Apparatus and method for placing stables in laparoscopic or endoscopic procedures

A surgical apparatus for driving surgical fasteners into body tissue comprising:

• a) a frame having a clamping handle, and actuating means for causing surgical fasteners to be fired into said tissue;
• and
• b) an endoscopic portion defining a longitudinal axis and extending distally from the frame, said endoscopic portion including:
• i) an extension tube extending from the endoscopic portion and rotatably connected to the clamping handle of the frame for longitudinal movement from a first position to a second position in response to movement of said clamping handle;
• ii) a cover tube mounted to the frame for rotational movement about a longitudinal axis;
• iii) an elongated support fixed to the cover tube, said elongated support retaining a replaceable cartridge assembly including a plurality of surgical fasteners slidably mounted therein and having a tissue engaging surface and said elongated support further pivotally retaining an anvil member having a fastener forming surface and an external ramped camming surface, the anvil member being pivotal between an open position corresponding to the first position of the extension tube and a closed position corresponding to the second position of the extension tube wherein the fastener forming surface is in close cooperative alignment with the tissue engaging surface of the cartridge assembly;
• iv) a channel attached to said actuating means and adapted for longitudinal movement within the elongated support and rotatable with the endoscopic portion;
• v) closure means having at least a camming surface transverse to said longitudinal axis for contacting said external ramped camming surface of said anvil member, whereby movement of said closure means relative to said anvil member causes said transverse camming surface to contact said ramped camming surface of said anvil member and movement of said anvil to said closed position;
• vi) pusher elements operatively associated with said actuating means for ejecting the surgical fasteners from the replaceable cartridge assembly;
• vii) means which translates with respect to said endoscopic portion independent of said extension tube for actuating said pusher elements.

A surgical apparatus comprising:

• a) a frame having a clamping handle;
• and
• b) an endoscopic portion defining a longitudinal axis and extending distally from the frame, said endoscopic portion including:
• i) an extension tube having a collar tube extending from a distal end thereof, the extension tube connected to the clamping handle of the frame for longitudinal movement through the endoscopic portion from a first open position to a second closed position in response to movement of said clamping handle;
• ii) a cover tube mounted to the frame;
• iii) an elongated support fixed to the cover tube, said elongated support retaining interacting first and second jaw members with said second jaw member having an external ramped camming surface, said second jaw member being pivotal from an open position corresponding to the first position of the extension tube to a closed position corresponding to the second position of the extension tube wherein the jaw members are in close cooperative alignment;
• and
• iv) closure means having at least a camming surface transverse to said longitudinal axis for contacting said external ramped camming surface of said second jaw member, whereby movement of said closure means relative to said second jaw member causes said transverse camming surface to contact said ramped camming surface of said second jaw member and movement of said second jaw member to said closed position.

A surgical apparatus for driving surgical fasteners into body tissue comprising:

• a) a frame;
• b) an endoscopic portion defining a longitudinal axis and extending distally from said frame, said endoscopic portion including:
• i) an elongated support for receiving a cartridge assembly, the cartridge assembly having a distal end and a proximal end and including a plurality of surgical fasteners slidably mounted therein, and having a tissue engaging surface;
• ii) a jaw member having an external ramped camming surface, a distal end and a proximal end, said proximal end of said jaw member being retained in said elongated support such that the jaw member and the cartridge assembly are pivotal with respect to one another to move between an open position and a closed position wherein the jaw member is in close cooperative alignment with the tissue engaging surface of the cartridge assembly and said distal end of said jaw member is in juxtaposed alignment with said distal end of said cartridge assembly;
• iii) a closure member for moving the jaw member between the open position and the closed position, said closure member having a camming surface transverse to said longitudinal axis for contacting said camming surface of said jaw member, said closure member slidably mounted for movement between a first position in which said transverse camming surface is located proximally to said camming surface of said jaw member and a second position in which said transverse camming surface contacts said camming surface of said jaw member, said closure member cooperating with said jaw member such that when said camming member is moved from said first position to said second position, said jaw member is urged to said closed position;
• iv) pusher elements for ejecting the surgical fasteners from the cartridge assembly through tissue;
• v) an elongated member which translates with respect to said endoscopic portion independent of said closure member for actuating said pusher elements;
• and
• c) a gas seal within said endoscopic portion which obstructs the passage of gaseous media therethrough.

A surgical apparatus for driving surgical fasteners into body tissue comprising:

• a) a frame;
• b) an endoscopic portion defining a longitudinal axis and extending distally from said frame, said endoscopic portion including:
• i) an elongated support for receiving a cartridge assembly, the cartridge assembly having a distal end, a proximal end and a midpoint therebetween defining a distal portion between said distal end and said midpoint and a proximal portion between said proximal end and said midpoint, said cartridge assembly including a plurality of surgical fasteners mounted therein, and having a tissue engaging surface;
• ii) a jaw member having an external ramped camming surface, a distal end, a proximal end and a midpoint therebetween defining a distal portion between said distal end and said midpoint and a proximal portion between said proximal end and said midpoint, said proximal end of said jaw member being retained in said elongated support such that the jaw member and the cartridge assembly are:
• pivotal with respect to one another to move from an open position, wherein distal ends of said jaw member and said cartridge assembly are open, and a closed position wherein the jaw member is in close cooperative alignment with the tissue engaging surface of the cartridge assembly and said distal portion of said jaw member is in alignment with said distal portion of said cartridge assembly;
• iii) a closure member having a camming surface transverse to said longitudinal axis for contacting said ramped camming surface of said jaw member, said closure member being slidably mounted relative to said jaw member for movement between a first position and a second position whereby movement of said closure member relative to said jaw member from said first position to said second position causes said closure member camming surface to contact said jaw member camming surface and movement of said jaw member to said closed position;
• and
• iv) pusher elements for ejecting the surgical fasteners from the cartridge assembly through tissue when said jaw member and said cartridge assembly have been moved to the closed position to capture tissue therebetween;
• v) an elongated member which translates with respect to said endoscopic portion independent of said closure member for actuating said pusher elements;
• and
• c) a gas seal within said endoscopic portion which obstructs the passage of gaseous media therethrough.

A surgical instrument for clamping tissue and for surgical suturing comprising a tube with an endoscopic portion for introduction into an abdominal cavity, said endoscopic portion defining a longitudinal axis and extending distally from said tube, said endoscopic portion including clamping means for clamping tissue, said clamping means having first and second jaws, said clamping means further comprising a stapling device therein with a staple cartridge including a plurality of surgical staples slidably mounted therein, said staple cartridge disposed in said first jaw and an anvil member having an external ramped camming surface in said second jaw, said first and second jaws having proximal and distal ends and being connected at their respective proximal ends to said endoscopic portion, said proximal end of said second jaw connected to said endoscopic portion for movement between an open position wherein the distal ends of said first and second jaws are spaced apart to receive tissue and a closed position wherein said distal ends are approximated into juxtaposed alignment to clamp tissue therebetween, said instrument further comprising closure means having at least a camming surface transverse to said longitudinal axis for contacting said external ramped camming surface of said anvil member, whereby movement of said closure means relative to said anvil member causes said transverse camming surface to contact said ramped camming surface of said anvil member and movement of said anvil member to said closed position and means for actuating said stapling device to set at least one row of staples while clamping the tissue by said clamping means.