Devices and methods for shortening a rectal stump during a lower anterior resection procedure

Abstract

A loading unit for a circular stapling device includes a shell member, a staple pusher assembly operably disposed within the shell member, a knife pusher assembly operably disposed within the shell member, a trocar assembly operably disposed within the shell member, and a tissue retraction assembly disposed within the shell member between the knife pusher assembly and the trocar assembly. The shell member includes an elongate tubular portion. The trocar assembly includes a trocar member movable from an advance position and a retracted position. The tissue retraction assembly includes a tissue retractor.

1 . (canceled) 
     
     
         2 . A loading unit for a circular stapling device, the loading unit comprising:
 a shell member having an elongate tubular portion;   a staple pusher assembly operably disposed within the shell member;   a knife pusher assembly operably disposed within the shell member and radially within the staple pusher assembly;   a trocar assembly operably disposed within the shell member and radially within the knife pusher assembly; and   a tissue retraction assembly disposed at least partially within the shell member and radially between the knife pusher assembly and the trocar assembly, the tissue retraction assembly including a tissue retractor having a piercing distal tip and a proximal end extending proximally from the shell member.   
     
     
         3 . The loading unit of  claim 2 , wherein the elongate tubular portion of the shell member is six to twelve inches in length. 
     
     
         4 . The loading unit of  claim 2 , wherein the elongate tubular portion includes inner and outer portions and defines a cavity between the inner and outer portions. 
     
     
         5 . The loading unit of  claim 4 , wherein the staple pusher assembly and the knife pusher assembly are operably received within the cavity and are movable between advanced and retracted positions. 
     
     
         6 . The loading unit of  claim 4 , wherein the tissue retraction assembly includes a holder, the holder defining a longitudinal opening and being selectively movable along the inner portion of the shell member. 
     
     
         7 . The loading unit of  claim 2 , wherein the trocar assembly includes a trocar member movable between an advanced position and a retracted position. 
     
     
         8 . A circular stapler comprising:
 a handle assembly;   an elongate body extending from the handle assembly; and   a loading unit selectively connectable to a distal end of the elongate body, the loading unit including:
 a shell member having an elongate tubular portion; 
 a staple pusher assembly operably disposed within the shell member; 
 a knife pusher assembly operably disposed within the shell member and radially within the staple pusher assembly; 
 a trocar assembly operably disposed within the shell member and radially within the knife pusher assembly; and 
 a tissue retraction assembly disposed at least partially within the shell member and radially between the knife pusher assembly and the trocar assembly, the tissue retraction assembly including a tissue retractor having a piercing distal tip and a proximal end extending proximally from the shell member. 
   
     
     
         9 . The circular stapler of  claim 8 , wherein the elongate tubular portion of the shell member is six to twelve inches in length. 
     
     
         10 . The circular stapler of  claim 8 , wherein the elongate tubular portion includes inner and outer portions and defines a cavity between the inner and outer walls. 
     
     
         11 . The circular stapler of  claim 10 , wherein the staple pusher assembly and the knife pusher assembly are operably received within the cavity and are movable between advanced and retracted positions. 
     
     
         12 . The circular stapler of  claim 10 , wherein the tissue retraction assembly includes a holder, the holder defining a longitudinal opening and being selectively movable along the inner portion of the shell member. 
     
     
         13 . The circular stapler of  claim 12 , wherein the tissue retractor extends through the longitudinal opening in the holder. 
     
     
         14 . The circular stapler of  claim 13 , wherein the tissue retractor is longitudinally fixed relative to the holder. 
     
     
         15 . A method of forming an anastomosis, the method comprising:
 receiving a loading unit within a rectal stump of a patient;   advancing a tissue retractor from the loading unit;   piercing the rectal stump with a distal tip of the tissue retractor;   securing the distal tip of the tissue retractor to the rectal stump by stitching the rectal stump to the tissue retractor;   retracting the tissue retractor within the loading unit such that the rectal stump is drawn within the loading unit to shorten the rectal stump; and   clamping, stapling and cutting the rectal stump.   
     
     
         16 . The method of  claim 15 , wherein the distal tip of the tissue retractor defines an eye, and wherein securing the distal tip of the tissue retractor to the rectal stump includes stitching the rectal stump to the eye of the distal tip. 
     
     
         17 . The method of  claim 15 , wherein advancing the tissue retractor from the loading unit includes advancing a holder. 
     
     
         18 . The method of  claim 17 , wherein retracting the tissue retractor includes retracting the holder. 
     
     
         19 . The method of  claim 15 , further including positioning a staple cartridge of the loading unit adjacent an anus of the patient as the rectal stump is drawn within the loading unit. 
     
     
         20 . The method of  claim 15 , wherein retracting the tissue retractor within the loading unit includes retracting the distal tip of the tissue retractor into a knife pusher assembly of the loading unit to draw the rectal stump into the knife pusher assembly.