Surgical stapling device

Abstract

A surgical stapling device is disclosed for the treatment of internal hemorrhoids. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The anvil assembly of the stapling device may include an approximation mechanism having an anvil retainer including an elongated distal extension dimensioned to be telescopingly received within a longitudinal bore of an anvil center rod of the anvil assembly. The elongated distal extension is of a length to provide telescopic engagement with the anvil center rod without obstructing visualization of the surgical site. A kit including a surgical instrument having a removable anvil assembly and an anvil assembly insertion handle is also disclosed. The kit may also include a speculum, an anal dialator and/or an obturator.

1 - 8 . (canceled)  
     
     
         9 . A method of treating internal hemorrhoids, the method comprising the steps of: 
 a) inserting an anvil assembly of a surgical stapling device through the anus into the rectum such that an anvil head of the anvil assembly is positioned beyond the internal hemorrhoids;    b) applying a purse string suture to rectal tissue and/or the internal hemorrhoids;    c) attaching a surgical stapling device including a handle assembly and a shell assembly to the anvil assembly after the anvil assembly has been inserted through the anus;    d) drawing the rectal tissue and/or the internal hemorrhoids towards a center rod of the anvil assembly with the purse string suture;    e) approximating the anvil assembly and the shell assembly; and    f) actuating the surgical stapling device to treat the rectal tissue and/or the internal hemorrhoids.    
     
     
         10 . A method of treating internal hemorrhoids according to  claim 9 , wherein the surgical stapling device includes an approximation mechanism having an anvil retainer with an elongaged distal extension, and wherein the attaching step includes using the distal extension to align the stapling instrument with the anvil assembly.  
     
     
         11 . A method according to  claim 9 , wherein the step of inserting the anvil assembly includes the step of attaching an insertion handle to the anvil assembly prior to inserting the anvil assembly through the anus.  
     
     
         12 . A method according to  claim 10 , wherein the step of applying a purse string suture includes using a speculum to apply the pursestring suture to the rectal tissue and/or internal hemorrhoids.  
     
     
         13 . A kit for treating internal hemorrhoids, the kit comprising: 
 a surgical stapling device including a handle assembly, a body portion extending distally from the handle assembly, an approximation mechanism including an anvil retainer, a shell assembly including a plurality of staples, and an anvil assembly removably attachable to the anvil retainer; and    an anvil assembly insertion handle removably attachable to the anvil assembly.    
     
     
         14 . A kit according to  claim 13 , wherein the anvil assembly includes a center rod having a longitudinal bore and the anvil retainer includes an elongated distal extension dimensioned to be telescopingly received in the longitudinal bore of the center rod.  
     
     
         15 . A kit according to  claim 14 , wherein the elongated distal extension is of a length to allow telescoping of the elongated distal extension of the anvil retainer and the center rod of the anvil assembly without obstructing visibility of a surgical site during a procedure for treating internal hemorrhoids.  
     
     
         16 . A kit according to  claim 15 , wherein the combined length of the anvil center rod and the elongated distal extension is greater than about 4.5 inches.  
     
     
         17 . A kit according to  claim 14 , further including a speculum having a semi-cylindrical body defining a channel, a blunt tip, and a semi-annular flange.  
     
     
         18 . A kit according to  claim 17 , wherein the semi-annular flange includes at least one finger tab.  
     
     
         19 . A kit according to  claim 14 , wherein the elongated distal extension has a diameter which is smaller than the diameter of a proximal portion of the anvil retainer.  
     
     
         20 . A kit according to  claim 13 , wherein the insertion handle includes a gripping knob, a substantially rigid shaft extending distally from the knob and a detent configured to be received in an opening formed in the anvil center rod.