| 摘要 |
1,198,663. Surgical staplers. UNITED STATES SURGICAL CORP. 6 Oct., 1967 [10 Oct., 1966], No. 45839/67. Heading A5R. [Also in Division B4] A surgical stapling instrument comprises a fixed jaw 11 for mounting an anvil 6 and a carrier member for mounting a staple cartridge P parallel to but spaced from the anvil, the carrier member being movable towards the fixed jaw to adjust the gap between the anvil and the cartridge so that tissue to be stapled may be clamped therebetween, a pusher P being movable relative to the carrier to eject staples from the cartridge, there being a stop fixed relative to the fixed jaw to define the limit of forward travel of the pusher towards the fixed jaw irrespective of the spacing between the carrier member and the jaw. As shown, the stapling instrument comprises an outer frame including the fixed jaw 11 and a channel shaped body part 7 and an inner frame IF which slides within the body part 7 and includes a hollow head 33 (see also Figure 9, not shown) in which the staple cartridge is removably mounted. Rotation of a nut 2 causes the inner frame to move relative to the outer frame so that tissue to be stapled is clamped between the jaw 11 and the staple cartridge C. Sliding within the inner frame is the pusher P which includes (see also Figure 15, not shown) a drive rod 41 able to be moved by a handle MH to eject with a combshaped part (93) the staples from the cartridge. The stop limiting the forward travel of the pusher comprises a vertical wall 19' on the outer frame which abuts the forward edge of a cam plate CP attached to the pusher drive rod 41 and moving within the-outer frame on rollers 52. In use, the handle MH is pulled towards a fixed handle 32 in order to eject the staples, the handle MH pivoting about a pin 60 and moving a cam 56 over a roller 52 on the cam plate so as to give the plate with the rod 41 and pusher P translatory motion. The cam 56 is shaped such that there is a mechanical advantage between the handle MH and the pusher varying in amplitude along the driving stroke of the handle in direct proportion to the force required to eject the staples from the cartridge against the anvil. A safety catch 80 between the fixed and movable handles prevents accidental operation of the instrument and a pin 116 removably fitted between the instruments jaws 11, 12 reinforces the jaws while maintaining the cartridge C and anvil 6 in position. The cartridge (see also Figures 21, 22, not shown) is provided with vertically or horizontally arranged slots (91) in which the metal staples are spring fitted, the cartridge being of a synthetic plastics material and arranged as a sliding fit (Figure 23, not shown) in the hollow head 33, pimples 96 on the cartridge providing a resilient hold between the cartridge and the head. The anvil 6 (Figures 26-30, not shown) is fitted to a rib (17) on the jaw 11 and is formed (Figures 28 or 34, not shown) with grooves (101, 256) to clinch the staples and with lead-in groove surfaces (103, 255) adjacent the grooves designed to guide into the grooves any slightly misaligned staples. An alternative stapling instrument (Figures 43-58, not shown) is similar to that described above but the operating handle (238) engages directly with the pusher rod (235). Abutments (254, 252a) on the outer frame and the pusher rod limit the forward travel of the pusher towards the fixed jaw. |
