Title:
SURGICAL APPARATUS FOR SUTURING TISSUE WITH STAPLES
United States Patent 3692224
Abstract:
A surgical apparatus for suturing tissues with staples, comprising a support housing having an open longitudinal cavity wherein slidable rods of the staple housing and pusher are accommodated. The staple housing has a head provided with a socket in which a magazine with staples is entirely inserted. The staple housing and the pusher are provided with screw drives to axially shift them relative to the support housing. The apparatus also comprises a limit strip capable of retaining the magazine when it is completely pushed into the socket and holding the tissue being sutured. The limit strip interacts with the nut of the drive of the staple housing, whereby the drive of the pusher is blocked with the drive of the staple housing in such a manner that a predetermined sequence of actions is provided during the operation of the apparatus. In accordance with this sequence, the staple housing can move only after the magazine is completely pushed into the socket of the staple housing, and the pusher can displace only after the staple housing has defined for a maximal suturing gap between the working surface of the magazine and the die.
US Patent References:
Instrument for stitching hollow organs
Strekopitov et al. - March 1963 - 3080564
Instrument for suturing living tissue
Strekopitov et al. - May 1966 - 3252643
Medical instrument
O'Dea - April 1967 - 3315863
SURGICAL INSTRUMENT FOR STITCHING TISSUES BY MEANS OF STAPLES
Akopov - June 1971 - 3589589
Instrument for stitching hollow organs
Strekopitov et al. - March 1963 - 3080564
Instrument for suturing living tissue
Strekopitov et al. - May 1966 - 3252643
Medical instrument
O'Dea - April 1967 - 3315863
SURGICAL INSTRUMENT FOR STITCHING TISSUES BY MEANS OF STAPLES
Akopov - June 1971 - 3589589
Inventors:
Astafiev, Georgy Vasilievich (Moscow, SU)
Korolkov, Ivan Alexandrovich (Moscow, SU)
Ozhgikhin, Anatoly Nikolaevich (Moscow, SU)
Korolkov, Ivan Alexandrovich (Moscow, SU)
Ozhgikhin, Anatoly Nikolaevich (Moscow, SU)
Application Number:
05/080934
Publication Date:
09/19/1972
Filing Date:
10/15/1970
View Patent Images:
Export Citation:
Primary Class:
International Classes:
A61B17/04; A61B17/072; A61B17/068; B25C5/02
Field of Search:
227/19
Primary Examiner:
Custer Jr., Granville Y.
Claims:
What is claimed is
1. A surgical apparatus for suturing tissues with staples, comprising a support housing with an open longitudinal cavity; a die on said support; a staple housing having an actuating rod provided with an external threaded end portion, and a head provided with a socket; said staple housing being disposed in said longitudinal cavity; a magazine loaded with staples, adapted to be entirely inserted in said socket, said magazine having a working surface adjacent to said die; a pusher having a pushing rod disposed in said longitudinal cavity; a first screw drive for axially shifting said staple housing, relatively to said support housing; a second screw drive for axially shifting said pusher relatively to said support housing; a limit strip slidably mounted on said staple housing for retaining said magazine into said socket and holding the tissue sutured; a safety device precluding premature displacement of said pusher relative to said staple housing, comprising blocking means cooperably with said first screw drive and said limit strip to provide a predetermined sequence of actions of the apparatus, said staple housing being displaceable only after said magazine is completely pushed into said socket, and said pusher being displaceable only after said staple housing has defined a maximal suturing gap between the working surface of said magazine and said die.
2. A surgical apparatus as claimed in claim 1, in which said second screw drive comprises a threaded spindle, the end portion of the actuating rod including a threaded bore, said spindle being mounted in said bore and being connected with said pushing rod through a fork; said safety device further comprising a spring-loaded pawl; a longitudinal slot provided on said second screw drive, said pawl being pivotally mounted in said slot; said blocking means comprising a nut mounted upon the external threaded end portion of said actuating rod, having a forward end provided with a slot and a rear end, including an open recess having a bevel surface cooperable with said pawl, said nut being freely rotatably arranged on said support housing.
3. A surgical apparatus as claimed in claim 1, in which said limit strip has one end removably connected with said magazine, and the opposite end portion is provided with a handle, removably associated with said slot, when said strip occupies an inoperative position.
1. A surgical apparatus for suturing tissues with staples, comprising a support housing with an open longitudinal cavity; a die on said support; a staple housing having an actuating rod provided with an external threaded end portion, and a head provided with a socket; said staple housing being disposed in said longitudinal cavity; a magazine loaded with staples, adapted to be entirely inserted in said socket, said magazine having a working surface adjacent to said die; a pusher having a pushing rod disposed in said longitudinal cavity; a first screw drive for axially shifting said staple housing, relatively to said support housing; a second screw drive for axially shifting said pusher relatively to said support housing; a limit strip slidably mounted on said staple housing for retaining said magazine into said socket and holding the tissue sutured; a safety device precluding premature displacement of said pusher relative to said staple housing, comprising blocking means cooperably with said first screw drive and said limit strip to provide a predetermined sequence of actions of the apparatus, said staple housing being displaceable only after said magazine is completely pushed into said socket, and said pusher being displaceable only after said staple housing has defined a maximal suturing gap between the working surface of said magazine and said die.
2. A surgical apparatus as claimed in claim 1, in which said second screw drive comprises a threaded spindle, the end portion of the actuating rod including a threaded bore, said spindle being mounted in said bore and being connected with said pushing rod through a fork; said safety device further comprising a spring-loaded pawl; a longitudinal slot provided on said second screw drive, said pawl being pivotally mounted in said slot; said blocking means comprising a nut mounted upon the external threaded end portion of said actuating rod, having a forward end provided with a slot and a rear end, including an open recess having a bevel surface cooperable with said pawl, said nut being freely rotatably arranged on said support housing.
3. A surgical apparatus as claimed in claim 1, in which said limit strip has one end removably connected with said magazine, and the opposite end portion is provided with a handle, removably associated with said slot, when said strip occupies an inoperative position.
Description:
FIELD OF THE INVENTION
The present invention relates to medical equipment, and, more particularly, to surgical apparatus for suturing tissues with staples that can be used for suturing stumps of blood vessels, guts, stomack, tissue of lungs and other organs.
BACKGROUND OF THE INVENTION
Known in the art is a surgical apparatus for suturing tissues with staples. This apparatus usually comprises a support housing with an open longitudinal slot. The support housing is provided with a die capable of bending the staples driven into the tissues. The slot of the support housing lodges a staple housing having a head secured on a hollow actuating rod and provided with a socket for a magazine containing staples.
The surgical apparatus is also provided with a pusher formed with a head secured on to a pushing rod. This pushing rod being slidably disposed within the actuating rod. The head of the pusher comprises essentially two plates cut into separate petals. The arrangement of said plates corresponding to the disposition of the staple slots in the magazine.
The staple housing has a limit strip secured thereto capable of displacing relative to the latter, said strip being used to hold the tissue being sutured and to completely retain the magazine with staples, when the magazine is inserted into the socket provided in said head. The staple housing and the pusher are provided with screw drives to impart them a reciprocating motion along the support housing. The screw drive of the staple housing comprises essentially a first nut screwed onto a threaded portion provided on the actuating rod and the screw drive of the pusher comprises a second nut screwed onto a threaded portion provided on said pushing rod. The end of the pushing rod terminates in a threaded portion wherein a limiting nut is screwed to move until it thrusts against said second nut.
The apparatus is also provided with a safety device for preventing the pusher from premature displacement and comprising a handle that can be set by hand in two positions. In the first position the safety device connects the pusher with the staple housing and prevents the pusher from displacing relative to the staple housing. In the second position of the safety device there is no such connection between the pusher and the staple housing, and in the course of rotation of the nut of the drive of the pusher the latter can move along the staple housing.
The above described surgical apparatus possesses, however, the following disadvantages. Before the beginning of the initial operation the surgeon may forget to set the handle of the safety device into the position in which the pusher is connected with the staple housing. In this case if he erroneously takes the nut of the drive of the staple housing instead of the nut of the drive of the pusher, which is quite possible as they are disposed near each other, he will push staples out of the magazine into the open wound.
If the surgeon sets the handle of the safety device in advance into the position in which the pusher is connected with the staple housing, but he still takes the nut of the drive of the staple housing instead of the nut of the drive of the pusher, he will not be able to push staples out of the magazine before time but will have to remember that the pusher that has been prematurely advanced has to be brought back to its initial position. Otherwise, the pusher will clamp the safety device and at the moment of suturing the surgeon will not be able to set the safety device into the second position, to release the pusher and to effect the suturing action.
OBJECTS OF THE INVENTION
It is therefore an object of the present invention to provide an apparatus for suturing tissues with staples, wherein its particular construction would provide a predetermined sequence of displacement of the constitutive parts of the apparatus when suturing, and consequently, would preclude the possibility of wrong actions on the part of the surgeon.
This object is accomplished by that in a surgical apparatus for suturing tissue with staples, according to the present invention, the safety device of the drive of the pusher is blocked with drive of the staple housing and the limit strip interacts with the drive of the staple housing in such a manner that it ensures a predetermined sequence of the actions performed by the apparatus, in accordance with which the staple housing can be moved only after the magazine is completely pushed into the socket of the staple housing, and the pusher can be displaced only after the staple housing has provided for the maximum gap of suturing between the working plane of the magazine and the die.
It is expedient to make the drive of the pusher as a screw connected with the rod of the pusher by means of a fork and interacting with the inner threading in the rod of the staple housing, and the safety device of the drive of the pusher as a spring-loaded pawl secured on the screw of the drive of the pusher and sunk into the slot in the screw of the drive of the pusher during its interaction with the bevel surface of a hole made in the nut of the drive of the staple housing.
It is advisable to provide a limit strip with a handle which enters the slot in the nut of the drive of the staple housing and which must come out of the slot in the nut of the staple housing when the limit strip occupies a position in which its end interacts with the upper butt end of the magazine.
DESCRIPTION OF THE DRAWING
The following description of exemplary embodiments of the present invention is given with reference to the accompanying drawings, in which;
FIG. 1 schematically shows the surgical apparatus for suturing tissue with staples, according to the present invention;
FIG. 2 shows parts of the disassembled surgical apparatus according to the present invention in accordance with their arrangement during the apparatus assembly;
FIG. 3 is a section taken along line III--III in FIG. 1.
The apparatus for suturing tissue with staples comprises support housing 1 (FIGS. 1,2) which is essentially a hook with elongated tail portion 2 having an open longitudinal cavity therein. A die 3 is mounted on the support housing 1 with cavities 4 used to bend staples. The cavity of the support housing 1 accomodates staple housing 5 having head 6 and an actuating rod 7.
The head 6 of the staple housing 5 comprises two parallel plates 8 (FIG. 3) which have slots 9 holding a magazine 10 inserted into a socket between the plates 8 and charged with II-shaped metallic staples 11 inserted into respective staple slots in the magazine 10. The end portion of the rod 7 (FIG. 1) of the staple housing 5, opposite to the head 6, comprises essentially a hollow tube having internal and external threaded surfaces. The nut 12 is threaded upon the external threaded end portion of the rod 7 and, it is freely rotatably disposed within projection 13 of the support housing 1 through an annular grove provided in the unit 12, as a result of which the nut 12 does not move in the longitudinal direction relative to the support housing 1. The nut 12 and the threading provided on the external surface of the rod 7 constitute a first screw drive for the staple housing 5 used to bring the latter closer to the die 3. Provided on the staple housing 5 are bosses 14 and 15 (FIG. 2) interacting with respective grooves 16 and through slots 17 of the support housing 1. Made on the boss 15 is scratch 18 and on the support housing 1 scratches 19 and 20 corresponding to the minimal and maximal suturing gaps whose value is controlled by the position of the scratch 18 relative to the scratches 19 and 20.
The apparatus is also provided with pusher 21 having a pushing rod 22, as well as the rod 7 of the staple housing 5, is positioned in the longitudinal cavity of the support housing 1. Secured on the rod 22 is the head of the pusher, which has two plates cut into separate petals 23. The disposition of the petals 23 in the pusher 21 corresponds to the disposition of the staple slots in the magazine 10. The magazine 10 has a vertical longitudinal slot 24 FIG. 3) accomodating the petals 23 of the pusher 21, the width of the slot 24 being chosen so that its side walls 25 are essentially a continuation of side walls 26 of the staple slots and, at the same time, serve as guides for the petals 23 of the pusher 21, whereby during the tissue suturing the petals 23 easily enter the staple slots and push out the staples 11.
Provided at the end portion of the rod 22 (FIGS. 1,2) of the pusher 21 is fork 27 cooperating with an annular groove 28 provided at one end of a threaded spindle 29 received into a hollow tube in which the actuating rod 7 of the staple housing 5 terminates. The screw or spindle 29 and the internal threading of the rod 7 of the staple housing 5 constitute a second screw drive of the pusher 21, used to shift the pusher 21 relative to the staple housing 5.
With the rod 22 of the pusher 21 connected with the spindle 29 with the aid of the fork 27, it is possible to quickly disassemble the apparatus as during the disassembly the pusher 21 can be separated from the apparatus immediately after the staple housing 5 is extracted from the slot of the support housing 1.
The spindle 29 has slot 30 (FIG. 1) accomodating pawl 31 pressed away by spring 32 and serving as a safety device of the drive of the pusher 21. The pawl 31 has projection 33 interacting with bevel surface 34 of the hole in the nut 12. With the pusher 21 moved away from the die 3, the end portion of the pawl 31 enters slot 35 of the rod 7 of the staple housing 5.
The apparatus is also provided with limit strip 36 holding the tissue while it is being sutured and made capable of displacing along the staple housing 5. Grooves 37 made in the plates 8 of the staple housing 5 and boss 38 provided on the staple housing 5 and interacting with slot 39 (FIG. 2) of the limit strip 36 serve as guides for the displacement of the limit strip 36. The limit strip 36 has handle 40 which, with the apparatus in the initial position, enters slot 41 of the nut 12 of the drive of the staple housing 5, thus precluding the turn of the nut 12 and, consequently, the advance of the staple housing 5 in the direction of the die 3. The length of the limit strip 36 is chosen so that during the apparatus initial position when the limit strip 36 enters slot 41 of the nut 12, the magazine 10 is loosely inserted into the head 6 of the staple housing 5. Only after the magazine 10 is completely pushed into the head 6, the limit strip 36 becomes capable of advancing to release the nut 12 of the drive of the staple housing 5. Thus, the displacement of the staple housing 5 is possible only after the magazine 10 is completely pushed-in and is fixed by the limit strip 36.
The surgical apparatus for suturing tissue with staples functions as follows;
With the apparatus in its initial position, the staple housing 5 and the pusher 21 occupy a position in which they are maximumly spaced from the die 3 (FIG. 1). In this position the pawl 31 of the drive of the pusher 21 enters the slot 35 of the rod 7 of the staple housing 5, i.e. the drive of the pusher 21 is blocked with the drive of the staple housing 5. The limit strip 36 enters the slot 41 of the nut 12 of the drive of the staple housing 5.
The magazine 10 charged with the staples 11 is inserted into the staple housing 5 and is fixed by the limit strip 36 as it has been described afore.
The hook of the support housing 1 is brought to under the organ to be sutured, and the limit strip 36 is completely moved in the direction of the hook, entering, at the same time, the slot 42 on the support housing 1 and fixing the tissue to be sutured. Thereby the handle 40 comes out of the slot 41 and releases the nut 12.
By rotating the nut 12 of the drive of the staple housing 5 the latter is moved along the support housing 1 in the direction of the tissue to be sutured until a necessary suturing gap is provided between the working plane of the magazine 10 and the die 3. In case the surgeon by mistake starts rotating the screw 29 of the drive of the pusher 21 instead of the nut 12 of the drive of the staple housing 5, that would result in the staples 11 being pushed out into the wound, the pawl 31 will thrust against the walls of the slot 35 in the rod 7 of the staple housing 5, which will preclude turning of the screw 29 and, consequently, the advance of the pusher 21.
The displacement of the staple housing 5 carried out to provide a suturing gap will be accompanied with the displacement of the screw 29 of the drive of the pusher 21, connected therewith and of the pusher 21. Thereby, the screw 29 is drawn inside the nut 12, and the projection 33 of the pawl 31 slides along the bevel surface 34 of the nut 12, as a result of which the pawl 31 is sunk into the slot 30. As soon as the staple housing 5 is set in the position corresponding to the maximumly possible suturing gap, the end portion of the pawl 31 comes out of the slot 35 in the staple housing 5, thereby releasing the screw 29 of the drive of the pusher 21. After this, by rotating the screw 29 the surgeon can advance the pusher 21, and the petals 23 of the pusher 21 enter the staple slots of the magazine 10 to push out the staples 11, the latter punch with their legs the tissue, thrust against the cavities 4 of the die 3 and are bent, thus tightly connecting the edges of the tissue being sutured. The limit strip 36 and the staple housing 5 are brought back to their initial position, and the apparatus is removed from the wound.
The design of the apparatus according to the present invention relieves the surgeon of the necessity to observe a required sequence of actions during the apparatus operation, which eliminates possible mistakes on the part of the surgeon, that sometimes lead to fatal consequences.
For instance, an inaccurate placing of the magazine into the socket of the staple housing may bring about a damage of the pusher or breakage of the tissue. In the apparatus of the present invention, in case the magazine is inserted into the socket of the staple housing inaccurately, the further operation of the apparatus will be impossible as the limit strip will not make it possible to turn the nut 12 of the drive of the staple housing and to advance the limit strip and to release the nut 12 until the magazine is completely inserted into the socket. Only after the magazine is accurately inserted and the tissue is fixed, can the surgeon start suturing the tissue. When using the apparatus according to the present invention the surgeon is relieved of the necessity of thinking about the position of the safety device connecting the pusher with the staple housing since the apparatus provides means for blocking the staple housing and the pusher. Until the tissue is compressed, the surgeon cannot turn the screw of the drive of the pusher and, consequently, push the staples out into the open wound; he cannot either clamp the safety device, as is the case in the known apparatus, since due to the pawl the pusher cannot be advanced. Only after the tissue is compressed up to a suturing gap, can the surgeon advance the pusher and tissue.
Besides, the design of the apparatus makes it possible for the surgeon to remove the latter in any sequence.
The afore-described advantages made the apparatus according to the present invention easy in use and reliable in operation.
The present invention relates to medical equipment, and, more particularly, to surgical apparatus for suturing tissues with staples that can be used for suturing stumps of blood vessels, guts, stomack, tissue of lungs and other organs.
BACKGROUND OF THE INVENTION
Known in the art is a surgical apparatus for suturing tissues with staples. This apparatus usually comprises a support housing with an open longitudinal slot. The support housing is provided with a die capable of bending the staples driven into the tissues. The slot of the support housing lodges a staple housing having a head secured on a hollow actuating rod and provided with a socket for a magazine containing staples.
The surgical apparatus is also provided with a pusher formed with a head secured on to a pushing rod. This pushing rod being slidably disposed within the actuating rod. The head of the pusher comprises essentially two plates cut into separate petals. The arrangement of said plates corresponding to the disposition of the staple slots in the magazine.
The staple housing has a limit strip secured thereto capable of displacing relative to the latter, said strip being used to hold the tissue being sutured and to completely retain the magazine with staples, when the magazine is inserted into the socket provided in said head. The staple housing and the pusher are provided with screw drives to impart them a reciprocating motion along the support housing. The screw drive of the staple housing comprises essentially a first nut screwed onto a threaded portion provided on the actuating rod and the screw drive of the pusher comprises a second nut screwed onto a threaded portion provided on said pushing rod. The end of the pushing rod terminates in a threaded portion wherein a limiting nut is screwed to move until it thrusts against said second nut.
The apparatus is also provided with a safety device for preventing the pusher from premature displacement and comprising a handle that can be set by hand in two positions. In the first position the safety device connects the pusher with the staple housing and prevents the pusher from displacing relative to the staple housing. In the second position of the safety device there is no such connection between the pusher and the staple housing, and in the course of rotation of the nut of the drive of the pusher the latter can move along the staple housing.
The above described surgical apparatus possesses, however, the following disadvantages. Before the beginning of the initial operation the surgeon may forget to set the handle of the safety device into the position in which the pusher is connected with the staple housing. In this case if he erroneously takes the nut of the drive of the staple housing instead of the nut of the drive of the pusher, which is quite possible as they are disposed near each other, he will push staples out of the magazine into the open wound.
If the surgeon sets the handle of the safety device in advance into the position in which the pusher is connected with the staple housing, but he still takes the nut of the drive of the staple housing instead of the nut of the drive of the pusher, he will not be able to push staples out of the magazine before time but will have to remember that the pusher that has been prematurely advanced has to be brought back to its initial position. Otherwise, the pusher will clamp the safety device and at the moment of suturing the surgeon will not be able to set the safety device into the second position, to release the pusher and to effect the suturing action.
OBJECTS OF THE INVENTION
It is therefore an object of the present invention to provide an apparatus for suturing tissues with staples, wherein its particular construction would provide a predetermined sequence of displacement of the constitutive parts of the apparatus when suturing, and consequently, would preclude the possibility of wrong actions on the part of the surgeon.
This object is accomplished by that in a surgical apparatus for suturing tissue with staples, according to the present invention, the safety device of the drive of the pusher is blocked with drive of the staple housing and the limit strip interacts with the drive of the staple housing in such a manner that it ensures a predetermined sequence of the actions performed by the apparatus, in accordance with which the staple housing can be moved only after the magazine is completely pushed into the socket of the staple housing, and the pusher can be displaced only after the staple housing has provided for the maximum gap of suturing between the working plane of the magazine and the die.
It is expedient to make the drive of the pusher as a screw connected with the rod of the pusher by means of a fork and interacting with the inner threading in the rod of the staple housing, and the safety device of the drive of the pusher as a spring-loaded pawl secured on the screw of the drive of the pusher and sunk into the slot in the screw of the drive of the pusher during its interaction with the bevel surface of a hole made in the nut of the drive of the staple housing.
It is advisable to provide a limit strip with a handle which enters the slot in the nut of the drive of the staple housing and which must come out of the slot in the nut of the staple housing when the limit strip occupies a position in which its end interacts with the upper butt end of the magazine.
DESCRIPTION OF THE DRAWING
The following description of exemplary embodiments of the present invention is given with reference to the accompanying drawings, in which;
FIG. 1 schematically shows the surgical apparatus for suturing tissue with staples, according to the present invention;
FIG. 2 shows parts of the disassembled surgical apparatus according to the present invention in accordance with their arrangement during the apparatus assembly;
FIG. 3 is a section taken along line III--III in FIG. 1.
The apparatus for suturing tissue with staples comprises support housing 1 (FIGS. 1,2) which is essentially a hook with elongated tail portion 2 having an open longitudinal cavity therein. A die 3 is mounted on the support housing 1 with cavities 4 used to bend staples. The cavity of the support housing 1 accomodates staple housing 5 having head 6 and an actuating rod 7.
The head 6 of the staple housing 5 comprises two parallel plates 8 (FIG. 3) which have slots 9 holding a magazine 10 inserted into a socket between the plates 8 and charged with II-shaped metallic staples 11 inserted into respective staple slots in the magazine 10. The end portion of the rod 7 (FIG. 1) of the staple housing 5, opposite to the head 6, comprises essentially a hollow tube having internal and external threaded surfaces. The nut 12 is threaded upon the external threaded end portion of the rod 7 and, it is freely rotatably disposed within projection 13 of the support housing 1 through an annular grove provided in the unit 12, as a result of which the nut 12 does not move in the longitudinal direction relative to the support housing 1. The nut 12 and the threading provided on the external surface of the rod 7 constitute a first screw drive for the staple housing 5 used to bring the latter closer to the die 3. Provided on the staple housing 5 are bosses 14 and 15 (FIG. 2) interacting with respective grooves 16 and through slots 17 of the support housing 1. Made on the boss 15 is scratch 18 and on the support housing 1 scratches 19 and 20 corresponding to the minimal and maximal suturing gaps whose value is controlled by the position of the scratch 18 relative to the scratches 19 and 20.
The apparatus is also provided with pusher 21 having a pushing rod 22, as well as the rod 7 of the staple housing 5, is positioned in the longitudinal cavity of the support housing 1. Secured on the rod 22 is the head of the pusher, which has two plates cut into separate petals 23. The disposition of the petals 23 in the pusher 21 corresponds to the disposition of the staple slots in the magazine 10. The magazine 10 has a vertical longitudinal slot 24 FIG. 3) accomodating the petals 23 of the pusher 21, the width of the slot 24 being chosen so that its side walls 25 are essentially a continuation of side walls 26 of the staple slots and, at the same time, serve as guides for the petals 23 of the pusher 21, whereby during the tissue suturing the petals 23 easily enter the staple slots and push out the staples 11.
Provided at the end portion of the rod 22 (FIGS. 1,2) of the pusher 21 is fork 27 cooperating with an annular groove 28 provided at one end of a threaded spindle 29 received into a hollow tube in which the actuating rod 7 of the staple housing 5 terminates. The screw or spindle 29 and the internal threading of the rod 7 of the staple housing 5 constitute a second screw drive of the pusher 21, used to shift the pusher 21 relative to the staple housing 5.
With the rod 22 of the pusher 21 connected with the spindle 29 with the aid of the fork 27, it is possible to quickly disassemble the apparatus as during the disassembly the pusher 21 can be separated from the apparatus immediately after the staple housing 5 is extracted from the slot of the support housing 1.
The spindle 29 has slot 30 (FIG. 1) accomodating pawl 31 pressed away by spring 32 and serving as a safety device of the drive of the pusher 21. The pawl 31 has projection 33 interacting with bevel surface 34 of the hole in the nut 12. With the pusher 21 moved away from the die 3, the end portion of the pawl 31 enters slot 35 of the rod 7 of the staple housing 5.
The apparatus is also provided with limit strip 36 holding the tissue while it is being sutured and made capable of displacing along the staple housing 5. Grooves 37 made in the plates 8 of the staple housing 5 and boss 38 provided on the staple housing 5 and interacting with slot 39 (FIG. 2) of the limit strip 36 serve as guides for the displacement of the limit strip 36. The limit strip 36 has handle 40 which, with the apparatus in the initial position, enters slot 41 of the nut 12 of the drive of the staple housing 5, thus precluding the turn of the nut 12 and, consequently, the advance of the staple housing 5 in the direction of the die 3. The length of the limit strip 36 is chosen so that during the apparatus initial position when the limit strip 36 enters slot 41 of the nut 12, the magazine 10 is loosely inserted into the head 6 of the staple housing 5. Only after the magazine 10 is completely pushed into the head 6, the limit strip 36 becomes capable of advancing to release the nut 12 of the drive of the staple housing 5. Thus, the displacement of the staple housing 5 is possible only after the magazine 10 is completely pushed-in and is fixed by the limit strip 36.
The surgical apparatus for suturing tissue with staples functions as follows;
With the apparatus in its initial position, the staple housing 5 and the pusher 21 occupy a position in which they are maximumly spaced from the die 3 (FIG. 1). In this position the pawl 31 of the drive of the pusher 21 enters the slot 35 of the rod 7 of the staple housing 5, i.e. the drive of the pusher 21 is blocked with the drive of the staple housing 5. The limit strip 36 enters the slot 41 of the nut 12 of the drive of the staple housing 5.
The magazine 10 charged with the staples 11 is inserted into the staple housing 5 and is fixed by the limit strip 36 as it has been described afore.
The hook of the support housing 1 is brought to under the organ to be sutured, and the limit strip 36 is completely moved in the direction of the hook, entering, at the same time, the slot 42 on the support housing 1 and fixing the tissue to be sutured. Thereby the handle 40 comes out of the slot 41 and releases the nut 12.
By rotating the nut 12 of the drive of the staple housing 5 the latter is moved along the support housing 1 in the direction of the tissue to be sutured until a necessary suturing gap is provided between the working plane of the magazine 10 and the die 3. In case the surgeon by mistake starts rotating the screw 29 of the drive of the pusher 21 instead of the nut 12 of the drive of the staple housing 5, that would result in the staples 11 being pushed out into the wound, the pawl 31 will thrust against the walls of the slot 35 in the rod 7 of the staple housing 5, which will preclude turning of the screw 29 and, consequently, the advance of the pusher 21.
The displacement of the staple housing 5 carried out to provide a suturing gap will be accompanied with the displacement of the screw 29 of the drive of the pusher 21, connected therewith and of the pusher 21. Thereby, the screw 29 is drawn inside the nut 12, and the projection 33 of the pawl 31 slides along the bevel surface 34 of the nut 12, as a result of which the pawl 31 is sunk into the slot 30. As soon as the staple housing 5 is set in the position corresponding to the maximumly possible suturing gap, the end portion of the pawl 31 comes out of the slot 35 in the staple housing 5, thereby releasing the screw 29 of the drive of the pusher 21. After this, by rotating the screw 29 the surgeon can advance the pusher 21, and the petals 23 of the pusher 21 enter the staple slots of the magazine 10 to push out the staples 11, the latter punch with their legs the tissue, thrust against the cavities 4 of the die 3 and are bent, thus tightly connecting the edges of the tissue being sutured. The limit strip 36 and the staple housing 5 are brought back to their initial position, and the apparatus is removed from the wound.
The design of the apparatus according to the present invention relieves the surgeon of the necessity to observe a required sequence of actions during the apparatus operation, which eliminates possible mistakes on the part of the surgeon, that sometimes lead to fatal consequences.
For instance, an inaccurate placing of the magazine into the socket of the staple housing may bring about a damage of the pusher or breakage of the tissue. In the apparatus of the present invention, in case the magazine is inserted into the socket of the staple housing inaccurately, the further operation of the apparatus will be impossible as the limit strip will not make it possible to turn the nut 12 of the drive of the staple housing and to advance the limit strip and to release the nut 12 until the magazine is completely inserted into the socket. Only after the magazine is accurately inserted and the tissue is fixed, can the surgeon start suturing the tissue. When using the apparatus according to the present invention the surgeon is relieved of the necessity of thinking about the position of the safety device connecting the pusher with the staple housing since the apparatus provides means for blocking the staple housing and the pusher. Until the tissue is compressed, the surgeon cannot turn the screw of the drive of the pusher and, consequently, push the staples out into the open wound; he cannot either clamp the safety device, as is the case in the known apparatus, since due to the pawl the pusher cannot be advanced. Only after the tissue is compressed up to a suturing gap, can the surgeon advance the pusher and tissue.
Besides, the design of the apparatus makes it possible for the surgeon to remove the latter in any sequence.
The afore-described advantages made the apparatus according to the present invention easy in use and reliable in operation.