JP2009538684A - Surgical stapler with timer and feedback display - Google Patents

Abstract

The surgical device has a clamp and a stapling mechanism. The clamp has a first jaw and a second jaw and clamps body tissue at a desired location for stapling action. The stapling mechanism is controlled by a trigger handle or switch assembly. The surgical device has a controller that provides a delay between clamping and actuation of the firing mechanism of the stapling mechanism. The delay provides the desired time for tissue compression to produce a more uniform staple formation. The surgical instrument also has an indicator. The indicator provides feedback on the status of the stapling mechanism and also displays the time of tissue compression by the clamp.

Description

(Citation of related application)
This patent application claims priority to US Provisional Application No. 60 / 687,406, filed June 3, 2005, by Viola et al., Which is hereby incorporated by reference in its entirety. . This patent application also claims priority to US Provisional Application No. 60 / 687,244, filed June 3, 2005, by Viola et al., Which is incorporated herein by reference in its entirety. The This patent application is also a U.S. patent application filed by Viola et al. Filed concurrently with that patent application incorporated herein by reference in its entirety. (Attorney Docket No. H-US-00377 (203-4730)).

(Technical field)
The present disclosure relates to surgical instruments. More particularly, the present disclosure relates to a surgical stapling device having a feedback and timer device. Even more particularly, the present disclosure relates to a surgical stapling device having a controller that adjusts one or more parameters of the surgical stapling device and provides tissue compression. Even more particularly, the present disclosure relates to a surgical stapling device that may also include a sensory (ie, visual, audible, tactile) indicator that determines position, time, or other valuable user feedback. .

  Once placed under pressure from the surgical stapler jaw structure, such as a clamping device, the body tissue slowly compresses. Compression by the clamping device reduces the amount of blood and fluid to the clamped tissue. Without such compression, uncompressed body tissue remains thicker, but compressed body tissue becomes thinner and more compact. Compressing tissue also generally causes blood and other bodily fluids to cross from a high pressure or compressed area to another low pressure or adjacent area.

  Once released, body fluid returns from the adjacent area to the previously compressed tissue due to the viscoelastic properties of the tissue. Some current surgical stapling devices initially compress tissue prior to the introduction of staples into body tissue. The time at which the tissue is compressed is now left to the surgeon's discretion. The surgeon manually controls the time that the tissue is compressed prior to firing the staples into the tissue. Accordingly, it is desirable to have a surgical stapling device that always fires staples after a predetermined amount of compression.

  In accordance with a first embodiment of the present disclosure, a surgical stapler is provided having a handle assembly that includes a fixed handle and a pivotable handle that is installed for operation via an actuation stroke. In another embodiment, the stapler may have a trigger that is operable to manipulate the cam member via an actuation stroke. The stapler also has an elongate body extending distally from the handle assembly and defining a longitudinal axis, and a staple cartridge supported near the distal end of the elongate body and including a plurality of staples.

  The stapler further has an anvil positioned to pivot relative to the cartridge near the distal end of the elongate body, the anvil having a fastener-forming surface thereon and spaced far from the staple cartridge. Installed for pivotal movement relative to the cartridge between an open position having a leading edge and a closed position in close contact with and cooperating with the staple cartridge. The stapler also has an actuation sled that is supported in the cartridge. The actuation sled moves to push a plurality of staples from the cartridge.

  The stapler further includes a drive assembly that includes a body having a working end and a cam member supported on the working end. The cam member is arranged to move relative to the anvil so as to maintain the anvil in the closed position during stapler firing. A trigger or pivotable handle is operably connected to the drive assembly, and manipulation of the pivotable handle via the actuation stroke results in movement of the cam member relative to the anvil. The stapler also has a channel for supporting the staple cartridge and a controller configured to control the actuation sled supported within the staple cartridge. When the anvil is in the closed position and in an arrangement for cooperating with the staple cartridge, the controller delays movement of the actuation sled to push the plurality of staples out of the staple cartridge for a predetermined period of time.

  In accordance with another aspect of the present disclosure, a surgical stapler has a handle assembly that includes a fixed handle and a trigger configured to manipulate a cam member via an actuation stroke. The stapler also has an elongate body extending distally from the handle assembly and defining a longitudinal axis, and a staple cartridge supported near the distal end of the elongate body and having staples. The stapler further has an anvil positioned to pivot relative to the cartridge near the distal end of the elongated body. The anvil has a fastener-forming surface thereon and pivots with respect to the cartridge between an open position having a distal end spaced from the staple cartridge and a closed position in close contact with and cooperating with the staple cartridge. It is installed for dynamic movement.

  The stapler also has a working sled supported within the cartridge. The actuation sled moves to push the staples from the cartridge. The drive assembly includes a body having a working end and the cam member supported on the working end. The cam member is arranged to move relative to the anvil so as to maintain the anvil in the closed position during firing of the stapler.

  A trigger is connected to the drive assembly so that manipulation of the trigger via the actuation stroke results in movement of the cam member relative to the anvil. The stapler also has a channel for supporting the staple cartridge. The stapler also has a controller. The controller is configured to control the working sled supported within the staple cartridge. When the anvil is in the closed position and in an arrangement for cooperating with the staple cartridge, the controller delays movement of the actuation sled to push the plurality of staples out of the cartridge for a predetermined period of time. The surgical stapler also has an indicator connected to the controller. When the predetermined period is reached, the controller provides an indication by controlling the indicator.

  In accordance with another embodiment of the present disclosure, a method for stapling tissue is provided. The method includes positioning tissue between the staple cartridge and the anvil and compressing tissue between the staple cartridge and the anvil. The method also includes manipulating the actuator and firing staples from the staple cartridge. The actuator is configured to automatically delay firing the staple for a predetermined period of time. The predetermined time period is of a length suitable to allow tissue compression during the predetermined time period and to allow the tissue to move from a first initial state to a second compressed state. The method also includes pushing the staples from the staple cartridge through the tissue when the predetermined period has elapsed when the tissue is in the second compressed state.

  In accordance with another aspect of the present disclosure, the surgical stapler has a controller that places a delay between actuation of the firing mechanism component and actual firing of the staples.

  In accordance with another aspect of the present disclosure, the surgical stapler has a control device that controls the stroke, distance, and / or time parameters of the firing mechanism component to increase the tissue compression time of the clamp.

  In accordance with yet another aspect of the present disclosure, the surgical staple has a motor and a first switch. The first switch is connected to the motor and delays operation of the motor to achieve sufficient tissue compression by the clamp. The surgical stapler can have a second switch. The second switch senses another position of the drive screw, activates the reversal function of the motor, and returns the drive screw to the initial position.

  In yet another aspect of the present disclosure, the surgical stapler has an indicator that measures the travel distance of the drive screw or the tissue compression time of the clamp.

  In yet another aspect of the present disclosure, the surgical stapler has a visual indication that indicates the position of the firing mechanism component or indicates the status condition of the surgical stapling.

  In another embodiment of the present disclosure, a surgical stapler is provided. The stapler includes a handle assembly including a trigger, a staple cartridge including a plurality of staples, and a clamping device having an anvil having a fastener forming surface thereon. The stapler has a controller configured to determine the occurrence of clamping by the anvil and staple cartridge. The controller controls the firing of a plurality of staples from the staple cartridge. When the trigger is activated, the controller delays the firing of the plurality of staples from the staple cartridge and provides a predetermined tissue compression period of tissue between the anvil and the staple cartridge. When the predetermined period is reached, the controller outputs a control signal to enable firing.

  Other and further objects, advantages and features of the present disclosure will be understood by reference to the following specification, taken in conjunction with the accompanying drawings, in which like reference numbers indicate like elements of the structure.

  In the drawings and description below, the term “proximal” refers to the end of the device that is closest to the operator, as is conventional, and the term “distal” refers to the end of the device that is furthest from the operator.

  The present disclosure can be used with any stapler known in the art and is intended to achieve the same results, both in terms of both conventional and endoscopic procedures and devices. It is intended to be stated in However, the use herein of terms such as “endoscopic”, “endoscopically”, “endoscopic portion” and the like, inter alia, involves an endoscopic tube. It should not be considered as limiting the present disclosure to devices for use. The devices of the present disclosure include, but are not limited to, small incisions such as arthroscopic and / or laparoscopic procedures, or use where access is limited to other conventional medical procedures. Or find use in treatment in other uses. The mechanism can also be used with surgical stapling devices where the clamping and firing procedures are independent or combined. The present disclosure may further be incorporated into a surgical stapling device having a mechanism for performing clamping and firing simultaneously or separately. The present disclosure is also intended for use with such surgical stapling devices having discontinuous clamping gradients.

  Referring now to the drawings, wherein like reference numerals identify like elements of the subject disclosure, and in FIG. 1 are configured in accordance with the subject disclosure embodiment and are indicated generally by the reference numeral 10. Fig. 2 illustrates a self-contained electric surgical stapler. Surgical stapler 10 is generally intended to be disposable, but is not limited to a disposable device, and other devices that are not disposable are contemplated and may be within the scope of the present disclosure.

  The surgical stapler 10 of the present disclosure (shown in perspective in FIG. 1 and described herein) includes a frame that is generally represented by reference numeral 12 and a frame that is generally represented by reference numeral 14. Handle. The frame 12 defines a series of internal chambers or spaces for supporting various cooperating mechanical components of the surgical stapler 10 along with a number of staples for application to body tissue.

  Frame 12 supports portion 16, i.e., the elongated tubular portion. Portion 16 can be rotated and has a relatively small diameter in the range of about 10 millimeters, and is inserted into a small opening, or body, such as the abdominal cavity or other similar body cavity. It is intended for insertion into a tube. Portion 16 has a longitudinal axis and has a length suitable for reaching the surgical site within the body. The surgical staple 10 is used with other equipment, such as an endoscope or other optical device that visually inspects the interior of the body, for example, with a camera with a CCD device, an optical fiber, or other optical or recording device. Can be used.

  Generally, the portion 16 of the surgical staple 10 is inserted through a small opening or wound and moved to the surgical site. The present disclosure is intended to be used with any surgical stapler including, but not limited to, surgical staplers having simultaneous clamping and discontinuous clamping.

  Portion 16 has a clamping assembly, represented generically by reference numeral 18, and a cutting assembly (not shown) known in the art. The clamping assembly 18 and cutting assembly (not shown) are positioned within the housing 20, which holds the fasteners and selective cutting tools for the surgical site. The clamping assembly 18 in this particular embodiment has a jaw or staple cartridge 21 and a second jaw or anvil 22. The staple cartridge 21 and the anvil 22 can be co-located in close proximity to each other such that the jaws 21, 22 form a clamp therebetween. The jaws 21, 22 can be first and second jaws that open and close, or can be another different clamping type structure as is known in the art. The staple cartridge 21 can be positioned at the distal end of the housing 20 within the jaws 21, 22 themselves, or others as described in US Pat. No. 7,044,353 by Mastri et al. The patent is incorporated herein by reference in its entirety. The staple cartridge 21 has one or more rows of staples. Surgical stapler 10 also has an anvil (not shown) and may further include a selective knife (not shown) as is known in the art to achieve stapling. Closing the jaws 21, 22 using the staple cartridge 21 and the anvil 22 can be accomplished by pivoting the anvil 22 relative to the staple cartridge 21, or pivoting the staple cartridge 21 relative to the anvil 22, or the staple cartridge 21. It is understood that this can be achieved by pivoting both the anvil 22 and the anvil 22 relative to each other.

  In general, actuation of the working portion of the clamping assembly 18 may be accomplished by an intermediate component disposed on or within the narrow longitudinally extending tubular portion 16. In one non-limiting example, a cylindrical tubular sleeve member surrounds portion 16. The sleeve can be moved in the longitudinal axis of the surgical stapling device. The sleeve slides over the anvil 22 to close the jaws 21, 22, which are biased open by a biasing device (not shown) to achieve clamping. Although the surgical staple 10 of the present disclosure has three basic operations or functions, the present disclosure includes, but is not limited to, simultaneous clamping (ie, simultaneous clamping and firing of staples) and single clamping. It is intended to be used with any surgical stapler including a surgical stapler having a ping (ie, clamping prior to staple firing).

  First, the portion 16 is introduced into the human or animal body and placed with the jaws 21, 22 aligned with the desired stapling site to receive the target tissue. This may be a part of the body, either by rotating the surgical staple 10 as a whole, or simply by rotating the part 16 relative to the frame 12, or by a combination of both movements. 16 rotations may be included. Next (ie, second), the surgical stapler 10 secures the target body tissue between the staple cartridge or jaw 21 and the anvil 22 at the distal end of the housing 20. This is achieved by the clamping action of the jaws 21, 22 or alternatively by another similar or different clamping member.

  The jaws 21, 22 are allowed to remain in the closed position for a desired period of time, depending on the particular tissue. By configuring the jaws 21, 22 to remain closed for a predetermined period of time, any excess fluid or fluid in the tissue can be drained from the body tissue prior to actuation of the stapling cartridge 21. . This ensures that, after firing, liquid will flow outward from the tissue and will not form non-uniform staples, but instead will ensure proper and uniform staple formation.

  With the target tissue clamping between the anvil 22 and the cartridge 21, the cam surface surrounding the housing 20 and the anvil 22 closes the jaws 21, 22 of the surgical staple 10, and the anvil 22 and the staple cartridge 21 Used to clamp tissue between tissue contacting surfaces. The jaws 21, 22 are clamped by actuation of a lever 24 opposite the jaws 21, 22 as is known in the art. Thereafter, the surgeon applies staples to the body tissue. The longitudinally extending channel is used to provide longitudinal movement to an axial drive member and tissue cutting knife as is known in the art.

  The shaft drive member or shaft drive screw contacts the pusher element. The pusher element drives the staples through the body tissue toward the fastener or anvil forming surface as described herein. In general, in the art, surgical stapler 10 is typically fired by actuation of a first trigger handle or alternatively using trigger switch 26. Thereafter, the clamping action of the jaws 21, 22 is released and the surgical stapler 10 or a portion thereof can be withdrawn from the body.

  Referring now to FIG. 2, a block diagram of the surgical stapler 10 of the present disclosure is shown. In accordance with the first aspect of the present disclosure, the surgical stapler 10 may have an optional controller 28. The controller 28 can be any electronic device coupled to the memory to execute one or more readable program instructions, or alternatively can be a suitable analog circuit. Still further, the controller 28 may be a suitable mechanical member or interlocking device for controlling one or more functions of the surgical staple 10.

  The controller 28 is connected to an internal or external power source and a motor, and is connected between the anvil 22 and the staple cartridge 21. In an alternative embodiment, the trigger handle or another actuation switch or component 26 is mechanically or electronically coupled, or as shown in dotted lines as is known in the art, a staple cartridge However, the present disclosure is not intended to be limited to any configuration. Once the stapling cartridge 21 is fired using the trigger switch 26, the jaws 21, 22 are opened and the firing mechanism is retracted. Surgical staple 10 can generally be withdrawn from body tissue or moved for the next or second stapling operation as shown.

  The surgical stapler 10 has a controller 28 that is connected to one of the jaw or anvil 21 or the jaw or staple cartridge 21 and a trigger switch 26, or of the jaws 21, 22. Both are connected to the trigger switch 26. In one embodiment, once the desired site is reached, the surgeon uses the jaws 21, 22 to compress the selected body tissue. Alternatively, the surgical staple 10 may have a single drive component that can drive both the anvil 22 and the stapling cartridge 21.

  Thereafter, the controller 28 may provide the necessary amount of delay between clamping and firing (or after clamping and before firing) to ensure tissue compression and fluid drainage. Make things. When the desired compression is achieved, the staple cartridge 21 can be automatically engaged by the controller 28 to fire staples from the staple cartridge 21 into body tissue, or alternatively, the controller 28 Being able to send a signal to the surgeon tells the surgeon the suggestion that the surgeon should fire staples. It is envisioned that firing can be automatic or manual.

  Further, the controller 28 may control the rate at which staples are fired from the staple cartridge 21. Still further, the controller 28 may control the amount of delay before firing. The controller 28 in one embodiment may provide a predetermined period of time that elapses prior to outputting a signal to the staple cartridge 21. In another powered staple embodiment, the controller 28 can reduce the speed of the motor, thereby increasing the compression time of the body tissue.

  In yet another embodiment, the controller 28 may engage the buffer device 30. The cushioning device 30 is configured to delay actuation of the staple cartridge 21 to increase the total compression time of the body tissue. Such dampening device 30 can be a hydraulic or pneumatic type dampener or any other device that can damp or regulate the operation of one or more components of surgical stapler 10. In another embodiment, the trigger 26 may simply hold the firing signal for a predetermined period of time in the associated control circuitry and signal the staple cartridge 21 upon expiration of the predetermined period.

  The controller 28 slows down the motor, adjusts the gear, and further engages the motor network to slow down or operate the motor, i.e., reduce the rate of rotation of the shaft drive screw. Can be configured. Still further, the surgical stapler 10 may also include a control stop switch 32. The control stop switch 32 is an automatic or manual device (or other switch) that selectively releases the controller 28 and causes any delay at the discretion of the surgeon. Instead, the trigger switch 26 enables direct operation of the staple cartridge 21.

  In one aspect of the present disclosure, the surgical stapler 10 includes jaws 21, 22 that compress tissue between the anvil 130 and the stapler cartridge 132 of the stapling cartridge 21 (FIG. 2B). . As shown in FIG. 2B, as a device that allows the surgeon to move and compress tissue between the anvil 130 and the staple cartridge 132 prior to pushing the staples 158 from the staple cartridge 132. The jaws 21, 22 are understood in the art. The jaws 21, 22 can be powered independently by a power source, such as a motor or pneumatic device, or can be powered by the same power source as the staple cartridge 21. The surgical stapler 10 uses the jaws 21, 22 to clamp tissue between the stapler cartridge 132 and the anvil 130 (FIG. 2b), and the jaws 21, 22 are further tightened when the stapler 10 is fired. As a result, the staple 158 is pushed out of the stapling cartridge 21.

  In one aspect, the surgical stapler 10 can use the jaws 21, 22 during the first interval to pre-clamp or compress the tissue. The first time interval may be preset and fixed, or may be variable according to the tissue type. The first interval may be a few minutes, a few seconds, or any other variable or fixed predetermined period. Next, prior to stapling, the jaws 21, 22 can be further clamped, compressing and firing the tissue during an additional compression time interval of several seconds. The second time interval may be different from the first time interval and may be shorter or longer than the first time interval. In another aspect, the instrument can use the jaws 21, 22 to pre-clamp or compress the tissue, then simply fire the device automatically and at the end of the first interval, the staple cartridge The staple 158 is pushed out from 132. Various configurations are possible, and the surgical stapler 10 may have program instructions for any number of compression intervals desired by the surgeon and / or designer. Surgical stapler 10 may alternatively use a second separate clamping device that cooperates with stapler 10. The present disclosure is incorporated into a device that joins tissue prior to firing, such as TA surgical staples such as US Patent No. 6,817,508 by Racinet et al., Which is hereby incorporated by reference in its entirety. It is understood that it can be used or used with equipment that does not require such bonding prior to launch.

  In another embodiment of the present disclosure, the surgical stapling device 10 may provide feedback to the surgeon via the indicator 36. Indicator 36 may display the compression time and / or provide feedback on the status of stapling, or may display information regarding the position of the drive screw or drive member. In another embodiment of the present disclosure, the surgical stapler 10 may not have a discontinuous clamping and firing actuator and includes a clamping gradient indicator 36 or a mechanism that directs clamping and firing simultaneously. obtain. For example, the surgical stapler 10 can be configured to allow control of firing rate, which in turn controls the clamping rate and timing, and then squeezes the tissue to tissue at the desired site. Provides optimal compression to extrude blood and body fluids from

  FIG. 2A shows an exploded view of a number of components of the surgical stapler 10 of FIG. The stapler 10 includes a rack 100 that is slidable within the handle portion 14. The rack 100 interacts with the clamp tube 102. A channel 104 exists on the distal side of the clamp tube 102. Channel 104 engages clamp tube 102 and engages a pair of forks 106, 108 distal to the channel. The stapler 10 also includes an upper cover 110, a lower cover 112, and an extension tube 114. The extension tube 114 engages the color tube 116. The stapler 10 also has a rotation knob 118 with a channel portion 120. The channel portion 120 has a pair of cam surfaces 122 at the distal end. The distal end also receives the anvil 22 by having a crimp 124 distally.

  In operation, the rack 100 slides and moves the clamping tube 102 distally. A clamping tube 102 is provided to interconnect the handle portion 14 and the extension tube 114. The channel 104 is installed to slide for reciprocal longitudinal movement. The extension tube 114 provides support for the surgical stapler 10 and has a slot that interacts with the collar tube 116. The surgical staple 10 also has a support 120 for longitudinal movement and for operating a stapling mechanism as described in FIG. 2b. The operation of these components is well known and is disclosed in US Pat. No. 5,318,221 to Green et al., Which is hereby incorporated by reference in its entirety.

  Advantageously, the rack 100 moves in the distal direction and advances the channel 104 in the distal direction. For operation of the stapler cartridge 21 shown in FIG. 2b, the channel 104 provides longitudinal movement to the pusher cam bar as is known in the art. The components shown in FIG. 2a only illustrate one embodiment of the present surgical stapler 10, and instead of the rack 100, the surgical stapler 10 is for longitudinal movement and It should be understood that a drive screw (not shown) may be provided to operate the staple cartridge 21. Referring now to FIG. 2b, an exploded view of the anvil 22 and the stapler cartridge 132 having the actuation sled 169 is shown.

  Referring to FIG. 2b, the stapler cartridge 21 includes an anvil assembly 130 and a cartridge assembly 132 that are shown in exploded view for illustration purposes. Anvil assembly 130 includes an anvil portion 22 having a plurality of staple deforming indentations (not shown) and a cover plate 136 secured to the upper surface of the anvil portion 134 and defining a cavity (not shown). Cover plate 136 prevents tissue clamping during clamping and firing of surgical stapler 10. The cavity is sized to receive the distal end of the shaft drive assembly 138.

  The anvil 130 has a longitudinal slot 140 that extends the entire anvil portion 130 to facilitate passage of the retaining flange 142 of the shaft drive assembly 138 into the anvil slot 140. A cam surface 144 formed on the anvil 22 is positioned to engage the shaft drive assembly 138 to facilitate tissue clamping. A pair of pivot members 146 formed on the anvil member 130 are disposed in a slot 146 ′ formed in the carrier 148 to guide the anvil portion 130 between an open position and a clamped position. .

  The stapler 10 has a pair of stabilizing members 152 that engage the respective shoulders formed on the carrier 148 so that the anvil portion 30 moves relative to the staple cartridge 132 as the cam surface of the anvil member 130 is deformed. To prevent sliding in the axial direction. Cartridge assembly 132 includes a carrier 148 that defines an elongated support channel 154. The elongated support channel 154 is sized and configured to receive the staple cartridge 132 shown above the carrier 148 in the exploded view of FIG. 2b. Corresponding tabs, slots formed along the staple cartridge 132, and the elongated support channel 148 ′ function to hold the staple cartridge 132 within the support channel 154 of the carrier 148. A pair of support struts formed on the staple cartridge 132 are positioned to lean against the side wall of the carrier 148 to further stabilize the staple cartridge 132 within the support channel 154, but support the cartridge 132 on the channel 154. This arrangement is not limiting as other arrangements can be used.

  Staple cartridge 132 includes a retention slot 156 for receiving a plurality of fasteners 158 and pusher 160. A longitudinal slot 156 extends through the staple cartridge 132 to receive the upstanding cam wedge 162 of the actuation sled 164. A central longitudinal slot 166 extends along the long axis of the staple cartridge 132 to facilitate passage of a knife blade (not shown). During operation of the surgical stapler 10, the actuation sled 164 moves farther through the longitudinal slot 156 of the staple cartridge 132 so that the cam wedge 162 is advanced distally into sequential contact with the pusher 160. Driven laterally, pusher 160 moves vertically within slot 156 and pushes fastener 158 out of slot 156 into the staple deformation well of anvil assembly 130 to achieve tissue stapling.

  With reference to FIG. 3, the surgical stapler 10 may include an indicator 36, which may be any device known in the art for providing sensory feedback to the surgeon. Indicator 36 may be any device that allows visual, tactile, or audible monitoring of one or more states of surgical stapler 10. Indicator 36 may be disposed on outer surface 34 and may be disposed on handle 14. Alternatively, the indicator 36 is placed in the portion 16, trigger switch 26, lever 24, or any other suitable position where the indicator 36 can be easily viewed by the surgeon without changing the position by the surgeon. obtain.

  In one embodiment as shown, indicator 36 includes a number of light valves 38. The light 38 may be a single light or a series of multiple light valves or LEDs having a single color or two or more different colors. Each of the lights 38 may have a color that represents one or more states of the surgical stapler 10. Alternatively, one or all of the lights 36 can be illuminated to indicate the status of the surgical stapler 10.

  When actuated by the trigger switch 26, the surgical stapler 10 can communicate a delay before firing the staples. However, in order to provide appropriate feedback to the surgeon, for example, the light 38 provides a visual indication regarding the progress of firing of the staple cartridge 21. For example, with continued reference to FIG. 3, a first light 40, a second light 42, a third light 44, a fourth light 46, and a fifth light 48 are shown. As the shaft drive screw (not shown and present in the handle) moves along a predetermined drive path, the lights 40, 42, 46, and 48 light sequentially, indicating the relative distance of the drive screw outside the handle. As the lights 40, 42, 44, 46, and 48 shine, the stapling cartridge 21 fires, which ensures that proper tissue compression occurs prior to staple placement.

  Referring now to FIG. 4, in another exemplary embodiment of the present disclosure, the surgical stapler 10 includes a plurality of discontinuous segments: a first segment 52, a second segment 54, A linear indicator 50 having three segments 56, a fourth segment 58, and a fifth segment 60 is included. Again, once the trigger 26 is activated and the staple cartridge 21 is fired, the segments 52, 54, 56, 58, and 60 each shine in a predetermined pattern, indicating the progress of the drive screw with the handle 14 to the surgeon.

  When all of the segments 52, 54, 56, 58, and 60 are illuminated, the staple cartridge 21 has confirmation that the body tissue compression period has expired and fires staples into the body. The linear display 50 may have one or more different colors or color combinations to indicate the position of the drive screw. For example, “red” indicates a fire, “green” indicates a fire is complete, and vice versa. Still further, the linear display 50 can display one or more graphical displays, images, and photographs to indicate one or more status or operating parameters of the surgical stapler 10.

  For example, the linear display 50 may indicate “FIRE” or “COMPLETE” or any other graphical display to indicate that the surgical stapler 10 will fire in a predetermined time period. Various possible combinations are possible and all fall within the scope of the present disclosure.

  In yet another exemplary embodiment of the present disclosure shown in FIG. 5, the surgical stapler 10 may include a digital display 62. Digital display 62 may indicate a countdown or countup (or other time interval) after activation of trigger 26. For example, the digital display 62 may count down to a desired stapling time after compression to ensure compression of a predetermined amount of tissue by the jaws 21,22. The digital display 62 is actuated by the jaws 21, 22 and can be closely associated with each other or actuated separately from clamping. A desired clamping interval can be preset for the desired tissue.

  Alternatively, the digital display 62 may be selectively pre-set and input by the surgeon using an input device (not shown) or buttons. The surgeon may enter a clamping period on display 62. The display 62 then recommends firing at the end of the clamping period, or automatically fires after a predetermined clamping period (eg, about 10-45 seconds), Compression can be ensured. The digital display 62 is configured to count down from a predetermined clamping set time and can visually convey a signal to the controller 28. After receiving the signal, the controller 28 allows a desired period of clamping to elapse. When the set period ends, the controller 28 transmits a second signal and can operate the staple cartridge 21. Alternatively, the controller 28 may simply adjust the speed of the motor to begin operation at a speed suitable to operate the staple cartridge 21 at the end of the desired period. In yet another embodiment, the digital display 62 can be configured to begin counting after the start of tissue clamping and can be monitored by the surgeon by simply displaying the previous time since that point. Allowing the trigger switch 26 to be manually activated at the end of the desired period. Thereafter, the digital display 62 may simply display the compression time and the exact elapsed time to the surgeon or may illuminate. The device can provide a predetermined delay and then indicate that the device is ready to be manually fired, or alternatively the device can be delayed, then indicated and fired automatically It is understood.

  Referring now to FIG. 6, the surgical stapler 10 may alternatively have an analog display 64 disposed on the outer surface of the handle 14, which functions similarly to the digital display 62. The analog display 64 may have an audible alarm, or alternatively may have a luminescent light that indicates whether the appropriate compression period of the tissue has been reached or exceeded.

  Referring now to FIG. 7, there is shown a cross-sectional view of the surgical stapler handle 12 taken along section line 7-7 of FIG. In this embodiment, the surgical stapler 10 is an electric device and has a motor 66 having a drive mechanism. The drive mechanism is a drive output shaft 68. The shaft 68 is connected to the first gear 70. The first gear 70 is connected to the second gear 72, which in turn engages with the shaft drive screw 74. The motor 66 may be a device that drives one or more components of the surgical stapler 10.

  The drive screw 74 is a threaded rod having a number of helical grooves, and when compression is performed by the surgeon using the clamps or jaws 21, 22, the stapling cartridge 21 is moved away from the surgical stapler 10. The spiral groove is intended to rotate and come into contact with another member so as to operate in the position. The shaft drive screw 74 is engaged and arranged with teeth through the central lumen 76 of the second gear 72. The shaft drive screw can also be arranged offset from the second gear 72 or can be arranged in any other desired gear arrangement. As is known in the art, upon actuation of the motor 66, the shaft drive screw 74 rotates and engages the staple cartridge 21 by moving distally through the portion 16 of the surgical stapler 10. To do. Alternatively, the surgical stapler 10 may have a drive piston or plunger instead of the shaft drive screw 74, or may have a single drive mechanism, thereby allowing the anvil 22 and stapling cartridge 21 to Control both. Such mechanisms are well known in the art and include US Pat. No. 6,330,965 to Milliman et al., US Pat. No. 6,250,532 to Green et al., US Pat. No. 6,241,139 to Milliman et al. US Pat. No. 6,109,500 to Alli et al., US Pat. No. 6,202,914 to Geiste et al., US Pat. No. 6,032,849 to Mastri et al., And US Pat. No. 5,954 to Viola et al. 259, which is hereby incorporated by reference in its entirety.

  Surgical stapler 10 may include a first switch 80. Switch 80 is positioned in a fixed position on the handle as shown. The stapler 10 also has a second switch 82 disposed distally with respect to the first switch 80, which is far from the path of the drive screw 74 at the first starting position 78. Present at or near the place. Similarly, the second switch 82 at the second firing position 84 is disposed distally from the first starting position and is disposed near or near the path of the drive screw 74. Each of the first and second switches 80, 82 is a limit switch, but alternatively may be moved from the first position by a simple movement of the axial drive screw 74 across or near the respective limit switch. It can be any switch known in the art that switches or toggles between the two positions.

  Once the shaft drive screw 74 or a portion thereof has passed across the first switch 80, the first switch communicates a signal to the controller 28 via lead 86. As a result, the controller 28 illuminates the indicator 36 or a portion thereof with the lead 88 to indicate to the surgeon the first position of the axial drive screw 74.

  Thereafter, the drive screw 74 or a portion thereof traverses or contacts the second switch 82 at the second firing position 84. The second switch 82 is also a limit switch and transmits a second signal related to the position or firing of the stapler cartridge 21 to the controller 28 via the lead 90. Controller 28 then indicates to the surgeon that stapling is complete by illuminating indicator 36 (or another portion thereof) with lead 88. When the stapling is complete, the surgeon / operator begins withdrawing and the lead 92 reverses the direction of the motor 66. The motor 66 then reverses motion and returns the shaft drive screw 74 to the initial position 78 for the next stapling operation.

  Alternatively, upon receipt of the first signal from the first switch 80 by the lead 86, the controller 28 adjusts one or more operations of the surgical stapler 10. For example, in response to receiving the first signal, the controller 28 may control one or more parameters of the surgical stapler 10, such as the tissue gap, the speed of the motor 66, the shaft drive screw 74. Control stroke, shaft drive screw travel distance, shaft drive screw rotation rate, and any combination thereof.

  Referring now to FIG. 8, the surgeon may operate / engage the firing mechanism to operate the stapling cartridge 21. The firing mechanism operates the motor 66 shown in FIG. As the shaft drive screw 74 begins to rotate and passes past the switch 80, the drive screw 74 activates the first switch 80. The first switch 80 outputs a signal to the controller 28 via the lead 86. Controller 28 activates first light 40 by lead 92 in response to a signal from first switch 80. Surgical stapler 10 may further have a suitable structure for engaging a stop function. The stop function prevents the drive screw 74 from being overdriven.

  Thereafter, the axial drive screw 74 crosses a predetermined distance to ensure tissue compression by the clamps or jaws 21,22. The second switch 82 is activated and outputs a second signal to the controller 28 via the lead 90. In response to the second signal, the controller 28 causes the second light 42 to shine by the lead 94. The second light 42 indicates that the stapling cartridge 21 has fired. The second switch 82 may further signal the controller 28 to reverse or stop the movement of the motor 66 in that direction, or to return the shaft drive screw 74 to its initial position. The physician / operator can also manually reverse the direction of the motor 66. The third light 44 may shine to indicate to the physician that the shaft drive screw 74 has returned to the initial position 78.

  FIG. 8A illustrates another embodiment of the stapler. In the illustrated embodiment, the physician can operate / engage the firing mechanism to actuate the stapling cartridge 21. However, the first switch 80 'is in a different position than the embodiment shown in FIG. In this embodiment, the first switch 80 ′ is positioned directly below the lever 24 that is proximal to the handle 14. The switch 80 ′ in FIG. 8A engages a tab 24 ′ disposed on the lever 24. When lever 24 is actuated and driven toward handle 14, tab 24 ′ contacts switch 80 ′ and switch 80 ′ outputs a signal to controller 28 via lead 86. Next, the controller 28 activates the first light 40 by the lead 92 in response to a signal from the first switch 80.

  Thereafter, after the shaft drive screw 74 has crossed a predetermined distance to ensure compression of the tissue by the clamps or jaws 21, 22, the second switch 82 is activated and the lead 90 causes the second to the controller 28. The signal is output. Again, the controller 28 causes the second light 42 to shine by the lead 94 in response to the second signal. The second light 42 indicates that the stapling cartridge 21 has fired. The second switch 82 is actuated by the switch 80 'to further signal the controller 28 to reverse or stop the movement of the motor 66 in that direction or to return the shaft drive screw 74 to its initial position. It can be emitted. A third indicator 44 may be included to indicate to the surgeon that the shaft drive screw 74 has returned to the initial position 78.

  FIG. 8B shows another embodiment, in which the first switch 80 ″ is positioned in another position on the handle 14 and on the opposite distal side of the lever 24 near the pivot. Various configurations are possible and within the scope of the present invention, and the switch 80 ″ can be arranged in various configurations with respect to the lever 24.

  FIG. 9 shows a surgical stapler 10 having a lever 24. The lever 24 shown in the raised position controls the clamps 21, 22, but this arrangement is not limiting and another drive member, for example a motor 66 (FIG. 7), can be used for the clamp or jaw 21, 22 can be controlled. The lever 24 opens and closes the clamp jaws 21, 22 to compress body tissue prior to surgical stapling. Surgical stapler 10 further includes electrical contacts 96 of conductive members to complete a suitable analog or digital circuit. When the lever 24 is in the lowered position or when mated with the handle 14, the electrical contacts 96 are in the complementary nesting position of the lever 24. The lever 24 engages the electrical contact 96 when the lever 24 is lowered from a raised or elevated position to a lowered position or contacts the handle 14. When in the lowered position, the electrical contacts can complete the appropriate timer circuit of the display 62. In this embodiment, electrical contact 96 activates display 62. Display 62 may count from zero to a predetermined deadline, or may count down from an ideal predetermined tissue compression time interval. Once the displayed time has reached a predetermined time interval, an audible alarm 98 can make a sound. An audible alarm 98 indicates that the optimal tissue compression time has been reached and that the firing mechanism should be activated to fire the staples from the staple cartridge 21 and ensure uniform staple formation. Provide the surgeon with a cue about what is happening.

  FIG. 10 illustrates yet another embodiment, in which the clamp formed by the jaws 21, 22 is actuated by lowering the lever 24. At the same time, the timer circuit of the display 62 is activated by the electrical contact 96 on the lever 24. The indicator 36 may be a linear display 50 that displays a first color that prompts activation of the stapling mechanism 21 by a trigger switch or button 26. The display 50 can then display a second image, or it can flash the number of segments corresponding to the travel path of the axial drive screw 74 as shown in FIG. In operation, the second switch 82 outputs a signal to the controller 28. The controller 28 then stops the motor 66 and the controller outputs a control signal to the display 50 to display from the first color to another second color or from the first image to the second image. To indicate that the stapling cartridge 21 has fired. Optionally, the controller 28 may further sound an audible alarm 28 indicating that the staple cartridge 21 has fired. The alarm can be any sound or auditory pattern, including a buzzer, song, chirp, chime, or any combination thereof. Various indicator configurations are possible and within the scope of this disclosure.

  In yet another embodiment, the jaws 21, 22 can be actuated by lowering the lever 24. At the same time, the timer circuit of the display 62 is activated by the lever 24. Thereafter, the indicator 36 indicates a first instruction that prompts activation of the stapling cartridge 21 by activating the switch 26 after a desired period of time has elapsed. When the trigger switch 26 is activated, the controller 28 activates the motor 30. Next, the motor 30 moves the drive screw 74 as shown in FIG.

  As the axial drive screw 74 moves axially, the drive screw (or another plunger 100 connected to the drive screw as shown in FIG. 11) is in contact with the second member 102. The second member 102 can be any member that provides instructions to the surgeon by translating based on movement of the plunger 100 and can be detected or sensed by another device. The second member 102 can be a resistance strip, and as the plunger 100 or axial drive screw 74 traverses along the portion 16 (or other suitable moving surface location) of the surgical stapler 10, the resistance strip becomes the plunger. The resistance is changed along 100 moving surfaces 104. Resistor strip 102 is coupled to indicator 36 so that a change in resistance of resistor strip 102 selectively causes each of lights 40-48 to shine, resulting in shaft drive screw 74 or plunger 100 or other suitable The amount of movement by the drive member is notified.

  Alternatively, the resistor strip 102 can be coupled to another indicator, such as the linear display 50. Until the shaft drive screw activates the stapler cartridge 21, the display 50 flashes the number of segments 52, 54, 56, 58, and 60 corresponding to the movement of the shaft drive screw 74 or plunger 100. In operation, resistor strip 102 outputs a signal to controller 28, which adjusts the operation of motor 66 and indicates another second signal to indicate that stapling cartridge 21 has fired. Is transmitted to the display 50. In response, display 50 may display an appropriate graphical image, another color, a text message, or any other indication to indicate to the surgeon that firing of stapling cartridge 21 is complete. Various indicator configurations are possible and within the scope of this disclosure.

  Referring now to FIG. 12, in still another embodiment of the present disclosure, the surgical stapler 10 may further include a non-contact sensor 106. Non-contact sensor 106 is optional, but may be used by discoverer E.I. H. It can be a so-called “Hall-effect non-contact sensor” (or alternatively any other non-contact sensor) that relies in part on the physical principle of the Hall effect named after Hall.

  For example, the end 108 of the shaft screw 74 is directly connected to, interlocked with, or offset from the motor 74, and the cap-like free end 110 of the shaft screw 74 is connected to the stapler cartridge 21. By contacting, the staple cartridge is actuated and fired as described above. The free end 110 of the drive screw 74 has a magnetic member 112, which is connected to the free end and is not removed by rotation of the drive screw 74. Alternatively, the magnetic member 112 can be disk-shaped and simply connected to the free end 110. In some initial positions, the free end 110 and the magnetic member 112 are positioned very close to or near the non-contact sensor 106. In this initial posture, the magnetic member 112 is separated from the non-contact sensor 106 by a first distance “d”.

  Once the trigger switch or button 26 is actuated, the motor 66 is actuated and rotated to actuate the staple cartridge 21 by traversing the drive shaft screw 74 distally as described above. In the second position, after the motor 66 is activated, the magnetic member 112 moves and is separated from the non-contact sensor 106 by a second distance “d”. The second distance is an arbitrary distance greater than the first distance “d”. As the magnetic member 112 moves away from the non-contact sensor 106, the non-contact sensor positioned a second distance away from the magnetic field of the magnetic member 112 adjusts the operation of the motor 66.

  The term “adjustment” adjusts the amount of voltage received by the motor 66 in a dynamic manner, “stops” the motor at the desired stroke, changes the speed of the motor, reduces the drive gear of the motor, Defined as a reduction in shaft drive screw pitch, or a change in motor voltage or current input, or a change to another firing component, a change in motor component, and any combination thereof. This can therefore slow down the operation of the motor 66 and increase the compression period of the body tissue between the jaws 21,22. In another alternative embodiment, the magnetic member 112 may be disposed on a suitable drive piston instead of the drive screw 66. As the drive piston moves away from the non-contact sensor 106, a reduced or adjusted amount of power can be provided to the motor 66. In yet another alternative embodiment, the non-contact sensor 106 may be located at the free end 110 of the drive screw 74 and the magnetic member 112 may be fixed.

  In another embodiment of the present disclosure, the surgical stapler can have a compound drive mechanism. The compound drive mechanism may control both the firing component and the clamping mechanism of the stapling mechanism. When activated, the surgical stapler 10 uses a clamping mechanism to initiate and hold the clamping by advancing the drive mechanism and then provides a predetermined delay as it waits. The surgical stapler 10 then provides instructions to the surgeon / operator once the desired amount of compression has been reached. Thereafter, the surgeon / operator activates the drive mechanism after a time delay. The drive mechanism fires staples from the stapling cartridge 21 into the compressed tissue, ensuring uniform staple formation. Thus, the surgical stapler 10 provides a time delay prior to stapling to ensure tissue compression.

  Although shown as an endoscopic surgical stapler, the present drive system can be used with any surgical stapling device known in the art, eg, an endoscopic surgical stapling device, pneumatic It can be used in stapling devices, GIA surgical stapling devices, endoscopic GIA stapling devices, TA surgical stapling devices, and any other stapler device for surgery known in the art. The present disclosure may also be used with single drive surgical staplers that drive both clamping and stapling devices. The present disclosure can be incorporated into a device that joins and fires from a TA surgical stapling device, or a surgical stapler that does not use any such tissue joining.

  It should be understood that the above description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variations. The embodiments described with reference to the accompanying drawings are presented only to illustrate certain examples of the disclosure. Other elements, steps, methods and techniques not substantially different from those described above and / or in the appended claims are also intended to be within the scope of this disclosure. .

FIG. 1 is a perspective view of a first embodiment of a surgical stapler of the present disclosure. FIG. 2 is a block diagram of a number of components of the surgical stapler of FIG. 2A is an exploded view of the channel of the surgical stapler of FIG. 2B is an exploded view of the staple cartridge, anvil, and drive sled of FIG. FIG. 3 is a perspective view of another embodiment of the presently disclosed surgical stapler having a plurality of lights. FIG. 4 is a perspective view of yet another embodiment of a surgical stapler having a linear indicator or display. FIG. 5 is a perspective view of yet another embodiment of a surgical stapler having a digital indicator or display. FIG. 6 is a perspective view of yet another embodiment of a surgical stapler having an analog indicator or display. FIG. 7 is a cross-sectional view of the surgical staple of FIG. 3 taken along section line 7-7. FIG. 8 is another cross-sectional view of another embodiment of the presently disclosed surgical stapler having a stapler having a first switch and a second switch, taken along section line 7-7 of FIG. . FIG. 8A is another cross-sectional view of another embodiment of the stapler of FIG. 8 having a first switch that engages a tab on the lever. FIG. 8B is another cross-sectional view of yet another embodiment of the stapler of FIG. 8 having a first switch positioned in the distal direction of the lever. FIG. 9 is another perspective view of yet another embodiment of a surgical stapler having an audible alarm. FIG. 10 is another perspective view of another embodiment of a surgical stapler having a display showing images. FIG. 11 is a schematic / sectional partial view of the path of travel of a drive member through an endoscopic-like portion of a surgical stapler having resistor strips. FIG. 12 is a schematic view of another embodiment of a surgical stapler having a non-contact sensor.

Claims (41)

A surgical stapler,
a) a handle assembly including a fixed handle and a trigger configured to operate the cam member via an actuation stroke;
b) an elongated body extending distally from the handle assembly and defining a longitudinal axis;
c) a staple cartridge supported near the distal end of the elongate body and including a plurality of staples;
d) An anvil positioned to pivot relative to the cartridge near the distal end of the elongate body, the anvil having a fastener forming surface thereon and spaced from the staple cartridge. An anvil installed for pivotal movement relative to the staple cartridge between an open position having a distal end and a closed position in close contact with and cooperating with the staple cartridge;
e) an actuation sled supported within the staple cartridge, wherein the actuation sled is movable to extrude a plurality of staples from the staple cartridge;
f) A drive assembly including a body having a working end and the cam member supported on the working end, the cam member maintaining the anvil in the closed position during firing of the stapler. The pivotable handle is operatively connected to the drive assembly such that manipulation of the trigger results in movement of the cam member relative to the anvil. A drive assembly;
g) a channel for supporting the staple cartridge;
h) a controller configured to control the working sled supported within the staple cartridge when the anvil is in the closed position and in a cooperating arrangement with the staple cartridge; And a controller for delaying movement of the actuation sled to extrude a plurality of staples from the staple cartridge for a predetermined period of time.   When the anvil is in the closed position and in a cooperating arrangement with the staple cartridge, the predetermined period allows for tissue compression during the predetermined period, and the tissue is in a first state from a first initial state. The surgical stapler according to claim 1, wherein the surgical stapler is of a length suitable to allow transition to a compressed state of two.   And further comprising a buffering device, wherein the controller is configured to control the buffering device, and when the anvil is in the closed position and in a cooperating arrangement with the staple cartridge, the buffering device includes the buffering device The surgical stapler according to claim 1, wherein the movement of the working sled is adjusted for a predetermined period of time to compress tissue.   The surgical of claim 3, wherein the cushioning device slows the movement of the actuation sled to compress the tissue when the anvil is in the closed position and in a cooperating arrangement with the staple cartridge. Stapler.   The surgical stapler according to claim 3, wherein the cushioning device is a hydraulic device.   The surgical stapler according to claim 3, wherein the cushioning device is a pneumatic device.   A motor configured to control movement of the working sled, wherein the controller controls the motor to delay pushing of the plurality of staples from the cartridge to the tissue; The surgical stapler according to claim 1, wherein the delay allows for a predetermined compression period when is in the closed position and in a cooperating arrangement with the staple cartridge.   The surgical stapler according to claim 7, wherein the controller provides the delay to compress tissue by slowing the operation of the motor.   The surgical instrument of claim 8, further comprising a gear assembly, wherein the controller is configured to actuate the gear assembly to slow down the operation of the motor and provide the delay to compress the tissue. Stapler.   The surgical stapler according to claim 1, further comprising a control stop switch, the control stop switch being on the body and configured to decouple operation of the controller. A surgical stapler,
a) a handle assembly including a fixed handle and a trigger configured to operate the cam member;
b) an elongated body extending distally from the handle assembly and defining a longitudinal axis;
c) a staple cartridge supported near the distal end of the elongate body and including a plurality of staples;
d) An anvil positioned to pivot relative to the cartridge near the distal end of the elongate body, the anvil having a fastener forming surface thereon and spaced from the staple cartridge. An anvil installed for pivotal movement relative to the cartridge between an open position having a distal end and a closed position in close contact with and cooperating with the staple cartridge;
e) an actuation sled supported within the cartridge, the actuation sled being movable to extrude a plurality of staples from the cartridge;
f) A drive assembly including a body having a working end and the cam member supported on the working end, the cam member maintaining the anvil in the closed position during firing of the stapler. A drive assembly, wherein the trigger is operatively connected to the drive assembly such that operation of the trigger results in movement of the cam member relative to the anvil; and ,
g) a channel for supporting the staple cartridge;
h) a controller configured to control the working sled supported within the staple cartridge when the anvil is in the closed position and in a cooperating arrangement with the staple cartridge; A controller that delays movement of the working sled to extrude a plurality of staples from the staple cartridge for a predetermined period of time;
i) an indicator connected to the controller, the controller comprising: an indicator that provides an indication by controlling the indicator when the predetermined period is reached; .   The surgical stapler according to claim 11, wherein the indicator is a visual indicator.   The surgical stapler according to claim 11, wherein the indicator is an audible indicator.   The surgical stapler according to claim 11, wherein the indicator is a tactile indicator.   The predetermined period is an optimal compression time during which the tissue is compressed between the anvil in the closed position and the anvil in a co-operating arrangement with the staple cartridge prior to firing the plurality of staples. The surgical stapler according to claim 11, wherein   12. The predetermined period of time is a pre-set compression time during which the tissue exists between the anvil in the closed position and the anvil in an arrangement that cooperates with the staple cartridge. Surgical stapler.   12. The indicator of claim 11, wherein the indicator is a linear display having a plurality of segments, wherein the plurality of segments illuminate sequentially and substantially at least two segments illuminate to provide an indication that the predetermined period has been reached. The surgical stapler as described.   The surgical stapler according to claim 11, wherein the indicator is a linear display having a graphical display, the graphical display being arranged to provide an indication that the predetermined period has been reached.   The surgical stapler according to claim 11, wherein the indicator is a linear display having a graphical display, the graphical display being arranged to provide an indication of parameters relating to the stapler.   The surgical stapler according to claim 11, wherein the indicator comprises a timer configured to count from a first interval to a predetermined time period.   The controller is configured to automatically move the working sled supported within the cartridge upon reaching the predetermined period, the movement of the working sled pushing the plurality of staples from the cartridge. The surgical stapler according to claim 11.   The controller comprises a resistor strip, the controller is connected to the indicator, the drive assembly contacts the resistor strip during a firing stroke, and the contact between the resistor strip and the drive assembly Adjusts the resistance of the resistor strip during the stroke, the resistor strip is connected to the controller and is configured to output the resistance to the controller, the controller based on the output The surgical stapler of claim 11, wherein the surgical stapler adjusts one or more parameters of the stapler.   The surgical stapler according to claim 22, wherein the controller adjusts the indicator based on the output.   The surgical stapler according to claim 22, wherein the controller adjusts the drive assembly based on the output.   The surgical stapler according to claim 22, wherein the controller reduces the speed of the drive assembly based on the output.   The surgical stapler according to claim 22, further comprising a buffering device connected to the drive assembly, wherein the controller operates the buffering device based on the output.   A sensor, wherein the sensor detects at least one characteristic of the magnetic member and outputs the detected characteristic to the controller, the controller based on the output based on the output; The surgical stapler according to claim 11, wherein one or more parameters of the stapler are adjusted.   The surgical stapler according to claim 27, wherein the sensor is a Hall sensor.   The surgical stapler according to claim 27, wherein the sensor is a non-contact sensor.   28. The surgical stapler according to claim 27, wherein the controller adjusts a measured gap between the anvil and the staple cartridge based on the output.   28. The surgical stapler according to claim 27, wherein the controller adjusts movement of an actuation sled based on the output.   28. The surgical stapler according to claim 27, wherein the controller reduces the speed of the drive assembly in response to the output.   32. The surgical stapler according to claim 31, wherein the controller provides instructions in response to the output.   The drive assembly includes a pivotable handle in contact with a switch, the switch operably connected to a timer, the pivotable handle being operated through the actuation stroke, and the cam member relative to the anvil. When causing manual movement, the swivel handle touches the switch to activate the timer, the timer counts to a predetermined time interval, and when the timer reaches the predetermined time interval 12. The timer of claim 11, wherein the timer outputs a signal to the controller and upon receipt of the signal, the controller outputs a control signal to the indicator to provide an indication that the predetermined time interval has been reached. Surgical stapler. A method of stapling tissue,
Positioning the tissue between the staple cartridge and the anvil;
Compressing tissue between the staple cartridge and the anvil;
Manipulating an actuator to fire staples from the staple cartridge,
The actuator is configured to automatically delay firing the staple for a predetermined period of time;
The predetermined period is of a length suitable to permit tissue compression during the predetermined period and to allow the tissue to transition from a first initial state to a second compressed state; ,
Pushing the staples from the staple cartridge through the tissue after a predetermined period of time when the tissue is in a second compressed state. A surgical stapler,
A handle assembly including a trigger;
A clamping device having a staple cartridge containing a plurality of staples and an anvil having a fastener-forming surface thereon;
A controller configured to determine the occurrence of clamping by the anvil and the staple cartridge, the controller comprising: a controller for controlling firing of the plurality of staples from the staple cartridge;
When the trigger is activated, the controller delays firing of the plurality of staples from the staple cartridge, provides a predetermined tissue compression period of tissue between the anvil and the staple cartridge, The surgical stapler outputs a control signal to enable firing when the period of time is reached.   The surgical stapler according to claim 34, wherein the controller is operably connected to a drive member to push the plurality of staples out of the staple cartridge.   35. The surgical stapler according to claim 34, wherein the controller is operably connected to a motor to push the plurality of staples from the staple cartridge.   The surgical stapler according to claim 34, wherein the staple is automatically fired after the predetermined period of time.   The surgical stapler according to claim 34, wherein the staple is manually fired after the predetermined period of time.   35. The surgical stapler of claim 34, further comprising an indicator connected to the controller, the indicator indicating a signal to the surgeon after the predetermined period.

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