1. Field of the Invention
This invention relates to surgical stapling apparatus, and more particularly to surgical apparatus for performing sequential operations such as tissue clamping, staple forming and/or tissue cutting.
2. Description of Related Art
Surgical stapling apparatus is known wherein tissue is first grasped or clamped between opposing jaw structure and then fastened by means of fasteners. In some instruments a knife is provided to cut tissue which has been joined. The fasteners are typically in the form of surgical staples however, two part polymeric type fasteners are also known.
Instruments for this purpose can comprise two elongated members which are respectively used to capture or clamp tissue. Typically, one of the members carries a disposable cartridge housing wherein a. plurality of staples are arranged in at least two lateral rows while the other member defines an anvil for forming the staple legs into a hook-like configuration as they are driven against the anvil. The stapling operation is effected by a pusher which travels longitudinally along the cartridge carrying member, acting upon the staples so as to place them in lateral rows in the body tissue. A knife may be optionally positioned in such a manner so as to operate immediately behind the pusher, and laterally positioned between the staple rows to longitudinally cut and/or open the stapled tissue between the rows of staples. Such instruments are disclosed for example in Bobrov et al. (U.S. Pat. No. 3,079,606) and Green (U.S. Pat. No. 3,490,675). These instruments comprise apparatus for simultaneously making a longitudinal incision and applying a row of staples on both sides of the incision.
A later development disclosed in Green (U.S. Pat. No. 3,499,591) applies a double row of staples on each side of the incision. This is accomplished by a cartridge assembly having a cam member which moves within a guide path between two sets of staggered staple carrying grooves. Staple drive members are located within the grooves for being contacted by the longitudinally moving cam member as it is driven along the groove to effect ejection of the staples.
The instruments described above were all designed to be used in surgical procedures in which surgeons have direct manual access to the operation site. However, in endoscopic or laparoscopic procedures surgery is performed from a location remote from the operative site through a small incision or through narrow cannulae inserted through small entrance wounds in the skin. In order to address the specific needs of endoscopic and/or laparoscopic surgical procedures, an endoscopic surgical stapling apparatus such as that which is shown in Green et at. (U.S. Pat. No. 5,040,715) has been developed. This apparatus is well suited for such procedures and incorporates a distal end having an anvil and staple cartridge assembly and a manually operated handle assembly interconnected by an endoscopic portion which permits the instrument to be inserted into a cannula and be remotely operated by the surgeon.
Many of the instruments described above are limited in their range of operability. Improvements have been made in the art of surgical instruments to increase their range of operability. For example, Nierman (U.S. Pat. No. 4,880,015) discloses a biopsy forceps designed for use through a flexible fiberoptic bronchoscope. The biopsy forceps includes a handle connected to a thin elongated flexible shaft with a distal portion thereof hinged to the shaft. A grasping tool or biopsy forceps is attached to the distal hinged portion. Control wires extend from the handle through the distal portion to the shaft for controlling the angular rotation of the distal portion of the instrument to increase its range of operability.
In accordance with these and other principles, it is an object of the present invention to provide a surgical apparatus for driving surgical fasteners into body tissue which apparatus may be operated from a location remote from the surgical site.
It is another object of the present invention to provide a surgical apparatus insertable through a small incision or narrow tube for driving surgical fasteners into body tissue and cutting the body tissue between the rows of staples.
It is another object of the present invention to provide a surgical apparatus for driving surgical fasteners into body tissue which apparatus has an increased range of operability.
It is still another object of the present invention to provide a surgical apparatus having sealing structure for inhibiting the escape of insufflation gas through the apparatus.
Yet another object of the present invention to provide a surgical apparatus for driving staples which is adapted for mounting a replaceable cartridge assembly.