawing and the following detailed description of the invention.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a perspective view of an illustrative embodiment of surgical fastener applying apparatus constructed in accordance with the principles of the invention.
FIG. 2 is a longitudinal sectional view of the apparatus of FIG. 1.
FIG. 3 is a detailed perspective view of a portion of the apparatus of FIG. 2.
FIG. 4 is a view similar to FIG. 3 showing the apparatus at a different stage in its operating cycle.
FIG. 5 is a view similar to FIGS. 3 and 4 (with some additional elements visible) showing the apparatus at yet another stage in its operating cycle.
FIG. 6 is a view similar to FIG. 2 showing the apparatus in the operating condition depicted in FIG. 4.
FIG. 7 is a view similar to FIG. 6 showing the apparatus in the operating condition depicted in FIG. 5.
FIG. 8 is a fragmentary sectional view taken along the line 8—8 in FIG. 7.
FIG. 9 is a view similar to FIG. 7 showing the apparatus at still another stage in its operating cycle.
DETAILED DESCRIPTION OF THE
Illustrative surgical fastener applying instrument 10 includes an elongated shaft 12 having a fixed handle 14 connected to its proximal end and a surgical fastener applying assembly 16 connected to its distal end. Fastener applying assembly 16 has two major components: (1) anvil assembly or member 18, which is rigidly connected to shaft 12; and (2) surgical fastener holding assembly 20, which is mounted for both pivotal and limited linear translational motion relative to anvil member 18. Surgical fastener holding assembly 20 initially contains a plurality of U-shaped metal surgical staples 22 (FIG. 7) arranged in two parallel rows. If desired, two-part plastic surgical fasteners of the type shown, for example, in Noiles U.S. Pat. No. 4,060,089 can be substituted for metal staples 22.