RU2587928C2 - Circular cross-linking tool with element for attachment detachable washer - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Cassette with suture brackets for circular cross-linking tool includes housing, brackets ejector and blade. Brackets ejector located within the housing and is configured to allow movement within the housing from the initial position (prior to actuation) in the operating position (after activation). Blade is attached to the brackets ejector.

EFFECT: blade includes a cutting edge and a member for releasable securing washer intended for rigid connection of the split washer while moving brackets pusher from the initial to the working position.

20 cl, 47 dwg

Description

Field of Invention

The present invention relates mainly to an element for attaching a split washer of a circular stapling tool blade.

BACKGROUND OF THE INVENTION

Circular stapling instruments are well known in surgery and are used for bowel surgery. Examples of such devices include Endoscopic Curved Intramural Stapling Instrument Endopath ILS ECS 25 manufactured by Ethicon Endo Surgery Inc. There are many patents for circular stapling instruments, for example No. 4207898 Becht, 4351466 Noiles, 5292053 Bilotti et al. and 5344059 Green et. al.

Typically, circular stapling tools are designed for a single use, during which tissue is excised and a stitch is removed from the brackets, after which the tool is disposed of. An annular tissue excision blade is extended during the incision and then retracted into the tool so that the cutting edge of the annular blade is protected, however, it remains possible to accidentally reuse the circular stapling tool if it was not immediately disposed of after the first use. The ring blade of a multi-use stapling tool may accidentally remain after use in the extended position. This could result in injury to the user with the open sharp cutting edge. In some reusable stapling tools, the cutting edge of the annular blade is held solely by friction against a hard surface. This is not a reliable way of fixing the sharp edge of the annular blade in the closed position, since in some cases the carrier cover may separate from the edge of the blade, exposing it.

To reduce one or more problems associated with the operation of previous models of circular stapling tools, you need a new circular stapling tool and method of application.

SUMMARY OF THE INVENTION

The present invention is described in the paragraphs of a patent application, and no part of this section should be construed as limiting these points.

In one aspect of the invention, a cassette with suture brackets for a circular stapling instrument is provided. The cassette with suture brackets includes a body, a bracket ejector and a blade. The ejector brackets is located inside the housing and has a configuration that allows movement within the housing from its original position (before actuation) to the working position (after actuation). The blade is attached to the ejector brackets. The blade includes a cutting edge and an element for securing the split washer, designed for rigid attachment of the split washer when the bracket ejector moves from the original to the working position.

In another aspect of the invention, a circular stapling tool is provided. The circular stapling tool includes a body, a bracket ejector, a thrust plate system, and a blade. The ejector brackets is located inside the housing and moves from its original position (before actuation) to the working position (after actuation). The thrust block unit includes a split washer attached to the surface of the base of the thrust plate. The block of the thrust plate moves from the open position (at a distance from the housing) to the closed position (adjacent to the housing). The blade is attached to the ejector brackets. The blade contains a split washer and an element for securing the split washer. When the ejector brackets is in its original position, the split washer is not separated by a blade and is not attached to its fixing element. When the trigger is actuated and the ejector brackets are moved to the operating position, and the thrust block unit is attached to the body, the blade separates the split washer and the separated part is firmly connected to the element for fixing it.

In another embodiment, a method of securing a blade to a split washer of a circular stapling tool is provided. At one stage, a circular stapling tool is presented. The circular stapling tool includes a body, a bracket ejector, a thrust plate system, and a blade. The bracket ejector is movably located inside the housing. The thrust plate system includes a split washer attached to the surface of the base of the thrust plate. The blade is attached to the ejector brackets. At another stage, the block of the thrust plate is moved from the open position (at a distance from the housing) to the closed position (adjacent to the housing). At an additional stage, the bracket ejector moves from the initial position in which the blade does not enter the washer and in which the element for fixing the washer on the blade is not attached to the washer, in the working position in which the blade enters the washer and the element for fixing the washer on the blade is rigidly attached to the puck.

Brief Description of the Drawings

The drawings and description below will help to better understand the invention. The scale of the components in the drawings may differ from the real one; the main attention in their preparation was given to illustrate the principles of the invention.

In FIG. 1 is a perspective view of an open type reusable circular stapling tool according to one preferred embodiment of the invention;

In FIG. 2 shows a perspective view of the reusable circular stapling tool of FIG. 1, in the open position with a thrust plate separated from the remainder of the reusable circular stapling tool;

In FIG. 3 shows a diagram of the components of the handle and barrel of the reusable stapling tool of FIG. one;

In FIG. 3A shows a cross-section along line 3A-3A through a rod for adjusting the position of a thrust plate of a reciprocating action of a reusable circular stapling tool;

In FIG. 3B shows a cross-section along line 3B-3B through another part of the shaft for adjusting the position of the thrust plate of the reusable circular stapling tool shown in FIG. 3;

In FIG. 4 shows a diagram of the components of a replaceable cassette unit of the reusable stapling tool of FIG. one;

In FIG. 5 is a view of a portion of a replaceable cassette unit of the reusable circular stapling tool of FIG. 1, unassembled, in section;

In FIG. 6 shows a replaceable cassette unit of the reusable circular stapling tool of FIG. 1, in a section in assembled form, with a thrust plate in the open position and an annular blade in the position before suturing;

In FIG. 7 shows the same system as in FIG. 6, but in the closed position, with the annular blade in the position before suturing;

In FIG. 8 is a diagram of the components of the thrust plate of the reusable cross-linking tool of FIG. one;

In FIG. 9 shows a diagram of one embodiment of the invention — a method for centering a removable cassette unit of a circular stapling tool;

In FIG. 10 shows a perspective view of the components of a thrust plate according to another embodiment of the invention;

In FIG. 11 is a perspective view of the reusable circular stapling tool of FIG. 1, with the thrust plate depicted in FIG. 10 separated from the remainder of the reusable circular stapling tool;

In FIG. 12 is a perspective view of constituent parts of a thrust plate assembly according to another embodiment of the invention;

In FIG. 13 is a perspective view of the reusable circular stapling tool of FIG. 1, in which the block of the thrust plate is replaced by the thrust plate of FIG. 12, which is separated from the remainder of the reusable circular stapling tool;

In FIG. 14 shows a diagram of one embodiment of the invention — a method for manufacturing a thrust block assembly;

In FIG. 15A and 15B show a perspective view of the components at different stages of assembly, including a handle for closing the thrust plate and a rod for adjusting the position of the thrust plate of the reusable stapling tool shown in FIG. one;

In FIG. 16A and 16B show a perspective view of a closing handle of a thrust plate connected to a rod for adjusting the position of the thrust plate shown in FIG. 15A and 15B, with the handle of the reusable circular stapling tool shown in FIG. 1, at different stages of assembly;

In FIG. 17A, 17B and 17C show perspective views of a closing handle of a thrust plate connected to a rod for adjusting the position of the thrust plate and the handle depicted in FIG. 16A and 16B, as well as the trigger rod of the reusable circular stapling tool of FIG. 1, at different stages of assembly;

In FIG. 18A and 18B are perspective views of a closing handle of a thrust plate connected to a reciprocating action rod, a handle, and a trigger release rod, shown in FIG. 17A and 17B and 17C of the reusable circular stapling tool of FIG. 1, at different stages of assembly;

In FIG. 19A, 19B and 19C are perspective views of a closing handle of a thrust plate connected to a rod for adjusting the position of the thrust plate, the handle and the trigger release rod, as well as the handle cover of FIG. 18A and 18B, as well as the barrel of the reusable circular stapling tool of FIG. 1, at different stages of assembly;

In FIG. 20 is a perspective view of an open type curved reusable circular stapling tool according to another preferred embodiment of the invention;

In FIG. 21 is a perspective view of parts of a curved reusable cross-linking tool of FIG. twenty;

In FIG. 22 shows a curved circular stapling tool with a device for reducing friction, in an open position, in a section;

In FIG. 23 shows a curved circular stapling tool with a device for reducing friction, in the closed position before suturing, in section;

In FIG. 24 shows a curved circular stapling tool with a device for reducing friction, in a position for suturing, in section;

In FIG. 25 shows a perspective view of a trigger rod of a curved circular stapling tool with a device for reducing friction;

In FIG. 26 is a perspective view of portions of a trigger rod of a curved circular stapling tool with a device for reducing friction;

In FIG. 27 is a perspective view of a trigger rod of a curved circular stapling tool with a device for reducing friction in a section;

In FIG. 28 is an enlarged view of a trigger rod of a circular stapling tool with another embodiment of a device for reducing friction adjacent to a rod for adjusting the position of a thrust plate reciprocating;

In FIG. 29 shows the annular blade of the interchangeable cassette unit of the circular stapling tool of FIG. 4, in a section;

In FIG. 30 is a perspective view of an annular split washer connected to a protective device;

In FIG. 31 shows the tool of FIG. 7, with an annular blade moved to the cutting position and inserted into the split washer when the thrust plate is closed;

In FIG. 32 is an enlarged view, and the annular blade shown in FIG. 31, wherein the annular blade enters the split washer and cuts off the round piece;

In FIG. 33 shows the detail shown in FIG. 31, wherein the thrust plate is pushed back to the open position after driving the annular blade;

In FIG. 33A shows an enlarged side view of one embodiment of a thrust plate control connected to a handle of a reusable circular stapling tool;

In FIG. 34 shows the detail shown in FIG. 33, with a thrust plate removed from a circular stapling instrument and with a split ring washer and a protective element attached to the annular blade;

In FIG. 35 shows the detail shown in FIG. 34, when trying to connect a new thrust plate to the cassette unit, when the protective element and the annular split washer prevent attachment;

In FIG. 36 is an enlarged view of a region bounded by a broken circle in FIG. 35, on which the protective element and the annular split washer are visible, preventing the new thrust plate from attaching to the removable cartridge unit;

In FIG. 37 is a diagram of one embodiment of the invention — a method for fixing a blade to a split washer of a circular stapling tool;

In FIG. 38A shows the circular stapling tool of FIG. 1, in section, with the thrust plate in the open position, outside the seam, at a distance from the body, with the trigger in a locked position before actuation;

In FIG. 38B is an enlarged view showing the relationship between the trigger and the rod in the assembled state shown in FIG. 17C;

In FIG. 39 is a perspective view of a portion of the tool of FIG. 38A, in section;

In FIG. 40 is a cross-sectional view through line 40-40 of FIG. 38A;

In FIG. 41 shows the reusable circular stapling tool of FIG. 1, in section, with a stop plate in the closed position located in the seam application area (adjacent to the body), with the trigger in the unlocked state, ready to be pressed for seam application;

In FIG. 42 is a perspective view of a portion of the tool of FIG. 41, in a section;

In FIG. 43 is a transverse view through line 43-43 of FIG. 41;

In FIG. 44 shows the reusable circular stapling tool of FIG. 1, in section, with a thrust plate in the closed position, in the suture area (adjacent to the body), with the trigger activated;

In FIG. 45 is a perspective view of a portion of the tool shown in FIG. 44, in a section;

In FIG. 46 is a cross-sectional view through line 46-46 of FIG. 44; and

In FIG. 47A and 47B show a sectional view of the cartridge unit attached to the handle, with the thrust plate in the open and closed state, respectively.

DETAILED DESCRIPTION OF THE INVENTION

In FIG. 1 shows a new surgical circular stapling instrument 100 for dissecting patient (human) tissue in accordance with the present invention. A surgical circular stapling instrument 100 can be used to excise tissues, including internal hemorrhoidal nodes or other types of human tissue. The circular stapling tool 100 is constructed based on the traditional circular stapling tool described in US Pat. No. 6,102,271, the contents of which are incorporated herein by reference in their entirety. The circular stapling instrument 100 has a removable cassette unit 102, designed for applying a circular suture from a number of surgical suture brackets 104 (see Figs. 7 and 31) to the mucosal layer at the base of the internal hemorrhoid, as well as to cut off the tissue of the mucous membrane together with hemorrhoidal a node from the side of the inner wall of the rectum or anus. In general, the circular stapling instrument 100 can be used to form an anastomosis of two sections of the intestine by applying a circular suture from surgical brackets 104 (see FIGS. 7 and 31) and excising a circular fragment bounded by a circular staple suture to pass the feces.

Shown in FIG. The 1.2 circular stapling instrument 100 includes an ergonomic barrel 106, a cassette with surgical brackets 108 having a housing 110, and a block of a thrust plate 112 detachably connected to a rod 114 for adjusting the position of the thrust plate for reciprocating movements. The interchangeable cassette unit 102 of the circular stapler includes a cassette with suture brackets 108 and an abutment plate 112. As shown in FIG. 1-3, the circular stapling tool 100 also includes a handle 116 having a cavity 118. The thrust plate control 120 is located at the proximal end of the grip 116 and is connected to the thrust plate 112 so that the rotation of the control 120 moves the thrust plate in the proximal or distal direction, depending on the direction of rotation of the control 120. The control 120 may include a handle for closing the thrust plate or another type of control element of the thrust plate. The circular stapling tool 100 includes a trigger 122 that pivots in a direction 124 from an open position (shown in the figure) to a closed position where suture braces 104 (see FIGS. 7 and 31) are inserted into the fabric (see FIG. 31), and excess tissue is cut off by an annular blade 126 (see FIG. 31) of the removable cartridge unit 102. The safety latch 128 is located on the trigger 122 and is shown in the upper and latched position blocking the release of the trigger. When the safety latch 128 is not latched, that is, shifted inwardly and downwardly 128a, the release mechanism 122 freely rotates in the direction 124 from the open position to the closed. The barrel 106 extends distally from the handle 116 and is detachably connected to the handle 116 at the proximal end using a connecting nut 130 that is screwed onto the threaded portion 132 (see FIG. 3) of the handle 116. The opposite connecting portion 134 (see FIG. 4) of the housing 110 is detachably connected to a corresponding female connecting part 136 (see FIG. 3) at the distal end of the barrel 106. Connection 134 includes an insertable part with deflection locking tabs and a female part 136 with holes. In other embodiments, the insertion portion 134 and the female portion 136 may include any type of matching parts.

As shown in FIG. 2, the housing 110 has an outer surface 138 with an expanded guide portion 140 and an outer tubular guide portion 142. Channels 144 include holes in the surface of the housing extending from the extended guide portion 140 to the outer tubular guide portion 142. An annular store for suture brackets 148 (see Fig. 4,5, 7 and 31) is attached to the distal end of the housing 110, while the connecting insertion part 150 (see Figs. 4, 7 and 31) of the suture staple magazine 148 is detachably connected to the female part 152 (see Fig. 4, 7 and 31) of the housing 110. The connecting part 150 has the projections and the female part 152 - sag locking elements. In other embodiments, the plug-in connecting portion 150 and the female portion 152 may include any type of connecting parts. An annular store for suture braces 148 includes a series of grooves for staples 154 (see FIGS. 4, 7 and 31) and is intended to hold and release suture braces 104 (see FIG. 31).

As shown in FIG. 4-7, the bracket ejector 156 forms a sliding connection with the ring magazine for brackets 148 with the keys 158 (see FIG. 4) of the bracket ejector 156, creating a detachable connection with the locking grooves 160 (see FIG. 4) of the ring magazine for the brackets 148. The ejector brackets 156 are movably connected to the housing 110 using the centering grooves 162 of the annular outer guide surface 164 of the ejector brackets 156, which is movably connected to the centering slots 166 of the annular inner surface of the housing 110, which makes it possible to move the ejector with the bracket 156 inside the housing 110, but prevents rotation of the ejector brackets 156 in the housing 110. The outer guide surface 164 of the ejector brackets 156 has an extended guide portion 170 and an outer tubular guide portion 171. Centering grooves 162 and centering slots 166 are parallel to the longitudinal axis 172 and 174 of the ejector brackets 156 and housing 110. In other embodiments of the invention, the housing 110 and the ejector brackets 156 can be oriented relative to each other using centering parts of any type, configuration and quantities allowing longitudinal movement.

The ejector brackets 156 has many protrusions 176, which are included in the grooves of the magazine for brackets 148, in which there are suture braces. The protrusions 176 serve to engage and guide the movement of multiple suture brackets 104 (see Fig. 31) from the grooves for the brackets 154 of the magazine for brackets 148, while the ejector brackets 156 moves from its original position until the trigger is pressed (see Fig. 7) working position after pressing the trigger mechanism 122 (see Fig. 3) (see Fig. 31). As shown in FIG. 4 and 7, the flexible locking element 178 of the ejector brackets 156 is detachably connected to the locking protrusions 180 of the housing 110. This arrangement allows the longitudinal movement of the ejector brackets 156 only when a certain force is applied to the stem 282 (see Figs. 44-46) and its effect on the ejector brackets 156. When the required force is applied, the flexible locking elements 178 on the ejector brackets 156 bend inward and move away from the locking protrusions 180 on the housing 110, which allows the ejector brackets 156 to move in the longitudinal and distal directions. In other embodiments, the flexible locking member 178 and locking tabs 180 may include other types of related parts.

An annular blade 126 is fixed to the distal end of the ejector brackets 156 and connected to a plurality of pins for securing the blade 182 (see FIGS. 5 and 31) included in the same number of holes 184 in the base 186 of the ring blade 126. The ring blade 126 has an opening 188 ( see Figs. 5 and 31) at the base 186. The open distal end 190 (see Figs. 4, 29 and 31) of the annular blade 126 has a cutting edge 192. The annular blade 126 moves with the ejector suture brackets 156 when the ejector brackets 156 displaced distally from the starting position (Fig. 7) to the working position of (FIG. 31) by pressing the trigger 122 (see. FIG. 3). When the trigger 122 is actuated, the latter rotates in a direction 124 from the position shown in FIG. 38-43, to the position shown in FIG. 44-46, which causes the associated trigger rod 282 to move in the housing 110 in the direction 329 and abut against the ejector brackets 156, which also moves inside the housing 110 in the direction 392. This movement leads to the movement of the ejector brackets 156 and the annular blade connected to it 126 from the position shown in FIG. 7 and 38-43, to the position shown in FIG. 31 and 44-46. While the brackets ejector 156 is moving, the protrusions 176 of the brackets ejector 156 move the brackets 104 from their initial position in the magazine 148 shown in FIG. 7 to the operating position, that is, the brackets are ejected from the magazine 148, as shown in FIG. 31.

The rod 114 for adjusting the position of the thrust plate, performing reciprocating movements (see Figs. 4 and 6), is located inside the cassette with brackets 108 and is placed so as to move inside the inner round barrel 194 (see Fig. 4 and 6) ejector brackets 156. As shown in FIG. 3A and 3B, the cross section of the shaft for adjusting the position of the thrust plate 114 varies in shape and size: one part along the line 3A-3A is circular in cross section, and the second part along the line 3B-3B has parallel side walls with a distance between them of 402 less than diameter 401, as shown in FIG. 3B. As shown in FIG. 4, the inner barrel 194 extends in the longitudinal direction inside the ejector brackets 156 parallel to the longitudinal axis 172 of the ejector brackets 156. The hole 196 is located inside the barrel 194. The surface for centering the thrust plate 198 extends in the longitudinal direction along the annular inner surface 200 of the annular inner barrel 194. The centering surface 198 has at least one longitudinal groove. In other embodiments, the centering surface for the thrust plate 198 may include any number or type of surfaces for alignment in various configurations. The inner surface 204 of the barrel 194 is separated from the other inner surface 206 of the ejector brackets 156 with a circular hole 208 located between the outer surface 204 of the inner barrel 194 and the circular inner surface 206.

In FIG. 1, 2, 4-7 and, in particular, 8, the thrust plate system 112 comprises a thrust plate 210, a surface for forming a stitch weld 212, an annular split washer 214, and a metal shaft 216. The thrust plate 210 is an integral polymer cast part including the shaft of the thrust plate 218, which is integral with the base of the thrust plate 220. The thrust plate 210 is made of a polymer including nylon filled with glass or carbon fiber. In other embodiments, the thrust plate 210 may be made of similar composite materials with tensile strengths greater than 103.4 MPa (15,000 psi) to avoid excessive bending when abutted against fabric.

The base of the stop plate 220 is cast together with the surface to form the stitch weld 212 and the metal shaft 216. In other embodiments, the base of the stop plate 220 can be attached to the surface to form the stitch weld 212 using various fixing mechanisms. The surface for forming the stitch weld 212 is made of sheet metal or a plate consisting of stainless steel, has an annular shape and has recesses in which brackets are inserted. In other embodiments of the invention, the surface for forming the stitch weld 212 may be made of aluminum or other materials capable of withstanding the forces arising from the application of suture brackets.

An annular split washer 214 is pressed into the cavity 222 of the base of the abutment plate 220 and abuts against the surface of the abutment plate 220. In other embodiments, the annular split washer 214 can be connected to the base of the abutment plate 220 in the cavity 222 using various fixing mechanisms. The split ring washer 214 is made of plastic including ABS (acrylonitrile butadiene styrene). In other embodiments, the annular split washer 214 may be made of nylon, polyethylene, or polypropylene.

The shaft of the thrust plate 218 is cast around the outer surface 224 of the end 226 of the metal shaft 216, while the metal shaft 216 enters the hole 228 of the shaft of the thrust plate 218. The cast hole 228 of the shaft of the thrust plate 218 ends inside the shaft of the thrust plate 218 and does not extend through the distal end of the thrust base the plate 220. The inner surface 230 of the shaft of the thrust plate 218 includes a female connecting part 232, pressed with a connecting part 234 of the outer surface 224 of the end 226 of the metal shaft 216. The female soy initelnaya alloy portion 232 includes annular ribs (FIG. 38), and connecting portions 234 - annular grooves (figure 8.). In other embodiments, the female coupler 232 and the male coupler 234 may include grooves and threads that embrace or male other types of couplers or couplers. In yet another embodiment, the shaft of the thrust plate 218 may be coupled to the metal shaft 216 using various coupling mechanisms. Channel 236 at the proximal end passes through a metal shaft 216. The end 238 of the metal shaft 216 includes slots for expansion 240 (see FIG. 2). The metal shaft 216 is made of stainless steel. In other embodiments, the metal shaft 216 may be made of various materials.

By the time of production of the thrust plate system 112, the metal shaft 216 and the surface of the formation of the stitch weld 212 have already been manufactured. The finished metal shaft 216 and the finished surface for forming the stitch weld 212 are inserted into the injection mold. The casting mold is then used to cast the thrust plate 210, so that the thrust plate 210 is cast together with the finished metal shaft 216 and the finished surface to form the stitch weld 212. During the injection molding process, the base of the thrust plate 220 is formed, which is pressed together a finished surface for forming a stitch weld 212, at the same time a thrust plate 218 is formed, which is pressed around the end 226 of the finished metal shaft 216. Then, an annular split washer 214 vp essovyvaetsya cavity 222 in the molded base swashplate 220. In other embodiments, the manufacturing process can be varied.

The insertable connecting portion 244 (see FIGS. 2 and 6) of the rod for adjusting the position of the thrust plate performing reciprocating motion is detachably connected to the channel at the proximal end 236 of the metal shaft 216 using a snap connection. Such a mechanism operatively connects the metal shaft 216 and the thrust plate 210 attached thereto to the control element of the thrust plate 120 of the rod for adjusting the position of the thrust plate 114. In other embodiments, the insertable connecting portion 244 of the rod 114 for adjusting the position of the thrust plate reciprocating may be attached to the metal shaft 216 using other attachment mechanisms. Slots for expansion 240 allow the end 238 of the metal shaft 216 to be pulled out during connection to the plug-in connecting portion 244 of the rod 114 to adjust the position of the thrust plate. After using the circular stapling instrument 100 for suturing the patient, the entire block of the abutment plate 112 is discarded. For subsequent use, a new cassette unit 102 is taken, including a new block of the thrust plate 112.

As shown in FIG. 8, the shaft of the thrust plate 218 includes a centering surface 246 formed during casting of the thrust plate 210. The centering surface 246 includes at least one slot parallel to the longitudinal axis 248 of the shaft of the thrust plate 218. The centering surface 246 extends from the upper part 250 of the thrust shaft plates 218 along the outer convex shaft surface 252 of the thrust plate 218 to the bottom portion 254 of the shaft of the thrust plate 218. The metal shaft 216 of the thrust plate system 112 does not have a centering surface. In other embodiments, the centering surface of the thrust plate 246 may include any number or type of centering surfaces in various configurations. For example, as shown in FIG. 12, in an embodiment of the invention in which the thrust plate system 112 includes only the shaft of the thrust plate 218 without a metal shaft 216 connected to the thrust plate system 112, the centering surface 246 may start from the upper portion 250 of the shaft of the thrust plate 218, extend along the outer convex surface 252 of the shaft of the thrust plate 218 and extend to the middle part 256 of the shaft of the thrust plate 218, not reaching the bottom portion 254 of the shaft of the thrust plate 218.

The block of the thrust plate 112 can be moved from the open position (see Fig. 6), in which the surface of the formation of the staple seam 212 is separated from the housing 110 to capture tissue, in the closed position (see Fig. 7), in which the surface of the formation of the staple seam 212 is adjacent to the casing 110 of the cassette unit 108, clamping the tissue between the brace magazine 148 and the surface of the staple joint 212 before triggering the trigger to seam and cut off excess trapped tissue. This is because the tip 242 (see FIGS. 2 and 6) of the insertion connecting part 244 of the rod 114 for adjusting the position of the thrust plate performing reciprocating movements is located inside the inner shaft 194 of the ejector brackets 156 and is connected to the channel 236 at the proximal end 238 of the metal shaft 216 of the thrust plate system 112. As a result, when the connected rod moves to adjust the position of the thrust plate 114, the shaft of the thrust plate 218 connected to the metal shaft 216 is movably located in the cavity of the shaft 1 94 of the ejector brackets 156, which makes it possible to move the surface of the formation of the bracket weld 212 of the system of the thrust plate 112 relative to the ejector brackets 156 and the housing 110.

The centering surface 246 (see FIG. 8) of the shaft of the thrust plate 218 has a shape corresponding to the centering surface of the thrust plate 198 (see FIG. 4) of the bracket ejector 156 for rotational alignment of the surface of the formation of the brace seam 212 with the magazine for brackets 148 when the base is thrust the plate 220 is in the closed position (see FIG. 7) and is adjacent to the cassette unit 108. At the beginning, as shown in FIG. 6, as the shaft 114 for adjusting the position of the thrust plate moves the metal shaft 216 and the shaft of the thrust plate 218 connected thereto, and therefore moves the base of the thrust plate 220 from the open position shown in FIG. 6 to the closed position shown in FIG. 7, the centering surface 246 (see FIG. 8) of the shaft of the thrust plate 218 does not coincide with the centering surface of the thrust plate 198 (see FIG. 4) of the inner round shaft 194 of the bracket ejector 165, since the centering surface 198 is located at the metal shaft 216, devoid of a centering surface. At this time, the surface of the formation of the brace seam 212 will not be aligned with the magazine for brackets 148. However, as shown in FIG. 7, when the centering surface 246 of the shaft of the thrust plate 218 reaches the inner shaft 194 of the bracket ejector 156, the centering surface 246 is aligned with the centering surface of the thrust plate 198 of the inner shaft 194, which leads to rotational alignment of the forming surface of the bracket joint 212 and the magazine for brackets 148, since the base of the thrust plate 220 is moved to the closed position adjacent to the cassette with brackets 108. In FIG. 33A, the marks 120A of the control plate of the stop plate 120 visually indicate the size of the gap between the forming surface of the bracket weld 212 of the stop plate 112 (see FIG. 7) and the bracket ejector 148 (see FIG. 7), which gives the user information about the thickness of the clamped tissues. When the device is in an almost closed position, the proximal end of the shaft for adjusting the position of the thrust plate 114 protrudes through the hole 120F of the control element of the thrust plate 120.

When the thrust plate system 112 is in the closed position, as shown in FIG. 7, and the trigger of the circular stapling tool 100 is actuated by moving the ejector brackets 156 in the housing 110 from the initial position shown in FIG. 7 to the suturing position shown in FIG. 31, the protrusions 176 of the bracket ejector 156 push the brackets 104 out of the grooves for the brackets 154 of the brackets 148 opposite the surface of the formation of the bracket joint 212 of the thrust plate 112. When interacting with the formation surface of the bracket joint 212, the brackets 104 emerging from the grooves fold to form a closed shape, such thus, the fabrics are stitched. At the same time, the ejector brackets 156 moves the annular blade 126 to the clamped fabric, caught between the surface of the formation of the staple seam 212 on the thrust plate 210 and the surface of the ejector brackets 148, cutting off the fabric at the split washer 214 of the system of the thrust plate 112.

In FIG. 9 shows a diagram 258 of one embodiment of the invention, a method for centering a cassette unit of a circular stapling tool. At 260, a cassette unit of a circular stapling tool is presented. Presented circular stapling tool includes a housing, a magazine for brackets attached to the housing, the ejector brackets, an annular blade and a thrust plate. At step 262, the bracket ejector is movably fixed in the housing in a centered position, and the connecting parts of the bracket ejector are connected to the corresponding housing connecting parts, which prevents the movement of the bracket ejector until a certain force is applied to it, acting on the trigger rod. At step 264, the base surface of the thrust plate is moved from an open position (separated from the housing), in which the surface of the brace seam is not aligned with the magazine for brackets attached to the housing to the closed position (close to the housing). At step 266, the centering surface of the thrust plate coincides with the centering surface of the ejector brackets, so that the surface for forming the bracket seam of the thrust plate is aligned by rotation with the magazine for the brackets when the base surface of the thrust plate is in the closed position and is adjacent to the housing. The centering surface of the thrust plate contains at least one slot, and the centering surface for the thrust plate of the ejector brackets contains at least one slot. In other embodiments, the type, number and configuration of the centering surfaces of the thrust plate and the ejector brackets may vary.

One or more embodiments of the invention can reduce one or more problems associated with centering in previous models of surgical circular stapling instruments. For example, the use of one or more embodiments of the invention can ensure proper direct alignment of the thrust plate and the bracket ejector instead of the combination of the thrust plate and the housing, and then the bracket ejector and the housing, as in current tools. This method of direct combination of the ejector and the thrust plate reduces the risk of changes in their mutual orientation and helps to improve the shape of the brackets.

In FIG. 10 is a schematic diagram of parts of a block of a thrust plate 112A in yet another embodiment of the invention, comprising a thrust plate 210A, a surface for forming a stitch weld 212A, and an annular split washer 214A, as well as a metal shaft 216A. The thrust plate 210A is an integral polymer molded part including a shaft of the thrust plate 218A cast together with the base of the thrust plate 220A. In other embodiments, the implementation of the thrust plate 210A may be made of a polymer including nylon filled with glass or carbon fiber. In other embodiments, the thrust plate 210A may be made of similar composite materials with a tensile strength of more than 103.4 MPa (15,000 psi) to avoid excessive bending when abutting against fabric.

The metal shaft 216A passes through the cast hole 228A, which reaches the shaft of the thrust plate 218A and the base of the thrust plate. One end of the metal shaft 216A exits the cast hole 228A and abuts against the upper portion 268 of the base surface of the thrust plate 220A. The end 226A of the metal shaft 216A has a larger diameter 270 than the diameter 272 of the cast hole 228A. The other end 238A of the metal shaft 216A protrudes from the cast hole 228A of the shaft of the thrust plate 218A. The metal shaft 216A includes connecting elements (not visible) that are fastened to the insertion part (not visible) of the shaft of the thrust plate 218A. Insert parts are threaded, and female parts are grooves. In other embodiments, plug-in and female connectors may include male and female connections or other types of connection mechanisms. In other embodiments, the metal shaft 216A may be coupled to the shaft of the thrust plate 218A using various locking mechanisms. Channel 286A extends from the proximal end 238A of the metal shaft 216A. The end of the metal shaft 216A also includes slots for expansion 240A. The metal shaft 216A is made of metal including hardened stainless steel. In other embodiments, the implementation of the metal shaft 216A may be made of other types of steel.

The base of the thrust plate 220A is cast along with the surface of formation of the stitch weld 212A. In other embodiments, the base of the abutment plate 220A may be attached to the surface of the formation of the stitch weld 212A using various fixing mechanisms. The surface of the formation of the stitch weld 212A is made of sheet metal or a plate consisting of stainless steel, has an annular shape and includes recesses for suture staples. In other embodiments, the surface of the formation of the stitch weld 212A may be made of other metals, stainless steel, aluminum, in the form of sheets or plates.

An annular split washer 214A is pressed into the cavity 222A of the base of the thrust plate 220A adjacent to the surface of the base of the thrust plate 220A. In other embodiments, the annular split washer 214A may be secured to the cavity 222A of the base of the thrust plate 220A using various locking mechanisms. The 214A ring split washer is made of plastic, including ABS (acrylonitrile butadiene styrene). In other embodiments, the implementation of the annular split washer 214A may be made of nylon, polyethylene or polypropylene.

By the time of manufacture of the block thrust plate 112A, the surface of the formation of the brace seam is ready. The surface of the formation of the stitch weld 212A is placed in the mold for injection molding. A mold is used to cast the thrust plate 210A, thus, the thrust plate 210A is connected to the surface of the formation of the stitch weld 212A. In the casting process, a base 220A is formed, which is cast along with the surface of formation of the stitch weld 212A. Then, the annular split washer 214A is pressed into the cavity 222A of the cast base of the thrust plate 220A. After casting the base of the thrust plate 220A, the end of the preformed metal shaft 216A extends into the cast hole 228A of the base of the thrust plate 220A and protrudes from the cast hole 228A in the shaft of the thrust plate 218A, thus the end 226A of the metal shaft 216A abuts against the upper portion 268 of the base of the thrust plate 220A . This action can be performed by the user before use. The metal shaft 216A is detachably connected to the shaft of the thrust plate 218A using the connecting parts (not visible) of the shaft of the thrust plate 216A, while the end 238A of the finished metal shaft 216A is inserted into and protrudes from the cast hole 228A of the thrust plate 210A. In other embodiments, the manufacturing process may vary.

As shown in FIG. 11, the plug-in connecting portion 244 of the rod 114 for adjusting the position of the thrust plate is detachably connected to the channel 236A at the proximal end of the metal shaft 216A using a snap-fit connection, operatively connecting the metal shaft 216A and the thrust plate 210A to the control element of the thrust plate 120 through the reciprocating rod 114 actions to adjust the position of the thrust plate. In other embodiments, the insert portion 244 of the rod 114 for adjusting the position of the thrust plate may be coupled to the metal shaft 216A using other fixing mechanisms. The expansion slots 240A allow the end 238A of the metal shaft 216A to be pulled out to elongate it while connecting the insert 244 of the rod 114 to adjust the position of the thrust plate. After using the circular stapling tool 100 for suturing the patient, the metal shaft 216A can be removed from the thrust plate 210A by disconnecting the insertion part (not visible) of the metal shaft 216A from the female part (not visible) of the metal shaft 218A, the thrust plate 210A can be disposed of, the metal shaft 216A can be sterilized and the metal shaft 216A can be connected to the new abutment plate using the process described above, so that the metal shaft 216A can be reused for suturing to another patient in combination with a new thrust plate and a new cassette with brackets.

As shown in FIG. 10.11, the shaft of the thrust plate 210A includes a centering surface 246A formed by casting the thrust plate 210A in the mold. The centering surface 246A includes at least one slot parallel to the longitudinal axis 248 of the shaft of the thrust plate 218A. The centering surface 246A extends from the upper shaft portion 250A of the thrust plate 218A along the outer tubular shaft surface 252A of the thrust plate 218A to the lower shaft portion 254A of the thrust plate 218A. The metal shaft 216A of the thrust plate 112A does not contain a centering surface. In other embodiments, the centering surface 246A may include any number or type of centering surfaces in various configurations.

In FIG. 12 is a schematic diagram of parts of a thrust plate 112A according to another embodiment of the invention, including a thrust plate 210B, a surface for forming a stitch weld 212B, and an annular washer 214B. The thrust plate 210B is an integral polymer molded part including a shaft of the thrust plate 218B cast along with the base of the thrust plate 220B. The thrust plate 210B is made of a polymer including nylon filled with glass or carbon fiber. In other embodiments, the thrust plate 210B may be made of similar composite materials with tensile strengths greater than 103.4 MPa (15,000 psi) to avoid excessive bending when abutted against fabric. A channel at the proximal end 236B extends inside the shaft of the thrust plate 218B. The shaft of the thrust plate 218B includes slots for expansion 240B.

The base of the thrust plate 220B is cast along with the surface of the formation of the stitch weld 212B. In other embodiments, the base surface of the abutment plate 220B may be attached to the surface of the formation of the brace seam 212B using various attachment mechanisms. The surface of the formation of the stitch weld 212B is made of metal, including austenitic stainless steel, has an annular shape and includes recesses for the brackets. In other embodiments of the invention, the surface of the formation of the stitch weld 212B may be made of other metals, stainless steel, aluminum, in the form of sheets or plates.

An annular split washer 214B is pressed into the cavity 222B of the base of the thrust plate 220B and abuts against the surface of the base of the thrust plate 220B. In other embodiments, the annular split washer 214B may be located in the cavity 222B of the base of the thrust plate 220B due to various locking mechanisms. The 214B ring washer is made of plastic, including ABS (acrylonitrile butadiene styrene). In other embodiments, the annular split washer 214B may be made of various materials.

By the time the thrust plate 112B was manufactured, the surface for forming the staple joint 212B had already been made. Then, the surface of the formation of the stitch weld 212B is placed in the mold for injection molding. A mold is used to cast the thrust plate 210B, so that the thrust plate 210B is connected to the surface of the formation of the stitch weld 212B. During casting, the base of the thrust plate 220B is formed, which merges with the surface of the formation of the stitch weld 212B. At the same time, the shaft of the thrust plate 218B, including the shaft attachment portion for adjusting the position of the thrust plate, is placed in the mold for casting the base of the thrust plate 220B and becomes a part thereof. Then, the annular split washer 214B is pressed into the cavity 222B of the molded base of the thrust plate 220B. In other embodiments, the manufacturing process may vary.

As shown in FIG. 13, the insert portion 244 of the rod 114 for adjusting the position of the thrust plate is detachably connected to the channel at the proximal end 236B of the shaft of the thrust plate 218B by means of a snap connection operatively connecting the shaft 218B of the thrust plate 210B to the control element of the thrust plate 120 through the reciprocating control rod for adjustment the position of the thrust plate 114. In other embodiments, the insertion portion 244 of the shaft for adjusting the position of the thrust plate 114 may be attached to the shaft of the thrust Lastin 218B using other fastening mechanisms. Expansion slots 240B allow the shaft of the thrust plate 218B to be pulled out while connected to the shaft insert 244 to adjust the position of the thrust plate 114. After using the circular stapling tool 100 for suturing the patient, the thrust plate 210B can be disposed of and a new thrust plate mounted on the circular stapling tool 100 for conducting another procedure in another patient.

As shown in FIG. 12,13, the shaft of the thrust plate 218B includes a centering surface 246B formed during casting of the thrust plate 210B. The centering surface 246B includes at least one slot parallel to the longitudinal axis 248 of the shaft of the thrust plate 218B. The centering surface 246B extends from the upper shaft portion 250B of the thrust plate 218B, extends along the outer convex shaft surface 252B of the thrust plate 218B and ends at the mid-shaft portion 256B of the thrust plate 218A, not reaching the lower shaft portion 254B of the thrust plate 218A. In other embodiments, the centering surface 246B may include any number or type of centering surfaces in various configurations.

In FIG. 14 shows a diagram 274 of one embodiment of the invention — a method of manufacturing a thrust plate assembly. At step 276, an already-made surface for forming a stitch weld, which may be made of metal or other material, is placed in a mold. At step 278, a thrust block assembly is obtained by casting the thrust plate together with the finished surface to form a stitch joint in a mold, resulting in a thrust plate with a shaft starting from the base of the thrust plate. The thrust plate can be molded as an integral part of a polymer, for example, nylon filled with glass or carbon fiber. In other embodiments, the thrust plate may be cast from other materials. In one embodiment, step 278 may further include casting a thrust plate with at least one centering surface comprising a slot or other type of centering surface. In another embodiment, step 278 may further include casting the block of the thrust plate so that the shaft of the thrust plate is integral with the finished shaft, which can be made of metal and other materials placed in the mold for step 276. In a further embodiment In the next step, the finished shaft, which can be made of metal or other materials, can be attached to the shaft of the thrust plate after casting the latter. At 280, a split washer is attached to the base of the thrust plate by pressing or other attachment mechanisms. The washer may have a ring or other shape, may be made of plastic, including ABS (acrylonitrile butadiene styrene), or other types of materials. In other embodiments, one or more steps of the method may vary.

One or more embodiments of the invention can reduce one or more problems associated with the use of previous models of thrust plates. For example, the use of one or more embodiments of the invention involves the use of a thrust plate, the production of which is one third cheaper than the production of the thrust plates currently in use.

As shown in FIG. 1-3, the circular stapling tool 100 includes a handle 116, a reciprocating rod 114 for adjusting the position of the thrust plate, a trigger rod 282, a handle cover 284, a barrel 106 detachably connected to the handle 116, a cassette with brackets 108 and a thrust plate system 112 , which is detachably connected to the rod 114 to adjust the position of the thrust plate, making a reciprocating motion. The handle 116 forms a cavity 118, which includes a trigger rod 282 and a rod for adjusting the position of the thrust plate 114, performing reciprocating movements. The retractable rod 114 for adjusting the position of the thrust plate has an insert portion 244 at the end 242 of the rod for adjusting the position of the thrust plate 114 and a threaded connecting portion 286 that is detachably connected to the control element of the thrust plate 120 at the proximal end of the rod 114 for adjusting the position of the thrust plate.

The trigger rod 282 is used to stabilize and securely fasten the rod 114 to adjust the position of the thrust plate performing reciprocating movements in the handle 116. The trigger rod 282 has a pair of grooves 288 and 290 and a connecting part 292 at the distal end. Preferably, the connecting grooves 288 and 290 are located on opposite sides of the trigger rod 282. The trigger mechanism 122 includes an upper end 294 that fits into the grooves 288 and 290 and detaches the trigger rod 282 and the shaft 114 to adjust the position of the thrust plate in the cavity 118 of the handle 116 An alternative way is to replace the grooves 288 and 290 with any releasable connection as described herein. Preferably, the trigger rod 282 and the rod 114 for adjusting the position of the thrust plate are located in the cavity 118, parts of the upper end 294 of the trigger mechanism 122 are included in one of the grooves 288 and 290, releasably securing the trigger rod 282 and the rod 114 for adjusting the position of the thrust plate in cavity 118. When releasing the trigger rod 282 and the rod 114 to adjust the position of the thrust plate in the cavity 118, the grooves 288 and 290 and the upper end 294 of the trigger rod 122 allow easy insertion of the trigger rod 282 and a rod 114 for adjusting the position of the thrust plate into the cavity 118 and removing from it, which simplifies the maintenance and replacement of these parts. The design of the cavity 118 and the properties of the components described above allow the user to clearly visualize them with the correct location and orientation. It also prevents the user from assembling the tool improperly.

The connecting shaft 292 has an opening 296 through which the tip 242 and the insert portion 244 of the shaft 114 pass to adjust the position of the thrust plate. The passage of the rod to adjust the position of the thrust plate 114 through the hole 296 of the shaft 292 helps to center the rod 114 inside the handle 116 and align the position of the rod 114 to adjust the thrust plate inside the cartridge with brackets 108. The cartridge with brackets 108 (see Fig. 1 and 2) is detachably connected with the distal end of the barrel 106 (see Fig. 3). The tip 242 of the insert portion 244 of the rod 114 for adjusting the position of the thrust plate extends inside the housing 110 (see FIG. 2) and is detachably connected to the channel 236 at the proximal end (see FIG. 2) of the metal shaft 216 of the block of the thrust plate 112 using a snap connection .

In FIG. 3, the carrier cover 284 slides over the handle 116 and closes the trigger rod 282, as well as a portion of the rod 114 for adjusting the position of the thrust plate in the cavity 118. Preferably, the carrier cover of the handle 284 has an opening 298 into which the threaded portion 132 of the handle 116 fits. Preferably, when the hole 298 is U-shaped and is located on the lower side 300 of the cover of the handle 284 so that when the cover of the handle 284 slides over the handle 116, the abutment surface 302 of the cover 284 is pressed against the portion of the handle 116, which would indicate the correct position e of the lid 284 relative to the trigger rod 282, and a portion of the reciprocating rod 114 for adjusting the position of the thrust plate was located in the cavity 118. When the lid 284 slides over the handle 116, the lid 284 protects the trigger rod 282 and the rod 114 for adjusting the thrust plate in cavity 118 and allows easy maintenance and replacement.

The barrel 106 is detachably connected to the handle 116 at the proximal end and to the cassette with brackets 108 (see Fig. 1) at the distal end. As used herein, the term “detachable” refers to a first component or part whose construction involves disconnecting or removing without damaging another component or part. In addition, the term “detachable connection” or “fastening” herein refers to connecting or securing the first part to the second part in such a way that each of them can be detached or removed without damaging any of the parts. This allows you to disconnect or unscrew the two parts from each other without damage, which makes the parts suitable for maintenance. The detachable connection may include a snap connection, a friction connection including parts held against each other by friction, a threaded connection, a magnetic connection or a mechanical connection, for example, using a hook and loop.

With reference to FIG. 3, it is preferred that the barrel 196 has a coupling nut 130 with an internal thread 304 forming a detachable connection with the threaded portion 132 of the handle 116. An alternative method is to replace the coupling nut 130 with any detachable connection as described herein. After detachable connection with the handle 116, the barrel 106 detachably secures the carrier cover 284 with the handle 116, making it easy to disassemble and maintain the circular stapling tool 100 and its components, for example, the barrel 106, the carrier cover 284, the handle 116, the trigger rod 282 and the adjustment rod 114 thrust plate position.

Due to the detachable connection of the barrel 106 with the handle 116, the detachable connection of the trigger rod 282 and the rod 114 to adjust the position of the thrust plate in the cavity 118, the sliding of the carrier cover 284 on the handle 116, the detachable connection of the rod 114 to adjust the position of the thrust plate with the control element of the thrust plate 120 the detachable connection of the barrel 106 with the handle 116 or the detachable connection of the thrust plate system 112 (see FIG. 1) with the rod 114 for adjusting the position of the thrust plate simplifies assembly and disassembly stapling tool 100, which allows for the care and maintenance of various components of the circular stapling tool 100.

In FIG. 15A and 15B, when assembling the circular stapling tool 100, the thrust plate control 120 is detachably connected to the reciprocating action rod 114 to adjust the position of the thrust plate. Preferably, when the control element 120 is movably connected to the threaded adjusting part 286 at the proximal end of the rod 114 to adjust the position of the thrust plate, so that the control element of the thrust plate 120 is rotated on the threaded part 286. Typically, the rotation of the control element of the thrust plate 120 turns the device into open position, and clockwise - to the closed.

Then, see FIG. 16A and 16B, a part of the control plate of the thrust plate 120 and a part of the rod 114 for controlling the thrust plate are detachably fixed in the cavity 118 of the handle 116. Preferably, the cavity 118 has a recess 306 corresponding to the part of the control element of the thrust plate 120 for releasably securing the control element of the thrust plate 120 and the reciprocating movement of the rod to adjust the position of the thrust plate 114 in the cavity 118. Alternatively, the ratio of the protrusion and the recess may be opposite. Immediately after the entry of the rod 114 to adjust the position of the thrust plate 118 in position 118A, the parallel and lying on the same plane walls 114B and 114C (see Fig. 15B) adjacent to the cavity 118 are connected so as to prevent the rotational movement of the rod 114 relative to the handle, but allow longitudinal movement.

In FIG. 17A, 17B and 17C, the tip 242 and the insertion part 244 of the rod 114 for adjusting the position of the thrust plate enter the hole 296 of the connecting part of the shaft 292 of the trigger rod 282, and then the grooves 288, 290 of the trigger rod 282 are located above and then on both sides of the top the end 294 of the trigger mechanism 122, thereby releasably securing the trigger rod 282, a rod 114 for adjusting the position of the thrust plate and the control element of the thrust plate 120 in the cavity 118.

As shown in FIGS. 18A and 18B, the carrier cover 284 then slides over the handle 116 and closes the trigger rod 282 and the shaft portion 114 to adjust the position of the thrust plate in the cavity 118. Preferably, the threaded portion 132 of the handle 116 passes through the hole 298 in the cover 284 and the carrier cover 284 slides until the abutment portion 302 of the cover 284 abuts against the portion 132a of the handle 116, which indicates the correct position of the cover 284.

In FIG. 19A, 19B, and 19C, the rod 114 for adjusting the position of the thrust plate passes through the barrel 106 and is located inside it, and the barrel 106 is detachably connected to the handle 116. Preferably, the barrel 106 has a connecting nut 130 with an internal thread 304 forming a detachable connection with the threaded part 132 of the handle 116. The barrel 106 detachably secures the cover of the handle 284 on the handle 116.

In FIG. 2, the cassette with brackets 108 is detachably connected to the barrel 106, and the tip 242 of the rod 114 for adjusting the position of the thrust plate passes through the central shaft of the cassette with brackets 108. Finally, the system of the thrust plate 112 is detachably connected to the rod 114 for adjusting the position of the thrust plate through the connecting part 244 of the rod 114 for adjusting the position of the thrust plate and the channel at the proximal end 236 of the metal shaft 216 of the thrust plate system 112.

In FIG. 20 and 21, according to one embodiment of the invention, a curved circular stapling tool 100A is shown including a cassette with brackets 108A having a housing 110A, a thrust plate 112C attached to the bent shaft 114A of the thrust plate opening mechanism, as discussed above, to prevent accidental removal of the thrust plate plate 112C, curved trigger rod 282A, detachably connected to flexible rod 114A to adjust the position of the thrust plate, handle cover 284A, detachably connected to handle 116A, control element 120A, connector but connected to a curved retractable shaft 114A to adjust the position of the thrust plate through the threaded portion 286A, and an ergonomic curved barrel 106A with a connecting nut 130A detachably connected to the handle 116A through the threaded portion 132A. The curved circular stapling tool 100A includes curved components, for example, a flexible reciprocating rod 114A for adjusting the position of the thrust plate, a trigger rod 282A, and a curved barrel 106A to facilitate insertion into the body cavity of the mammal.

Due to the components that are releasably connected to each other, the circular stapling tool 100 or the curved circular stapling tool 100A is an open-structure reusable stapling tool that uses a grip carrier cover 284, 284A with a U-shaped opening 298, 298A, which allows you to collect additional components, for example, a rod 114, 114A for adjusting the position of the thrust plate and the barrel 106, 106A, mainly in the transverse direction. Cross-assembly provides better visibility and reduces assembly time, making assembly and disassembly easier. Thus, it often takes less than a minute to assemble the circular stapling tool 100 or the curved open-type circular stapling tool 100A. In addition, the open structure allows you to use the appropriate characteristics when you need to install components. In addition, thanks to the components detachably connected to each other, the circular stapling tool 100 or 100A is easy to assemble or disassemble, which allows you to clean or sterilize the circular stapling tool 100 or 100A after use.

In FIG. 22-28, according to one embodiment of the invention, the circular stapling tool 100D includes a cassette with brackets 108D with a housing 110D, a block of a thrust plate 112D connected to a shaft 114D of the mechanism for opening the thrust plate, as discussed above, to prevent accidental removal of the thrust plate 112D, the trigger a rod 282D detachably connected to the rod 114D for adjusting the position of the thrust plate, a handle cover 284D connected to the handle 116D, a control element 120D connected to the rod 114D for adjusting the position of the thrust plate and a barrel 106D with a connecting nut 130D connected to the handle 116D via a threaded portion 132D. Preferably, the stapling tool 100D is a curved circular stapling tool, as shown in FIG. tool 100D, and contained curved components, for example, a rod 114D for adjusting the position of the thrust plate, a curved trigger rod 282D, and an ergonomic curved barrel 106D to facilitate insertion of the tool into the body cavity of the mammal. However, the circular stapling tool 100D does not have to be a curved circular stapling tool, as shown in FIG. circular stapling tool 100D; it can relate to any type of circular stapling tool, for example, a relatively straight circular stapling tool, such as a circular stapling tool 100, and have relatively straight components, for example, a relatively straight rod 114D for adjusting the position of the thrust plate, relative to the straight trigger rod 282D and relatively straight trunk 106D.

The reciprocating action rod 114D for adjusting the position of the thrust plate includes a first insertion connecting part 244D at the tip 242D of the retractable rod 114D for adjusting the position of the thrust plate and a threaded connecting part 286D at the base 402D of the rod 114D for adjusting the position of the thrust plate. Preferably, the rod 114D for adjusting the position of the thrust plate includes a base 402D at one end and an insertion portion 244D at the opposite end, as well as a flexible tie strap 400D, which may be flexible and curved, connecting the base 402D to the insertion portion 244D. In FIG. 22 and 23, the trigger rod 282D is movably connected by its first end 430D to the trigger 122D, and the second end 432D to the cartridge with brackets 108D through the second connecting portion 416D. In FIG. 28, the trigger rod 282D forms a first connecting surface 406D that faces the corresponding second connecting surface 408D on the shaft 114D to adjust the position of the thrust plate. Preferably, the tie strap 400D forms a second connecting surface 408D directed toward the first connecting surface 406D of the trigger rod 282D.

The circular stapling tool 100D further includes an element for reducing friction 420D located between the first and second contacting surfaces 406D, 408D to reduce friction between the retractable shaft for adjusting the position of the thrust plate 114D and the stem 282D. The movement of the rod to adjust the position of the thrust plate 114D and the trigger rod 282D starts when the trigger 122D is pressed against the handle 116D, as a result of which the trigger rod 282D moves to the cassette with brackets 108D and is aligned with it, causing the brackets to be ejected from the cartridge 108D. The movement of the rod 114D to adjust the position of the thrust plate 282D also occurs when the control 120D is activated, as a result of which the rod 114D and the thrust plate system 112D connected to the tip 242D of the rod 114D are moved to 108D to adjust the distance between the cassette with brackets 108D and the thrust plate 112D . With each movement of the rod to adjust the position of the thrust plate 114D and the trigger rod 282D, the rod 114D forms a sliding connection with the rod 282D, and friction occurs between the rod to adjust the position of the thrust plate 114D and the rod 282D. The term "sliding joint" in this document means the movement of one surface over another while maintaining constant smooth contact between them. The friction between the adjusting position rod 114D and the stem 282D in the curved circular stapling tool 100D is typically 20-40% higher than in the relatively straight circular stapling tool 100. In one embodiment of the invention, the configuration of the circular stapling tool 100D causes the tie strap 400D to exert contact force on the trigger rod 282D, increasing friction between the rod 282D and the extendable shaft 114D to adjust the position of the thrust plate. By positioning member 420D to reduce friction between the first and second contacting surfaces 406D and 408D, friction between the shaft for adjusting the position of the abutment plate 114D and the stem 282D can be reduced. There are other areas in which frictional forces arise between the stem 282D and other parts of the handle 116D when the trigger is pulled. These forces are reduced due to a certain surface angle of the grooves 288D and 290D of the trigger rod 282D. As shown in FIG. 28B, the angular surface 288F may have a vertical deviation of 5 to 15 degrees. The result of this is a 10-20% decrease in the pressing force of the trigger rod 282D.

The friction reducing member 420D may be any mechanical device or chemical compound that can be used to reduce friction between the two parts, for example, between the rod 114D for adjusting the position of the thrust plate and the rod 282D. In particular, the member for reducing friction 420D reduces the coefficient of friction μ between two parts, which becomes lower than the normal coefficient of friction μ _normal between two parts without an element for reducing friction. Preferably, the member for reducing friction 420D provides a reduced coefficient of friction μ _reduced , which is at least 20% lower or, preferably, 40% below the normal coefficient of friction μ _normal between the two parts.

Chemical compounds for the 420D friction reduction element may include: hard coatings, including graphite, or polymer coatings, such as Teflon. The chemical compounds to form the 420D friction reduction member may be applied in the form of coatings bonding to either surface 406D, 408D, or both. The chemical compounds to form the 420D friction reduction element can also be applied as coatings to freely moving intermediate components located between two surfaces 406D, 408D. The mechanical devices used to produce the 420D friction reduction member include any mechanical device capable of reducing friction between a pair of surfaces, such as a ball or roller bearing. The friction reducing member 420D may be coupled to the rod 114D to adjust the position of the thrust plate or to the stem 282D, or both. The 402D friction reduction member is designed so that it does not rub off or deteriorate when cleaning and maintaining the handle for reuse.

In FIG. 25-27, one embodiment of the invention is shown in which the friction reducing member 420D includes a roller 404D connected to the trigger rod 282D via a pin 412D and located in a cavity 410D formed in the trigger rod 282D. Preferably, the pin 412D is located in the hole 414D formed in the trigger rod 282D. Preferably, more than one 404D roller, such as three rollers, is connected to the stem 282D. In one embodiment, hole 414D is a circular hole into which pin 412D fits, as shown in FIG. 26, which allows limited movement of the 412D pin. In one embodiment, the hole 414D is a generally oval-shaped hole through which a pin 412D is inserted, the latter may make lateral movements to or from either end 430D, 432D of the trigger rod 282D; wherein the up and down movements of the pin 412D that are not related to the movement from or to either end 430D, 432D of the trigger rod 282D provide an additional degree of freedom compared with the previous embodiment of the invention.

In FIG. 29 is a perspective view of the annular blade 126 of the cartridge with brackets 108 of the circular stapling tool 100 of FIG. 4. As shown in FIG. 29, the annular blade 126 includes an annular cutting edge 192 and a part 308 connected to a split washer. An annular blade 126, including an annular cutting edge 192 and an element for securing a split washer 308, is made of metal, such as stainless steel. In other embodiments of the invention, the annular blade 126 may be made of any material strong enough to cut through the fabric. The washer fixing member 308 includes a plurality of engaging teeth starting from the portion 310 of the annular blade 126 adjacent to the cutting edge 192. The washer fixing member 308 extends inwardly at an indirect angle 312 with respect to the cutting edge 192. The indirect angle 312 may be within from 56 to 60 degrees. In other embodiments, an indirect angle may range from 30 to 60 degrees. In other embodiments of the invention, the detachable washer element 308 may be made of various materials, vary in quantity, shape, size, location, direction, or configuration with respect to the annular blade 126. For example, in other embodiments, the detachable fastener element 308 the washers may contain a locking protrusion, a depression or other type of connecting element.

In FIG. 6 shows the base surface of the thrust plate 220 of the thrust plate system 112 of the cassette unit 102 of the circular stapling tool 100 in the open position, at a distance from the housing 110, the bracket ejector 156 and the attached annular blade 126 are located in the front of the cut in the housing 110. An annular split washer 214 is pressed into the cavity 222 of the base of the abutment plate 220 of the abutment plate 210. The protective portion 314 is attached with a hook 316 to the upper part 318 of the annular washer 214 located in the cavity 222 of the base of the abutment plate 220.

In FIG. 30 is an enlarged view of a split washer 214 connected to the protective element 314. The protective element 314 includes an annular protective cap made of red colored polycarbonate. In other embodiments, the security element 314 may vary in manufacturing material, shape, size, location, color, or configuration and may be attached to the ring washer 214 using various attachment mechanisms. In other embodiments, the protective element 314 may not be used, and the annular split washer 214 may be pressed into the cavity 222 of the base of the thrust plate 220 without the protective element 314.

In FIG. 7 shows the base of the thrust plate 220 of the thrust plate system 112, moved to the closed position with respect to the housing 110 and close to it, with the bracket ejector 156 and the attached annular blade 126 still in the pre-actuation position enclosed in the housing 110 and separated from split washers 214. In this position, before operating, the flexible locking elements 178 of the bracket ejector 156 are releasably connected to the protrusions 180 of the housing 110 to form a connection that prevents the movement of the bracket ejector 156 while it is not certain force is applied. In other embodiments, the flexible locking member 178 and locking tabs 180 may include various types of related parts.

In FIG. 31, the bracket ejector 156 and the annular blade 126 connected thereto are shown after pressing the trigger, as a result of which the bracket ejector 156 is moved relative to the housing 110 from the initial position to the position where the cutting edge 192 of the ring blade 126 is inserted into the ring washer 214 and cuts off a piece of fabric while the base of the thrust plate 220 of the system of the thrust plate 112 is in the closed position. During suturing, the locking elements 178 of the bracket ejector 156 are released from the protrusions 180 of the housing 110, allowing the bracket ejector 156 to move beyond a certain point 320 relative to the housing 110.

In FIG. 32 is an enlarged view of the cutting edge 192 of the annular blade 126 shown in FIG. 31, included in the ring washer 214. The cutting edge 192 cuts the grid 320 located between the walls 322 and 324 of the ring washer 214. In this case, the element for fixing the washer 308 is fixedly fixed to one of the walls 322 of the split ring washer 214, blocking the ring blade 126 in an annular washer 214, while the protective element 314 (see Fig. 31) is still attached to the upper part 318 (see Fig. 31) of the annular washer 214 located in the cavity 222 of the base of the thrust plate 220.

In FIG. 33 shows the base of the thrust plate 220 of the thrust plate system 112, pushed back to the open position from the housing 110 after actuating the ejector brackets 156 and the attached annular blade 126, which engages in the split ring washer 214. The split ring washer 214 remains locked in place above ring blade 126 due to the element 308 for fixing the washer 314, still attached to the upper part 318 of the ring washer 214 and acting as a protective barrier over the cutting edge 192 of the ring blade 126. The protective ele The cop 314 prevents accidental cutting by the cutting edge 192 of the annular blade 126 after triggering the trigger. At least one of the elements — the annular split washer 214 or the protective element 314 — has a visual indicator 326 showing, as a precaution, that the bracket ejector 156 and the attached annular blade 126 are actuated. The visual indicator 326 includes a first color different from the second color of the case 110 of the circular stapling tool 100. In other embodiments, the visual indicator 326 may include any type of visual indicator showing when the bracket ejector 165 and the attached annular blade 126 are actuated. In another embodiment, only the inside of the ring washer 214 and the visual indicator 326 remain attached to the ring blade 126 after being cut. The outer portion of the washer 214 remains attached to the base of the thrust plate 220 after opening the tool.

In FIG. 34 shows the thrust plate 210 of the thrust plate system 112 of FIG. 33, removed from the circular stapling tool 100, after actuating the ejector brackets 156 and the annular blade 126 connected thereto and cutting off the washer 214, while the annular split washer 214 and the protective element 314 remain attached to the annular blade 126 due to the washer 308 fixing member The guard 314 continues to prevent accidental cutting by the cutting edge 192 of the annular blade 126 after actuating the ejector brackets 156 and the annular blade 12 connected thereto. In addition, the visual indicator 3 26 continues to show that the bracket ejector 156 and the attached annular blade 126 are actuated.

In FIG. 35 shows a new abutment plate 210C when attempting to attach to the circular stapling tool 100 shown in FIG. 34. As shown in FIG. 36, a protective member 314 attached to an annular washer 214 that is attached to an annular blade 126 actuated prevents the new abutment plate 210C from attaching to the circular stapling tool 100. As shown in FIG. 35, this is because the diameter 328 of the shield 314 is larger than the inner diameter 330 of the new ring washer 332. Even if the shield 314 is not attached to the ring washer 214, the ring washer 214 will still prevent the new thrust plate 210C from attaching to the circular stapling tool 100, since the ring washer 214 has a diameter of 334 equal to or greater than the inner diameter 330 of the new ring washer 332.

In order to use the circular stapling tool 100 shown in FIG. 34, again, it is possible to remove the cassette unit 102 shown in FIG. 1-2, with the circular stapling tool 100, thereby removing the annular blade 126 and the washer 214 connected to it after the cut. After sterilizing the remainder of the circular stapling tool 100 (e.g., handle 116 and other components shown in Fig. 1), another unused cassette unit may be attached to them, including a new annular blade and a new annular split washer, to reuse the circular stapling tool 100. In FIG. 37 shows a diagram of one embodiment of the invention, a method 340 for fixing a blade on a split washer of a circular stapling tool, at step 342 a circular stapling tool is presented. The circular stapling tool comprises a body, a bracket ejector, a thrust plate unit, and a blade. The bracket ejector is movably located inside the housing. The thrust block unit includes a split washer attached to the surface of the base of the thrust plate. The blade is attached to the ejector brackets.

At 344, the thrust block assembly moves from an open position (away from the housing) to a closed position (adjacent to the housing). At step 346, the bracket ejector moves from the initial position where the blade does not fit into the washer and in which the washer attachment element on the blade is not attached to the washer, to the seam position where the blade enters the washer and the washer fixation element on the blade is rigidly attached to the puck. The washer fixing member may include at least one tooth for holding the washer on the blade, located at an indirect angle to the cutting edge of the blade. An indirect angle can range from 56 to 60 degrees. In other embodiments, an indirect angle may range from 30 to 60 degrees. In further embodiments, the washer fixing member may be different. In one embodiment, step 346 includes a blade that cuts the washer net and at least one locking element that is rigidly attached to one of the washer walls.

In an additional step 348, any of the following is possible: the washer may come into contact with one or more components of the circular stapling instrument, preventing the blade from being drawn into the housing and reused; the washer or a protective element attached thereto may act as a protective barrier over the blade, or a visual indicator of the washer may indicate that the bracket ejector has been activated.

In a further step 350, the following steps are possible: the cassette unit can be removed from the circular stapling tool, thereby removing the used blade and washer; the remainder of the circular stapling instrument can be sterilized; and a new cassette unit including a new blade and a new washer may be attached to the circular stapling tool before reusing the circular stapling tool. In other embodiments, one or more of the steps of method 340 may be different.

The result of one or more embodiments of the invention can be any of the following: preventing the unintentional re-activation of the used blade of a circular stapling tool, and thus improving cleanliness and safety; preventing accidental cuts with the used circular blade of a circular stapling tool; preventing erroneous actuation of the circular stapling tool or other type of advantage.

In FIG. 38-46 show various images of the circular stapling tool 100 of the embodiment of FIG. 1 and 2, depicting a locking mechanism 352 in different states that can be used with any embodiment of the invention to protect against accidental actuation of the trigger mechanism 122 and the corresponding ejector brackets 156. FIG. 38-40, various images of the thrust plate system 112 are shown in the open position, outside the suture area, at a distance from the housing 110, with the trigger mechanism 122 and indirectly connected ejector brackets 156 locked in the position before the suture. When the system of the thrust plate 112 is moved to the open position, at a distance from the seam zone and the body 110, when using the attached rod 114 to adjust the position of the thrust plate and the control element of the thrust plate 120, the base surface of the thrust plate 220 is located at a distance of 354 ranging from 0 , 25 to 7.62 cm from the end of the guide brackets 148. In this position, before applying the seam, the threaded end 285 of the rod 114 for adjusting the position of the thrust plate is located inside the inner part 358 the threaded shaft 360 of the control element of the thrust plate 120 and away from the end 362 of the corresponding threaded shaft 360 of the control element of the thrust plate 120.

The edge 364 of the trigger 122 abuts against the first portion 366 of the rod 114 to adjust the position of the thrust plate, acting as a locking mechanism 352 and preventing the trigger device 122 from being rotated in the direction 124. The second portion 370 of the rod 114 for adjusting the position of the thrust plate is located away from edges 364. Edge 364 includes opposing walls 372 and 374 located at a distance of 376 equal to 0.48 cm from each other. The width 378 of the first part 366 of the rod 114 for adjusting the position of the thrust plate is 0.74 cm. The width 380 (see FIG. 43) of the second part 370 of the rod 114 for adjusting the position of the thrust plate is 0.43 cm. The trigger mechanism 122 cannot be rotated in direction 124 due to the fact that the width 378 of the first part 366 is greater than the distance 376 between the opposite walls 372 and 274 of the edge 364.

The upper end 294 of the trigger 122 corresponds to the grooves 288 and 290 (see FIG. 3) of the trigger rod 282. The upper end 294 of the trigger 122 includes opposing surfaces 294A and 294B spaced 382 apart from each other equal to 1.46 cm. Distance 382 between the opposite surfaces 294A and 294B is greater than the width 378 of the first part 366, which allows the opposing surfaces 294A and 294B to extend into the grooves 288 and 290 above the first part 366. The end 384 of the trigger rod 282 is located away from the end 386 of the ejector brackets 156. As a result, what n The first part 366 of the rod 114 for adjusting the position of the thrust plate blocks the trigger 122 from rotating in the direction 124, the end 384 of the trigger rod 282 corresponding to the trigger mechanism 122 remains at a position remote from the end 386 of the ejector brackets 156, which keeps the ejector brackets 156 locked position before suturing.

In FIG. 41-43, various images of the thrust plate system 112 are shown in the closed position (in the seam area) close to the housing 110, with the trigger mechanism 122 and the brackets ejector 156 indirectly connected to it in an unlocked state, ready for flashing, but still not shown into action as shown in FIG. 38-40. When the thrust plate system 112 is located in the closed position (in the seam area) and is brought closer to the housing 110 by the attached rod 114 and the thrust plate control 120, the base surface of the thrust plate 220 is located at a distance of 388 (in the range of 0.15 to 0 , 25 cm) from the end of the ejector brackets 148. The control element 120 rotates, which causes the threaded end 286 of the rod 114 to adjust the position of the thrust plate to move in the direction 390 from the inner part 358 of the corresponding threaded shaft 360 of the element of the thrust plate 120 toward the end 362 of the corresponding shaft 360 of the thrust plate control element 120. As a result of this movement, the first part 366 of the rod 114 for adjusting the position of the thrust plate moves in the direction 390 and moves away from the opposite walls 372 and 374 of the edge 364, so the first part 366 is larger does not interfere with the edge 364. The second portion 370 of the rod 114 also moves in the direction 390 away from the edge 364 to a position above the edge 364.

Due to the fact that the width 380 of the second part 370 is less than the distance 376 between the opposite walls 372 and 374 of the edge 364, the trigger 122 can be freely actuated, since it will not abut against the adjacent second part 370. Opposite surfaces 294A and 294B the upper end 294 of the trigger 122 is still included in the grooves 288 and 290 (see FIG. 3) of the trigger rod 282. Since the trigger 122 was not rotated in the direction 124 and, although unlocked, is in position before suturing, the trigger 122 did not set in motion th trigger rod 282 and the end 384 of the trigger rod 282 is still away from the end 386 pusher brackets 156, so the ejector brackets 156 has not yet been activated, but is ready for it.

In FIG. 44-46 show different images of the system of the thrust plate 112, located in the closed position, in the area of the seam in contact with the housing 110, with the trigger mechanism 122, rotated in the direction 124, that is, actuated and actuated the ejector brackets. The trigger 122 could be actuated since the first portion 366 of the retractable shaft 114 was previously moved to position 390 away from the edge 364, so that the first part 366 is no longer an obstacle to the edge 364 and the width 380 of the second portion 370 of the extendable the rod 114 for adjusting the position of the thrust plate is less than the distance 376 between the opposite walls 372 and 374 of the edge 364, which allows you to trigger the trigger mechanism 122 without obstacles from the side of the second part 370.

When the trigger 122 is actuated, when the trigger 122 is turned in the direction 124, the opposite surfaces 294A and 294B of the upper end 294 of the trigger 122 move in the direction 392, abutting against the corresponding grooves 288 and 290 (see FIG. 3) of the trigger rod 282 , which causes the trigger rod 282 to also move in direction 392. This movement causes the end 384 of the trigger rod 282 to abut against the end 386 of the bracket ejector 156, which causes the bracket ejector 156 to also move in the direction 392. During casting The brackets ejector 156 movement of the brackets ejector 156 pushes the brackets 104 (see Figs. 7 and 31) from the ring magazine 148 (see Figs. 4,5, 7 and 31), and the annular blade 126 connected to the brackets ejector 156, as described earlier, cuts off a piece of tissue (see Fig. 31).

Thus, the locking mechanism 352 automatically prevents accidental actuation of the trigger mechanism 122 and the corresponding ejector brackets 156, and therefore, the stitching of the fabric with brackets 104 (see Figs. 7 and 31), and the user of the circular stapling tool does not have to manually activate the locking mechanism . In addition, the locking mechanism 352 automatically locks the trigger 122, the corresponding ejector brackets 156 and brackets 104 (see Fig. 7 and 31) in the position before suturing, when the system of the thrust plate 112 is in the open position, and automatically unlocks the trigger 112 and a corresponding bracket ejector 156 with brackets 104 (see FIGS. 7 and 31) when the thrust plate system 112 is in the closed position. The locking mechanism 352 acts in this way regardless of the number of openings and closures of the thrust plate system 112 or the triggering of the trigger mechanism 122 and the corresponding ejector brackets 156 with brackets 104 (see FIGS. 7 and 31).

In FIG. 47A shows another embodiment of the invention, the circular stapling tool of FIG. 1, with another locking mechanism 352A preventing the pusher of the brackets 156 from moving when the cartridge unit 108 (see FIG. 2) is attached to the handle 116 (see FIG. 2) and the thrust plate 210 is in the open position. Under these conditions, when the thrust plate 210 is in the open position, the portion 114E of the rod 114 for adjusting the position of the thrust plate adjacent to the flexible locking elements 178 has a size, width or diameter 401 (see FIG. 3B) less than the width or diameter 196A of the hole of the round inner shaft 194 of the ejector brackets 156, but close enough in size to it, so the distance 400 to the flexible locking elements 178 between the rod portion 114E for adjusting the position of the thrust plate 114 and the surface of the inner hole 196B is insufficient for deflection and disengagement with the locking protrusions 180, which, in turn, impedes the movement and actuation of the ejector brackets 156. As shown in FIG. 48B, when the abutment plate 210 is in a close to closed position, the narrower portion 114F of the rod 114 for adjusting the position of the abutment plate adjacent to the flexible retainer elements 178 has a size, width or diameter 402 (see FIG. 3A) that is smaller, than the width or diameter 196A of the hole 196 of the round inner shaft 194 of the ejector brackets 156, so that the flexible locking elements 178 have a sufficient distance 400 between the portion 114F of the rod to adjust the thrust plate 114 and the surface of the inner hole 196B for deflection and disengagement with retaining protrusions 180, which, in turn, allows movement and actuation of the ejector brackets 156.

An abstract of the invention is provided in order to enable the reader to quickly become familiar with the nature of the technical invention. It is provided with the understanding that it will not be used for interpretation and will not limit the scope of the patent application. In addition, in the foregoing detailed description, it can be seen that various characteristics are grouped together in various embodiments of the invention in order to simplify the description of the invention. Such a disclosure method should not be understood in such a way that the claimed embodiments require more features than are expressly described in each application. Rather, as the following paragraphs reflect, the subject matter of the invention includes fewer characteristics than all the characteristics of one claimed embodiment. Thus, the following paragraphs are included in the detailed description, with each paragraph in itself describing a separate subject of the application. While various embodiments of the invention have been described, it will be apparent to those skilled in the art that other embodiments and implementations are possible within the scope of this disclosure. Accordingly, this disclosure should not be limited, with the exception of limitations in light of the foregoing paragraphs and their equivalents.

Claims (20)

1. A cassette with suture staples for a circular stapling instrument, including:
housing;
the ejector brackets, made with the possibility of placement inside the specified case and having a configuration that allows movement inside the case from its original position (before putting it into action) to the working position (after putting into action); and
a blade capable of attaching to said bracket ejector, wherein said blade includes a cutting edge and an element for securing the split washer for rigid attachment to the split washer when the bracket ejector moves from the position before being brought into the actuation position. 2. The cartridge with suture brackets according to claim 1, where the element for securing the split washer has at least one retaining tooth extending from the blade at an indirect angle to the cutting edge. 3. A cassette with suture brackets according to claim 2, wherein said indirect angle is from 30 to 60 degrees. 4. The cassette with suture brackets according to claim 2, wherein said at least one retaining tooth for the split washer moves away from the blade at a location near the cutting edge. 5. A circular stapling tool comprising the following components:
housing;
the ejector brackets located inside the specified case and moved from its original position (before putting into action) to the working position (after putting into action);
the block of the thrust plate containing a split washer attached to the surface of the base of the thrust plate, while the block of the thrust plate can move from the open position (away from the housing) to the closed position (adjacent to the housing); and
a blade attached to said bracket ejector, wherein said blade has an element for securing the split washer, wherein when the bracket ejector is in position before being actuated, the split washer is not separated by the blade and the split washer attachment member is not attached to the split washer, and when the bracket ejector is in the actuation position and the thrust plate assembly is in the closed position, the blade separates the split washer and the split washer fastener ikreplen to the separated portion of the split washer. 6. The circular stapling tool according to claim 5, wherein the element for securing the split washer comprises at least one retaining tooth extending from the blade at an indirect angle to the cutting edge of the blade. 7. The circular stapling tool according to claim 6, wherein said indirect angle is from 30 to 60 degrees. 8. The circular stapling tool according to claim 6, wherein said at least one retaining tooth for the split washer moves away from the blade at a location near the cutting edge. 9. The circular stapling tool according to claim 5, in which the split washer has a pair of walls separated from each other and a grid between them, while when the brackets are pushed into the actuating position and the thrust plate block is in the closed position, the blade cuts the grid, and the element to fix the split washer is rigidly attached to one of the divided walls. 10. The circular stapling tool according to claim 5, in which the split washer contains or is attached to another element that has a visual indicator indicating that the ejector brackets are activated. 11. The circular stapling instrument of claim 10, wherein the visual indicator comprises a first color different from the second color of the body of the circular stapling instrument. 12. The circular stapling tool of claim 5, wherein the split washer is attached to the protective element acting as a protective barrier above the edge of the blade when the split washer fixing member is rigidly attached to the split washer. 13. A method of securing a blade on a split washer of a circular stapling tool, including:
providing a circular stapling tool including a housing, a bracket ejector, movably placed in said housing, a thrust plate unit including a split washer attached to a base surface of the thrust plate, and a blade attached to the bracket ejector;
moving said thrust block assembly from an open position (away from the housing) to a closed position adjacent to the housing; and
moving the ejector of brackets from the position to the actuation in which the split washer is not cut by the blade and in which the element for fixing the washer on the blade is not attached to the washer, in the actuation position in which the blade cuts the washer and the element for fixing the washer on the blade rigidly attached to the separated part of the split washer. 14. The method according to p. 13, in which the element for securing the split washer contains at least one retaining tooth, extending from the blade at an indirect angle to the cutting edge. 15. The method according to p. 14, wherein said indirect angle is from 30 to 60 degrees. 16. The method according to p. 14, in which the split washer has a wall separated by a gap and a grid located between them and in which when the bracket ejector moves to the actuation position and the thrust plate block in the closed position, the blade cuts the grid and at least one said retainer the tooth for securing the split washer is rigidly attached to one of these separated walls of the washer. 17. The method according to p. 13, further comprising, after rigidly securing the detachable washer with an element for fixing on the blade, the interaction of the detachable washer with the housing to prevent the blade from retracting into the housing and its reuse created by the detachable washer. 18. The method according to p. 13, further comprising, after rigidly securing the detachable washer with an element for attaching to the blade or attaching the protective element to the detachable washer, creating a detachable washer of a protective barrier above the blade. 19. The method according to p. 13, further comprising, after rigidly securing the split washer with an element for fastening to the blade, visualizing the split washer or other element attached to the split washer, indicating that the bracket ejector has been activated. 20. The method according to p. 13, further comprising, after rigidly securing the detachable washer with an element for attaching to the blade, removing the recharged cartridge unit from the circular stapling tool, thereby removing the blade and the detachable washer, sterilizing the remaining part of the circular stapling tool and attaching to it an unused cassette recharge unit containing an unused blade and an unused split washer before reusing the circular stapling tool enta.

Images