SURGICAL CUTTING AND STAPLING METHODS Russian patent published in 2019 - IPC A61B17/68 A61B17/72 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medical equipment, specifically to surgical cutting and suturing tools and staples cartridges for them. Surgical method for treating a target tissue in a patient's body comprises the steps of: installing a hollow port for a trocar in the patient's body; providing a surgical end effector; insertion of a surgical end effector into a hollow port for the trocar such that the inner surface of the hollow port for the trocar is compressed by the upper branch into the insertion position, in which the upper branch is pressed to the compressible foam material layer on the lower branch to provide a surgical end effector with the least cross-sectional area, and wherein the upper branch remains in the insertion position until the surgical end effector extends from the distal end of the port for the trocar, after which the layer of compressible foam material moves the upper branch into the initial open position; applying driving motion to upper branch to move upper branch into fully open position; manipulating the end effector so that the target tissue is placed between the upper and lower branches; applying another drive motion to the upper branch to move the upper branch into a fully closed position; and application of start-up motion to the firing element in order to cause movement of the firing element from the initial position to the final position inside the end effector. Surgical end effector comprises an elongated shaft assembly, a lower branch, a top branch and a trigger element. Elongated stem assembly defines the longitudinal axis of the tool. Lower branch is connected functionally to the elongated shaft assembly. Lower branch comprises an elongated channel and a compressible foam layer. Elongated channel comprises base and wall extending upward from said base, wherein compressible foamed material layer extends along upper surface of elongated channel extending upwards. Upper branch is supported to move relative to lower branch when drive motions are applied thereto. Lower and upper branches form a cross-section along the plane passing through the branches and oriented perpendicular to the longitudinal axis of the instrument. Upper branch is configured to move between a first insertion position in which the upper branch is pressed against the compressible foam material layer on the lower branch to impart a cross-section shape to the end effector that has the smallest cross-sectional area provided by the lower branch and the upper branch, to facilitate passage of the surgical end effector through the hollow port for the trocar into the patient's body and the initial open position when driving motion is applied to it. Upper branch is configured to move into a completely open position for placing target tissue between upper and lower branches, and when applying another drive to upper branch, upper branch moves into fully closed position, wherein target fabric is clamped between upper and lower branches. Trigger element is functionally maintained for selective functional movement inside the surgical end effector when starting motion is applied to it. In a second embodiment, the surgical method for treating a target tissue in a patient's body comprises the steps of: moving the control insert to a first position; movement of the control insert to the second position to enable the compressible foam material layer to move the upper branch into the initial open position. Control insert functionally holds the section of the upper branch and is supported with possibility of selective movement in the lower branch for movement between the first position which corresponds to the insertion position and the second position corresponding to the main open position. In a third embodiment, a surgical method for treating a target tissue in a patient's body comprises: a functional connection of an elongate shaft assembly with a surgical end effector, wherein the elongated shaft assembly defines a longitudinal axis of the instrument and comprises a distal section of the closing tube, which is supported for axial movement relative to the upper branch to apply drive motions to it, wherein the distal portion of the closing tube comprises a biasing means for automatically shifting the upper branch into the main open position after the upper branch from the trocar port, wherein said displacing means comprises resilient foam material, wherein resilient foamed material extends along top surface of elongated channel extending upward. Surgical end effector comprises a lower branch including an elongated canal and a staple cassette.

EFFECT: inventions provide stapling tissue.

19 cl, 220 dwg