# US 2017/0281189 A1 · Circular stapling system comprising an incisable tissue support

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- Number: US 2017/0281189 A1
- Document ID: US20170281189A1
- Status: Published application
- Kind: A1
- Application number: 15/089,312
- Filed: 2016-04-01
- Published: 2017-10-05
- Earliest claimed: 2016-04-01
- Assignees: Ethicon Endo-Surgery, Inc.
- Applicants: Ethicon Endo-Surgery, LLC
- Inventors: Anil K. Nalagatla; Jason L. Harris; Frederick E. Shelton, IV; Jerome R. Morgan
- Web page: https://patentgrep.com/patent/US20170281189A1

## CPC

- A61B 17/072: for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/0686: {having a forming anvil staying below the tissue during stapling}
- A61B 17/07207: {the staples being applied sequentially}
- A61B 17/105: {Wound clamp magazines (for packaging sharps A61B50/3001)}
- A61B 17/115: Staplers for performing anastomosis, e.g. in a single operation
- A61B 17/1155: {Circular staplers comprising a plurality of staples}
- A61B 17/32: Surgical cutting instruments ({A61B18/042 takes precedence; suture cutters A61B17/0467;} implements for ligaturing and cutting {A61B17/122, A61B17/12; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133})
- A61B 17/3211: Surgical scalpels, knives; Accessories therefor
- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/07292: {Reinforcements for staple line, e.g. pledgets}
- A61B 17/29: Forceps for use in minimally invasive surgery
- A61B 17/320092: {with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2017/00017: {Electrical control of surgical instruments}
- A61B 2017/00022: {Sensing or detecting at the treatment site}
- A61B 2017/00115: {with audible or visual output}
- A61B 2017/00128: {related to intensity or progress of surgical action}
- A61B 2017/00199: {with a console, e.g. a control panel with a display}
- A61B 2017/00305: {Constructional details of the flexible means}
- A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like}
- A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids}
- A61B 2017/00407: {Ratchet means}
- A61B 2017/00424: {ergonomic, e.g. fitting in fist}
- A61B 2017/0046: {with a releasable handle; with handle and operating part separable}
- A61B 2017/00464: {for use with different instruments}
- A61B 2017/00473: {Distal part, e.g. tip or head (A61B2017/00464 takes precedence)}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00734: {battery operated}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00946: {malleable}
- A61B 2017/07214: {Stapler heads}
- A61B 2017/07221: {curved}
- A61B 2017/07228: {Arrangement of the staples}
- A61B 2017/07235: {containing different staples, e.g. staples of different shapes, sizes or materials}
- A61B 2017/07242: {achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes}
- A61B 2017/07257: {characterised by its anvil}
- A61B 2017/07264: {characterised by its staple forming cavities, e.g. geometry or material}
- A61B 2017/07271: {characterised by its cartridge}
- A61B 2017/07278: {characterised by its sled or its staple holder}
- A61B 2017/07285: {characterised by its cutter}
- A61B 2017/2903: {transferring rotary motion}
- A61B 2017/2905: {flexible}
- A61B 2017/291: {the position of the handle being adjustable with respect to the shaft}
- A61B 2017/2912: {transmission of forces to actuating rod or piston}
- A61B 2017/292: {connection of actuating rod to handle, e.g. ball end in recess}
- A61B 2017/2922: {toggle linkages}
- A61B 2017/2923: {Toothed members, e.g. rack and pinion}
- A61B 2017/2927: {the angular position of the head being adjustable with respect to the shaft}
- A61B 2017/2932: {Transmission of forces to jaw members}
- A61B 2017/2946: {Locking means}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/08021: {of the patient or his organs}
- A61B 2090/0808: {for indicating correct assembly of components, e.g. of the surgical apparatus}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B 2090/0814: {Preventing re-use}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A surgical instrument comprising an end effector is disclosed. The end effector comprises a staple cartridge including a cartridge body comprising an annular array of staple cavities, staples removably stored in the staple cavities, a firing drive configured to eject the staples from the staple cavities, and a cutting member circumscribed by the staple cavities. The end effector further comprises an anvil including a tissue compression surface, forming surfaces configured to deform the staples and a tissue block. The anvil is movable toward the cartridge body to compress tissue between the cartridge body and the tissue block and the cutting member is configured to incise the tissue and the tissue block during a cutting stroke of the cutting member.

## Claims

### Claim 1

An end effector for use with a circular surgical stapling instrument, said end effector comprising:
a staple cartridge, comprising:
a cartridge body comprising an annular array of staple cavities;
staples removably stored in said staple cavities;
a firing drive configured to eject said staples from said staple cavities; and
an annular cutting member, wherein said annular cutting member is surrounded by said annular array of staple cavities; and
an anvil, comprising:
a tissue compression surface;
forming surfaces configured to deform said staples; and
a tissue support, wherein said anvil is movable toward said cartridge body to compress tissue between said cartridge body and said tissue support, and wherein said cutting member is configured to incise the tissue and said tissue support during a cutting stroke of said cutting member.

### Claim 2 (depends on 1)

The end effector of claim 1, wherein said tissue support is aligned with said tissue compression surface.

### Claim 3 (depends on 1)

The end effector of claim 1, wherein said tissue support comprises:
a first annular wall;
a second annular wall; and
lateral walls connecting said first annular wall and said second annular wall.

### Claim 4 (depends on 3)

The end effector of claim 3, wherein said cutting member is configured to incise said lateral walls.

### Claim 5 (depends on 3)

The end effector of claim 3, wherein said tissue support further comprises a cavity defined intermediate said lateral walls.

### Claim 5 (depends on 5)

effector of claim 5, wherein said cavity is enclosed.

### Claim 6 (depends on 5)

The end effector of claim 5, wherein said cavity comprises an annular cavity.

### Claim 8 (depends on 5)

The end effector of claim 5, wherein said cavity comprises at least one enclosed side and at least one open side.

### Claim 9 (depends on 3)

The end effector of claim 3, wherein said lateral walls comprise an annular array of lateral walls, and wherein said tissue support further comprises an annular array of cavities defined within said annular array of lateral walls.

### Claim 10 (depends on 3)

The end effector of claim 3, wherein said first annular wall is shorter than said second annular wall.

### Claim 11 (depends on 1)

The end effector of claim 1, wherein said tissue supporting surface comprises an annular recess aligned with said annular cutting member.

### Claim 12 (depends on 1)

The end effector of claim 1, wherein said tissue support comprises:
a first annular wall;
a second annular wall; and
radial walls connecting said first annular wall and said second annular wall.

### Claim 13 (depends on 1)

The end effector of claim 1, wherein said tissue support comprises:
an annular wall; and
lateral walls extending from said annular wall.

### Claim 14 (depends on 1)

The end effector of claim 1, wherein said tissue support extends above said tissue compression surface.

### Claim 15 (depends on 1)

The end effector of claim 1, wherein said tissue support extends above said staple forming surfaces.

### Claim 16

An end effector of a circular surgical stapling instrument, said end effector comprising:
a staple cartridge, comprising:
a cartridge body comprising an annular array of staple cavities;
staples removably stored in said staple cavities;
a firing drive configured to eject said staples from said staple cavities; and
a cutting member, wherein said cutting member is circumscribed by said annular array of staple cavities; and
an anvil, comprising:
a tissue compression surface;
forming surfaces configured to deform said staples; and
a tissue block, wherein said anvil is movable toward said cartridge body to compress tissue between said cartridge body and said tissue block, and wherein said cutting member is configured to incise the tissue and said tissue block during a cutting stroke of said cutting member.

### Claim 17 (depends on 16)

The end effector of claim 16, wherein said tissue block is aligned with said tissue compression surface.

### Claim 18 (depends on 16)

The end effector of claim 16, wherein said tissue block extends above said tissue compression surface.

### Claim 19 (depends on 16)

The end effector of claim 16, wherein said tissue block extends above said staple forming surfaces.

### Claim 20

An anvil for use with a circular surgical stapling instrument comprising a cartridge body and a cutting member during a surgical technique, said anvil comprising:
a frame;
a shaft extending from said frame;
a tissue compression surface;
forming surfaces configured to deform staples ejected from the surgical stapling instrument during a step in the surgical technique; and
a tissue block, wherein said anvil is movable toward the surgical stapling instrument to compress tissue between the cartridge body and said tissue block, wherein the tissue has formed staples therein from a previous step in the surgical technique, wherein the cutting member and said tissue block are co-operatively configured to incise the previously stapled tissue and said tissue block during a cutting stroke of the cutting member, and wherein said tissue block is configured to prevent the formed staples from creating more than localized yielding in said tissue block during the cutting stroke.