Circular stapling instruments with secondary cutting arrangements

[0001] The present invention relates generally to surgical staplers, and more particularly to devices for holding and / or protecting tissue adjacent to the stapler head of a circular stapler.

BACKGROUND OF THE INVENTION [0002] In certain types of surgical procedures, the use of surgical staples has become the preferred method for joining tissue and specially configured surgical staplers have been developed for such applications. For example, intra-cord or circular staplers have been developed for use in surgical procedures for the lower colon in which the lower colon portions are joined together after the affected part has been removed. Circular staplers useful in performing such procedures are disclosed, for example, in U.S. Patent Nos. 5,104,025, 5,205,459, 5,285,945 and 5,309,927.

[0003] Generally, a standard circular stapler typically consists of an elongated shaft that has a proximal actuating mechanism and a further stapler head mounted on an elongated shaft. The further stapler head usually consists of a mounted staple cartridge that accommodates a plurality of staples configured in a concentric circular arrangement. The circular cutting knife is mounted inside the cartridge concentrically with the staples for axial movement inside it. A movable trocar roller extends from the center of the cartridge in an axial direction, which is adapted to be detachably attached to the stitching anvil. The anvil is configured to form staple finishes when they are routed to it. The distance between the distal side of the staple cartridge and the staple anvil is usually controlled by a adjusting mechanism that is mounted on the proximal end of the stapler shaft to control the axial movement of the trocar. The tissue that is clamped between the staple cartridge and the staple anvil is simultaneously stapled and cut when the actuator is activated by the surgeon.

[0004] When performing a lower colon surgery using a circular stapler, a portion of the intestine can be laparoscopically stapled using a conventional surgical stapler that is inserted through the trocar. The traditional surgical stapler is used to place multiple rows of staples on each side of the affected part of the colon to be removed. The target or disease segment is simultaneously cut when the adjacent end of the intestine is stapled. After removal of the diseased section, the surgeon usually introduces an anvil of the circular stapling device to the distal end of the wire, away from the staple line. This can be accomplished by inserting the anvil head into the inlet opening cut out at the distal end of the conductor by the surgeon. The bottom staple line is used to place the colon tissue on a circular cartridge. Such a method makes it possible to seal both ends of the colon exclusively to cut and remove the sealed parts. The staple lines used in this intermediate step are only temporary and facilitate the next step of the procedure.

[0005] In certain situations the anvil can be arranged transanally by placing the anvil head at the distal end of the stapler and inserting the tool through the rectum. When the anvil has been installed in the distal part of the intestine, the intestine is secured around the anvil shaft, which is referred to as the "slipper" seam. The proximal part of the intestine is similarly attached around the stapler head by means of a slit seam.

[0006] When the ends of the intestine are secured around their respective components, the surgeon may use a gripping device to engage the anvil shaft and attach it to a part of the trocar protruding inside the stapler head through a suitable trocar sleeve. The surgeon then closes the space between the anvil and the cartridge, thereby clamping the proximal and distal end of the intestine in this space. The surgeon then actuates the stapler, causing several rows of staples to be inserted through both ends of the intestine and formed, thereby joining the ends and forming a tube passage. At the same time, when the staples are inserted and formed, the concentric annular blade of the knife is inserted through the endings of the intestinal tissue, cutting the ends adjacent to the inner row of staples.

[0007] Such procedures and devices require the surgeon to install two slit stitches, which extends the time required to complete the surgical procedure. In addition, such procedures can sometimes cause "wrinkling" of the tissue during the tissue cutting / stitching process.

[0008] Various attempts have been made to place the colon and other tissues around the suturing apparatus. For example, US patents numbered 5,309,927; 6,117,148 and 7,094,247 disclose different configurations that substantially utilize fasteners, lashing elements, rings, springs and the like that are outside the stapling device itself for positioning the tissue in place. US Patent No. 5,669,918 discloses a mechanism that uses a gripper, such as an arm, to frictionally block tissue on the trocar handle. Although such a device is substantially independent, the gripper arms ultimately may not be able to effectively hold the tissue in place.

[0009] As a result, there is a need for devices to reduce the time required to complete the procedure and to solve other disadvantages and problems associated with placing tissue in place while using the circular stapler configuration.

[0010] The above discussion is intended to show only some of the disadvantages of the current solutions known in the art and should not be regarded as incompatible with the scope of the invention.

SUMMARY OF THE INVENTION [0011] According to a general aspect of the various non-limiting embodiments of the present invention, there is provided a surgical instrument that includes an elongated shaft that defines a central axis and has a distal end portion that is configured to functionally insert a circular staple cartridge therein. The tissue collection roller is rotatably placed within the elongated shaft. The tissue acquisition roller has a distal end portion which projects further away from the distal end portion of the elongated shaft. At least one tissue removal element is pivotally connected to the distal end portion of the tissue removal roller in a manner such that that each tissue retrieval element can selectively rotate from the retracted position to the positions deployed when an arranging motion is applied to it. The rotating cutting element is positioned in the vicinity of the tissue removal means and rotates selectively around the central axis when an actuating cutting motion is applied to it.

[0012] According to a further general aspect of the various non-limiting embodiments of the present invention, a surgical instrument is provided that comprises a handle assembly that has an elongated shaft extending therefrom. The longitudinal shaft determines the central axis and ends in the stapler head. In various non-limiting embodiments, the staple head includes a circular staple cartridge that has a surface of the attachment member and an axially movable cutting element operably disposed therein. The surgical instrument further comprises a triggering element that is operably disposed in the elongated shaft and is arranged to apply a triggering movement to the circular staple cartridge. The anvil shaft assembly is positioned functionally within the elongated shaft and can be configured to receive actuation movements from the handle assembly to cause axial movement of the anvil shaft assembly within the elongation shaft such that its distal engagement portion moves axially with respect to the mounting element surface. The anvil can be attached with the possibility of removing the anvil shaft assembly to the distal part. The tissue removal roller is rotatably mounted within the elongated shaft. Many tissue retrieval elements are pivotally connected to the distal end portion of the tissue removal roller and can selectively rotate from the retracted position to the positions deployed when applying the arranging motion to them.

[0013] According to a further general aspect, a surgical procedure is provided for conducting a circular union of the pipe-shaped body. The surgical procedure involves inserting the surgical stapler head into a pipe-shaped body in the vicinity of its target portion. The staple head retains the staple cartridge inside. The staple cartridge has a further surface. The procedure further comprises taking up the proximal portion of the pipe body that is adjacent to the target portion using a plurality of tissue removal elements of the surgical instrument. The procedure also includes retaining the proximal portion of the pipe-shaped body adjacent the distal surface of the staple cartridge and rotating the target portion of the pipe-shaped body from the proximal portion. In addition, in combination with various non-limiting embodiments, the procedure includes cutting off the target portion of the tube body from a distal portion of the pipe body and inserting the anvil to a distal portion of the tubing in such a way that the anvil junction protrudes beyond the open end of the distal portion of the body having the tube. form of a pipe. The procedure further includes attaching a distal portion of the anvil tube and connecting the anvil to the surgical instrument. The procedure further comprises drawing the anvil in a proximal direction to the stapler head in such a way that the proximal end of the distal portion of the pipe-shaped body and the proximal portion of the pipe-like body are adjacent to each other and gripped between the anvil and the surface of the fastener, and stapling the proximal end. the distal portion and the proximal portion being positioned together to form the treated tubular body. The procedure further includes cutting the proximal end of the distal portion and keeping the proximal portion adjacent to the staples. and stitching the proximal end of the distal portion and the proximal portion to itself to form the treated tubular body. The procedure further includes cutting the proximal end of the distal portion and keeping the proximal portion adjacent to the staples. and stitching the proximal end of the distal portion and the proximal portion to itself to form the treated tubular body. The procedure further includes cutting the proximal end of the distal portion and keeping the proximal portion adjacent to the staples.

BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings, which are incorporated and form a part of the present description, illustrate embodiments of the invention and together with the general description of the invention given above and the detailed description of the embodiment below serve to explain the principles of the present invention.

Fig. 1 is a perspective view of a circular stapling device in accordance with various non-limiting embodiments of the present invention.

Fig. 2 is a sectional view of a distal portion of the longitudinal shaft of the stapling apparatus of Fig. 1 inserted into a proximal portion of a tubular body, such as a colon.

Fig. 2a shows an end view of an elongated shaft.

Fig. 3 shows an exploded view of a distal end portion of the tissue acquisition roll, the dispensing roll and the knife shaft according to various non-limiting embodiments of the present invention.

Fig. 4 is a partial perspective view of the tissue removal roll of Fig. 3 with its tissue arms in a retracted position.

Fig. 5 shows a perspective view of the pickup roller of Fig. 4 with its tissue arms in an deployed position.

Fig. 6 shows a sectional view of a distal portion of the longitudinal shaft of the surgical instrument of Fig. 1 inserted into the proximal part of the colon with the anvil assembly removed therefrom.

Fig. 7 shows a sectional view of the distal end portion of the elongated shaft with the tissue removal arms disposed in the proximal portion of the colon.

Fig. 8 shows a cross-sectional view of a distal end portion of a longitudinal shaft along lines 45-45 in Fig. 7.

Fig. 9 shows another sectional view of the distal end portion of the elongated shaft after the tissue extraction arms have been placed in the proximal portion of the colon and then moved to the retracted position in which the punctured proximal part is grasped between the tissue extraction arms and the tissue removal roller .

Fig. 10 shows a section view of the distal portion of the longitudinal roller of Fig. 9 along lines 47-47 in Fig. 9.

Fig. 11 shows a sectional view of a distal end portion of a longitudinal shaft with a diseased portion of the colon removed from the proximal part and distal portion and removed from the colon by means of conventional grippers.

Fig. 12 shows a cross-sectional view of the elongated shaft after the anvil has been inserted into the distal part of the colon and attached to it by means of a slit seam.

Fig. 13 shows a cross-sectional view of the elongated shaft of Fig. 12 after the anvil has been connected to the anvil assembly and pulled to an opposite position with the staple cartridge present therein.

Fig. 14 shows a cross-sectional view of the elongated shaft of Fig. 13 after the staple cartridge has been released and the annular cutting element protruded by the parts of the stitched tissue.

Fig. 15 is a cross-sectional view of the elongated shaft of Fig. 14 withdrawn from the colon after completion of the stitching procedure.

Fig. 16 is a view of the open abdominal cavity of the patient illustrating different tissues and structures adjacent to the colon portion.

Fig. 17 shows a further partial view of the open abdominal cavity of Fig. 16.

Fig. 18 shows a further view of the abdominal cavity of Fig. 16 illustrating the insertion of the trocar into the abdominal cavity to provide an embodiment of the protective cover of the present invention.

Fig. 19 shows a further view of the abdominal cavity of Fig. 18 with the form of a protective cover withdrawn from the trocar bushing by a conventional gripping device.

Fig. 20 shows a further view of the abdominal cavity of Fig. 19 illustrating a method of disposing a protective sheath around a circumference of a portion of the colon to be treated.

Surgical END6739USNP / 100063;

Fig. 21 shows a further view of the abdominal cavity of Figs.

after the protective cover has been placed around the circumference of the outer part of the colon to be treated.

DETAILED DESCRIPTION Applicant of the present application also has US patent applications indicated below, which were filed on the same day as this application: US Patent Application No. 12/844697, entitled "Surgical Circular Stapler With Tissue Retention Arrangements", identification number END6741USNP / 100065; US Patent Application No. 12/846964, entitled "Tissue Acquisition Arrangements and Methods For Stapling Devices", U.S. Patent Application Number Nos. 12/8446956, entitled "Transwall Visualization Arrangements and Methods For Surgical Circular Staplers", identification number END6738USNP / 100062 and U.S. Patent Application No. 12/846952,

[0016] Certain exemplary embodiments will now be described to provide a complete understanding of the principles of construction, functionality, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are shown in the attached drawings. Those skilled in the art will be aware that the devices described in detail herein and in the accompanying drawings are non-limiting of the scope of the invention, its exemplary embodiments, wherein the scope of the various embodiments of the present invention is determined solely by the claims.

[0017] The terms "proximal" and "distal" are used herein to refer to a practitioner operating a part of a surgical device holder. The term "proximal" refers to the part closest to the doctor, and the term "further" refers to the part located away from the doctor. Furthermore, it should be noted that for convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" may be used herein in connection with the drawings. However, surgical instruments are used in many directions and positions, and these terms are not limiting and / or absolute.

[0018] Fig. 1 shows a further circular stapler 900 in accordance with various non-limiting embodiments of the invention. The circular stapler 900 generally comprises a handle assembly 912 that has an elongate shaft 914 extending therefrom. The elongated shaft 914 can define an central axis AA. As can be seen in FIG. 1, the longitudinal roller 914 includes a rigid outer cover 916 that has a stapler head 920 at its distal end 917. In various non-limiting embodiments, the stapler head 920 is configured to functionably insert a circular staple cartridge 930 into the staple cartridge. interior. Such circular staple cartridges 930 are known in the art and may substantially retain within them one, two or more than two circumferentially staple and alternatively rows of staples 36. The non-objectionable embodiment shown in FIG. 2A, which has two rows 32, 34 of staples 36. The traditional ring knife 940 is coaxially positioned and movable in the stapler head 920. See FIG. 2.

[0019] The circular stapler 900 further comprises a firing roller 950 which is placed within the rigid outer shell 916 for selective axial movement within it. See FIG. 2. The portion 952 of the distal end of the firing shaft 950 has an outer portion 954 of the staple driver to connect each of the staples 36 in the outer row 32 of the staples 36 in the staple cartridge 930. Further, the distal end portion 952 of the firing shaft 950 has an inner portion 956 of the staple driver configured to attach each staple 36 in the inner row 34 of staples 36 inside the staple cartridge 930. As can also be seen, for example, in Fig. 2, the portion 952 of the distal end of the firing pin assembly 950 further has a flange portion 958,

[0020] In various non-limiting embodiments, the first roller 950 can communicate with a release trigger 960 that is operably connected to the handle assembly 912. See FIG. 1. As can be seen in FIG. 1, the firing trigger 960 can be rotatably connected to the assembly. 912 of the holder such that when the firing trigger 960 is rotated towards the handle assembly 912, the firing shaft 950 is advanced in the distal direction DD. Such triggering trigger configurations are known in the art.

For example, an exemplary trigger release configuration is disclosed in US Patent Publication No. 2008/0078806 A1, entitled "Surgical Stapling.

Instrument With Mechanical Indicator to Show Levels of Tissue

Compression ".

[0021] How can you

2, a variety of non-limiting embodiments of the invention may also include an empty dispensing shaft 970 that is disposed within the hollow shaft 980 coaxially for tissue acquisition. The proximal end of the distribution roller 970 is functionally attached to the handwheel 910, which is rotatably mounted on the handle assembly 912. Anvil shaft assemblies and control dial configurations are generally known. For example, the control rod assembly and the control knob can be configured as disclosed in published US Patent Application No. US 2008/0078806 A1. Thus, the rotary movement of the arm distributor 910 on the handle assembly 912 will result in an arrangement 970 around the particular and with respect to Figure 3, in various embodiments, the distal end 972 of the placement roller 970 protrudes through the opening 982 in the tissue picking roller 980 and has a drive gear 974 attached thereto. The distal end 984 of the tissue picking roller 980 is configured to functionally insert at least one tissue removal element or arm 1000. It is advantageous to use two rotational movements of the center shaft AA. In the axis or more 1000 tissue arms. In the non-limiting embodiment shown in Figure 3, all four tissue arms 1000 are rotatably attached to the distal end The distal end 984 of the tissue retrieval roll 980 is configured to functionally insert at least one tissue collection element or arm 1000. It is preferred to use two rotational movements of the center roller AA. In the axis or more 1000 tissue arms. In the non-limiting embodiment shown in Figure 3, all four tissue arms 1000 are rotatably attached to the distal end The distal end 984 of the tissue retrieval roll 980 is configured to functionally insert at least one tissue collection element or arm 1000. It is preferred to use two rotational movements of the center roller AA. In the axis or more 1000 tissue arms. In the non-limiting embodiment shown in Figure 3, all four tissue arms 1000 are rotatably attached to the distal end

984 a roller 980 for tissue retrieval by appropriate pins

986.

[0022] Each tissue arm 1000 may have a body portion 1002 that may be made of, for example, stainless steel (300 or 400 series), titanium, titanium-steel composite, ceramic and the like, and have a driven gear 1004 attached thereto or molded on her. A driven gear 1004 of each tissue arm 1000 is positioned movably within a respective arm cavity 988 formed in the distal end 984 of the tissue picking roller 980. Each driven gearwheel 1004 is in mesh with the drive gear 974 on the metering roller 970.

As a result, the rotational motion of the arranging shaft 970 will result in the rotation of the tissue arms 1000 from the retracted position shown in Figure 4 to the deployed position shown in Figure 5. In various embodiments, the body portion 1002 of each tissue arm 1000 may further include a tissue piercing end 1006 formed on it or attached to it in a different way.

[0023] In various embodiments, the knife shaft 1010 is positioned coaxially within the positioning roller 970 and connects to the knife knob 1020 (Figure 1) rotatably mounted on the handle assembly 912 so that the rotary movement of the knife knob 1020 results in a rotation of the roller 1010. knife. The knife shaft 1010 further has a distal end 1012 that protrudes beyond the distal end 972, 984 of the dispensing roller 970 and the tissue picking roll 980, respectively. See FIG. 3. The knife 1030 can be releasably attached to the distal end 1012 of the knife shaft 1010, e.g. by means of pins 1032 or other suitable fastening elements. In various embodiments, the knife 1030 may be substantially flat and may have tissue piercing points 1031, 1033 formed against it,

[0024] As can also be seen in Fig. 2, various non-limiting embodiments may further include anvil shaft assembly 440 that includes a distal end post 442 that projects from a portion of the firing roller 950 that coaxially extends within the arranging shaft 970 for selective axial movement. inside him. The post-stop post 442 retains in its interior a distal anvil connector 450 that is connected to the adjustment knob 460 that is rotatably mounted on the handle assembly 312 in accordance with various methods discussed above.

The circular surgical stapler 900 further comprises an anvil 470, as shown in FIG. 2. In various non-limiting embodiments, the anvil 470 includes an anvil base 471 that has in its interior a series of staple forming pockets 472. The anvil base 471 may further define a shearing edge 473 to facilitate shearing of the tissue through the annular knife 940. The anvil 470 may further include an incontinent shaft 474 that is releasably connected to a distal anvil 450 connector. In particular, the coupling shaft 476 projects from the proximal end 475 of the anvil shaft 474 and is sized such that it can be slidably inserted in the channel 452 in the anvil shaft assembly 450. The anvil 470 may further include an anvil adapter 478 that defines the tissue cavity 479,

[0026] One exemplary method of using a circular stapler 900 will be described with reference to Figures 2 and 6-14. Referring first to FIG. 2, the stapler head 920 is inserted into a tubular body such as a colon 200 through the patient's anus. The stapler head 920 is located in the proximal portion 201 of the colon 200 that is adjacent to the diseased portion 202. Next, the tissue arms 1000 are radially disposed by rotating the dial 910 for arm positioning in the first direction (indicated by the arrow 911 in Figure 1), it also causes rotation of the distribution roller 970. The rotational movement of the distribution roller 970 in the first direction also causes rotation of the driving gear 974, which is meshing with the driven parts 1004 of the gear wheel of each tissue arm 1000. Thus, the rotational movement of the drive gear 974 in the first direction causes the radial deployment of the tissue arms 1000. When the tissue arms 1000 are radially disposed, the tissue piercing ends 1006 pierce the proximal portion 201 of the colon 200. See FIGS. 7 and 8. The surgeon can then turn the handwheel 910 to arrange the arms in the opposite or the second direction (indicated by the arrow 913 in FIG. 1 ) to retract the tissue arms 1000 to their retracted position. When the tissue arms 1000 are retracted, the punctured proximal portion 201 of the colon 200 is discharged through the tissue arms 1000 in such a way, that portion 201 is collected between the tissue arms 1000 and the arm shaft 980 in a position opposite to the staple cartridge 930. The surgeon can then turn the knife knob 1020 to cause the knife 1030 to rotate and cut away the diseased portion 202 of the colon 200 from the proximal portion of the colon 201.

The sick part 202 may be cut off from the distal colon portion 208 using a traditional laparoscopic tissue cutting device (not shown) inserted through the trocar sleeve (not shown) placed in the abdominal cavity 601. After the sick part 202 has been cut off from the proximal portion 201 colon 200 and distal portion 208, diseased portion 202 can be removed from the trocar sleeve using a conventional gripping device 600. See FIG. 11.

The surgeon may then set the anvil 470 within the distal portion 208 of the colon 200 in such a way that the anvil shaft engaging shaft shaft engaging shaftpiece 476 projects beyond the distal portion 208 of the colon 200, as shown in Figure 12. The surgeon may then tie the end of further a colonic section 208 around the anvil shaft 474 using the prior art "mantle staple" 220. After the distal portion of the colon 208 is sutured around the anvil shaft 474, the anvil shaft 476 engaging shaft 474 is introduced into the duct 452 in the anvil roller assembly 450. . The coupling shaft 476 may be sized with respect to the channel 452 to form a press fit between them for receiving the coupling shaft 476 in the channel, but allowing the coupling stem 476 to be removed from the channel at a later time. See FIG. 12.

The surgeon then draws the anvil 470 toward the stapler head 920 (in the proximal direction "PD") by rotating the anvil control knob 460 in a proper direction until the colon part 205, 210 is clamped between the anvil 470 and the staple cartridge 930. as shown in Fig. 13. The surgeon then actuates the firing trigger 960 to axially extend the firing roller 950 in the distal direction "DD". When the firing roll 950 is extended in the distal direction, the staple driver part 954 serves to guide the staples 36 through the colon portions 205, 210 to the staple forming pocket 472 in the anvil base 471. The firing shaft 950 also extends the ring cutter 940 to sever the colon portion 201, 207 respectively from the colon portion 205, 210. The surgeon may then move the anvil 470 in the distal "DD" to release the stapled section 205, 210 of the colon between the anvil 470 and the stapler head 920. The apparatus 900 can then be removed from the colon 200. See FIG. 14. The resected portion 207 is captured in the anvil cavity 479 and the cut portion 201 is placed between the tissue arms 1000 and the arm roller 980. Thus, the cut portions 201, 207 of the colon 200 are removed from the treated colon when the device 900 is withdrawn therefrom. and the cut portion 201 is placed between the tissue arms 1000 and the arm roller 980. Thus, the cut portions 201, 207 of the colon 200 are removed from the treated colon when the device 900 is withdrawn therefrom. and the cut portion 201 is placed between the tissue arms 1000 and the arm roller 980. Thus, the cut portions 201, 207 of the colon 200 are removed from the treated colon when the device 900 is withdrawn therefrom.

[0029] When the surgeon performs the above-described procedures or other related procedures in this area of ​​the body, care must be taken to avoid unintentional damage to the adjacent soft tissue and bone structures. Figures 15 and 16 show some of the adjacent tissues and bone structures that are located near the colon 200. In Figure 15 the peritoneum 1100 has been cut to represent, for example, anal sphincter 1101, cruciate ligament 1102, sciatica 1104, sciulomar cavity 1106, the levator ani muscle 1108, and the third sacral vertebral circle 1110. Fig. 116 further shows the analvial recess 1112, sacral genital 1114, catheter 1116, vas wipe 1118, urinary bladder 1120, periparous collapse 1122, and intravesical folds 1124.

The surgeon must also be careful not to damage the muscles, nerves, blood vessels and arteries along the internal wall of the peritoneum 1100 while accessing the dissected portion of the colon 200.

[0030] Figures 17-20 show the use of protective cover 1200 according to a non-limiting embodiment of the present invention. In various embodiments, sheath 1200 may be manufactured, for example, from Kevlar, polyethylene, nylon, and the like, and compressed so as to give it a natural tendency to curl into a spiral. See FIG. 18. In various embodiments, measurement or reference indicators 1202 may be provided on the sheath 1200 to provide the surgeon with assistance when setting the functional part of the surgical instrument (e.g., the stapling head of the circular stapler) and to avoid accidental damage to adjacent nerves, vessels blood and tissues. In further embodiments, the sheath 1200 may be produced from a magnetic-field sensitive tape, which would allow magnetic attraction to the functional part of the device to protect adjacent anatomical structures and tissues, e.g. against instrument parts that can damage neighboring tissues, muscles, bones, nerves and the like in the event of accidental contact of a portion of the device with them. In further alternative embodiments, the skirt 1200 may have a magnetically interacting ring or portion that is pulled to the stapler head. As a result, at least a portion of the sheath 1200 may be a magnetic shield or otherwise have magnetic material attached thereto. nerves and the like in the event of accidental contact of parts of the device with them. In further alternative embodiments, the skirt 1200 may have a magnetically interacting ring or portion that is pulled to the stapler head. As a result, at least a portion of the sheath 1200 may be a magnetic shield or otherwise have magnetic material attached thereto. nerves and the like in the event of accidental contact of parts of the device with them. In further alternative embodiments, the skirt 1200 may have a magnetically interacting ring or portion that is pulled to the stapler head. As a result, at least a portion of the sheath 1200 may be a magnetic shield or otherwise have magnetic material attached thereto.

The sheath 1200 can be installed through the cannula 1252 of the traditional trocar 1250 inserted laparoscopically through the abdominal wall into the abdominal cavity as shown in FIG. 17. The traditional laparoscopic gripping device 600 can be used as shown in FIGS. 17 and 18. to remove the sheath 1200 from the trocar canula 1252. The surgeon may then wrap the unobstructed sheath 1200 around the colon 200 using conventional grippers 600 as shown in Fig. 19. Fig. 20 shows the sheath 1200 after wrapping it around the colon 200 and before starting to insert the colon stapling device. The natural tendency of the casing to curl into a spiral allows it to be placed in a spiral around the colon 200.

[0032] The sheath 1200 of the present invention can be effectively used to protect neighboring tissues and organs during any of the described embodiments. See, for example, Figures 2, 6-14, where the sheath 1200 is installed around the colon 200 in the manner described above. In addition, non-limiting embodiments of the sheath 1200 may also be effectively used with traditional circular stapling devices and similar devices without departing from the concept and scope of the present invention. In embodiments of the device using light sources on detection means or the like, the sheath 1200 may be made of, for example, a photosensitive film that would change the color of the sheath portion 1200 in areas adjacent to the illuminated detection means.

[0033] Various embodiments of the present invention represent a significant improvement over previous configurations of circular staplers and related procedures. Although several embodiments of the invention have been described herein, it will be apparent to those skilled in the art that various modifications, alterations, and adaptations to these embodiments are possible, with some or all of the advantages of the invention. The present application is intended to cover all such modifications, changes and adaptations without departing from the scope of the disclosed invention as defined in the appended claims.

[0034] The invention to be protected is not to be construed as limited to the particular embodiments disclosed herein. The embodiments should therefore be regarded as illustrative and not restrictive. Changes and modifications can be made without departing from the present invention. Accordingly, it is expressly provided that all such variations, modifications and variations that are included within the scope of the present invention in the form as defined in the claims are thus contemplated.

26587 / EP / 16

EP 2 598 056