A CIRCULAR STAPLER HAVING A FOLDABLE ANVIL Technical Field

The present invention relates to circular staplers used as automatic suture-positioner in the digestive system surgical operations. The present invention especially relates to a foldable anvil cap ensuring quick and secure anastomosis in providing the continuation of the circular stapler digestive system.

Prior Art

Currently, the staplers are composed of two parts: a main body (handle) and an anvil attached to the end part of said body. Even said circular staplers which are available in the market make it possible to conduct quick and safe anastomosis, it is very limited for them to be used especially in laparoscopic surgery because of several shortcomings. The major shortcomings limiting the area of use in both open and laparoscopic surgery that:

1- A separate and large space is required to be formed on the bowel wall in order to locate the anvil into the bowel or stomach lumen that are going to be anastomosed,

2- lt is difficult and time-wasting to close the open end with shirring suture even if it is located through the open end of the bowel and the stomach (for instance locating into esophagus following total gastrectomy) in both open and laparoscopic surgery.

3- ln some cases (after esophagus surgery), the anvil is needed to reach the anastomosis line orally by being attached to the end of a catheter, as a result of which the microorganisms in the oral cavity and esophagus, spread into the abdomen, and thus the risk of infection increases.

Said applications cause difficulty of use and waste of time, and they limit the area of use. For example, it is not possible to use the available stapler anvils by attaching them onto the endoscope ends, and such an example of usage is not available. In the research conducted in relation with the prior art, an application numbered CN201782789 has been found. In this application, a trigger mechanism created on a main body, back-pull handle, a modular anvil, and an anvil cap are disclosed. The invention discloses a foldable and movable anvil cap which can pass from the horizontal position to the parallel position.

The Objects of the Present Invention In order to eliminate the disadvantages of the prior art, an object of the present invention is that the anvil cap can be folded onto itself by being divided into two and more parallel parts.

Another object of the present invention is that it can be made to go through a smaller space by reducing the surrounding area down to 1/2 and 1/3 of the diameter when it is open.

Another object of the present invention is that unlike the foldable anvil cap according to the invention numbered CN201782789, the anvil cap can be folded as multiple parts or foldable wings and it has a smaller diameter down to 1/2 and 1/3 when folded.

A further object of the present invention is that it can be produced in a detachable manner on the main body in a fixed or modular way (one-piece/modular), and go into the end that is going to be anastomosed through a small cut and conduct anastomosis by being opened n the shape of a shutter mechanism inside the lumen.

Another object of the present invention is that there is no need for a separate bigger cut to locate it inside the lumen.

A further object of the present invention is that it eliminates the need for locating the shirring suture in order to close the space that it goes into. A further object of the present invention is that it provides advantage in both open and laparoscopic interventions.

Another object of the present invention is to expand the area of use in laparoscopic surgery.

A further object of the present invention is to eliminate the need for anastomoses conducted by linear staplers and by locating sutures manually in laparoscopic surgery, and the difficulty of conducting manual anastomosis.

A further object of the present invention is to expand the laparoscopic surgery indications thanks to the ease of use of the stapler.

Another object of the present invention is to make it possible to apply various surgical interventions through the natural openings (NOTES - Naturel Orifice Transluminal Endoscopic Surgery) of the body by being mounted to the end parts of endoscopy systems (Gastroscope, colonoscope, sigmoidoscope).

So as to fulfill the above-mentioned objectives, the present invention relates to a foldable anvil providing secure anastomosis in circular staplers and comprising a main body and a clamping arm, punch section and a punch surface corresponding to that punch section configured on said main body; characterized in comprising an anvil cap comprising many foldable wings, a command wire connected with said wings, a wire wrap pulley directing said command wire, multiple hinges connecting the wings and providing the folding process.

Description of the Figures

Figure 1 is the general side view of the foldable anvil according to the present invention,

Figure 2 is the close-shot view of the detail a of the foldable anvil according to the present invention,

Figure 3 is the general top sectional view of the wings of the foldable anvil according to the present invention, Figure 4 is the detail B view of the wings of the foldable anvil according to the present invention.

Figure 5 is the two-dimensional general side view of the foldable anvil according to the present invention when it is in a closed position.

Figure 6 is the general perspective view of the foldable anvil according to the present invention when it is in a closed position.

Figure 7 is the view of the stretching steel wire of the foldable anvil according to the present invention together with the connection clip.

Figure 7.1 is the perspective view of the wings of the anvil cap when they are opened together with the hinges providing their opening movement.

Description of the Reference Numbers

Ref. No Ref. Name

1. Carrier shaft body

2. Movable shaft

2.1 Wire space

3. Intermediate wing

4. Protective element

5. Right wing 1

6. Left wing 1

7. Connection point

8. Command wire

A, B, C Wire ends

9. Punch surface

10. Withdrawing arm

11. Clamping arm

12. Pressure Control Section

13. Wire wrap pulley

14. Right wing 2

15. Left wing 2

16. Anvil cap

17. Hinge 18. Cartridge

19 Punch section

20. Blade mechanism

21. Foldable anvil

22. Wire crossing space

23. Connection end

24. Groove

25 Main body

26 Steel wire upper end connection points

27 Steel wire lower end connection points

28 Clips mechanism (with steel wire connection)

Detailed Description of the Invention

The present invention relates to a foldable anvil (21) providing secure anastomosis in circular staplers and comprising an anvil cap (16) comprising a main body (25), clamping arm (11) configured on said main body (25), punch section (19) and a punch surface (9) corresponding to said punch section (19); characterized in comprising an anvil cap (16) comprising multiple foldable wings (3,5,6,14,15), a command wire (8) connected with said wings (3,5,6,14,15), a wire wrap pulley (13) directing said command wire (8), multiple hinges (17) connecting said wings (3,5,6,14,15) and providing the folding process, a connection point (7) connecting the intermediate wing (3) to the movable shaft (2) by means of a hinge (17), grooves (24) configured on each wing (3,5,6,14,15) for the connection of said command wire (8), connection ends (23) to which the command wire (8) that is embedded in said grooves (24), is fixed, wire space (2.1) configured on said movable shaft (2) and a wire crossing space (22) configured at the center of said anvil cap (16).

The present invention is a foldable anvil (21) which makes it possible to conduct quick and secure anastomosis in providing the continuation of the digestive system of the circular staplers. In the art of foldable anvil (21), the anvil cap (16) according to the present invention is divided into two or more parts and these parts are connected to each other by means of hinges (17). In Figure 1 and 2, the general side view of the foldable anvil according to the present invention is shown. According to the figure, there is a shaft withdrawing arm (10) enabling the anvil to be approached to the stapler carrier shaft body (25), combined with the cartridge (18) and locked. There is shown a clamping arm (11) enabling the textures to be punched after the staples inside the cartridge (18) go out, and providing the excess of texture to be cut by operating the blade mechanism (20).

As it is seen again in Figure 1 , there is a pressure control section (12) so as to indicate the level of combination of the anvil according to the present invention with the cartridge (18). It comprises a pulley (13) around which the command wire (8) system that changes the position of the anvil cap (16) from parallel to vertical direction is collected and which opens the anvil wings (3,5,6,14,15) when they are in closed position.

In Figure 2, there is the detail A view of the foldable anvil according to the present invention. According to the figure, there is a carrier shaft body (1) carrying the anvil parts. The anvil according to the present invention has a movable shaft (2) enabling the stapler to be connected with the carrier shaft body (1) and providing the anvil to approach to the cartridge (18) part. The protective element (4) as a fixer is also shown in Figure 2. The protective element (4) is preferably made of a plastic-based substance.

A command wire (8) is used, which enables the anvil wings (3, 5, 6, 14, 15) to open and anvil cap (16) to change its position from parallel to vertical. The punch staples, on the other hand, are carried by the punch section (19).

In Figure 3, the general front view of the wings (3, 5, 6, 14, 15) of the foldable anvil according to the present invention is shown. In the figure, an intermediate wing (3) providing the anvil cap (16) to be closed like a shutter and the parts to be attached to the carrier shaft body (1); a right wing 1 (5) and a left wing 1 (6) and right wing 2 (14) and left wing 2 (15), which ensure folding are shown. In Figure 4, the detail B view of the wings (3, 5, 6, 14, 15) of the foldable anvil according to the present invention is shown. In this view, the connection point (7) is clearly shown. The divided anvil shown in Figure 1 is attached from the intermediate wing (3) connection point (7) to the movable shaft (2) by means of a hinge (17), and it is located onto the movable shaft (2) in a parallel way like a bayonet cap (see Figure 5). The parts (5, 6, 14, 15) located on both sides of the intermediate part (intermediate wing) (3) are wrapped around the movable shaft (2) like a shutter mechanism by being folded. The system to be configured in this way is made to proceed through a much narrower space than the width of the anvil when it is open, towards the bowel and stomach lumen.

After the anvil according to the present invention is made to proceed towards the lumen, a steel-based command wire (8) passing through the movable shaft (2) is used so as to open the closed shutter mechanism and to drop the anvil cap (16). After said command wire (8) according to the present invention is made to go through the wire crossing space (22) on the lower surface of the intermediate part (3), it is divided into three parts (A,B,C). One end of the wire (8) is attached to the connection end (23) corresponding to the carrier shaft body (1) of the intermediate main part (3) by passing through a groove (24) opened on the upper surface (See Figure 4). The other two ends of the wire (8) are made to proceed through a groove (24) similar to the side parts and the most outer wings (14, 15) are made to be attached from their middle parts. The foldable anvil (21) is in a folded position like a bayonet (see Figure 6).

The lower end connection points (27) on the carrier shaft body (1) are connected with the upper end connection points (26) on the movable shaft (2) by means of a clips mechanism (28).

A wire wrap pulley (13) to be configured on the middle part of said carrier shaft body (25), which can be hold manually, is combined with this steel command wire (8). Upon the pulley (13) is operated, the wire (8) is stretched. With the stretching process, the wire (8) will change the anvil from parallel position to a vertical position to the movable shaft (2), and then, as the stretching process continues, the side parts (5,6,14,15) are opened towards the outer part like a shutter mechanism. After the anvil cap (16) is opened entirely, the anvil is made to approach to the cartridge part (18) with the help of shaft withdrawing arm (10) on the main body (25), and the anastomosis process takes place after the clamping arm (11) is tightened.

In Figure 6, on the other hand, the general perspective view of the closed position of the foldable anvil (21) according to the present invention is shown. In this view, the anvil cap (16) of the foldable anvil (21) is folded like a bayonet by means of the wings (3,5,6,14,15), and a very small diameter is obtained. Therefore a much secure anastomosis can be performed with a much smaller diameter.