SURGICAL STAPLING SYSTEM

摘要

A system is provided for joining two tubular structures by a surgical stapling procedure. The system includes a series of sizers (900), a specifically designed graft (10, 50), a loading unit (100) , a wand (300) , a surgical loop (400) and a stapling instrument (500). The sizers are for determining the diameter of a target aorta and the availability of a sufficient transected aortic length to perform a stapling procedure. The loading unit holds the graft in position in the body and deploys a circumferential line of staples (150) through the graft and an overlapping end of the aorta. The graft may include a side port (20) by which the loading unit holds the graft during the stapling procedure, and which may be closed once the stapling procedure has been completed. The wand may be used to introduce the loading unit and graft into the body, to position them within the transected aorta, and to hold them in place during the application of the surgical loop. The surgical loop may include a band (416) formed from a flexible material and having a width greater than its thickness so as to facilitate the formation of an annular loop. With the surgical loop holding the aorta and graft in relative overlapping positions, the wand may be removed from the loading unit and the stapling instrument may be assembled thereto. The stapling instrument includes a plurality of anvils (518a, 518b, 518c) which may be closed to form a circle overlying the aorta, and a trigger mechanism (670, 802) for firing the staples. When fired, the staples are deployed radially outward through the graft and aorta, whereupon their free ends are bent inwardly by staple returns (528) on the anvils. As a result, a plurality of staples may be simultaneously deployed quickly and accurately in a circumferential pattern so as to join together two tubular structures. The system may be used in either an open surgical procedure or laparascopically.