Method of applying staples to liver and other organs
A method for treating a patient includes a surgical instrument having a handle assembly, a shaft assembly, and an end effector. The end effector includes an upper jaw and a lower jaw configured to pivot to receive a tissue of the patient therebetween. The upper and lower jaws respectively have upper and lower crush surfaces, which extends generally parallel with a centerline and are configured to receive the tissue thereagainst. The upper jaw also includes an anvil, whereas the lower jaw includes a staple cartridge and a deck facing the anvil. In addition, the lower jaw has a plurality of staple opening formed through the deck with a plurality of staples received therein. The upper and lower crush surfaces are configured to compress the tissue therebetween with a crush pressure configured to sever the tissue along the upper and lower crush surfaces.
1. A method of operating on tissue, comprising:
(a) positioning tissue between a first jaw and a second jaw of an end effector, wherein the first jaw comprises a plurality of staples and a first crush surface, wherein the plurality of staples includes a distal-most staple defining a crown length and the first crush surface includes a distal-most first crush surface portion such that the distal-most first crush surface portion distally terminates less than or equal to half of the crown length to the distal-most staple, wherein the second jaw comprises a plurality of staple forming features and a second crush surface facing toward the first crush surface, wherein the end effector is in an open configuration during the act of positioning tissue between the first jaw and the second jaw;
(b) compressing the tissue between the first crush surface of the first jaw and the second crush surface of the second jaw, wherein the act of compressing the tissue provides dissection of at least some of the compressed tissue, wherein the dissection of the at least some of the compressed tissue distally terminates at the distal-most first crush surface less than or equal to half of the crown length to the distal-most staple and the dissected tissue reveals a vessel or duct; and
(c) actuating the end effector to drive one or more of the staples through the revealed vessel or duct, thereby ligating the revealed vessel or duct.
2. The method of claim 1 , further comprising severing the ligated vessel or duct.
3. The method of claim 2 , wherein the act of severing the ligated vessel comprises actuating a cutting member through the end effector.
4. The method of claim 3 , wherein the act of actuating the end effector to drive one or more of the staples comprises driving a cam distally with the cutting member, wherein the cam drives the staples toward the second jaw.
5. The method of claim 3 , wherein the cutting member comprises an indicator visually indicating a longitudinal position of the cutting member, wherein the act of severing the ligated vessel further comprises observing the indicator to determine the longitudinal position of the cutting member.
6. The method of claim 5 , wherein the indicator is configured to extend through the second jaw, and observing the indicator further includes observing the indicator on the second jaw to determine the longitudinal position of the cutting member.
7. The method of claim 1 , further comprising transitioning the end effector to an open configuration after performing the act of compressing the tissue and before performing the act of actuating the end effector to drive one or more of the staples.
8. The method of claim 1 , wherein the tissue comprises liver tissue.
9. The method of claim 1 , wherein the plurality of staples of the first jaw comprises at least two longitudinally extending rows of staples.
10. The method of claim 1 , wherein the end effector further comprises a plurality of staple drivers, wherein each staple driver of the plurality of staple drivers is operable to simultaneously drive at least two respective staples of the plurality of staples simultaneously toward the second jaw, wherein the act of actuating the end effector to drive one or more of the staples comprises driving the plurality of staple drivers toward the second jaw, thereby driving the plurality of staples toward the second jaw.
11. The method of claim 1 , wherein the first jaw further comprises a staple cartridge containing the plurality of staples, the method further comprising removing the staple cartridge from the first jaw after performing the act of actuating the end effector to drive one or more of the staples.
12. The method of claim 1 , wherein the end effector comprises a plurality of staple drivers and a wedge sled, wherein each of the staple drivers comprises an underside having a cam surface, wherein the staple drivers are operable to drive the staples toward the second jaw, wherein the wedge sled comprises a cam surface operable to bear against the cam surface on the underside of each staple driver and thereby drive the staple drivers toward the second jaw in response to distal movement of the wedge sled, wherein the act of actuating the end effector to drive one or more of the staples comprises driving the wedge sled distally, thereby driving the staple drivers toward the second jaw, thereby driving the staples toward the second jaw.
13. The method of claim 12 , wherein the plurality of staple drivers comprises a distal-most staple driver, wherein the wedge sled defines a distal length component dimension, wherein the act of driving the wedge sled distally comprises driving the wedge sled to a distal-most position, and wherein at least a majority of the distal length component dimension is configured to be positioned directly under the distal-most staple driver when the wedge sled is in the distal-most position.
14. The method of claim 1 , wherein the first jaw extends to a planar distal tip, wherein the planar distal tip has a distal-most surface that is proximate and perpendicular to the first crush surface.
15. A method of operating on tissue, comprising:
(a) positioning liver tissue between a first jaw and a second jaw of an end effector, wherein the first jaw comprises a plurality of staples and a first crush surface extending toward a planar distal tip, wherein the planar distal tip has a distal-most surface that is proximate and perpendicular to the first crush surface, wherein the second jaw comprises a plurality of staple forming features and a second crush surface facing toward the first crush surface, wherein the end effector is in an open configuration during the act of positioning liver tissue between the first jaw and the second jaw;
(b) compressing the liver tissue between the first crush surface of the first jaw and the second crush surface of the second jaw, wherein the act of compressing the liver tissue provides dissection of at least some of the compressed liver tissue; and
(c) actuating the end effector to drive one or more of the staples through a vessel or duct associated with the liver, thereby ligating the vessel or duct.
16. The method of claim 15 , wherein the plurality of staples includes a distal-most staple defining a crown length and the first crush surface includes a distal-most first crush surface portion such that the distal-most first crush surface portion distally terminates less than or equal to half of the crown length to the distal-most staple, and wherein the dissection of the at least some of the compressed tissue distally terminates at the distal-most first crush surface less than or equal to half of the crown length to the distal-most staple.
17. The method of claim 15 , further comprising:
(a) actuating a cutting member through the end effector, wherein the cutting member includes an indicator extending through the second jaw; and
(b) observing the indicator on the second jaw to determine a longitudinal position of the cutting member in the end effector.
18. A method of operating on tissue, comprising:
(a) positioning liver tissue between a first jaw and a second jaw of an end effector, wherein the first jaw comprises a plurality of staples and a first crush surface, wherein the first jaw extends to a planar distal tip, wherein the planar distal tip has a distal-most surface that is proximate and perpendicular to the crush surface, wherein the second jaw comprises a plurality of staple forming features and a second crush surface facing toward the first crush surface, wherein the end effector is in an open configuration during the act of positioning liver tissue between the first jaw and the second jaw;
(b) compressing the liver tissue between the first crush surface of the first jaw and the second crush surface of the second jaw, wherein the act of compressing the liver tissue provides dissection of at least some of the compressed liver tissue; and
(c) actuating the end effector, wherein the act of actuating the end effector comprises:
(i) driving one or more of the staples through a vessel or duct associated with the liver, thereby ligating the vessel or duct,
(ii) actuating a cutting member through the end effector, wherein the cutting member includes an indicator extending therefrom and through the second jaw,
(iii) driving the cutting member through the vessel or duct to thereby sever the vessel or duct while simultaneously moving the indicator along the second jaw, wherein the vessel or duct is severed adjacent to the staples in the vessel or duct, and
(iv) observing the indicator on the second jaw to determine a longitudinal position of the cutting member in the end effector.
19. The method of claim 18 , wherein the plurality of staples includes a distal-most staple defining a crown length and the first crush surface includes a distal-most first crush surface portion such that the distal-most first crush surface portion distally terminates less than or equal to half of the crown length to the distal-most staple, and wherein the dissection of the at least some of the compressed tissue distally terminates at the distal-most first crush surface less than or equal to half of the crown length to the distal-most staple.