ES2924643T3 - Grapas quirúrgicas con parte posterior expandible - Google Patents

Grapas quirúrgicas con parte posterior expandible Download PDF

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ES2924643T3
ES2924643T3 ES18170882T ES18170882T ES2924643T3 ES 2924643 T3 ES2924643 T3 ES 2924643T3 ES 18170882 T ES18170882 T ES 18170882T ES 18170882 T ES18170882 T ES 18170882T ES 2924643 T3 ES2924643 T3 ES 2924643T3
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staple
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Stanislaw Kostrzewski
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Covidien LP
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
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    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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    • A61B2017/07214—Stapler heads
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    • A61B2017/07214—Stapler heads
    • A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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    • A61B2017/07214—Stapler heads
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    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract

Una grapa quirúrgica (100) incluye un cuerpo (10) que tiene una primera pata (14), una segunda pata (16) y un tramo posterior (12). Cada una de las patas primera y segunda tiene una primera parte de extremo (14a, 16a) y una segunda parte de extremo (14b, 16b). El tramo posterior tiene una primera parte (12a), una segunda parte (20) y una tercera parte (22). La primera parte del tramo posterior incluye un elemento en bucle (18) que tiene una primera parte de extremo (18a) y una segunda parte de extremo (18b). La segunda porción (20) del tramo posterior se extiende entre la primera porción extrema (14a) de la primera pata y la primera porción extrema (18a) del elemento en bucle. La tercera porción (22) del tramo posterior se extiende entre la primera porción extrema (16a) de la segunda pata y la segunda porción extrema (18b) del elemento en bucle. La segunda porción (20) del tramo posterior y la tercera porción (22) del tramo posterior están en contacto lateral. (Traducción automática con Google Translate, sin valor legal)

Description

DESCRIPCIÓN
Grapas quirúrgicas con parte posterior expandible
Antecedentes
Campo técnico
La presente descripción se refiere a grapas quirúrgicas para uso con instrumentos de grapado quirúrgico. Más particularmente, la presente divulgación se refiere a grapas quirúrgicas para uso con instrumentos de grapado quirúrgico para unir tejido de espesores variables.
Antecedentes de la técnica relacionada
Las grapas quirúrgicas se aplican al tejido utilizando instrumentos de grapado quirúrgico para unir tejido o segmentos de tejido de una manera rápida y eficaz en una variedad de procedimientos quirúrgicos, por ejemplo, procedimientos de anastomosis.
Por lo general, una grapa quirúrgica incluye una parte posterior y un par de patas separadas. Las patas se introducen a través del tejido y en un conjunto de yunque de un instrumento de grapado quirúrgico para deformar la grapa en una configuración deseada, por ejemplo, grapa B, para efectuar la hemostasia. Las grapas quirúrgicas actuales tienen un tamaño particular y son adecuadas para tejido de un rango de grosor dado para efectuar la hemostasia. Como tal, un médico debe elegir una grapa que tenga un tamaño apropiado para un rango de grosor de tejido determinado para garantizar una hemostasia eficaz. Si el médico identifica erróneamente el grosor del tejido o si el grosor del tejido cae cerca de los bordes exteriores del rango para un tamaño de grapa determinado, aumenta la probabilidad de una hemostasia ineficaz.
Los documentos de patente EP3257448 A2 (relevante según el artículo 54(3) EPC), US5242457 A y US 2008/172088 A1 describen grapas de la técnica anterior que comprenden un miembro en bucle en una parte posterior. El documento EP1728473 A1 describe una grapa que tiene una parte posterior expansible y un par de patas separadas. El parte posterior expandible está configurado para expandirse o deformarse para acomodar tejidos de diversos grosores. La cantidad de deformación de la parte posterior es proporcional al grosor del tejido, es decir, cuanto mayor es el grosor del tejido, mayor es la deformación de la parte posterior.
En consecuencia, existe una necesidad continua en las técnicas de sutura de una grapa quirúrgica que sea capaz de adaptarse a una mayor variedad de espesores de tejido para proporcionar al médico una mayor flexibilidad cuando realiza una variedad de procedimientos quirúrgicos.
Resumen
La invención se define por las reivindicaciones adjuntas. La invención proporciona en un aspecto una grapa quirúrgica que incluye un cuerpo que tiene una primera pata, una segunda pata y una parte posterior. Las patas primera y segunda tienen cada una primera parte de extremo y una segunda parte de extremo. El parte posterior tiene una primera parte, una segunda parte y una tercera parte. La primera parte de la parte posterior incluye un miembro en bucle que tiene una primera parte de extremo y una segunda parte de extremo. La segunda parte de la parte posterior se extiende entre la primera parte de extremo de la primera pata y la primera parte de extremo del miembro en bucle. La tercera parte de la parte posterior se extiende entre la primera parte de extremo de la segunda pata y la segunda parte de extremo del miembro en bucle. La segunda parte de la parte posterior y la tercera parte de la parte posterior están en contacto lateral sustancial.
La segunda parte de la parte posterior se extiende en una dirección paralela a la tercera parte de la parte posterior. En algunas modalidades, el miembro en bucle de la parte posterior se extiende transversalmente entre la segunda parte de la parte posterior y la tercera parte de la parte posterior.
En determinadas modalidades, el miembro en bucle de la parte posterior define un eje que se extiende entre una primera parte de extremo de la segunda parte de la parte posterior y una primera parte de extremo de la tercera parte de la parte posterior.
La segunda parte de la parte posterior define un primer eje y la tercera parte de la parte posterior define un segundo eje, donde el primer eje de la segunda parte está desplazado lateralmente del segundo eje de la tercera parte para definir una distancia de desplazamiento entre el primer eje de la segunda parte y el segundo eje de la tercera parte. En determinadas modalidades, el miembro en bucle de la parte posterior incluye un vértice, la segunda parte de la parte posterior incluye una primera parte intermedia y la tercera parte de la parte posterior incluye una segunda parte intermedia. El vértice del miembro en bucle y la primera y segunda mitades de las segunda y tercera partes de la parte posterior definen un eje que es perpendicular al primer eje de la segunda parte y al segundo eje de la tercera parte.
En algunas modalidades, la distancia de desplazamiento entre el primer eje de la segunda parte y el segundo eje de la tercera parte es igual al diámetro del cuerpo de la grapa quirúrgica.
La grapa quirúrgica incluye una configuración no conformada y una configuración conformada. En la configuración no conformada de la grapa quirúrgica, el vértice del miembro en bucle de la parte posterior está separado de cada una de la segunda parte y la tercera parte de la parte posterior una primera distancia. En la configuración conformada de la grapa quirúrgica, el vértice del miembro en bucle de la parte posterior está separado de cada una de la segunda parte y la tercera parte de la parte posterior una segunda distancia que es menor que la primera distancia de la configuración no conformada.
En algunas modalidades, la grapa quirúrgica se puede deformar desde la configuración no conformada a la configuración conformada al engancharse con el tejido, donde en la configuración conformada de la grapa quirúrgica, la segunda distancia entre el vértice del miembro en bucle de la parte posterior y cada uno de la segunda parte y la tercera parte de la parte posterior disminuyen a medida que aumenta el grosor del tejido enganchado por la parte posterior.
En ciertas modalidades, en la configuración conformada de la grapa quirúrgica, la primera pata se posiciona en un primer lado lateral del miembro en bucle y la segunda pata se posiciona en un segundo lado lateral del miembro en bucle opuesto al primer lado lateral del miembro en bucle.
La presente invención proporciona en otro aspecto más un conjunto de cartucho de grapas para usar con un instrumento de grapado quirúrgico que incluye una pluralidad de grapas quirúrgicas según el primer aspecto, un cartucho de grapas y una pluralidad de empujadores. El cartucho de grapas tiene una pluralidad de bolsillos de grapas dispuestas en filas y posicionadas de forma oblicua con respecto a un eje longitudinal del cartucho de grapas. Cada uno de la pluralidad de bolsillos para grapas está configurado para recibir al menos una de la pluralidad de grapas quirúrgicas de tal manera que la primera y la segunda pata de cada una de la pluralidad de grapas quirúrgicas estén alineadas longitudinalmente con respecto a la primera y la segunda pata de cada uno de la otra pluralidad de grapas quirúrgicas. Cada uno de la pluralidad de empujadores está asociado con uno respectivo de la pluralidad de bolsillos para grapas. Cada uno de la pluralidad de empujadores está configurado para hacer avanzar una de la pluralidad de grapas quirúrgicas desde el respectivo de la pluralidad de bolsillos para grapas. En algunas modalidades, cada uno de la pluralidad de bolsillos para grapas incluye un contorno que tiene un primer segmento formado y dimensionado para recibir la primera pata de la grapa quirúrgica, un segundo segmento formado y dimensionado para recibir la segunda pata de la grapa quirúrgica y un segmento intermedio conformado y dimensionado para recibir la parte posterior de la grapa quirúrgica. El contorno de cada uno de la pluralidad de bolsillos de grapas está posicionado de forma oblicua con respecto al eje longitudinal del cartucho de grapas.
En ciertas modalidades, cada uno de la pluralidad de empujadores incluye un asiento de grapa configurado para recibir de forma liberable una parte posterior respectiva de cada una de la pluralidad de grapas quirúrgicas, estando el asiento de grapa posicionado de forma oblicua con respecto a un eje longitudinal de cada uno de la pluralidad de empujadores. El asiento de grapas de cada uno de la pluralidad de empujadores está adaptado para alinear cada una de la pluralidad de grapas quirúrgicas con cada uno de la pluralidad de bolsillos de grapas del cartucho de grapas.
En algunas modalidades, el asiento de grapa de cada uno de la pluralidad de empujadores incluye una primera pared que se proyecta desde una primera parte del asiento de grapa, y una segunda pared que se proyecta desde una segunda parte del asiento de grapa, definiendo la primera pared y la segunda pared un canal oblicuo que se extiende entre la primera parte del asiento de grapa y la segunda parte del asiento de grapa, estando el canal oblicuo posicionado sesgado con respecto al eje longitudinal del empujador.
En ciertas modalidades, el canal oblicuo del asiento de grapa de cada uno de la pluralidad de empujadores está adaptado para recibir de forma liberable la parte posterior respectiva de cada una de la pluralidad de grapas quirúrgicas, de manera que cada una de la pluralidad de grapas quirúrgicas se posiciona de forma sesgada en el asiento de grapa de cada uno de la pluralidad de empujadores con respecto al eje longitudinal de cada uno de la pluralidad de empujadores.
En algunas modalidades, cuando cada una de la pluralidad de grapas quirúrgicas se posiciona en un asiento de grapa respectivo de cada uno de la pluralidad de empujadores, la primera pared del asiento de grapa respectivo está configurada para enganchar la segunda parte de la parte posterior respectiva de cada uno de la pluralidad de grapas quirúrgicas y la segunda pared del respectivo asiento de grapa está configurada para enganchar la tercera parte de la parte posterior respectiva de cada una de la pluralidad de grapas quirúrgicas para recibir de forma liberable el respectivo parte posterior de cada una de la pluralidad de grapas quirúrgicas.
Breve descripción de los dibujos
Varias modalidades de las grapas posteriores expandibles y los cartuchos para soportar las grapas que se describen en este documento se describen en el presente documento con referencia a los dibujos, en donde:
La Figura 1 es una vista en perspectiva de una modalidad ejemplar de la grapa quirúrgica descrita actualmente, que ilustra la grapa quirúrgica en una configuración sin formar;
La Figura 2 es una vista frontal de la grapa quirúrgica de la Figura 1;
La Figura 3 es una vista desde arriba de la grapa quirúrgica de la Figura 1;
La Figura 4A es una vista frontal de la grapa quirúrgica de la Figura 1 en una configuración conformada que se acopla al tejido que tiene un primer grosor;
La Figura 4B es una vista frontal de la grapa quirúrgica de la Figura 1 en la configuración conformada que se acopla al tejido que tiene un segundo grosor mayor;
La Figura 4C es una vista frontal de la grapa quirúrgica de la Figura 1 en la configuración conformada que se acopla al tejido que tiene un tercer grosor aún mayor;
La Figura 5 es una vista en perspectiva de un instrumento de grapado quirúrgico que incluye un cartucho que soporta las grapas quirúrgicas de la Figura 1 con un conjunto de herramientas del instrumento de grapado quirúrgico en una posición libre;
La Figura 6 es una vista en perspectiva de una unidad de carga del instrumento de grapado quirúrgico de la Figura 5 con el conjunto de herramientas de la unidad de carga en la posición libre;
La Figura 7 es una vista en perspectiva del conjunto de herramientas de la Figura 6 en la posición de sujeción; La Figura 8 es una vista en despiece de un conjunto de cartucho de grapas de la unidad de carga de la Figura 6; La Figura 9 es una vista desde arriba de un cartucho de grapas del conjunto de cartucho de grapas de la Figura 8;
La Figura 10 es una vista ampliada del área de detalle indicada delineada como 10 en la Figura 9;
La Figura 11 es una vista ampliada del área de detalle indicada delineada como 11 en la Figura 8;
La Figura 12 es una vista lateral en perspectiva de un empujador del conjunto de cartucho de grapas de la Figura 8;
La Figura 13 es una vista lateral en perspectiva del empujador de la Figura 12 con una pluralidad de las grapas quirúrgicas de la Figura 1 dispuesto sobre el empujador;
La Figura 14 es una vista desde arriba del empujador de la Figura 12;
La Figura 15 es una vista en sección transversal tomada a lo largo de las líneas de sección "15-15" de la Figura 7 con tejido que tiene un primer grosor sujeto dentro del conjunto de herramientas de la unidad de carga; y La Figura 16 es una vista en sección transversal tomada a lo largo de las líneas de sección "16-16" de la Figura 7 con tejido que tiene un segundo grosor sujeto dentro del conjunto de herramientas de la unidad de carga. Descripción detallada de las modalidades
A continuación se describirán en detalle modalidades de la grapa quirúrgica descrita en la presente con referencia a los dibujos en los que números de referencia similares identifican elementos similares o idénticos. En los dibujos y en la siguiente descripción, el término "proximal" debe entenderse como la parte o el extremo del instrumento que está más cerca de un usuario durante el uso adecuado, mientras que el término "distal" debe entenderse como referencia a esa parte o extremo del instrumento que está más alejado de un usuario durante el uso adecuado, como es tradicional y convencional en la técnica.
Haciendo referencia inicialmente a las Figuras 1-3, una modalidad ejemplar de la presente divulgación se muestra generalmente como una grapa quirúrgica 100. La grapa quirúrgica 100 incluye un cuerpo 10 que tiene una parte posterior 12, una primera pata 14 y una segunda pata 16. La grapa quirúrgica 100 tiene una configuración sin formar, como se muestra en las Figuras 1 a 3, en donde el primer brazo 14 y el segundo brazo 16 son paralelos, o sustancialmente paralelos, entre sí y separados por una distancia entre sí. Alternativamente, en la configuración no conformada, las patas primera y segunda 14, 16 pueden divergir ligeramente o converger ligeramente, etc. entre sí. Cada una de las patas primera y segunda 14, 16 incluye una primera parte de extremo 14a, 16a, respectivamente, y una segunda parte de extremo 14b, 16b, respectivamente. Cada una de las segundas partes de extremo 14b, 16b de las patas primera y segunda 14, 16 incluye una punta de penetración de tejido 14c, 16c. En una modalidad, cada una de las puntas de penetración de tejido 14c, 16c de la primera y segunda patas respectivas 14, 16 de la grapa quirúrgica 100 se puede formar con un extremo biselado o cónico para facilitar la penetración de la primera y segunda patas 14, 16 en tejido "T" (véanse las Figuras 4A-4C). Alternativamente, las puntas de penetración de tejido 14c, 16c de las patas primera y segunda respectivas 14, 16 de la grapa quirúrgica 100 no necesitan ser ahusadas, se pueden ahusar en una dirección diferente o pueden definir una superficie cónica o plana.
Con referencia continua a las Figuras 1-3, la parte posterior 12 incluye una primera parte 12a que tiene un miembro en bucle 18, una segunda parte 20 que es sustancialmente lineal y se extiende entre la primera parte de extremo 14a de la primera pata 14 y una primera parte de extremo 18a del miembro en bucle 18, y una tercera parte 22 que es sustancialmente lineal y se extiende entre la primera parte de extremo 16a de la segunda pata 16 y una segunda parte de extremo 18b del miembro en bucle 18. El miembro en bucle 18 de la parte posterior 12 incluye una parte arqueada 24 que se extiende entre la segunda y la tercera parte 20, 22 de la parte posterior 12. En la configuración no conformada de la grapa quirúrgica 100, la segunda parte 20 de la parte posterior 12 puede ser sustancialmente paralela a la tercera parte 22 de la parte posterior 12 y en contacto lateral o alineación estrecha con la tercera parte 22 de la parte posterior 12, como se ilustra en la Figura 1.
En las modalidades, la parte arqueada 24 del miembro en bucle 18 se extiende transversalmente entre la segunda parte 20 y la tercera parte 22 de la parte posterior 12. En la configuración no conformada de la grapa quirúrgica 100, la segunda parte 20 de la parte posterior 12 define un eje "X1-X1" y la tercera parte 22 de la parte posterior 12 define un eje "X2-X2". El eje "X1-X1" de la segunda parte 20 y el eje "X2-X2" de la tercera parte 22 pueden estar desplazados lateralmente entre sí una distancia de desplazamiento "OD". Se prevé que la distancia de desplazamiento "OD" entre el eje "X1-X1" de la segunda parte 20 y el eje "X2-X2" de la tercera parte 22 pueda ser sustancialmente igual a un diámetro "BD" del cuerpo 10 de la grapa quirúrgica 100 de modo que la segunda parte 20 y la tercera parte 22 estén posicionadas muy próximas o en contacto entre sí.
La parte arqueada 24 del miembro en bucle 18 define un eje "X3-X3" que se extiende entre una primera parte de extremo 20a de la segunda parte 20 de la parte posterior 12 y una primera parte de extremo 22a de la tercera parte de extremo 22 de la parte posterior 12 . En las modalidades, el miembro en bucle 18 y la segunda y tercera partes 20, 22 pueden definir una abertura cerrada 26 que puede tener una configuración circular u ovalada. Se prevé que la parte arqueada 24 del miembro en bucle 18 de la parte posterior 12 se pueda formar con cualquier radio de curvatura deseado para adaptarse a una necesidad particular, procedimiento quirúrgico o rango de espesores de tejido (como se discutirá más adelante). También se prevé que la abertura 26 definida por el vano 12 no necesite ser circular u ovalada sino que pueda tener otras configuraciones, como por ejemplo en forma de U, trapezoidal, rectangular, etc. El vano puede tener otras formas, como como redondo, rectilíneo, etc., y el miembro 18 puede ser recto, en ángulo o curvo. Además, en las modalidades, la parte posterior 12 puede incluir más de un miembro en bucle 18.
El cuerpo 10 de la grapa quirúrgica 100 puede tener una sección transversal circular en toda su longitud. Alternativamente, se prevé que el cuerpo 10 de la grapa quirúrgica 100 pueda tener una variedad de formas de sección transversal diferentes que incluyen rectangular, ovalada, cuadrada, triangular, trapezoidal, etc. También se prevé que la parte posterior 12 de la grapa quirúrgica 100 y las patas primera y segunda 14, 16 de la grapa quirúrgica 100 pueden tener diferentes formas de sección transversal. Por ejemplo, en una modalidad, la parte posterior 12 de la grapa quirúrgica 100 puede tener una forma de sección transversal rectangular y las patas primera y segunda 14, 16 de la grapa quirúrgica 100 pueden tener una forma de sección transversal ovalada.
La grapa quirúrgica 100 puede fabricarse a partir de un material conformable, tal como, por ejemplo, titanio, acero inoxidable o una variedad de diferentes polímeros biocompatibles. De esta manera, la grapa quirúrgica 100 puede introducirse sobre el tejido mientras está en una configuración sin formar, y luego deformarse o fijarse sobre el tejido para asegurar la grapa quirúrgica 100 al tejido. Se contempla que la grapa quirúrgica 100 pueda fabricarse a partir de cualquier material biocompatible no degradable conocido por los expertos en la técnica.
Con referencia ahora a las Figuras 4A-4C, en algunas modalidades, las patas primera y segunda 14, 16 de la grapa quirúrgica 100 se deforman contra un conjunto de yunque 1400 (ver Figura 5) de un instrumento de grapado quirúrgico 1000 en una configuración de grapa sustancialmente en forma de B. Dado que las patas primera y segunda 14, 16 de la grapa quirúrgica 100 se extienden desde la segunda y tercera parte 20, 22 de la parte posterior 12, respectivamente, y el eje "X1-X1" de la segunda parte 20 y el eje "X2- X2" de la tercera parte 22 están desplazados lateralmente entre sí por la distancia de desplazamiento "OD", que es sustancialmente igual al diámetro "BD" del cuerpo 10 de la grapa quirúrgica 100, se prevé que en la configuración conformada de la grapa quirúrgica 100, la primera pata 14 de la grapa quirúrgica 100 se posiciona en un primer lado lateral 24a de la parte arqueada 24 del miembro en bucle 18 y la segunda pata 16 se posiciona en un segundo lado lateral opuesto 24b de la parte arqueada la parte 24 del miembro en bucle 18 (véanse las figuras 3, 4A y 4B).
En la configuración conformada, la parte arqueada 24 del miembro en bucle 18 de la parte posterior 12 está configurada para deformarse en relación con la segunda y tercera parte 20, 22 de la parte posterior 12, donde la primera y la segunda parte transversal 20, 22 del miembro en bucle 18 de la parte posterior 12 permanece sustancialmente lineal. Específicamente, la deformación de la parte posterior 12 de la grapa quirúrgica 100 depende del grosor, por ejemplo, "T1", "T2", "T3", etc., del tejido "T" a sujetar. Inicialmente, en la configuración no conformada de la grapa quirúrgica 100, el miembro en bucle 18 de la parte posterior 12 incluye una distancia no comprimida "D1" entre un vértice 24c de la parte arqueada 24 del miembro en bucle 18 y el segundo y tercer partes 20, 22 de la parte posterior 12, como se ilustra en la Figura 2. En algunas modalidades, se contempla que el vértice 24c de la parte arqueada 24 y una parte intermedia "M1" (ver Figura 1) de la segunda parte 20 de la parte posterior 12 y una parte intermedia "M2" (ver Figura 1) de la tercera parte 22 de la parte posterior 12 define un eje "X4-X4" que es sustancialmente paralelo a al menos una de las patas primera y segunda 14, 16 de la grapa quirúrgica 100 y/o sustancialmente perpendicular al eje "X1-X1" de la segunda parte 20 de la parte posterior 12 y el eje "X2-X2" de la tercera parte 22 de la parte posterior 12. Al acoplarse con el tejido "T", el miembro en bucle 18 de la parte posterior 12 se comprime entre el tejido "T" y el conjunto de yunque 1400 (ver Figura 5) de un instrumento de grapado quirúrgico 1000 de tal manera que el miembro en bucle 18 de la parte posterior 12 define una distancia comprimida "D2" entre el vértice 24c de la parte arqueada 24 del miembro en bucle 18 y las partes segunda y tercera 20, 22 de la parte posterior 12, como se ilustra en las Figuras 4A-4C. A medida que el miembro en bucle 18 entra en contacto con el tejido "T" posicionado entre la primera y la segunda patas 14 y el miembro en bucle 18 a medida que se deforman las grapas 100, la distancia ""D2" disminuye en una cantidad que está directamente relacionada con el grosor del tejido " T". Más específicamente, a medida que aumenta el grosor del tejido, la fuerza aplicada al miembro en bucle 18 por el tejido "T" posicionado entre la primera y la segunda patas 14, 16 y el miembro en bucle 18 de las grapas 100 como las grapas 100 son aumentos deformados, para aumentar la cantidad de deformación del miembro en bucle 18.
La Figura 4A ilustra una grapa 100 cuando la grapa 100 se forma en un tejido "T" relativamente delgado que tiene un primer espesor "T1". A medida que la grapa 100 se deforma alrededor de un tejido "T" relativamente delgado que tiene un grosor "T1", el tejido "T" se comprime entre la primera y la segunda pata 14, 16 y el miembro en bucle 18 de las grapas 100. A medida que las patas primera y segunda 14, 16 de la grapa 100 se deforman en una configuración B contra el conjunto de yunque 1400 del instrumento de grapado quirúrgico 1000 (Figura 5), las patas primera y segunda 14, 16 empujan el tejido "T" hacia y contra el miembro en bucle 18 de la parte posterior 12. Debido a que el conjunto de yunque 1400 está dispuesto a una distancia fija del ensamblaje del cartucho 1300 cuando se dispara el instrumento de grapado (como se describe en detalle a continuación), todo el tejido "T" debe caber entre la primera y la segunda patas 14, 16 y el bucle. miembro 18 de la parte posterior 12. Así, cuando el tejido "T" es relativamente delgado, el tejido no aplica ninguna fuerza sustancial sobre el miembro en bucle 18 ya que las patas primera y segunda 14, 16 se deforman y se produce poca o ninguna deformación en el miembro en bucle 18. Por lo tanto, la distancia "D2" entre el vértice 24c de la parte arqueada 24 del miembro en bucle 18 y la segunda y tercera parte 20, 22 de las grapas quirúrgicas 100 permanece sustancialmente sin cambios o solo disminuye ligeramente. Haciendo referencia a la Figura 4B, donde el tejido "T" tiene un grosor moderado de "T2", el tejido "T" requiere más espacio entre la primera y segunda patas 14, 16 y el miembro en bucle 18 de la parte posterior 12. Por lo tanto, a medida que la primera y la segunda patas 14, 16 se deforman contra el conjunto de yunque 1400 y el tejido "T" se empuja hacia el miembro en bucle 18 de la parte posterior 12, se aplica una fuerza mayor al miembro en bucle 18 para causar una mayor cantidad de deformación del miembro en bucle 18 de la parte posterior 12. Así, la distancia "D2" entre el vértice 24c de la parte arqueada 24 del miembro en bucle 18 y la segunda y tercera parte 20, 22 de la parte posterior 12 de la grapa quirúrgica 100 disminuye moderadamente. De manera similar, donde el tejido "T" tiene un gran espesor de "T3" como se muestra en la Figura 4C, el tisú "T" requiere incluso más espacio entre la primera y la segunda patas 14, 16 y el miembro en bucle 18 de la parte posterior 12 cuando se deforma la grapa 100. Por lo tanto, a medida que las primera y segunda patas 14, 16 se deforman contra el conjunto de yunque 1400 y el tejido "T" se empuja hacia el miembro en bucle 18 de la parte posterior 12, se aplica una fuerza aún mayor al miembro en bucle 18 para provocar un mayor cantidad de deformación del miembro en bucle 18 de la parte posterior 12 para reducir aún más la distancia D2" entre el vértice 24c de la parte arqueada 24 del miembro en bucle 18 y las partes segunda y tercera 20, 22 de la parte posterior 12 del quirúrgico grapa 100.
Como se ilustra en las Figuras 4A-4C, se prevé que la parte arqueada 24 del miembro en bucle 18 de la parte posterior 12 se vuelve progresivamente más lineal a medida que aumenta el grosor del tejido "T". La capacidad de la parte posterior 12 de la grapa quirúrgica 100 para deformarse de acuerdo con el espesor relativo del tejido "T" facilita el uso de las grapas descritas actualmente con tejido que tiene una gama más amplia de espesores al tiempo que proporciona una hemostasia eficaz.
Para colocar la grapa quirúrgica 100 descrita actualmente en el tejido "T", se proporciona un aparato quirúrgico en forma de instrumento quirúrgico de grapado 1000, como se ilustra en la Figura 5. El instrumento de grapado quirúrgico 1000 se aproxima y se dispara de manera similar y de acuerdo con otro instrumento de grapado quirúrgico conocido, por ejemplo, el instrumento de grapado quirúrgico descrito en la patente de Estados Unidos número 5,865,361.
Como se ilustra en la Figura 5, el instrumento de grapado quirúrgico 1000 generalmente incluye un conjunto de mango 1002 con un mango móvil 1003a y un mango estacionario 1003b, un eje alargado 1004 que se extiende distalmente desde el conjunto de mango 1002 y una unidad de carga 1008 que está acoplada a una parte distal del eje alargado 1004. En cualquiera de las modalidades descritas en el presente documento, el conjunto de mango puede incluir uno o más motores o estar unido a uno o más, o podría configurarse para trabajar con un sistema robótico quirúrgico.
Con referencia a las Figuras 6-8, la unidad de carga 1008 del instrumento de grapado quirúrgico 1000 incluye un conjunto de herramienta 1200 que tiene un conjunto de cartucho de grapas 1300 que aloja una pluralidad de grapas quirúrgicas 100 (ver Figura 8) y un conjunto de yunque 1400 asegurado de forma móvil en relación con el conjunto de cartucho de grapas 1300 de manera que el conjunto de herramienta 1200 se puede mover entre una configuración abierta (ver Figura 6) donde el conjunto de cartucho de grapas 1300 está separado del conjunto de yunque 1400, y una configuración sujeta (ver Figura 7) donde el cartucho de grapas el conjunto 1300 y el conjunto de yunque 1400 son aproximados. Alternativamente, el conjunto de cartucho 1300 se puede sostener de forma móvil en relación con el conjunto de yunque 1400.
Volviendo ahora a la Figura 8, el conjunto del cartucho de grapas 1300 incluye un transportador 1310 que tiene un canal de soporte alargado 1312. El canal de soporte alargado 1312 está dimensionado y configurado para recibir un cartucho de grapas 1314. El conjunto de cartucho de grapas 1300 incluye un par de miembros elásticos o resilientes 1316a, 1316b que están configurados y dimensionados para aplicar y mantener una fuerza de compresión constante en el tejido "T" posicionado entre el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 (véanse las Figuras 15 y 16) del conjunto de herramientas 1200. En modalidades, el par de miembros elásticos o resilientes 1316a, 1316b pueden configurarse como dos miembros alargados sustancialmente paralelos que se posicionan entre el cartucho de grapas 1314 y un par de rebordes 1318a, 1318b formados en el soporte 1310, respectivamente. El par de miembros elásticos 1316a, 1316b puede unirse o disponerse de otro modo sobre el par de rebordes 1318a, 1318b del soporte 1310, y puede unirse de manera fija o liberable al mismo en modalidades alternativas. El par de miembros elásticos 1316a, 1316b está configurado para comprimirse para acomodar tejidos de diferentes grosores entre el conjunto de cartucho 1300 y el conjunto de yunque 1400. Para una descripción más detallada de la construcción y operación de un ejemplo del par de miembros elásticos 1316a, 1316b, se puede hacer referencia a la patente de Estados Unidos No. 8,152,041.
El cartucho de grapas 1314 del conjunto de cartucho de grapas 1300 incluye una pluralidad de bolsillos de grapas 1320 que están dispuestos en filas. La pluralidad de bolsillos para grapas 1320 está dimensionada para recibir la pluralidad de grapas quirúrgicas 100 y una pluralidad de empujadores 1322, como se detallará a continuación. El ensamblaje del cartucho de grapas 1300 incluye un mecanismo de accionamiento 1324 sostenido de manera móvil dentro del canal de soporte alargado 1312 del transportador 1310. Durante la operación, el trineo de accionamiento 1324 está configurado para avanzar a lo largo del canal de soporte alargado 1312 del portador 1310 para contactar secuencialmente con la pluralidad de empujadores 1322, de modo que la pluralidad de empujadores 1322 se desplazan dentro de la pluralidad de bolsillos de grapas 1320 para expulsar la pluralidad de grapas quirúrgicas 100 desde la pluralidad de bolsillos de grapas 1320 hacia el conjunto de yunque 1400.
Como se detalla anteriormente con referencia a las Figuras 1-4C, el eje "X1-X1" de la segunda parte 20 de la parte posterior 12 y el eje "X2-X2" de la tercera parte 22 de la parte posterior 12" están desplazados lateralmente entre sí por la distancia de desplazamiento "OD ". Para compensar la orientación desplazada lateralmente de la parte posterior 12 de la grapa quirúrgica 100 y garantizar que la primera y segunda patas 14, 16 de cada una de la pluralidad de grapas quirúrgicas 100 estén alineadas longitudinalmente con respecto a la otra pluralidad de grapas quirúrgicas 100 en una fila correspondiente de grapas quirúrgicas 100, la pluralidad de bolsillos de grapas 1320 del cartucho de grapas 1314 y una pluralidad de asientos de grapas 1326 de la pluralidad de empujadores 1322 están dimensionados y conformados como se detalla a continuación.
Específicamente, con referencia a las Figuras 9-11, cada uno de la pluralidad de bolsillos de grapas 1320 del cartucho de grapas 1314 incluye un contorno "C" que corresponde a la orientación de la grapa quirúrgica 100 como se muestra en la vista superior de la grapa quirúrgica 100 en la Figura 3. El contorno "C" del bolsillo de grapas 1320 del cartucho de grapas 1314 incluye una primera parte "C1" que tiene la forma y las dimensiones para recibir la primera pata 14 de la grapa quirúrgica 100, una segunda parte "C2" que tiene la forma y las dimensiones para recibir la segunda pata 16 de la grapa quirúrgica 100, y una parte intermedia "C3" posicionada entre la primera parte "C1" y la segunda parte "C2" que tiene la forma y las dimensiones para recibir la parte posterior 12 de la grapa quirúrgica 100. La pluralidad de bolsillos de grapas 1320 del cartucho de grapas 1314 están posicionadas de forma oblicua con respecto a un eje longitudinal "AA" del cartucho de grapas 1314 de tal manera que la primera y la segunda patas 14, 16 de cada una de la pluralidad de grapas quirúrgicas 100 están alineadas longitudinalmente con respecto a la otra pluralidad de grapas quirúrgicas 100 en la fila correspondiente de grapas quirúrgicas 100.
Con referencia a las Figuras 12-14, cada uno de la pluralidad de asientos de grapas 1326 de la pluralidad de empujadores 1322 está adaptado para recibir de forma liberable la parte posterior 12 de la grapa quirúrgica 100. El asiento de grapas 1326 del empujador 1322 está posicionado de forma oblicua con respecto a un eje longitudinal "BB" del empujador 1322, como se ilustra en la Figura 14 Se prevé que la configuración sesgada del asiento de grapas 1326 del empujador 1322 esté adaptada para alinear la grapa quirúrgica 100 con el bolsillo de grapas 1320 posicionado de forma oblicua del cartucho de grapas 1314, a medida que la grapa quirúrgica 100 es expulsada a través del bolsillo de grapas 1320 hacia el conjunto de yunque 1400, como se ilustra en las Figuras 10, 15 y 16. Específicamente, el asiento de grapas 1326 del empujador 1322 incluye una primera pared 1326a que se proyecta desde una primera parte 1326b del asiento de grapas 1326 y hacia el bolsillo de grapas 1320 del cartucho de grapas 1314, y una segunda pared 1326c que se proyecta desde una segunda parte 1326d del asiento de grapas 1326 y hacia el bolsillo de grapas 1320 del cartucho de grapas 1314. Las primera y segunda paredes 1326a, 1326c del asiento de grapas 1326 del empujador 1322 definen un canal oblicuo 1328 que se extiende entre la primera y la segunda parte 1326b, 1326d del asiento de grapas 1326 del empujador 1322. El canal inclinado 1328 del asiento de grapa 1326 está posicionado inclinado con respecto al eje longitudinal "BB" del empujador 1322.
Cuando la grapa quirúrgica 100 está ubicada en el asiento de grapa 1326 del empujador 1322, la primera pared 1326a del asiento de grapa 1326 está configurada para enganchar la segunda parte 20 de la parte posterior 12 y la segunda pared 1326b del asiento de grapa 1326 está configurada para enganchar la tercera parte 22 de la parte posterior 12 para recibir de forma liberable la parte posterior 12 de la grapa quirúrgica 100. Dado que el canal oblicuo 1328 del asiento de grapa 1326 está posicionado de manera sesgada con respecto al eje longitudinal "BB" del empujador 1322, se prevé que cuando la grapa quirúrgica 100 esté ubicada en el asiento de grapa 1326 del empujador 1322, la grapa quirúrgica 100 está posicionado de forma oblicua con respecto al eje longitudinal "BB" del empujador 1322, como se ilustra en las Figuras 13 y 14.
Volviendo ahora a las Figuras 8, 9, 15 y 16, en las modalidades, la pluralidad de bolsillos de grapas 1320 están dispuestas en filas en los lados laterales de una ranura de cuchilla 1330 que se extiende a través del cartucho de grapas 1314 del conjunto de cartucho de grapas 1300. La ranura de la cuchilla 1330 está configurada para acomodar el movimiento de una cuchilla 1332 u otro miembro de corte similar para cortar el tejido "T" (véanse las Figuras 4A-4C) dispuesto entre el ensamblaje del cartucho de grapas 1300 y el conjunto de yunque 1400. En las modalidades, la ranura de la cuchilla 1330 puede extenderse a lo largo de una línea central "CL" del cartucho de grapas 314 del conjunto del cartucho de grapas 1300, como se ilustra en la Figura 8. Alternativamente, la ranura de la cuchilla 1330 puede estar desplazada lateralmente desde la línea central "CL" del cartucho de grapas 1314 del conjunto del cartucho de grapas 1300.
Con referencia a las Figuras 15 y 16, el conjunto de yunque 1400 incluye una ranura de cuchilla correspondiente 1402 en una superficie que mira hacia el tejido 1404 del conjunto de yunque 1400 que está configurada para acomodar el movimiento de la cuchilla 1332. En las modalidades, la cuchilla 1332 incluye una configuración de viga en I tal que una parte superior 1332a de la cuchilla 1332 está dispuesta de forma móvil dentro de la ranura de la cuchilla 1402 del conjunto de yunque 1400 y una parte inferior 1332b de la cuchilla 1332 está dispuesta de forma móvil dentro de la cuchilla. ranura 1330 del cartucho de grapas 1314 del conjunto del cartucho de grapas 1300. En cualquiera de las modalidades descritas en este documento, la cuchilla puede tener otras formas, o podría ser parte del trineo o estar unido al mismo.
Con referencia continua a las Figuras 15 y 16, la cuchilla 1332 incluye una altura "H". Cuando el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 se aproximan y la cuchilla 1332 se traslada a través de las respectivas ranuras de cuchilla 1330, 1402, la altura "H" de la cuchilla 1332 proporciona una distancia constante "D3" entre el conjunto de yunque 1400 y cada uno de la pluralidad de asientos de grapas 1326 de la pluralidad de empujadores 1322, independientemente del grosor del tejido "T" (véanse las Figuras 4A-4C) dispuesto entre el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 e independientemente del posicionamiento del cartucho de grapas 1314. La altura "H" de la cuchilla 1332 también proporciona un espacio de tejido máximo cuando la cuchilla 1332 se traslada a través de las respectivas ranuras de cuchilla 1330, 1402.
Con referencia ahora a las Figuras 5-16, en funcionamiento, el instrumento de grapado quirúrgico 1000 se manipula de tal manera que el tejido "T" se dispone entre el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 con el conjunto de herramienta 1200 separado, en la configuración abierta (ver Figura 6). El conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 se aproximan accionando el mango móvil 1003A del conjunto de mango 1002 para sujetar el tejido "T" dispuesto entre el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400 de modo que se aplique una fuerza de compresión. al tejido "T".
Con el tejido "T" sujeto firmemente entre el conjunto de cartucho de grapas 1300 y el conjunto de yunque 1400, el instrumento de grapado quirúrgico 1000 se dispara para expulsar la pluralidad de grapas quirúrgicas 100 accionando el mango móvil 1003A. Al disparar el instrumento de engrapado quirúrgico 1000, el deslizador de accionamiento 1324 (Figura 8) avanza a lo largo del canal de soporte alargado 1312 del transportador 1310 para contactar secuencialmente con la pluralidad de empujadores 1322, de modo que la pluralidad de empujadores 1322 se desplazan dentro de la pluralidad de bolsillos para grapas 1320 para expulsar la pluralidad de grapas quirúrgicas 100 desde la pluralidad de bolsillos para grapas 1320 hacia el conjunto de yunque 1400.
La pluralidad de grapas quirúrgicas 100 pasa a través de la pluralidad de bolsillos de grapas 1320 del cartucho de grapas 1314 (véase la figura 8) ya través del tejido "T". Después de pasar a través del tejido "T", la pluralidad de grapas quirúrgicas 100 se acoplan a la superficie 1404 que mira hacia el tejido del conjunto de yunque 1400 y se deforman sustancialmente en una configuración de grapa B (véanse las Figuras 4A-4C). Tras la formación dentro del tejido "T", la pluralidad de grapas quirúrgicas 100 mantienen una fuerza de compresión sobre el tejido "T" para efectuar la hemostasia.
El disparo secuencial de las grapas quirúrgicas 100 continúa hasta que el deslizador de accionamiento 1324 avanza hacia un extremo distal del cartucho de grapas 1314, momento en donde se habrá expulsado toda la pluralidad de grapas quirúrgicas 100 alojadas en el cartucho de grapas 1314. La cuchilla 1332 puede luego trasladarse a través del conjunto de herramientas 1200 para formar una incisión entre las filas de tejido "T" grapado.
En cualquiera de las modalidades descritas en el presente documento, el conjunto de herramientas se puede incorporar con la parte alargada del conjunto de mango. El cartucho de grapas puede ser un conjunto desmontable y reemplazable, en un instrumento con una unidad de carga reemplazable o un conjunto de herramientas o un conjunto de herramientas incorporado.
Las grapas quirúrgicas descritas en el presente documento se pueden utilizar en una configuración en donde no se pretende que se deforme la parte posterior. En determinadas modalidades, la parte posterior puede estar configurado para alojar un material u objeto, con una parte posterior deformable o una parte posterior indeformable. El material u objeto puede incluir materiales médicamente útiles, como hemostáticos o sellantes, productos farmacéuticos, como agentes quimioterapéuticos, e incluso agentes radiactivos, como partículas o semillas de braquiterapia. Dichos materiales u objetos pueden disponerse en la abertura formada por el miembro en forma de bucle o incorporarse en una malla, material tejido, trenzado, no tejido, o una sutura, que se dispone en el miembro en forma de bucle.
Se comprenderá que pueden hacerse diversas modificaciones a las modalidades divulgadas en el presente documento. Por ejemplo, la grapa descrita anteriormente puede estar formada por cualquiera de una variedad de materiales quirúrgicamente aceptables, incluidos titanio, plásticos, materiales reabsorbibles, etc. Por lo tanto, la descripción anterior no debe interpretarse como limitante, sino simplemente como ejemplos de modalidades preferidas. Los expertos en la técnica visualizarán otras modificaciones dentro del alcance de las reivindicaciones adjuntas a la misma.

Claims (12)

REIVINDICACIONES
1. Una grapa quirúrgica (100) que comprende:
un cuerpo (10) que incluye:
una primera pata (14) que tiene una primera parte de extremo (14a) y una segunda parte de extremo (14b);
una segunda pata (16) que tiene una primera parte de extremo (16a) y una segunda parte de extremo (16b); y un parte posterior (12) que incluye:
una primera parte (12a) que tiene un miembro en bucle (18), el miembro en bucle que incluye una primera parte de extremo (18a) y una segunda parte de extremo (18b); una segunda parte (20) que se extiende entre la primera parte de extremo de la primera pata y la primera parte de extremo del miembro en bucle, definiendo la segunda parte un primer eje (“X1-X1”); y una tercera parte (22) que se extiende entre la primera parte de extremo de la segunda pata y la segunda parte de extremo del miembro en bucle, definiendo la tercera parte un segundo eje ("X2-X2"), en donde el primer eje está desplazado lateralmente desde el segundo eje para definir una distancia de desplazamiento ("OD") entre el primer eje y el segundo eje;
en donde la grapa quirúrgica incluye una configuración no conformada y una configuración conformada, en donde en la configuración no conformada la segunda parte (20) de la parte posterior se extiende en una dirección paralela a la tercera parte (22) de la parte posterior, las segunda y tercera partes son cada una sustancialmente lineal y en contacto lateral a lo largo de su longitud en la configuración no conformada; y
en donde el miembro en bucle de la parte posterior incluye un vértice (24c), en donde en la configuración no conformada, el vértice está separado de cada una de la segunda parte y la tercera parte de la parte posterior una primera distancia ("D1"), y en donde en la configuración conformada de la grapa quirúrgica, el vértice está separado de cada una de la segunda parte y la tercera parte de la parte posterior una segunda distancia ("D2") menos que la primera distancia de la configuración no conformada.
2. La grapa quirúrgica (100) según la reivindicación 1, en donde el miembro en bucle (18) de la parte posterior (12) se extiende transversalmente entre la segunda parte (20) de la parte posterior y la tercera parte (22) de la parte posterior.
3. La grapa quirúrgica (100) según cualquiera de las reivindicaciones anteriores, en donde el miembro en bucle (18) de la parte posterior (12) define un eje ("X3-X3") que se extiende entre una primera parte de extremo (20a) de la segunda parte (20) de la parte posterior y una primera parte de extremo (22a) de la tercera parte (22) de la parte posterior.
4. La grapa quirúrgica (100) según cualquiera de las reivindicaciones anteriores, en donde la distancia de desplazamiento ("OD") entre el primer eje ("X1-X1") de la segunda parte (20) y el segundo eje ("X2-X2") de la tercera parte (22) es igual a un diámetro del cuerpo (10) de la grapa quirúrgica.
5. La grapa quirúrgica (100) según cualquiera de las reivindicaciones anteriores, en donde la grapa quirúrgica es deformable desde la configuración no conformada a la configuración conformada al engancharse con el tejido, en donde en la configuración conformada de la grapa quirúrgica, la segunda distancia ("D2") entre el vértice (24c) del miembro en bucle (18) de la parte posterior (12) y cada una de la segunda parte (20) y la tercera parte (22) de la parte posterior disminuye a medida que aumenta el grosor del tejido enganchado por la parte posterior.
6. La grapa quirúrgica (100) según cualquiera de las reivindicaciones anteriores, en donde en la configuración conformada de la grapa quirúrgica, la primera pata (14) está posicionada en un primer lado lateral (24a) del miembro en bucle (18) y la segunda pata (16) se posiciona en un segundo lado lateral (24b) del miembro en bucle opuesto al primer lado lateral del miembro en bucle.
7. Un conjunto de cartucho de grapas (1300) para usar con un instrumento de grapado quirúrgico (1000), el conjunto de cartucho de grapas que comprende:
una pluralidad de grapas quirúrgicas (100) según cualquiera de las reivindicaciones anteriores;
un cartucho de grapas (1314) que tiene una pluralidad de bolsillos para grapas (1320) dispuestos en filas y posicionados de forma oblicua con respecto a un eje longitudinal ("AA") del cartucho de grapas, en donde cada uno de la pluralidad de bolsillos para grapas está configurado para recibir al menos una de la pluralidad de grapas quirúrgicas de manera que la primera pata (14) y la segunda pata (16) de cada una de la pluralidad de grapas quirúrgicas estén alineadas longitudinalmente con respecto a la primera pata y a la segunda pata de cada una de la otra pluralidad de grapas quirúrgicas; y
una pluralidad de empujadores (1322), cada uno de la pluralidad de empujadores se asocia con uno respectivo de la pluralidad de bolsillos para grapas y cada uno de la pluralidad de empujadores se configura para hacer avanzar una de la pluralidad de grapas quirúrgicas desde la respectiva de la pluralidad de bolsillos de grapas.
8. El conjunto de cartucho de grapas (1300) según la reivindicación 7, en donde cada uno de la pluralidad de bolsillos de grapas (1320) incluye un contorno ("C") que tiene un primer segmento ("C1") conformado y dimensionado para recibir la primera pata (14) de la grapa quirúrgica (100), un segundo segmento ("C2") conformado y dimensionado para recibir la segunda pata (16) de la grapa quirúrgica, y un segmento intermedio ("C3") conformado y dimensionado para recibir la parte posterior ( 12) de la grapa quirúrgica, en donde el contorno de cada uno de la pluralidad de bolsillos de grapas está posicionado de forma oblicua con respecto al eje longitudinal ("AA") del cartucho de grapas (1314).
9. El conjunto de cartucho de grapas (1300) según la reivindicación 8 o la reivindicación 9, en donde cada uno de la pluralidad de empujadores (1322) incluye un asiento de grapas (1326) configurado para recibir de forma liberable una parte posterior respectiva (12) de cada una de la pluralidad de grapas quirúrgicas (100), estando el asiento de grapa posicionado de forma oblicua con respecto a un eje longitudinal ("BB") de cada uno de la pluralidad de empujadores, en donde el asiento de grapa de cada uno de la pluralidad de empujadores está adaptado para alinear cada una de la pluralidad de grapas quirúrgicas con cada uno de la pluralidad de bolsillos de grapas (1320) del cartucho de grapas (1314).
10. El conjunto de cartucho de grapas (1300) según la reivindicación 9, en donde el asiento de grapas (1326) de cada uno de la pluralidad de empujadores (1322) incluye una primera pared (1326a) que se proyecta desde una primera parte (1326b) del asiento de grapas, y una segunda pared (1326c) que se proyecta desde una segunda parte (1326d) del asiento de grapa, la primera pared y la segunda pared definen un canal oblicuo (1328) que se extiende entre la primera parte del asiento de grapa y la segunda parte del asiento de grapa, estando el canal oblicuo posicionado de forma oblicua con respecto al eje longitudinal ("BB") del empujador.
11. El conjunto de cartucho de grapas (1300) según la reivindicación 10, en donde el canal oblicuo (1328) del asiento de grapas (1326) de cada uno de la pluralidad de empujadores (1322) está adaptado para recibir de forma liberable la parte posterior respectiva (12) de cada uno de la pluralidad de grapas quirúrgicas (100) de tal manera que cada una de la pluralidad de grapas quirúrgicas esté posicionada de forma oblicua en el asiento de grapas de cada uno de la pluralidad de empujadores con respecto al eje longitudinal ("BB") de cada uno de la pluralidad de empujadores.
12. El conjunto de cartucho de grapas (1300) según la reivindicación 10 o la reivindicación 11, en donde cuando cada una de la pluralidad de grapas quirúrgicas (100) se posiciona en un respectivo asiento de grapas (1326) de cada una de la pluralidad de empujadores (1322), la primera pared (1326a) del respectivo asiento de grapa está configurada para enganchar la segunda parte (20) de la parte posterior respectiva (12) de cada una de la pluralidad de grapas quirúrgicas y la segunda pared (1326c) del respectivo asiento de grapa está configurada para enganchar la tercera parte (22) de la parte posterior respectiva de cada una de la pluralidad de grapas quirúrgicas para recibir de forma liberable la parte posterior respectiva de cada una de la pluralidad de grapas quirúrgicas.
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